Episode 2

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0:00:04 > 0:00:08When it comes to our health, it seems everyone has an opinion

0:00:08 > 0:00:10and everyone has an agenda.

0:00:10 > 0:00:13But what's the health advice you can really trust?

0:00:16 > 0:00:22We're here to weigh up the evidence and use our expertise to guide you

0:00:22 > 0:00:25through the contradictions and the confusions.

0:00:28 > 0:00:31We do the research no-one else has done.

0:00:32 > 0:00:36And put your health at the heart of what we do.

0:00:36 > 0:00:39We listen to the questions you want answered.

0:00:43 > 0:00:46And ensure you get the information you need.

0:00:51 > 0:00:54We're here when you want to know the latest findings,

0:00:54 > 0:00:56and not just the latest fads.

0:00:58 > 0:01:00I'm Michael Mosley.

0:01:00 > 0:01:04In this series I'm joined by a team of doctors.

0:01:04 > 0:01:06Together, we'll cut through the hype,

0:01:06 > 0:01:09the headlines and the health claims.

0:01:09 > 0:01:11This is Trust Me, I'm a Doctor.

0:01:18 > 0:01:19Welcome to Walsall.

0:01:19 > 0:01:23We're here to do what I hope will be a series of fascinating experiments,

0:01:23 > 0:01:27to see what, if anything, you can do to boost your metabolism.

0:01:28 > 0:01:33We'll also investigate the toxic chemical lurking in your rice.

0:01:33 > 0:01:34And what you can do about it.

0:01:34 > 0:01:37I have absolutely no idea where you're going with this

0:01:37 > 0:01:39but I like surprises!

0:01:39 > 0:01:42We'll reveal how to deal with cold sores,

0:01:42 > 0:01:45and exciting new treatments for eczema,

0:01:45 > 0:01:49and how air pollution is really affecting our health.

0:01:49 > 0:01:51I don't think that enough people are aware of

0:01:51 > 0:01:54the scale of the problem.

0:01:54 > 0:01:57And should you go heavy or light at the gym?

0:01:57 > 0:01:59We'll find out.

0:02:00 > 0:02:04But first, it's over to GP Dr Zoe Williams.

0:02:06 > 0:02:09When it comes to burning calories, we tend to think of exercise,

0:02:09 > 0:02:15but actually, between 40 and 70% of our energy is spent not on exercise,

0:02:15 > 0:02:17but on simply keeping us alive.

0:02:19 > 0:02:22There are countless processes going on inside our bodies just to keep

0:02:22 > 0:02:23them ticking over.

0:02:25 > 0:02:28From the blood pumping around our bodies, to our heart beating,

0:02:28 > 0:02:30breathing and even thinking,

0:02:30 > 0:02:33and the minimum amount of energy to keep all of that going is called our

0:02:33 > 0:02:36resting metabolic rate.

0:02:37 > 0:02:40The higher this rate, the faster your metabolism,

0:02:40 > 0:02:43and the more calories you burn. So can we give it a boost?

0:02:44 > 0:02:49The media is full of quick fixes that claim to help us do just that.

0:02:49 > 0:02:51But is it really possible?

0:02:54 > 0:02:58To find out, we've recruited 28 volunteers who are going to put some

0:02:58 > 0:03:00popular methods to the test.

0:03:01 > 0:03:06First, we're taking some baseline measurements to establish their resting metabolic rate

0:03:06 > 0:03:08before they start the experiment.

0:03:08 > 0:03:12This is measured accurately using these masks, which detect the amount

0:03:12 > 0:03:14of oxygen and carbon dioxide in their breath.

0:03:16 > 0:03:19Dr Ian Lahart from the University of Wolverhampton can tell me what

0:03:19 > 0:03:20might affect their readings.

0:03:22 > 0:03:27There will be slight variations due to somebody's age, gender,

0:03:27 > 0:03:31genetic factors, body size - such as having more muscle.

0:03:31 > 0:03:35Somebody with more muscle will have a higher resting metabolic rate.

0:03:37 > 0:03:41Muscle tissue needs a lot of energy just to maintain it.

0:03:41 > 0:03:42More than fat tissue does.

0:03:43 > 0:03:46So one of the key things affecting our metabolic rate is the amount of

0:03:46 > 0:03:48muscle and fat in our bodies.

0:03:50 > 0:03:52We'll be measuring our volunteers' muscle mass and body fat with a

0:03:52 > 0:03:54DEXA scanner.

0:03:56 > 0:04:00Now, we're going to split our volunteers into three groups,

0:04:00 > 0:04:03who will each try one of the most popular methods claiming to boost

0:04:03 > 0:04:04your metabolism.

0:04:04 > 0:04:08All three methods we'll test are cheap and easy,

0:04:08 > 0:04:12and all have some basis in science to suggest why they might work.

0:04:12 > 0:04:17These are simple, small changes that anybody can do, that over time,

0:04:17 > 0:04:19can make a big impact.

0:04:21 > 0:04:24Our first group are going to be drinking a litre of water,

0:04:24 > 0:04:27chilled to 5 degrees, every day.

0:04:27 > 0:04:31The theory is they'll use up extra energy heating the cold water to

0:04:31 > 0:04:32body temperature.

0:04:34 > 0:04:36Our second group will try green tea,

0:04:36 > 0:04:40this contains natural chemicals called catechin polyphenols,

0:04:40 > 0:04:43that it's claimed can raise our metabolic rate and tell our bodies

0:04:43 > 0:04:44to burn more fat.

0:04:45 > 0:04:49Our final group are going to be doing resistance exercises totalling

0:04:49 > 0:04:51one hour each week.

0:04:51 > 0:04:54This should help them build some new muscle.

0:04:54 > 0:04:58Our volunteers will be doing their tasks for eight weeks,

0:04:58 > 0:04:59and at the end of that time,

0:04:59 > 0:05:01will repeat all the same tests to see if

0:05:01 > 0:05:04we can find any changes in their metabolism.

0:05:05 > 0:05:08Because our experiment is a relatively short period of time,

0:05:08 > 0:05:11are we actually going to see any change?

0:05:11 > 0:05:15We might see small changes in resting energy expenditure.

0:05:15 > 0:05:19And the point being that if we can accumulate those small changes

0:05:19 > 0:05:21over a longer period of time,

0:05:21 > 0:05:24that can make a real difference in somebody's weight.

0:05:24 > 0:05:27We'll be back later in the programme for the results.

0:05:36 > 0:05:39Now, whether you're a gym junkie or a first-timer,

0:05:39 > 0:05:42the weights end of the training room can be intimidating.

0:05:42 > 0:05:45What should we be lifting?

0:05:45 > 0:05:47Over to Doctor Chris van Tulleken,

0:05:47 > 0:05:48who has the latest research.

0:05:50 > 0:05:52The problem that lots of us have with lifting weights,

0:05:52 > 0:05:55is that there's so much conflicting advice out there

0:05:55 > 0:05:58about exactly how much weight to lift.

0:05:58 > 0:06:02So there's an old weightlifting adage, that goes, "Go heavy...

0:06:02 > 0:06:04"or go home."

0:06:04 > 0:06:06But recent headline suggests that in fact,

0:06:06 > 0:06:09lifting lighter weights might be just as effective.

0:06:09 > 0:06:10So what's the truth?

0:06:12 > 0:06:16The answer comes from a study published last year

0:06:16 > 0:06:18from McMaster University in Canada.

0:06:18 > 0:06:2149 weight trainers were split into two groups,

0:06:21 > 0:06:25one half lifting heavy weights, and the other lighter ones.

0:06:25 > 0:06:28The other key difference was the number of repetitions, or reps,

0:06:28 > 0:06:31each group performed.

0:06:31 > 0:06:35Now, when we lift weights, sooner or later, no matter how heavy

0:06:35 > 0:06:39they are, we reach a point where we just can't lift...any more.

0:06:40 > 0:06:42And that's known as failure.

0:06:49 > 0:06:52But it's not a judgment on your level of effort.

0:06:52 > 0:06:56Technically speaking, failure is to do with motor units,

0:06:56 > 0:07:01groups of muscle fibres controlled by a nerve that make our muscles contract.

0:07:01 > 0:07:04When we lift weights, lots of motor units are activated,

0:07:04 > 0:07:07and as they get tired, more need to be used.

0:07:07 > 0:07:10Eventually, all our motor units become exhausted,

0:07:10 > 0:07:12and that's when we can't lift any more.

0:07:15 > 0:07:16Now, with heavy weights,

0:07:16 > 0:07:19you might reach failure after just a few reps,

0:07:19 > 0:07:21with lighter weights, you'll still get there,

0:07:21 > 0:07:25it just might take a bit longer.

0:07:25 > 0:07:27The key thing about the McMaster study

0:07:27 > 0:07:29was that because both groups lifted to

0:07:29 > 0:07:31the point of failure, they could be compared.

0:07:36 > 0:07:39So, the team found that the group using the lighter weights actually

0:07:39 > 0:07:43gained as much strength as the heavier-weight group.

0:07:43 > 0:07:47Now, this doesn't mean that you always need to lift to failure.

0:07:47 > 0:07:51For most of us, the crucial thing is that you do need to push your

0:07:51 > 0:07:53muscles a little bit beyond what's easy.

