Wondering how to improve gut health? It’s all about getting a healthy balance of bacteria. If you nourish your gut and look after it, you’ll enable the friendly bacteria to thrive – and when your gut bacteria become healthier, you feel better too.

'Good gut health can be linked to the health of many other parts of the body because 70 per cent of the body’s immune cells lay along the digestive tract,' says nutrition expert, Penny Weston. 'While some bacteria are associated with causing illness, others are extremely important for our immune system, heart, weight and many other aspects of health.'

This is because your gut not only helps to digest the foods you eat and absorb nutrients to fuel your body, it also helps get rid of waste and toxins, too. But, if gut isn’t happy, your body will struggle to do this, which can lead to a variety of health problems such as a weakened immune system, poor mental health, as well as cardiovascular diseases and cancer. Luckily, there are plenty of easy ways to show your gut some TLC and boost your health and wellbeing. Here, our experts reveal all...

How to improve gut health

1. Eat fermented food

According to the British Heart Foundation, fermented foods are those that have undergone microbial growth and fermentation. This is where microorganisms such as yeast and bacteria break down food components (eg sugars such as glucose) into other products (eg organic acids, gases or alcohol). This gives fermented foods that unique and desirable sour taste, smell, texture and appearance.

‘Including fermented foods in our diet can give our guts regular exposure to live bacteria. Good food sources include fermented dairy like natural yoghurt or Yakult, sauerkraut, miso, tempeh and pickled vegetables,’ says dietitian and Yakult advisor Lucy Kerrison. Since different fermented foods provide different bacteria, variety is key.

Other fermented foods include:

• Kefir
• Kimchi
• Kombucha
• Cheese
• Sourdough
• Vinegar

Make sure you always read the label when buying fermented foods from the supermarket as some may contain high levels of sugar or additives.

2. Fill up on prebiotics

'Prebiotic foods are high in a special type of plant fibre, which helps look after your digestive system, increasing good bacteria in the gut and also improving metabolic health,' says Penny.

'Prebiotics come from types of fibre that humans can’t actually digest but the good bacteria in your gut will eat. Prebiotics are found in many fruits and vegetables, especially those that contain complex carbohydrates.'

Research from the American Gut Project found that individuals who eat over 30 different plant foods a week have a more diverse gut, compared to those who eat ten. A varied diet packed with plant foods also benefits your mood, weight and overall health and wellbeing.

'Upping your intake of plant foods doesn’t have to be difficult or expensive, and it is not just the more obvious healthiest vegetables and fruit which counts, but also legumes such as beans and lentils, wholegrains, nuts, seeds, herbs and spices,' says Lucy.

Prebiotic foods include:

• Jerusalem artichoke
• Garlic
• Onions
• Leeks
• Asparagus
• Bananas

3. Boost your probiotic intake

Asking yourself 'Prebiotics and probiotics for gut health: what's the difference?' Simply put, probiotics are live bacteria and yeasts, which help to restore the balance of gut bacteria after it has been affected by illness and can help ease the symptoms of IBS. Prebiotics, on the other hand, are a type of dietary fibre, and are found in foods such as leeks, onions and garlic, which feed the friendly bacteria in your gut, such as Lactobacillus and Bifidobacterium.

Probiotic foods include:

• Sour cream
• Pickles
• Miso soup
• Yoghurt
• Aged cheese
• Kombucha

4. Take supplements

While you can get the majority of good bacteria through your diet, taking a prebiotic or probiotic supplement can give you extra benefits.

A study published in the journal Alimentary Pharmacology & Therapeutics found that people with irritable bowel syndrome (IBS) saw improvements in stool consistency, reduction in bloating and gas, and even improvements in anxiety after taking a prebiotic supplement.

You can take prebiotics and probiotics together. However, it's recommended to wait around 15 minutes to avoid bloating. Take your probiotic first thing in the morning.

5. Reduce alcohol

Alcohol is a gut irritant. 'If you drink alcohol in excess, it can interfere with the production of digestive enzymes and juices so it becomes harder for your body to digest and absorb nutrients from food,' says Penny.

'This can lead to excessive fermentation in your gut, which causes bloating, gas and loose stools.' Alcohol also increases cravings for processed, sugary foods which can make these symptoms worse. Why not swap for one of the best non-alcoholic wines instead?

'Drinking water during or after a meal will help your body break down and process food and therefore help the digestion process,' says Penny. 'This breaking down of food helps your body to absorb those important nutrients and flush out the toxins. It also helps make your stools softer, preventing constipation.'

6. Snack on dark chocolate

Yes, eating this sweet treat really does have health benefits. Dark chocolate contains fibre that moves undigested through our digestive tract to the large intestine where our probiotics feed off of it to grow and boost our health.

Research published in Nutrients found that the flavanols in chocolate help reduce inflammation in the gut – which can cause chronic constipation, abdominal pain and nausea. Another study published in The Journal of Nutritional Biochemistry found that the polyphenols in dark chocolate reduced the risk of colon cancer and intestinal anti-inflammatory disease.

To reap the most benefits, opt for 70% cocoa chocolate and stick to just the recommended 30g of chocolate a day – that's roughly three to four squares.

7. Limit artificial sweeteners

While sweeteners are often used as an alternative to sugar when dieting, or simply cutting down your intake for other health reasons such as diabetes, they can wreak havoc with your gut microbiome. This is because the GI tract doesn't break down sweetener in the same way it does sugar and other processed foods, meaning when they reach your digestive tract, they're undigested.

However, unlike dark chocolate, studies have found that this causes sweetener to negatively impact your gut bacteria, even reducing some of the good stuff! Findings published in The International Journal of Molecular Sciences showed that excessive consumption of artificial sweeteners can become toxic to the gut, leading to health problems such as damage to the liver and intestines.

As well as the sweeteners you add to your own drinks, they can also be found in shop-bought items, such as:

• Diet/ sugar-free drinks
• Energy drinks
• Baked goods such as pastries and cakes
• Sugar-free condiments such as ketchup
• Granola and other cereals
• Greek yoghurt

Aim to stick to the acceptable daily intake (ADI) of artificial sweetener which is 50 milligrams for each KG of body weight.

Signs of poor gut health

'Due to the gut-brain axis, which is the direct link between the gut and brain, gut health can have a big impact on mood, mental and physical health, energy and overall wellbeing,' says Lucy. 'Low mood and energy, disrupted sleep and poor immunity can all be signs of poor gut health because of this connection.'

Other signs of poor gut health include:

• Changes to your stools. If your stools are harder and painful to pass you might be dehydrated or not have enough fibre in your diet. Usually, constipation home remedies will help this. If you don't see improvement after a week, book an appointment with your GP. If your stools are a colour other than brown, such as green, black, red or yellow, you should also see your GP,' says Penny. 'With a healthy gut, your poo should also be smooth in a sausage shape and should sink in the toilet bowl. If it floats, it means there could be undigested fat in the poo.'
• Stomach pain: 'Cramping or bloating for example, might also be indications of gut health problems. Bloating can signal stress, indigestion or a reaction to a specific food,' says Lucy.
• Headaches: This is due to the connection between the gut and the brain, and inflammation. The more inflammation there is in the body, the more pain that manifests. For people with celiac disease who also experienced migraine symptoms, research published in Medical Hypotheses found that reducing their gluten intake (and therefore, inflammation) for six months saw a big improvement in the number of migraine attacks they had.
• Bad breath. 'Not passing poo properly can cause a build up of toxins in the body, resulting in bad breath,' says Penny.

Worst foods for gut health

• High protein intakes: Around 15% of protein is malabsorbed, high intakes in the absence of fibre can have a negative impact on the microbiome. What is key here is not to avoid protein, but to ensure a good protein: fibre ratio.
• High levels of saturated fats: These tend to be solid at room temperature and are within animal products as well as foods such as crisps and chocolate. In high quantities, these can cause inflammation.
• High alcohol intake: Alcohol is an irritant, affecting the guts ability to absorb water and nutrients from food.
• Low fibre intake: Fibre can help strengthen gut muscles, draw in water to soften stools and also add roughage to the gut so there is more to ‘grip on to’. Make sure you’re eating a range of different fibre types including vegetables, wholegrains, nuts and seeds to feed your gut optimally.

Lucy recommends limiting the above in your diet if you're looking for ways to improve your gut health.

Our family got a puppy a fortnight ago. She's done what no personal trainer ever could; I am suddenly clocking up 10,000 daily steps without even trying. 

Between matrescence and mum guilt, it's hard to commit time to your health and fitness goals as a busy working parent.  So when my 10-year-old daughter's pleas for a puppy finally wore us down and we found ourselves saying yes to getting a puppy, I hoped it would help me to boost my daily step count. But I hadn't realised that it would prompt me to achieve my goal of walking 10,000 steps a day quite so easily.

Here's how I went from a fairly sedentary life as a constantly tired mum of three to walking 10,000 steps every day without even leaving the house...

1. I start my daily step count early

Lazy mornings are a thing of the past with a puppy in your life. I'm walking laps of the garden within minutes of my alarm going off in the morning instead of hitting the snooze button. 

Before dog ownership, I could always cancel the gym or cry off going for an early morning walk. But toilet training a puppy means there's no debate. Your step count gets going the moment you're awake because, well, nature is calling your furry friend. And the quicker you react, the less cleaning up you have to do. That's quite the fitness motivator.

2. I'm smashing my stand goal

It's well-documented that sitting for long periods like this can be detrimental to our health. As a remote worker with a cosy home-office setup, it's too easy for me to spend hours and hours at my desk, barely moving except for bathroom breaks and the occasional dash to the kitchen for more coffee. But since this bundle of boundless energy burst into my life, my Apple Watch has suddenly started congratulating me for closing my Stand ring every day. (The goal is to get up and move around for at least one minute every hour.)

I haven't consciously tried to spend less time sitting but it's another knock-on effect of puppy-owning life. Puppies are into everything so it's impossible to sit down for very long before you have to leap up to snatch something contraband out of their mouths. While writing this paragraph alone, I retrieved a Jenga block, an item of school uniform, and an unidentifiable remnant of something plastic (Lego?) from my puppy's jaws. 

Once you're out of your seat, you've got to find somewhere to place the confiscated item out of the puppy's reach. And since you're up, you might as well do a lap of the garden just in case nature is calling again. Usually, I find my pupster waits until we're back inside to answer the call of nature, so then it's off to the kitchen for the puppy accident cleaning materials. Then it makes sense to make a cuppa while you're in the kitchen and lo, you've racked up another hundred steps (and a bit of cardio-boosting cleaning) without even noticing.

3. Playtime has become a priority

When a puppy wants to play, only someone with a heart of stone could resist. It used to take a legit emergency to tear my away from desk during the working day, which is partly why I struggled to walk anything close to the recommended 10,000 steps per day. 

But when those tiny teeth start nipping at my slippers and those puppy dog eyes start pleading with me to pop outside for bit of rough and tumble, I can't say no. We're not even doing proper daily dog walks yet as my puppy hasn't had her second set of vaccinations, but it's amazing how quickly all those short bursts of puppy playtime soon add up to thousands and thousands of steps per day.  

4. Mealtimes are more mindful

Confession: I find it easy to work through my lunch break, either skipping lunch altogether or stuffing my face with something quick and easy (ok, Oreos, since you're wondering...) to eat between calls. I always intend to go outside for a walk at lunchtime but it rarely happens.  

Feeding a puppy at regular intervals has inspired me to put more thought into what I eat, too. She's so easily distracted that I have to stand by her bowl to encourage her to eat up, so I might as well use the time to prepare myself a healthy meal while I'm in the kitchen. That doesn't up my daily step count by much but it is yet another way that my puppy's presence in my life has had a positive effect on my overall health and wellbeing.

5. A final lap before bed matters

Much like getting my steps in early the moment my puppy wakes up, I've noticed that I never fail to do a few laps of the garden in the evening, now that I'm a canine parent. Before the puppy came to join our family, I'd sometimes spend the entire evening telling myself that I would definitely go for a run or hit the exercise bike soon. And then I'd often fall asleep on the sofa while watching Netflix. Now, my nightly routine revolves around - you guessed it - yet more laps of the garden before I pop the pup in her crate for the night and then fall into bed myself. 

And just like that, without trying and often without even leaving the house, my Apple Watch will tell me that I've crushed my Daily Move goal and clocked up another 10,000 steps. 

Being a puppy mum isn't easy. And it's certainly a pretty extreme method of increasing your daily step count. But I'm delighted that my favourite four-legged friend is already impacting my health and fitness in such positive ways. Now, just imagine how many steps I'll be racing through when we start going for proper daily walks on the beach...

Kit that helps me walk 10,000 steps a day

Looking for more original family content? Check out I tried the ‘romanticise your life’ social trend as a busy mum of three or have a read of Joe Wicks just dropped a parenting truth bomb about sibling rivalry and I feel so seen . We've also got 10 things I’ve learned about love after 25 years of marriage and Parenting tips: 18 things I know on my son's 18th birthday.

Nail biting can cause some health issues you might have expected – will the below facts make your child stop biting their nails for good?

There’s so much to think about when it comes to our children. If you’re not worried about screen time you might have childhood mental health on your mind – and then there are those bad habits like nail biting, too. 

If your child is always biting their nails, and you’ve tried every trick in the book to make them stop, you’re not alone. 

However, even kids who revel in the grossest facts might not like to find out that, when you bite your nails, you’re putting yourself at risk of a whole host of potential diseases.

Richard Scher, M.D., told Men’s Health that a lot of germs live in our fingernails, Enterobacteriaceae. This family of bacteria includes salmonella and E. coli, said Dr. Scher, and “tends to thrive in the cosy crevice beneath the tips of your nails.”

He adds, “When you bite your nails, those bacteria end up in your mouth and gut, where they can cause gastro-intestinal infections that lead to diarrhoea and abdominal pain.”

But that’s not all. Biting your nails can be harmful to your teeth, too. Anna Peterson, a dentist and dental therapist, said, per HuffPost UK that nail biting can cause your teeth to chip, crack, and break, due to the pressure and stress we apply to our teeth when we bite our nails. 

It can lead to resorption, which in the longer term can lead to the tooth falling out. 

And, to finish off this triple whammy of undesirable nail-biting consequences, it can lead to fungal infections, too. Per Health, “A skin infection called paronychia can occur after an injury to the nail area from biting or picking at the nail or trimming or pushing back the cuticle too far.”

If this isn’t treated, it can lead to a build-up of pus. This can cause your nail to look yellow or green, and eventually lead to an abscess and further nail damage.

So, if you’ve tried everything else, will these facts help your children biting their nails?

In other health news, here are the common types of insect bites in the UK, while this is why your sunscreen might be giving you less protection than you think. Meanwhile, here are some natural remedies for hay fever, recommended by doctors, that can also be used in pregnancy.

It’s a good idea to keep a red cloth in your first aid kit if you have young children, a pediatric nurse has claimed.

When you have young children, it’s a good idea to know the basics of first aid and to keep a first aid kit nearby at all times. After all, if your child grazes their knee or has a temperature, you’ll want to have everything on hand to make them feel better. Bandages, plasters, painkillers, antiseptic spray – there’s something to help manage almost every ailment or injury whether it’s you or your child who needs some extra care. 

But one thing it may not have occurred to you to keep in your family’s first aid kit is a red cloth. Yet, for pediatric nurse Sarah Hunstead, who runs the Instagram account CPR Kids, it’s a must-have. 

Essentially, the reason for this is that it helps to hide the sight of blood, something that could be distressing for young children. As Hunstead explains, “If you or your little one don't like the sight of blood or if your little one completely freaks out at even a drop, these are a necessity. 

“They can help with the fear and anxiety some little (and big) ones get from seeing blood, which helps to make dealing with nose bleeds or cuts easier. If your little one has regular nose bleeds and can't stand the sight of blood, stock up on a few!⁠”

When you think about it, it makes perfect sense. And CPR Kids’ followers certainly seemed to agree, explaining that while they’d not considered the need for a red cloth previously, they’ll make sure they keep one in their first aid kits in future. 

So, while we hope you won’t need to use it, why not put a red cloth or two in your first aid kit just in case?

For more health tips, here are 16 natural cold remedies suitable for all the family, and here’s how to cool a baby down.

A recent study has indicated that maternity deaths have risen to their highest levels in two decades, with black women and women from deprived areas most at risk.

In recent years, there’s been a lot more discussion around maternal health and wellbeing, from speaking out about maternal mental health to sharing experiences  of traumatic births. 

Now, research shows that between January 2020 and December 2022, there were 13.41 deaths per 100,000 women in the UK either during pregnancy or in the first six weeks after pregnancy had ended, the highest levels since 2003-05. Even if deaths from Covid-19 are excluded, the figure of 11.54 deaths per 100,000 women is higher than the figure from 2017 to 2019, which was 8.79 deaths per 100,000.

Black women are three times more likely than white women to die, though the maternal death rate among black women has fallen slightly since the previous survey. Meanwhile, Asian women are twice as likely to die as white women. There are socio-economic factors too. The study found that women living in the most deprived areas of the UK are more than twice as likely to die as women from the least deprived areas.

Among the leading causes of death across 2020-22 were thrombosis and thromboembolism – blood clots in the veins – Covid-19, heart disease, and mental health-related illnesses.

The data comes from Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK), which monitors maternal deaths, as well as stillbirths and infant deaths, and their causes for the national Maternal, Newborn and Infant clinical Outcome Review Programme (MNI-CORP), and the research was led by the Oxford Population Health’s National Perinatal Epidemiology Unit (OPHNPEU).

Professor Marian Knight, director of OPHNPEU and the MBRRACE-UK maternal reporting lead, explained that there are “clear examples of maternity systems under pressure,” and said, “Ensuring pre-pregnancy health, including tackling conditions such as being overweight or obese, as well as critical actions to work towards more inclusive and personalised care, need to be prioritised as a matter of urgency.”

In other health news, here are 15 reasons you might be feeling tired all the time, and this is how to cool down while pregnant. 

Better weather means more opportunities for outdoor adventure with your children, but that also means you might be more likely to have to deal with different types of insect bites or stings. 

It is more common for people to get bitten or stung by insects in the warmer months of the year, and last summer the NHS reported triple the number of those seeking advice on bites and stings via its website compared to the previous year. According to the government, climate change is causing the UK’s insect populations to alter in size.

We spoke to Dr José Costa, a senior consultant paediatrician specialising in children’s allergies, and GP Dr Luke Powles, who shared their advice with us on the main types of insect bites and doctor-approved treatments you can use at home to help soothe the bite and stop it itching. The doctors also shared their insights as to why some children are more at risk of being bitten, and the red flags to look out for so you know when to take your child to see the GP to get their insect bite looked at by a doctor. 

The information in this article is for general purposes only and does not take the place of medical advice. It is essential to be guided by your GP and take note of official NHS advice. As a parent, you know your child better than anyone and you should always trust your own judgement. If you are at all in doubt or worried about your child's symptoms, or their symptoms get worse or are not getting any better, you should contact your GP.

If your child is limp, floppy or not responding like they normally do, their lips, mouth, throat or tongue suddenly become swollen, they are breathing very fast or struggling to breathe, their skin, tongue or lips turn blue, grey or pale, they become very confused, drowsy or dizzy, or faint, you should call 999 or take your child to A&E. These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

The most common types of insect bites in the UK

"The main types of insect bites - or stings - expected during the summer will come from mosquitoes, flies, fleas, ticks, honeybees, bumblebees, wasps, hornets, yellowjackets, harvester ants and fire ants," says Dr Costa. Similarly, Dr Powles adds that midges, mites, bedbugs and horseflies may cause problems too. 

Dr Costa says, "The signs [of an insect bite] often vary, depending on what has bitten or stung your child," but the main symptoms of an insect bite or sting are a small, swollen lump on the skin and pain at the site of the bite. The NHS notes, "The lump may look red. It may be more difficult to see on black or brown skin, but you should be able to feel it."

Dr Costa and Dr Powles explained what the following different types of insect bites might look like:

• A mosquito bite - This will look like a hive or welt - being raised, mildly pale in the centre and quite itchy. These symptoms tend to present after a few hours. 
• A bee, honeybee, wasp, hornet, or yellow jacket sting - This will look like a mosquito bite, but it can swell much more and tends to be quite painful. Symptoms usually start immediately and progress, mainly with increased swelling.
• Red ants - Red ant bites will leave a red area with a central white spot. The sting tends to be quite painful, burning and itchy. 
• Flies - The symptoms of a fly bite will be similar to the red ant but will not be painful.
• Midges - Midge bites can be very itchy and swell up to form blisters filled with liquid - they’re usually found in groups on the skin.
• Ticks - Tick bites can be spotted by the tick that’s attached themselves to the skin. Sometimes, but not always, a bullseye-shaped rash can develop around the site - if it does, seek medical advice as it could be a symptom of Lyme’s disease, which needs antibiotics.
• Fleas - Flea bites are commonly found below the knee. They appear as small, raised swellings, often in lines or clusters. 
• Mites - In contrast to flea bites, mite bites are very itchy, leading to lumps and sometimes blisters on the skin. 
• Bedbugs - Bedbug bites don’t usually hurt but they may form on your child’s face, neck, hands or arms. If it’s not your first time with bedbugs, they may cause irritation. 
• Horseflies - Horsefly bites are large in size - they’re painful and may end up bleeding, which can lead to infection.

The NHS provides pictures of common insect bites, stings and rashes here. If you or your child have been bitten or stung by an insect and were stung in the mouth or throat, or near the eyes, were stung more than once, or a large area around the bite or sting becomes red and swollen, you should ask for an urgent GP appointment or call NHS 111.

How long do insect bites last?

Insect bites or stings are not usually serious and get better in a few days, but if you or your child have been bitten or stung by an insect and the symptoms get worse or are not getting any better, you should see your GP as soon as possible. 

"If the bite doesn’t get better after a few days, or becomes worse, speak to a healthcare professional," says Dr Powles. "Additionally, it’s important to seek advice if your child has been bitten around their eyes, mouth or throat."

"Bites usually last anywhere between a few days and up to a week, with scabs from scratching possibly lasting a bit longer," explains Dr Costa.

"If the bite has become infected, you might have a skin reaction lasting for a couple of weeks." If you think an insect bite has become infected you should seek medical advice straight away.

How to treat insect bites at home

The NHS says that you, "can often treat an insect bite or sting without seeing a GP" and the doctors we spoke to shared their advice on how to treat insect bites at home.

"Start with simple measures like washing the sting or bite area," advises Dr Costa. "Applying refreshing creams like Eurax - or ones that are chamomile, mint or aloe vera-based - can help to decrease the itch and swelling." He adds: "Occasionally, pain relief - like ibuprofen or paracetamol - can also be given to ease symptoms."

Dr Powles agrees saying, "If your child is struggling to leave the bitten area alone, it may be useful to give them the medication to offer relief. It can be given in liquid or tablet form, depending on your child’s age." Consult with your GP or pharmacist first before giving your child pain relief. 

"You can also give them an antihistamine, as this will also help with the itch and swelling," says Dr Costa. Antihistamines are medication used to relieve symptoms of allergies - such as reactions to bites - but should only be given to children with advice first from your doctor and they are not suitable for babies. 

To help treat swelling from insect bites Dr Powles recommends, "use a cold compress - like a clean cloth soaked in cold water - and apply to the area. If you can, elevate where your child was bitten as this may help to lower swelling."

How to stop insect bites itching

Finding a way to stop your child itching an insect bite will not only make them more comfortable but is also important to stop the bite becoming infected. Dr Powles explains, "Helping your kid avoid scratching the area can reduce the chance of the bite becoming infected. If your child is finding their bite irritating, applying an unscented moisturising cream to their skin might help minimise the itching sensation."

"Regular bathing may also soothe irritation, along with dressing them in loose clothing and keeping their nails trimmed short to curb their temptation to scratch."

Dr Costa adds: "Applying refreshing creams like Eurax - or that are chamomile, mint or aloe vera-based - can help to decrease the itching sensation. You can also give them antihistamines."

When to see a doctor

Most bites should heal and their symptoms ease with time, however the NHS states that you should ask for an urgent GP appointment if you've been bitten or stung by an insect and:

• your symptoms get worse or are not getting any better
• you were stung in your mouth or throat, or near your eyes
• you have tummy pain and are being sick
• you feel dizzy or lightheaded
• a large area around the bite or sting becomes red and swollen
• you have a high temperature and swollen glands
• you were stung more than once
• you've had a serious allergic reaction to an insect bite or sting before

"You should see a doctor is if there is increased swelling  – in case this is an allergic reaction," warns Dr Costa. "If you find a tick and cannot remove it, it is wise to see a doctor so that the head can be got rid of before it causes an infection."

Dr Costa adds: "You should also be concerned if symptoms present in different areas to where the insect bite happened, and it’s important to keep an eye out for any developments over the coming weeks. 

"For example, certain tick bites can lead to Lyme disease, encephalitis and meningitis. It is important to note that the lesion from a tick can appear between one and four weeks after the bite – and in rare cases, showing up three months later. So often, parents don’t make a link between an initial bite and symptoms later on."

There are other instances in which you should seek advice from your child’s GP or another specialist fairly urgently. "Including if the bites become particularly swollen, blistered or start oozing pus," urges Dr Powles. "Additionally, you should make an appointment if your child has had an allergic reaction to an insect bite before or experiences symptoms such as a large red and swollen area forming around where they were bitten.

"Additionally, look out for whether they are developing a high temperature and swollen glands, and look or feel unwell, start experiencing tummy pains, nausea or being sick, dizziness or light-headedness and developing a rash after a tick bite."

"The main thing to look for is whether there is a discharge from the site where the bite or sting happened," advises Dr Costa. "This indicates an infection, and whether your child might need oral antibiotics.

"If the bite is on the upper body - such as the arms, chest, back or shoulders - and there is significant swelling around the area, spreading progressively towards the head, this is a concern and indicates a significant allergy. In this case, give them antihistamines and take them to A&E or call ‘999’. 

"Swelling of the throat, with shortness of breath and difficulty breathing, is a sign of anaphylaxis. In this case, do not give your child antihistamines, but take them to the nearest A&E or call ‘999’."

There are other instances when you should take the same measures. "They might need hospital treatment, if they become non-responsive or floppy, find it difficult to focus or lift their head, and if they feel faint and can’t be woken back up," warns Dr Powles. "Be alert to changes in the colour of their lips, tongue, palms or soles of their feet. If they become grey or paler, it could be a sign of circulation problems. They may also become disorientated or confused."

The NHS advises that you call 999 if: 

• your lips, mouth, throat or tongue suddenly become swollen
• you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
• your throat feels tight or you're struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

Additional questions about insect bites answered by doctors

The information on GoodTo.com does not constitute medical or other health advice or diagnosis and should not be used as such. Although GoodtoKnow consults a range of medical experts to create and fact-check content, this information is for general purposes only and does not take the place of medical advice. Always seek the guidance of a qualified health professional or seek urgent medical attention if needed.

Our experts

Heat rash, also known as prickly heat, is an uncomfortable and itchy red rash that can develop on the body after exposure to heat and excessive sweating.

The rash consists of small, red raised spots, which can be itchy and therefore cause discomfort. Heat rash is not infectious and cannot be passed on to other people.

The NHS explains that heat rash is caused by, "sweat glands [that] get blocked and the trapped sweat leads to a rash developing a few days later" and although prickly heat can be uncomfortable for your child, the NHS also reassures that prickly heat is "usually harmless". 

Heat rash can develop anywhere on the body, but is more often found on the neck, chest, and back, and affects babies as well as children and adults. GP Dr Hana Patel, specialist in skin health and women's health, explained to GoodTo.com that, "babies often get heat rash because they cannot control their temperature as well as adults and children can.” 

We spoke to Dr Hana Patel, as well as Dr Samira Neshat, Consultant Paediatrician, at The Portland Hospital (part of HCA Healthcare UK) and pharmacist Anshu Kaura about what to do if your child has heat rash and how to soothe them until the rash goes away. 

If your baby or child has a rash and you're worried, your child seems unwell, or the rash does not improve after a few days, always speak to your GP immediately. As a parent, you know your child better than anyone and you should always trust your own judgement. If you are at all in doubt and you're worried about your child's symptoms, you should contact your GP.

What should you do if your child has heat rash?

GP Dr Hana Patel told GoodToKnow that the main thing to do if you discover that your baby or child has heat rash, “is to keep the skin cool” to avoid any further sweating that will irritate the rash. This might include keeping your child out of the sun if possible and keeping your home as cool and well-ventilated as possible. 

Dr Samira Neshat, Consultant Paediatrician at The Portland Hospital agrees, advising, “if your child has a heat rash, it's important to keep them in a cool and well-ventilated environment.”

"Dress them in loose, light clothing and encourage them to drink plenty of fluids to stay hydrated," Dr Neshat continues. "Lightweight bedding may also help."

Try to distract your child from scratching the heat rash, as scratching or rubbing the area will only work to further irritate the rash and if the skin breaks, the rash could become infected and require further medical treatment. For similar reasons, pharmacist Anshu Kaura advises to "avoid using fragranced products" when bathing your child, as it may aggravate the heat rash.

Dr Samira Neshat also advises to, “avoid using creams or ointments as these can block the sweat glands and make the rash worse. If the rash doesn't improve in a few days, or your child seems unwell, please seek medical advice,” Dr Samira Neshat states. 

What to do if your child has heat rash at a glance:

What to do at a glance:

• Keep your child cool
• Dress them in loose, light clothing
• Encourage your child to drink plenty of fluids to stay hydrated
• Distract your child from scratching the heat rash
• Apply a cool compress to the affected areas or give them a cool bath or shower

How to soothe heat rash in children

"To soothe heat rash in children, first, move them to a cooler environment and remove any excess clothing," Dr Neshat says. "Apply a cool compress to the affected areas or give them a cool bath or shower to help reduce itching and discomfort. Keep them well hydrated and try to distract them from scratching the rash, as this can lead to infection."

