Older women are being exploited by IVF clinics “trading on hope”, the fertility watchdog has warned.
Sally Cheshire, chairwoman of the Human Fertilisation and Embryology Authority (HFEA), told the Daily Telegraph some private clinics were using “selective success rates” to target older women.
IVF is less likely to be successful as a woman gets older.
Since 2004 the number of women in their 40s undergoing fertility treatment has doubled to 10,835 in 2017.
The new figures, published by the Telegraph, show that among those using their own eggs, just 75 women aged 42 to 43 will end up with a baby.
For those over 44, there was a success rate of just 1% between 2004 and 2017.
In an interview with the newspaper, Mrs Cheshire called for clinics to be “honest and transparent” with women about their chances of success.
“What the clinics shouldn’t be doing is trading on that hope,” she said.
NHS guidelines recommend that women under 40 should be offered three full cycles of IVF, while those between 40 and 42 should be offered one full cycle. However eligibility criteria varies in different areas of the country.
IVF is not usually recommended for women over the age of 42 because of low success rates.
What is In Vitro Fertilisation (IVF)?
- An egg is removed from the woman’s ovaries and fertilised with sperm in a laboratory
- The fertilised egg is then returned to the woman’s womb to develop
- IVF worked for the first time on 10 November 1977. On 25 July 1978, the world’s first IVF baby, Louise Brown, was born
- On average, IVF fails 70% of the time
- The highest success rates are for women under 35
- On average, it takes almost four-and-a-half years to conceive with IVF
Source: Human Fertilisation and Embryology Authority/Fertility Network UK
Mrs Cheshire said some parts of the sector were using “blatant” sales tactics to persuade “vulnerable” women to undergo treatment.
The 50-year-old said she had even been offered IVF treatments herself, by staff who were unaware of her role with the regulator, at a visit to a fertility show in Manchester.
“We now see things like ‘guaranteed baby or your money back,” she said.
Mrs Cheshire also called for the watchdog to be given powers to regulate prices, saying that some private centres were charging up to £20,000 for cycles – four times as much as she said treatments should cost.
She said prices were often inflated by the growing use of “add-on treatments”, such as embryo glue and endometrial scratches, offered by clinics to boost chances of success.
However, earlier this year the watchdog, which regulates all fertility services in the UK, warned that these were being offered without conclusive evidence that they increase the chance of pregnancy.
Its website now has a “traffic light” rating for such treatments. None have been given the green light, which indicates there is more than one quality trial showing the procedure is effective and safe.
Seven-year-old Leia Armitage lived in total silence for the first two years of her life, but thanks to pioneering brain surgery and years of therapy she has found her voice and can finally tell her parents she loves them.
“We were told you could put a bomb behind her and she wouldn’t hear it at all if it went off,” said Leia’s father, Bob, as he recalled finding out their baby daughter had a rare form of profound deafness.
Leia, from Dagenham in Essex, had no inner ear or hearing nerve, meaning that even standard hearing aids or cochlear implants wouldn’t help her.
As a result, she was never expected to speak – but despite the risks, her parents fought for her to be one of the first children in the UK to be given an auditory brainstem implant, requiring complex brain surgery when she was two years old.
NHS England calls the surgery “truly life-changing” and has said it will fund the implant for other deaf children in a similar position.
It is estimated that about 15 children a year will be assessed for the procedure and nine will go on to have surgery.
Hear cars beeping
Bob says opting for this type of brain surgery was a huge decision for them, but “we wanted to give Leia the best opportunity in life”.
He and his wife Alison hoped that after the surgery at Guy’s and St Thomas’ NHS Foundation Trust she would be able to hear things like cars beeping their horns as she crossed the road – to make her safer in the world.
However, in the five years since the surgery, her progress has been much greater than they ever expected.
It started slowly, with Leia turning her head at the sound of train doors closing shortly after the operation.
Gradually, she started to understand the concept of sound while her parents continually repeated words, asking her to mimic the sound.
Now, after lots of regular speech and language therapy, she can put full sentences together, attempt to sing along to music and hear voices on the phone.
“We can call her upstairs when we’re downstairs and she will hear us,” Bob explains.
‘I love you’
But it’s at mainstream school, in a classroom with hearing children, where Leia is really flying, thanks to assistants using sign language and giving her plenty of one-to-one time.