0:07:53 > 0:07:55If you want to use a lighter weight that's fine,

0:07:55 > 0:07:58but you're going to have to do more reps.

0:07:58 > 0:08:01The important thing is to have a training programme that's safe.

0:08:01 > 0:08:04So if you haven't done weights before, make sure you take instruction from

0:08:04 > 0:08:08a suitably qualified person.

0:08:08 > 0:08:11And if you're going to go really heavy, make sure you get medical

0:08:11 > 0:08:14advice before you start.

0:08:14 > 0:08:15So for most of us,

0:08:15 > 0:08:18unless you're going to be a bodybuilder or a power-lifter,

0:08:18 > 0:08:21don't worry too much about weights versus reps.

0:08:21 > 0:08:25The important thing is just to push yourself a little bit out of

0:08:25 > 0:08:27your comfort zone.

0:08:37 > 0:08:40In the UK we are eating more rice than ever.

0:08:40 > 0:08:43In fact, we now eat at least four times more rice

0:08:43 > 0:08:46and rice products than we did

0:08:46 > 0:08:5040 years ago. And many of us do so because of their healthy reputation.

0:08:51 > 0:08:55But at the same time, I've also noticed lots of newspaper reports

0:08:55 > 0:09:00which suggest that rice has quite high levels of arsenic in it.

0:09:00 > 0:09:03So, is this something I should be worried about,

0:09:03 > 0:09:05or is it just another scare story?

0:09:05 > 0:09:07I'd love to find out.

0:09:09 > 0:09:11Arsenic is well known as a poison,

0:09:11 > 0:09:15but most of us don't realise it occurs naturally in soil and water.

0:09:15 > 0:09:18So tiny amounts can get into food.

0:09:18 > 0:09:20Levels tend to be higher in rice

0:09:20 > 0:09:22because it's grown under flooded conditions.

0:09:22 > 0:09:26Last year, the EU brought in new regulations on the levels

0:09:26 > 0:09:28allowed in rice products.

0:09:29 > 0:09:33I'm meeting Professor Andy Meharg at Queens University, Belfast,

0:09:33 > 0:09:37who's been researching the subject for nearly 20 years.

0:09:37 > 0:09:40I must admit, Andy, it had never ever occurred to me that there was

0:09:40 > 0:09:42arsenic in rice.

0:09:42 > 0:09:44And does it matter?

0:09:44 > 0:09:48I mean, the doses you find it in, does it really affect your health?

0:09:48 > 0:09:53Totally. We know that low levels of chronic exposure to arsenic causes a

0:09:53 > 0:09:55wide range of disease.

0:09:55 > 0:09:57And over a lifetime exposure,

0:09:57 > 0:10:00it leads to increased risks of cancer.

0:10:00 > 0:10:04We know that if you have low levels of exposure during infancy it causes

0:10:04 > 0:10:07a range of other developmental problems.

0:10:07 > 0:10:12- What sort of things?- Immune development, growth rate,

0:10:12 > 0:10:15IQ development - are all linked to arsenic exposure.

0:10:17 > 0:10:20Andy has tested levels of arsenic in different types of rice,

0:10:20 > 0:10:23and compared them with other cereal crops.

0:10:23 > 0:10:28He found that white basmati rice has five times as much arsenic as wheat

0:10:28 > 0:10:32or barley. Other white rice typically has ten times the amount,

0:10:32 > 0:10:35and brown rice, 20 times.

0:10:36 > 0:10:40These levels are all below the new legal limit set in Europe,

0:10:40 > 0:10:43but Andy is still concerned.

0:10:43 > 0:10:46All they've done is set them at levels which are typically found

0:10:46 > 0:10:50in rice. They've done nothing to make rice growers,

0:10:50 > 0:10:54or rice food manufacturers do anything about it.

0:10:54 > 0:10:58And I would argue very strongly that it's not fine to have those levels.

0:10:59 > 0:11:03The UN Food and Agricultural Organisation, who advise on

0:11:03 > 0:11:05acceptable limits, said levels need to be low enough

0:11:05 > 0:11:07to protect public health,

0:11:07 > 0:11:10but still allow sufficient trade and availability of rice in the

0:11:10 > 0:11:14developing world. Their full statement is on our website.

0:11:15 > 0:11:19Another concern Andy has is with rice products like rice crackers,

0:11:19 > 0:11:25rice cereals, and baby rice - which is many babies' first food.

0:11:25 > 0:11:26Rice has become very popular,

0:11:26 > 0:11:29it's given to young children because it's supposed to be healthy.

0:11:29 > 0:11:31And you're saying it's pretty unhealthy?

0:11:31 > 0:11:35I would not want to be giving my child high amounts of rice,

0:11:35 > 0:11:37because of the arsenic content.

0:11:37 > 0:11:41The legal limits for arsenic in children's rice products, like baby

0:11:41 > 0:11:44rice, are set at half the adult amount.

0:11:44 > 0:11:48But puffed rice cereals don't have to meet the child requirements,

0:11:48 > 0:11:52because they are deemed as not being directly marketed at children.

0:11:53 > 0:11:57The Food Standards Agency also advises that children under

0:11:57 > 0:12:00four-and-a-half should not be given rice drinks,

0:12:00 > 0:12:02as these too contain arsenic.

0:12:02 > 0:12:05But while some manufacturers put this on their packaging,

0:12:05 > 0:12:09there is no legal obligation to do so.

0:12:09 > 0:12:13What about someone like me, I like rice, I like basmati rice, you know,

0:12:13 > 0:12:14I have it a couple of times a week.

0:12:14 > 0:12:17Your actual exposure is relatively low, but there's many people,

0:12:17 > 0:12:19for many different reasons,

0:12:19 > 0:12:22taking two, three, four bowls of rice per day, or equivalent to that in rice products.

0:12:22 > 0:12:26And if I was doing that day in, day out,

0:12:26 > 0:12:30I certainly would be highly concerned about my arsenic intake.

0:12:30 > 0:12:33So is there anything we can do when we're cooking rice at home to reduce

0:12:33 > 0:12:34the amount of arsenic?

0:12:34 > 0:12:39Andy's brought me to the university kitchens to try an experiment.

0:12:40 > 0:12:42So, Michael, tell me how you normally cook your rice?

0:12:42 > 0:12:44OK, so I get the rice.

0:12:44 > 0:12:47Occasionally wash it, normally I don't bother.

0:12:47 > 0:12:52Add some water, so that's probably slightly less than twice as much

0:12:52 > 0:12:57water as there is rice. Cook it until all the water is absorbed.

0:12:57 > 0:13:03Letting all the cooking water absorb into the rice is also the way most rice cookers work.

0:13:03 > 0:13:06Andy's method is very different.

0:13:06 > 0:13:08He is cooking with a lot more water.

0:13:08 > 0:13:10Five times as much water as rice.

0:13:10 > 0:13:12Give it a pre-rinse first.

0:13:12 > 0:13:15In Southeast Asia, this is how people used to cook rice.

0:13:15 > 0:13:17OK.

0:13:17 > 0:13:21But we're also trying a third method, Andy has soaked this rice overnight.

0:13:23 > 0:13:25He drains it, rinses,

0:13:25 > 0:13:30and cooks it. Again using five times more water than rice.

0:13:30 > 0:13:32That's probably a bit more fluffy.

0:13:32 > 0:13:34Not a huge amount in it.

0:13:34 > 0:13:37More importantly, did the different cooking methods change

0:13:37 > 0:13:39the levels of arsenic?

0:13:40 > 0:13:43In my rice, nearly all the arsenic remained.

0:13:44 > 0:13:46Whereas in Andy's method,

0:13:46 > 0:13:49just 43% of the arsenic was still in the rice.

0:13:51 > 0:13:54But when the rice had been soaked overnight, incredibly,

0:13:54 > 0:13:56less than 20% of the arsenic was left.

0:13:57 > 0:14:01In all the cooking methods, arsenic escaped into the water.

0:14:01 > 0:14:04In my method, the rice reabsorbed almost all the water,

0:14:04 > 0:14:07and all the arsenic it contained.

0:14:07 > 0:14:11Using Andy's method, more water, and therefore more arsenic,

0:14:11 > 0:14:13were poured away.

0:14:13 > 0:14:16But soaking the rice first is even better,

0:14:16 > 0:14:20because this opens up the structure of the grains, allowing more arsenic

0:14:20 > 0:14:21to escape into the cooking water.

0:14:23 > 0:14:26What I love about this, is it tastes better, it looks better,

0:14:26 > 0:14:29there's no chance you're going to burn it,

0:14:29 > 0:14:31which is what I do an awful lot of the time anyway.

0:14:31 > 0:14:33And it has only a fraction of the arsenic.

0:14:33 > 0:14:35- Yes.- That's cool. I'm impressed.

0:14:35 > 0:14:37Thank you.

0:14:39 > 0:14:44I was really surprised by how much difference it made to

0:14:44 > 0:14:47the arsenic levels in rice when you cook it different ways,

0:14:47 > 0:14:49particularly if you pre-soak it.

0:14:49 > 0:14:52I'm certainly going to give that a go.

0:14:52 > 0:14:55Now, if you are concerned about the amount of arsenic in the food you're

0:14:55 > 0:14:57eating, particularly if you have young children,

0:14:57 > 0:15:01then do visit our website for more information.