Pharmacist Anshu Kaura also told us, "You can naturally calm the prickly heat rash by applying a cold flannel to the rash for no more than 20 minutes and patting the rash, instead of scratching it."

How long can heat rash last in kids?

Heat rash is usually harmless and should get better on its own after a few days. Dr Samira Neshat explains, "Heat rash typically lasts between two to three days in children, but it can last longer if the child continues to be exposed to heat and humidity."

To help soothe the heat rash Dr Neshat adds, "It's important to keep your child cool and dry to help the rash disappear more quickly."

What to do if you child's heat rash is not going away

It is always important to see a GP if your baby or child has a rash and you're worried or don’t know what it is. You should also see your GP if your child has heat rash and the rash does not improve after a few days.

Dr Samira Neshat says, "If your child's heat rash is not going away or is getting worse, it's important to seek medical advice. Persistent heat rash could be a sign of an infection or a more serious underlying / different condition. A healthcare professional can provide appropriate treatment, which may include topical creams or medications to reduce inflammation and discomfort."

The information on GoodTo.com does not constitute medical or other health advice or diagnosis and should not be used as such. Although GoodtoKnow consults a range of medical experts to create and fact-check content, this information is for general purposes only and does not take the place of medical advice. Always seek the guidance of a qualified health professional or seek urgent medical attention if needed.

Our experts

The experts share what might be behind your symptoms and how best to make them go away, so you can enjoy intercourse without worrying that it might make you want to vomit.

Wondering why have I gone off sex lately? For some, it may be because you’re skipping foreplay and missing out on some of the fun in the process. You can solve that by exploring what is tantric sex – a slow sex trend that’s more wholesome than it sounds. Others may be trying to conceive, which has the potential to make love-making a bit of a chore. Trying fun sex positions for conception could help here. Another reason why your sex life may have fallen off the boil is discomfort before, during or after intercourse. And there’s nothing less sexy than feeling sick after sex, though it’s certainly not uncommon.

GP and women’s intimate health expert Dr Shirin Lakhani says: “Many women do feel sick after sex, but it’s important to try and find out what is causing this, in case there's an underlying issue. Don't hesitate to discuss it with your doctor, especially if it becomes a frequent problem." Fortunately, some of the possible causes of post-coital queasiness are easy to treat, whether by tweaking your sexual technique or just popping a painkiller.

Why do I feel sick after sex?

1. Endometriosis, cysts or fibroids

If nausea after sex is accompanied by pain, it could be an indication of endometriosis. Similarly, if experienced alongside other pelvic symptoms, it could be caused by an ovarian cyst or fibroid.

“Endometriosis is a condition where tissue similar to the lining of the womb grows in other places. It can mean intercourse is painful and it’s important to visit the doctor if you suspect you may have it,” says Dr Lakhani. According to the Royal College of Nursing, endometriosis is the second most common gynaecological condition (after fibroids) and it affects one in 10 women. Unfortunately, it takes an average of seven years for most women to get diagnosed, as symptoms including painful bowel movements overlap with IBS.

Former GP and founder of Cambridge Women’s Health, Dr Susanna Unsworth adds: "Deep pain during sex can also be a feature of other pelvic conditions such as fibroids or cysts. Changes in bleeding patterns or very heavy, painful periods may also accompany this." Fibroids are non-cancerous tumours that develop on the uterus, whereas cysts are fluid-filled pouches usually in or attached to the ovaries.

All three of these conditions can impact fertility. However, regardless of whether you are trying for a baby, if you do have other pelvic symptoms alongside feeling nauseous after sex, it’s important you speak to your doctor.

2. Orgasm

If you are feeling sick immediately after orgasm, this may be the cause of your nausea.

"Some people feel sick after orgasm because the body releases hormones that make us feel relaxed, which can lead to nausea,” says Dr Lakhani. It could also be due to the effects of the contractions that can occur in the womb after an orgasm. “Finally, adrenaline is released during arousal, which could contribute to lightheadedness,” says Dr Lakhani.

“For most women, this will not be a severe problem and will settle quickly, however, if you are finding it is causing significant discomfort, you could try taking some pain relief prior to having sex – ibuprofen is a good option for this,” says Dr Unsworth, who is also the in-house gynaecologist for intimate wellbeing brand INTIMINA.

3. Certain sex positions

Vigorous sex or positions that allow for deeper penetration can trigger nausea after sex.

“Deep penetration that impacts on the pelvic organs, particularly the cervix, can trigger a drop in blood pressure and heart rate,” explains women's health specialist Dr Unsworth. “This is known as a vasovagal reaction – caused by stimulation of the vagus nerve which supplies many organs in the body, including the cervix.”

It’s possible you may also have experienced this outside of the bedroom. For example, if a smear test or having an IUD fitted made you feel light-headed, sweaty, or dizzy.

“A vasovagal reaction caused by sex is usually more mild,” says Dr Unsworth. “Drinking water, lying down, and trying to elevate your legs can often help relieve it.” To avoid it happening in the first place, you could alter how you are having sex. “Try to have sex in positions where you can control how deeply you are penetrated,” says Dr Lakhani.

Intercourse itself may also cause nausea if you are moving around a lot, or moving at speed. “If you are rocking back and forth and start feeling sick you may be suffering from motion sickness,” says Dr Unsworth. Consider slowing the pace or choosing different positions and techniques if this is the case – your symptoms may well improve.

4. Alcohol and/or drugs

If you have been drinking alcohol or have taken drugs, this may well be why you’re feeling sick after sex.

“Drink and drugs both have a tendency to make you feel sick anyway,” says Dr Lakhani.

Of course, it is possible that you are feeling sick because of a combination of drink or drugs and another of the causes listed here. To check that this isn’t the case, don’t drink too much or take drugs before having sex and see if your symptoms go away. If you feel better, cut back on what you are consuming until your symptoms stop impacting on your enjoyment. If you don't, you'll need to investigate your symptoms further with the help of a medical professional.

5. Dehydration

Dehydration can cause nausea, so it’s likely a common cause of feeling sick after sex.

“People often feel nausea even if you are only slightly dehydrated,” says Dr Lakhani. “Make sure you drink enough water throughout the day.” This means drinking 6-8 glasses of water per day, according to the Eatwell Guide. Of course on hot days or if you have been exercising, this requirement increases. The good news is that nausea-free sex aside, there are many other benefits of drinking water, such as better brain and gut function, and improved mood.

6. A urinary tract infection (UTI)

If you experience nausea after sex alongside pain when passing urine, fever or even blood in your urine, you may have a UTI.

“UTIs can make you feel systemically unwell, with nausea being a possible symptom,” says Dr Unsworth. “If this occurs alongside any of the symptoms listed above, visit your GP as you may need treatment to clear the infection.”

7. Anxiety

If there are no obvious physical reasons for feeling nauseous after sex, you may be struggling with anxiety.

“Nausea can often be a symptom of anxiety. I am sure we will all have experienced ‘butterflies’ in our stomachs at some time in our lives,” says Dr Unsworth. "This is one of the body’s responses to stressful/anxious situations, as our gastrointestinal system is full of nerve endings, making it very sensitive to these emotions. If you are feeling anxious about sex, this could trigger feelings of nausea, either before or after.”

“Perhaps you are feeling uncomfortable having sex with a partner,” says Dr Lakhani. “Sexual aversion is a mental health condition where a person experiences anxiety and fear related to sex." A Canadian study found that the prevalence of sexual aversion symptoms was 7% for cisgender men, 11% for cisgender women, and 17% for transgender or nonbinary individuals.

"Ultimately, if sex doesn’t feel good, it is important to speak to a mental health professional,” says Dr Lakhani. Addressing the underlying reasons for your anxiety is the best way to treat any unpleasant physical symptoms you are experiencing.

Does feeling nauseous after sex mean you are pregnant?

No, feeling sick after intercourse does not mean you have conceived.

“Pregnancy-related nausea is often related to the production of the hormone beta HCG (the ‘pregnancy’ hormone picked up in a pregnancy test),” says Dr Unsworth. “This takes a while to reach a level that can cause nausea (it can actually take up to 3 weeks to reach the small level detectable on a pregnancy test).”

“Obviously pregnancy can cause nausea, and if you are already pregnant there is the chance this may occur after sex too, but I would not link the two as a sign of conceiving,” concludes Dr Unsworth.

Should I be worried if I feel sick after sex?

Not necessarily. It depends on how many times this has happened, how severe the nausea is, and if other symptoms are present.

“If it’s a one-off, then you don’t need to worry,” says Dr Lakhani, “but if it impacts on your enjoyment of sex regularly and you don’t know why you are feeling nauseous, it’s time to seek help to identify why.”

Once you find out what might be at fault, you can treat it. In some cases, this may be simple. For example, avoiding triggers such as alcohol or drugs, or adjusting your position during sex. In other cases, you will need further help, tests and/or advice from a medical professional.

Looking for more like this? Check out our advice on how to spice up your relationship – with 25 tips from relationship experts – or perhaps you're at the stage where what you really need is a list of the early signs of pregnancy.

Video of the week

We asked the experts if air fryers are toxic, after several viral TikTok videos caused panic among consumers.

If you're an avid TikTok user, then you've probably noticed a few videos cropping up that claim air fryers are toxic. These handy kitchen appliances have dramatically grown in popularity over the past year or so, partly because they are reported to be a low-cost way of making meals amid the cost of living crisis, and partly because there are so many things you can cook in an air fryer. And while many have previously questioned whether air fryers are healthy, it's only recently that some have wondered if they could be toxic.

Jim Finley, CEO of My Cleanse Plan, told us: "Research on the safety of air fryers is ongoing, and while there have been some studies that have raised concerns about the potential health risks associated with the use of air fryers, the overall consensus is that air fryers are generally safe to use." With that in mind, let's take a look at where the TikTok claims have come from...

Are air fryers toxic?

Most air fryers are not toxic. The TikTok videos that claim air fryers are toxic point to the Teflon coating as the health hazard, but modern Teflon is no longer manufactured with the chemical PFOA - meaning the vast majority of air fryers are safe to use.

Teflon is the brand name of a chemical coating (polytetrafluoroethylene), and is often used on cook wear as a non-stick coating. PFOA, which Teflon used to be manufactured with, has been linked to liver and kidney disease. However, Teflon manufacturers eliminated PFOA from all of their cookware in 2013, so any air fryers made after then will be safe to use.

Jim Finley, explained, "While it is true that some air fryers may produce harmful compounds when heated to high temperatures, it's important to note that not all air fryers are created equal.

"Some air fryers are made with materials that are more likely to release harmful chemicals when heated, while others are made with safer materials such as stainless steel or ceramic. Additionally, the type of food being cooked and the temperature at which it is cooked can also affect the formation of harmful compounds."

Even then, it's usually only when cooking at high temperatures of 500F (260C) or above that toxic fumes could be released, and most air fryers don't reach temperatures that high.

Do air fryers produce harmful chemicals?

Cooking food at high temperatures can in some instances produce chemicals. Oil can produce smoke and other potentially harmful chemicals at high temperatures, while starchy foods can produce acrylamide.

Jim Finley said: "One important factor to consider when using an air fryer is the type of oil that you use. While air fryers can reduce the amount of oil needed to cook food, it is still important to choose a healthy oil with a high smoke point, such as avocado oil or coconut oil, to minimize the formation of harmful compounds when cooking."

While air fryers are no more likely to produce these chemicals than cooking food in an oven, damaged non-stick coating in an air fryer can cause toxins to be released into the air and food. So, avoid using rough tools when cleaning your air fryer, so you don't damage the coating.

If you’re really worried about the non-stick, consider an air fryer made from ceramic or stainless steel instead, like the Ninja Air Fryer MAX AF160UK (one of our best air fryers), which has a ceramic-coated pan and crisper plate. 

• View Ninja Air Fryer MAX AF160 - RRP £169.99 | Ninja

Our Features Writer, Ellie Hutchings, recently put the Ninja Air Fryer Max to the test. She said: "You can cook whole meals for several people using this air fryer - and you can even bake desserts in it too. The range of cooking modes means there are pretty much limitless options in terms of what recipes you can try, so I can see myself using the Ninja air fryer really regularly."

Read our full review of the Ninja Air Fryer MAX AF160UK here.

What is acrylamide and should you be worried about it?

Acrylamide is a chemical that can be created by cooking processes including baking, air frying, and toasting, and it is considered a carcinogen - meaning it could cause cancer.

However, the claims that acrylamide causes cancer are based only on studies in laboratory animals, and there is no research linking acrylamide consumption to cancer in humans.

Acrylamide is most commonly found in foods that have a lot of sugar or amino acids, like potato chips and French fries, and during the heating process of these foods a series of chemical reactions result in the formation of acrylamide.

Antoaneta Dimitrova, cleaning services manager at Fantastic Services, explains, "Due to the way air fryers work, they produce fewer harmful chemicals than traditional frying methods. However, cooking certain foods, like potatoes, at a high temperature can still produce acrylamide."

How do I prevent acrylamide in my air fryer?

It's not necessarily the appliance that creates acrylamide, it because it can be naturally present in food.

In fact, when compared to deep frying, air frying food can actually lower acrylamide content by up to 90 percent, according to a 2015 study in the Journal of Food Science. 

The Food and Drug Administration (FDA) recommends soaking starchy vegetables in water for around 15 minutes before cooking and making sure not to cook food at a too high temperature for too long to reduce acrylamide.

Antoaneta recommends soaking food for an hour. She adds, "You can also use a cooking spray or your favourite oil to coat the food before placing it in the air fryer. Needless to say, you need to avoid overcooking and burning food."

How to use your air fryer safely

Avoid using a non-stick air fryer if the material is damaged, scratched, or chipping, and make sure you use wooden or heat-resistant silicone utensils in your air fryer minimize the chance of scratching the non-stick coating.

You should never put plastic containers or Tupperware in your air fryer, or leave it plugged in when not in use. Make sure you familiarize yourself with the manufacturer's guide before using your air fryer. 

As Jim Finley said, "It's important to follow proper usage guidelines when using an air fryer. This includes preheating the air fryer before use, not overcrowding the basket with food, and avoiding cooking foods that are high in fat or oil."

Looking for more air fryer content? Check out our round up of the best air fryer cook books, and best air fryer recipes - plus find out how much it costs to run an air fryer too.

Video of the Week

From probiotic supplements to sunning yourself by a window, you won't believe how easy it can be.

Widely researched due to its link with depression, serotonin is a hot topic. If you struggle with low mood, or often wonder ‘Why am I so tired’, then knowing how to boost serotonin naturally is very useful information. Whatever your symptoms, there are a number of ways to top up your serotonin tank, which could include going teetotal (improved serotonin levels are one of the benefits of not drinking alcohol) or filling your diet with mood boosting foods.

Don’t know what serotonin is? Psychology expert and neuroscientist Laura Ellera explains: "Serotonin is a chemical. It's called a hormone when it’s in your body, or a neurotransmitter when it’s in your brain, and it plays different roles depending on where it is found.” Recently, a University College London review questioned if low serotonin levels did in fact cause depression, as had been thought. This in turn cast some doubt on the widespread use of SSRIs to treat the condition. Neuroscientist Laura says: “Depression is multifaceted and doesn’t just stem from one neurotransmitter. While reduced amounts of serotonin alone are unlikely to be the cause of depression, studies have shown they play a role.” 

How to boost serotonin

1. Watch your diet

Neuroscientist Laura says: “Serotonin is made from the amino acid tryptophan. You can't eat serotonin, but you can increase your intake of tryptophan through certain foods.” 

While turkey is high in this amino acid, it isn't as simple as eating turkey in every meal. Neuroscientist Laura continues: “It can be quite difficult for your body to convert tryptophan into serotonin. One way to get past this problem is to get your tryptophan intake from complex carbs such as fruits, vegetables and whole grains. This helps to bypass other, competing processes and increase your serotonin levels.” These foods include pineapple, bananas, tomatoes and plums.

In general, eating a diet rich in whole foods and low in unprocessed foods will benefit both your physical and mental health. People who reported eating more ultra-processed foods (think sugary drinks and packaged snacks) were significantly more likely to report more mentally unhealthy days in a Public Health Nutrition study.

Finally, consider giving up alcohol. While drinking alcohol can boost serotonin levels in the brain in the short term, over time this can lead to lower levels. This is why drinking alcohol isn't advised if you are also taking SSRIs, according to the NHS.

2. Stress less

If you can manage it, it’s a great way to safeguard your serotonin levels. Medical scientist and founder of Functional Medicine Associates Pete Williams, explains how this works: “Higher levels of stress interfere with the normal production, transport and receptor effectiveness of serotonin.” But stress is not always something we can control. So what happens when that work meeting is pulled forward at the last minute or you have a worrying doctor’s appointment in the diary?

Instead of trying to avoid stress, check in with your stress levels regularly and alter your reactions to triggers when you can. Neuroscientist Laura says: “Breathing is the most direct and accessible way to reduce stress levels.” Try taking a deep breath in and then breathe out slowly out through your mouth as if through a straw. Do this several times. It can help reduce heart rate, calm your nervous system and increase your serotonin levels.

3. Be kind

Being kind goes beyond politeness. It involves going out of your way to do something or help someone, often without reward or praise. You could even build this into your week officially by volunteering. 

Neuroscientist Laura says: “Acts of kindness positively affect mood due to increased levels of oxytocin. But oxytocin also provokes the release of serotonin.” This is supported by a 2010 survey by Harvard Business School, which found that those who were more generous reported greater happiness.

Other things that increase oxytocin levels – and therefore serotonin – are hugging, cuddling, giving someone a massage and holding hands.

4. Exercise more

And running isn’t the only thing that works. Medical scientist Pete explains: “Any form of physical activity increases the uptake of amino acids that are normally competing with tryptophan to cross the blood-brain barrier. In other words, exercise reduces the amount of competition, so more tryptophan can cross into the brain, increasing serotonin levels.”

This has been proven by several studies. In one Canadian study of moderately depressed people, 20-40 minutes walking, three times per week for six weeks successfully reduced depression symptoms.

5. See the sun

Neuroscientist Laura says: “When sunlight enters our eyes, it triggers the production of serotonin. This is why people tend to be happier on sunny days.” Five 30-minute sessions of light therapy using a lightbox were shown to have an antidepressant effect in a Canadian study.

In reality, this means prioritising going outdoors in daylight hours. Or you could sit in a sunny window for 15 minutes a day. Neuroscientist Laura says: “Even if it’s not bright sunshine, you will still get some benefit. And double points if you exercise in natural daylight!"

6. Look after your gut

Medical scientist Pete Williams says: “Gut bacteria manufacture about 95% of the body’s supply of serotonin – provided you have a healthy gut microbiome.” This means that a healthier, more balanced gut should increase the levels of tryptophan in your blood. In turn, this increases the chance of more crossing the blood-brain barrier. A systematic review in the Annals of General Psychiatry found strong evidence that probiotic supplements can ease symptoms of depression through this action.

Wondering how to improve gut health? Firstly, try to add more prebiotics and probiotics for gut health to your diet. The former includes foods like bananas, onions and garlic, while the latter includes yogurt and kimchi. You could also try a probiotic supplement, such as Bio-Kult Everyday.

It’s also worth noting that the gut-brain connection works both ways. Stress can reduce diversity in your gut, which will have double the knock-on effects on your serotonin levels. This was proven by an Australian study which tested stool samples from university students before term started and then during exam week. The researchers found fewer lactobacilli (a type of probiotic ‘good’ bacteria) in the samples taken when the students were stressed by their upcoming assessments. This suggests that looking after your serotonin levels via several methods may be more effective than focussing on just one.

And have you ever wondered why going to the loo feels good? Neuroscientist Laura explains: “In your gut, serotonin controls peristalsis, which pushes food down through your gut. It's thought that this is the reason you feel relieved when you go to the toilet!”

What causes a lack of serotonin?

As there are many ways to increase your levels of serotonin, there are also many potential causes of insufficiency. However, one of the most common causes is chronic stress. 

Neuroscientist Laura says: “Stress puts such huge pressure on the body. It sucks energy away from other important functions, such as regulating hormones.” 

There are many different causes of stress. They include lack of sleep, sunshine or movement, not socialising with people you feel close to or eating an unhealthy diet, which can cause an imbalance in your gut microbiome. Short bursts of stress are normal, but when this continues over a long period of time, it can be problematic.

Other causes of serotonin insufficiency that we are less able to control include genetics and certain medications or drugs. Medical scientist Pete says: “Some individuals have gene variants that mean their body does not produce or use serotonin as it should.”

What are the signs of low serotonin levels?

• Mood disorders such as depression and anxiety
• Poor gut motility - this could mean constipation or bloating
• Sleep disorders
• Increased pain

Neuroscientist Laura explains: “Low serotonin levels have historically been associated with low mood, depression and anxiety. But they’re also linked to stomach problems, including bloating and cramps, and sleep problems. The latter is due to serotonin’s link to melatonin production, which is the hormone that induces sleep.”

Other mental health conditions such as OCD are also linked to low serotonin levels, as a Free University of Berlin study showed. Indeed panic disorders and panic attacks appear to be made worse by lack of serotonin too, according to research.

Video of the week

If you struggle to nod off, you've most likely exhausted the majority of tried-and-tested methods to help you fall asleep faster. But, what about talking yourself into a good night's rest – also known as sleep affirmations? "Do sleep affirmations work?" I hear you ask. 

When it comes to questions about our sleeping behaviours, those such as "What does it mean when you dream about someone?" or "Why do I sweat a night?" are perhaps more easily answered. Sleep affirmations require you to do the work, practice and have some degree of patience. 'Reading sleep affirmations or saying them out loud, especially before bed, can have a powerful effect on our mental state and our ability to sleep well,' says sleep and dream expert Charlie Morley. 'And if we say them in the alpha and theta-rich hypnotic trance-state of the hypnagogic, this effect is supercharged.'  

Theta waves occur during light sleep or deep relaxation, while alpha waves occur when people feel relaxed, and when the brain is resting, without concentrating on anything. So, if you're wondering 'Why do I keep waking early?' or 'Why am I so tired?', sleep affirmations might be the solution to those long, sleepless nights. 

 What are sleep affirmations?

Sleep affirmations are positive statements or phrases that you repeat to yourself before hitting the sheets. These are especially helpful if you often experience a lack of sleep. 

‘They are intended to help you focus on positive thoughts and feelings, and to reinforce positive beliefs about yourself and your life,’ says Martin Seeley, sleep expert and CEO of Mattress Next Day. ‘Sleep affirmations can be used to reduce anxiety, improve self-esteem, increase motivation, and promote a sense of calm and relaxation.’ 

Sleep affirmations can be as simple as repeating a single phrase, such as "I am calm and at peace," or they can be more complex statements that address specific areas of your life, such as "I am worthy of love and respect," or "I trust myself to make wise decisions." The key is to choose affirmations that resonate with you and feel meaningful and authentic. 

How do sleep affirmations work?

Sleep affirmations are most effective when you are relaxed, which is when your mind is feeling more open to change. 'One way to make the most of your open and relaxed mind is to practise some simple self-hypnosis techniques,' says Charlie. 'We enter natural states of hypnosis over the course of the day, and like hypnosis, self-hypnosis is simply about passing on helpful messages to your subconscious.'

The subconscious mind likes to please, and it is there to serve us, so if you can connect with it (which is easier than you might think) you are sitting on a goldmine of opportunity, just waiting to be untapped. 

'You can get yourself into a relaxed state using a Progressive Muscular Relaxation (PMR),' says Charlie. 'Dr Edmund Jacobson invented this technique way back in the 1920s as a way of helping his patients deal with anxiety. The technique simply involves working through various muscle groups, first tensing and then releasing them.' It forms a vital part of the Military Sleep Method, which was designed to help the United states Navy fall asleep fast during the Second World War.

PMR usually starts with the feet and then works up through the body slowly and smoothly. Not only does this help promote sleep, but it also works well as one of the relaxation techniques for stress, through releasing the day's tension held in the body. 'It can be done at any time of day or night, but if we practise it while we’re drifting through the hypnagogic, it may lead to an even deeper level of relaxation,' says Charlie. 

Want to give it a try? Follow Martin's tips for trying sleep affirmations for the first time:

• Choose your affirmations: 'Start by choosing affirmations that resonate with you and feel meaningful and authentic,' says Martin. You can choose from our list below or create your own based on your own personal goals and desires.
  
• Create a routine: Incorporate your affirmations into your bedtime routine.'This could include taking a few minutes before bed to sit quietly, meditate, or journal while repeating your affirmations to yourself,' says Martin.
  
• Use present tense: Phrase your affirmations in the present tense, as if they are already true. For example, "I am calm and at peace" rather than "I will be calm and at peace."
  
• Visualize: 'As you repeat your affirmations, try to visualize the positive outcomes you are affirming,' says Martin. Imagine yourself feeling calm, confident, and happy.
  
• Be consistent: Try to practice your affirmations every night. It may take some time to see results so be patient and persistent.

To get yourself started, try this guided sleep affirmations meditation: 

Benefits of sleep affirmations

1. Helps you overcome negative patterns

'The right mindset goes a long way when it comes to getting good sleep. Similarly, telling yourself beneficial things through the use of affirmations, such as "I sleep well and wake feeling refreshed," can help the potential to shift negative thinking and overcome patterns you would like to change,' says Charlie.

2. Boosts self-esteem

'Affirmations such as "I’m proud of myself for what I achieved today" or "I trust myself" can help change negative self-beliefs into more positive ways to view yourself, as well as increased confidence for the following day,' says Laura Duester, psychotherapist from Counselling Directory.  

One study published in the journal of Social Cognitive and Affective Neuroscience found that the neural pathways in the ventromedial prefrontal cortex of the brain increase when a person practices self-affirmation. This cortex is associated with positive self-valuation.

3. Reduces stress levels

'Affirmations are also proven to lower stress levels, decrease anxiety, improve focus, concentration and confidence,' says Charlie. Another study published in Social Cognitive and Affective Neuroscience found that affirmations can activate the reward centres in the brain, helping to buffer stress levels.

4. Tunes into gratitude

'Using gratitude sleep affirmations, such as "I’m thankful for today" or "I’m grateful for X, Y and Z", helps to rewire your brain to notice and appreciate the positives in life,' says Laura. This is an incredibly powerful tool that is linked with increased happiness and wellbeing.

5. Encourages your body to rest

'Sleep affirmations such as "It’s time to rest" or "I’m recharging my mind and body" encourage you to let go of bodily tension and relax your muscles so you can fall into a deep, undisturbed sleep,' says Laura.

The best sleep affirmations

• All that I did today was enough. I sleep with a light and serene mind.
• I am feeling calm now that my day is done.
• My life is easy and filled with joy and compassion.
• I release all tension from the body as I prepare for bed.
• I am grateful for my bed, my room and my quiet body.
• I relax my head, face, neck, arms, stomach, legs, and feet. I let them sink deeply into the bed.
• I am a good sleeper.
• My body heals while I sleep.
• My heart is happy and relaxed.
• Sleep rejuvenates me.
• The outside world is fading into the background now.
• I cherish my relationship with sleep.
• Peace and happiness are my priority right now.
• I am in control of my sleeping patterns.

Video of the week

Interested in taking a chilly dip? Here's everything you need to know about the benefits of cold water swimming and how to do it safely before you take the plunge.

Cold water swimming became an unlikely saviour for many in the Covid-19 pandemic, providing a much-needed outlet to folks across the UK amid the repeated closures of gyms, leisure centres, and public pools. Participation in cold water swimming in natural bodies of water, otherwise known as ‘wild swimming', has increased by between 1.5 and 3 times since 2019, according to a trends report by Outdoor Swimmer.

The magazine also found that 52% of people said they had enjoyed the pastime more than they had anticipated, while 47% liked it just as much as they’d expected. This surge in popularity is reflected in consumer trends, with leading triathlon brands like Zone3 seeing a triple-figure growth in the sales of their neoprene swimwear accessories between 2020 and 2021.

From boosting your mood to reducing inflammation, a dip in cold water is sopping with physical and mental health benefits - and it turns out that being cold does burn calories too. From what to expect on your debut swim and the health benefits of cold water swimming to staying safe in the water, we’ve covered everything you need to know before you strip off for your first icy dip with advice from the experts.

What are the physical health benefits of cold water swimming?

Swimming in cold water has been associated with targeting inflammation and thus reducing the symptoms of a wide range of conditions, including migraine, arthritis, Type 2 diabetes, and many types of depression.

With the human body’s natural temperature resting at an average of 37˚C, plunging into frigid waters is never going to feel comfortable. But for many, this initial 'ouch' is a small price to pay for the bounty of health benefits of cold water swimming.

"Inflammation is affected in two ways – one is a long-term effect, which is this adaptation to cold, your cold stress response is reduced as you get used to it, and that means that your stress response to other stresses is also reduced," Dr. Mark Harper, consultant anaesthetist and author of Chill: The Cold Water Swim Cure, explains.

There’s also research to suggest that cold water swimming could lead to higher immunities, with one study finding that cold water immersion may help to temporarily boost your white blood cell count – the body’s personal army against infection.

What are the mental benefits of cold water swimming?

After the shock of entering cold water wears off, many people report feeling an overwhelming sense of calm as their body adjusts to its new environment. The chilly temperatures force one to concentrate and control their breathing, similarly to how they would in traditional meditation.

And after this scrumptious bite of relaxation comes its even more delicious aftertaste – the euphoria. Cold water immersion has been proven to increase the brain's 'happy hormones', leaving the swimmer on a natural high that can last several hours. The great news is that even just one to two minutes in the water will do the trick.

"All these chemicals are being released [when you enter cold water] – adrenaline, noradrenaline. That’s what gives you the buzz," explains Dr. Harper.

