q I am unable to fall asleep and so find it difficult to wake up in the morning. I can’t function like this. I don’t want to take sleeping tablets.

If you don’t want medication, you can try keeping a consistent sleep-wake rhythm by going to bed at the same time each day. Darkness is essential for sleep, so do not have lights from a television, smartphone or bathroom. Drink some warm milk or any non-caffeinated beverage about an hour before sleeping. Exercise by walking 40 minutes briskly two hours before your anticipated bedtime.

Low testosterone

q I have a low sperm count and low testosterone levels. Is there any way I can increase it naturally?

You need a complete physical check-up and blood tests to see if there is any correctable reason for the low levels. If you do not want to take medication or supplements, it will come up to some extent if you are not obese. Have a healthy diet, exercise regularly, and avoid smoking and alcohol. Wear shorts-type underwear and not a V-cut. Some vitamin supplements are believed to help.

Cholesterol control

q I read that you don’t have to worry about cholesterol any more, and I can stop taking medication.

Elevated cholesterol causes heart attack, stroke and hastens the onset of dementia. If your lipid profile is abnormal and your physician has started you on statins, it is better for you to continue. To reduce cholesterol naturally, you need to attain ideal body weight. Also, reduce your consumption of trans fats found in snacks. As a family, use only 500ml of oil per person for cooking for a whole month.

Burning feet q My feet burn and feel numb, interfering with my sleep at night.

This is peripheral neuritis, and the most common cause is diabetes. Control your blood sugars if you are diabetic and correct any vitamin deficiencies, particularly B12 and D3. There are some yoga exercises that help with peripheral neuritis. You can look them up on YouTube.

Multiple pills

q I have heart disease, diabetes, hypertension and weak bones. I take about 15 medicines, and I am worried.

If you are seeing multiple specialists, there may be inadvertent duplication of your medications. Also, if you tend to take unprescribed supplements, you may overdose.

Whenever you go to a doctor, carry all your prescriptions with you. Also, make a list of any unprescribed drugs you may be taking. That way, you minimise your chance of error and may be able to reduce the number of medicines.

Gestational diabetes

q I had diabetes during pregnancy. After delivery, I relocated to another city. When and how should I have a follow-up?

The recommendation is to test after six weeks. The diabetes may have disappeared, but a diagnosis of diabetes is made if the HBA1C is at least 6.5 per cent, fasting plasma glucose is at least 126 mg/dl, and/or 2-h plasma glucose is at least 200 mg/dl on a 75-g GTT. HBA1c alone is not recommended.

If you are borderline diabetic, start exercising and remain on a 2,000-calorie diet if breastfeeding. Delay your next pregnancy by at least two to three years so that you have time to get back into shape and recover from pregnancy and childbirth.

Remember you have a 50 per cent chance of developing diabetes in the next 5-10 years, especially if you remain overweight and don’t exercise.

Exercise time

q The recommendation is 150 minutes of aerobic activity a week, but I cannot spare that much time daily.

Many people have the same problem. Try for five or 10-minute bouts of intermittent activity throughout the day, walking, jogging, running in place or stair climbing. See if you can do 150 minutes a week this way.

The writer has a family practice at Vellore and is the author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in