0:15:07 > 0:15:09SNEEZE

0:15:09 > 0:15:12On our website, you can ask the health questions you've

0:15:12 > 0:15:14always wanted answered.

0:15:17 > 0:15:21I would like to ask the team if they could give any advice or tips on

0:15:21 > 0:15:23staying healthy as a night-shift worker?

0:15:25 > 0:15:28One for regular shift worker Dr Saleyha Ahsan,

0:15:28 > 0:15:32who's off to New Covent Garden Market as the night shift ends.

0:15:34 > 0:15:39In the UK, it's estimated that about one in six working adults do shift work.

0:15:39 > 0:15:42It's not a healthy lifestyle, really.

0:15:42 > 0:15:45It's almost a jet-lagged type of existence.

0:15:45 > 0:15:48It kills you. It takes years off you.

0:15:48 > 0:15:49Shift work is bad for us,

0:15:49 > 0:15:53because it plays havoc with what we crudely call our body clock.

0:15:53 > 0:15:57Which is actually a delicately balanced system.

0:15:57 > 0:16:00We've recently started to understand that it's a lot more complex than

0:16:00 > 0:16:05we previously thought, because we don't just have one body clock,

0:16:05 > 0:16:07we have loads.

0:16:08 > 0:16:11We have them in our stomach,

0:16:11 > 0:16:13our gut, our liver, and even our muscles.

0:16:13 > 0:16:15All of them are influenced by one

0:16:15 > 0:16:17master clock in our brain,

0:16:17 > 0:16:20which works to keep everything in sync.

0:16:20 > 0:16:24But working shifts with unnatural rhythms of activity and rest,

0:16:24 > 0:16:27knocks all of these clocks out of sync.

0:16:27 > 0:16:31And research has linked shift work to weight gain, diabetes,

0:16:31 > 0:16:33and heart disease.

0:16:33 > 0:16:35So is there a way to minimise the damage?

0:16:36 > 0:16:38There's no simple answer,

0:16:38 > 0:16:41and you might need to try a few different things until you work out

0:16:41 > 0:16:43what's right for you.

0:16:43 > 0:16:46But there are a few key things that researchers agree on.

0:16:46 > 0:16:49So we've come up with a Trust Me guide.

0:16:50 > 0:16:54The key is finding ways to keep the clocks in time, even when you're

0:16:54 > 0:16:58working through the night, and the first problem is sleeping.

0:17:00 > 0:17:03I don't get copious amounts of sleep, so I'm tired quite a lot.

0:17:03 > 0:17:05Sleep when you can. You do.

0:17:05 > 0:17:09I've got two kids and I'm married, so you sleep when you can.

0:17:09 > 0:17:12We all need around seven solid hours of sleep,

0:17:12 > 0:17:14but many shift workers struggle to get this.

0:17:14 > 0:17:17A big problem is light.

0:17:17 > 0:17:20From dawn till midday, daylight is mostly blue.

0:17:20 > 0:17:24And blue light is known to stimulate our brain, which wakes us up,

0:17:24 > 0:17:28and can make it difficult to get to sleep after a night shift.

0:17:28 > 0:17:30So what can you do about it?

0:17:31 > 0:17:35One solution is to wear sunglasses like these.

0:17:35 > 0:17:40The lenses have an orange-coloured filter which blocks out blue light.

0:17:42 > 0:17:47In fact, wearing any good sunglasses on your way home from a shift can help.

0:17:47 > 0:17:51And wear an eye mask while sleeping through the day, to block out light

0:17:51 > 0:17:53and help you get your seven hours.

0:17:53 > 0:17:56The next problem, eating correctly.

0:17:56 > 0:17:59You don't normally have your breakfast, lunch and dinner.

0:17:59 > 0:18:00You just eat when you can.

0:18:02 > 0:18:04The evidence for the best time

0:18:04 > 0:18:07for shift workers to eat really varies.

0:18:07 > 0:18:09But researchers suggest that you should try

0:18:09 > 0:18:11to stick as closely as possible

0:18:11 > 0:18:14to your normal eating pattern that you have during the day.

0:18:16 > 0:18:20In fact, some researchers advise avoiding food altogether between

0:18:20 > 0:18:21midnight and 6am.

0:18:22 > 0:18:26The reason for this is our blood sugar and fat levels are higher at

0:18:26 > 0:18:30night, and eating more at this time can push them to levels that can be

0:18:30 > 0:18:31bad for our health.

0:18:33 > 0:18:38So if you do need to eat during the night, pick lean meat, fish, nuts,

0:18:38 > 0:18:40seeds, fruit and veg.

0:18:40 > 0:18:44And to help maintain your body's natural rhythm, have a light meal

0:18:44 > 0:18:47when you get home, while most people are eating breakfast.

0:18:49 > 0:18:51And the final problem, exercise.

0:18:52 > 0:18:55This is important for us all,

0:18:55 > 0:18:58but it can be difficult to fit in when you work shifts.

0:18:58 > 0:19:02And doing it at the wrong time can disrupt your body clock.

0:19:02 > 0:19:07Exercise increases alertness, so the best advice is to do it before work,

0:19:07 > 0:19:10and not when you're heading home to bed.

0:19:10 > 0:19:13Many of us can't help having to work shifts.

0:19:13 > 0:19:15Me included.

0:19:15 > 0:19:19But research is revealing more about the health risks,

0:19:19 > 0:19:21and what we can do about them.

0:19:21 > 0:19:26The key is to work with our body clocks, and not against them.

0:19:26 > 0:19:30Do that, and you could live a healthier life, despite your work patterns.

0:19:40 > 0:19:44We are running a big experiment in Walsall to test three different ways

0:19:44 > 0:19:48that it's claimed can boost your metabolism.

0:19:48 > 0:19:52I feel a lot more alert, I feel like I want to do more things and not doze off to sleep.

0:19:52 > 0:19:56We will find out later on in the programme whether any of our methods

0:19:56 > 0:19:57have worked, but in the meantime,

0:19:57 > 0:19:59we're going to take a look into

0:19:59 > 0:20:01another aspect of our metabolism that many of you

0:20:01 > 0:20:03have told us you are concerned about.

0:20:05 > 0:20:08On Trust Me, we get a lot of questions about the thyroid.

0:20:08 > 0:20:11This is a gland in your neck that produces hormones which regulate

0:20:11 > 0:20:14your metabolism, and is vital for your health.

0:20:14 > 0:20:17The thing is, there is a lot of controversy about the treatment and

0:20:17 > 0:20:21diagnosis of issues related to the thyroid.

0:20:21 > 0:20:23So how do you know if you have got a problem

0:20:23 > 0:20:24and what can you do about it?

0:20:26 > 0:20:29We have had so many people write to us worried they might have thyroid

0:20:29 > 0:20:33problems, that I have done something that is a first on Trust Me.

0:20:33 > 0:20:37I have set out to investigate this particular illness myself.

0:20:38 > 0:20:42The thyroid gland is a bit like the accelerator pedal on your car.

0:20:42 > 0:20:47It produces hormones that speed your metabolic rate right up.

0:20:47 > 0:20:51If that doesn't happen, then your metabolic rate will slow right down.

0:20:51 > 0:20:54MUSIC: Down Down by Status Quo

0:20:54 > 0:20:56MUSIC WINDS DOWN

0:20:56 > 0:20:58And it is a finely tuned machine.

0:20:58 > 0:21:02First, your body needs to produce what is called

0:21:02 > 0:21:04thyroid-stimulating hormone or TSH,

0:21:04 > 0:21:07which tells your thyroid to get working.

0:21:07 > 0:21:10Next, your thyroid releases hormones into the blood.

0:21:10 > 0:21:13Mainly one called T4.

0:21:13 > 0:21:18Later, T4 is converted in our tissues to T3.

0:21:18 > 0:21:21The active hormone that revs up our metabolism in our cells.

0:21:23 > 0:21:26But sometimes, the thyroid doesn't produce enough hormones.

0:21:26 > 0:21:29This is known as hypothyroidism.

0:21:29 > 0:21:32The result is normally a slower metabolism.

0:21:32 > 0:21:36Now, it affects around one in 1,000 men, but it is more common in women,

0:21:36 > 0:21:38affecting around one in 50.

0:21:39 > 0:21:43Sufferers put on weight and have other common symptoms,

0:21:43 > 0:21:45as Jo Parker experienced.

0:21:45 > 0:21:48The most prominent symptoms where the fatigue and the cold.

0:21:48 > 0:21:51Other symptoms were hair loss,

0:21:51 > 0:21:53migraines five days a week, low mood.

0:21:53 > 0:21:56I wouldn't say clinical depression, but low mood.

0:21:58 > 0:22:01Jo's symptoms were caused by an underactive thyroid,

0:22:01 > 0:22:03but getting it diagnosed was a struggle.

0:22:04 > 0:22:08And there are thousands more women in the UK with symptoms like Jo's,

0:22:08 > 0:22:11who feel they have not been properly diagnosed.

0:22:11 > 0:22:13One of the problems lies in the way

0:22:13 > 0:22:15the activity of the thyroid is measured.

0:22:17 > 0:22:20If you have symptoms of hypothyroidism,

0:22:20 > 0:22:22your GP will test your blood.

