I have tried all kinds of exercise to lose weight but to no avail.

Maintaining correct weight is important. Excess weight and obesity eventually lead to a plethora of medical problems such as type 2 diabetes, heart disease, stroke, arthritis, dementia and even early death. Crash diets help you lose weight only initially; the weight usually creeps back. To keep the weight off long-term, a combination of aerobic exercise, weight training, flexion and stretching have to be followed. Even then, as age advances, weight tends to slowly creep up. You then have to increase exercise and reduce food intake.

Time pills right

I am hypothyroidic and diabetic. I am confused as to how to take my medication for both. Should I take it before or after food?

Thyroid replacement tablets (Thyroxin/Eltroxin) have to be taken first thing in the morning on an empty stomach. Daonil and glimepiride for diabetes have to be taken 15-30 minutes before food. Other diabetes medication such as metformin can be taken after food. Ask your physician or follow instructions on the tablet box. Food interferes with the absorption of some tablets.

TV disturbs sleep

I watch an hour of television before bed to unwind but then I find it difficult to fall asleep.

Television sets, computers and even cellphones emit blue light. This reduces the body’s production of melatonin, the chemical required for sleep, so falling asleep becomes difficult. It is better to read a book or listen to music to induce sleep.

Fast prevents stones?

I have sludge in my gall bladder. Will intermittent fasting help in any way to prevent gall stones?

To help with digestion, the gall bladder releases bile every time you eat. It also gets accustomed to a certain rhythm based on the usual timings of meals. If you do intermittent fasting,the rhythm gets disturbed and your gall bladder does not release bile. It becomes concentrated. Bile anyway has a high concentration of cholesterol. This can precipitate out, forming sludge and gall stones.

Toenail trouble

My toenails are hard and no nail cutter seems sharp enough to cut them.

Soak your feet in warm water to which a teaspoon of salt has been added. The nails will become softer, less brittle and more manageable.

Side effects

I have been taking ibuprofen regularly for knee pain for many years. I am afraid it may have side effects.

Tackle the pain with external applications of pain-relieving ointment followed by ice compress. Try physiotherapy to strenthen the muscles around the knee. If that does not work, you could go back to pain medication but try to avoid using them regularly. Take them only when absolutely necessary. Paracetamol and ibuprofen are probably the safest. Try not to take steroids or addictive medication such as codeine. Avoid alcohol with the medication. If high dose medication and physical therapy do not help, you could opt for knee replacement surgery.