“She is picking up more and more and she’s not far behind others of her age in most things,” Bob says.
At home, using her voice is what pleases her parents most.
“‘I love you Daddy’ is probably the best thing I’ve heard her say,” Bob says.
“When I’m putting her to bed she now says ‘good night Mummy’, which is something I never expected to hear,” Alison says.
The cutting-edge surgery involves inserting a device directly into the brain to stimulate the hearing pathways in children born with no cochlea or auditory nerves.
A microphone and sound processor unit worn on the side of the head then transmits sound to the implant.
This electrical stimulation can provide auditory sensations, but it cannot promise to restore normal hearing.
However, Prof Dan Jiang, consultant otologist and clinical director of the Hearing Implant Centre at Guy’s and St Thomas’ NHS Foundation Trust, said some children can develop a degree of speech.
“The outcomes are variable. Some will do better than others,” he said.
“They have to adapt to it and younger children do better so we like to insert the implant early if possible.”
Children under five are best placed to learn new concepts of sound and respond to intensive therapy, he said.
Susan Daniels, chief executive of the National Deaf Children’s Society, said: “Every deaf child is different and for some, technology like auditory brainstem implants can be the right option and can make a huge difference to their lives.
“With the right support, deaf children can achieve just as well as their hearing peers and this investment is another important step towards a society where no deaf child is left behind.”
The Soap Co. was set up in 2015 to help encourage and support people with disabilities back into the workplace.
The products they sell are made entirely by hand by disabled workforces in Cumbria and London.
Two employees, Billy and Sue tell us their stories.
Video Journalist: Sophie van Brugen
A Nottingham midwife saved her friend’s life when she popped round for coffee.
Aimee Summers recognised the signs of a potentially fatal blood clot and gave emergency first aid.
She has become one of three nurses to get the Cavell Star Award, which recognises people in the caring profession who go above and beyond in their role.
A new campaign says we should pay less tax on plants because they are good for the environment and mental health.
It’s being backed by the National Garden Scheme at a time when house plants are becoming increasingly popular – particularly among young people who can’t afford gardens.
In the UK, plants which don’t produce food are subject to full VAT (Value Added Tax) at a rate of 20%. Whereas in other European countries, it can be at least half that.
Nearly one-in-10 heart attacks and strokes in England and Wales could be prevented if routine check-ups were better targeted, say researchers.
Currently, people aged 40 and over are eligible to have their heart health assessed every five years.
But UCL scientists say people at low risk are being checked too often while those considered at high risk are not checked often enough.
They say a personalised approach could save lives without costing any more.
Chances of a heart attack or stroke can be worked out by looking at risk factors such as blood pressure, cholesterol and blood-sugar levels, age, family history and whether the person smokes.
High-risk patients are told to change their lifestyle, and if that does not work they are offered statins to reduce “bad” cholesterol or drugs to lower blood pressure.
The researchers followed 7,000 people to see how long they spent in different risk categories.
The study, in the Lancet Public Health, showed:
- “Low-risk” patients took an average of nine years to reach “intermediate-low-risk”.
- “Intermediate-low-risk” patients spent an average of seven years in this category; 90% went on to become “intermediate-high-risk”.
- But within four years, 70% of “intermediate-high-risk” patients became “high-risk” and needed treatment.
The researchers then simulated different ways of screening people depending on their heart-risk category.
For example, screening low-risk patients every seven years, intermediate-low every four years and intermediate-high every year cost the same as the current system.
How big an impact?
However, the targeted system would enable high-risk patients to be treated sooner and prevent 8% of heart attacks and strokes, say the researchers.
That would prevent 5,000 people a year in England and Wales having a potentially life-threatening heart attack or stroke.
Prof Mika Kivimaki, one of the researchers, said: “The key message is use individualised screening, not one-size-fits-all.
“I believe this will change because there is a tendency towards precision medicine and individualised treatment and prevention.
“I think this will be taken up in future and I hope it will happen sooner rather than later.”
The next stage of the research would be to perform a clinical trial to see whether switching screening methods would actually make a difference.
Prof Sir Nilesh Samani, medical director at the British Heart Foundation, said: “While changing the frequency of heart-health check-ups based on a person’s individual risk could potentially save lives and costs, it’s easier said than done.