0:22:22 > 0:22:26The telltale sign they are looking for is high levels of

0:22:26 > 0:22:28thyroid-stimulating hormone, TSH,

0:22:28 > 0:22:33together with low levels of the main thyroid hormone, T4.

0:22:33 > 0:22:37It sounds straightforward, but it isn't.

0:22:37 > 0:22:41What are considered normal levels of these hormones varies around the world,

0:22:41 > 0:22:45and the threshold for a diagnosis in the UK is higher than many.

0:22:47 > 0:22:51Dr Anthony Toft is former president of the British Thyroid Association.

0:22:51 > 0:22:55He thinks the test results are sometimes interpreted too

0:22:55 > 0:22:59rigidly, and that results which fall just within the limits of the

0:22:59 > 0:23:03normal range can merit further investigation.

0:23:03 > 0:23:06If the T4 is right down at the lower limit of normal,

0:23:06 > 0:23:10the TSH is up at the upper level limit of normal, that is suspicious.

0:23:10 > 0:23:12That is a prompt to take it a little further.

0:23:12 > 0:23:16I think the trouble is there isn't enough debate about interpretation.

0:23:18 > 0:23:21If you are diagnosed with an underactive thyroid,

0:23:21 > 0:23:25then you will most likely be prescribed a synthetic version of T4.

0:23:26 > 0:23:29This works for the majority of patients,

0:23:29 > 0:23:33but in around 10% of cases, the symptoms don't improve.

0:23:35 > 0:23:39One reason might be because some patients can't convert T4 into the

0:23:39 > 0:23:44active hormone, T3. T3 hormone in tablet form does exist,

0:23:44 > 0:23:48but price is a problem in the UK.

0:23:48 > 0:23:53The cost of T3 has escalated incredibly.

0:23:53 > 0:23:58It is now about £300 for two months supply of T3,

0:23:58 > 0:24:00whereas it costs pennies to make.

0:24:00 > 0:24:02So if I go along to my GP and ask for T3,

0:24:02 > 0:24:06- there is a good chance they will say, "No, it's too expensive."- Yes.

0:24:06 > 0:24:10There is a less expensive thyroid supplement, taken from animals.

0:24:10 > 0:24:14It contains both T3 and T4 hormones.

0:24:14 > 0:24:18But it isn't licensed in the UK.

0:24:18 > 0:24:22So do you think most patients should have T4 and T3?

0:24:22 > 0:24:26I suspect that in time that is what will happen.

0:24:26 > 0:24:30The trouble is the evidence base is not as strong as we would wish it to be,

0:24:30 > 0:24:33but I suspect it will be a long time before we have

0:24:33 > 0:24:34sufficient evidence.

0:24:36 > 0:24:38Many doctors won't prescribe T3,

0:24:38 > 0:24:43and there are patients who choose to buy pills online from abroad.

0:24:43 > 0:24:46Self-medicating is always risky.

0:24:46 > 0:24:49And taking T3 in large doses may cause side-effects in the long term,

0:24:49 > 0:24:53such as heart problems. But, like many women,

0:24:53 > 0:24:55Jo has accepted these risks.

0:24:56 > 0:24:59On balance, I think I will go with what I feel the best.

0:24:59 > 0:25:02If I am at an increased risk of anything,

0:25:02 > 0:25:04at least I am living my life to the full,

0:25:04 > 0:25:08rather than being locked indoors, overweight, cold,

0:25:08 > 0:25:10not able to function mentally.

0:25:10 > 0:25:13Have people suggested to you that this is simply the placebo effect?

0:25:13 > 0:25:17I can only say one thing. If it is a placebo effect,

0:25:17 > 0:25:22I am the best I have been in all my life and shouldn't that be good enough?

0:25:23 > 0:25:28The diagnosis and treatment of hypothyroidism is tricky.

0:25:28 > 0:25:30The same symptoms can be caused by a

0:25:30 > 0:25:32number of factors such as stress,

0:25:32 > 0:25:33depression, and a poor diet.

0:25:35 > 0:25:37If you have had a blood test and results have come back normal,

0:25:37 > 0:25:40then you can investigate it further.

0:25:40 > 0:25:44But you may also have to accept that medication is not for you and that

0:25:44 > 0:25:47lifestyle changes may be more appropriate.

0:25:47 > 0:25:49To find out more, do visit our website.

0:25:58 > 0:26:00Every day, we all use toiletries

0:26:00 > 0:26:03like shampoos, shower gels, and soaps.

0:26:03 > 0:26:07Most of these contain a particular ingredient that helps wash us clean.

0:26:07 > 0:26:10But can also have nasty side-effects.

0:26:10 > 0:26:12Chris has been investigating.

0:26:14 > 0:26:17If you look on the ingredients list of skincare products like moisturising creams

0:26:17 > 0:26:19or shampoo,

0:26:19 > 0:26:21you will see near the top of the list something called SLS,

0:26:21 > 0:26:23sodium lauryl sulfate.

0:26:23 > 0:26:25It is a really strong detergent.

0:26:25 > 0:26:28Now, I have reported on Trust Me, I'm A Doctor before,

0:26:28 > 0:26:30that if you leave it on your skin,

0:26:30 > 0:26:33it can cause skin damage and eczema-like symptoms.

0:26:33 > 0:26:36But it isn't only found in skin products.

0:26:37 > 0:26:40SLS is a very common ingredient in toothpaste.

0:26:40 > 0:26:43It helps make it foam and spread around your mouth better.

0:26:43 > 0:26:46It also kills microbes and reduces plaque.

0:26:46 > 0:26:50But some of you have been telling us you are better off without it.

0:26:50 > 0:26:54We have had a lot of people write in and say that switching to an

0:26:54 > 0:26:57SLS-free toothpaste has helped them with their mouth ulcers.

0:26:57 > 0:26:58Now, this to me is very plausible.

0:26:58 > 0:27:02The tissue on the inside of our mouths is much more sensitive than the skin

0:27:02 > 0:27:03on the rest of our bodies,

0:27:03 > 0:27:07so sluicing it out with SLS twice a day might not be good for us.

0:27:07 > 0:27:10So we have decided to look into it.

0:27:10 > 0:27:14There have been a number of studies on ulcers and SLS in toothpaste.

0:27:14 > 0:27:17The results have been, well, quite varied.

0:27:17 > 0:27:19Some reported that using

0:27:19 > 0:27:22SLS-free toothpaste reduced the amount of mouth ulcers by 70%,

0:27:22 > 0:27:26whilst others found no difference at all.

0:27:26 > 0:27:27In the two most recent trials,

0:27:27 > 0:27:32scientists put people who suffer with mouth ulcers into two groups.

0:27:32 > 0:27:36One using SLS-free toothpaste and the other using SLS toothpaste.

0:27:36 > 0:27:39And whilst there was no difference in the number of ulcers between

0:27:39 > 0:27:42the two groups, those people who used the SLS-free toothpaste

0:27:42 > 0:27:46found that their ulcers were less painful and they healed

0:27:46 > 0:27:49more quickly. So if you do get ulcers,

0:27:49 > 0:27:53it might just be worth trying an SLS-free toothpaste.

0:28:01 > 0:28:06Coming up, we reveal a brand-new eczema treatment that could also

0:28:06 > 0:28:09help us fight antibiotic resistance.

0:28:09 > 0:28:12And we talk to survivors of eating disorders about how to spot the

0:28:12 > 0:28:14signs and save lives.

0:28:16 > 0:28:17But first -

0:28:17 > 0:28:20a few years ago on Trust Me,

0:28:20 > 0:28:24we looked at ways to reduce air pollution in our homes.

0:28:24 > 0:28:26But outside the home, it is a growing problem.

0:28:26 > 0:28:30It's recently been labelled the biggest environmental killer in the

0:28:30 > 0:28:34world today. And already this year has been in the news with reports of

0:28:34 > 0:28:37new research linking it to dementia.

0:28:37 > 0:28:40But is there more to all of this than hype?

0:28:40 > 0:28:45I want to delve a bit deeper, find out exactly what it is I am inhaling and

0:28:45 > 0:28:48what effects, if any, that is having on my body.

0:28:48 > 0:28:50Should I worry about air pollution?

0:28:52 > 0:28:56Some have suggested that in Britain alone air pollution is responsible

0:28:56 > 0:29:00for the premature deaths of up to 40,000 people a year.

0:29:04 > 0:29:07Now, I regularly cycle and walk through the busy streets of London

0:29:07 > 0:29:12and I am fully conscious of all that traffic belching out nasty toxic fumes.

0:29:12 > 0:29:15The thing is, just how bad for me is it?

0:29:15 > 0:29:18Well, I am wearing this equipment which is provided by King's College, London,

0:29:18 > 0:29:22and I am about to go for a lengthy stroll through the busy

0:29:22 > 0:29:26streets. I am almost nervous to find out what I have been inhaling these

0:29:26 > 0:29:27last few decades.

0:29:30 > 0:29:34We could have conducted this experiment in almost any town or

0:29:34 > 0:29:39city in the UK. Because so many have high levels of air pollution.

0:29:39 > 0:29:44Big offenders include Southampton, Glasgow, Port Talbot, Eastbourne,

0:29:44 > 0:29:46and Leeds.

