Episode 3 Trust Me, I'm a Doctor

When it comes to our health, it seems everyone has an opinion,

and everyone has an agenda.

But what's the health advice you can really trust?

We're here to weigh up the evidence and use our expertise

to guide you...

Through the contradictions and the confusions.

We do the research no-one else has done.

And put your health at the heart of what we do and ensure you get

the information you need.

We're here when you want to know the latest findings and not

just the latest fads.

I'm Michael Mosley.

In this series I'm joined by a team of doctors.

Together we will cut through the hype, the head lines

and the health claims.

This is: Trust Me, I'm A Doctor.

This time we're in Newcastle, carrying out the most ambitious

experiment we have ever attempted: To find out if turmeric can ever

protect us against cancer.

Also, are fast-acting pain killers worth the extra money?

With a dangerous strain of meningitis on the rise,

how do you protect yourself?

That's when I went anto cardiac arrest.

And when is mindfulness medicine, or mumbo jumbo?

And should we all have a stab at testing our own cholesterol.

But first, welcome to Newcastle, we're here to do a truly

ground breaking experiment with the university to see

if turmeric, a spice commonly used in Indian cooking can help

protect us against cancer.

It's one of the nation's favourite dishes but not one that is generally

thought of as healthy.

But could one of curry's key ingredients contain the secret

to long life and good health?

This is turmeric, in its raw state it looks a little like ginger root

but when you grind it down you get that distinctive yellowy, orange

powder, that is so opulent in South Asian cuisine,

but it is possible

that turmeric is doing something more than just adding flavour

to your food.

There are claims that turmeric can fend off anything from allergies

to depression, even cancer.

But for once there is a hint of evidence behind the claims.

In many countries that cook with turmeric, rates of cancer

are surprisingly low.

So what's going on?

There are at least 200 different compounds in turmeric

but there is one that scientists are interested in.

It gives the spice its colour.

It is called curcumin.

Thousands of scientific papers have been published looking at turmeric

and curcumin in the laboratory, some with promising results.

But far fewer experiments have been done in the real world,

at Dr Anthony Watson of the Newcastle University explains.

There is test tube evidence and there is animal evidence

that shows that turmeric could have an effect on cell

signalling and changes in cells

but the data that shows effects on humans is quite limited.

So the study is not there to point the way?

Exactly.

This is exactly the sort of situation where we on Trust Me,

like to make a difference.

We are going to do a real world experiment.

To test turmeric on our health in a way that has

never been tried before.

We have tracked down leading researchers from across the country,

whose work, we think, could help find the answer.

And we have recruited nearly 100 volunteers.

First, in a true Trust Me style, we have to divide

them into three groups.

One group will be consuming a teaspoon of turmeric a day,

ideally mixed in with their food.

Another lot are going to get a supplement of turmeric, the third

group will have the placebo.

They are going to take their turmeric powder,

supplements or placebo for six weeks.

We are taking blood samples now and we'll do it again at the end.

We are going analyse them using ground breaking techniques

to test two of the big claims made for turmeric,

that it can be good for your immune system and good for cancer.

One of the tests we are taking is an ?oxidative

stress test?.

It is brand new, developed here at Newcastle University.

It gives a measure of how good your blood cells

are at resisting inflammation, therefore a measure also of how

robust your immune system is.

But how to test weather turmeric could really help

protect us from cancer?

We've found a group from University College London,

whose research, we think might help.

Here at UCL, they're doing a test for us that involves

new science and technology, that should reveal for the first

time subtle changes in DNA, associated with cancer risk.

This test is based on a new understanding of how cancer starts

and could have major implications for all of us.

We are finding out about more of this later in the programme.

By bringing out this latest scientific knowledge

to a real world study, we hope to find out once

and for all, whether turmeric really does have genuine health benefits.

Now down the years we have done lots of projects with different

universities and got some really exciting results but this is by far

the most ambitious thing we have ever attempted so finger

crossed we get a result!

Now over to Dr Chris van Tulleken.

Now over to Dr Chris van Tulleken.

Joint pain is something that loads of us worry about as we get older.

Lots of people are turning to supplements.

One of the most popular supplements for joints is gloucosamine.

The idea is that as glucosamine is found naturally in our joints,

taking it as a supplement, may help replace or repair our own joint

tissue as it suffers wear and tear.

Here in the UK we spend nearly ?55 million a year

on glucosamine pills.

They are sold over the counter as a food supplement,

not a medicine, which means that they are less regulated, so,

are we wasting our money?

Firstly, how much glucosamine do these pills contain?

Well to find out we have taken nine brands, easily available in the UK

and brought them to the lab for testing.

We are going to analyse the chemistry to find out

if the products really contain what they say they do.

So what does our test show?

The doctor at the pharmaceutical institute has the results.

We saw that two out of the nine have lesser amounts than expected.

So as much as 30% less.

Really, 30% less?

Is that worrying?

It is worrying in the sense that this pills are not regulated.

They could have any amount of glucosamine in them.

In fact they could even have none at all.