This ‘buzz’ is so potent that many cold water swimmers compare the experience to taking stimulant drugs – without the nasty comedown or risk of addiction. "It’s like cocaine," says Dr. Harper. "The crucial difference is, it's the body using its own store so it has control over the situation."

If you want to really reap these benefits, there are a couple of easy things you can do. While it’s not necessary to dunk your entire head under the water, getting your face wet is a surefire way to enhance the high. Splashing your face with cold water activates the vagus nerve, which runs from the brain through the face and into the abdomen.

"This directly stimulates the parasympathetic nervous system – the rest, digest system – that will directly reduce inflammation," Dr. Harper explains.

What to expect from your first cold water swim

If you’re new to cold water swimming, it’s important to mentally prepare yourself for the inevitable 'Oh My Gosh' that you’re like to gasp – or splutter – upon taking that initial plunge.

Cold water shock, otherwise known as a cold water stress response, refers to the body’s automatic response to being submerged in waters 15 degrees and below. Symptoms include uncontrolled breathing, hyperventilating, a racing heart rate, and even muscle spasms. These intense reflexes, which are caused by the sudden constriction of blood vessels in response to the skin’s cooling, occur within the first minute of exposure to cold water and are typically more pronounced in people who are less acclimatised to low temperatures.

"Like with any shock, the sympathetic nervous system activates the fight or flight response," Dr Harper adds. "The adrenaline makes your heart beat and your blood pressure go up."

Ironically, what feels like your body attacking itself is actually a protective technique. "The noradrenaline, [a chemical that functions in the brain as both a neurotransmitter and a hormone] is what squeezes all the blood vessels to your skin and shuts them down, so that all your heat stays in the core, rather than being given back to the water," Dr. Harper continues.

"Your organs work best in a very narrow temperature zone and so the body tries to make sure those that are vital to survival are maintained at this optimal level (36.5-37.5˚C)."

Why am I in so much pain when I enter cold water?

Your body may also feel physically pained when immersed in cold water, especially in temperatures below 10˚C.

If you wondering how an icy splash could elicit such a severe reaction (it’s just H2O, after all!), there are a few things to keep in mind.

Firstly, cold triggers the body’s pain receptors. The thermoreceptors that sensor cold are also higher in quantity than those that register warmth, which means our bodies are basically designed to ring alarm bells when subjected to lower temperatures.

The hands tend to receive the brunt of this agony, with their physiological makeup and exposed location on the body leaving them more vulnerable to the water’s bite. Some cold water swimmers may even experience 'claw hand', the term that describes a loss of fine motor control in the human hands after prolonged exposure to cold water.

"The hand is very sensitive to cold water," Dr. Harper warns. "It’s got lots of nerve receptors in them and it’s very superficial, being out on a limb, so it’s not as good at protecting itself."

That stinging numbness can also be blamed on the circulatory system of the hand, which functions in a different way from the rest of the body. "The palms of the hands have what’s called ‘glabrous skin’ which, basically, means it’s hairless and the blood vessels remain open even when all the other peripheral vessels are constricted," Dr. Harper explains. The soles of the feet also have this type of smooth skin surface that facilitates heat loss, which is why your toes are also the first to seize up during or after an icy dip.

Muscle spasms are another culprit of pain during cold water swimming, as the low temperatures cause the muscles to stiffen and cramp due to the overexcitement of nerves. Fortunately, the severity of this cold water shock is likely to subside with increased exposure.

"After about six times, your response will be a lot lower," Dr. Harper says. What’s particularly important is that the body’s reflexive gulp of air, which often leads people to inhale water and drown, is no longer so pronounced.

How to start cold water swimming as a beginner and how to stay safe

Now that you’ve been sold on the benefits of cold water swimming, it’s time for the exciting bit – actually doing it. Starting to swim in cold water can be daunting for anyone – including those who can swim proficiently – and like learning any new skill, is likely to come with its fair share of ups and downs (or ebbs and flows, if you will.)

It’s also crucial to remember the importance of safety when dealing with waters of low temperatures so that you can mitigate the risks of hypothermia and/or drowning.

It's not uncommon for swimmers to feel warm upon exiting very cold water, leaving some even itching for round two. It's highly advised you resist this urge, however, as it's unlikely to do you any favours in the long run and could put you at greater risk of hypothermia.

"Don't overdo it," warns Dr. Harper. "If you’re out and you want to get back in, you’ve done it just right. You won’t get any bigger high, because your body has limits to how much of these endorphins and substances can be released."

1. Join an open water swimming community 

If you’re a total beginner to cold water swimming, the first port of call is to find a community that can help teach you the ropes. Not only is this an excellent way to meet new people and find suitable spots to swim, but it’s also crucial to maximizing your safety in and out of the water.

"Beginners should always swim with others and if they are swimming in a location that is new to them, it is key to go with someone that knows the entry and exit points especially," says Sue Wilson, Zone3 ambassador and qualified Open Water swim coach.

"The Outdoor Swimming Society Facebook Page and local outdoor/open water clubs are great places to start. They will be familiar with locations and will have a good understanding of any currents or features to be aware of when taking to the water."

2. Invest in quality kit 

Investing in high-quality kit for cold water swimming can be a game changer, making the experience more pleasurable (or at least less painful) without diluting that post-dip high.

It’s up to you whether you wear a wetsuit or your trusty swimming costume, but experts agree that you should protect your extremities as much as possible in cold water.

To avoid that dreaded 'claw hand', thermal waterproof gloves are an absolute must. We had success with the Zone3 Neoprene Heat Tech Gloves, which boast unapologetic insulation and clever technology to customise the fit. (They also work great if you want to keep your fingers toasty on an outdoor run or cycle, making them a lovely multi-functional purchase). Their counterpart socks, which have the same hook and loop fastening for optimal sizing, are equally effective in sealing in the heat.

Wearing a hat is also crucial to keeping warm, Dr. Harper advises. "You lose a lot of heat from the head," he warns. "It's quite thin that layer between the skull and the brain."

Go with a beanie or bobble hat, or if you really want to fend off the elements, the fleecy Zone3 Neoprene Heat Tech swim hat won't disappoint.

As for your after-swim attire, the snugger and heavier, the better. The Zone3 Polar Fleece Parka Robe is an excellent choice to keep shivers at bay, promising instant warmth and coziness from the moment you slide into it.

The Red Original Evo Parka is another safe bet if warmth is what you're after. Made with 100% recycled fabric, this plush robe is both waterproof and super soft – the perfect marriage for any post-swim garment. It also features hands-free changing, so you won't have to waste any time searching for shelter to get back into your warm clothes.

If you're looking for something to get you from wet to dry quickly in the summer months, go with the Compact Robe by Lifeventure. Lightweight yet roomy, this nifty piece allows you to redress in total privacy and dries 8x more quickly than a standard towel. A sturdy thermal flask to keep your drink hot, like the leak-proof Primus Klunken Vacuum, is also a good shout.

3. Enter the water slowly 

While it might be tempting to 'get it over with' by diving or jumping in, it’s always recommended that people approach cold water cautiously.

"Swimmers entering cold water should always enter slowly and gradually," Wilson advises. "Splash yourself with water, slowly progress deeper, and feel your way forward. Remember to breathe, maintain control and relaxed.

"Jumping in can not only cause shock and panic and in some cases, swimmers may not know how deep the water is or what is beneath the surface that could cause injury."

4. Skip the front crawl 

You may be a bullet in your local pool with your streamlined front crawl, but when it comes to cold water, it’s best to rein in the speed.

Public pool temperatures are significantly higher than those of natural bodies of water, with most being heated at between 26˚C and 28˚C to allow swimmers to train for extended periods of time without the risk of hypothermia.

The average sea temperature of the British Isles in the winter months, on the other hand, hovers in the far chillier range of between 6˚C and 10˚C.

Inland waters tend to have even more extreme conditions, with temperatures dropping to as low as zero at certain times of the year. Meanwhile, summer temperatures of the sea rarely exceed 20C, which means that, no matter what the season, you’ll likely find it difficult to replicate your pool sessions.

To avoid tiring yourself out and/or swimming too far out, breaststroke, a.k.a. 'frog stroke', is your best option.

"Breaststroke is very helpful for seeing where you are going and ensuring that swimmers don’t stray too far away from the edge," Wilson says. "Breaststroke is also helpful for maintaining regular breathing, blowing bubbles on the surface can be useful to maintain focus on breathing."

5. Pay attention to your body

When it comes to cold-water swimming, there’s no one-size fits all approach. What works for one person may not apply to another, so it's important that you pay attention to your own body and stay within your limits.

Unfortunately, certain myths about cold water swimming have gained traction in recent years that have directly jeopardised the safety of newbies to the pastime.

One popular snippet you may have heard is the 'One minute per degree' rule, which argues that the temperature of the water should directly reflect the number of minutes you stay in it. So for example, if the water is 5˚C, you can safely stay in it for five minutes, and if it’s 30˚C, then half an hour's your goal. Not only is this claim completely unsubstantiated, but it can also be extremely dangerous to the safety and well-being of the swimmer.

"Anything that has a definite time to it, whether it’s one minute per degree, or 11 minutes optimal time, is wrong," Dr. Harper says. "That is the biggest myth that needs to be kicked off."

Wilson agrees, arguing that tolerance varies from person to person. "Important factors to consider are; water and air temperature, nutrition, overall tiredness, time of day, are you well hydrated, and your current mental health."

6. Warm up quickly after getting out of cold water 

If there’s a time to act fast in your cold water swimming adventure, it’s now. Once you’re back on dry land, it’s crucial that you warm up as quickly as possible. "If you are a bit chilly getting out of the water (not hypothermic), getting dressed with lots of layers as soon as possible is key to ensuring your body temperature doesn’t get too cold once you have left the water," says Wilson.

"It is easy to get caught up in conversations with other swimmers but prioritising getting warm then having a chat is important. Once dressed, move around, jump around, sip a warm drink and have some food."

Whether you embrace the cold or prefer to stayed wrapped up and warm, there's no denying that cold showers, cold water swimming and cold winter walks have grown in popularity as natural remedies to a variety of mental and physical health conditions. But while there are certainly some benefits, cold exposure as a weight loss solution has shaky scientific backing at best.

While no one should feel under pressure to lose weight, you may be wondering if a daily dip or even a lower room temperature can sway the answer to ‘how many calories do I burn in a day’ in your favour.

Of course, as Superintendent Pharmacist at Pharmica, Carolina Goncalves reminds us, there are no quick fixes to long-term weight loss: "Maintaining a calorie deficit by consuming fewer calories than you burn through a combination of diet and exercise remains the best way to achieve long-term weight loss."

Does being cold burn calories?

Yes, being cold does burn calories. This is because being cold increases the energy needs of your body, which can therefore lead to burning slightly more calories.

Superintendent Pharmacist Carolina explains more: "When you are exposed to cold temperatures, your body has to work harder to maintain its core temperature. This is a process known as thermogenesis, which can result in a small increase in calorie burn."

There are two types of thermogenesis, and one is more well-known than the other. You’ve probably noticed that when you get cold, you tend to shiver, which involves your muscles involuntarily contracting to create heat and maintain core body temperature. The second type is called ‘nonshivering thermogenesis’. This takes place in fat cells called brown adipose tissue, which uses stored fat to generate heat.

At this point, it’s important to understand that as adults we only have a small amount of brown adipose tissue. Humans have most brown fat when newborn, at which stage brown fat makes up 2-5% of total body weight. According to research, this declines with age, and leaner people with a lower BMI retain most brown fat activity. As studies to date show, women also often have higher brown fat activity than men.

So the extent to which you burn calories when cold is unquantifiable, as we are all unique. However, a small study in 2001 by Maastricht University researchers proved that thermogenesis does increase the amount of calories burned. The study compared the energy expenditure of nine males who spent 60 hours in a room kept at 16 degrees celsius compared to 22 degrees celsius. They found that in the colder room they burned 4-6% more calories.

Does your body burn more calories in the cold?

Superintendent Pharmacist Carolina says: "No, you don't necessarily burn more calories when you're cold compared to when you're hot."

This is because your body also has to work hard to keep itself cool in hotter temperatures.

Several studies have attempted to clarify whether exercise in hot or cold environments uses more energy, and there is no clear consensus yet. However, only low intensity exercise at a cooler temperature will burn more calories when compared the same exercise at an ambient temperature. This is because if the exercise itself is not strenuous enough to warm you up, your body still has to compensate through thermogenesis. Basically, if your body has to shiver, you’re using extra calories. This effect is demonstrated by a study conducted on walkers in Wyoming, which found that they expended 34% more calories in winter compared to spring.

On the other hand, when you start exercising with higher intensity, for example running, your body is sufficiently heating itself up through physical activity, so you won’t get that extra calorie burn.

Superintendent Pharmacist Carolina concludes: "It's also important to note that body type, fitness level and acclimatisation to the temperature, will all affect the number of calories burned during exercise. So what works for one person may not necessarily work for another."

Does being cold increase metabolism?

Being cold may boost your metabolism temporarily, but not drastically enough to impact weight loss in the long-term.

Superintendent Pharmacist Carolina explains: "When the body is cold and begins shivering to achieve thermogenesis, brown fat tissue generates heat by burning calories. This process can increase the metabolic rate, leading to an increase in calorie burn." But this will only last while you are cold.

However, there is some evidence that if you are continually exposed to colder temperatures, you may experience a more significant increase in your metabolism, as your body adapts to the environment and develops more calorie-burning brown fat cells. One 2014 study, published in Diabetes journal, showed that after a month of exposure to mild cold (19 degrees celsius), five healthy young men experienced a 42% increase in brown fat volume and a 10% increase in fat metabolic activity.

These changes were almost completely reversed when the temperature returned back up again to 24 degrees celsius. And although the participants didn’t experience a change in body composition, as well as the increase in brown fat cells, the men did exhibit improved insulin sensitivity. This is why brown adipose tissue remains a subject of interest for researchers seeking treatments for conditions such as obesity and diabetes.

Is being cold good for weight loss?

No. While research regarding brown fat has prompted interest, it is not an advisable nor currently viable solution to weight loss.

The small amount of calories you may cut by being cold for an hour would far more safely and comfortably be taken out of the equation by exercising for slightly longer, increasing your steps or swapping a sugary snack such as a chocolate bar for a healthy snack, like an apple.

Nutrition Manager at the British Nutrition Foundation, Dr Annette Creedon explains: "Although activating brown fat could result in an increase in energy expenditure, this could be a very small increase and it is also possible that you may feel hungrier as a result and therefore eat more."

Indeed a literature review found that people tend to eat more after exercising in the cold, compared to exercise in warmer temperatures, which can actually induce a loss of appetite.

Is the cold good for you?

Whether the cold is good for you or not depends on the individual and the conditions of exposure. There are some benefits, but also some risks to consider.

Superintendent Pharmacist Carolina shares some of the health benefits of cold exposure:

1. Improved immunity: Cold temperatures can boost the immune system by stimulating the production of white blood cells.
2. Reduced inflammation: Cold exposure can reduce inflammation in the body, which is a common contributor to many chronic diseases.
3. Better circulation: Cold exposure can improve blood circulation, particularly in the extremities, by constricting blood vessels and pushing blood back towards the heart.
4. Stress relief: Cold-water face immersion has been shown to lower heart rate, which has a calming effect and can help to reduce stress and anxiety levels.
5. Enhanced athletic performance: Cold exposure, such as ice baths, can help to reduce muscle soreness and improve recovery after intense physical activity.

Meanwhile, the health risks include:

1. Hypothermia: This can occur when the body loses heat faster than it can produce it, leading to a dangerously low body temperature.
2. Frostbite: This occurs when the skin and other tissues freeze due to exposure to cold temperatures. It can cause permanent tissue damage and even amputation in severe cases.
3. Heart problems: Cold exposure, especially sudden exposure to cold water, can put additional stress on the heart and potentially trigger cardiac events in individuals with pre-existing heart conditions.

Nutritionist Dr Annette Creedon concludes: "Deliberately making yourself cold is not a good idea, especially among older and more vulnerable people."

Everyone should be cautious when exposing themselves to the cold, for example during cold water swimming. And if you have any existing medical conditions, you should only do so after consultation with a medical professional such as your GP.

Video of the week

Wondering how to improve gut health? Asking yourself  ‘why is my stomach bloated?’ or maybe you often find yourself researching, ‘how to get rid of trapped wind?’ It’s all about getting a healthy balance of bacteria. If you nourish your gut and look after it, you’ll enable the friendly bacteria to thrive – and when your gut bacteria become healthier, you feel better too. 

'Good gut health can be linked to the health of many other parts of the body because 70 per cent of the body’s immune cells lay along the digestive tract,' says nutrition expert, Penny Weston. 'While some bacteria are associated with causing illness, others are extremely important for our immune system, heart, weight and many other aspects of health.' 

This is because your gut not only helps to digest the foods you eat and absorb nutrients to fuel your body, it also helps get rid of waste and toxins, too. But, if gut isn’t happy, your body will struggle to do this, which can lead to a variety of health problems such as a weakened immune system, poor mental health, as well as cardiovascular diseases and cancer. Luckily, there are plenty of easy ways to show your gut some TLC and boost your health and wellbeing. Here, our experts reveal all...

How to improve gut health

1. Eat fermented food

According to the British Heart Foundation, fermented foods are those that have undergone microbial growth and fermentation. This is where microorganisms such as yeast and bacteria break down food components (eg sugars such as glucose) into other products (eg organic acids, gases or alcohol). This gives fermented foods that unique and desirable sour taste, smell, texture and appearance. 

‘Including fermented foods in our diet can give our guts regular exposure to live bacteria. Good food sources include fermented dairy like natural yoghurt or Yakult, sauerkraut, miso, tempeh and pickled vegetables,’ says dietitian and Yakult advisor Lucy Kerrison. Since different fermented foods provide different bacteria, variety is key. 

Other fermented foods include:

• Kefir
• Kimchi
• Kombucha
• Cheese
• Sourdough
• Vinegar

Make sure you always read the label when buying fermented foods from the supermarket as some may contain high levels of sugar or additives.

2. Fill up on prebiotics

'Prebiotic foods are high in a special type of plant fibre, which helps look after your digestive system, increasing good bacteria in the gut and also improving metabolic health,' says Penny. 

'Prebiotics come from types of fibre that humans can’t actually digest but the good bacteria in your gut will eat. Prebiotics are found in many fruits and vegetables, especially those that contain complex carbohydrates.'

Research from the American Gut Project found that individuals who eat over 30 different plant foods a week have a more diverse gut, compared to those who eat ten. A varied diet packed with plant foods also benefits your mood, weight and overall health and wellbeing. 

'Upping your intake of plant foods doesn’t have to be difficult or expensive, and it is not just the more obvious healthiest vegetables and fruit which counts, but also legumes such as beans and lentils, wholegrains, nuts, seeds, herbs and spices,' says Lucy.

Prebiotic foods include:

• Jerusalem artichoke
• Garlic
• Onions
• Leeks
• Asparagus
• Bananas

3. Boost your probiotic intake

Asking yourself 'Prebiotics and probiotics for gut health: what's the difference?' Simply put, probiotics are live bacteria and yeasts, which help to restore the balance of gut bacteria after it has been affected by illness and can help ease the symptoms of IBS. Prebiotics, on the other hand, are a type of dietary fibre, and are found in foods such as leeks, onions and garlic, which feed the friendly bacteria in your gut, such as Lactobacillus and Bifidobacterium. 

Probiotic foods include:

• Sour cream
• Pickles
• Miso soup
• Yoghurt
• Aged cheese
• Kombucha

4. Take supplements

While you can get the majority of good bacteria through your diet, taking a prebiotic or probiotic supplement can give you extra benefits. 

A study published in the journal Alimentary Pharmacology & Therapeutics found that people with irritable bowel syndrome (IBS) saw improvements in stool consistency, reduction in bloating and gas, and even improvements in anxiety after taking a prebiotic supplement. 

You can take prebiotics and probiotics together. However, it's recommended to wait around 15 minutes to avoid bloating. Take your probiotic first thing in the morning.

5. Reduce alcohol

Alcohol is a gut irritant. 'If you drink alcohol in excess, it can interfere with the production of digestive enzymes and juices so it becomes harder for your body to digest and absorb nutrients from food,' says Penny. 

'This can lead to excessive fermentation in your gut, which causes bloating, gas and loose stools.' Alcohol also increases cravings for processed, sugary foods which can make these symptoms worse. Why not swap for one of the best non-alcoholic wines instead?

'Drinking water during or after a meal will help your body break down and process food and therefore help the digestion process,' says Penny. 'This breaking down of food helps your body to absorb those important nutrients and flush out the toxins. It also helps make your stools softer, preventing constipation.'

6. Snack on dark chocolate

Yes, eating this sweet treat really does have health benefits. Dark chocolate contains fibre that moves undigested through our digestive tract to the large intestine where our probiotics feed off of it to grow and boost our health.

Research published in Nutrients found that the flavanols in chocolate help reduce inflammation in the gut – which can cause chronic constipation, abdominal pain and nausea. Another study published in The Journal of Nutritional Biochemistry found that the polyphenols in dark chocolate reduced the risk of colon cancer and intestinal anti-inflammatory disease.

To reap the most benefits, opt for 70% cocoa chocolate and stick to just the recommended 30g of chocolate a day – that's roughly three to four squares.

7. Limit artificial sweeteners

While sweeteners are often used as an alternative to sugar when dieting, or simply cutting down your intake for other health reasons such as diabetes, they can wreak havoc with your gut microbiome. This is because the GI tract doesn't break down sweetener in the same way it does sugar and other processed foods, meaning when they reach your digestive tract, they're undigested.

However, unlike dark chocolate, studies have found that this causes sweetener to negatively impact your gut bacteria, even reducing some of the good stuff! Findings published in The International Journal of Molecular Sciences showed that excessive consumption of artificial sweeteners can become toxic to the gut, leading to health problems such as damage to the liver and intestines.  

As well as the sweeteners you add to your own drinks, they can also be found in shop-bought items, such as:

• Diet/ sugar-free drinks
• Energy drinks
• Baked goods such as pastries and cakes
• Sugar-free condiments such as ketchup
• Granola and other cereals
• Greek yoghurt

Aim to stick to the acceptable daily intake (ADI) of artificial sweetener which is 50 milligrams for each KG of body weight.

Signs of poor gut health

'Due to the gut-brain axis, which is the direct link between the gut and brain, gut health can have a big impact on mood, mental and physical health, energy and overall wellbeing,' says Lucy. 'Low mood and energy, disrupted sleep and poor immunity can all be signs of poor gut health because of this connection.'

Other signs of poor gut health include:

• Changes to your stools. If your stools are harder and painful to pass you might be dehydrated or not have enough fibre in your diet. Usually, constipation home remedies will help this. If you don't see improvement after a week, book an appointment with your GP. If your stools are a colour other than brown, such as green, black, red or yellow, you should also see your GP,' says Penny. 'With a healthy gut, your poo should also be smooth in a sausage shape and should sink in the toilet bowl. If it floats, it means there could be undigested fat in the poo.'
• Stomach pain: 'Cramping or bloating for example, might also be indications of gut health problems. Bloating can signal stress, indigestion or a reaction to a specific food,' says Lucy.
• Headaches: This is due to the connection between the gut and the brain, and inflammation. The more inflammation there is in the body, the more pain that manifests. For people with celiac disease who also experienced migraine symptoms, research published in Medical Hypotheses found that reducing their gluten intake (and therefore, inflammation) for six months saw a big improvement in the number of migraine attacks they had.
• Bad breath. 'Not passing poo properly can cause a build up of toxins in the body, resulting in bad breath,' says Penny.

Worst foods for gut health

• High protein intakes: Around 15% of protein is malabsorbed, high intakes in the absence of fibre can have a negative impact on the microbiome. What is key here is not to avoid protein, but to ensure a good protein: fibre ratio.
  
• High levels of saturated fats: These tend to be solid at room temperature and are within animal products as well as foods such as crisps and chocolate. In high quantities, these can cause inflammation.
  
• High alcohol intake: Alcohol is an irritant, affecting the guts ability to absorb water and nutrients from food.
  
• Low fibre intake: Fibre can help strengthen gut muscles, draw in water to soften stools and also add roughage to the gut so there is more to ‘grip on to’. Make sure you’re eating a range of different fibre types including vegetables, wholegrains, nuts and seeds to feed your gut optimally. 

Lucy recommends limiting the above in your diet if you're looking for ways to improve your gut health.

Whether pain is keeping you up at night or you're struggling to nod off during your pregnancy, you might be asking yourself, 'What sleeping position is best?' and 'How much deep sleep do you need?'

Not only can a poor night's rest leave you feeling grouchy, but according to the Sleep Foundation, sleep deprivation can lead to a variety of health problems such as diabetes, high blood pressure and a weakened immune system. This is why sleep is important. 

"The best sleeping position is a very personal thing and predominantly should be comfortable, therefore allowing a good period of undisturbed sleep," says Gregory Davis, Physiotherapy Consultant and Director at The Medical, Bristol. "Whilst you are sleeping your body should be working hard repairing and recovering, so good quality sleep is key and the last thing you want is to wake up with more discomfort than before you nodded off." Want to finally put an end to those sleepless nights? Here, our experts explain how to find the best sleeping position to suit your needs so you can get those all-important ZZZs.

 What sleeping position is best?

The best sleeping position is largely down to what makes you feel comfortable and this can depend on a variety of factors, such as managing pain, being pregnant or even common complaints that lead to a lack of sleep, such as snoring.

"From the perspective of a physiotherapist, it is important to keep your spine and neck aligned and supported; as spending 6-10 hours doing one thing, even sleeping, can cause your body to adapt in good or bad ways," says Gregory. 

"The ”optimal” sleeping position according to most literature and what I would advise is left-sided sleeping, with a pillow that allows a neutral spine position," he adds. This will not only help with many aches and pains throughout the body, but may help with breathing, reflux and pregnancy. It might also be beneficial for those who are wondering how to stop snoring. However, there are still plenty of benefits to other sleeping positions – the most important thing is finding one which suits your needs and allows you to both nod off and wake up, without pain and discomfort.

Choosing the best sleeping position

1. The best sleeping position for back pain

The best sleeping position for back pain is one that aligns the spine – and sleeping on your back is most effective for this. However, there are moderations you can make to your usual sleeping position if you find this difficult.

According to the International Association for the Study of Pain , around 7.5% of the global population experience lower back pain, and the Sleep Foundation points out that the link between poor sleep and back pain is a two-way relationship. Back pain makes it difficult to get comfortable enough to fall – and stay – asleep, while poor sleep can affect our body's ability to heal, increase our sensitivity to pain and disrupt the chemicals in our brain that are responsible for our perception of pain.

“Lying on your back, as difficult as this is for most of us, is the best sleeping position for keeping your back straight and reducing the risk of back pain as well as helping to manage it, particularly lower back pain," says physiotherapist, Sammy Margo from Mind Your Back UK. Placing a pillow beneath your knees can also help keep your spine neutral and take pressure off your lower back.

Can't nod off in this position? "Sleeping on your side with a pillow between the knees can have a similar effect. For extra support, you can also place a pillow behind your back," adds Gregory. "As you age, sleeping on your back can become more difficult as the natural flexibility of your spine will decrease. This is when sleeping on your side with a pillow for support will be most useful for you."

2. The best sleeping position for sciatica

“Sleeping on your back is also the best position for sciatica. The pain comes from the sciatic nerve (which is in the lower back and lumbar discs), so it’s important to reduce the pressure in this area," says Sammy.

"Lie on your back then place pillows (as many as you find comfortable) under your knees. If you find it difficult to sleep like this place an extra pillow at the side of your back, under each of your elbows and one under your neck," she says.

Try to avoid sleeping on your stomach if you can. This is because it flattens the spine’s natural curve and can add unnecessary strain to the muscles and joints. Sleeping with a body pillow can help prevent you from rolling over in your sleep.

3. The best sleeping position for pregnancy

The safest sleeping position during pregnancy is on either your right or left side. "This will not only relieve pressure because of you ever-growing bump but will also allow efficient blood flow to your liver, kidney, heart, and around both of your bodies (that’s yours and your foetus)," says Gregory.

The Midland and North of England Stillbirth Study (MiNESS), which looked at the sleeping habits of 400 women who had a stillbirth at or after 28 weeks of gestation, found that those who slept on their back during the third trimester, had a 2.3-fold increased risk of stillbirth compared to those who slept on their side. 

The exact cause for this isn't known but researchers suggest this is due to the combined weight of the baby and uterus (womb) putting pressure on the main blood vessels that supply the uterus, which can restrict blood flow/oxygen to the baby. Sleeping on your side is advised for going to sleep at night and daytime naps. Don't worry if you wake up on your back – just roll over onto your side.

4. The best sleeping position for neck pain

The best sleeping positions for your neck are on your back or your side. "I recommend the back in the first instance. It’s important to make sure to use a pillow that supports the curvature of your neck and a flatter pillow to cushion your head," says Sammy. 

"Sleeping on your side is the second best position for neck pain but use a thicker pillow under your neck so that neck aligns with your head. This will reduce any strain on your neck and keep your spine straight.”

Using a supportive pillow can also help you get a comfortable night's sleep. Gregory recommends the Groove Pillow. "It includes a contoured dip that supports the cervical (neck) area that helps facilitate neutral spinal alignment by guiding your upper body into a comfortable sleeping position whether you lie on your back or are a side sleeper," he says.

• View Groove Pillow | £29.95 – Groove

5. The best sleeping position for shoulder pain

Whether a recent injury or chronic shoulder pain is the reason you can't sleep, it probably goes without saying that it's recommended that you avoid sleeping on the side where you have the pain. 

