The six mid-life changes you should never ignore ...Middle East

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If you’re between 40 and 65, also known as middle age, your body might be experiencing a whole load of new problems. Think random aches, a drop in energy, or simply just feeling very unfit.

It’s easy to blame these symptoms on age, but research published in the BMC Public Health journal showed that more than one in three British adults suffer from two or more chronic health conditions in middle age. These include arthritis, heart disease, asthma, and diabetes.

“In mid-life, people often write off new symptoms as ‘just getting older’ instead of asking for help,” says Mayoni Gooneratne, doctor and functional medicine director at Personalised Health Clinics. “This could be because changes creep up slowly, everyone around them seems to feel the same, and there’s still a lot of stigma about bothering the doctor.”

But casting everything under the same light can mean your problems only get worse.

A lot of changes will be nothing to worry about, however it’s worth seeking help if you’re experiencing any of the below.

Constant tiredness

Feeling tired after a busy day is one thing, but heavier, more persistent tiredness that doesn’t go after a good night’s sleep could indicate a problem.

Gooneratne says it could be due to a sleep condition such as sleep apnoea, where breathing stops and starts during sleep. Around 1.5 million people in the UK have obstructive sleep apnoea, with rates highest in men aged 55 to 75. Up to 80 per cent of people with the condition may be undiagnosed according to research in the journal Respiratory Medicine.

“Sleep apnoea becomes more common in middle age because weight often increases, muscle tone in the throat falls, and for women, the hormonal changes of menopause affect breathing and fat distribution,” says Gooneratne. “Daytime sleepiness is a symptom, but also loud snoring, gasping at night, morning headaches, brain fog, low mood, raised blood pressure, and needing to pee in the night.”

Your GP may refer you to a sleep specialist clinic for testing.

Fatigue could also be iron deficiency anaemia. Gooneratne says this is common in mid-life due to slow, ongoing blood loss. “In perimenopausal women that’s often heavy or erratic periods, and in men and postmenopausal women it’s usually from the gut, in the form of ulcers, polyps, bowel disease and even bowel cancer. Low iron means poorer oxygen delivery and energy production, so you feel wiped out, breathless and often notice paler skin or hair/nail changes”.

A blood test arranged by your GP can assess your iron levels.

Gooneratne adds that problems with your thyroid, a small butterfly-shaped gland in your neck, can peak in women aged 30-60. “Thyroid problems, especially under-active thyroid, can be triggered or unmasked around perimenopause. Other symptoms alongside fatigue include weight gain, feeling cold, low mood, brain fog, dry skin and hair, constipation, heavy or irregular periods, and sometimes puffiness around the eyes.”

Visit your GP, who will typically take a full history and run basic blood tests.

Joint aches that don’t go

It’s easy to blame sore knees or hips on old age and often, it is. “As we age, cartilage and supporting tissues gradually wear and become inflamed, especially in weight‑bearing or previously injured joints,” says Gooneratne.

But if pain is ongoing, stiff, limiting your movement, and/or you have bone swelling, it could be arthritis. More than 10 million UK adults have arthritis and while there is no treatment, there are ways to manage symptoms including physiotherapy and medicines.

If you’re experiencing sudden, severe pain in your big toe, it could be gout, a type of arthritis affecting one in 40 adults. It’s treatable, providing you book an appointment with your GP as soon as symptoms develop.

“Shooting or radiating pain that travels down a limb or around the body often points to nerve compression rather than a joint issue,” says Gooneratne. “This becomes common with age because the spine slowly degenerates, especially in women, thanks to dropping oestrogen. Discs dry and bulge, bone spurs form and joints and ligaments thicken, all of which can narrow the space for nerve roots.”

Visit your GP, who can arrange blood tests and scans to diagnose. GPs will examine your joints and spine, arrange tests and scans, offer pain relief, physiotherapy, and refer you to rheumatology or orthopaedics when needed.