“An issue that is even more important to address is why so many people who could benefit from health checks are not getting them in the first place.
“If you know you’re at higher risk of developing heart and circulatory disease, it’s really important to attend regular health checks to help manage your risk factors to prevent problems later in life.”
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Even small amounts of red and processed meat – such as a rasher of bacon a day – can increase the risk of bowel cancer, according to research.
The latest study led by Oxford University and funded by Cancer Research UK, adds to evidence, including from the World Health Organization, that eating red meat can be harmful.
But exactly how big is the risk? And how much is too much?
Here’s what you need to know.
What the study found:
Researchers analysed data from almost half a million people involved in the UK Biobank study.
Over the six years of their study they found 2,609 people developed bowel cancer.
- Eating three rashers of bacon a day rather than just one could increase the risk of bowel cancer by 20%
- For every 10,000 people in the study who ate 21g a day of red and processed meat, 40 were diagnosed with bowel cancer
- The comparable figure for those who ate 76g a day, was 48
According to the NHS, 76g of cooked red meat is equivalent to about half an 8oz sirloin steak. A slice of ham or rasher of bacon is about 23g of processed meat.
How much is too much?
It’s not clear. Cancer Research UK (CRUK) says 5,400 of the 41,804 cases of bowel cancer seen each year in the UK could be prevented if people did not eat processed meat at all.
According to Emma Shields, information manager at CRUK, “This study shows the more meat you eat, the higher your risk of getting cancer and obviously the reverse is true – the less you eat the less likely you are to get bowel cancer,”
But she acknowledges smoking poses a much bigger risk, causing 54,300 cases of cancer each year.
Public Health England says from its surveys many people eat too much red and processed meat.
And experts advise people who eat lots of it to find ways to cut down.
The Department of Health advises anyone eating more than 90g a day of red and processed meat should cut down to 70g.
Is eating some OK?
NHS guidance says there are some benefits of red meat – iron and protein content, for example – that must be balanced against potential risks.
People can still eat meat and be healthy.
What makes it risky?
Processed meat – including bacon, some sausages, hot dogs, salami – is modified to either extend its shelf-life or change the taste – the main methods are smoking, curing, or adding salt or preservatives.
It is thought the chemicals involved in the processing could be increasing the risk of cancer. High temperature cooking, such as on a barbecue, can also create carcinogenic chemicals.
When it comes to red meat like beef, lamb and pork, there are suggestions that one of the proteins (that gives it its red colour) can damage the gut when it is broken down.
But experts are still trying to fully understand the link.
What do experts say?
Prof Gunter Kuhnle, at the University of Reading, described the study as a very thorough analysis of the link between meat intake and bowel (also known as colorectal) cancer.
He said: “The results confirm previous findings that both, red and processed meat consumption, increase the risk of colorectal cancer.
“The increase in risk of approximately 20% per 50g increase of red and processed meat intake is in line with what has been reported previously, and confirms these findings.
“The study also shows that dietary fibre reduces the risk of colorectal cancer. An increased consumption of fibre, as shown by this study, would be of considerably more benefit.”
Carrie Ruxton, of the Meat Advisory Panel, an industry-funded body, said: “Red meat provides valuable nutrients, such as protein, iron, zinc, vitamin D and B vitamins.”
She said it was known that “a range of lifestyle factors have a significant impact on the risk of bowel cancer, most notably age, genetics, lack of dietary fibre, inactivity and high alcohol consumption”.
The study is published in the International Journal of Epidemiology.
Mums-to-be could be routinely offered an ultrasound scan at 36 weeks to help spot risky breech deliveries, when a baby’s bottom or feet will emerge first, say UK researchers.
Breech births can be hazardous and tricky to diagnose.
Currently, midwives and doctors tend to rely on the shape and feel of the mother’s bump to check.
Researchers estimate the scans would avoid 4,000 emergency caesareans and eight baby deaths a year in England.
If the scans could be done cheaply enough then it should also save the NHS money in terms of care, says the University of Cambridge team in the journal PLoS Medicine.
About three to four babies in every 100 are in a breech position near the end of pregnancy.
More babies start out breech but will turn to the ideal “head-first” position by about 36 weeks’ gestation.