"I regularly treat people with shoulder pain and the common theme is that sleeping on their side is a no go, even though the side sleeping itself is not the cause, but something that aggravates the issue," says Gregory. "Many front sleepers can suffer with shoulder pain as a result of their sleeping position as it puts pressure on the tendons that work to stabilise the shoulder. "

When suffering with shoulder pain, to fix your sleep schedule, you should either try sleeping on the other side to relieve pressure, or if you are suffering in both shoulders, back sleeping will be the way to go. "You should also try stretches, icing and if the problem persists, speak to a physiotherapist or medical professional," adds Gregory.

6. The best sleeping position for breathing problems

If you suffer from breathing problems such as sleep apnoea then you need to sleep in a position that elevates your head and makes it easier to breathe. 

Martin Seeley, sleep Expert and CEO of Mattresss Next Day suggests two ways you should sleep which should help to make breathing easier and help you to feel more comfortable:

• If you are a side sleeper, you should place a pillow between your legs and also add a pillow or two under your head to keep it elevated.
• Back sleepers should lie straight, and keep their head elevated with pillows and knees bent, with a pillow placed under the knees.
  

"The reason for the pillows under the knees is that it helps to open up your airways by keeping your posture more aligned," he says.

Want to read more like this? Find out What is the Military Sleep Method and 'How much deep sleep you need' - and how much sleep do teenagers need too - to boost the quality of your slumber further!

Video of the week

Knowing how to use essential oils is key to getting the most out of them, whether you’ve heard that they are powerful natural anxiety remedies or soothing sleep aids.

The attraction of using essential oils to improve our health and wellbeing is obvious: they’re inexpensive, natural and we have access to them from home. They've also been well researched. Aromatherapy is one of few tried-and-tested natural ways to help you fall asleep, and the application of certain oils is often suggested by natural health experts among their top tips for healthy hair: we’ll cover both of these uses below. And the great news is, essential oils are far more versatile than that, which means you get great value for your money. Aromatherapist and expert advisor to Tisserand Aromatherapy, Jo Kellett says: “Essential oils are composed of many different chemical molecules that have varying therapeutic properties. Some, as you may know, help with sleep and others reduce anxiety. But aromatherapy can help with so many other complaints. I see clients who present with mental health concerns as well as physical issues such as IBS, menstrual imbalance, muscular aches and pains… the list goes on!”

One mistake often made by first-time essential oil-users is to assume that because essential oils are natural, they are completely safe. Aromatherapist, best-selling author and managing director of Aqua Oleum, Julia Lawless says: “Essential oils are concentrated liquids extracted from plants. They need to be respected and used with caution.” And as with plants, they each have unique properties, effects and uses, so doing your own research, or asking an expert for advice, is vital.

How to use essential oils:

Researcher, natural health and wellness expert and part of Puressential's expert hub, Dr Tim Bond says: “The most common way of using essential oils is to inhale them, most conveniently in the form of a spray, or alternatively inhaling them from a bottle or by using a diffuser or humidifier." You can also inhale essential oils simply by putting a few drops on a tissue or piece of cotton wool.

"Inhalation is the fastest way to get essential oil molecules into the body," adds Dr Bond. They activate receptor cells in the nose, which then signal our brain to release neuro-messengers linked to our immune system and other bodily systems, some of which influence heart rate, blood pressure and breathing.

Other ways to use essential oils:

• Massage
• Aromatic bathing
• Skin & beauty care
• First-aid
• Scenting household items such as linen
• Natural disinfectants and cleaning agents
• Natural perfumes
• Room fresheners
• Purifying the air to ward off airborne germs

As a result of natural remedies gaining popularity, electric diffusers/vaporisers like the Aroma Spa Diffuser below are now a must-have item for many wellness enthusiasts. “The benefit of using an electric diffuser is that it can be precisely controlled," says aromatherapist Julia Lawless.

Make sure you follow the correct instructions for your appliance. This usually involves adding a certain number of drops of your pure essential oil or blend to an amount of water. 

Natural health researcher Dr Bond says: “If using a diffuser aim for intermittent use for 30-60 minutes at a time. Build up gradually to doing this about 3 to 4 times daily as your body adapts.” For example, don’t let your diffuser run all night – instead use it to prepare a room for a good night's sleep or meditation session. And don’t think that exceeding the dose you have been advised to use will be more effective – it won’t. “Diffusing continuously does not increase the benefits and can cause toxicity,” says natural health researcher Dr Bond.

You must also ensure that you keep your diffuser maintained. “An improperly cleaned diffuser can lead to growth of microbes and increased risk of infections,” adds Dr Bond.

The most important rule to stick to is to never use oils neat; this includes to bathe in, massage with or as first-aid (studies show lavender oil promotes wound healing, among other things). 

Aromatherapist Jo Kellett says: “Essential oils should not be taken internally or used neat on the skin even though you may have read otherwise.” You should always dilute the oils to the correct strength – this is most commonly done at home using a carrier oil (such as coconut, olive or sunflower oil), though it is possible to add essential oils to creams, lotions and even gels. 

If you don't dilute your essential oil, it may irritate or even burn the skin. Adding pure essential oils to water is not enough, as the two substances will not mix, which could lead to skin irritation. Follow the instructions provided on your product to create the correct strength for you. 

Finally, it’s important you buy a safe, quality product. There are a few ways you can check this before you buy:

1. Buy 100% pure or organic essential oils. Aromatherapist Julia Lawless says: “Some brands commonly adulterate and dilute their essential oil products with synthetic substitutes.”
2. Read the product name. “A quality product will use the oil’s scientific name. For example rosemary is Rosmarinus offinalis,” says natural health researcher Dr Bond.
3. Check if the brand belongs to the Aromatherapy Trade Council. “That way you will know that their essential oils have passed guidelines for safety, labelling, packaging and marketing,’” says aromatherapist Jo Kellett.

Are essential oils safe to use during pregnancy?

While some are thought to be helpful, you should not use essential oils during pregnancy – particularly during the first trimester – unless you are doing so under the guidance of a professional. 

There are many studies that show certain essential oils can help during pregnancy and labour. For example, lavender can aid relaxation throughout pregnancy and during labour, according to a study published in Nursing & Care Open Access Journal, “and lemon oil inhalation is useful if dealing with nausea, according to research," says natural health researcher Dr Bond.

Understandably then, aromatherapists may prescribe essential oils, but they must be used correctly and therefore shouldn’t be used without their supervision. For example, aromatherapist Julia Lawless would advise that if pregnant, you halve the percentage used: “I would dilute massage oils to just 1.5% during pregnancy rather than using a 3% blend.” 

And there are a few essential oils that are best avoided altogether. These include clary sage, rosemary, hyssop and fennel.  

Aromatherapist Julia Lawless also advises that you should “avoid using essential oils on babies under six months,” though there are several alternative, safe baby massage oils. Meanwhile, children and the elderly also require weaker essential oil solutions. The potential health risks are demonstrated by three cases of prepubertal gynecomastia in boys aged 4-10, which research concluded may have been caused by repeated topical application of lavender and tea tree oils. It is thought this disrupted hormones that control male characteristics.

Always read product labels, as many will warn against use during pregnancy, and if you are unsure how to use essential oils safely, use The International Federation of Aromatherapists directory to find a local aromatherapist.

Benefits of essential oils

1. Essential oils for hair growth

Rosemary is the most well-known aid for hair growth. One six-month long study found that rosemary oil performed as well as minoxidil, a popular hair growth treatment, while it caused less side-effects, such as itching.

There are several more essential oils that are proven to help, as well as other natural remedies for hair loss. Natural health researcher Dr Bond says: “A laboratory study has shown the benefit of lavender essential oil in hair growth promotion. Peppermint oil creates a cold sensation where it is applied. This can increase circulation and a laboratory study has shown that it can also improve hair growth.”

2. Essential oils for headaches

Both lavender and peppermint oil are commonly used to treat a sore head.

Aromatherapist Jo Kellett says: “Lavender oil has been used traditionally for soothing headaches for centuries.” Add a few drops to a tissue and inhale.

Natural health researcher Dr Bond adds: “Peppermint oil is another commonly used essential oil to treat headaches and migraine attacks. It contains menthol, which can help relax muscles and ease pain.” One study found that peppermint oil was as effective as paracetamol in treating tension-type headaches, which is the most common type of headache characterised by pain on both sides of the head. Several other essential oils, such as chamomile, which can help muscles to relax, could also help. 

3. Essential oils for anxiety

Several essential oils can help with anxiety, including bergamot, lemon, rose, neroli and cedarwood – lavender is the most commonly used. 

Natural health researcher Dr Bond says: “Lavender essential oil has traditionally been used for anxiety and helping sleep. A 2019 research review evaluated 71 studies that used lavender to ease anxiety. It found that inhaling lavender could significantly lower anxiety levels measured using a clinically validated scale.”

4. Essential oils for better sleep

Lavender oil is a well-known sleep aid. A US study of 31 young people found lavender essential oil increased both slow and rapid eye movement (REM) sleep in participants and left them feeling more energised the next day. 

In addition, “sandalwood, which is rich in alpha and beta-santalol compounds, has recognised sedative effects,” says natural health researcher Dr Bond.

“Spray a little lavender water onto a pillow before retiring to encourage a restful night’s sleep,” says aromatherapist Julia Lawless. 

5. Essential oils for congestion

Add a few drops of eucalyptus or peppermint oil, which contains menthol, to a bowl of hot water and inhale.

Natural health researcher Dr Bond says: “Essential oils are a popular natural treatment for sinus congestion, unblocking a stuffed nose and promoting sinus drainage. Several, including eucalyptus, lavender, lemon, oregano, peppermint, tea tree and thyme oils have antimicrobial properties.” This means that as well as clearing nasal congestion, they also help fight infection and prevent the spread of airborne germs, which makes essential oil-infused steam inhalation one of the best natural flu remedies.

6. Essential oils as insect repellent

The strong, distinctive fragrances of essential oils make them repellent to some insects. Citronella is probably the best known for its use as a mosquito repellent. “This can either be diffused into the air or applied to the skin directly as a flower water, as long as it is applied regularly,” says aromatherapist Julia Lawless. 

Aromatherapist Jo Kellett adds: “Peppermint is considered a spider deterrent." Place two drops on a cotton wool ball and place where you'd like to keep spider-free. "Finally, Cedarwood is an effective moth deterrent. Again, place two drops on a cotton wool ball and place in your wardrobe or amongst your clothing," says aromatherapist Jo Kellett.

Our pick of the best essential oils:

• View Puressential Rest & Relax Air Spray - £9.99 | Boots

• View Tisserand Aromatherapy Sleep Better Bath Oil - £7.59 | Amazon

• View Puressential Headache Roll-On - £7.49 | Amazon

• View Aqua Oleum Lavender Water - £7.99 | Aqua Oleum

Video of the week

If you're stuck in bed running a high fever and feeling sorry for yourself, be assured that there are effective, natural flu remedies within arm's reach right now.

Firstly, make sure you are treating the right condition: Natural cough remedies, natural cold remedies and natural headache remedies will help some of your symptoms, but the flu can be more severe and may well require something more specific. Dr Richard Middleton, pharmacist and director of the British Herbal Medicine Association says: "Flu differs from colds insofar as cold symptoms normally only affect the nose and throat, whereas flu affects you more widely and is accompanied by aches and pains and exhaustion, making it difficult to cope with activities of everyday living."

Many people start by taking paracetamol and/or ibuprofen, and for good reason – they will provide effective relief for aches and pains and will help to reduce your temperature if you have a fever. Some people prefer to avoid synthetic painkillers such as these due to interactions with other medications they are taking or potential side effects – high doses of paracetamol can be toxic to the liver and ibuprofen can cause gastrointestinal problems. Others take painkillers but seek extra help from natural remedies. While this is generally safe, you should always read the leaflet included inside any medicines and seek advice from a pharmacist if you’re unsure. Abbas Kanani, superintendent pharmacist at Chemist Click says: "Paracetamol is not generally affected when taking herbal remedies or supplements." However, you should avoid taking gingko biloba or zinc alongside ibuprofen. "Currently, there are inadequate levels of research into which other herbal remedies and supplements are safe to take with ibuprofen," adds Abbas.

Natural flu remedies

1. Stay hydrated

This is the number one rule of flu recovery. There are many benefits of drinking water when you’re healthy, but it’s even more important when you’re unwell, as flu symptoms such as a fever, cough, diarrhoea and vomiting and a loss of appetite can all contribute to dehydration.

Ensuring your body gets enough fluids helps your body regulate its temperature and minimises nasal irritation. It can also improve a headache, if you have one: in a study of 102 men, almost half of those who drank more water reported headache improvement, while only 25% of the men in the control group - who did not drink any more than usual - reported this effect.

Dr Middleton says: "Keep hydrated by drinking plenty of water or warm drinks containing a traditional combination of soothing honey and vitamin C-rich lemon juice – items you will likely find to hand in your kitchen."

2. Take Echinacea purpurea

An antiviral herb, Echinacea purpurea is a traditional natural medicine used to relieve cold and flu. It is available to buy in several forms – tablets, liquids, lozenges and throat sprays – but research shows that Echinaforce® Hot Drink is as effective as Oseltamivir (an anti-flu drug sold under the brand name Tamiflu) in terms of shortening the duration of flu symptoms and reducing respiratory complications. In the study, this natural flu remedy was also associated with fewer side effects, particularly nausea, diarrhoea or vomiting. 

Dr Middleton says: "If you are considering using a different Echinacea product, always choose a licensed medicine that includes a PL [product license] or THR [traditional herbal medicine] number on the pack, as this gives assurance about the quality and safety of the product."

3. Drink pineapple juice

Bromelain is an enzyme that is used in clinical medicine as an anti-inflammatory agent. While available as a supplement, the only natural source of the enzyme is in pineapple juice and the pineapple stem. 

Abbas says: "This natural flu fighter is promoted for reducing pain and swelling, especially of the nose and sinuses, gums and other body parts after surgery or injury. The anti-inflammatory properties help reduce irritation at the backs of our tongues and in our voice boxes."

Studies show it is well-absorbed and has no significant side effects, even after prolonged periods, though the mode of its action is not yet fully understood. 

Be careful though – Bromelain can interact with antibiotics, blood thinners and sedatives. And as an acidic fruit, too much pineapple juice could aggravate a cough if you suffer with acid reflux [see below].

4. Increase your antioxidant intake

When poorly, low appetite may make eating challenging. However, if you do feel like food, consume some berries, which are high in antioxidants. Dr Middleton says: "This will help to boost the immune system and aid a quick recovery." 

One review study concluded that treating flu with both antivirals and antioxidants is the best treatment for patients with severe influenza-associated complications.

5. Avoid acid reflux triggers

That said, make sure you follow a diet that suits you. If you’re prone to acid reflux, it’s even more important to avoid any triggers when unwell. Abbas says: "Acid reflux can be a common cause of a cough and is made much worse by a bad diet. Food and drinks that frequently trigger heartburn and should be avoided whilst unwell include fried foods, fatty meats, caffeine, full-fat dairy and chocolate." You should also avoid highly acidic foods like citrus fruits and tomatoes, which can aggravate your stomach. 

"Instead, eat foods that minimise aggravation," says Abbas. "Apples, avocados and bananas are less likely to trigger symptoms. Green vegetables are also good: foods such as asparagus, broccoli and Brussel sprouts offer high fibre whilst being low in fat and sugar." Research also shows a link between high fibre diets (including foods such as oatmeal, whole grain bread and brown rice) and a reduced risk of heartburn symptoms.

If you think acidic foods are worsening gastrointestinal symptoms, but want to stay topped up with vitamin C, you could try a supplement instead. Low vitamin C levels often lead to poorer health outcomes, with supplements shown to speed up recovery from pneumonia.

6. Avoid foods high in histamine

In the same vein, if one of your flu symptoms is a headache, or you have a history of migraines, it’s a good idea to reduce your intake of foods containing histamine. Abbas says: "This may help to reduce symptoms because histamine can be a migraine trigger." Foods high in histamine include alcohol, red meat and aged cheese. 

"Diet alone can cause histamine levels to rise so high that someone with a histamine intolerance experiences allergy-like symptoms without having an allergic reaction," continues Abbas. "A histamine-related headache is usually accompanied with tearing of the eyes, nasal congestion and/or runny nose, facial sweating and/or a sense of agitation."

7. Eat spinach

One of the main symptoms of flu is extreme fatigue and exhaustion. Fortunately, you can also tweak your diet to minimise this. Abbas says: "Spinach contains potassium, iron and folate as well as many B vitamins, all of which are important to energy metabolism. 

"Low levels of iron can cause major fatigue so it's important to boost the body with these vitamins and minerals when feeling weak and lethargic from the flu virus."

8. Keep warm

Bacteria and viruses thrive at cooler temperatures, so if you’ve got the flu it’s vital you stay warm and dry. One Yale University study found that the cold virus replicated faster when the temperature in the nose of mice dipped below the core body temperature of 37C. At a cooler temperature of 33C, key immune system proteins could not function properly, which allowed the cold virus to reproduce and spread in airway cells.

Dr Middleton says: "If confined to bed, a good old-fashioned hot water bottle can be very helpful, as well as comforting."

9. Prioritise rest and sleep

Flu can really wipe you out – don’t fight the urge to nap and get as much rest and sleep as you can. While we sleep the body releases cytokines, which stimulate the movement of cells towards sites of inflammation, infection and trauma. And the more we rest the more energy and resources the body has available to use in this battle. 

Indeed, research by Washington State University showed that sleep is associated with a brain protein called AcPb that sped up recovery in tests done on lab mice that were infected with the flu strain H1N1.

10. Try essential oil-infused steam inhalation

As lack of sleep could harm your recovery rate, any method of relieving symptoms that disrupt sleep, such as a cough or congestion, is also well worth a shot. Dr Middleton says: "Menthol and eucalyptus steam inhalation is a traditional remedy that has stood the test of time to relieve nasal congestion."

Place a few drops of oil into a bowl of steaming water, position your head a few inches away from it and inhale. 

How long does the flu usually last?

Most people will feel better within a week, but some symptoms, such as fatigue or a cough, may last longer. In general, you will be contagious for around one day before symptoms start and a further three to seven days afterwards.

Dr Middleton says: "Colds and flu are usually self-limiting, and most people recover quickly from them. However, vulnerable groups such as young children, the elderly, diabetics and people with long-term conditions or a weakened immune system, can develop complications and if in doubt, you should contact their pharmacist or doctor for advice." 

Children and people with lowered immune systems may also be contagious for a few days longer than average.

And, of course, prevention is better than cure: "Wherever possible and appropriate, vulnerable people should have a flu vaccination as a priority," says Dr Middleton. 

Video of the week

During the winter, you’re probably often asking yourself, ‘Why am I always cold?’ But while you might simply put this down to the fact the outside temperature is dropping, your health could be a factor, too. 

"Increased cold sensitivity is a normal part of ageing, but it can also be a sign of a health problem that is linked to poor blood flow and circulation," says co-founder and registered manager of online pharmacy The Independent Pharmacy, Scott McDougall.

"Conditions such as anaemia, Raynaud’s disease and diabetes, as well as low body weight are common causes of feeling cold." Fed up of constantly feeling chilly? Here, our experts get to the root of what might be causing those shivery spells and how to stay warm this winter.

 Why am I always cold? 4 possible reasons

1. Anaemia

Anaemia occurs when there are not enough healthy red blood cells to provide oxygen to the body's organs. Symptoms include fatigue, dizziness and feeling cold.

"The types of anaemia which tend to cause this cold symptom are related to iron and vitamin deficiencies (namely, vitamin B12 and folate)," says Kim Goldin, GP and health assessment doctor at Nuffield Health.

Iron produces haemoglobin – a protein in your red blood cells, which carries oxygen, nutrients and heat all over the body. You can boost your levels by eating foods high in iron, such as seafood - especially clams, oysters and mussels - red meat and quinoa. If you think you might be anaemic, you can book an appointment with your GP for a blood test.

2. Poor blood circulation

The answer to 'Why am I always cold?' might be simply be down to poor circulation. "As we age, the arteries get furred up with fatty deposits by a condition known as atherosclerosis," says Dr Deborah Lee from Dr Fox Online Pharmacy. "Because blood cannot pass so well through blocked arteries, the tissues beyond the blockage are relatively starved of oxygen."

This means your toes and feet may look pale, with bluish nail beds, and feel cold. You might also experience numbness and tingling in your hands and feet.

3. Raynaud’s syndrome

Raynaud's disease: the 'cold hand syndrome' that affects one in five of us causes spasms in small blood vessels in your fingers and toes. "They may turn white to blue, then flush red as blood returns," says Scott. "This occurs when blood vessels constrict due to cold or stress, so staying warm in the winter and avoiding stressful triggers is critical."

People with primary Raynaud's disease – where the cause is unknown and isn't linked to any underlying cause – often experience mild symptoms, which can be managed with lifestyle changes. 

According to the NHS, things you can do to help manage Reynaud's include:

• keep your home warm
• wear warm clothes during cold weather, especially on your hands and feet
• exercise regularly – this helps improve circulation
• try breathing exercises or yoga to help you relax
• eat a healthy, balanced diet

4. Low body mass index

Body fat helps to insulate you from the cold, so those with decreased body fat will feel the it more. 

"Causes of a low BMI (below 18.5kg) include malnourishment, eating disorders such as anorexia nervosa, severe chronic diseases or cancer patients who have low levels of body fat," says Dr Lee. 

Why am I always cold in the morning?

The reason we may feel cold in the morning is due to our circadian rhythm, which regulates our sleep-wake cycle.

"It forms part of our 'internal body clock' and follows an approximate 24-hour cycle. One of the body’s functions that falls under this rhythm is our core body temperature," says Dr Goldin.  

"We usually reach our lowest body temperature about midway through our sleep so when we do wake up, our bodies have often not fully warmed up to our typical body temperature," she adds. "For this reason, we may feel cold in the morning as our body temperature regulates itself."

Why am I always cold at night?

Lack of sleep caused by feeling cold? Again, this comes back to our circadian rhythm. "Even though it can be incredibly frustrating if you can't sleep due to feeling cold, it's normal to feel chillier at night. This is due to our core temperature starting to drop as our body prepares us for sleep," says Dr Goldin. "This is a natural response to the lack of daylight and it lets our body know it's time to rest."

Menopausal women may also experience night-time chills. "The decrease in oestrogen levels has an effect on the hypothalamus, making it less effective at regulating body temperature. This causes both chills and hot flushes," says Scott.

"Poor positioning can also cause numbness and coldness in the arms and legs at night," he adds. "Back sleepers can improve their circulation by placing a pillow under their feet, while side sleepers can place a pillow in between their knees."

To fix your sleep schedule, you can warm up before drifting off. Take a hot water bottle to bed or invest in one of the best blanket hoodies to hunker down in.

How can I stop being cold all of the time?

1. Keep a warm home

"Wear layers such as a thermal vest made of a wicking fabric which absorbs moisture such as polyester, followed by a woollen jumper, and then a wind-resistant jacket on top," says Dr Lee.

And while you might not want to blast the heating, there are plenty of ways you can stay warm at home. "Keep your head warm with woolly hats and scarves, and try fingerless gloves. And wear slippers, rather than walking about bare foot," she adds. 

Of course, an electric blanket will also keep you toasty, but if you're worrying how much does it cost to run an electric blanket?, you can opt for a hot water bottle or a microwavable heat pack.

2. Manage your weight

Managing your weight is important – but not through crash diets, fad diets or ‘yo-yo’ dieting, which can be bad for your health, and often lead to more weight gain long-term. 

"You need to find a healthy eating plan you can stick to and lose weight steadily and gradually," says Dr Lee. 

"If you are seriously underweight (BMI of 18.5kg or under) you need to book an appointment with your GP to rule out possible medical causes," she adds.

If you have an eating disorder, you can seek help and advice at the eating disorders charity, Beat. You can also make an appointment with your GP who may refer you to a specialist for treatment, where you can have a tailored plan to help you gradually restore your weight to a healthy range

3. Hydrate

It might not be the first thing you think of to keep yourself warm, but Dr Goldin explains that "if we become dehydrated, our body causes constriction of the blood vessels to conserve the water in the body, which can cause a constant cold feeling."

Limit your caffeine intake and drink warm water or herbal/decaffeinated tea if you're having a hot drink. Sipping hot ginger tea is especially good for warming you up as it can stimulate thermogenesis and it's a diaphoretic (warms your body from the inside out).

4. Eat a balanced diet

Eat a well-balanced diet that is varied and nutritionally complete. Foods that take longer to digest will keep you warm. These include:

• Complex carbohydrates – porridge or oatmeal, wholegrains, potatoes and lentils.
• Bananas – contain vitamin B and magnesium, which help the function of your adrenal glands and thyroid. These both help regulate body temperature.
• Dry fruits and nuts generate heat in the body and can also help boost iron levels. Just don't eat more than the recommended 30g daily as they're high in fat.
• Root vegetables such as onions, sweet potatoes, turnips, garlic and radishes.
• Spices including capsaicin and cayenne.
  

"Fill your diet with warm nourishing foods, such as soups and casseroles, and have plenty of warm drinks," says Dr Lee. "If you're vegan or vegetarian, it’s advisable to take B12 supplements." And does being cold burn calories? Yes, a small amount! So factor this in to your daily intake too.

Video of the Week

We've reached out to sleep experts to answer that age-old question - what does my dream mean?

We all have dreams every now and then that really stick in our minds. Ever dreamt about an ex-partner that you haven't thought about in years? How about the one we all hate - finding yourself naked in public? Although most of our dreams don’t make any sense, that doesn’t stop us from asking questions about them, like what it means when you dream about someone or when you dream about being pregnant - you might even want to know how to lucid dream. But perhaps the most common question we ask ourselves when we wake up from a deep slumber is: what does my dream mean?

Psychologist Dr Keith Hearne says, "Sometimes meanings behind these weird dreams aren't quite as obvious as you might think. Dreams are often mistranslated and the actual message is different to the original. They should be taken metaphorically, not literally." 

So, before you start worrying that you're really in love with the postman, and for next time your child wakes you up in the night with questions about their strange dream, read our guide below to make sense of some of the most common dream meanings. 

14 of the most common dream meanings explained

1. Dreaming about your ex

Break-ups happen for a reason (whether they're romantic relationships or friendships) and most of us don't like to be reminded of ex-partners or friends years down the line, especially if we're happy with the relationships we have now. But it’s not uncommon to dream about an ex, leaving you wondering why you're being plagued by the past.

UKCP Psychotherapist Yuko Nippoda says that the meaning behind the dream depends on the relationship. "The re-experience of the relationship might have sweet memories, and people might be unconsciously fantasising to go back to the time of this relationship. However, if it was a sour relationship, people might feel that they have unfinished business or regret, and be unconsciously wishing to fix it." 

She adds "If it was a damaging relationship, then it can become a nightmare which creates further fear, instead of offering a safe place. In that case, it is important to be aware that the relationship has already ended and it will not come back, so that the dreamer can create a safe place for themselves."

2. Dreaming about cheating or being cheated on

Perhaps even less pleasant than dreaming about an ex - but just as common - is dreaming about being cheated on. 

Dream analyst Lauri Lowenberg previously told Harper's Bazaar "If there’s infidelity in your past, either in this relationship or a past relationship, this will keep cropping up because it’s a bone of contention within yourself." 

However, she adds that if there are no trust issues in your relationship, another hidden meaning could be that there is something else you feel is taking time and attention away from you, such as a job, a hobby or a new friend.

If you're the one cheating in the dream, then think about the person you're cheating with. Bed retailer Dreams says "Typically, these dreams don’t indicate a sexual attraction but that they may have certain qualities that you wish your partner could emulate."

3. Dreaming about being naked in public

We've all had that dream where we're at work or in a busy public place and all of a sudden we realise we've forgotten to get dressed. The way we react to this in our dreams is key to working out the meaning.

Psychologist Dr Keith Hearne says, "In this case, a feeling of embarrassment and shame probably accurately reveals the essential emotion, and the content symbolically displays the cause of the dream. The dreamer should focus on what they have done or said to ‘show themselves up’.”

However, dreams of this type aren’t always negative.

"It may be a rebuke from the unconscious of unacceptable social behaviour, but if the feeling in the dream is of exhilaration, it may represent a new-found sense of freedom," explains Dr Hearne.

Theresa Cheung, author of international bestseller The A to Z Dream Dictionary noted that dreams about being naked in public hold a similar meaning to dreams about relieving yourself in public. She says, " These kind of exposure dreams suggest that you are feeling vulnerable or exposed in some aspect of your waking life, perhaps because you are in a new situation or relationship and don’t feel like you can be your authentic self yet."

4. Dreaming about your teeth falling out

Losing your teeth is a common dream to have during deep sleep. Sometimes the dream starts off with teeth having already fallen out, or in other versions of this dream the teeth drop out one-by-one. Both are unpleasant, but what do they mean?

One interpretation of a teeth-loss dream is that you're concerned about losing your looks. It has been widely reported that women experiencing menopause symptoms reportedly dream frequently about teeth loss, and in this instance it often represents worries about growing old and losing their femininity.

Dr Hearne adds, "This dream may be interpreted as a warning that time is passing and important things need to be done in life, or that you are embarrassed over something insensitive you’ve said to someone else."

Meanwhile, Theresa says this dream could be about a need for change in your waking life or something to do with communication. She says, "Consider if there is something you have said that you may regret or that there is something you need to say."

5. Dreaming about snakes and spiders

For many of us, dreaming about snakes and spiders are more like nightmares, but there could be a meaning behind seeing these creatures while you sleep that you can apply to your waking life. 

Theresa says that dreaming about animals can often mean your dreaming mind wants you to learn from the qualities associated with that animal, and that of all the animals it is snakes and spiders that feature most commonly in our dreams. 