Because of the lack of regulation, we can have no idea how

much our glucosamine pills contain.

We found that pills that could cost you almost ?300 a year,

contain similar amounts of glucosamine as the ones that cost

?9 a year.

Christina has other concerns too.

I have a slightly creeky knee, what advice would you give to me

if I said I want to buy glucosamine?

I would recommend you not to buy it, there is no clinical

evidence it works.

It it's an interesting point.

So your glucosamine supplements may not contain as much glucosamine

as you thought.

But even so, it leaves the question of whether or not they can do

the thing that people buy them for, to make sore joints better.

Countless trials have been done on glucosamine to see

if it helps our joints.

It has been come paired with pain killers and other remedies,

even with placebos, people taking a dummy pill.

But for all the research, there is no definitive answer.

It is an analysis, so pulls the results from thousands

of patients from other studies and the authors were still unable

to show any conclusive benefit from taking glucosamine

but they do go on to say, that patients who take glucosamine

often are convinced of its benefits and it doesn't do them harm.

So what is going on here?

For me, the fact that many trials show that placebo pills are just

as effective as glucosamine might mean in the case of joint pain

taking glucosamine pill, only makes people's joints feel

better as they think it does, it is just a placebo.

So I want to do an experiment.

To help me get this right I have called on a world expert

in osteo-arthritis, Professor Phil conhad been

in osteo-arthritis, Professor Phil Conaghan

from the University of Leeds.

Together we have done a study that we think reveals

the truth about glucosamine.

But Phil thinks it will need a lot of people.

We need about a minimum of 40 patients.

Per arm, so say in 80 patients in total for the study.

80 people with painful knee joints?

No problem.

We divided them into two groups.

The first group will be shown how to do something that is shown

to relieve pain, daily exercises to strengthen muscles and tendons

around the knee.

The other group will be getting a pill to pop every day.

You'll be getting the supplement, that is one pill a day to be

taken in the morning.

We want to see how well the supplement measures up

against the gold standard, exercise.

We have measured the range of movement each has in the knee

joint and they have filled in a form describing their pain levels.

In eight weeks' time, the volunteers come back and fill

out the pain scores.

And then we will find out if there has been an improvement.

Two months after the trial started, the volunteers gather

in Leeds to find out.

Have the exercises or the supplement pills made any difference

to their joints?

I was in the exercise group.

How did it go?

Absolutely fabulous.

I felt much, much, better.

How have the last few weeks gone on the #1u7mentes?

How have the last few weeks gone on the supplement?

Fantastic.

I have almost forgot been the pain.

So you feel like we have cured you?

I feel like a new person.

You do?

I do, yeah.

Thank you all very much for coming.

Are you all looking forward to the results?

ALL SPEAK AT ONCE: Yes.

Phil, start by telling us what happened

to the exercise groups.

OK.

The exercise group, 80% of the people in your group improved

their symptoms by over a third.

So a large number of you really did very well.

Over a third we know from previous studies is the amount we think

is clinically important.

It is the amount you recognise you notice difference

in your symptoms.

So that is 80% of the group.

Then the supplement group, how did they do?

So, 55% of the people in this group also

improved a third or more.

55%/80%.

That's the difference between the groups.

So over half of you did well in this group with the supplement.

So 55% of the supplement group reported a clinically significant

drop in pain.

It's an impressive improvement but what was it they were taking?

We have to come clean with you guys, what you were taking

was a totally inert sugar pill, it was a placebo.

We didn't do it to deceive you, we did it for a good

and important reasons, the result that 55% of you had

a clinically significant improvement in symptoms is surprising.

So the placebo effect has indeed been really strong.

Over half the group felt that got better taking a sugar pill.

This explains the complicated picture around glucosamine.

Many people swear by it but as we have proved,

even sugar pills can make your joints feel better.

Huge studies on thousands of people have shown glucosamine to be no more

effective than our placebo.

The exercise did trump the pills, and that's really encouraging it

The exercise did trump the pills, and that's really encouraging, it

means there is something we can all do to help our joint pain that

is free and works in most of us.

A lot of the pain is coming from the tendons and

the structures around the joint.

If they are unloaded, you reduce the pain.

We see it for knees, or hands, and if there is anybody listening

and they are having trouble getting out of a chair

and undoing a jar, they

are at risk of joint pain because their muscles are weak.

This is the time to look at getting strong.

They have seen the evidence, now they have to do something

for their leg muscles and their arm muscles.

I'm gardening and doing everything I have never done before.

Really it has made so much difference.

I had a colleague at work who had a problem, I suggested he should do

this type of exercise, after two weeks he came back

and said he was fine.

So, you have been spreading the word?

And I feel we have cleared up a lot of the murky evidence around

the pills.

If you are 100% convinced that glucosamine works for you,

then by all mean, keep taking it.

But for most of us, the best evidence says that

you can save your money, which is lucky, given the low levels

of glucosamine we found in some of the pills on the market.

The exercises are free, effective and virtually no side effects.