The researchers offered breech scans to 3,879 pregnant women:
- 179 (4.6%) were found to be breech
- In more than half of these cases (96 of the pregnancies or 55%) there had been no suspicion until the scan result
Making the diagnosis at 36 weeks meant the women could be offered an attempt at manually encouraging the baby to turn in the womb to the head-first position before labour – a manipulation method called external cephalic version.
For the women who declined, or where it did not work, a planned caesarean section was arranged. None of the women opted to attempt a vaginal breech birth, which is possible but carries some risk.
Nineteen of the 179 women were able to deliver vaginally, 110 had a planned caesarean and 50 needed an emergency caesarean.
Researcher Prof Gordon Smith said it should be feasible to provide the service at a low cost, for example by making it a part of a standard midwife appointment and using inexpensive portable ultrasound machines.
“If it was under £20 per patient then it would be cost-effective and if it could be done for under £13 then it should save the NHS money in the long run,” he said.
Experts said the cost-effectiveness for the NHS should be explored.
Private patients can pay from £30 to £200 or more for a pregnancy ultrasound scan.
Prof Andrew Shennan, professor of obstetrics at King’s College London, said the scans should be rolled out.
“Breech can be difficult to manage in labour if previously unsuspected, as labour can be quick,” he said.
“Breech deliveries have some risk, and counselling and decision-making in labour can be challenging. Scans are routinely available now, and minimal skills are required to determine breech presentation. This should be implemented.”
But Prof Jean Golding, emeritus professor of paediatric and perinatal epidemiology at the University of Bristol, disagrees. She said bigger, randomised trials were needed first.
Prof Basky Thilaganathan, from the Royal College of Obstetricians and Gynaecologists, said more research was needed, but added: “So far, the evidence for its use looks very promising.”
The number of measles cases reported worldwide in the first three months of 2019 has quadrupled compared with the same time last year, according to the World Health Organization (WHO).
The UN body said provisional data indicated a “a clear trend”, with all regions of the world seeing outbreaks.
Africa had witnessed the most dramatic rise – up 700%.
The agency said actual numbers may be far greater, since only one in 10 cases globally are reported.
Measles is a highly infectious viral illness that can sometimes lead to serious health complications, including infections of the lungs and brain.
Ukraine, Madagascar and India have been worst affected by the disease, with tens of thousands of reported cases per million people.
Since September, at least 800 people have died from measles in Madagascar alone.
Outbreaks have also hit Brazil, Pakistan and Yemen, “causing many deaths – mostly among young children”, while a spike in case numbers was reported for countries including the US and Thailand with high levels of vaccination coverage.
In total, some 170 countries reported 112,163 measles cases to WHO, in comparison to 28,124 cases across 163 countries during the same period in 2018.
The UN says the disease is “entirely preventable” with the right vaccines, but global coverage of the first immunisation stage has “stalled” at 85%, “still short of the 95% needed to prevent outbreaks”.
In an opinion piece for CNN, WHO head Tedros Adhanom Ghebreyesus and UNICEF head Henrietta Fore said the world was “in the middle of a measles crisis” and that “the proliferation of confusing and contradictory information” about vaccines was partly to blame.
Why the sudden ‘global measles crisis’?
By James Gallagher, health and science correspondent, BBC News
It is one of the most contagious viruses around. However, nothing about measles has changed. It has not mutated to become more infectious or more dangerous. Instead the answers are entirely human.
There are two stories here – one of poverty and one of misinformation. In poorer countries fewer people are vaccinated and a larger portion of the population is left vulnerable to the virus.
This creates the environment for a large outbreak to occur – such as those in the Democratic Republic of the Congo, Kyrgyzstan and Madagascar.
But rich countries with seemingly high vaccination rates are seeing cases spike too. This is because clusters of people are choosing not to vaccinate their children due to the spread of untrue anti-vax messages on social media.
It is worth noting these figures are provisional, the WHO says the true figures will be much higher. And that measles is far from harmless. It kills around 100,000 people, mostly children, every year.
The pair wrote that it was “understandable, in such a climate, how loving parents can feel lost” but that “ultimately, there is no ‘debate’ to be had about the profound benefits of vaccines”.