0:29:46 > 0:29:49It isn't just vehicles that cause it.

0:29:49 > 0:29:52Factories, airports, and even shipping plays a role.

0:29:52 > 0:29:54Over the next five miles,

0:29:54 > 0:29:58the kit in my backpack will be measuring black carbon from

0:29:58 > 0:30:01diesel cars and particulate matter.

0:30:01 > 0:30:05That is tiny particles, much smaller than the width of a human hair,

0:30:05 > 0:30:10that can get deep inside your lungs and can lead to long-term health problems.

0:30:11 > 0:30:15My walk will take me on busy roads from the Strand to Marble Arch

0:30:15 > 0:30:17and then I will return through quieter backstreets,

0:30:17 > 0:30:19so we can compare the different routes.

0:30:23 > 0:30:26Well, that was actually quite a pleasant stroll, apart from the traffic,

0:30:26 > 0:30:29which was sort of moderate for London.

0:30:29 > 0:30:31There was a bit of breeze coming along, which I imagine swept

0:30:31 > 0:30:33some of the pollution away.

0:30:33 > 0:30:37I have no idea what I was inhaling, but the machine will reveal all.

0:30:38 > 0:30:40A few days after my walk,

0:30:40 > 0:30:42I am back at King's College to look at the results.

0:30:42 > 0:30:46Dr Ben Barratt is an air pollution scientist who has been

0:30:46 > 0:30:49assessing London's air for more than 22 years.

0:30:50 > 0:30:53OK, so what was I inhaling?

0:30:53 > 0:30:56You started off very clean in the Somerset House courtyard.

0:30:56 > 0:31:01As you head out onto the Strand, very congested, slow-moving traffic,

0:31:01 > 0:31:06and you can see, immediately pollution levels rise up really quite high.

0:31:06 > 0:31:09And then you head towards Marble Arch.

0:31:09 > 0:31:13The general level of pollution gets really quite elevated and this is

0:31:13 > 0:31:15typical of the Central London area.

0:31:15 > 0:31:18And was there any difference when I was kind of returning?

0:31:18 > 0:31:22On the way back, the levels drop off really quite dramatically.

0:31:22 > 0:31:26You can see, towards the end here, we have got some really very low levels,

0:31:26 > 0:31:29- but then you have got these very high spikes.- OK.

0:31:29 > 0:31:32So this is probably one vehicle that is passing, that you have breathed

0:31:32 > 0:31:34in a lot of the exhaust coming from that.

0:31:34 > 0:31:38- OK, right, well.- But I can see from the data that at the end of your walk,

0:31:38 > 0:31:43- you got into a vehicle, probably a taxi.- Oh, of course. Yes, we did, didn't we?

0:31:43 > 0:31:45Yes. And the taxi got stuck in traffic

0:31:45 > 0:31:47for quite a long period of time.

0:31:47 > 0:31:51Actually, the highest levels of exposure that you received were in

0:31:51 > 0:31:53that taxi on the way back.

0:31:53 > 0:31:57The inlet for that vehicle is right behind the exhaust pipe of the vehicle in front

0:31:57 > 0:32:00and the pollution comes straight into your cab and it is important,

0:32:00 > 0:32:02it's not your vehicle that you are in,

0:32:02 > 0:32:05it's the vehicles that are surrounding you that are causing the problem.

0:32:05 > 0:32:07Right. So what's the best way?

0:32:07 > 0:32:09Active travel. Walking, cycling...

0:32:09 > 0:32:12Cycling, but preferably over back streets?

0:32:12 > 0:32:15Better for your health in many ways and better for the environment.

0:32:15 > 0:32:18OK. It's the unintended experiments which are the most

0:32:18 > 0:32:19illuminating and entertaining.

0:32:21 > 0:32:24But are all these small particles we're breathing in, causing us any

0:32:24 > 0:32:25serious harm?

0:32:25 > 0:32:29Professor Frank Kelly from King's College, London, advises on

0:32:29 > 0:32:33the health impacts of air pollution across the world.

0:32:33 > 0:32:36So why are small particles bad?

0:32:36 > 0:32:37Because they're smaller,

0:32:37 > 0:32:41they will penetrate deeper into your lungs when you breathe.

0:32:41 > 0:32:46They're carriers of a complex set of chemicals on their surface and these

0:32:46 > 0:32:51chemicals then will interact with your blood vessel walls and they'll

0:32:51 > 0:32:56set up reactions, which over a long period of time damage those walls,

0:32:56 > 0:32:58which we associate with heart disease.

0:32:58 > 0:33:00What about other diseases?

0:33:00 > 0:33:04Diabetes involves changes to your vessel walls as well.

0:33:04 > 0:33:07So that's why it's been linked.

0:33:07 > 0:33:12And neurodegenerative diseases such as Alzheimer's, that also...

0:33:12 > 0:33:16has damaged the blood vessels in the brain and now there is

0:33:16 > 0:33:18a strong series of studies which suggests

0:33:18 > 0:33:20that the air you breathe also is associated

0:33:20 > 0:33:23with your susceptibility to stroke.

0:33:23 > 0:33:26How much does it sort of knock off your life on average, do you think?

0:33:26 > 0:33:28If you take the current data that we have,

0:33:28 > 0:33:31we think somewhere between three and nine months.

0:33:31 > 0:33:33Some people it's maybe one day

0:33:33 > 0:33:36and some people it may be up to ten years.

0:33:36 > 0:33:39If you'd asked me, I would've said things are getting better,

0:33:39 > 0:33:42the air we breathe is probably getting healthier and healthier.

0:33:42 > 0:33:43Am I naive?

0:33:43 > 0:33:45No, you're trusting your eyes.

0:33:45 > 0:33:47In the 1950s,

0:33:47 > 0:33:51when we had black smoke and sulphur dioxide from burning coal,

0:33:51 > 0:33:54that was pretty visible most of the time.

0:33:54 > 0:33:58The pollution problem we have these days is from burning diesel

0:33:58 > 0:33:59and burning petrol,

0:33:59 > 0:34:02so it's road transportation primarily in our cities.

0:34:02 > 0:34:05One of the things I find quite distressing

0:34:05 > 0:34:08is I see a school playground and then I see a van

0:34:08 > 0:34:12or perhaps some parents outside, their engines are just ticking over,

0:34:12 > 0:34:14am I right to feel anxious about such things?

0:34:14 > 0:34:17This is a particularly worrying new finding.

0:34:17 > 0:34:21It seems that if a child is growing up with air

0:34:21 > 0:34:24which is of poor quality,

0:34:24 > 0:34:27then that holds back their lung growth

0:34:27 > 0:34:32and as your lung normally stops growing around the age of 18,

0:34:32 > 0:34:35it means that if you've reached that point with a smaller lung,

0:34:35 > 0:34:38you're not going to be able to recover that capacity.

0:34:38 > 0:34:41So as I say, we've seen this in America, we've seen it in London,

0:34:41 > 0:34:42we've seen it in China.

0:34:42 > 0:34:46Wow! How do you respond to your own data, your own information?

0:34:46 > 0:34:48Have you changed your life?

0:34:48 > 0:34:52I'll think about the route I take and if I can take a side street,

0:34:52 > 0:34:57if I can walk on the other side of the road, where I know the wind is

0:34:57 > 0:35:01blowing away from, I know my exposure to pollution will be less.

0:35:01 > 0:35:02Are you optimistic?

0:35:02 > 0:35:05In the short-term, no.

0:35:05 > 0:35:09I haven't been for a while, in the medium to longer term, yes.

0:35:09 > 0:35:12I think we will sort this problem out.

0:35:12 > 0:35:15Whether we sort it out in time to protect the

0:35:15 > 0:35:19current generation of children's lungs or not, I don't know.

0:35:21 > 0:35:24So, should I worry about air pollution?

0:35:24 > 0:35:26The short answer is yes.

0:35:26 > 0:35:30I was particularly shocked by the amount of the bad stuff I was

0:35:30 > 0:35:33inhaling while I was in that taxi in heavy traffic.

0:35:33 > 0:35:35Now, in future,

0:35:35 > 0:35:39I will continue to cycle and walk where I can in London because I

0:35:39 > 0:35:42enjoy it and because it's good for my heart and lungs,

0:35:42 > 0:35:47but I will try and stick to quieter backstreets because I'm now

0:35:47 > 0:35:50convinced that that will make a big difference.

0:35:50 > 0:35:53To look for data on air pollution in your area,

0:35:53 > 0:35:55visit the Trust Me website

0:35:55 > 0:35:58where there are also tips on how to reduce your exposure.

0:36:06 > 0:36:10In the UK, one in five children and one in 12 adults

0:36:10 > 0:36:14suffers from eczema, that red, scaly skin condition.

0:36:14 > 0:36:18Now there is a new treatment which could help not only eczema sufferers

0:36:18 > 0:36:21but also our battle against the superbugs.

0:36:21 > 0:36:25Surgeon Gabriel Weston has been to the Netherlands to investigate.

0:36:27 > 0:36:32The clinical trial that I'm on my way to see is focusing on a

0:36:32 > 0:36:35condition that has played a significant role in my own life.

0:36:37 > 0:36:40It's hard to imagine if you've never suffered from eczema, just how

0:36:40 > 0:36:45debilitating the itching, redness and soreness can be.