So if it were me, I would ditch the pills and do a few leg raises.

To see Phil's exercises in detail, go to the Trust Me

I'm a Doctor website.

Painkillers are the most popular over-the-counter medicines you can

buy, but some cost ten times more than others.

So, are they worth it?

Over to Doctor Saleyha Ahsan.

The range of painkillers to buy over-the-counter is huge, and the

choice can be pretty overwhelming.

There are painkillers that come as tablets,

caplets, liquid capsules, painkillers that claim to act

caplets, liquid capsules, painkillers that claim to act

fast or target pain.

Big-name brands and cheaper generic products.

So which should you choose?

You might be tempted into thinking that a higher

price carries with it and increased guarantee of effectiveness.

But is that actually the case?

To find out, I'm going to collect a range of ibuprofen painkillers and

put them to the test.

About half of them are well known brand names, the

big companies that often do the initial drug research and charge

higher prices.

The other half are the modestly priced generic products

made by companies who wait for the patents to run out,

then they simply produced their own version of an

existing medicine.

We've taken a range of branded and generic

products and send them for some laboratory tests.

Head of the pharmaceutics lab at University

College London is Simon Gaisford. The first test is, do they contain

as much ibuprofen as they claim?

So, Simon, what did you find?

So we found that each product contained

ibuprofen, which is the drug designed to reduce pain, and that

each product contained the amount of ibuprofen claimed on the box.

Exactly as it should be.

As licensed medicines in the UK are tightly

regulated by the Medicines and Health Care Products Regulatory

Authority.

The MHRA.

But even if they contain the same stuff, do the

cheaper products really worked just as well?

cheaper products really work just as well?

Our labs did a second set of tests to find out how quickly the

drug was released from the tablets.

A simulation of how quickly the ibuprofen might get into our

bloodstream.

Here are the results for the branded product.

Talk me through this.

So on this axis is the amount of drug that is

dissolving from the tablet into solution as a percentage, and this

axis is time in minutes.

axis is timed in minutes.

We can see when we added the tablet to the

solution most of the product started to release their drug quite quickly.

I think it's important to note that different

products release drugs at

different rates.

The requirement to sell a product on the market is that

after a particular time period, a minimum percentage

of drug has been released.

In this case, after 40 minutes, they all need to be above

75%, and they are.

That is the branded.

How did the generics do?

The generics are shown in blue, branded in red.

We can see there is a degree of variability in the

release rates at the start but again after 40 minutes all the products,

more than 75% of the drug has been released.

Both the generic and branded products released the

majority of the ibuprofen after 40 minutes.

And there's no significant difference between the different

manufacturers products.

So according to our tests, there is no advantage

in paying for more expensive tablets.

The cheaper ones are just as good, and that is, in fact, a

legal requirement here in the.

legal requirement here in the UK.

If I'm a company and I want to develop

a generic version of a product, I have to

demonstrate to the MHRA that

my product is bio-equivalent to the brand leader.

What that means is, the drug which is released from

my generic product reaches the bloodstream

at the same rate as the

brand leader.

But companies use lots of marketing tactics to get us to

part with more cash.

What about the versions claimed to be fast acting?

Some of them work by using a slightly different form of

ibuprofen, so your body can absorb it more quickly.

Others give it to you in solution in a soft capsule.

We put some of these products to the test, too.

Now if we look at the critical points we can see after 20

minutes all of these products have released more than 75% of their

drug.

That's 20 minutes.

As opposed to 40.

We were there before.

The normal release.

We now there.

We arenow there.

Absolutely, so 20 minutes we've got the same

amount of drug released as

the standard release tablets released in 40 minutes.

The claim to be fast acting or express is also

regulated by law in the UK, so again there is no advantage in paying

more.

Cheap express products should work just as quickly as the

expensive brands.

The other way companies can tempted to spend more

The other way companies can tempt you to spend more

is to sell painkillers for different kinds of pain.

For instance, Neurofen sell ibuprofen in all kinds of

packages for all kinds of things.

This suggests there is something different in each box, and they are

often more expensive than the supposedly regular tablets.

The thing is, ibuprofen doesn't target

just one of these things.

It works on everything.

It has an analgesic effect over the entire body.

It does all of these things all at the same

time.

Ibuprofen works because it dampens pain no matter where it is

in the body, so it'll help headaches at the same time as helping back

pain.

That's true of any ibuprofen product regardless of price.

In 2015 and Australian court found that

In 2015 an Australian court found that

Neurofen had misled the public by marketing four products that

claims to target specific types of pain.

Back pain, period pain and headaches.

When, in fact, it was exactly the same medicine in each

box.

In the UK you can also buy supposedly paying specific forms of

Neurofen while some of the different boxes

contain the same form of

ibuprofen.

The advertising standards authority this year cracked down on

one of their adverts.

Neurofen aren't the only company selling

targeted ibuprofen.

Despite the various ways companies try to tempt

you to spend more money, in the UK and EU, you are protected by law,

and can safely buy the cheapest versions on offer.