She says, "Spiders represent small fears which are being exaggerated or which you need to change your perspective about before they become deadly, and snakes represent the shedding of old skins, so this is about transformation and letting go of what is holding you back."

6. Dreaming about falling

You're probably familiar with the feeling when you wake with a start after having a dream that you're falling. A study of 2,000 UK adults carried out by Bed SOS found falling to be the second most common dream (45%), after having sex (48%). Being chased (37%) was in third place. 

The common myth is that if you ever actually hit the ground you'll die in real life, but this, unsurprisingly, isn't true.

"Falling dreams can cover several different scenarios, and often seems to come up as a linguistic pun," says Dr Hearne. "The word ‘fall’ is used in several contexts in everyday life. It may appear either as a wish (for example to fall in love, or to fall pregnant), or refer to a negative event (say, to fall out with someone, to decline or fail in some way). Recall what was happening in the dream, and the characters present, to uncover the probable topic."

Theresa offers another perspective, saying, "If you fall from a great height in your dream this suggests a fear of failure. It could also suggest that you feel insecure or are lacking support in your waking life."

7. Dreaming about flying

Flying dreams can be really fun - who wouldn’t want to soar through the sky without a care? When you dream you're flying and it feels like the most natural thing in the world, it indicates that you are on top of a situation and feel confident that you will succeed.

Dr Hearne says "This is a well known metaphor for doing well in life, and progressing with ease." However, Theresa adds that if it is not a pleasant dream, "it could also be your dreaming mind urging you to let go of self-imposed limitations and to rise above and see the bigger picture."

The experts at Dreams add, "A tough time flying in your dream suggests that someone (or something) is stopping you from moving to the next step in your life. If you are unable to fly it suggests that you might be struggling to meet the high goals you set for yourself."

8. Dreaming about failing a test or arriving late

Dreams about failing a test or arriving late can both leave you waking up in a cold sweat, and Theresa Cheung tells us that these dreams have a similar meaning - usually that you are feeling unprepared.

She says, "Back-to-school dreams are usually related to current career issues and feeling judged in some way. Many highly successful people have these kinds of dreams, as their dreaming mind cathartically takes them to the worst-case scenario so they don’t have to go there in their waking life."

9. Dreaming about being lost

"The feeling of being lost is a powerful emotion, in life and in dreams," Dr Hearne explains. "Children can be traumatised by such an experience, and a ‘sub-personality’ may form, stuck at that age, subsequently influencing their life and their dreams.

"Symbolically, the dreamer may be ‘lost in life’, and needs to find a way forward to a rewarding place."

Have you been worrying about your career path? Or perhaps you're concerned about how a relationship with a partner has changed lately? This could be a good chance to assess where things are going.

Theresa says this could also be the case if you are dreaming about being trapped. She adds, "If you have this dream often, just before you go to sleep, ask your dreaming mind to help you find a solution and see what symbols are presented to you."

10. Dreaming about someone that has died

Being visited in our dreams by loved ones that have died can be comforting or upsetting. Some people see it as a sign that the person is trying to communicate from the afterlife, but watch out for reading too much into this as it can lead to an obsession over what they're trying to tell you.

Another interpretation is that it means you still need to deal with issues surrounding their death, even if it was a long time ago. Whichever you choose to believe, their appearance in your dream means this person remains in your memories.

"The ancients understood the concept of opposites in dreams," reveals Dr Hearn, saying "The unconscious message might be that a birth is in fact imminent." This could mean an actual birth, or a new beginning. 

11. Dreaming about drowning

Drowning is another common theme in dreams - or nightmares - and Theresa suggests this probably means you are feeling emotionally overwhelmed in your waking life, or that you are bottling up your emotions.

She advises that if you're having this dream, "Time to let it go! Time also to understand that your emotions do not control or define you. You choose your emotions, just as you also choose your thoughts and your actions. You are in charge of what you feel, think and do."

12. Dreaming about being chased

Another common dream that falls into the nightmare category is the experience of being chased by someone or something. 

Theresa says that these dreams, "suggest that you are feeling threatened in some way in your waking life."

By way of advice, she says, "Try to identify who or what is chasing you and how this relates to circumstances in your daily life. Fears need to be faced and understood and when they are faced and understood they will lose their power over you."

13. Dreaming about dying

As well as dreaming about people who have died, some unlucky sleepers have had dreams where they have died themselves. The good news is, this doesn't mean your dream is going to come true.

Theresa: "If you are the dying person, your dreaming mind is urging you to make changes, let go of one stage in your life and move forward in a new direction. With every end, there is always a new beginning. This dream is all about the power of transformation."

Meanwhile, if someone you know in a dream dies, or is dead, this means that the part of yourself you see represented in that person is dead, or needs to die.

14. Dreaming about having sex

One of the most common dreams out there is dreaming about having sex - and more often than not this will be with someone you're not in a romantic or sexual relationship with. 

But don't worry, this doesn't mean you're at risk of having an affair or sleeping with someone you shouldn't. Theresa says, "Having sex in your dreams – especially with someone you aren’t attracted to in real life – is also about merging aspects of your personality together or developing aspects of yourself that are hidden. 

"If you have a dream affair, ask yourself what does the person you are having an affair with in your dream represent? Your dreaming mind wants you to get intimate with and discover that within yourself."

She adds that this dream might be a sign to consider what cheating means to you and if you are cheating yourself out of something.

Here on Goodto, we've got plenty more expert advice to help with sleep problems. From ways to fall asleep fast and tips for waking up in the morning to the reasons why you feel tired all the time and why you might sweat at night. 

We spoke to the following sleep experts:

CIf you've ever had a panic attack you'll know how scary it can be. If you haven't, it helps to be aware of panic attack symptoms and how manage them.

Every year in England, 1 in 4 of us will suffer from a mental health problem. Conditions can range from stress or depression, to debilitating phobias, to panic and anxiety. In fact, according to mental health charity Mind, every week 6 in 100 people are diagnosed with generalised anxiety disorder (GAD) and around 1 in 100 with a panic disorder.

A panic attack can be incredibly frightening. Ironically, though, it's a sign that your body is acting as it should – at first, anyway. “A panic attack happens when your body triggers the ‘fight-or-flight’ response, where you experience symptoms that are essentially trying to ‘pump up’ your body into action," explains psychological wellbeing practitioner Holly Thurston. "This is a normal response to a fearful situation. However, sometimes this response is triggered when there’s no real threat.”

There is a wide range of panic attack symptoms, some of which can be very alarming. It's not uncommon, for example, for people to believe they are having a heart attack or that they are dying. What's more, just the thought of having one can trigger one, so it can be a difficult cycle to break.

"Panic attacks can be maintained by worrying about what symptoms mean," continues Holly. "If we worry about the dangers of our symptoms this will make us feel anxious, and when we feel more anxious these symptoms appear or become stronger. We are hyperaware of these symptoms and so we think that there must be something really wrong with us. In turn, we worry more," she explains.

The good news is that if you recognise panic attack symptoms, you can avoid known triggers or – if one occurs – use tried-and-tested ways to calm down. Not only is educating yourself an act of self-care, you’ll be able to help other sufferers.

What is a panic attack?

A panic attack is an extreme response to either a real or imagined fear. Symptoms can affect us physically, mentally or emotionally.

"Panic attacks are a rush of intense psychological, behavioural and physical symptoms – an exaggeration of the body’s normal ‘fight or flight’ reaction," reiterates Dave Smithson, operations director at Anxiety UK. "This is often a sudden period of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something bad is going to happen."

Panic attacks can feel impossible to escape from, but there are ways to minimise them. They rarely last long and are not dangerous – although it can be hard to believe this when you're in the midst of one. "Panic attacks usually last between 5-20 minutes," says Mind's head of content Kerry McLeod. "Some people have one then don't ever experience another, whilst others will experience them regularly, or have several in a short space of time."

Panic attack symptoms

These are some common symptoms of a panic attack. Whether mental or physical, these symptoms can have a negative effect on our emotional wellbeing.

Physical: 

• Breathlessness and/or rapid breathing
• Chest and/or stomach pain
• Faster heart rate/palpitations
• Feeling faint or dizzy
• Feeling very hot or cold
• Ringing in the ears
• Nausea
• Numbness
• Shaking
• Sweating

Mental: 

• A feeling that something bad will happen
• Having a desperate need to escape
• Intense fear
• Losing sense of reality
• Thinking you might die
• Worrying you're having a heart attack

Panic attack symptoms vs heart attack symptoms

It's not unusual to think that the symptoms of a panic attack are, in fact, the same as having a heart attack. There are similarities, such as chest pain, rapid heartbeat and sweating, but there are also marked differences.

"One difference between a panic attack and a heart attack is that heart attacks frequently begin during physical exertion, such as walking up stairs or running," says Holly, who works for livelife, a UK social enterprise providing affordable, NHS-quality online therapy. "However, panic attacks can occur when we're resting or not doing anything."

The length of time of the attack also matters. "Panic attacks get better and are usually over within 20 minutes," she explains. "Whereas a heart attack would last longer and get worse over time."

It's also rare to faint during a panic attack, while a loss of consciousness is common with heart attacks, she adds. "And seek medical attention if you experience intense chest pain that lasts longer than a couple of minutes, or chest pain that spreads to the jaw or shoulders," she says.

If you are unsure always call 111 for urgent medical advice, or 999 for an ambulance.

How do you calm a panic attack?

In the lead-up to, or during a panic attack, you may struggle to believe that there are ways to calm yourself down. However, there are some excellent techniques for managing panic attack symptoms and for shortening an attack, as well as ways to prevent attacks.

Ways to manage a panic attack

• Breathe deeply and slowly. Breathing exercises can be a very effective way of reducing stress and anxiety. "It's good to find a breathing technique that you like, such as ‘box breathing’," says Holly. "This involves closing your eyes, breathing in through your nose and using stomach breathing (your stomach should rise instead of your chest) while counting slowly to four, holding your breath while counting slowly to four, then slowly exhaling for four seconds. Repeat these steps around three times." For more advice on how to breath to manage your emotions, read Stuart Sandeman's book Breathe In, Breathe Out (HQ, £16.99 from Waterstones).
• Stamp on the spot. As well as being a distraction, "some people find this helps control their breathing," says Kerry.
• Focus on something structured and repetitive. Counting out loud is useful. Or repeat a mantra over and over, such as 'I am okay, I am safe, I can get through this moment.'
• Imagine a peaceful setting. Picturing your happy place – a beach or meadow, for instance – or remembering a moment when you felt safe, such as hugging your mum, can boost feelings of wellbeing.
• Focus on your senses. Kerry recommends sucking a sweet or chewing gum, or cuddling something soft. You could also try aromatherapy. For instance, applying Tisserand's Total De-Stress Pulse Point Roller Ball (£6.41, Amazon) to your pulse points and inhaling the scent can reduce anxiety.
• Try not to fight it. This may seem counterintuitive, but knowing that a panic attack can't harm you and that it will be over soon can help you gain control of the situation. "Acknowledge and accept that you are having a panic attack. Remember that it will pass," says Kerry 

Ways to prevent a panic attack

• Practise mindfulness and meditation. If you are less stressed in your day-to-day life you are in a stronger position to cope with anxiety-inducing moments or situations. Mindfulness and meditation are natural ways to relieve stress that can ground you and help you face your fears. A 2020 study found that daily mindfulness training can actually make it easier for us to forget our fears. "These are a great way to remain calm and present, and not to be controlled by fears and worries," says Dave.
• Start talking. Therapy can help you recognise and manage the feelings that lead to panic, as well as help you understand any unhelpful thoughts that perpetuate your anxiety. You could try counselling, cognitive behavioural therapy or psychotherapy. Speak to your doctor for a referral or visit a mental health charity website for information. "Anxiety UK has a national team of talking therapy practitioners that offer therapies such as counselling , CBT, CFT, and clinical hypnotherapy," advises Dave.
• Keep a diary. Kerry suggests noting down difficult thoughts or feelings. "This might help get them out of your head and make them feel less overwhelming. You can then reflect on them when you feel calmer," she says.
• Avoid stimulants. Alcohol, caffeine, smoking and street drugs can all raise our heart rate and trigger a panic attack. If you're prone to panic, or are more stressed that unusual, avoid these.
• Take regular exercise. It's well-documented that exercising releases endorphins and reduces stress. One study found that regular exercise reduced anxiety by 20%. Even a daily 20 minute walk or a quick run can make a difference to mood.
• Try exposure therapy. While it's important to use techniques such as breathing to manage anxiety, in the long-term it's possible to become too reliant on these 'safety behaviours' and hide behind them, rather than treating the cause of the panic. To get to the root of the issue, Holly suggests exposure therapy. "It's helpful to expose ourselves to situations that make us feel anxious, and to remain in those situations without escaping them or using safety behaviours. Over time, the anxious feelings will naturally start to decline," she says. To do this, start small and work your way up. "For example, if you experience panic in shopping centres, then your first goal might be to go to a shopping centre at a quieter time of day, with a friend or family member for support, and stay in the situation until the anxiety subsides. Then, slowly increase your exposure," she suggests.
• Consider medication. If your feelings of panic are particularly severe, your doctor may suggest medication such as anti-depressants or betablockers. Because of the addictive nature of tranquilisers, these are increasingly only offered in extreme cases, and only for a short period.

It also helps to treat yourself kindly afterwards. “Following a panic attack, it’s important to pay attention to what your body needs," says Kerry. "For example, consider practising self-care such as finding somewhere quiet to rest, or eat or drink something."

You can also benefit from telling someone close to you what happened, what your symptoms were, and what helped, so they can support you in the event of another attack, says Kerry.

What can trigger a panic attack?

The most commonly known panic attack trigger is stress – such as a job interview or bereavement – or a threat to our wellbeing, such as experiencing a traumatic event. There are physiological reasons too, such as a lack of sleep, having a genetic predispostion, or the menopause.

Common panic attack triggers:

• Stress. This can be caused by a job interview, job loss, exams, a relationship break-up, bereavment, or moving house.
• Shock. This could be because you were in – or witnessed – an accident. Or you were the victim of a crime, experienced trauma, or received bad news.
• Menopause. Hormonal fluctuations – and in particular low oestrogen – can trigger anxiousness and panic. Indeed,  a 2020 study found that 58% of women aged 44-55 years suffered from anxiety. Hormone replacement therapy (HRT) can keep anxiety at bay, as well as manage the 'embarrassing' symptoms that can trigger panic. "Women may start to panic when experiencing hot flushes in social situations, due to distressing physical sensations," says Holly.
• A lack of sleep. Research indicates that sleep therapy can benefit people who suffer from anxiety or panic attacks.
• A genetic predisposition to anxiety disorders. There can be a biological cause for people's anxiety, which may be treated with medication and/or therapy.
• Sometimes there is no obvious trigger or reason for a panic attack. If this is the case, managing symptoms is the best course of action.

Panic attack vs anxiety attack

Panic attack vs anxiety attack are two interchangeable terms. Often, people will use them to mean the same thing, although some health practictioners believe that there are differences.

"Panic attacks and anxiety attacks share similarities, but they are two different things," says Holly. "The main difference is that an anxiety attack is triggered by a current stressor or event, such as an exam or presentation, whereas panic attacks can be unpredictable and often appear to come out of the blue with the particular stressor unknown," she explains.

"Whereas anxiety is an emotion often described as a general sense of dread or fear, a panic attack is usually characterised as an episode of sharp, intense anxiety where extreme physiological and psychological symptoms are experienced," adds Dave. "It's also often described as a sudden rush or spike of intense anxiety."

When to see a doctor about panic attack symptoms

Sometimes, a panic attack is an isolated incident, but as panic attack symptoms can be frightening seeing a doctor can be very reassuring. A health professional can check that you don't have any underlying health conditions, then offer advice and support on how to manage any future panic attacks.

"In general, if you're having frequent panic attacks then it's important to see your doctor," says Holly. You may have a panic disorder, which requires treatment. "You should especially contact your doctor when your panic starts to interfere with your daily life," she says. "For example, if you change your behaviour to try to prevent a panic attack. Examples include not going out alone or taking time to plan your escape route. Or, if you start to avoid certain situations due to worrying about having a panic attack there."

A doctor or therapist is usually your best option, but some people feel uncomfortable talking about their mental health. If this sounds like you, Mind's article on seeking help for a mental health problem is really useful. You can also contact Anxiety UK or call their helpline (03444 775 774) for advice.

For more advice, visit:

• Mind's useful contacts for anxiety and panic
• Mental Health Org
• Anxiety Care UK

Can babies get hay fever? We asked the experts and got answers from an award-winning Paediatric Allergist and the Acting Head of Clinical Services at the leading national patient charity for people living with all types of allergy.

According to charity Allergy UK, 40% of children in the UK have been diagnosed with an allergy and the four most common allergies in children are food allergy, eczema, asthma, and hay fever. We know that children can suffer with hay fever, which is also known as seasonal rhinitis, but can babies get hay fever too?

To answer this question, we spoke to paediatric allergy consultant and child allergy specialist Professor Adam Fox and Margaret Kelman, a Research Nurse and Acting Head of Clinical Services for Allergy UK. They share their insights and expert advice on the topic of hay fever in babies and young children below. 

The information in this article is for general purposes only and does not take the place of medical advice. It is essential to be guided by your GP and take note of official NHS advice. As a parent, you know your child better than anyone and you should always trust your own judgement. If you are at all in doubt or you're worried about your child's symptoms, you should contact your GP. If your child has a temperature, their symptoms worsen or a rash appears, then it is crucial to seek personalised advice from a doctor as soon as possible. 

Can babies get hay fever?

"Yes, babies and young children can be affected by hay fever," Margaret tells us, although Professor Fox explains why it isn’t common, "It’s relatively rare for babies under the age of 2 to experience hay fever symptoms, as typically children require at least two seasons of exposure to pollen before an allergic reaction takes place. 

"It is still possible to see symptoms in babies before 2 years of age," Professor Fox adds, "However, it’s important to consider other possible causes of a baby’s symptoms such as infection before assuming it is hay fever related."

As highlighted by Professor Fox, it's important to seek medical advice to get an accurate diagnosis if your baby or young child develops hay fever symptoms, just in case the symptoms are related to an infection that needs to be treated and in order to rule out asthma or other medical conditions which may require prescription medication.

How do I know if my baby has hay fever? What are the main symptoms to look out for?

"Sore, itchy, watery eyes and a runny, blocked nose are the most common hay fever symptoms that babies can have," Professor Fox says. "Sufferers of all ages can also experience lesser-known symptoms such as swelling of the eye-lids and light sensitivity, and eyelids that feel difficult to open in the morning."

Margaret explains that hay fever symptoms in babies are often missed, as they are, "similar to those of a common cold". The main difference between hay fever and a cold is the season that the symptoms occur and the presence of a fever or temperature. Hay fever never causes a fever, so if a child has a high temperature they likely have a cold or a different illness and need to get seen by a doctor. 

The season that the symptoms occur also might indicate if your child has hay fever. It might be a sign that your baby is suffering from hay fever instead of just a common cold if their symptoms get worse in warm, sunny weather - and don’t clear up quickly like a cold. 

"Typically babies and young children are likely to experience symptoms of hay fever during the pollen seasons in spring and summer months, depending on the pollen trigger," Margaret explains. 

"Your baby might be allergic to only a particular type of pollen and have symptoms in the spring or late summer for example, or they could be allergic to more than one pollen type (such as tree and grass pollen) and have symptoms from spring all the way through to autumn," says Professor Fox. 

How severe hay fever symptoms are will depend on the pollen count that day. The weather also plays a part as there's more pollen in the air on a hot, dry day than a wet and cloudy one.

"Hay fever symptoms also vary depending on the time of day and the weather conditions, which affect the amount of pollen in the air (pollen count)," Professor Fox explains. “The count is usually at its highest in the morning and on hot, dry and windy conditions, so this is when symptoms are likely to be at their worst."

"However, in young children, [hay fever] symptoms can be difficult to distinguish from other conditions or illnesses including the common cold or teething," says Margaret. "We always suggest that if there is any doubt, people shouldn’t hesitate to seek medical advice."

If your baby is displaying any of these symptoms, it’s best to make an appointment to see your GP and get a formal diagnosis and personalised medical advice on treatment. 

Why does my baby have hay fever?

Hay fever is usually caused by pollen, although it can be induced by other allergens such as dust mites. Hay fever symptoms can occur because the body is mistakenly seeing pollen as a threat, so the immune system is attempting to prevent the perceived 'infection' from spreading.

In the UK, hay fever symptoms are mostly triggered by pollen from trees, grasses and weeds, as well as environmental moulds. Hay fever is at its peak between April and September, but your child may suffer for a shorter period if they are only allergic to a particular type of pollen. The time of year their symptoms flare up can give you an idea of which type of pollen they might be having a reaction to.

• February to June – tree pollen
• May to July – grass pollen (the most common hay fever trigger) 
• June to September – weed pollen

Genetics also play a role in why your child might have hay fever. "Your child is more likely to suffer from hay fever if other close family members have allergies," Margaret says, with Professor Fox adding, "If any immediate family member (siblings or parents) have eczema, hay fever or asthma, it makes it more likely that the baby could develop allergies."

Do I need to see a doctor for hay fever in babies?

Yes, you should make an appointment to see a doctor and seek medical advice if you think your child might have hay fever or if they are displaying symptoms that become troublesome or concern you. 

If hay fever in babies is left untreated it can lead to the development of wheezy symptoms or you risk missing a more serious underlying issue that needs to be seen and treated by a doctor. 

"Allergy symptoms are troublesome for children and parents, and if left untreated, they may increase the likelihood of wheezy symptoms,” says Professor Fox. “Always speak with your GP or pharmacist for advice if you are worried about your baby’s symptoms."

What can parents do at home to help their baby with hay fever?

Some natural remedies for hay fever are suitable for children as well as adults, but the main thing that parents can do at home to help their child manage their hay fever is try and minimise their child’s exposure to pollen. Margaret suggests that parents monitor and be aware of the daily pollen forecast. "It might help if parents can reduce the time your baby spends outside during peak hay fever times." 

Professor Fox also suggests that you can help to ease hay fever symptoms in babies and children by:

• Washing their clothes if they've been outside to remove the pollen
• Keeping windows and doors shut to avoid pollen coming in to your home
• Vacuuming regularly and dust with a damp cloth to remove pollen on carpets and surfaces
• Bathing every evening to remove pollen from your baby’s skin, hair and eye lashes

The information on GoodTo.com does not constitute medical or other health advice or diagnosis and should not be used as such. Although GoodtoKnow consults a range of medical experts to create and fact-check content, this information is for general purposes only and does not take the place of medical advice. Always seek the guidance of a qualified health professional or seek urgent medical attention if needed.

Our experts

Is bouncing on the trampoline with the kids out of the question these days? Does the thought of going for a run bring you out in a cold sweat? If so, you’re not alone. 

Let’s get straight to the point - 18% of UK women experience some form of bladder leakage or incontinence* and it’s time to end the stigma that surrounds it.

It’s probably not a common topic of conversation when you meet up with the school mums but there really is no need to feel embarrassed about incontinence. All sorts of factors can impact bladder function, from pregnancy and menopause to diabetes - and it affects both men and women. 

People of all ages experience different levels of incontinence and it’s not always entirely related to your age - younger people can suffer from moderate to severe bladder weakness, while some older sufferers have a milder experience of the condition.

There’s no need to let bladder weakness and incontinence hold you back from doing any of the things you love, however. Would you feel embarrassed about a sudden sneezing fit in public? Or let an attack of hayfever stop you from enjoying the sunshine? Hopefully not, and bladder weakness shouldn’t put a stop to your fun either.

The key to living with bladder weakness is finding the perfect product for you. Boots STAYDRY can help with this - we have a wide range of different products with something for everything from light to heavy leaks. Our comprehensive range of products caters for both men and women, and includes liners, pads, day pants, night pants, discreet underwear, slips, and a range of accessories too. We even have an online tool to help you select the best product for you.

Managing any health condition with confidence is so much easier when you’re using the right products. But research** shows that one-fifth of women use menstrual products instead of incontinence products for bladder weakness. Yet comfort, discretion and dryness are key when it comes to choosing the right product, so don’t settle for something that isn’t designed for bladder weakness.

STAYDRY is the number 1 incontinence brand sold in Boots*** and offers 4x protection to help you feel secure, confident and dry - whatever you get up to.

Suitable for moderate to heavy bladder weakness, Boots STAYDRY Pants are skin-friendly disposable pants designed for all-round comfort. With a better-than-ever fit, having recently been updated, they’re designed to feel more like real underwear and constructed using ultrasonic bonding technology which brings the absorbent core closer to the body, offering better protection from leaks.

The active zone within the absorbent core is capable of locking away over 30x its own weight of liquid as a gel, while a soft top sheet keeps moisture away from the skin. Dermatologically tested, STAYDRY products also have Derma Dry Technology for skin dryness and comfort, and Stay Fresh Technology which provides natural odour protection.

You can buy the STAYDRY range at Boots both online and in-person in our Boots stores.

While it’s normal to feel some embarrassment about buying an incontinence product at first, stocking your bathroom cabinet with the perfect product to help you manage your condition with confidence is the first step to taking back control of your life.

Now, time to assemble the kids - and race them to the trampoline.

* Data from Walgreens Boots Alliance Health of the Nation Study. 3,510 individuals aged 18+ were interviewed October 26th - November 8th 2021.

** Data from research by Walgreens Boots Alliance ‘Understanding the Incontinence Landscape’ dated October 2019.

*** Based on sales data from 04/05/2021 to 03/05/2022.

It's more common than you think to catch covid twice.

The government's Living with Covid plan put an end to all legal coronavirus restrictions in Spring. But many medical experts warn that the pandemic is far from over, with new covid cases continuing to be reported daily. And most in part to the spread of Omicron symptoms.

Those that have previously been through the process of positive lateral flow tests and self-isolation may think they're off the hook from the big C. But new research is proving that this might not be the case - with reinfection rates being a factor monitored globally. Our guide tells you everything you need to know about catching Covid twice.

Can you catch Covid twice in a month?

Although incredibly rare - yes, you can test positive for Covid twice in a month. However, whilst there have been cases of this, testing positive twice in one month is considered highly unlikely. And most data shows reinfections occur much later on.

This being said, Dublin-based Ph.D student Amelia McConville is one such example of catching covid twice in about a month. She first tested positive on 25 November, 2021 and received a second positive PCR result on 27 December 2021.

Amelia told Slate that her doctor believed she was infected with two different coronavirus variants. The delta variant first and then Omicron.

"She [doctor] said 'I’ve spoken to several people with what I suspect are reinfection rates or cases of reinfection along the same sort of timeline as you. I think that omicron doesn’t factor in delta antibodies in the way that previous variants , you’d have protection from them. It’s unlucky, but it’s definitely possible.'"

Amelia adds that whilst she can't prove this to be the case "all the symptoms are pretty consistent with both".

There's certainly evidence to suggest that Omicron is the dominant reinfection strain too. Research from scientists at Imperial College London deemed that the chance of testing positive again was 5.4 times greater with Omicron than Delta.

Similar alarming figures have been reported by the UK's Office for National Statistics (ONS). Their data found the risk of reinfection was 16 times higher when Omicron was the dominant variant, compared to the period when Delta was most dominant. This is because Omicron's genetic make-up tends to evade the body's natural immune responses. And as a result, in the last six months protection against reinfection has dropped from 85% to between 0-27%.

How long after having Covid can you get it again?

The consensus is that people can catch Covid again after three-months. The UK Health Security Agency defines reinfection as testing positive after 90 days of a previous infection. During this time, patients should have at least one symptomless month between the two cases.

America's Centre for Disease Control and Prevention agrees that there must be a negative-testing period between the two cases. "Reinfection with the virus that causes COVID-19 means a person was infected, recovered, and then later became infected again," they state.

90 days onwards does appear to be the typical time period when reinfection occurs. Indeed, one South African study reported 35,670 suspected reinfections amongst 2.7 million adults studied. These were people who had previously tested positive with a Covid infection after 90 days.

Research from Yale University explains why this occurs. Their study found that the average reinfection risk rises from about 5% four months after initial infection. And that this risk increases to 50% by 17 months.

Whilst reinfection is a possibility, one Chinese study published in December 2021 stated that "the rate of reinfection with SARS-CoV-2 is relatively low". They outline that this is because after having a positive case, your body has some natural immunity against the infection. It therefore knows how to fight it off or prevent reinfection if it comes into contact with the virus again.

Further good news came from the study, in that they deemed vaccines just as effective as natural immunity. This supports the need and current push for booster jabs by the UK government. Who hope that vaccination will prevent us going back into lockdown.

The latest government figures on reinfection have recorded 532,570 reinfection cases since the beginning of the pandemic. South Korean scientists were the first to report the possibility of catching Covid twice in April 2020. Though it wasn't until August 2020 that the evidence arrived - in the form of 111 official reinfected cases.

How long can you test positive for Covid after having it?

According to Gavi, people who have had covid can continue to test positive for the virus "for weeks or even months" after. However, the vaccine alliance agency state that whilst you may be showing up as positive you're not necessarily still contagious for this long and "therefore are unlikely to transmit the virus to others".

There are a few factors that determine why you're still showing up with Covid after having it. Gavi explains that it "depends on the severity of the case, and also on the test itself."

"PCR tests that hunt out parts of viral genetic material (RNA in the case of COVID-19) in our bodies and amplify it so we can detect it are extremely sensitive and can even pick up the presence of few viral fragments," the Gavi website states. "This is because fragments of viral RNA can remain in our bodies long after the infection is over and the virus has been cleared from our system."

In contrast, lateral flow tests look for viral proteins called antigens. (hence why they're also known as antigen tests). This makes lateral flow tests less sensitive and less likely to test positive again after you're first infected.