They added: “More than 20 million lives have been saved through measles vaccination since the year 2000 alone.”
In response to recent measles outbreaks, calls have mounted in several countries to make immunisation mandatory.
Last month, Italy banned children under six from attending schools unless they had received vaccines for chickenpox, measles and other illnesses.
A public health emergency has also been declared in areas of New York, ordering all residents to be vaccinated or face a fine.
A machine which simulates the effects of gravity could reduce muscle wastage for patients in hospitals as well as astronauts on long missions.
Tests will explore what happens when volunteers are spun daily on a human centrifuge after 60 days of bed rest.
It is hoped the technique will speed up patient recovery and lessen the impact on future space flights.
The research in Manchester and Newcastle is backed by the UK Space Agency.
Professor Hans Degens, who is leading the work at Manchester Metropolitan University, said: “Artificial gravity could help astronauts to maintain muscle mass in space and help back here on Earth too by preventing severe muscle degeneration in hospitalised patients.
“Currently astronauts have to exercise for up to 2.5 hours every day, take nutrient supplements, and keep high protein diets to maintain muscle mass while they are in space. Despite this, severe muscle deterioration still occurs.
“One day, astronauts might have a daily quick spin in a centrifuge on the ISS [International Space Station] rather than spend hours on gym equipment in space.
“For hospital patients it could greatly improve their recovery during rehabilitation and after they leave.”
The research is backed by the UK Space Agency with £500,000 awarded to Northumbria University and Manchester Metropolitan University.
Twelve men and twelve women volunteers will be subjected to 60 days of bed rest, simulating the long-term effects of weightlessness.
Some of the group will spend 30 minutes every day lying flat in the human centrifuge as it spins and researchers will examine muscle degeneration.
An eight-year-old boy who complained of neck pain while his mother washed his hair was diagnosed with a rare cancer.
McKenzie John, from Swansea, is undergoing chemotherapy to treat a nasopharyngeal tumour.
The youngster is being treated in Cardiff, where he is on his second of three rounds of chemotherapy.
His mother Rhian John said: “I’m absolutely heartbroken. I never expected something like this to happen to us.”
The 35-year-old added: “It’s a hell of a lot for an eight-year-old to cope with. McKenzie is in high spirits, but he has a long road ahead of him.”
The NHS health care support worker said her son first complained of a painful neck in November while showering.
In January, a GP dismissed his symptoms as a viral infection.
Ms John said: “He’s always been a strong and healthy kid, and he never made a fuss or tried to skip school, so it was unusual for him to complain of this neck pain.
“Whenever he tried to tip his head back to wash his hair, he’d say it really hurt.”
Various tests came back negative before an MRI scan in March revealed the tumour.
McKenzie spent four days in an induced coma before being transferred to an oncology ward at the Noah’s Ark Children’s Hospital in Cardiff, where he had emergency “adult doses” of chemotherapy.
Mother-of-four Ms John said her son was “getting on with it”.
“McKenzie understands he has cancer, he lost all his hair after his first dose of chemo, but he’s getting on with it, taking it in his stride.”
He is due to undergo proton beam therapy at The Christie NHS Foundation Trust in Manchester, which opened last year.
About 250 people a year in the UK are diagnosed with the cancer, which affects the part of the throat connecting the mouth and the nose.
A Go Fund Me page set up to help support the family’s stay in Manchester has so far raised more than £4,000.
Piles of washing up, trying to squash all your rubbish in one bin and sharing a bathroom is all part of living in a shared house.
But for people living with medical conditions these things can be more than a headache.
Amber Davies, 21, has a stoma after having her bowel removed after developing ulcerative colitis.
She loves living with her friends but worries about bin collections as there are strict rules in place.
With services varying across Wales and some councils fining residents who throw too much away, there are calls for greater support to make life easier for those with medical conditions living away from home.
- What it’s really like to get a colostomy bag in your 20s
- ‘Wearing a stoma bag is part of my life and it is a great one’
“We only get one black bin every two weeks, and I am responsible for filling up most of that,” said product design student Amber, who changes her ostomy bag daily, but gets no extra allowance from Cardiff council despite living with three other people.
“To a shared house, one bin is not a lot at all, I know when I am back at home the council are a lot more lenient with what you are allowed, but here if the bin is open or over spilling then they won’t take any of it, that then leads to problems.”