0:36:45 > 0:36:48I suffered from severe eczema as a child

0:36:48 > 0:36:50and right into my early adulthood

0:36:50 > 0:36:53and at times it made me really miserable.

0:36:53 > 0:36:57And then miraculously, one day, it all disappeared.

0:36:57 > 0:36:59But for thousands of people suffering from eczema,

0:36:59 > 0:37:01things don't turn out so well.

0:37:04 > 0:37:07I've eczema since I was two years of age.

0:37:07 > 0:37:11It started on my knees and on my elbows.

0:37:11 > 0:37:16The main problem or main symptom I have is itching of skin and also

0:37:16 > 0:37:20redness and dryness of my skin.

0:37:20 > 0:37:25Sometimes it will bleed because of the wounds I get from the itching.

0:37:25 > 0:37:28So it's painful sometimes.

0:37:28 > 0:37:33Anouk is a student in Rotterdam and like many eczema sufferers,

0:37:33 > 0:37:36has found that one of the only ways to manage the symptoms is with

0:37:36 > 0:37:38powerful steroid creams,

0:37:38 > 0:37:42which ideally should only be used in short bursts.

0:37:42 > 0:37:47But now, Anouk is taking part in a trial of an alternative treatment at

0:37:47 > 0:37:50the Erasmus Medical Centre in Rotterdam.

0:37:50 > 0:37:54We still don't fully understand what causes eczema in the first place,

0:37:54 > 0:37:57but it can be triggered by many different things.

0:37:59 > 0:38:03This trial is focusing on the role played by the different bacteria

0:38:03 > 0:38:05that naturally live on our skin.

0:38:07 > 0:38:10The researchers are taking skin swabs from each patient and sending

0:38:10 > 0:38:12them off for analysis.

0:38:16 > 0:38:20Doctor Bjorn Herpers is a clinical microbiologist and a medical adviser

0:38:20 > 0:38:24to the company who've developed the treatment I've come to see.

0:38:24 > 0:38:28He's working with the team analysing the bacteria.

0:38:28 > 0:38:34These samples were taken from the skin from a healthy patient and here

0:38:34 > 0:38:37you see a lot of different bacteria growing.

0:38:37 > 0:38:39So there's a lot of diversity

0:38:39 > 0:38:42of bacteria on the skin in this culture.

0:38:42 > 0:38:47The next plate is a skin sample swab taken from a patient from the trial,

0:38:47 > 0:38:51- and here you see a completely different story.- Wow.

0:38:51 > 0:38:53You don't see the diversity any more,

0:38:53 > 0:38:58but you see this one green colony overgrowing all the rest of it

0:38:58 > 0:39:01and this is staphylococcus aureus,

0:39:01 > 0:39:03and in some patients who have an eczema flare,

0:39:03 > 0:39:05up to 80 or 90% of all bacteria

0:39:05 > 0:39:09has become staph aureus and this is called dysbiosis,

0:39:09 > 0:39:12an imbalance of the bacterial skin flora.

0:39:12 > 0:39:15Why does that matter if you have one more than others on your skin?

0:39:15 > 0:39:17It matters for two things.

0:39:17 > 0:39:21First of all, a lot of bacteria that normally inhabit the skin are

0:39:21 > 0:39:23actually protective and needed

0:39:23 > 0:39:26for healthy and good skin and the problem

0:39:26 > 0:39:30with staphylococcus aureus is that it can produce substances,

0:39:30 > 0:39:33toxins, and with these types of toxins,

0:39:33 > 0:39:38staphylococcus aureus produces or ignites the inflammation like the

0:39:38 > 0:39:40redness and the itch seen in eczema.

0:39:40 > 0:39:43Researchers have shown that in eczema,

0:39:43 > 0:39:49one particular bacterium tends to dominate, staphylococcus aureus.

0:39:49 > 0:39:53Now they want to know whether reducing the amount of it on

0:39:53 > 0:39:55the skin could alleviate the symptoms.

0:39:55 > 0:39:59The challenge is how to get rid of staph aureus without destroying

0:39:59 > 0:40:01the healthy bacteria too.

0:40:01 > 0:40:04And that's exactly the problem the new treatment they're trialling

0:40:04 > 0:40:06is designed to solve.

0:40:07 > 0:40:13In nature, viruses kill bacteria and they do this by latching onto them,

0:40:13 > 0:40:15reproducing inside them

0:40:15 > 0:40:18and then bursting out through their cell wall.

0:40:18 > 0:40:23Now the thing that allows them to break out in this way is an enzyme

0:40:23 > 0:40:25and it's called an endolysin

0:40:25 > 0:40:29and it's this that the treatment is based on.

0:40:31 > 0:40:35Each natural endolysin kills a specific strain of bacteria,

0:40:35 > 0:40:37leaving all the others unharmed.

0:40:37 > 0:40:43So the researchers have harnessed those that only target staph aureus.

0:40:43 > 0:40:47These test tubes contain staphylococcus aureus bacteria,

0:40:47 > 0:40:50which makes the liquid appear cloudy.

0:40:50 > 0:40:55But when the endolysin is introduced, the results are astonishing.

0:40:55 > 0:40:59In little more than an hour, the bacteria are destroyed.

0:41:02 > 0:41:07Now this endolysin has been turned into a cream and is being tested

0:41:07 > 0:41:09in the eczema trial.

0:41:09 > 0:41:14This independent clinical trial has recruited 100 patients,

0:41:14 > 0:41:1950 of them get the cream with the endolysin inside and 50 get

0:41:19 > 0:41:22the placebo and because this is a randomised, double-blind trial,

0:41:22 > 0:41:27neither the doctors nor the patients know who's getting what treatment.

0:41:28 > 0:41:30Alongside their treatment,

0:41:30 > 0:41:33each participant is also using a steroid cream which is weighed at

0:41:33 > 0:41:37each appointment, so the researchers know how much has been used.

0:41:37 > 0:41:39I asked two of the researchers,

0:41:39 > 0:41:42Dr Joan Totte and Professor Suzanne Pasmans

0:41:42 > 0:41:45what they were hoping to see.

0:41:45 > 0:41:49We hope to reduce the level of staph aureus and restore the balance of

0:41:49 > 0:41:51the microbial composition a bit.

0:41:51 > 0:41:53What we want to investigate also -

0:41:53 > 0:41:55if it really reduces the staph aureus

0:41:55 > 0:41:57load and then, complementary,

0:41:57 > 0:42:01we want to see if that reduction of the staph aureus load also leads to

0:42:01 > 0:42:04a reduction in symptoms and a reduction in steroid use.

0:42:04 > 0:42:08So it won't be a cure, but an additional therapy.

0:42:08 > 0:42:11What are the measures of improvement in your patients?

0:42:11 > 0:42:16The severity of the eczema has decreased and the patient probably

0:42:16 > 0:42:19also has discovered then that he has less inflammation in the skin.

0:42:19 > 0:42:22How soon do you think it's going to be

0:42:22 > 0:42:24before you'll know some of the results?

0:42:24 > 0:42:27The first data will be there after a year,

0:42:27 > 0:42:29so probably a few months later,

0:42:29 > 0:42:32we have, really, the visuals analysed.

0:42:34 > 0:42:39This research is the first clinical trial of this treatment and will

0:42:39 > 0:42:41show whether it's effective.

0:42:41 > 0:42:44But because this cream doesn't contain any substance

0:42:44 > 0:42:47that's classified as a drug, it's less tightly regulated

0:42:47 > 0:42:51and is already available outside of the trial.

0:42:51 > 0:42:54One person using it is Miriam.

0:42:54 > 0:42:58Her son, Renzo, has had eczema since he was very young.

0:43:00 > 0:43:03Miriam, tell me what it was like when you first discovered that your

0:43:03 > 0:43:09- son had eczema?- Well, his skin was very dry and red and he had a terrible itch.

0:43:09 > 0:43:13He had eczema all over his body and also his skin got infected.

0:43:13 > 0:43:14It was terrible.

0:43:14 > 0:43:17Tell me about what changed that.

0:43:17 > 0:43:19When I used the endolysin,

0:43:19 > 0:43:23he slept the whole night through and his skin, also, was calm,

0:43:23 > 0:43:28it wasn't red any more, it was the difference between day and night.

0:43:28 > 0:43:31He's happy, so when he's happy, I'm happy.

0:43:31 > 0:43:34It's totally different.

0:43:34 > 0:43:39The endolysin treatment has made a big difference in Renzo's case,

0:43:39 > 0:43:41but as well as alleviating eczema,

0:43:41 > 0:43:45there are other reasons to get excited about this new treatment.

0:43:45 > 0:43:50Researchers have found that bacteria cannot develop resistance to

0:43:50 > 0:43:55endolysins and this offers amazing advantages for the treatment of

0:43:55 > 0:43:56a range of infections.

0:43:57 > 0:44:00With endolysins, because they do not induce resistance,

0:44:00 > 0:44:05you can have a continuous suppression therapy, so I see before

0:44:05 > 0:44:08me that with burn wounds, with diabetic wounds,

0:44:08 > 0:44:12you can have a continuous treatment and I think that a lot of problems

0:44:12 > 0:44:18we now see in the hospital with infected wounds can be prevented by

0:44:18 > 0:44:22using endolysins in a very early colonisation stage before

0:44:22 > 0:44:25this colonisation leads to infection,

0:44:25 > 0:44:27and I think this is a real paradigm shift we will see

0:44:27 > 0:44:29in the coming next years.