None of these products can target specific pain,

so there's no point paying any more for a box that suggests it does.

If you're ever in any doubt, always ask

the pharmacist.

The only time it might be worth spending a little bit

more is if you need fast acting pain relief.

Even then, the cheaper generic packets work just as well as

the more expensive brands.

Neurofen told us seven in ten people find

paying specific products help them decide which best meets their needs.

Any Neurofen products with the same active

ingredient, pack size and

formulation have the same recommended retail price.

Their full statement is on our website.

Next, we've invited GP Doctor Zoe Williams

to investigate whether monitoring our own health at home is

worthwhile.

This time, measuring our cholesterol levels.

Cholesterol testing is one of the things that

makes up the NHS health check, essentially that means anyone over

the age of 40 should be checking their cholesterol.

Cholesterol is the type of fat we all have in our

blood, and if we have too much of it, it can

build upon the insides of

build up on the insides of

our blood vessels, increasing the risk heart

disease and stroke.

So we should know our levels, but should

we measure them ourselves?

It's like these are available over-the-counter, so that means you

can check your cholesterol at home.

But are these worth spending our money on and what do our results

mean anyway?

I've found some volunteers willing to put

cholesterol tests to the test.

First, I've invited them to the surgery to take their blood

and put it through the standard test you get

from your GP, then we'll see how this compares

to the results from a

range of home test kits.

The test that we do doesn't actually measure

the amount of cholesterol, it measures the amount of protein that

carries the cholesterol.

That is supposed to give an indication if

you are at increased risk of heart disease or stroke.

The professional test will measure two different

proteins.

LDL carries cholesterol to the cells in the body, and this is

often called bad cholesterol, as you don't want too much of it.

HDL carries cholesterol away from

yourselves to be disposed of in the liver.

This is often called good cholesterol, so higher levels are

better.

Tomorrow we'll be checking the home testing kits to see if they

give as accurate a reading as these samples.

So the volunteers have arrived.

Here we have the kits.

There are several kinds on the market, they all require

a pinprick of blood.

And, as it turns out, it can be difficult to use.

The cheapest kits use your blood sample

and a bit of chemistry to give a result in the form of a coloured

dot.

And some more expensive devices give a digital reading.

But are any of them accurate?

Cholesterol levels don't change dramatically overnight,

so the results should be about the same as the laboratory test from

yesterday that I brought with me.

Three of our kits aren't a good match.

I wouldn't say that's very accurate.

A little bit out, that one.

We'll put that over there.

One of them was the more expensive digital device we tested.

So you have the fancy machine and we were

able to check your total cholesterol, total cholesterol was

out.

One of the simple devices seemed to match the professional

test.

Very accurate.

But perhaps it's not quite as clear-cut it

appeared.

To me, the blood sample is showing a really light grey colour,

but the chart I'm comparing it to is various shades of green.

We are not particularly impressed with the home

test kits, but even if we did get accurate results, what do they mean?

So, the measure we ultimately interested in is the cholesterol

ratio.

The HDL in comparison to the LDL.

The advice is that your HDL levels should be above one and your

LDL levels below three.

Interpreting cholesterol results has always been

controversial but the latest advice is bringing down your LDL levels and

increasing your HDL levels will reduce your risk of heart disease

and stroke.

You can do this through changing what you eat, doing more

exercise and giving up smoking, as well as taking medication such as

statins.

Would our volunteers use the home kits to measure their

cholesterol?

Bearing that in mind, how useful for you at home is the

information from the other kits?

I would prefer to go to a GP to get the test done.

Because I'm not sure how accurate is this one.

I doubt the accuracy of that.

What I'm expecting, because I'm a big foodie,

so I know I like my food, I suspect that my cholesterol cannot be that

low.

As we've seen, the home testing kits are not only difficult to

operate, it's also difficult to interpret the results, so my advice

would be if you are over the age of 40 or in any doubt at all, go see

your doctor and let them test-tube and interpret the results for you.

your doctor and let them test and interpret the results for you.

It'll probably save you some money in the meantime.

Earlier in the programme we started one of the most

ambitious experiments Trust Me has ever done, putting some of the

supposed health benefits of turmeric to the test.

Involves nearly 100 people, over six weeks, with tests

in four labs right across the UK.

One of these tests could have major implications for all of us as it

might provide an early warning system for cancer.

It's been made possible thanks to people like

Caroline, who found out in 2007 she was at increased risk of hereditary

breast and ovarian cancer.

I was put on a screening programme and the

results came back from those that I had shadows on both breasts.

I was absolutely terrified and convinced I

was going to die and that was it, I was going to leave my three children

without a mother.

In 2009 I had a risk reducing bilateral mastectomy

with reconstruction.

From there I had my fourth child in 2013 and

after that I had more risk reducing surgery and had my ovaries and

fallopian tubes removed to lower my risk of ovarian cancer.

Caroline donated tissue samples to a research

group at University College London and their work has recently led to a

breakthrough in how we might identify an individual's risk of

cancer.