The general rule is that if you test positive on a PCR but negative on a lateral flow then you are not still infectious. However, if you're testing positive for both then you might still be contagious. So caution is preferred.

Whilst the Living with Covid plan has stated that Brits no longer have to isolate with Covid, other organisations say differently. The World Health Organisation (WHO) says that some who has Covid and is symptomatic for 30 days, will need to isolate until their symtoms disappear.

Who is most likely to get Covid twice?

Research is ongoing. But current data suggests that those who are unvaccinated, plus healthcare workers and households with children are groups most likely to catch Covid twice.

2022 data from the ONS showed that those who weren't double jabbed "were approximately twice as likely to be reinfected". This is in comparison to those who had received their second vaccine 14-89 days ago.

The same survey reported that reinfection risk increased for individuals who previously had a "milder" Covid infection. This was based on these cases having a lower viral load when ill.

Two other susceptible groups were highlighted in Imperial College London and Ipsos MORI's joint REACT study. They found that healthcare workers and households with children at school were more likely to get Omicron after having a previous infection. This is likely due to the two groups being in environments were transmission is higher.

A spokesperson for the UK's Health Security Agency also cited evidence that schoolchildren have been forefront in reinfection cases:

"Many of these shorter interval reinfections are likely to be school-age children because they had the highest levels of infection in September and October, just before Omicron emerged."

Can you get the same symptoms twice?

Evidence suggests that people with a reinfection can experience symptoms the second time around. So be aware of the usual signs: a high temperature, a new, continuous cough and a loss or change to your sense of smell or taste.

A study by the Cleveland clinic studied a number of reinfection cases and found that 50% of these had known Covid-19 symptoms. Plus there's fresh data from the ONS which says symptoms were just as likely in patients' second infection. Particularly during the current period where Omicron is the dominant strain.

So if you're feeling tired or experiencing any Delta variant covid symptoms, it's good to get checked out. And you definitely shouldn't go to work with a cold until you've ruled out coronavirus.

"If you get symptoms of coronavirus (COVID-19) again, self-isolate immediately and get a PCR test (test that is sent to a lab), even if the symptoms are mild," NHS guidance reads. They add that you should self-isolate until you receive your result. And if positive follow the recently changed self-isolation rules.

Though symptoms can occur when you catch covid twice, you also might not experience any. We're constantly reminded by the government that asymptomatic covid cases are a thing too. So symptoms are never 100% guarenteed.

"One in 3 people with COVID-19 have no symptoms and could be spreading it without realising it," reads a statement on the government website.

This is why - although we've been told we can stop wearing face masks - some people are continuing to use them. But of course it's now personal choice to wear or not.

What to do if you get Covid symptoms again:

NHS advice is to "stay at home and avoid contact with other people if you get symptoms of coronavirus (COVID-19) again". Particularly if you have a high temperature and don't feel well enough to carry out everyday activities.

"You probably have some immunity to the virus but it's not clear how long it lasts," the website states. "Take extra care to avoid close contact with anyone who is at higher risk of getting seriously ill from COVID-19.

What are the symptoms of long Covid in adults?

• Fatigue
• Headache
• Attention disorder
• Hair loss
• Dyspnea (shortness of breath)

A 2021 scientific review found that these were the five most common symptoms of long covid. With fatigue reported by 58% of participants. Whilst these five are ones to look out for, researchers cited a total of 55 long-term effects. This included rarer symptoms like nausea, joint pain, weight loss and anaemia.

What's more, the review claims that up to "80% of individuals with a confirmed COVID-19 diagnosis continue to have at least one overall effect beyond 2 weeks following acute infection". So don't be surprised if you're still suffering somewhat 2 weeks after your positive test.

There's more science needed to better understand the condition. And in fact, in February 2021, the government announced they would be donating £18.5 million to tackle long Covid through further research.

It's not known why some people experience this and others don't. But one 2020 American research paper found that SARS-CoV-2 can persist for months inside a person's gut. And it's this might explain how long-lasting covid symptoms can occur post-infection. 

Video of the Week:

As covid infections rise across the UK for the first time in two months, many want to know the symptoms of Omicron and how long you're contagious with it.

Omicron - it's officially the most infectious strain of the virus we've ever seen. And as much as we'd like it to, signs show it's not completely going away any time soon. The Office for National Statistics (ONS) confirmed in the week ending June 10 that covid cases in England were up 1.46% - with Omicron variants behind these increased infections. 

Medical professionals have claimed that symptoms differ from the Delta variant covid symptoms. Making it even more important for people to recognise and understand what Omicron symptoms are. Whilst the UK government's new Living with Covid plan has scrapped self-isolation rules, healthcare experts are encouraging people to still isolate as a duty of care for others. This means not sending your kid to school if they have Covid and working from home to prevent passing it on.

What are the symptoms of Omicron covid variant?

Patients who have tested positive for Omicron have reported symptoms of fatigue, a scratchy throat, runny nose, headache, and sneezing. According to the ZOE symptom tracker app, people have also reported symptoms which aren't usually associated with coronavirus, including diarrhoea, loss of appetite and nausea.

Dr Tim Spector - who has headed up the ZOE study - stated that people should look out for "most cold symptoms" which are likely to be Omicron symptoms. This was based on data recently logged in March 2022. It showed that 300,000 covid cases were being registered each day - most of them of the Omicron strain.

Omicron was first recognised as a strain in November 2021. And Dr Angelique Coetzee, a GP and chair of the South African Medical Association was the first to detect it. She told BBC's Andrew Marr that cases examined felt "extremely tired" and had "body aches and pains with a bit of a headache".

She also noted how symptoms of Omicron differed from previous recognisable covid symptoms. With subjects reporting "not really a sore throat, more of a scratchy type of description and no cough or no loss of smell and taste."

This certainly supports data from the Office of National Statistics recorded throughout December 2021. The found that those presenting with Omicron symptoms were less likely to report loss of taste and smell than patients with Delta symptons.

Dr Coetzee added that cases presented "very very mild symptoms". And this certainly supports what Peter McGinn described to CNN. He was the first American to test positive with the Omicron variant: "It honestly felt like a mild cold for about a day," he said. "I had light fatigue, a runny nose and a sore throat. And after a day those symptoms went away."

Here's more details on what Omicron symptoms you should look out for:

1. Headache

A study in the Journal of Headaches and Pains looked into Covid-related headaches. And researchers found they tended to last for three days plus, with moderate to severe pain reported on both sides of the head. Participants said their headaches had a "pulsing" "pressing" or "stabbing" quality to them. And that the headache did not clear up when painkillers were taken.

As for headaches being a Covid symptom, health professionals of the ZOE COVID Symptom Study gave a few possible reasonings:

"It may be the virus directly affecting the brain. Or it could be related to being ill, such as dehydration or hunger caused by not eating and drinking normally."

Read our advice on how to get rid of a headache fast if you are currently suffering.

2. Fatigue

A Netherlands study determined fatigue is "highly prevalent" in long Covid cases. Researchers described it as severe with patients showing "both physical and mental fatigue".

Mental fatigue is a medical condition that is defined as when someone feels tired and emotionally exhausted. They may find themselves less productive and experiencing poor cognitive function like not being able to concentrate or stay focused on tasks.

Meanwhile, physical fatigue affects the general body. "A person with physical fatigue may find it physically hard to do the things they usually do, such as climbing the stairs," says Medical News Today. "Symptoms include muscle weakness, and diagnosis may involve completing a strength test.

3. Other body aches and pains

Various complaints of pain were reported in one Indonesian study looking into Covid patients. Researchers cited muscular pain, in addition to "joint pain, stomach pain, and testicular pain".

Indeed those using the Zoe Covid app reported aches and pains especially in their shoulders and legs. "This muscle pain stops them from doing day-to-day tasks," they added.

4. Sore or 'Scratchy' throat

Figures from an Egyptian study suggest a sore throat as a common byproduct of the covid infection. Researchers examined 120 people with COVID-19 and reported that 30% of them reported a sore throat.

Data from the Zoe COVID app also found that sore throats were commonly reported in adults aged between 18-65, rather than elderly patients. It tended to be a mild symptom that tended not to last more than 5 days.

Another study - published April 2022 - additionally deemed that a sore throat was a more common symptom with the Omicron strain than with Delta.

South African Dr Angelique Coetzee, who discovered the Omicron variant has spoken a lot about patients with this strain experiencing more of "a scratchy throat". This is likely to be irritable and painful when you swallow.

Check out our sore throat remedies if you are currently experiencing pain.

5. Runny nose

A runny nose is considered a covid symptom when you experience it alongside other identified covid symptoms.

For example, the Zoe COVID Study reports that "nearly 60% of people who tested positive for COVID-19 with loss of smell also reported having a runny nose."

A runny nose is also a common factor associated with allergies like Hay fever plus colds and the seasonal flu.

"A runny nose and headache are symptoms of many infections, but may also be the first symptoms – and only symptoms – of Covid," explains Professor Irene Petersen, an epidemiology and health professor at University College London. "Therefore, if you have these symptoms, I’d encourage you to use lateral flow tests for a couple of days."

6. Sneezing

The scientists at ZOE Covid study have stated that whilst "sneezing is not normally a symptom of COVID-19," they have seen data to suggest that increased sneezing in vaccinated people can be a sign you're infected.

"Interestingly, our data shows that people who had been vaccinated and then tested positive for COVID-19 were more likely to report sneezing as a symptom compared with those without a jab," they said. "This suggests that sneezing a lot with no explanation after you’ve been vaccinated could be a sign of COVID-19."

Whilst they have found a connection between the two they are careful to remind people that "the link between sneezing and COVID-19 isn’t very strong." If sneezing is your only symptom, be sure to do a lateral test to rule anything out. Though in most cases it is likely to be a cold or allergy instead.

Is sickness a symptom of Omicron?

Yes sickness could be a symptom of Omicron. Several medical professionals have shared that nausea has been reported by Covid positive patients. Though vomiting on it's own is not likely to be a covid symptom. But rather something like food poisoning. If worried, it's always good to do a lateral flow test to rule out the possibility.

Tim Spector, Professor of Genetic Epidemiology at King’s College London stated that those who were double vaxxed and had Covid registered feeling sick alongside other more known Omicron symptoms.

"Quite a few of them had nausea, slight temperature, sore throats and headaches," he said. And in some cases this nausea turned to vomiting."

"It’s true that nausea and vomiting are potential symptoms of COVID-19, the respiratory disease caused by the novel coronavirus SARS-CoV-2," adds Tufts Medical Centre, in a statement on their blog.

This is further supported by The Centers for Disease Control & Prevention (CDC). They observed that some Covid-positive patients developed gastrointestinal symptoms such as vomiting and diarrhea. And these were often before the more familiar symptoms of cough, high fever and shortness of breath.

If you are experiencing vomiting or nausea alongside Omicron symptoms like fatigue, coughing, headache sore throat and a runny nose then do a lateral flow immediately. However, if you're just feeling sick, it's more likely to be nothign to do with Covid. And more likely a bug or side effects of poor food consumption or pregnancy.

How long are you contagious with Omicron?

The UK government have stated that people with Covid - including the Omicron strain - can be infectious for up to 12 days. And during this time it's likely you'll still show up as positive on lateral flow tests.

"People who have COVID-19 can infect others from around 2 days before symptoms start, and for up to 10 days after," reads the government website. "They can pass the infection to others, even if they have mild symptoms or no symptoms at all, which is why they must stay at home."

It's worth noting that this 12-day infectious period is a general pre-caution as everyone's experience with the virus is different. Self-isolation rules changed in December to reflect this, as those who test negative on lateral flow tests after 7 days are no longer considered infectious.

Furthermore, new data reveals that the Omicron variant may carry a shorter infectious period than other strains.

"Recent analysis from the UK Health Security Agency suggests that the window between infection and infectiousness may be shorter for the Omicron variant than the Delta variant," UK health secretary Sajid Javid told MPs on 6 December.

This certainly supports a study by the Centers for Disease Control and Prevention (CDC) which found that it took just three 3 days for people to show symptoms after being infected with Omicron. And according to scientists, it makes sense for the incubation period of Omicron infections to be shorter seeing as it's more contagious.

"That's why the spread is occurring at a much faster pace," said Dr. Anita Gupta, an anesthesiologist and critical care physician at the Johns Hopkins School of Medicine.

Whilst the government has since scrapped all official Covid rules, people are still choosing to isolate for at least a week if still positive with Omicron. Just to be safe.

Does Omicron show up on lateral flow and PCR tests?

Yes those who have the Omicron variant will test positive on both lateral flow and PCR tests. It is important to know that unlike PCR tests, lateral flow tests will not be able to tell you if you specifically have Omicron. They simply show whether you have a Covid infection or not.

"PCR tests can detect those infected with the Omicron variant," reads a statement on the UK Parliament website. "It is likely that lateral flow tests will detect infections caused by Omicron; research is underway to verify this."

Indeed, scientists at Goethe University’s Institute of Medical Virology in Frankfurt have said that lateral flow tests produced by three major companies have detected Omicron in samples. And this includes ACON's Flowflex test - the main provider of NHS Test and Trace's nose-only lateral flow tests.

This, according to Professor Christina Pagel, director of University College London’s Clinical Operational Research Unit is "good news".

The reason PCR tests can detect Omicron is to do with a mutated gene in their biological make-up.

"As Omicron has a mutation here, that means that this part of the PCR test will fail. This is called S-gene drop-out or target failure," continues the statement on Parliament.uk. "While not 100 percent accurate, it can be used as a proxy method for tracking the variant, especially if other dominant circulating variants are S-gene positive, as the Delta variant is."

If you are experiencing symptoms and are in doubt, always take a PCR test.

Can you get Omicron twice?

Yes it's certainly possible to get Omicron twice. And there have been cases worldwide where patients have tested positive with covid twice from this strain. One study also reported that Omicron reinfection is more likely than with the Delta variant.

Stanley Weiss, M.D., is a professor at the Rutgers New Jersey Medical School and the Department of Epidemiology at the Rutgers School of Public Health. He told Yahoo: "Yes, you can get Omicron twice." This was based on his recent visit to a lecture with a top virologist in South Africa. And here it was reported that doctors had found cases where several people had been reinfected with Omicron.

A December 2021 study from Imperial College London additionally supports the stance that you can get Omicron twice. With researchers finding that "the risk of reinfection with the Omicron variant is 5.4 times greater than that of the Delta variant."

There is some good news though, courtesy of Dr Mike Ryan, Executive Director of WHO's Health Emergencies Programme.

In a live Q&A broadcast he explained that covid infection is diagnosed from the nose, essentially making it an infection of the mucus lining. And this is significant:

"You can have a re-infection and you can probably find the virus in your nose," he said. "But you're not sick because your immune system inside your body, in effect, is mounting an immune response and able to cope with that infection. So reinfection does not automatically mean severe disease."

What's more, America's Centre for Disease Control and Prevention (CDC) have stated that those who have had Covid previously have a "low risk of subsequent infection" for at least six months. This means it would be rare for someone whose recently tested positive to get Omicron again within six months.

Can I get Omicron if I've had Covid before?

Yes, research suggests that those who tested positive with Covid of a different strain can still catch the Omicron variant. Households with children in school and healthcare workers are amongst the two groups most likely for this to occur.

The findings were reported by React - a UK-wide study by Imperial College London and Ipsos MORI. And it reported that as many as two thirds of people recelty infected with Omicron had Covid previously.

Further analysis unveiled that groups who were susceptible to this tended to be households with kids. Plus people that have a lot of family members. NHS workers were also highlighted as at risk of reinfection.

Is Omicron milder than Delta?

Yes, current research has reported that Omicron is milder than the Delta variant. And these studies suggest that hospitalisation is less likely with Omicron compared to previous strains of the virus. Nevertheless Omicron related deaths have been reported globally and so it shouldn't be underestimated even though it's 'milder'.

A report by the UK Health Security Agency found that those who tested positive with the Omicron variant were about 50% less likely to be hospitalised than those with the Delta variant. This was based on an analysis of both Omicron and Delta cases between 22 November and 26 December.

This report re-affirms a Scottish study which also evaluated the severity of Omicron based on national data. Scientists at Edinburgh and Strathclyde Universities concluded that "Omicron is associated with a two-thirds reduction in the risk of COVID-19 hospitalisation when compared to Delta."

A similar verdict was recorded in Imperial College London's Omicron report released in December. Researchers involved confirmed that those with Omicron symptoms where 11% less likely to turn up at A&E - compared to those infected with the Delta variant.

There's further good news too - with research suggesting that Omicron symptoms clear up faster than Delta symptoms. In a new study published by The Lancet, participants with the Omicron strain reported their symptoms as lasting two days shorter than those with the Delta variant.

Has anyone died from the Omicron variant?

The UK Health Security Agency have reported a total of 75 Omicron related deaths in the United Kingdom. These fatalities were recorded in the government agency's last recorded Omicron daily overview report on 30 December 2021. They have since seized to report on Omicron related deaths. And are now instead returning to reporting the daily coronavirus death count.

Elsewhere in the world, there has been Omicron-related deaths in Germany and India. And America reported their first Omicron death in late December - an unvaccinated man in the state of Texas.

The first UK recorded Omicron related death was reported by the Prime Minister on 13 December 2021.

Boris Johnson shared the sad news during a visit to a vaccination clinic in West London:

"Sadly yes Omicron is producing hospitalisations and sadly at least one patient has been confirmed to have died with Omicron."

This was based on data from the UK Health Security Agency. Who said the individual who died from Omicron was diagnosed in hospital.

Britain's Omicron deaths have contributed to the UK's total Coronavirus death count which now exceeds 160,000. According to figures from Our World in Data, this rate is 7% higher than the European Union average.

Death from Omicron seems less likely than previous strains according to new data. A South African study published in the International Journal of Infectious Diseases found that patient deaths from Omicron averaged 4.5% during the country's recent surge. And this is much lower than the 21.3% recorded from previous strains.

Video of the Week:

Many are wondering if they can now go to work with Covid after the British government scrapped all legal covid requirements.

It began in February 2022, when Downing Street put into place their Living with Covid plan. This effectively ended all covid rules on face masks and isolation. But whilst government legislation stopped, Covid didn't - and hasn't - with Omicron symptomsand a spike in people getting covid twice still prevalent in the UK.

A lack of rules has led to widespread confusion on how to navigate life when that positive line appears. However, much like deciding whether your kid can go to school with Covid, there are public health guidelines out there that should be followed if you're covid positive but able to work.

Can you go to work with Covid?

In England, legally there is nothing to stop you from going to work with Covid. However current government and NHS advice asks you to prioritise working from home instead. Staying away from your workplace can help prevent passing Covid onto others - especially those who are potentially vulnerable.

The NHS website clearly states that those testing positive, showing Covid symptoms, a high temperature or feeling generally unwell should "try to stay at home and avoid contact with other people".

This message is supported by the government. They've stated that those who fall under one of these categories should "try to work from home if you can". "If you are unable to work from home, talk to your employer about options available to you," continues the statement on the government website.

Scottish legislation changed on May 1, 2022, ending the need to legally self isolate. Like England, they ask people to practice caution by working from home and staying away from others.

As for elsewhere in the UK, Wales and Northern Ireland covid legislation remains in place. This means those that think they have Covid symptoms should get a lateral flow test and self-isolate whilst waiting for the result. If positive, self-isolation continues until at least day 6 or a negative test result appears.

When can I return to work after Covid?

Current government guidance in England states that those with Covid can go back to work once they've tested negative or "until you no longer have a high temperature (if you had one) or until you no longer feel unwell."

In a letter shared with healthcare staff in late February, NHS England bosses clarified protocol on when they can return to work after testing positive with Covid. They state that workers should not attend work until they've had "two negative LFD test results taken 24 hours apart".

"The first test should not be taken before day 5 after their initial positive test," the letter adds. "These tests need to be 24 hours apart. And providing they are medically fit, they can return to work on the morning of day 6 providing they tested negative 24 hours earlier."

Public health advice from the NHS also supports this 5 day isolation period from when symptoms start. This is because this time period is when people with Covid are considered to be the most infectuous.

The NHS adds that positive individuals should also try "avoiding meeting people at higher risk from COVID-19 for 10 days, especially if their immune system means they’re at higher risk of serious illness from COVID-19, even if they’ve had a COVID-19 vaccine."

For best practice follow public health advice and talk to your employer. You can then both agree on an appropriate return to work date together.

Will I get paid if I call in sick with Covid?

According to solicitors Landau Law, employees off sick from work with Covid will receive their usual sick pay entitlements. "This would include Statutory Sick Pay (‘SSP’), and any contractual sick pay that your employer offers," they state.

Trade Union UNISON agrees that SSP will cover individuals off work with Covid-19: "From the 25 March, the normal SSP rules will apply to Covid-related absence, which means that SSP will only be paid from the fourth qualifying day you are off work regardless of the reason for your sickness absence."

During the peak of the pandemic, legislation on Statutory Sick Pay changed slightly. So that workers received this state pay from the first day of absence. However, ending the legal requirement to self-isolate meant SSP has reverted back to normal. This means payment applies after the fourth day of absence.

Can you go to work if a household member has Covid?

There is now no legal requirement to self isolate if you come into contact with a positive Covid case. So it's up to the individual on whether they go to work if a fellow household member has Covid. This being said, if you start to develop symptoms it's recommended you carry out testing. And take the necessary precautions if the result is positive.

From a pay perspective, employers are no longer obliged to pay staff who are off work isolating. And this includes Statutory Sick Pay. Self isolation and the legislation around it officially ended on 25 March 2022.

"Staff are no longer entitled to SSP for self-isolation, unless they are not well and off sick," reads a statement on the government's Advisory, Conciliation and Arbitration Service (ACAS) website.

Video of the Week:

Whether enjoying good weather in the UK or heading on a hot family holiday, it's vital to know the difference between heat stroke and heat exhaustion. This is because even mild heat exhaustion can escalate rapidly and if it turns to heat stroke, this is a medical emergency that requires immediate medical attention. 

Children are naturally more vulnerable than adults to the heat, so whether it’s an unexpected heatwave in the UK, a holiday to a hot country, or simply warmer weather at home than they are used to, it’s important to know the difference between heat stroke and heat exhaustion, so that as a parent you can take measures to cool them down or seek urgent medical attention if necessary.

If you are unsure how to manage your child's symptoms after they’ve been outside in the heat, then it’s crucial to seek personalised advice from a doctor as soon as possible - either a GP or at A&E.

GPs Dr Arthi Sinha and Dr Babak Ashrafi shared with us their advice for parents on heat stroke and heat exhaustion, including how to tell the two related conditions apart, appropriate treatment and measures parents can take to aid their youngster’s recovery at home after they’ve seen a doctor. 

It is important that parents follow key NHS advice and are guided by their GP. You should immediately seek help if your child has been in the heat and they show symptoms such as a high temperature, fast heartbeat, shortness of breath, seizure or fit, or loss of consciousness. This could be heat stroke and requires emergency medical care. 

What is the difference between heat stroke and heat exhaustion

"Heat exhaustion and heat stroke are both conditions caused by the body becoming overheated, sweating and losing excessive amounts of water and salt," explains Dr Sinha. "Heat stroke is a medical emergency that requires immediate help, whereas heat exhaustion may not require this if managed appropriately and on time."

"Heat stroke and heat exhaustion usually happen during a heatwave in the UK or in a hot climate on holiday," says Dr Ashrafi. "Both heat stroke and heat exhaustion can develop quickly over a few minutes or gradually over several hours or days." It is important to remember that it is possible to develop heat exhaustion even when you are not in direct sunlight.

Dr Sinha explains that the symptoms of heat exhaustion include, "excessive sweating - maybe with a heat rash - as well as fatigue, dizziness, nausea and headaches," she explains. "They might also feel very thirsty with cramps in their arms and legs, and they may feel their heart racing too. Children, especially younger ones, may become irritable."

If someone has heat exhaustion then it is important they are cooled down as soon as possible, advises Dr Sinha. "This involves moving away from the source of heat, removing excess clothes, using cooling measures such as a fan or sponging - especially in the armpits or neck area - and taking on water and perhaps a rehydration or electrolyte drink," she suggests.

"If cooling does not work, they will start to get symptoms of heat stroke," warns Dr Sinha. "This involves a deterioration, with an ongoing high body temperature, racing heartbeat, confusion, fits, delirium or even loss of consciousness." She adds that they should be placed in the recovery position, and you should call 999.

As mentioned, if not treated, heat exhaustion can lead to heat stroke. "It occurs when the body is unable to regulate its internal temperature, which will rise above 40 degrees celsius," warns Dr Ashrafi. "Symptoms among children additionally include sweating, rapid heartbeat and breathing, loss of consciousness, seizures, disorientation and feeling flushed, as well as hot and dry skin." If these symptoms are present then your child might have heat stroke which is considered a serious medical emergency and you need to call 999. 

How do I know if my child has heat exhaustion?

"Heat exhaustion symptoms among children include cool, clammy skin despite the warmer temperatures, headache, goosebumps, nausea and vomiting, dizziness and increased heavy sweating," warns Dr Ashrafi. "A child’s temperature can be higher than normal during heat exhaustion, but less than 40 degrees celsius."

Dr Sinha notes: "Children, especially those under the age of five, can sometimes have symptoms that are more atypical or harder to recognise when it comes to both heat stroke and heat exhaustion. They may just present as more irritable, reduce their eating or drinking or eventually become drowsy, sleepy or lethargic."

Children are more susceptible to heat exhaustion than adults because, "children are less able to regulate their body temperatures as efficiently as adults and can become unwell quickly, so even mild heat exhaustion is important to recognise as it can escalate rapidly," explains Dr Sinha.

What to do if your child has heat exhaustion

"Heat exhaustion usually does not need urgent medical attention if your child can cool down within 30 minutes," says Dr Ashrafi. Measures you can take include moving them away from the source of heat, removing excess clothes, using cooling measures such as a fan or sponging, giving them water and perhaps a rehydration or electrolyte drink.

The NHS says, "If someone has heat exhaustion, follow these 4 steps:"

• Move them to a cool place.
• Remove all unnecessary clothing like a jacket or socks.
• Get them to drink a sports or rehydration drink, or cool water.
• Cool their skin – spray or sponge them with cool water and fan them. Cold packs, wrapped in a cloth and put under the armpits or on the neck are good too.

If these steps to cool down are working, the NHS says, "They should start to cool down and feel better within 30 minutes."

However, Dr Sinha emphasises how important it is to react quickly to heat exhaustion symptoms in children to help avoid it turning into a more serious condition and advises seeking medical help if you see any concerning symptoms in your child: "If you think your child is suffering from heat exhaustion, you should take them to see a doctor as soon as possible," advises Dr Sinha.

 "They can also become unwell quickly, so it’s important to act fast," warns Dr Sinha. "Seeking medical help early for kids is important as they can often have unusual symptoms that may be hard to recognise, and they can also become unwell quickly. Having worked as a GP in the NHS and private sector, I always tell parents to follow their gut instinct and to just get their child checked if they are not sure - they are usually right." She adds that you shouldn’t worry about revisiting your doctor several times if needed, since your child’s symptoms can change.

Once they’ve been seen by a healthcare professional, there are certain steps parents can take to aid their child’s recovery from heat at home. “Keep your them indoors and out of the sun," recommends Dr Ashrafi. "Encourage them to drink cool fluids, and apply a cool flannel or sponge to their skin."

What to do if you think your child might have heat stroke

Heat stroke is considered a serious medical emergency and if you think your child might have heat stroke you need to call 999. 

As mentioned above, if your child has heat exhaustion but starts deteriorating - with an ongoing high body temperature, racing heartbeat, confusion, fits, delirium or even loss of consciousness - then they might have heat stroke and should be placed in the recovery position and you should call 999 immediately.

When to see a doctor

As Dr Sinha emphasies above, due to the potential severity of heat exhaustion, she would advise that you see a doctor straight away if you think your child has heat exhaustion. If you, your child or someone else have signs of heatstroke, call 999 now. 

"If your child has symptoms that you are worried about - such as an ongoing high body temperature, racing heartbeat, confusion, fits, delirium or even loss of consciousness - then you should take them to see a doctor straight away, which can be your GP or in A&E depending on how unwell they are," says Dr Sinha. "It is always best to get checked to ensure nothing is wrong, rather than wait."

You should call 999 if your child has symptoms of heat stroke, such as a temperature above 40 degrees celsius, sweating, rapid heartbeat and breathing, loss of consciousness, seizures, disorientation and being flushed, as well as hot and dry skin. "Seek emergency medical care straight away," insists Dr Ashrafi.

How to reduce the risk of heat exhaustion and heat stroke

There are certain factors that can make children more vulnerable to heat. "They are not able to regulate their body temperatures as efficiently as adults," explains Dr Sinha. "In addition, they are less likely to be able to spot that they are getting overheated and take appropriate measures - such as stopping physical activity, taking rest, hydrating with fluids and ensuring clothing is appropriate."

Parents should be particularly cautious about their children during heatwaves in the UK, or while holidaying in a hot climate. "Heat stroke and heat exhaustion can both be prevented by taking precautionary measures," says Dr Ashrafi. "These include drinking plenty of liquids, staying out of the sun during peak high temperatures, wearing loose fitting clothing, applying sunscreen, and avoiding extreme physical exertion during higher temperatures."

Dr Sinha adds that you should keep your house cool in summer if possible: "Parents should ensure that the environment is the correct temperature – using fans or other cooling measures as appropriate. They should make sure their children are appropriately dressed for the weather and that they do not play outdoors during peak heat hours - between 11am and 3pm. During hot weather or heat waves, it is useful if they have a water bottle that they are in the habit of drinking from, to ensure that they have had enough fluids during the day."

