Every time I comb my hair, large clumps fall out. I am afraid I am going bald. I am 23 years old.

The loss of up to 150 hairs a day is normal. If it is greater than this, it may be cause for worry. Baldness or male pattern hair loss can start in the early twenties. There is usually a family history, a receding hairline and hair loss from the crown.

Medical conditions such as anaemia, vitamin or mineral deficiency, diabetes, hypothyroidism, autoimmune diseases and cancer treatment can also cause hair loss.

If patchy clumps of hair are falling out, it may be a condition called alopecia areata. Please consult a physician.

Diet control

I keep dieting but am just unable to keep the weight off.

If your lifestyle is sedentary, then men require 2,000- 2,500 and women require 1,500-2,000 calories. Diets with less than 1,200 calories a day for women and 1,800 calories a day for men are difficult to sustain.

Download an app to count the daily calories in your food. Try and work off some of the calories with exercise. Even short bursts of activity intermittently throughout the day will keep your metabolism up. Build muscle using repetitive movements with light weights.

A sustainable calorific deficit is 500 calories a day. That will help you lose half a kilo in a week.

Sleepy side effect

I have nerve pains all over my body. In addition to painkillers, I was prescribed amitriptyline. I feel very sleepy.

Try taking the tablet at 7pm whether or not you have had your dinner. That way, you will fall asleep between 9 and 10pm and wake up by 6am.

Tummy trouble with sushi

I developed vomiting and diarrhoea after eating sushi.

Sushi is made from raw fish. This means it can be contaminated with bacteria. This can cause stomach pain, vomiting and diarrhoea. If you get these symptoms every time you eat sushi, just avoid it. Small children as well as pregnant and breastfeeding women should avoid sushi.

Medical maintenance

I just turned 50 and wondered what medical tests I should take to stay healthy. Many of my friends discover diseases only after they have advanced to a stage where complications have set in.

You must have a blood pressure evaluation and check for diabetes and cholesterol. After 50, you need a mammogram every two years, a pap smear every three years and a colonoscopy every 10 years. You also need to ensure that your immunisations for Corona, pneumonia, herpes zoster and flu vaccine are up-to-date.

Mental illness

My brother says he hears people telling him to do things; he sits staring into space and is very unhygienic. Is he depressed?

It may be depression, but these symptoms sound more like the early onset of schizophrenia. There is no medical test for either depression or schizophrenia. You need to have your brother evaluated by a psychiatrist. Both conditions respond very well to medication.

Trim for hair health

If I trim my hair regularly, will it become thicker?

Hair tends to split at the ends as it grows. The split travels up the hair shaft and can damage the roots and also cause the hair to break off. Hair grows at the rate of about half a centimetre in a month. Therefore, you can safely trim about half an inch every three months. Regular trimming will decrease hair loss and make your hair appear thicker.

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