It came about thanks to a relatively new understanding of how

changes in our genes can trigger cancer.

But not the changes we once thought.

Over to surgeon Gabriel Weston.

Over the past few decades, our understanding of our genes has

altered dramatically.

And one of the most important thing is we're

learning is that it's not just the DNA we inherit that matters, but

also how those genes are used in our bodies on a daily basis.

The genetic code we inherit is like a colossal

book of instructions for all the difference

cells in our body.

But exactly which part of these instructions any individual cell

reads will make a dramatic difference to what kind of cell it

is and how it behaves.

If I cover at different parts of a sentence, it

If I cover up different parts of a sentence, it

changes its meaning, so an instruction not to do something

becomes an instruction to do something.

In our cells, it turns out that this covering up of parts

of our genetic code, happens all the time.

It's an important way to tell

some of our cells to do

different things from others.

It's called DNA mmethylation.

And now researchers have discovered that

methylation can go wrong and

that can lead to cancer.

It's a whole new branch of being, known as epi- genetics, it is

turning out to be every bit as important as genetics.

Here at UCL, this are trying to work out how to

use it to help us all reduce our cancer risk.

Professor Martin Widschwendter is head of the team

that studied tissue samples from Caroline

and over 70 other women.

They compared cells from women who had

breast cancer, with cells from those who did not.

They found a key change in DNA mmethylation that happens

before a cancer develops.

This DNA methylation signature allows us to

identify women who are getting breast cancer in the future.

How many cancers do you think might have some of this methylation

process at the heart of them?

What has been shown thoroughly, is that

every cancer has a DNA methylation signature,

so this is very good evidence that DNA methylation is a

key trigger for cancer development.

What is so important about DNA methylation is that it can be

changed relatively easily.

We now understand that the things we know can increase your risk of

DNA methylation to a bad or abhorrent

form, crucially, the changes are reversible.

We know that smoking triggers the abhorrent DNA methylation

if you stop smoking it goes back.

So with the brand new understanding, Martin

is developing a test looking for dangerous DNA methylation

patterns in several types of cancer.

We know they are an early warning system,

one that allows people to take action before they develop cancer.

He hopes that the test will be available to the public by 2020.

This could be revolutionary, because if you can predict

the development of a cancer before it happens, you

have the chance to change the factors that enable that cancer to

occur.

It's been estimated for example that ten years after giving

up smoking, your risk of developing lung cancer is comparable to someone

who has never smoked.

Prevention is better than cure, yet experience

tells us we find it difficult to make changes in our lives,

until we are given a personal diagnosis.

As recently as 1981, up to 330,000 people a year

were dying with cardiovascular disease without a

warning.

Then cholesterol and high blood pressure were identified as

a warning sign, so people were able to manage their risk and the death

rates fell by up to 50%.

This new personalised test for assessing cancer risk, that I have

seen being developed here at UCL could hold out a similar promise,

potentially leading to a dramatic reduction in deaths from cancer.

For Caroline, it's an exciting prospect.

I feel very lucky to be part of the research that the team

are doing into risk prediction.

It means that future generations not only of

my family but of other families and the general

public may not have to

have such drastic surgery, they a may not have to remove

healthy body parts.

While some changes we could make to reduce our cancer risk might involve

giving things up, others may involve actively adding something to our

lives.

This is where our turmeric trials are really exciting.

There are some researchers that believe

there is an active ingredient in turmeric that can affect the

methylation of genes.

If this is the case, it could help explain

turmeric's supposed anticancer properties?

But is it true?

By comparing our volunteers' methylation

patterns at the start and end of the trial,

Martin is hoping to find out it will be the first time anyone has

looked in this way at whether or not changing our diet can make a change

to our DNA methylation.

We will find out the result later on in the

programme.

Still to come: Is there a natural alternative to HRT?

And what does practicing mindfulness do to

your brain?

But first, meningitis was in the news earlier this year

because of the tragic death of a two-year-old girl.

But meningitis can strike down anyone at any age

so.

What are the signs we should be looking out for?

Meningitis is an inflamation of the lining of the

brain and spinal chord and can have a range

of different causes.

The most common cause of the infection

is a virus or a bacterium that occurs in the nose and the throat.

One of the most dangerous misconceptions about meningitis is

that it only happens in children, it doesn't!

It can affect anyone at any

age and with great speed.

And the effects can be long-lasting and even

life threatening.

There is a dangerous strain now on the rise and

at this time of year young people leaving

home to start college or

university are especially vulnerable.

So here at London's South Bank university we have set up

our own Trust Me awareness stall to spread the word.

It is on the rise between 18 and 24-year-olds.

Helping us is Sophie who contracted meningitis three years ago.

I didn't really know it could happen to adults.

So when I did contract it

was a big shock.

Can you describe to me your symptoms?

I had vomiting, diarrhoea, dislike of bright lights,

headache...

A stiffness, not feeling well.

Flu-like symptoms, and then the next morning I woke up and I was

violently shaking.