0:44:32 > 0:44:36On this trip, I've seen a lot to get excited about.

0:44:37 > 0:44:42I can't wait to discover the results of this trial and if it's positive,

0:44:42 > 0:44:44who knows how many conditions

0:44:44 > 0:44:47we might be using endolysins for in the future?

0:44:55 > 0:44:58Next, we've been finding the answer to another one of

0:44:58 > 0:45:00your health questions.

0:45:01 > 0:45:05How do you get cold sores and what can you do about them?

0:45:06 > 0:45:10Cold sores, those unsightly blisters around the lips.

0:45:10 > 0:45:13It's been estimated that one in five of us get them.

0:45:13 > 0:45:15- Do you get cold sores?- Yeah.

0:45:15 > 0:45:16Only when I get stressed, really.

0:45:16 > 0:45:20When I'm run down or when I'm tired and I'm stressed out.

0:45:20 > 0:45:24They always seem to pop up at the most inconvenient times.

0:45:24 > 0:45:27Cold sores are caused by the herpes simplex virus.

0:45:27 > 0:45:30You might be surprised how many of us harbour it.

0:45:32 > 0:45:35Hi, there. Can I have my usual, please?

0:45:35 > 0:45:39Estimates suggest that around two out of three of us are infected.

0:45:39 > 0:45:41Most of us get it in childhood.

0:45:41 > 0:45:44Perhaps a friendly kiss from an aunt.

0:45:44 > 0:45:47The thing is, once you've got it, it's there for life.

0:45:47 > 0:45:48You can't get rid of it.

0:45:48 > 0:45:51So why is it we don't have cold sores all the time?

0:45:53 > 0:45:54The virus lies hidden,

0:45:54 > 0:45:57usually without causing any visible symptoms.

0:45:57 > 0:46:00So you probably have it and don't even know.

0:46:00 > 0:46:02That is, until it's triggered.

0:46:04 > 0:46:07The things that cause a cold sore to erupt vary from person to person.

0:46:07 > 0:46:10Essentially it's about weakening your immune system.

0:46:10 > 0:46:14This could be the result of stress, feeling run-down,

0:46:14 > 0:46:17even exposure to lots of strong sunlight.

0:46:17 > 0:46:20You can often detect the beginnings of a cold sore from a tingling or

0:46:20 > 0:46:22burning sensation under the skin.

0:46:22 > 0:46:26Then a blister that shows up which can burst and leave a scab.

0:46:26 > 0:46:28Once you feel that familiar tingling,

0:46:28 > 0:46:32you should stop kissing people or doing anything more intimate.

0:46:32 > 0:46:35Cos that is a very common way for the virus to spread.

0:46:36 > 0:46:40You should also avoid touching the cold sore as this may delay healing

0:46:40 > 0:46:44and wash your hands often, so you don't spread the virus.

0:46:44 > 0:46:46So, can you do anything about a cold sore?

0:46:46 > 0:46:48Well, home remedies like mint

0:46:48 > 0:46:52might reduce the pain and antiviral creams,

0:46:52 > 0:46:54if you are very conscientious,

0:46:54 > 0:46:58may reduce the amount of time that it hangs around for.

0:46:58 > 0:47:01If you do nothing at all, then it should go in about ten days.

0:47:03 > 0:47:07So, you could just wait it out, but if the cold sore persists or if

0:47:07 > 0:47:11you're getting them often, then do go and see your doctor.

0:47:11 > 0:47:14They may prescribe stronger oral antiviral medication.

0:47:14 > 0:47:19If you only get them occasionally, then prevention is probably best.

0:47:19 > 0:47:22So do try and find out the sort of things that trigger your cold sores

0:47:22 > 0:47:26and avoid them if possible, and if you have an active cold sore,

0:47:26 > 0:47:28no kissing until it gets better.

0:47:36 > 0:47:39SNEEZE

0:47:39 > 0:47:41These days people are much more open

0:47:41 > 0:47:43when it comes to discussing mental illness

0:47:43 > 0:47:46but there are still some conditions which are hard to talk about.

0:47:46 > 0:47:50In the UK, around three quarters of a million people suffer from an

0:47:50 > 0:47:54eating disorder, and it's really important this gets picked up early.

0:47:54 > 0:47:58Over to Dr Saleyha Ahsan.

0:47:58 > 0:48:02Anorexia has the highest mortality rate of any mental illness,

0:48:02 > 0:48:06with up to 20% of sufferers dying prematurely.

0:48:06 > 0:48:09And a quarter of people with eating disorders will go on to develop

0:48:09 > 0:48:11a chronic illness.

0:48:12 > 0:48:16Most people have heard of eating disorders like anorexia,

0:48:16 > 0:48:18bulimia and binge eating,

0:48:18 > 0:48:23but they often assume that they only affect teenage girls.

0:48:23 > 0:48:26Well, actually, they can affect anyone at any age.

0:48:26 > 0:48:28Men as well as women.

0:48:30 > 0:48:32The causes are usually complex,

0:48:32 > 0:48:37psychological factors like low self-esteem, anxiety

0:48:37 > 0:48:39or depression can be triggers.

0:48:39 > 0:48:42But it's the physical signs that we are most likely to spot

0:48:42 > 0:48:45and learning to recognise these could save a life.

0:48:47 > 0:48:50Julie and Dave both suffered from anorexia,

0:48:50 > 0:48:54an illness where a person keeps their weight extremely low

0:48:54 > 0:48:56and restricts how much they're eating.

0:48:56 > 0:48:59I would generally be in the bathroom five, ten minutes,

0:48:59 > 0:49:02just weighing myself. Because if it was a good weight, I'd be, like,

0:49:02 > 0:49:04I have to know that's correct.

0:49:04 > 0:49:06So I'd reset the scales. I'd do it five or six times.

0:49:06 > 0:49:10If it was a bad weight, I'd be, like, no, this can't be happening.

0:49:10 > 0:49:12And then I'd reset the scales five or six times.

0:49:12 > 0:49:17My hair was falling out, I had ear infections, eye infections,

0:49:17 > 0:49:20skin infections. I had no skin on my fingers.

0:49:20 > 0:49:24It was painful but I was at a point where I just didn't...

0:49:24 > 0:49:25I didn't care.

0:49:27 > 0:49:32Holly and Rebecca have both grappled not only with anorexia but also

0:49:32 > 0:49:37with bulimia, which involves eating excessive amounts and then purging

0:49:37 > 0:49:40yourself by means of laxatives or vomiting.

0:49:40 > 0:49:45I'd either go through massive periods of seeing how far I could get on as little

0:49:45 > 0:49:50as I could, or I'd binge and then I'd purge

0:49:50 > 0:49:55and it was very much that for a good six years.

0:49:55 > 0:49:57I'd do my morning exercise.

0:49:57 > 0:50:02I'd then go and usually I would buy a lot of food that I would maybe

0:50:02 > 0:50:06consume all in one go and then I would purge that food and then

0:50:06 > 0:50:08I'd do some more exercise.

0:50:09 > 0:50:12One of the things that's common to eating disorders is that

0:50:12 > 0:50:15the condition is often shrouded in secrecy.

0:50:15 > 0:50:17So what are the signs to look out for?

0:50:18 > 0:50:20Some of the key red flags,

0:50:20 > 0:50:25common to most eating disorders, are an obsessive focus on food,

0:50:25 > 0:50:29dieting and exercise, complaining of being overweight,

0:50:29 > 0:50:34even when they are not, weighing yourself repeatedly, skipping meals,

0:50:34 > 0:50:39bingeing, regular visits to the bathroom especially after meals,

0:50:39 > 0:50:42being withdrawn and secretive.

0:50:42 > 0:50:45Most sufferers in the early stages of the disease are often ambivalent

0:50:45 > 0:50:48or even in denial about the condition,

0:50:48 > 0:50:53so it can fall to friends and family to break the silence and suggest

0:50:53 > 0:50:56there's a problem.

0:50:56 > 0:51:00My cousin noticed that I would go to the bathroom after each meal and he

0:51:00 > 0:51:03actually came up and said to me,

0:51:03 > 0:51:05"You've got to stop going to the bathroom after we've eaten."

0:51:07 > 0:51:10Broaching the subject can open the door to a sufferer getting the right

0:51:10 > 0:51:12professional support and treatment.

0:51:13 > 0:51:16I was working in a summer school and one of the teachers said,

0:51:16 > 0:51:19"Look, I've been in therapy for bulimia three times.

0:51:19 > 0:51:22"Have you ever thought you might be anorexic?"

0:51:22 > 0:51:23Just down to earth.

0:51:23 > 0:51:25That was a different approach, wasn't it?

0:51:25 > 0:51:28- Absolutely.- I've got a really good friend.

0:51:28 > 0:51:31When I was first poorly,

0:51:31 > 0:51:36he would take me out for breakfast every Saturday and even if I just

0:51:36 > 0:51:39had water, then that's fine,

0:51:39 > 0:51:43and then gradually we built up to toast and a coffee.