Dr Sinha adds: "Certain children may also be more susceptible to heat exhaustion and heat stroke. These include obese children - since body temperature regulation is more difficult - as well as those not wearing the right clothes, such as certain types of school uniforms, and those with learning disabilities who may have less awareness and not be able to seek help as needed."

The NHS advises doing the following to help prevent heat exhaustion or heatstroke:

• drink more cold drinks, especially if you're active or exercising
• wear light-coloured, loose clothing
• avoid the sun between 11am and 3pm
• avoid excess alcohol
• avoid extreme exercise
• if you're inside on a very hot day, close curtains, close windows if it's hotter outside than in your home and turn off electrical equipment and lights that get hot

The information on GoodTo.com does not constitute medical or other health advice or diagnosis and should not be used as such. Although GoodtoKnow consults medical experts to create and fact-check content, this information is for general purposes only and does not take the place of medical advice. Always seek the guidance of a qualified health professional or seek urgent medical attention if needed.

Our experts

A vitamin D deficiency can cause a host of problems, while sufficient levels contribute greatly to our health and longevity.

Vitamin and mineral deficiencies are relatively common, in particular, vitamin D. In fact, it's estimated that – globally – 1 billion people have low vitamin D levels. In the UK, 20% of the population is deficient while 1 in 6 adults have low levels.

Some people are more vulnerable to developing a vitamin D deficiency than others. Children under 5 and people over 65, pregnant or breastfeeding women, people with darker skin, vegans and vegetarians, and the overweight are more at risk. If you fall into one of these categories, it doesn't mean you're deficient. But if you're not sure it makes sense to get your levels checked, even if you don't show any symptoms. Here's the lowdown on a vitamin D deficiency, including symptoms, causes, and treatment.

What is a Vitamin D deficiency?

A vitamin D deficiency is a lack of vitamin D in your body. This can affect your health and wellbeing. Limited exposure to sunlight, a diet lacking in vitamin D-rich foods, and some health conditions or medications are some of the causes.

"Vitamin D is a fat-soluble essential nutrient that has many different functions in the body, from immune and bone health to mood," says Roxanne Bakker, a registered dietitian for Vitl. "We can produce it through our skin in the presence of sunlight and the sun is arguably the best source; however, one of the most common causes of vitamin D deficiency is the lack of exposure to sunlight," she explains. "In the UK and other countries in similar latitudes, the UVB strength of the sun is enough to produce vitamin D from April-September."

Other sources include oily fish, red meat, eggs, liver and fortified dairy products. Fortified cereals and cereal products are also important, providing 13-20% of the UK's dietary intake.

You can have low levels of vitamin D and not know it. Symptoms – which include fatigue, bone pain, muscle aches, frequent colds, and low mood – can be vague and easily attributed to lifestyle factors. "Many people will not necessarily notice the initial symptoms as they can be subtle and non-specific," confirms Jen. "However, once people who've had a diagnosed vitamin D deficiency are treated, they often comment on how different they feel."

How much vitamin D do you need?

The NHS recommends that adults get 10mcg of vitamin D a day. Children over the age of one, pregnant and breastfeeding women, and people more prone to a vitamin D deficiency, should have the same.

"The UK recommendation is a daily 10mcg (400iu) supplement during the autumn and winter months," confirms registered dietitian Jen. "However, people at high risk of deficiency, children aged 1-4, and babies who are having less than 500ml of infant formula daily should take a daily supplement all year round," she advises.

It helps to know your levels before you supplement, as too much vitamin D can be harmful. "Vitamin D is a fat-soluble vitamin, which means that if you take too much it can be detrimental to your health as stores build up within the body," warns Jen. While unusual (you need to be taking in excess of 250mcg – or 10,000iu – most days), research shows that taking too much vitamin D can cause confusion, stomach pain, vomiting, and hypercalcemia (too much calcium in the blood).

If anything, we are a nation with less – not more – vitamin D in our bodies. "Typically, levels in the UK population are around 35 nmol/l – although levels should be above 75 nmol/l, says Suzanne. "Studies have shown that some people may need to take 40-50mcg of vitamin D daily to achieve blood levels of 75 nmol/l," she adds, and you won't know what your blood levels are without taking a test.

To get your levels checked, visit your GP for a blood test or order a home blood test kit from a company such as Vitl | £49.95. This home test measures your vitamin D levels alongside B9 (folate), B12, iron, and zinc, as well as your cholesterol.

Vitamin D deficiency symptoms

1. Fatigue

Feeling tired is a tricky symptom to attribute to one condition. Many of us lead busy lives, suffer from stress, and don't get enough sleep. But it's one of the most common symptoms. "Recently, studies have found that vitamin D has a role in mitochondrial function (the energy-producing part of a cell)," reports Suzanne Sawyer, clinical nutritionist for Alive! "Additionally, fatigue can often make you less likely to go outdoors, further decreasing your opportunity to get some vitamin D through sun exposure, causing your body’s levels of the nutrient to deplete even further," she adds.

2. Getting sick frequently

As mentioned previously, low vitamin D levels can jeopardise our immune system and make us more vulnerable to catching colds, coughs and viruses. Vitamin D improves immunity in a number of ways. "These include improving adaptive immunity by uprating production of antibodies that fight viruses, and by creating a physical cellular barrier to infection," says Suzanne, citing a 2017 study. "Vitamin D deficiency has also been linked to respiratory conditions such as bronchitis and pneumonia."

3. Joint pain 

Tiredness, overwork, overexercising, or fighting an infection or virus are some of the reasons why you may get joint pain. But as our bones are reliant on healthy vitamin D levels, aches and pains can be a sign that you're in need of more of this vitamin.

"If you’re experiencing pain in your bones or the lower back area, it may be a sign you have vitamin D deficiency," says Suzanne. "This can, especially in severe cases, inhibit the body’s ability to generate new bone tissue, leading to the softening of bones. This causes joint pain and increases the risk of osteoporosis,” she warns.

4. Poor mental health

Increasingly, there are links between vitamin D deficiency and low mood, depression, and other mental health disorders. "This may be due to the fact that vitamin D helps to protect against the depletion of serotonin and dopamine, hormones that affect mood by activating their synthesis; in particular of serotonin," explains Suzanne.

She adds: "This is particularly pronounced in the winter months when we experience less sunlight. In turn, this can lead to SAD (seasonal affective disorder)."

5. Problems conceiving

There are many reasons for infertility issues, and low vitamin D may be one. "Low levels can impact ovulation," says Jen. "There are also studies that suggest sufficient levels of vitamin D improves embryo implantation rate." Jen recommends that women trying to conceive and pregnant women get a vitamin D check.

Meanwhile, pregnancy charity Tommy's recommends that all pregnant and breastfeeding women take a daily 10mcg (400iu) supplement "to give your baby enough vitamin D for the first few months of life. Do not take more than 100 micrograms (4,000 iu) of vitamin D a day as it could be harmful."

Vitamin D deficiency causes

1. A lack of exposure to sunlight

This is the primary way to get vitamin D, says Suzanne. If you don't go out much you may be more at risk. This was highlighted during Covid quarantine, when Public Health England recommended we all take a supplement year-round, rather than just in winter.

"It may be a particular issue for those who are housebound or live in northern latitudes. Or wear long robes or head coverings for religious reasons, or have an occupation that prevents sun exposure," explains Suzanne. "Even in places with plenty of sunshine, a deficiency may occur because the SPF in high factor sunscreen decreases vitamin D synthesis.”

2. Being overweight

If you're overweight or obese, there's a possibility you'll have a vitamin D deficiency. Vitamin D is fat-soluble – rather than water-soluble – which means it's stored in fat tissue. "In those who are obese, their body fat binds to some vitamin D and prevents it from getting into the blood, plus the vitamin D is more diluted throughout the body," explains Suzanne (as shown in this study). "As a result, people with a body mass index (BMI) of 30 or greater often have low blood levels. They, therefore, require a greater amount of the nutrient than those who are slimmer,” she says.

3. Certain medications

Some medicines can have a detrimental effect on our vitamin D intake by depleting certain nutrients. "Medications can impact our body’s ability to utilise vitamin D, which can contribute to developing a deficiency," says Jen. This is especially true, says Suzanne, of antidepressants, anticonvulsants, corticosteroids, and those used to treat type 2 diabetes – namely metformin. Check the side effects of any drugs you take or ask your doctor for advice.

4. Poor diet

Another cause of low vitamin D levels is a lack of vitamin D-rich foods. These include dairy, fortified cereal, eggs, oily fish, and red meat. "Those following a plant-based diet are very prone to insufficiencies of this vitamin, as well as older demographics,' says Roxanne.

5. Some health conditions

If you have a diet rich in vitamin D and you spend plenty of time outdoors, you may have a condition that causes a deficiency.

For example, some gastrointestinal disorders cause malabsorption. "The intestines struggle to absorb vitamin D that naturally occurs in foods as vitamin D is a fat-soluble vitamin," says Suzanne. "Certain gastrointestinal conditions such as coeliac disease, cystic fibrosis, and inflammatory bowel disease (e.g. Crohn’s disease and ulcerative colitis) can affect the body’s ability to absorb fat."

Kidney and liver disorders can also cause a deficiency. "We need both organs for effective vitamin D conversion to its most active form,” adds Suzanne. Some studies suggest that heavy drinking and/or alcholism can cause low levels of vitamin D, in part because of alcohol's affect on liver and kidney function.

6. Getting older

Older people are more vulnerable to a vitamin D deficiency, in part because they spend more time indoors. "Even when they do catch some rays, their skin doesn’t produce as much of the nutrient as it would have when they were younger,” says Suzanne.

7. Skin colour

Different skin colours contain different amounts of pigment. This can affect whether we burn in the sun, for example. Or whether we're more vulnerable to a vitamin D deficiency. "If you have dark skin, you may need as much as 10 times more sun exposure to produce the same amount of vitamin D as a person with pale skin. This is because the skin’s pigment acts as a natural sunscreen," explains Suzanne. "The more pigment you have the more time you’ll need in the sun to make adequate amounts of vitamin D."

There are numerous reasons for developing a vitamin D deficiency. You may discover that one or more of the above is the likely culprit for your low levels. Alternatively, you may never know the exact reason why.

Does a vitamin d deficiency affect sleep?

The jury is still out as to whether a vitamin D deficiency is a definitive reason for sleep difficulties. However, research indicates that it may be a contributing factor.

"Some studies associate low levels of vitamin D with poor sleep quality and reduced sleep quantity, but in the absence of robust research, we do not yet have a clear answer," says Jen. "Although we know vitamin D is involved in the production pathways of melatonin, a hormone involved in circadian rhythm and sleep."

"A vitamin D deficiency has also been linked with increased inflammation of the nose and tonsils, which can lead to sleep apnoea and disturbed sleep," adds Suzanne.

How to increase vitamin D

1. Spend more time outdoors

This is arguably the best way to source vitamin D. Being outdoors can significantly boost your vitamin D levels. As stated in the Instagram post, above, our bodies create vitamin D when the UVB rays from the sun hit our bare skin. This synthesis is adversely affected if we're covered up or wearing sunscreen, so it's important to expose our faces or bare arms to the sun for at least 20 minutes a day before applying sunblock or wearing long-sleeved clothes. However, this isn't always possible for people who don't get out much, burn easily or cover-up for cultural or religious reasons.

"Recommendations vary, but it's thought that about 20 minutes of sunlight exposure a few times a week is sufficient," says Jen. "However, we also need to be mindful of the risk of skin damage when exposing skin to sunlight. Wearing sun cream can also interfere with the body’s ability to absorb vitamin D, but it's important to continue to wear it to avoid burning your skin. Taking an appropriately dosed vitamin D supplement is a safer way to meet your needs."

2. Eat foods high in vitamin D

The best foods to eat to increase your vitamin D levels are oily fish or fish oil (such as cod liver oil,, which is usually taken as a supplement), egg yolks, liver, mushrooms, dairy products and fortified bread and cereal. However, the levels we get from food are very low in comparison to what we absorb from sunlight or supplements.

Vegans and vegetarians may find it harder to get vitamin D from their diet. "As most of these food sources are animal-based, it's especially difficult for people who suffer from milk allergies or follow a strict plant-based diet to consume sufficiently. This is why supplementation is so important," says Suzanne.

3. Regular exercise 

Making an effort to exercise will also help "Exercising regularly, particularly outdoors, can boost your vitamin D intake and can also help you maintain a healthy weight and lower the risk of several lifestyle-related disorders,” says Suzanne.

Even going for a walk will help. "Going out for a walk during the hours when the sun is at its strongest [between 11am-3pm in the UK] with some skin exposed will allow your body to naturally produce it," says Roxanne. "Short walks have other great benefits too. A brisk walk improves your cardiovascular system and mood."

Twenty minutes before applying sunscreen will do the trick. This applies to children, too.

4. Take a vitamin D supplement

While current advice stands at 10mcg daily supplement, the Scientific Advisory Committee on Nutrition (SACN) suggests that ‘at risk groups’ may need more, says Suzanne. In particularly, people whose skin has little or no exposure to the sun, such as people in care homes, or those who cover their skin when they're outside.

Supplements are easy to find in pharmacies, supermarkets and online. We like Alive! Vitamin D3 Gummies (£15.99), which contain 50mcg vitamin D3 per dose, as well as calcium and phosphorus.

https://www.youtube.com/watch?v=1NTuB_jXZC0

Why is Vitamin D important?

All vitamins and minerals are important to us, but vitamin D plays an integral role in certain functions in the body. A lack of vitamin D can not only affect our physical health but our mental wellbeing. If left untreated, it can raise the risk of numerous conditions, ranging from bone pain to depression.

Part of its function is to regulate other minerals in the body, as registered dietitian Jen Credicott explains: "Vitamin D helps regulate the amount of calcium and phosphate within the body – nutrients crucial for bone health." Roxanne explains further: "As vitamin D plays a role in the absorption of calcium, a deficiency can lead to weakened bones (known as osteomalacia), which is a risk factor for fractures." In children, weakened bones is better known as rickets – this condition affects their bone development and causes the tell-tale bowed legs, as well as pain, poor growth and dental problems. Vitamin d is important for pregnant women - the UK Department of Health recommends they take a vitamin D and folic supplement.

As well as supporting bone health, vitamin D plays a role in maintaining a healthy immune system "A chronic insufficiency of vitamin D may increase the risk and susceptibility of illness," says Roxanne. "In fact, increasing evidence links vitamin D deficiency and autoimmune diseases – e.g. multiple sclerosis, rheumatoid arthritis, type 2 diabetes and inflammatory bowel disease." There's also some evidence that supplementation can lower blood pressure in people with hypertension.

Research shows that vitamin D is also integral to mental health. There's a correlation between low vitamin D levels and low mood, depression, seasonal affective disorder (source), premenstrual tension (source) and even schizophrenia (source)

When should you take vitamin D, morning or night?

There is limited research on whether taking vitamin D in the morning or at night is better, so it's really up to personal preference. Some people find taking vitamin D in the morning or at a certain time of day useful for remembering, especially if they also take other tablets. Whereas others prefer the evenings at dinner time, with some research suggesting better absorption with a meal, but other minimal evidence would suggest that late-night consumption could affect sleep.

Constantin Karuzin, co-founder and medical director at Bioniq, tells us that ultimately aiming for breakfast could be best. "Breakfast is a great time to take an immune-supporting supplement, which contains the highest-grade antioxidants and Swiss manufactured vitamins, including Zinc, Vitamin D3, K2 and C. It is blended into tiny granules that should be taken in the morning and then again in the evening for optimal absorption. This unique absorption process allows you to digest and tolerate the granules easier than vitamins that are taken singularly in pill format, which can often cause nausea and other adverse side effects. Simply mix the formula into smoothies, on top of yogurt or with juice or water.

And to help things along, Konstantin says to aim for a well-balanced breakfast with a mixture of protein, complex carbohydrates, fats, fruits and veggies for enough energy throughout the day. "Our immune system requires energy to function optimally, and low energy intake can slow our immune system responses. Some well-balanced breakfast examples include rye bread topped with salmon and avocado, an omelette with butternut squash and yogurt topped with oats and nuts."

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The UK's dropping of Covid rules has left many confused about isolation and whether a child can go to school if a parent has Covid. We cut through the jargon to give you the need-to-know information.

The government's Living with Covid plan has brought about an end to previous rules on self-isolation and testing in England. But whilst no longer legally valid, health officials are still asking the public to maintain precaution when it comes to the virus - especially with the recent spike in Omicron symptoms and possibility of people getting covid twice.

Though Covid can be mild for most, the infection can still be dangerous for those that are vulnerable. Which is why many want to do the right thing and isolate when a positive Covid situation occurs. For those living with children of school age, it's a case of continuing to follow the current public health advice. This can help prevent other kids from contracting it and taking Covid home to their families.

Can kids go to school with Covid?

No, any child with symptoms or testing positive with Covid-19 must not attend school and should self-isolate at home instead. They should get tested, isolate for at least five days and only return to school once they have had two negative lateral flow tests.

"If a child has any of the main symptoms or a positive test result, the public health advice remains unchanged and is to stay at home and avoid contact with other people," reads a statement by the Department of Education.

This advice is also supported by the UK Health Security Agency who state that "children and young people with COVID-19 should not attend their education setting while they are infectious".

The same self-isolation practice applies in that kids should do a lateral flow test on days 5 and 6. If both of these show up as negative they can return to school. However, if still positive, they should continue to isolate and test until they receive two negative test results.

Can my child go to school if I have Covid?

Yes, children who do not have Covid-19 can still go to school even if a parent is positive. The UK Health Security Agency state that they should continue to attend their education setting "as normal". So long as they are testing negative and are displaying no Covid-19 symptoms.

"Children and young people who usually attend an education or childcare setting and who live with someone who has COVID-19 should continue to attend the setting as normal," reads a statement on the government website.

If your child starts presenting with a new continuous cough, a high temperature or loses their sense of taste and smell, then they should perform a lateral flow test to rule out Covid. And this should be done before being sent to school.

According to Health Service Ireland (HSE), if they have "tested negative and have not had any new symptoms for 48 hours" they are fit to attend school.

Diarrhoea

Whilst it's important to look out for the usual Covid-19 symptoms, health officials are also warning of another symptom. HSE advise keeping a child at home if they have diarrhoea and are aged 12 and under. This is based on new research which suggests this to be a sign of Covid-19 in kids.

One 2021 study in the Journal of Medical Case Reports stated that "dysentery may be the only presentation" of Covid-19 in children. Whilst another published in the Archives of Disease in Childhood suggests that gastrointestinal symptoms like diarrhoea is prevalent in kids who are testing positive with Covid-19.

"We are finding that diarrhoea and vomiting is a symptom reported by some children and I think adding it to the list of known symptoms is worth considering," said Dr Thomas Waterfield, lead author of the study.

Nevertheless, if you're confident your child has none of the above symptoms, then sending them to school is the right course of action.

Can a child to go to school if I am self-isolating?

Yes, you can send your child to school if they are testing negative and have no symptoms whilst you are self-isolating with Covid-19. During your isolation period, you should minimise contact with your child and take steps to prevent the spread of Covid in your household.

The government recommends these measures when self-isolating to reduce the risk of spreading Covid in your household:

• Avoid or spend as little time possible in shared areas like kitchens and living rooms. If you do need to be in the same room as negative-testing people then wear a surgical face mask and open windows and doors to aid ventilation.
• If possible, try to use a separate bathroom to everyone else in the household.
• Cover your mouth and nose with a tissue when coughing or sneezing to catch particles. Then dispose of the tissue in a rubbish bin.
• Wash hands frequently - especially before and after food.
• Regularly clean surfaces like door handles and remote controls. Also wipe down surfaces in shared areas like the kitchen and bathroom.

"Many people will no longer be infectious to others after 5 days," states the government website on self-isolation practices. They advise people to do a lateral flow test five days after your symptoms start. And another test the day after.

"If both these test results are negative, and you do not have a high temperature, the risk that you are still infectious is much lower and you can safely return to your normal routine," they add. You should record your lateral flow test results online after taking each test.

Meanwhile, if you child starts developing Covid symptoms whilst your are self-isolating you should order a PCR test. They should also self-isolate whilst waiting to find out if the test is positive or negative. And if negative, they may return to school.

Can a child go to nursery if I am self-isolating?

Yes, toddlers can still go to nursery if a parent is self-isolating - so long as they are not showing any Covid-19 symptoms. The same rules apply as if it were a child going to school. During this time, the positive parent should refrain from dropping or picking their kid up from nursery. And additionally maintain minimal contact to avoid passing it onto their child and others.

Video of the Week:

We all have days when we're fed up. Perhaps we are tired or hungover or have a dose of the winter blues – all of which can lead to a low mood. But when a 'down' day becomes a 'down' week that turns into a 'down' month it's worth knowing what the signs of depression are.

"Depression is a common mental disorder and is quite different from just feeling sad or unhappy," says Richard Colwill, a spokesperson for the mental health charity SANE. "Common mental disorders cause significant emotional distress and interfere with a person’s ability to function."

Cases of depression are on the rise. According to the National Office of Statistics (ONS), levels are higher than before the pandemic. About 1 in 6 (17%) adults experienced some form of depression in summer 2021 as opposed to 1 in 10 before coronavirus took hold. While this upsurge is, to some extent, pandemic-related, there are certain age groups that seem more vulnerable. "In recent years, there's been an increase among men and women in later middle age, as well as among young women," says Richard. For example, between 21 July-15 August 2021, around 1 in 3 (32%) women aged 16-29 years suffered from moderate to severe depressive symptoms, according to the ONS.

While these are concerning statistics, as well as it being a particularly challenging time – which makes increased rates an inevitability – we are becoming better educated about our mental health. Therefore, more cases are reported. However, many of us are still unsure as to what actually constitutes the condition or feel afraid to admit to it. By reading up and understanding the signs of depression you can help yourself or others who are struggling.

What is depression?

The signs of depression can differ depending on who is feeling them, but the key symptoms are feelings of hopelessness and unhappiness that persist for more than a few weeks. "If you experience mild depression, you might find that you get less enjoyment from the things you previously enjoyed," says Rosie Weatherley, on behalf of mental health charity Mind. "You might feel like you want to withdraw from loved ones, have trouble eating, sleeping and exercising, or, conversely, do these things more than you normally would," she explains.

Many people manage depression by self-care. This means eating and sleeping well, exercising, taking time to relax, and talking to friends and family or having therapy. Moderate to severe depression can also benefit from these actions, but sufferers may also need more intense therapy or medication.

"If you’re experiencing severe depression, you might be thinking about or doing things to harm yourself. Or you may struggle with suicidal thoughts," says Rosie. "You might also experience hallucinations – seeing or hearing things that others can’t – or delusions when you experience an altered state of reality."

There are a number of reasons why we might become depressed, and no one is immune. These can range from having a genetic predisposition – people with a family history of depression are more likely to experience it – to life-changing events, such as the death of a loved one. Even positive events such as having a baby can trigger postnatal depression in women, as well as male postnatal depression.

“The causes of depression vary from person to person, but we know that there is a link between worsening mental health and major life events, such as bereavement and redundancy," says Rosie. This applies even for those who have never struggled with their mental health before. "Problems with things like housing, finances and benefits are also linked to poor mental health."

11 signs of depression

Signs of depression can be multiple and – at times – surprising. What's more, if you have depression your symptoms can differ from someone else with the same condition. They can be both psychological and physical and vary between individuals, explains Michelle Morgan, an ambassador for Mental Health First Aid England and author of Own Your Awkward (Amazon | £10). Her book charts her experiences of depression that will resonate with many. "Yet what I experienced could be very different compared to someone else," she says.

Michelle struggled with low mood, feelings of hopelessness and tearfulness, guilt and irritability. She had little motivation and stopped enjoying activities that were normally enjoyable. She also found it difficult to make decisions and suffered from a lack of energy and disturbed sleep. "I can remember experiencing all of these at some point in my depression, but it took me far too long to talk about how I was feeling, and then even longer to ask for support," she says.

Our checklist, below, details some of the more common signs of depression. Have a read and if you suspect your lingering low mood is concerning take this NHS self-assessment test for depression. You can also watch this video, courtesy of Mind, where sufferers talk about their experiences.

https://youtu.be/m82jEQXRurg

1. Low mood that lasts longer than two weeks

If you feel low, desperate or hopeless for more than a fortnight, you may be depressed. These feelings can occur because of an event in your life – anything from a big life change to trauma or illness – or appear out of the blue for no apparent reason. For women, their menstrual cycle may play a part – there is a link between women who get PMT or suffer from PMDD (pre-menstrual dysphoric disorder) and depression.

How to ease it: If you notice changes to your thoughts, feelings and behaviours that are affecting your daily life, last longer than two weeks, or keep returning – talk to someone you trust, ideally your GP. Rosie Weatherley, on behalf of mental health charity Mind, told us, "A health professional can carry out an assessment to help decide whether your symptoms of depression are mild, moderate, or severe. This will be based on the type, severity, length, and frequency of the reported symptoms, and the extent to which they affect your day-to-day life."

2. Loss of pleasure

If you find that doing the things you once loved – such as hobbies or spending time with friends, children or pets – no longer make you happy, you could be experiencing a loss of pleasure. Known medically as anhedonia (the inability to feel pleasure), it's one of the telltale signs of depression. It's also found in people suffering from chronic illness or substance abuse.

"We can feel disconnected from interests we enjoy, like sex, sports or games when struggling with depression. This is because our hormones are unbalanced," says Grace McMahon, a life coach at BeingWell, which provides expertise on how to live well. "We don’t get those dopamine reward hits or serotonin boosts like we usually would. So we don’t find that joy we once did in finishing a painting or jigsaw, in exercising or pleasure."

How to ease it: Although anhedonia can cause social withdrawal, Grace's recommendation is to reach out sooner rather than later. "Let someone you trust know how you’re feeling," she says. "Perhaps they’ll help with errands or encourage you when you can’t encourage yourself."

3. Lethargy

Lethargy means a lack of energy and enthusiasm in daily life. Although it can just feel like tiredness at first, lethargy is more akin to that 'meh' feeling you get when you can't be bothered with anything, or you don't feel like waking up in the morning, socialising or exercising. Even people with mild depression may find it harder to care for themselves, their pets or their families.

These are the three core symptoms we associate with depression: low mood, a loss of pleasure in things you normally enjoy, and a lack of energy or motivation, says Richard. He adds: "Depression can rob you of your ability to engage in the world around you. Even simple tasks can feel next to impossible if you become very unwell."

How to ease it: Again, if this feeling doesn't go away, your best course of action is to speak to a professional. "If these symptoms are persistent, and last for more than two weeks, consult your GP," he advises.

4. Feeling numb

Also known as emotional blunting, feeling numb can be another of those signs of depression. You may have difficulty accessing your emotions and feel out of touch with your feelings. "Depression zaps our joy, it causes us to think and feel very negatively," says Grace McMahon, a life coach at BeingWell. "Many report feeling ‘numb’ when depressed. There are no feelings towards anything, which further zaps our motivation to change it," she explains.

It's not unusual to self-medicate when you're depressed as stimulants can offer relief or escape. But this is only temporary. "It can be tempting to turn to alcohol or other drugs to help cope with symptoms, but you should avoid these as it can make things worse," says Richard Colwill, a spokesperson for the mental health charity SANE. In fact, according to the Royal College of Psychiatrists 'self-harm and suicide are much more common in people with alcohol problems'.

How to ease it: While it may not work for everyone, taking time out to try and 'reignite' our joy and to do things that make us feel happy or safe can be very useful. "This can be tricky when we really don’t feel like anything is joyful," says Grace. "So start small and start familiar, then it doesn’t seem too daunting."

Grace suggests taking five minutes out of your day to do something nice. Build on this time until you've had an hour of joyful activity. This could be a walk in nature, having a massage, spending time with a pet or friend, going for a swim, doing crafts or writing in a journal.

5. Loss of appetite or overeating

When we are depressed our basic functions, such as eating and sleeping, are affected. Some people – especially those whose depression is accompanied by feelings of anxiety – may find their stomach is too churned up to eat and could lose weight. Others may 'eat their feelings' and self-soothe by overeating.

"Appetite can be a problem for some people with depression, who find it difficult to eat. Although, conversely, for others overeating can be a problem," says Richard.

How to ease it: To counteract this, Richard suggests sticking to a routine. "One strategy to tackle this would be to focus on eating at regular mealtimes – especially breakfast – and avoid snacking," he suggests.

Limit or stop drinking alcohol, caffeine and sugar as these are stimulants that may cause fluctuations in mood. And swap junk and refined foods for nourishing meals (the Mediterranean diet is a good option) that contain lean protein like chicken and fish, and wholegrains that provide a steady source of energy.

6. Trouble sleeping

Studies show that stress and anxiety impacts our sleep. And so can depression. In fact, the link is so strong that research undertaken by members of the Psychopharmacology Unit at the University of Bristol found that around three-quarters of depressed patients showed symptoms of insomnia, while hypersomnia (daytime sleepiness) was apparent in 40% of young depressed adults, especially women.

A lack of sleep is also one of the proven risk factors of suicide in people with major depressive disorder (MDD), so getting enough sleep or, at the very least, rest is integral.

"Problems with sleeping are common," says Richard Colwill, a spokesperson for the mental health charity SANE. "Many find it hard to sleep, while others sleep too much and struggle to get out of bed in the morning," he says.

How to ease it: While it may feel like the last thing a depressed person feels like doing, exercise - such as running - can help lift the mood by stimulating endorphins (feel-good hormones). "Regular exercise helps regulate sleep, though it needs to be tailored to what you feel capable of doing. Walking each day (especially if you have access to a park or countryside) is a helpful start," says Richard.

It's preferable to exercise outside for numerous reasons. Although more research is needed, there's a link between depressive symptoms and vitamin D deficiency. Getting plenty of sunshine is one of the best ways to get your fill of this vitamin. Being surrounded by nature also improves mood and wellbeing. Visit the Mind website to learn about ecotherapy and how it can help you.