My ends of my fingers had turned a bluish colour,

the ends of my nose and feet there.

There was a rash on my legs spreading up.

Sophie had become dangerously ill.

Her infection spread to her blood which caused sepsis.

She had to have the tips of her fingers and toes

amputated.

Something that could have been prevented if the symptoms had

been recognised sooner.

There are different forms of meningitis but

there is a group of symptoms mainly the same across them all.

Headache, eyes sensitive to light.

Neck stiffness, diarrhoea and vomiting.

Lethargy.

You can get muscular and joint pain and cold hands and feet which may

indicate the beginning of sepsis, which is dangerous.

Another symptom that people know about

commonly is the rash that doesn't disappear when you press a glass

against it but that is actually a late sign so, please don't wait

against it but that is actually a late sign so please don't wait

until that appears to get help, as that could be fatal.

Students are especially at risk as they mix with

lots of new people and the viruses and the bacteria that cause

meningitis are spread in similar ways to the common cold, in

sneezing, and coughing and prolonged close contact like kissing.

A quarter of the age group hash our

the bacteria in the nose and throat but the meningitis occurs when the

bacteria breaks through to invade the body.

Even if the young people don't fall ill themselves, they can

spread the bacteria to the more vulnerable, such as the very young

and the very old.

What is the one thing you would say to people

watching this about meningitis?

I would say it happens very fast.

They need to know the science of the symptoms and if you can to get

vaccinated.

Here at our Trust Me stall, we have medical staff on hand to give

vaccinations to students who have not had one.

Who has had the meningitis vaccine?

No.

No.

Have you had the vaccination?

When we were young.

You have had the little one but there is another one.

There are different vaccinations to prevent

against different strains of

bacteria.

The one now offered to young people protects against four

types, A, C, Y and the most dangerous, MW.

After the exam is done, come and celebrate and get yourself

vaccinated it is not any of the ones you have had before, it's a life

saver.

The aim as well as protecting against the disease is to prevent

spreading amongst other age groups.

Who is going to have it?

I have not had it, so I would like to have it.

Brilliant.

OK.

Another one in the bag.

If you're starting university and have not already had the

vaccination, you should get it as soon as you can.

It's still important to stay vigilant as no

vaccine gives 100% protection.

Remember that meningitis can affect anyone of any age, not just young

people.

Learn to recognise the warning signs of meningitis in case you or someone

you know becomes unwell.

Because recognising the symptoms and getting

early help is so important.

For a list of symptoms check out our website: BBC.co.uk/trustme.

In this series we are taking a close look at some of the so-called

alternative therapies that claim to do things like relieve pain, cure

addiction or improve our mental health.

But do any of them really help?

This time we are looking at mindfulness.

This has become very popular in the UK in recent years.

Fans claim it can be used to help depression, anxiety,

all forms of mental illness that affect one in

four of us.

But how well does it really work?

Now, I must admit I do occasionally practice mindfulness, as

a way of managing stresses in my life.

It's a form of meditation.

What I do is sit somewhere quiet, close my eyes, and then I sort of

breathe slowly in and out.

And the idea is that thoughts and feelings will come and go

but you just allow them to drift off, like

leaves falling into a river.

Mindfulness is about letting go of distracting thoughts and focussing

on the present moment.

The idea is that by teaching us to be more aware

of thoughts and feelings, mindfulness helps us cope with

stress and manage problems like depression and anxiety.

I want to find out what impact mindfulness has

on my brain.

My investigation starts at Liverpool John Moores University in the

laboratory of Dr Peter Melinoski.

He has developed an experiment to see if

the effects of mindfulness are measurable.

What Peter is doing at the moment is applying electrodes to

my head and he's going to be measuring the electrical activity in

my brain.

In a short while I'm going to be looking at some images, some

serene, some of them quite disturbing, so disturbing you are

not allowed to see them.

We will see what it does to my brain, then I

will be allowed to go off and meditate and then repeat the

process, and see if doing so makes any difference to the electrical

activity going on inside my brain.

It should be interesting.

The extreme pictures I am shown should create measurable shock waves

of activity in my brain that Peter can record.

Although I had been forewarned, some of the images are

disturbing and provoke a strong reaction,

which can be seen in the

electrical activity in my brain.

Next, I'm going to practice mindfulness for five minutes and

then I'm going to be shown the images again.

These particular images have been chosen as tests

have shown that they would normally produce

a consistent reaction in the

brain each time they are shown.

But does mindfulness make a difference

to the way my brain responds?

Thank you.

That was quite hard work.

It was also really interesting.

Some of the photographs were very extreme.

When I was doing it the first time I did

wince a lot.

When I did it while I was practicing mindfulness, it felt

more abstract, if you like.

It will be really interesting to see what

the effects on my brain were.

This is while you are just taking in the pictures.

You are not in the state of mindfulness.

With the neutral pictures, the black lines,

there is not a strong response.

With the pleasant pictures, you see a

stronger brain response and for the unpleasant pictures,

the strongest brain response.