A stoma is an opening in the stomach where faeces are collected in a bag after part or all of the bowel is removed due to a disease or obstruction.
Many people with ileostomies, where the large colon has been removed, have bags which can be emptied but need to be changed.
But while the number of stoma bags prescribed in Wales almost trebled in the last 18 years, how the used bags are collected differs depending on where you live.
Currently, six councils in Wales collect the bags in special absorbent hygiene collections, while the rest tell people to put the used appliances in household bins, collected about every two weeks.
It is not collected by the NHS as it is not classed as “clinical waste”, such as needles and infectious waste.
And rules differ for large households, with some areas allowing large families or people living in house shares to put out extra rubbish, while others have strict limits and can fine those who put out extra bags.
In Cardiff the council allows extra rubbish for people living in houses with six or more people, if they can prove they recycle properly.
Having a stoma is a big thing to adapt to live with, but generally life since surgery is a lot better and I can do so much more.
Amber, from Builth Wells, Powys, was diagnosed with ulcerative colitis – one of the main forms of Inflammatory Bowel Disease (IBD) – when she was 13.
After years of trying medications and being in and out of hospital, when she was 17 she had emergency surgery to remove part of her diseased large bowel, leaving her with a stoma.
Not long after her second operation – which removed the rest of her colon leaving her with a permanent bag – she moved away from home for the first time to go to Cardiff Metropolitan University.
Amber moved into a house with eight other students.
“It was quite daunting to start, but I am quite open and honest with people about my disease and my bag, so I made sure everyone I lived with was in the know,” she said.
Now in her second year, she lives in a house share with three of the girls who know everything about her illness.
Loving life since her surgery, she has jumped out of a plane, is training for a half marathon, and even does swimwear shoots and is a role model on Instagram for others who need or have an ostomy to break down barriers.
But she still worries about filling up the bin with her used bags, which she changes every day, or has to change if they leak, as they only get one bin collection every two weeks
Amber said it would be really hard if she was not so open about her condition.
“For some people it could pose really big problems, but I have always been honest from day dot with the people I live with, which has made it easier,” she said.
Wayne Lewis, project manager for Crohn’s and Colitis UK in Wales, said the challenges of living with a stoma were different for each person and that more support was needed to help people.
“If you are a student and you are moving away, you are getting to know who you are, you are trying to make new friends, and you don’t want to stand out from the crowd,” he said.
“If you’ve got a stoma and you’ve got to dispose of the waste, that’s a difficult thing at that age to come to terms with sometimes.”
The Welsh Local Government Association (WLGA), which represents local councils, said while arrangements varied across Wales people with medical conditions could contact their council to discuss individual needs.
“Many councils have relaxations or exemptions available to cater for residents with specific medical needs,” a spokesman said.
A Cardiff council spokesman said if anybody living in a shared house was struggling with full bins, they could request a larger one.
“We will then come out to do an assessment to come up with a solution,” a spokesman added.
Free sanitary products will be offered to girls in all primary schools in England from early 2020.
It follows Chancellor Philip Hammond’s announcement last month of funding for free sanitary products in secondary schools and colleges.
Amika George, founder of the #FreePeriods campaign, called the latest move “fantastic news”.
Children and families minister Nadhim Zahawi said: “No-one should be held back from reaching their potential”.
When Mr Hammond made the original announcement in his Spring Statement last month campaigners argued that it should also include primary schools.
“We’re so glad that the government has extended this pledge to primary schools,” said Ms George, 19, a student at Cambridge University.
“Period poverty should never be a barrier to education.”
The next tampon
She said it meant that every student could go to school without “worrying where their next pad or tampon will come from” and could “fully participate in lessons and focus in class”.
Ms George began campaigning two years ago, while still at school, after reading about period poverty in the news.
She described herself at the time as “shocked” to find out girls were missing school because of not having sanitary products.
Girlguiding says its own research has suggested almost a third of 11 to 21-year-old girls and young women have missed school or college because of their period.
Isla, also 19, and a member of Girlguiding’s panel of advocates, called the figures “unacceptable”, adding that “giving primary school girls access to tampons and pads will help break the taboo of periods from a young age”.