0:51:43 > 0:51:45- Oh, that's lovely.- It was amazing.

0:51:45 > 0:51:49- He was really good.- But if you do decide to raise the subject,

0:51:49 > 0:51:54do so carefully, because some of the most powerful triggers of

0:51:54 > 0:51:57the disease are feelings of anger and anxiety.

0:51:57 > 0:51:59When anyone would address it during mealtimes,

0:51:59 > 0:52:01I found that very difficult.

0:52:01 > 0:52:03For example, someone saying to me,

0:52:03 > 0:52:05"You've put absolutely no carbs on your plate."

0:52:05 > 0:52:09And that just made me not want to eat anything at all.

0:52:09 > 0:52:11What helped?

0:52:11 > 0:52:15Not always seeing the eating disorder, but the person,

0:52:15 > 0:52:18because people can forget that underneath

0:52:18 > 0:52:21you are still the girl who loves to read and, you know, watch films.

0:52:21 > 0:52:24But people won't ask you - "What books have you enjoyed lately?"

0:52:24 > 0:52:26Instead, they just talk about food.

0:52:28 > 0:52:32Talking and listening are powerful tools in the fight against these

0:52:32 > 0:52:37diseases, and they are beatable, as our survivors have proved.

0:52:37 > 0:52:41I've been fully recovered for about two years now.

0:52:41 > 0:52:43It feels very freeing.

0:52:43 > 0:52:46Like, you're in control of your life now,

0:52:46 > 0:52:49not this voice that is telling you how to behave.

0:52:49 > 0:52:51You are doing what you want to do, because you enjoy it.

0:52:51 > 0:52:55The biggest thing that I've learnt is the management of kind of

0:52:55 > 0:52:57I love and care for myself, so it's just

0:52:57 > 0:52:59change the language to be just, like,

0:52:59 > 0:53:03don't beat yourself up about it, if you feel a certain way.

0:53:03 > 0:53:06- It's OK.- I'm still kind of, you know,

0:53:06 > 0:53:10seeing my therapist, but I feel furthest away from it now than

0:53:10 > 0:53:12I ever have done before.

0:53:12 > 0:53:15I'm really having a new life because I've wasted so long.

0:53:17 > 0:53:18It's a waste of life.

0:53:20 > 0:53:23Remember that however difficult it may seem,

0:53:23 > 0:53:27these diseases are manageable, and you can help.

0:53:29 > 0:53:33Breaking the silence and helping someone acknowledge a problem,

0:53:33 > 0:53:35can be a big step towards treatment and recovery.

0:53:35 > 0:53:37Go to our website...

0:53:40 > 0:53:43..for more information on eating disorders and the support available.

0:53:53 > 0:53:57Eight weeks ago, we started an experiment testing different methods

0:53:57 > 0:53:59that claimed to boost our metabolism.

0:53:59 > 0:54:03In other words, help our bodies burn more calories.

0:54:03 > 0:54:05Raising your metabolic rate in the long term,

0:54:05 > 0:54:06should help you lose weight.

0:54:08 > 0:54:1028 volunteers from the Midlands

0:54:10 > 0:54:12have been trying out one of three options.

0:54:13 > 0:54:17Our first group has been drinking chilled water twice a day.

0:54:17 > 0:54:20The idea is that warming this up to body temperature will make them

0:54:20 > 0:54:22use more energy.

0:54:23 > 0:54:26I have lost a little bit of weight and feel as though

0:54:26 > 0:54:28I'm doing my body some good.

0:54:28 > 0:54:32It's had an overall positive effect on me, without a doubt.

0:54:32 > 0:54:35Our second group have been drinking green tea.

0:54:35 > 0:54:38This contains chemicals, that it is claimed, will make their bodies burn

0:54:38 > 0:54:41- more calories. - It's given me more energy.

0:54:41 > 0:54:44I've been up and about busying myself, you know,

0:54:44 > 0:54:47and just keeping myself active, so, again, mentally I felt better

0:54:47 > 0:54:50for the thing, and I don't know why but I just have.

0:54:51 > 0:54:54Our final group have been doing some simple exercises using a

0:54:54 > 0:54:57resistance band, to build some muscle and lose fat.

0:54:58 > 0:55:01As muscle uses more energy than fat, even at rest,

0:55:01 > 0:55:05this should up the number of calories they are burning through the day.

0:55:05 > 0:55:08My energy levels improved and I know that because I was whizzing around

0:55:08 > 0:55:10the house doing housework a lot more.

0:55:12 > 0:55:15Dr Ian Lahart from the University of Wolverhampton measured

0:55:15 > 0:55:19the resting metabolic rate of our volunteers before and afterwards.

0:55:20 > 0:55:23We also did DEXA scans, which allowed us to measure the amount

0:55:23 > 0:55:26of muscle and fat in each volunteer's body

0:55:26 > 0:55:28before and after the experiment.

0:55:28 > 0:55:30Now it's time for the results.

0:55:31 > 0:55:33First up, the cold water.

0:55:33 > 0:55:37In this group, there were some dramatic individual results.

0:55:37 > 0:55:42Alison's resting metabolic rate went up by 21% and she lost 1.4kg

0:55:42 > 0:55:44of body fat.

0:55:45 > 0:55:48While Judith lost 1.9kg of body fat.

0:55:50 > 0:55:54But overall, the metabolic rate of our group didn't rise and they

0:55:54 > 0:55:56didn't burn much fat.

0:55:56 > 0:56:00It's likely that simply taking part in our experiment, triggered Alison

0:56:00 > 0:56:03and Judith to adopt a healthier lifestyle.

0:56:03 > 0:56:06On average, we weren't able to find an effect,

0:56:06 > 0:56:10so that might be that there is no effect or that the effect is

0:56:10 > 0:56:13so small we weren't be able to detect it.

0:56:13 > 0:56:15Next, the green tea group.

0:56:15 > 0:56:18Here, we saw very similar results.

0:56:18 > 0:56:22There was no overall increase in our volunteers' metabolic rate.

0:56:22 > 0:56:27One person, Clive, did lose an impressive 2.6kg of body fat.

0:56:27 > 0:56:31Again, though, that is unlikely to be down to the green tea alone.

0:56:32 > 0:56:35And how does that reflect in previous research?

0:56:35 > 0:56:37I think overall it's in line.

0:56:37 > 0:56:42There's inconsistent results around green tea, so the jury's still out.

0:56:42 > 0:56:45And finally, our resistance exercise group.

0:56:45 > 0:56:48Again, there were some impressive individual results.

0:56:48 > 0:56:52Arlene lost an incredible 3.5kg of weight.

0:56:52 > 0:56:56But this time there were also encouraging signs for the rest of

0:56:56 > 0:56:59the group, particularly in the DEXA scans.

0:56:59 > 0:57:03We found that six out of nine people improved their muscle mass,

0:57:03 > 0:57:07so given a longer period of time performing those exercises,

0:57:07 > 0:57:11people might increase their muscle mass further and that would raise

0:57:11 > 0:57:13their resting metabolic rate.

0:57:13 > 0:57:15We can't forget the other benefits

0:57:15 > 0:57:17associated with being active, such as

0:57:17 > 0:57:21better quality-of-life, improved fitness and reduced risk of disease.

0:57:23 > 0:57:27So while the results for water and green tea were inconclusive,

0:57:27 > 0:57:31our short study showed that resistance exercise was already

0:57:31 > 0:57:34bringing improvements in just eight weeks.

0:57:34 > 0:57:37This reflects other studies that have shown that increasing

0:57:37 > 0:57:39the amount of muscle you have, burns more calories.

0:57:43 > 0:57:47Our experiment has shown just how difficult it is to boost your

0:57:47 > 0:57:50metabolism and you're unlikely to lose significant amounts of weight

0:57:50 > 0:57:51from any of these quick fixes,

0:57:51 > 0:57:56however, it also showed that simple changes to your everyday routine

0:57:56 > 0:57:58can help you reap the benefits.

0:57:58 > 0:58:02In our test, doing just a few sessions of simple exercises a week,

0:58:02 > 0:58:04made a meaningful difference.

0:58:04 > 0:58:07For full details of these exercises and more information about our

0:58:07 > 0:58:09experiment, go to the Trust Me website...

0:58:19 > 0:58:21That's it from Walsall.

0:58:21 > 0:58:24Next time, we're in Liverpool, where we are carrying out a really big

0:58:24 > 0:58:29experiment to find out what's the best way to include more healthy

0:58:29 > 0:58:32fish oils in your diet.

0:58:32 > 0:58:34We'll also be finding out whether we should worry

0:58:34 > 0:58:37about plastics in our food.

0:58:37 > 0:58:40And how a high-fat diet affects our bodies.

0:58:40 > 0:58:44MUSIC: Dr Wanna Do by Caro Emerald

0:58:50 > 0:58:53# Doctor, I want you

0:58:53 > 0:58:55# Ooh, my Dr Wanna Do

0:58:55 > 0:58:57# I can't get over you

0:58:57 > 0:59:00# Doctor, do anything that ya wanna do

0:59:00 > 0:59:02# Doctor, I want you

0:59:02 > 0:59:04# Dr Wanna Do

0:59:04 > 0:59:07# I can't get over you

0:59:07 > 0:59:09# Doctor, do anything that you wanna do. #