Over the past year I’ve suffered from endless bouts of goosebumps, which start at my head and flush down my back, chest and to my legs.
This can happen randomly, even while just sitting reading.
My skin has become so tender that I can’t dry it with a towel. Blood tests, hormone tests and heart monitoring proved OK.
Andy McCormack, Manchester.
Dr Martin Scurr replies: This is an unusual and extremely vexing problem – but the fact that you experience extreme discomfort triggered by even a light touch when drying with a towel suggests it’s cutaneous allodynia.
That is, when the nerves in the skin become hypersensitive to stimulation, such as a light touch.
First, let me explain a bit more about goosebumps generally. These occur when, in response to the cold or strong feelings such as fear, the tiny arrector pili muscles at the bottom of the hairs contract.
This in turn causes the hair to stand up. The skin around the hair comes with it, leading to small bumps.
Goosebumps occur when, in response to the cold or strong feelings such as fear, the tiny arrector pili muscles at the bottom of the hairs contract, leading to small bumps
The theory is that this reflex (known as the pilomotor reflex) is a hangover from our evolutionary past – trapping air under the hair (or fur) to keep us warm, and making us appear larger when under threat.
The sensitivity you describe is linked to a number of common problems, including shingles, diabetes or even migraine (all nerve-related conditions).
More rarely, it can be a sign of temporal lobe epilepsy, which affects the side of the brain.
In some cases, this can cause pilomotor seizures – goosebumps. I would suggest speaking to your GP about being referred to a neurologist. If this is the cause, then suitable anticonvulsant medication will, hopefully, abolish these unpleasant sensations. I’m optimistic for you.
I’ve been on 10mg omeprazole for at least 25 years for a hiatus hernia. I have seen bad stories about this drug and wondered if there was an alternative.
I have tried doing without it, but my hernia becomes sore. I am now bothered with arthritis – is this linked to omeprazole?
Margaret Baker, Grangemouth.
Dr Martin Scurr replies: Omeprazole is so widely prescribed that there will be many who have similar concerns. It is a testament to the safety of this type of drug – a proton pump inhibitor (PPI), which suppresses the production of stomach acid – that it’s readily available without a prescription.
When any drug is prescribed long term, the patient needs to be reassessed at least annually to ensure the benefits outweigh the risk of side-effects.
Given the fact that omeprazole eases the pain of your hernia, the benefit of your modest dose is clear. This must be set against the potential harms.
We know that as stomach acid helps the body absorb vitamin B12 from food, there is a risk of deficiency (which can lead to fatigue and muscle weakness).
For similar reasons long-term use of PPIs can affect magnesium and calcium absorption, each of which has consequences (weak bones and increased fracture risk, in the case of calcium; muscle cramp and heart rhythm problems if magnesium is deficient). So you need a blood test every year to check these levels.
Thirdly, suppressing acid production in theory can raise the risk of infection via organisms entering through the gastrointestinal tract – for instance, C.diff or Salmonella (both bacteria can cause severe diarrhoea, fever and pain).
The serious risks you allude to from long-term use, such as weaker bones, are not clear-cut – not least as many people taking these highly effective drugs long term will also have other health problems requiring different medication, so interactions may be another factor.
I must reassure you that there is no evidence of a connection between the long-term use of omeprazole and arthritis.
My feeling is that you would be well advised to continue on your small daily dose of omeprazole, but discuss your concerns on an annual basis with your doctor.
