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Put the bite on midges (Filed: 08/08/2001)

Dr Sarah Brewer on nature's answer to Viagra, deterring troublesome insects, worries over a recurring cough, and homoeopathic alternatives to HRT

DEAR DOCTOR - Can you enlighten me about a product called Veromax which is available at Boots? I understand it is made from tropical fruit extract and increases sex drive. What would be the effect on someone with chronic renal failure?

Veromax is a herbal remedy developed by an American urologist to enhance normal sexual function. It contains amino acids (l-arginine, l-lysine, l-alanine, glutamic acid) and extracts from jujube dates that act as sources of nitrogen for the production of nitric oxide in the body, which is needed to initiate increased blood flow to the genitals. It also contains the herbs Korean ginseng and ginkgo biloba plus, in the female version, oestrogen-like isoflavones.

It is taken daily and usually produces a response within 10 days. A trial involving 60 healthy males found that the frequency and rigidity of erections, level of desire and satisfaction with sexual intercourse was significantly increased in those taking active tablets at both one and two months compared with controls. It is designed to enhance normal sexual function, so if you are experiencing erectile difficulties it may not help. The manufacturer is not aware of any contra-indications, but if you are on a protein-restricted diet because of chronic renal failure, it is best avoided due to its amino acid content. Available in Boots, £32.99 for one month's supply.

DEAR DOCTOR - I'm going on holiday to Scotland and worry about being bitten by midges. Are there any natural ways to deter them?

One of the newest natural insect repellents in the UK is based on neem oil extracted from the Indian neem tree (Azadirachta indica). Neem oil is used in Ayurvedic medicine and widely burned in India to repel insects. It was recently tested in Scotland where there are 37 species of biting midge, although the Highland midge is responsible for 90 per cent of attacks. Midges were shown to detect the presence of neem oil at concentrations of just 0.01 per cent, and to be repelled and stop biting completely at a concentration of one per cent.

NeemCare Herbal Insect Repellent contains two per cent neem oil plus bergamot, rosemary and eucalyptus essential oils and is available from health stores and some pharmacies (£3.99 for 50ml). Interestingly, it is also effective in repelling head lice. And garlic powder tablets help mask the personal sweat odours that attract midges.

DEAR DOCTOR - My father has had a recurrent cough for several months, but he won't go to the doctor. Is this anything to worry about? I've heard that TB is on the increase - could his cough be a sign of this?

A persistent cough should always be investigated and your father's GP will want to find out about other symptoms he may have, examine him and arrange a chest X-ray in the first instance. A number of lung conditions can cause recurrent cough, of which TB is one. Other possible signs of TB include unexpected loss of weight, night fever and night sweats.

A recurrent cough can also be due to other lung problems, including asthma, chronic bronchitis, emphysema, allergic lung diseases or even the side effects of certain drugs. Although your dad may be afraid that he has a more serious problem such as lung cancer, this is not necessarily the case.It is important to realise that the sooner it is diagnosed and treated, the greater the chance of a successful outcome. It is better to know what is causing a symptom than to put off seeking advice and continue worrying, perhaps, unnecessarily.

DEAR DOCTOR - I recently had to stop HRT after 10 years, as I was diagnosed with a DVT. Since then I have suffered with hot flushes six to seven times a day, for which my doctor is reluctant to prescribe anything.

A number of alternative approaches are available if you cannot take HRT, including herbal supplements such as Black Cohosh, sage extracts, isoflavones and Siberian and Brazilian ginsengs. Sage extracts (available as Menosan) for example, were found in a recent, randomised, double blind, placebo-controlled study involving 39 women to decrease the frequency of hot flushes by 56 per cent over a period of eight weeks, versus a five per cent increase in frequency among those taking inactive placebo.

Dietary and lifestyle changes plus vitamin and mineral supplements designed for this time of life will also help. Homoeopathic remedies are best prescribed by a homoeopath so they can be individually tailored to your symptoms and constitutional type. Those commonly used include Sepia 30c for night sweats (twice a day for a week) and Glonoin 30c for hot flushes (take every five minutes until flush recedes, for up to 10 doses). A 16-page booklet of useful contacts is available free by writing to: Novogen Redclover Positively Natural about Menopause Directory Offer, Freepost IH3932, Beyton, Bury St Edmunds, IP30 9BR, or phoning the Natural Menopause Helpline: 0845 603 1021.

DEAR DOCTOR - I am booked in for liposuction and have heard that pineapple extracts are good for reducing bruising, but I haven't been able to find any. Do they exist and where can I obtain them?

Look for supplements known as bromelain, as this is the digestive enzyme extracted from pineapples. It helps to clot milk and digest protein but as it is absorbed intact into the circulation from the intestines, it is mainly used for its systemic effects.

It is taken to reduce pain, swelling and inflammation associated with bruising, sprains, wounds, minor operations and burns. It is sometimes recommended before liposuction to reduce post-operative swelling and bruising, but check with your surgeon before taking any supplements.

If readers have any trouble in obtaining nutritional supplements featured in this column, the Nutri Centre in London can will be happy to supply them by mail order at a 15 per cent discount. Call 020 7436 5122 Letters should be sent to Dr Sarah Brewer, Features Department, The Daily Telegraph, Canada Square, Canary Wharf, London E14 5DT; fax 020 7513 2508. Letters cannot be answered individually. Before following any advice, please consult your GP. No responsibility can be taken for advice given in this column. Questions can also be sent by e-mail: drsarah@bizonline.co.uk

-- Anonymous, August 10, 2001