A Department for Education spokesman said officials would begin talking to school and college leaders on the quantities of sanitary products likely to be needed from early next year, and how best to deliver them.
He said they were likely to be bought in bulk and distributed locally.
Mr Zahawi added: “After speaking to parents, teachers and pupils, we are now extending this to more than 20,000 primary schools so that every young person in all our schools and colleges gets the support they need.”
- Last year the Scottish government announced a £5.2m scheme to provide free sanitary products in schools, colleges and universities
- And earlier in April the Welsh government announced a £2.3m grant for free sanitary products in all Welsh primary and secondary schools
- Last year a local authority in Northern Ireland announced free sanitary products in some public buildings
Cholesterol-lowering “statin” drugs taken by millions of Britons may not work well enough in about half of those prescribed them, research suggests.
UK investigators looked at 165,000 patients on statins and found that for one in two, the drugs had too little effect on bad cholesterol – one of the big risk factors for heart disease.
They are not sure why statins appear to help some more than others.
Patients should not stop taking the drugs without seeing their doctor.
One possible explanation is patients not taking their prescribed drugs or doctors giving them at too low doses, experts suggest.
Cardiovascular disease kills about 150,000 people in the UK each year.
“Bad” low-density lipoprotein (LDL) cholesterol is a major contributor – it can lead to furring and blockage of blood vessels.
Smoking and obesity
Cutting down on saturated fat can help lower bad cholesterol, but some people will also need medication. Millions of people in the UK are given statins for this reason.
But statins can cause side effects and there is a debate about how many patients should be prescribed them.
The study, published in the journal Heart, included 165,411 patients who had been put on statins to cut their risk of developing heart disease by lowering their cholesterol to a healthy level.
Half of the patients – 84,609 in total – did not see their cholesterol go down by enough – the required 40% or more reduction specified by guidelines – even after being on the daily treatment for two years.
Experts say the study findings are somewhat limited because they cannot prove that patients who do not respond well to statins will necessarily fare worse as a consequence. Other factors – like smoking and obesity – also raise cardiovascular risk.
But the work does provide “real life” data and experience to draw on.
Researcher Dr Stephen Weng, from Nottingham University, said: “Our research has shown that in almost half of patients prescribed statins, they are very effective and offer significant protection against cardiovascular disease.
“However, for the other half – whether it’s due to your genetic make-up, having side effects, sticking to the treatment or other medications – we don’t see that intended benefit.”
In the study, a higher proportion of patients with a sub-optimal response to statins were prescribed lower potency doses, compared with those with an optimal response.
He said: “We have to develop better ways to understand differences between patients and how we can tailor more effective treatment for those millions of patients who are simply blanket-prescribed statins.”
Prof Metin Avkiran, associate medical director at the British Heart Foundation, advised: “Statins are an important and proven treatment for lowering cholesterol and reducing the risk of a potentially fatal heart attack or stroke.
“If you have been prescribed statins, you should continue to take them regularly, as prescribed. If you have any concerns you should discuss your medication with your GP. There are now other drugs available to help lower cholesterol levels, and it may be that another type of medication will be an effective addition or alternative for you.”
Prof Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: “When we prescribe medication, we have to rely on patients to make sure that they take it, both at the recommended dose and for the duration of time that we think will benefit them most.
“There is a substantial body of research showing that statins are safe and effective drugs for most people, and can reduce the risk of heart attacks and stroke, when prescribed appropriately – but controversy remains around their widespread use and their potential side-effects.
“There are complex reasons why patients choose not to take their prescribed medication, and mixed messaging around statins could be one of these.”
There is a growing trend for intravenous “vitamin” drips – but what are the risks? And do they even work?
Last month, a 51-year-old woman from Hunan, China, nearly died after blending 20 different fruits to create a homemade intravenous (IV) drip. She thought vitamins from the fresh fruit would benefit her health.
Instead, she developed a fever and itchiness, and was taken into intensive care with multiple organ damage. After dialysis, and several rounds of antibiotics, she is now recovering.
This is an extreme example, but she may have been inspired by the growing trend for IV in which vitamins and other substances are administered directly into the blood.
The practice is very popular in Asia where IV drips are offered in beauty salons, often by unlicensed and unqualified practitioners.