Shortness of breath

Noticed that everyday jobs are leaving you gasping for breath more? It could be a lack of fitness, but Clair Granger, an online doctor for Superdrug, says that breathlessness may be a sign of underlying conditions like asthma, chronic obstructive pulmonary disease (COPD), or heart disease.

Men over 50 are most likely to develop heart disease, however research has found that around 58 per cent of people aged 40 to 49 already have atherosclerosis, a build-up of fat and cholesterol inside the arteries, which can make them narrower and increase heart attack risk.

COPD, a lung condition that makes it difficult to breathe air out of the lungs, affects around four per cent of over-forties, according to Asthma and Lung UK, yet many go undiagnosed.

“Seek medical advice if breathlessness is new, worsening, occurs at rest or with minimal exertion or is accompanied by symptoms such as chest pain, dizziness, swelling in the legs or a persistent cough,” says Granger.

Asthma can cause wheezing attacks, too. “Your GP will assess your symptoms, medical history and risk factors, and may carry out blood tests, lung function tests, an ECG or a chest X-ray.”

If you’re between 40 and 75, you’ll also be invited to an NHS health check by your GP or local council every five years to check your heart and blood vessels.

Unexplained weight loss

If you haven’t made any changes to your diet or exercise regime, but you’ve noticed the pounds dropping – more than five per cent of your body weight over six to 12 months – it could signal something’s going wrong, including thyroid disorders, diabetes, or, more rarely, cancer.

An overactive thyroid, known as hyperthyroidism, affects one in every 100 people. “It often leads to weight loss alongside a rapid heartbeat, sweating, anxiety and difficulty sleeping, despite a normal or increased appetite,” says Granger. “Diabetes may cause weight loss together with increased thirst, frequent urination, fatigue and sometimes blurred vision.

“Cancer-related weight loss is often accompanied by fatigue, unexplained pain, changes in appetite or bowel habits or unusual lumps or swelling, depending on the type of cancer and part of the body that’s affected,” adds Granger.

If in doubt, visit your GP.

A rise in anxiety

Feeling on edge or worried? A study in the journal Health Science Reports, which involved 242 women, some premenopausal, some menopausal, found that 54 per cent had anxiety.

“Fluctuating levels of oestrogen can significantly affect mood during perimenopause, leading to anxiety, irritability, low mood and even panic attack symptoms,” says Granger. “Your GP may discuss hormone replacement therapy (HRT)”. This replaces the oestrogen and progesterone hormones, which have dropped, helping to stabilise your mood.

Needing to pee in the night

Waking up twice or more for a wee, even when you’ve not had a drink before bed, is known as nocturia. Gooneratne says this is more common in mid-life onwards, usually caused by Type 2 diabetes, sleep apnoea or bladder and/or prostate changes.

Diabetes diagnoses in the over-forties have increased by 25 per cent according to Diabetes UK, plus, 1.3 million people are currently living with type 2 diabetes but are yet to be diagnosed.

“Bladder and prostate changes are common with age,” says Gooneratne. “Hormonal shifts during perimenopause can cause thinning of the pelvic floor muscles, bladder lining and vulval tissues. These changes can affect continence and lead to bladder irritation.”

Pelvic floor exercises help strengthen muscles, while reducing caffeine and alcohol can reduce irritation and the urgent need to pee. Around one in three men over the age of 50 have urinary symptoms, with an enlarged prostate being the most common, and usually harmless, cause.

“Peeing in the night can also reflect conditions like heart failure as fluid shifts from your lower body back into your bloodstream when you lie down, and your kidneys have to process it, where it comes out as urine,” says Gooneratne. (Feeling breathless, swollen legs and lightheadedness are other symptoms of heart failure which warrant a trip to your GP.)

“If nighttime peeing is affecting your life, it comes with thirst, burning when you pee or sudden weight change, it’s best to see your GP,” warns Gooneratne.

“A GP will ask you about your drinking habits and urinary symptoms, examine you, test your urine, check your bloods and then advise on lifestyle changes, medicines or onward referral depending on what they find,” says Gooneratne.

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