Practices

Here is a question that costs nothing: has anyone in your family been told their vitamin D was low? It runs in families through genes, skin tone, where you live and how much time anyone spends outside.

The clinician telling this story found out only afterwards that his mother, father and brother had all been low. Nobody had mentioned it, because it…

Around seven in ten people who use herbal products never mention it to their doctor. Not out of secrecy, mostly because a tea or a gummy does not feel like it belongs on a list of medications.

The useful move is to answer a wider question than the one you were asked. When someone asks what medication you take, tell them what else you take…

A real food allergy shows itself on the body: a rash, a swollen or inflamed throat, something you can see. Behaviour on its own does not identify one, although behaviour often improves once a genuine allergy is dealt with.

One child's attention and mood went back to her usual level once berries came out of her diet, and what made that findable was the rash and the sore…

Most eating advice quietly assumes a budget. Fresh food is expensive and does not keep, so a household relying on food assistance ends up buying what lasts, and what lasts comes in tins and packets.

If money is the constraint, say it out loud rather than nodding along and then failing quietly at home. The advice can be rebuilt around what is…

Health advice usually assumes a kitchen, a fridge and money for the week. If you are working with less than that, the answer is not to try harder at the advice. It is to shrink the plan until it fits what you actually have.

A plan you cannot keep does more than fail. It quietly adds to the pile of evidence that nothing you do makes any difference, and that pile is heavy…

A child struggling with attention, anxiety and daily reflux at once may be dealing with one problem wearing three coats. Undiagnosed coeliac disease and other food reactions can produce all of it, and the gut symptom is the clue worth following.

Symptoms that arrive together are worth asking about together. If reading, mood and stomach all went wrong over the same period, that pattern is…

If you are testing whether a food affects you or your child, the test has to be complete. Among children with suspected sensitivity to artificial colouring, most reacted to as little as 100 mg, so a bit left in is enough to blur the answer.

What usually happens is that a family removes the obvious sources, misses the ones hidden in medicines, sauces and cereals, sees no change, and…

Cutting artificial preservatives out can genuinely help a child who reacts to them, because a child who feels unwell behaves worse. What it does not do is treat the ADHD underneath, which will still be there once they feel better.

Worth being clear with yourself about what you are hoping for, because these diets are expensive and hard to keep up. If your child does have…

Gluten free and dairy free eating is essential in coeliac disease and in a genuine milk allergy. Neither one treats ADHD, and putting a child on them without a reason carries costs of its own.

The cost is not only money and nutrition. It is the birthday party where they cannot have the cake and the lunch table where their food is different…

If you are going to test whether a food matters, work out in advance where the plan will leak. School lunch swaps, a grandparent's biscuit tin, your own memory on a hard week: all of it decides whether the answer means anything.

Change one thing at a time and keep everything else steady, otherwise you cannot tell which change did what. Then be honest about who is running the…

Telling somebody one thing you are quietly embarrassed about will bring you closer than a month of pleasant conversation.

It does not have to be dramatic. The worry you have never said out loud, the mistake you still think about at night, the thing you are no good at.…

You cannot decide to feel closer to people. You can decide to eat with them, walk with them, sit near them and say one true thing, and the closeness tends to follow.

The chemistry gets talked about a great deal and it is the least useful part. What you can act on is the diary: a standing meal with someone, a hand…

Four ordinary things take the edge off a hot temper: being touched by someone you trust, eating with people, moving your body hard enough to breathe, and sitting still for a few minutes a day.

None of them are about anger directly, which is the point. Exercise lowers what you are already carrying before the argument starts. A shared meal…

If eating together helps, it is the together that is helping. Being full is not a route to feeling close, and treating it as one goes wrong quickly for some people.

Sit down with somebody once a week and eat whatever you were going to eat anyway. That is the whole practice. If you notice yourself reaching for…

You can say what an SSRI does in one sentence. It blocks the doorway that carries serotonin back out of the gap between two nerve cells, so more of it stays there for longer and is likelier to be picked up.

Worth being able to say plainly, because most people are carrying something vaguer and more frightening than that. It also sets a fair expectation.…

Serotonin syndrome comes from stacking, and the second agent is usually something nobody thought to mention: a migraine tablet, a cough medicine, a herbal remedy for low mood.

Triptans, tramadol, dextromethorphan, linezolid and St John's wort all count, as do other antidepressants. Someone who mentions in passing that they…

The standing side-effect list is sexual difficulty, less appetite, an unsettled stomach, disturbed sleep and headache. Sexual side effects are common, and almost nobody raises them unprompted.

So ask directly, and ask about sleep while you are there. People do not usually announce these things. They quietly stop taking the tablet and say…

If you know something about a person's history that the prescriber may not, say it. A past eating disorder or a single seizure can change what is safe to prescribe.

Bupropion lowers the seizure threshold, and in someone who is purging, restricting or very underweight that risk climbs meaningfully. The therapist…

If a young driver in your house takes medication, the dose and the car keys belong together. Driving is the everyday task where one lost second costs the most.

The gap tends to open at weekends and in the holidays, when the dose gets skipped because there is no school and then someone drives anyway. Make it…

If swallowing the capsule is the sticking point, ask whether yours is the bead type that can be opened and tipped onto a spoonful of soft food. The little beads go down unchewed and the medicine still lasts as long as it should.

Inside these capsules sit lots of coated pellets, some with thin coats that dissolve early and some with thicker coats that dissolve later, which is…