I was surprised recently to see a young patient in my surgery showing the symptoms of lead poisoning - joint and muscle pain as well as having memory problems.
A blood test showed that he did indeed have high traces of the toxic metal in his system.
I thought lead poisoning was a Victorian-era problem long consigned to the past. But latest figures show that in 2023 more than 200 cases were reported in children in England, and across the UK around 200,000 children had elevated lead levels in their blood.
Left untreated, lead poisoning can cause brain damage in children and even death. It is treated either by simply getting the child away from the problem area or there are strong drugs that can clear it from the body.
But it is still a modern problem because many drinking water pipes still contain lead, and older properties might have been decorated with now-banned lead paint.
Do you believe you or your family have fallen ill due to lead poisoning? Do you know the cause?
Latest figures show that in 2023 more than 200 cases of lead poisoning were reported in children in England, and across the UK around 200,000 children had elevated lead levels in their blood
What is causing bulging veins and a rash on my ankle?
Q: I'm 77 and I have prominent veins around my left ankle. Recently a rash and swelling has also appeared in the area. What could be the cause?
A: Visible veins, swelling and a rash around the ankles are a catalogue of symptoms related to the blood vessels.
In order to help move blood around the body, muscles squeeze the veins, pushing it onwards.
In old age these muscles can become weak, meaning the blood flows slower. This can also happen as a result of injury or disease. The legs are one of the most common areas for this problem to occur.
When the blood moves slowly, fluid in the veins begins to seep out into the surrounding tissue. This is what causes swelling, as well as what appears to be a rash but is actually blood underneath the skin. These problems tend to get worse at night and better during the day, because the blood moves more freely when the legs are active.
One of the most common treatment options for vein issues in the legs is compression socks. These are special socks or tights which help the blood to circulate better by mimicking the action of the body's muscles by adding extra pressure on the legs.
But elevation will also help - which might mean resting the legs on a stool or chair while sitting down.
Moreover, any movement improves circulation. So regular gentle exercise such as walking will improve the flow of blood by working the calf muscles.
I'm suffering with extreme tiredness which makes it difficult to work or exercise. My GP has run tests but everything has come back normal. I'm vegan and going through the menopause. What can I do?
A: Fatigue is a symptom of perimenopause or menopause due to the sharp reduction in hormones that women experience during this period.
Unfortunately there is no blood test that can verify whether a patient's fatigue is caused by this. However, a GP can write a prescription for HRT - hormone replacement therapy - which can help combat fatigue.
A vegan diet - one which contains no animal products such as meat or dairy - can also cause fatigue.
This is usually due to a vitamin B12 deficiency, a nutrient found in substantial amounts only in animal products.
Low vitamin B12 levels also have a number of other health risks, including problems with vision and memory.
For this reason, vegans are typically told to take a daily B12 supplement.
An iron deficiency is also a cause of fatigue, though this is one of the first tests that a GP would usually order, or it could be a side effect from medicine or even depression.
However, it's important not to forget one of the most common - and obvious - causes of fatigue: poor sleep.
It might be worth testing out going to bed earlier or avoiding looking at screens in the hour before turning in, to see if this has any effect on energy levels.