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Sweetening the pain (Filed: 29/08/2001)

Dr Sarah Brewer on the use of honey to treat leg ulcers, ways to boost the metabolism and dealing with an unsightly rash

DEAR DOCTOR - I am keen to find out more about the effectiveness of honey in the treatment of leg ulcers. I understand it is used for this purpose in Australia.

Honey can be used to treat wounds such as leg ulcers, as it has a high concentration of natural sugars. This creates a strong, osmotic effect to absorb fluid while making it difficult for bacteria to thrive. Honey also releases natural antiseptic substances, such as hydrogen peroxide, which inhibit the growth of many common skin bacteria.

Manuka honey made by bees feeding on nectar from the New Zealand Manuka bush appears to be one of the most effective for wound healing. It contains an additional natural antibiotic known as the Unique Manuka factor (UMF) - those with a rating of at least UMF 10 are as effective against the skin bacterium Staphylococcus aureus as a 10 per cent phenol solution. Honey promotes moist wound healing to reduce pain, inflammation and reduces the risk of scarring.

It is usually applied on absorbent dressing, under medical supervision, with dressings changed at least three times a day. As some honeys may contain spores from Clostridium bacteria, it may be wise to use a honey treated with gamma-irradiation to prevent a theoretical risk of infection.

DEAR DOCTOR - Is there an alternative product that might help to boost the metabolism? I've had a weight problem all my life which is getting worse as I get older.

The most effective way known to boost metabolism is exercise, which can increase the metabolic rate as much as 10 fold, and encourages weight loss by mobilising fatty acids from fat cells to act as the preferred fuel for muscle cells. The mineral iodine is essential for the production of thyroid hormones that regulate the metabolism and, if your iodine intake is low, sources of iodine - such as kelp - act as a mild thyroid stimulant to encourage a more efficient metabolism.

If you are experiencing a general slowing down, it is a good idea to ask your doctor if you warrant a blood test to check thyroid function before taking an iodine supplement. Co-enzyme Q10 may also be useful in weight loss by stimulating fat metabolism in mitochondria.

A pilot study involving nine obese subjects following a weight loss diet found that those taking 100mg CoQ10 daily lost an average of 30lb, compared with an average of 13lb for those not taking CoQ10. An extract from green tea leaves, known as AR 25 catechol (Exolise), was shown in clinical studies with healthy volunteers to boost the rate at which the body burns calories by as much as 40 per cent over a 24-hour period.

This is due to its ability to inhibit a metabolic enzyme so that levels of noradrenaline increase to stimulate the amount of energy given out as heat in body cells. It also blocks the activity of intestinal enzymes (gastric and pancreatic lipases) so that 30 per cent less dietary fat is absorbed overall. Exolise is available from health food stores, chemists or mail order on 020 8763 1414; £15.95 for 30 capsules.

DEAR DOCTOR - I have had an unusual rash called granuloma annulare all over my body since 1993. It is unsightly, yet various doctors have said it will go away with time. Is this true?

Granuloma annulare is a skin condition that mainly affects children and young adults. Small flesh-coloured or slightly red skin papules develop that often form into rings, usually on the backs of the hands and feet.

The condition seems to result from degeneration of collagen - why this happens is unknown, although occasionally it is associated with diabetes. Spontaneous resolution does usually occur, but cryotherapy - or injection with the drug triamcinolone - may help to hasten disappearance of localised areas.

DEAR DOCTOR - Three smear tests have come back showing either no readings and having to be repeated, or showing inflammation. The GP says not to worry - is it serious and does it need treatment?

An inadequate smear is nothing to worry about - it just means that not enough endocervical cells were obtained to be able to give an accurate reading.

Inflammation is often seen on a cervical smear and may imply an infection such as candida, chlamydia or a common bacterial imbalance such as bacterial vaginosis. It is usually best to obtain a full screen at a genito-urinary medicine clinic, which can tell you whether an infection is present, and supply treatment. Sometimes, no obvious cause of inflammation is found.

If readers have any trouble in obtaining any of the nutritional supplements featured in this column, the Nutri Centre in London will be happy to supply them by mail order at a 15 per cent discount. Please call the centre on 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.

-- Anonymous, September 03, 2001