Those promoting vitamin IV drips claim they can boost energy, strengthen the immune system, improve skin, cure hangovers, burn fat, fight jet lag, and cure a myriad of other minor ailments.
In the US, a bus will even come to your house to offer infusions as part of a party package, to “cure” hangovers.
Treatments can be very expensive, costing anything from £120 to £3,000 in one London clinic.
Celebrities such as Miley Cyrus, Cara Delevingne and Chrissy Teigen have taken part in the growing trend, posting images of themselves on social media hooked up to IV bags.
“The treatments are increasingly popular, particularly as a quick fix or hangover cure – but there is no evidence of benefits and they can potentially be dangerous,” says Marcela Fiuza, from the British Dietetic Association.
“Within a medical setting, we would never infuse anything intravenously, unless we absolutely had to,” says Sophie Medlin, who used to work as a clinical dietitian and as a lecturer in nutrition and dietetics at King’s College London.
“There is simply no medical justification for administering nutrition intravenously in any case other than intestinal failure, because it is so high risk.”
Typically, in a medical setting, a patient who has anything injected intravenously would have a thorough medical history taken.
Infusion of vitamins potentially puts the liver and kidneys under stress, and to go ahead without screening the liver and kidney function first is prohibited by the National Institute for Clinical Excellence (NICE) in the UK.
“That kind of provision is not being taken in most of the clinics I’ve seen practising intravenous vitamin drips,” says Ms Medlin.
What is in the bag of fluid varies around the world. In Taipei, customers can receive a menu to choose what kind of vitamins they want to include.
In New Delhi, customers can pick between drips called “Basic” or “Thirsty” if for hydration, or treatments for skin called “Woke” or “Lit”.
There is even a drip named “Magic Markle” after the Duchess of Sussex. In London, along with detox and beauty drips, one outlet offers mood boosts.
To boost their chances in university entrance exams, high school students in Hubei, China, were photographed hooking themselves up to intravenous vitamin drips.
The image went viral, and the school claimed that the students had volunteered to take amino acids. As the school’s infirmary became too full with the demand, the students took the IVs to the classroom where they could continue to study.
Ms Medlin is shocked by this – she says that IVs should never be administered outside a carefully-controlled clinical environment.
“Any time you put anything into your body intravenously, you’re running the risk of infection from the site where it’s entered your bloodstream,” she says.
And why risk possible infection when our gut is excellent at absorbing the vitamins and minerals we need?
For most people, a healthy balanced diet (and in some cases an oral vitamin supplement) is sufficient to provide all vitamins you need, says Ms Fuiza.
Using IV drips mean that “people could be unknowingly receiving excessive amounts of nutrients which may have health implications, particularly for those having it regularly and people with background health conditions (known or unknown)”, she warns.
Who needs vitamin supplements?
Certain groups at risk of deficiencies should use supplements:
- All pregnant and breastfeeding women should take vitamin D supplements
- Women trying to conceive and women in the first 12 weeks of their pregnancy are recommended to take folic acid supplements, which reduce their child’s risk of neural tube defects such as spina bifida
- People aged 65 and over should take vitamin D supplements
- People with darker skin and people who are not exposed to much sun should take vitamin D supplements
- All children aged six months to five years should be given a supplement containing vitamins A, C and D
- Your doctor may also recommend supplements if you need them for a medical condition
- If you fall outside these groups and buy vitamin pills then the chances are that you will be spending your money on surplus amounts of vitamins you have already gained through your diet
Lisa Rogers, from the World Health Organization, thinks that people are being overzealous in their ingestion of extra vitamins.
“They think that it will give them a certain advantage. People only need vitamins in tiny amounts and only in the case of having a deficiency is it worth considering taking extra supplements,” she says.
Force-feeding vitamins into the veins via a drip could even put people at risk of a potential overdose, warns Ms Medlin.
“IV drips push vitamins into our bloodstream in a force-fed way. We will probably just excrete at least 90% of what’s being infused in, so actually the benefits are very minimal, if any at all, and the risks massively outweigh the benefits,” she says.
Even if no complications arise from injecting the vitamin drips, Ms Medlin says that ultimately, “You are just making very expensive urine. It is literally money down the toilet.”
Listen to The Inquiry: How did we get hooked on vitamins? from BBC World Service on BBC Sounds.