Once you induce a state of mindfulness, what we see is

that the three conditions cannot be distinguished anymore.

The brain processes them in the same way.

Isn't this a bad thing, I'm becoming robotic,

I am not longer in touch with my feelings?

If you were only able to be in this state, I would say yes,

but what our data clearly show is that you have

the freedom to engage or not engage.

So it's basically up to you to decide,

now I want to engage in a

mindful way and let neutral positive negative just pass by without

engaging with it or you decide this is something that is important to

me, I engage with it.

And through the practice apparently you have

gained the freedom to do one or the other.

That's very encouraging.

I can be happy.

You should be.

Neutral.

That was impressive, a few minutes of meditation and you could

see a

see a big effect.

But what about the real world, what effect does mindfulness

have an positive mental health?

To find out, I've invited a

specialist from Oxford University to talk me through the recent explosion

of scientific studies on mindfulness.

His name is Professor Willem Kuyken.

Now, you run the mindfulness centre at Oxford, so you have

a

vested interest, don't you, in

talking about effectiveness?

Do you think you can be impartial this

regard?

I'm also a scientist.

I'm a scientist in terms of trying to ask

good important questions using the very best

methodology I can, and

then reporting what I find responsibly.

What's the evidence it's effective, and if so, for what?

So the evidence is strongest in the area I work in,

which is recurring depression.

There have been at least ten randomised controlled trials now

suggesting that mindfulness-based cognitive therapy is an effective

treatment to help people with a long history of depression stay well.

As effective as other active treatments.

How do you think it works?

What happens with recurring depression is very small shards of

experience, thoughts, feelings, can quickly

spiralled downwards.

What mindfulness enables people to do is

to see that happening.

To see that unfolding, to step back and respond

in different and more resilient ways.

What about something like anxiety or insomnia.

With anxiety, I'd say it's much more mixed.

But there is some good, promising

evidence for insomnia.

So there is a huge industry out there from five

maybe ten minute apps, to going on a full

course of say 12 weeks.

Is there any evidence that the short cut stuff is all effective?

There have been some systematic reviews,

metro-analyses, online, web-based mindfulness courses

do lead to less space, best depression, less

do lead to less stress, best depression, less

anxiety.

You cannot reach the population of people who might

benefit from something to offering courses and one-to-one therapy.

The way to reach them is through larger

media, like the Internet, like apps.

What benefit would someone like me get from doing it?

I'm not depressed, I'm occasionally anxious

and I'm occasionally an insomniac.

I think very many of us spend quite a

bit of our time on automatic pilot and we sometimes do and say things

we perhaps regret, I think all of us bring a bit more awareness to our

life, can maybe respond to our life with more wisdom, a little bit more

skilful nest.

skilfulness.

Willem certainly makes a compelling case for mindfulness,

particularly in the context of recurring depression.

So should I try mindfulness?

What I would say is that if you do it, you'll probably

get a lot of benefit, but it's a bit like exercise.

Many people start enthusiastically and then give up.

The real challenge with mindfulness is to find a way to build it into

your life and keep on going.

Some mindfulness -based therapies are

available on the NHS, but they may not be

suitable for everyone, so

take advice from your GP.

While there is some evidence online tools

can be effective, detailed research is still lacking.

You'll find more information on our website.

On our website you can send in the health

questions you'd most like to see answered.

Are there any natural alternatives to HRT?

Over to Gabriel.

Hormone replacement therapy or HRT, is prescribed for women

during the menopause.

Now, this is that time in a woman's life, usually

between the age of 45 and 55, when the body stops producing enough

oestrogen and progesterone to release an egg and the periods come

to an end.

But oestrogen and isn't just important for reproduction, it

also protects us against osteoporosis, and may even have a

role to play in maintaining our mental health.

Having lower levels of these hormones can also cause unpleasant

symptoms that some women suffer for years

before the menopause, and they

can continue for years after periods have stopped.

HRT can help alleviate the symptoms but it's not suitable

for everybody.

In particular, women with a history of breast cancer are

recommended not to use it, because oestrogen stimulates

the growth of breast cells.

Aside from this, there are lots of women who would

simply prefer to try natural remedies.

There are over 200 treatments on offer for symptoms of

the menopause.

Many are heavily marketed supplements, however,

there's very little evidence any of them

are effective, and some have

been found to interfere with the prescribed medication or nasty

side-effects.

Some of the most popular remedies are ones to be wary

of.

Evening primrose oil can interfere with other drugs for blood

pressure, cancer and diabetes.

Ginseng can cause bleeding and breast pain.

High doses of vitamin each may give you stomach cramp,

High doses of vitamin E may give you stomach cramp,

blurred vision and even an increased risk of stroke.

Black Cohosh might reduce hot flushes and night sweats,

but there is a risk of damage to the liver.

And St John's Wort might

improve mood, but interacts with many medications.

And remember, if you buy herbal supplements, always make

sure you look for that THR mark which ensures the product complies

with the quality and safety standards.

But there are some cheaper and possibly more effective

things than these you can try.

One of these is soy.

There's some research that suggests that

particular foods might have a

beneficial effect.

One of these is soy.

It's rich natural substances called isoflavones, that behave

similarly to oestrogen in our bodies.

Isoflavones can also be found in tofu, soy beans and soy

milk and fermented soy bean miso paste.

But not in soy sauce.

Studies have shown that in Asia, where women eat about ten times more

soy than women in the West, the symptoms of menopause, such as hot

flushes, tend to be far less severe.

Another good source of isoflavones is flaxseed.

More research is needed, but it's thought soy or flax

might help in about a third of Western women and that unlike HRT,

it doesn't carry any increased risk of breast cancer.

There are alternatives for HRT and one of them

might work for you, but this is my basic advice.

Before taking any new supplement, do talk to your GP.

Do your best to get as much exercise and rest as possible.

And consider adding soy or flax seeds to your

diet.

They are not going to harm you, they might help, and they are

definitely tasty.

In a Newcastle, are ambitious trial to test if

turmeric affects our health has come to an end.

Of nearly 100 participants, a third have been

taking turmeric powder for six weeks, a third the same amount of

turmeric as a supplement and the third a placebo pill.

And they've had mixed experiences.

I took turmeric powder.

Awful.

It's not normally part of my diet.

When I first started cooking with it I was

quite surprised what the taste was like.

We've brought together researchers working together at the

forefront of their fields to help us find out whether turmeric really can

reduce immune system problems like allergies or even help

protect us from cancer.

First up, the test that Newcastle University developed to

assess the health of their immune systems.

Doctor Anthony Watson, and

Doctor Kirsten Brandt, are here to present results.

And they've found that stress on everyone's immune

system increased over the six weeks.

It was no difference whether you were taking the white

capsules with the placebo or the brown ones with

the real turmeric, or you are cooking with it.

There wasn't any difference between the placebo group

and the group who were...

Cooking with this stuff?

Yes.

The fact everyone's immune system became a

little more stressed could be because the weather became sunnier

during the trial, something known to affect immunity.

But the fact the placebo group changed as much as the

other two shows it wasn't the turmeric making the difference.

Next to the test we did looking at

changes in the methylation of their DNA.

This brand-new test developed by University College London has

never been used in a study like this before.

Professor Martin Widschwendter shares the results for

the three groups.

What did you find?

We didn't find any changes in the placebo

group between before and

after six weeks.

The supplements group didn't show any

difference, but the powder group definitely showed quite substantial

differences between the pre-and post-turmeric exposure.

Interesting.

Placebo no effect, supplements no effect, but turmeric

powder definitely an effect.

Yes, that was really, really quite exciting, to be

honest.

And we found one particular gene which showed the

biggest difference and what we know is that this gene is involved in

three specific diseases.

One is depression and anxiety.

OK.

One is asthma and eczema and the third is cancer.

Quite interestingly, and this is really

striking, is that those are

the three entities, that we know turmeric is affecting in a positive

way.

That is very impressive, isn't it.

Do you like turmeric?

I'm sure I would!

This is a really significant change in a gene associated with

conditions that turmeric has been rumoured to improve.

It is something that has never been seen before and it is an exciting

finding and it happened after only six weeks.

But why did we see a

change only in those cooking with turmeric?

Not those taking it as a

supplement.

Dr Kirsten Brandt explains.

So the food with the turmeric in it is somehow making a difference it

could be that the way we are cooking, adding fats,

heating it up, so it is becoming more soluble, that

might make it easier tor us to take up the turmeric, that inspires us to

might make it easier for us to take up the turmeric, that inspires us to

say, we should probably use more turmeric in our cooking that then we

did before!

Many things can effect how much of a substance we absorb in

our bodies, it seems that in the case of turmeric, the good stuff

might only get into our blood when it is combined with other foods,

These results have changed our volunteer's opinion of

the spice.

The results surprised me that the natural form was the best

one but probably is a bit obvious, when you

think about it, having a natural one, rather

than having it put in a

capsule.

Whether I can have it as much in as high a dose under normal

circumstances, I don't know but yes, I will certainly keep using it.

I think I might add turmeric to my food!

Our experiment has been a

resounding success.

We've been able to show that cooking with turmeric

can affect our bodies at the level of gene, and inparticular,

the gene linked to cancer and other ills ins,

the gene linked to cancer and other illnesses,

in doing so, with have turned researcher's new understanding of

DNA mmethylation to a practical benefit.

DNA methylation to a practical benefit.

Now that was the most ambitious experiment we have ever

attempted on Trust Me.

I thought that the results were absolutely

fascinating.

We have shown, for what I think is the first time, what a

small change in our diet can alter the methylation of the genes, which

in turn we know is associated with your risk of cancer.

And the great thing is that the techniques used in

this test could be used to taste a whole range of other

things, not just turmeric.

It's a fantastic way to end this series of Trust Me but

don't worry, we will be back.

In the meantime why not visit our website, where you can

volunteer for experiments and find out more

the things we have done in

this series.