Another option is a natural supplement to help you sleep. We love Healthspan's Night Time CBD Oil Drops (Healthspan | £17.20). As well as CBD it contains natural extracts of chamomile, hops, lavender and lemon balm to help you relax and fall asleep. However, if you are on any medication, check with your GP before taking this product.

7. Anger or irritability

Some of the less well-known signs of depression are anger and irritability. Depression is associated with lethargic, passive behaviour and feeling the need to hide from the world. But it's not unusual to feel angry when depressed. This anger is brought on by feelings of guilt, desperation or fear. Or it can have a biological basis – i.e. fluctuations in certain brain chemicals. Whatever the cause, it can be very disturbing to witness someone fly off the handle. And suppressed anger can lead to self-harming.

"Signs of depression include angry outbursts, irritability or frustration, even over the small things," says Grace McMahon, a life coach. "Our emotional regulation is not able to function as usual. We all have the logical brain and the emotional brain. When we’re depressed the emotional brain takes over and our thought processes lose logic. Spilt milk? Logical brain would get us to wipe it up and move on. Emotional brain gets frustrated. This can ruin most of the day," she explains.

How to ease it: Anger can be hard to manage and it may take time to find ways to calm down. Avoid drugs and alcohol, which can affect mood and make people more short-tempered, especially on a hangover or comedown. And be kind to yourself. "We often try to push negative feelings out the way to feel better, but they usually just come back stronger and longer," says Grace. "Allow yourself these feelings and be compassionate."

You could also try Cognitive Behavioural Therapy (CBT). This type of therapy challenges learned behaviours and provides tools to enable you to manage certain emotions. For example, in this case study a young man showed a significant decrease in anger as well as depression after undergoing CBT. The online CBT register is a resource that can help you find a CBT practitioner.

8. Brain fog

Brain fog can occur during a depressive episode, in pregnancy or the lead-up to menopause, or be a symptom of Long Covid or another chronic illness. It's a form of cognitive dysfunction that affects our memory, attention span, and our ability to think clearly and learn and retain information. Prioritising tasks and making decisions may also become more difficult. If you're not aware that brain fog is one of the signs of depression it can be a worrying symptom. Some people even believe they're developing dementia, hence its alternative name: pseudodementia.

"Depression clouds our executive functioning – that’s our thinking processes, like memory, learning, and attention," says life coach Grace McMahon. "Which is why it can interfere with our daily lives and make it difficult to maintain a routine."

How to ease it: While it's an alarming symptom, brain fog is manageable. "Get some rest, whether it’s physical rest by sleeping, or mental rest by watching a funny series, having a bath or going for a gentle walk," advises Grace. "Depression is emotionally draining, so we need to rest to recover and help our brains reset. Sometimes physical rest can be hard to come by when feeling depressed, so mental rest or relaxation can help here."

Certain supplements can help to lift brain fog. Omega-3 fish oil is excellent for brain health in general and has been linked to relieving depressive symptoms in people with major depressive order, especially those taking antidepressants. Try Aavalabs High Strength Omega-3 (Amazon | £17.99).

There is also promising research indicating that magnesium can ease depressive symptoms. Try Nutri Advanced Magnesium Glycinate (Nutriadvanced | £20.80).

9. Feeling of worthlessness and guilt

Depression is still a misunderstood condition. For those who have never experienced it, it can be hard to fathom how all-consuming it can be. If people show a lack of sympathy – usually out of ignorance rather than malice – depressed people can feel even more worthless and guilty for not enjoying life. Alternatively, sufferers often beat themselves up for feeling low when others seem to have worse lives. Or they may feel guilty because they struggle to enjoy their children or support their spouse or friends.

How to ease it: Cognitive Behavioural Therapy (CBT) or counselling can help you work through these negative feelings. It doesn't matter if your illness isn't 'physical' as such. Remember that you are unwell and deserve to get better as much as anyone else.

"There are no quick fixes for depression, but small changes and steps to feel a bit better each day will help us get back to our usual selves," says Grace. "Even then we’ll have good and bad days, so don’t be too hard on yourself."

10. Sexual dysfunction

A low libido (sex drive) - and wondering why you've gone off sex -  can also be signs of depression that many will experience. According to research published in the Journal of Clinical Psychiatry around 40% of women with a sexual disorder such as a lack of desire, or an inability to become aroused or to reach orgasm experience concurrent depression.

How to ease it: As well as not feeling 'in the mood' many depressed people will withdraw from intimate contact. But if you can manage it, you may find that sex or masturbation is helpful. This is because these acts release the mood-boosting chemicals dopamine, endorphins and oxytocin that relieve stress, improve mood and aid sleep. If you can't face sex and you have a loving partner, cuddling or holding hands can release oxytocin. This 'love hormone' can ease anxiety and help you feel closer to another person.

Somewhat ironically, antidepressants and certain other medications can also affect libido or cause sexual dysfunction. If you think this may be the case, talk to your doctor.

11. Suicidal ideation or attempts

In extreme cases, someone with depression may fantasise about ending it all, or may attempt to commit suicide. It's immaterial if this is a cry for help. If someone is considering suicide they will need immediate help and support. "When depression consumes us, we can feel there is no other way out," says Grace McMahon. "Or that we don’t want to be here with those thoughts anymore. We feel worthless about ourselves which can lead to guilt, suicidal thoughts or attempts."

How to ease it: If you, or someone you know, is at this stage it's essential they get help. "It’s so important to seek professional help for depression to prevent getting to this point and help us come back from it if we’re already there," says Grace. "Speak to your GP about options. It can be scary, but they’ve heard it before and can offer different treatment approaches to help you."

Contact your GP to request an urgent appointment. Closed surgeries usually provide details of an out-of-hours doctor. Alternatively, call a friend or loved one, go to A&E, or call a helpline such as the Samaritans on 116 123 or the National Suicide Prevention Helpline on 0800 689 5652.

When to seek medical advice

If you are persistently depressed, low or tearful these are signs of depression, so talk to someone. While friends and family can be brilliantly supportive, a professional can provide more practical help rather than a shoulder to cry on. GPs are well-versed in treating depressed patients. They will offer advice and recommend lifestyle changes, therapy or medication depending on the severity of your symptoms. However, if you don't feel you are getting the help you need from your GP you are perfectly entitled to change doctors.

Unfortunately, waiting lists for therapy or counselling through the NHS can be long. If this turns out to be the case for you, find a private therapist. Many offer a sliding scale of payment, depending on what you can afford. You can meet someone in person, or have virtual sessions (this has become an increasingly popular option since lockdown). Take a look at the Counselling Directory to find a counsellor or therapist nearby. Again, if you don't 'gel' with your therapist don't feel you have to stick with them.

Treating depression sooner rather than later can make life easier. "This is especially important as evidence suggests that the earlier you begin treatment, the better the outcome is likely to be, as depression can become entrenched over time," says Richard Colwill, a spokesperson for the mental health charity SANE.

You may find that people will say something did or didn't work for them. While it's helpful to hear other people's experiences, try not to compare your experience to theirs. "There’s no one ‘cure’ or treatment for poor mental health. You must have some patience and perseverance to find what works for you – we are all different," says Michelle. "Stick with it though, as there really are so many different and effective ways to support your mental health."

Michelle designed her own personal support. Called The M-Plan (Move, Meditate, Make, Meet, Meaning and Mindset) it gives prompts to check in with what she needs daily to support her mental health. "It’s flexible and I use it to give myself space and permission to consider what would feel beneficial to me," she explains. "I also take medication and have therapy when I need some extra support. I’m not ashamed of any of the supports I use to look after my mental health; in fact, I have more moments of joy in my life than ever before," she says.

"Everyone with a mental health problem deserves to be able to access the help that they need," says Rosie Weatherley, on behalf of mental health charity Mind. "No matter what kind of depression you have, treatments are available."

For more advice read SANE's factsheet on depression or visit the MIND website.

Prime Minister Boris Johnson announced the government's living with Covid plan on February 21, just days before scrapping the isolation requirement for those who test positive for the virus. 

Speaking to the House of Commons, he explained that the Queen's positive Covid-19 test was "a reminder that this virus has not gone away but because of the efforts we have made as a country over the past two years we can now deal with it in a very different way, moving from government restrictions to personal responsibility."

The living with Covid plan may be an exciting prospect for those able to look beyond the pandemic. But not all countries in the UK are ending coronavirus restrictions at the same time.

What is the living with Covid plan?

No need to self isolate with Covid-19

If you test positive for Covid via a lateral flow test or a PCR from Thursday February 24, you do not legally need to isolate under the living with Covid plan. Until April 1, however, the government are still advising those who test positive to stay at home.

"But after that," the PM said, "We will encourage people with Covid-19 symptoms to exercise personal responsibility, just as we encourage people who may have flu to be considerate to others."

Routine contact tracing, i.e. the NHS Track and Trace system, will no longer be in operation. Those who are fully vaccinated close contacts of someone who has tested positive won't have to test daily for seven days. This also applies to anyone under the age of 18 and also to those who are not fully vaccinated.

Naturally, not having to isolate means that self-isolate support payments will end. This gives businesses reliant on them through the pandemic no choice but to welcome in staff who are testing positive - or pay out of pocket. Similarly, Covid provisions for Statutory Sick Pay will end next month.

There's already been a wave of backlash from MPs, charities, unions and scientists against the decision. Many have pointed out that new variants mean you can get Covid twice, for instance, to varying degrees of severity. Many have also accused Boris Johnson of trying to distract from the controversy around the Downing Street parties, following the publication of the Sue Gray report earlier this year.

Speaking to Kay Burley on Sky News, Professor Devi Sridhar of Edinburgh University Medical School said, “I don’t think it’ll be a welcome surprise to most people. To release isolation…isolation is about stopping someone who’s infectious passing that on to someone else… it’s, I think, too early right now.

But the prime minister has said that the move is justified because "levels of immunity are so high. And deaths are now, if anything, below where you would normally expect for this time of year."

He continued, "And it only because we know Omicron is less severe, that testing for Omicron on the colossal scale we have been doing is much less important, and much less valuable in preventing serious illness."

No more testing for schoolchildren or the general population

From February 21, the government removed the guidance for staff and students in most education and childcare settings to take twice-a-week asymptomatic Covid-19 tests. Initially, this was put in place to try and reduce the spread of the virus from educational settings to the wider community.

And then from April 1, both lateral flow and PCR testing for the general public will no longer be free of charge. Boris Johnson has said that in line with many other countries, they are working "to ensure that everyone who wants to can buy a test."

Under the living with Covid plan, free symptomatic tests (PCR tests, for example) will still be available for those in older age groups and those most vulnerable to Covid-19.

No more compulsory face masks

When can we stop wearing face masks? It's been the question on everyone's mind since the beginning of the pandemic, with rules changing amid every spike of the virus. But now, following the scrapping of all Covid restrictions in England, face coverings won't be a legal requirement - anywhere.

Instead, businesses will have to dictate whether they want employees and customers to wear masks. And members of the public will be able to make their own decision on masks in public places. This includes public transport.

On February 21, Mayor of London Sadiq Khan said that masks were no longer compulsory on the Tube. Up until now, they were optional in other public areas. But Transport for London personally made them a condition of travel.

He said, "Following the government dropping all legal Covid restrictions, and in light of falling infection levels in London, it is expected that wearing a face covering will no longer be a condition of carriage on the TfL network."

No more vaccine passports

The requirement to offer proof of a double vaccination was only really put into place around Christmas last year, when the Omicron wave hit but the government confirmed that we were not going back into lockdown.

From April 1, they will no longer be a requirement anywhere in England - for domestic use or international travel. However, anyone who requires a vaccine passport will be able to access their certification on the NHS app.

Spring booster jabs for those vulnerable and/or over 75

The Covid booster jab has been attributed as the primary reason for being able to lift these restrictions. In his speech to the Commons, the prime minister said, "It is because of the extraordinary success of this vaccination programme, that we have been able to lift our restrictions earlier than other comparable countries, opening up last summer, while others remained closed, and keeping things open this winter, when others shut down again."

According to the most recent data available, over 71% of all adults have now had a third jab, including 93% of those over the age of 70.

And so to continue the programme, Mr Johnson announced that the government was taking further action to "guard against a possible resurgence of the virus". They will do this by following advice from the Joint Committee on Vaccination and Immunisation and offer a new Spring booster jab to those over 75, older care home residents and those over 12 who are also immunosuppressed.

The Coronavirus Act expires

The Coronavirus Act 2020 became law in March 2020, just before the first lockdown, to allow the government emergency powers. It gave officials the ability to limit or suspend public gatherings and detain individuals suspected to be infected with Covid-19. Along with easing the burden on the public health service, assisting healthcare workers and those economically affected, and relaxing regulations when they saw fit.

While the government had the power to prolong the act by six months at ministerial discretion, it had a two-year time limit. This means that the act expires in March this year and the only way it could continue would be with votes by ministers.

On February 21, Boris Johnson announced that all provisions of the Coronavirus Act will now expire. "Of the original 40, 20 have already expired. 16 will expire on 24 March and the last 4 relating to innovations in public service will expire six months later. After we have made those improvements permanent via other means," he said.

New surveillance system to avoid future pandemics

The prime minister set out a strategy to try and 'future-proof' the country against any possible future pandemics. Among the plans was:

• More protection against laboratory leaks
• A refresh to the UK Biosecurity Strategy to protect the country against natural and accidental virus spillovers. Along with biological threats from other countries or terrorists.
• The Office for National Statistics (ONS) infection survey will remain in place to monitor the virus
• Laboratories will ramp up testing to combat any new possible Covid-19 variants

But ultimately, the prime minister said that Covid-19 will be a routine public health issue - much like the flu."In all circumstances, our aim will be to manage and respond to future risks through more routine public health interventions, with pharmaceutical interventions as the first line of defence," he said.

When can you come out of Covid isolation in England?

Self-isolation is due to end on February 24 2022 in England as part of the PM's plan to bring society "towards a return to normality". The rules were due to end on March 24, following an announcement by the PM in January.

But the PM hinted that if there was positive data, the plan would come earlier. Mr Johnson explained, “Providing the current encouraging tends in the data continue, it is my expectation that we will be able to end the last domestic restrictions, including the legal requirement to self-isolate if you test positive, a full month early.”

Prior to February 24, you could come out of isolation in England 5 full days after testing positive for Covid. As long as you have a negative lateral flow test on day 5 and day 6. Anyone who still tests positive after two lateral flow tests days apart should continue to isolate. As the two lateral flow tests will confirm whether you're still infectious with the virus, the need for them to both be negative before exiting isolation is "crucial", government guidance says. 

Sajid Javid said, “After reviewing all of the evidence, we’ve made the decision to reduce the minimum self-isolation period to 5 full days in England. These 2 tests are critical to these balanced and proportionate plans. I’d urge everyone to take advance of the capacity we’ve built up in tests so we can restore more freedom to this country, whilst we are keeping everyone safe.” 

Both the health secretary and the PM have stressed the need for two jabs for freedoms that the change brings. This includes the Covid booster jab, which is still available at many walk-in clinics and GP surgeries. 

However when it comes to coronavirus restrictions, not all the devolved nations in the UK are on the same page.

When is isolation ending in Scotland?

Scotland has powers to keep those testing positive in isolation until September 24 2022. Up until the new year, much like England, the quarantine period was 10 days without exception. But as of January 6, self-isolation ends for those who don't have a fever and test negative on day 6. And then again at least 24 hours later.

Those with three doses of the vaccine don't need to isolate if they are a close contact of someone who tests positive. So long as they can produce a negative test every day for seven days and don't have a fever. This rule applies even to those who they share a household with and those under the age of 18.

First Minister Nicola Sturgeon said of the new rules, "These changes are significant, but we believe they are also justified. They balance the importance of self-isolation – in slowing the virus’s spread and reducing the harm it can cause – with the wider harms to the economy that broader self-isolation rules can cause."

When do Covid rules change in Wales?

Self-isolation rules in Wales could revert to guidance as early as March, Economy Minister Vaughan Gething said. It follows a statement from the government that confirmed rates were falling. This meant that some rules - such as the need for a Covid passport - could be axed from February 18. However, for the moment, all other restrictions are in place.

Mr Gething said that the prime minister's decision to end isolation on February 24 was not based on scientific evidence.

If you have symptoms of Covid-19 and are living in Wales, you should self-isolate immediately. And take a PCR test as soon as possible. Following five days of isolation, you can take a lateral flow test on day five and a second one the following day to end the quarantine. As long as you test negative. Guidance from the Welsh government says, "You should not take a LFT before day 5 of your self-isolation. The risk of remaining infectious and therefore passing the infection onto others before this period is significantly higher."

Those who are still testing positive on day 5 should stay in isolation. At least until they can offer 2 consecutive negative lateral flow tests. If day 10 of isolation comes sooner than this, they can leave on this day. This is without the need to produce a negative lateral flow test result, unless they still have a temperature. In this rarer case, they should continue to isolate until this goes away.

When can you stop isolating in Northern Ireland?

The Department of Health in Northern Ireland has "no plans" to scrap Covid-19 testing or isolation. All other restrictions, including the need for a Covid passport, became guidance on February 15. But Health Minister Robin Swann has stressed that there aren't any plans to cut arrangements for quarantine. So for the moment, there's no date for when Wales' plan for living with Covid will begin.  

The minimum self-isolation period for those testing positive became 5 days, down from 7, on January 21.

Are the rules for travelling changing?

Yes, along with the rules on when can you come out of Covid isolation, these are changing too. Rules for those looking to go on holiday from the UK are being relaxed on Friday February 11 2022. Anyone coming into the country with two jabs will not have to take any Covid tests. Unvaccinated passengers will not have to isolate either - but they will have to take tests. 

Everyone, regardless of their vaccination status, will have to fill in a passenger locator form.

It’s important to note, however, that the living with Covid plan applies to those entering the UK. Every country has the right to refuse entry based on vaccination, testing or other requirements. Spain, for example, has recently announced that they will not admit anyone over 12 without proof of a double vaccination. Ahead of the school half-term, it’s caused chaos for many families looking for a splash of February sunshine. 

When do Covid rules change? Prime Minister Boris Johnson has announced his plans for "living with Covid" in the foreseeable future, one of which includes scrappig the legal necessity to self-isolate while infected.

The plan to lift Covid-19 regulations has been in place since January, when Mr Johnson announced that rules could be over by April. However, following a recent "positive trend" that shows cases declining, he revealed that the plans would move forward earlier. Speaking to the House of Commons, the PM said that he planned to move the date forward due to the "hard work of the British people" paying off in controlling the virus. But with scientists confirming that you can get Covid twice, if not more, experts have warned that lifting restrictions sends a message that the pandemic is "over" too soon.

And with discussions about whether we will go back into lockdown this year still going on in some circles, the decision to end isolation early for millions is certainly a controversial one. So what are the rules right now?

When can you come out of Covid isolation in England?

Self-isolation is due to end on February 24 2022 in England as part of the PM's plan to bring society "towards a return to normality" following "current encouraging trends in the data". The rules were due to end on March 24 this year, following an announcement by the PM in January. But he hinted that if there was positive data, the restrictions would end earlier. Mr Johnson explained, “Providing the current encouraging tends in the data continue, it is my expectation that we will be able to end the last domestic restrictions, including the legal requirement to self-isolate if you test positive, a full month early.”

He did stress there would still be guidance though. And added that going to work while testing positive would still be off the cards. “That would not be what we are recommending,” he said. “What we would simply be doing is removing the domestic regulations which relate to isolation.“But obviously in the same way that someone with fly, we wouldn’t recommend they go to work, we would never recommend anyone goes to work when they have an infectious disease.” 

However, there's already been a wave of backlash from charities, unions and scientists against the decision. Many have accused Boris Johnson of trying to distract from the controversy around the Downing Street parties, following the publication of the Sue Gray report. Speaking to Kay Burley on Sky News, Professor Devi Sridhar of Edinburgh University Medical School said, “I don’t think it’ll be a welcome surprise to most people. To release isolation…isolation is about stopping someone who’s infectious passing that on to someone else… it’s, I think, too early right now.

“We have great lateral flow tests," she continued. "They identify if someone has a high viral load if they’re infectious. We have a system where if you test negative on day five or day six you can get out of isolation. I don’t know why you’d change that right now when we still have over 200 deaths a day to Covid. If you look at the timing, it’s really clearly to make headlines today and distract from the problems the Prime Minister is facing. Which is that…he seems to have broken lockdown rules.”

At the moment, you can come out of isolation in England 5 full days after testing positive for Covid. As long as you have a negative lateral flow test on day 5 and day 6. Anyone who still tests positive after two lateral flow tests days apart should continue to isolate, as stated by the UK's Health Security Agency. As the two lateral flow tests will confirm whether you're still infectious with the virus, the need for them to both be negative before exiting isolation is "crucial", government guidance says. 

The second of the two tests must be taken no earlier than the fifth day of isolation. The second one has to be taken the following day. If you are positive on day 5, a negative test is a requirement on day 6 and day 7. This has been the rule since January 17, when the guidelines changed the isolation period from 7 days. It was around the same time that the government's Plan B, a response to new symptoms of the Omicron variant, was scrapped as well.

The default isolation period is 10 days. If you are still testing positive on day 6 and 7 then you should quarantine until you reach 10 days. 

During the isolation period as it is now, you must not leave your home for any reason. The current government guidance stipulates that you can exercise with Covid inside your home if you're feeling well enough, but you can't go outside for anything other than an emergency. This includes trips to buy food or medicines. And you also should not allow people inside your home during this period either.

Anyone who is able to leave quarantine on or before day 6 is “strongly advised” to wear a mask. It’s also suggested that those leaving isolation avoid close contact and stay away from poorly ventilated spaces, working from home if they can, to avoid any chance of spreading the virus as lateral flow tests can be false negative.

Health Secretary Sajid Javid said, “After reviewing all of the evidence, we’ve made the decision to reduce the minimum self-isolation period to 5 full days in England. These 2 tests are critical to these balanced and proportionate plans and I’d urge everyone to take advance of the capacity we’ve built up in tests so we can restore more freedom to this country, whilst we are keeping everyone safe.” 

Both the health secretary and the PM have stressed the need for two jabs for freedoms that the change brings. This includes the Covid booster jab, which is still available at many walk-in clinics and GP surgeries. Last year, the Mr Javid told BBC Radio 4 that the booster programme was the country's "new national mission". "In terms of the public health of this country, there is nothing more important than this booster programme," he said. 

When is isolation ending in Scotland?

Scotland has powers to keep those testing positive in isolation until September 24 2022. Up until the new year, much like England, the quarantine period was 10 days without exception. But as of January 6, self-isolation ends for those who don't have a fever and test negative on day 6. And then again at least 24 hours later.

Those who have had three doses of the vaccine do not need to isolate if they are a close contact of someone who tests positive. So long as they can produce a negative test every day for seven days and don't have a fever. This rule applies even to those who they share a household with and those under the age of 18.

First Minister Nicola Sturgeon said of the new rules, "These changes are significant, but we believe they are also justified at this phase of the pandemic. They balance the importance of self-isolation – in slowing the virus’s spread and reducing the harm it can cause – with the wider harms to the economy that broader self-isolation rules can cause."

When do Covid rules change in Wales?

Self-isolation rules in Wales could revert to guidance as early as March, Economy Minister Vaughan Gething said. It follows a statement from the government that confirmed rates were falling. This meant that some rules - such as the need for a Covid passport - could be axed from February 18. However, for the moment, all other restrictions are in place.

Mr Gething said that the prime minister's decision to end isolation on February 24 was not based on scientific evidence.

If you have symptoms of Covid-19 and are living in Wales, you should self-isolate immediately. And take a PCR test as soon as possible. Following five days of isolation, you can take a lateral flow test on day five and a second one the following day to end the quarantine. As long as you test negative. Guidance from the Welsh government says, "You should not take a LFT before day 5 of your self-isolation because the risk of remaining infectious and therefore passing the infection onto others before this period is significantly higher."

Those who are still testing positive on day 5 should stay in isolation. At least until they can offer 2 consecutive negative lateral flow tests. If day 10 of isolation comes sooner than this, they can leave on this day. This is without the need to produce a negative lateral flow test result, unless they still have a temperature. In this rarer case, they should continue to isolate until this goes away.

When can you stop isolating in Northern Ireland?

The Department of Health in Northern Ireland has "no plans" to scrap Covid-19 testing or isolation. All other restrictions, including the need for a Covid passport, were replaced with guidance from February 15. But Health Minister Robin Swann has stressed that there aren't any plans to cut arrangements for quarantine. So for the moment, there's no date for when Covid rules will change.

The minimum self-isolation period for those testing positive was reduced from 7 days to 5 days on January 21.

Are the rules for travelling changing?

Yes, along with the rules on when can you come out of Covid isolation, these are changing too. Rules for those looking to go on holiday from the UK are being relaxed on Friday February 11 2022. Anyone coming into the country with two jabs will not have to take any Covid tests. Unvaccinated passengers will not have to isolate either - but they will have to take tests. 

Everyone, regardless of their vaccination status, will have to fill in a passenger locator form.

It’s important to note, however, that these rules apply to those entering the UK only. Every country has the right to refuse entry based on vaccination, testing or other requirements. Spain, for example, has recently announced that they will not admit anyone over 12 without proof of a double vaccination. Ahead of the school half-term, it’s caused chaos for many families looking for a splash of February sunshine. 

With 2022 being dubbed the year of rest and relaxation following two years of pandemic anxiety, there’s no better time to plan a spa and wellbeing getaway.

Whether it’s a full-body massage you’re after or a bespoke pottery-making workshop, these excellent retreats will see you back on top form in no time. And with little chance that we're going back into lockdown this year, you can be (almost) safe in the knowledge that your trip will go off without a hitch.

Topping our list is Birch Community, a perfect all-rounder where your downtime between activities can be spent lounging in the bar, taking a walk through the Hertfordshire countryside or challenging a friend to a game of ping-pong. There's fitness facilities - everything from an outdoor pool to a yoga studio - and the customer service is beyond compare.

With each of these retreats offering something different, check out our list and find best spa and wellbeing getaway for 2022.

Best spa and wellbeing getaways in 2022

1. Best overall: Birch Community, Hertfordshire

Double (medium) room from £120 per night. 

VISIT BIRCH HERE 

If you’re looking for a complete getaway - both mind and body - then Birch is the place for you. Set within the semi-revamped walls of an 1800s manor house, built by an illustrious baron and his extravagant wife, the retreat offers an escape by means of contemporary art, uniquely delicious food and adventure. 

Other retreats may offer more in terms of massages and facials (although these are available at the Wellness Centre), but you certainly won’t find a menu of experiences like the ones at Birch elsewhere. During your stay, you have to check out the cultural programme - with the pottery-making workshop being a particular highlight. Under lighthearted instruction, you completely detach from reality by moulding and creating with your hands. No matter what you make at the end of the two hour session, it’s blown in your choice of colour and popped in the post within just a few weeks. £50 per homewares session - an absolute bargain when you consider what it would cost to buy the same crockery at Anthropologie. But if that's not for you, don't worry - there's also sourdough and soda bread-making, foraging, wine and whisky tasting, plus so much more.

If you fancy stretching your legs, you can also opt for one of the several fitness classes available for free during your stay - including yoga, spinning, strength training and more. There's a state-of-the-art gym at your disposal complete with a weights room, cardio machines and a sauna. If you're feeling truly brave (or you're lucky enough to have scored a weekend in the summer), head to the retreat's own outdoor pool after your session. It'll be a bracing dip in the colder months - but if wellness is what you're looking for, there's truly nothing better for you than a cold swim.

If you prefer a more chilled-out approach to your spa and wellbeing getaway, take a walk through the illustrious golf-course-turned-farm that Birch is built on and see the farm-to-table approach to food at the retreat for yourself. Birch Community boasts award-winning chef Robin Gill’s Zebra Riding Club restaurant on site. It's the place to go for something a little more like fine dining - with their three course brunch menu starting at £38 per person - but with the simplicity of Birch's ethos. Highlights for meat-eaters include deviled egg and lobster mayo in the snack selection and the pork belly chop for main. There's separate vegan, veggie and kids' menus available too.

But when it comes to food at Birch, it’s really got to be Valerie’s. Named after the zebra-riding former resident herself, you can - and should - start and finish your day here. Think poached eggs in the morning, delicious wild mushroom truffle pasta in the afternoon, coffee and CBD-infused drinks, and steak in the evening. Just remember to book in advance if you go later in the day as it fills up quickly with guests, members and their dogs alike. 

In the evening when you're ready for sleep, head upstairs to one of the 140 minimalist rooms built within the old house itself. Here you'll find an exceptionally comfortable bed and a surprisingly retro-style pink bathroom to see you through to the morning.

The best part about Birch that makes it the number one getaway on our list? It caters for how ever you want to relax. If a boozy vacay with friends is what you’re after, book a Weekender and never be bored. Or if you’re looking for a chilled-out retreat, two days spent soaking in the fresh air on nature walks and ironing out the creases in a Power Flow yoga session should do the trick. No matter what you’re into, you’ll find it here. 

2. Best location: Merchant's Manor, Falmouth

Double rooms from £150 in the off-peak season and £165 in high season. 

VISIT MERCHANT'S MANOR HERE

While kids are more than welcome at Birch, this spa and wellbeing getaway is just for the grown-ups. Situated an easy 10-minute walk from Falmouth Town in Dorset, Merchant’s Manor has an incredible vantage point for sea-lovers. From the hotel, it's just another few minutes to the beach and you can even have your (inclusive) breakfast of avocado on toast with poached eggs and harissa looking out onto the sea view in the mornings. If you're an early riser, take a stroll down to the front and watch the sunrise. 

When you’re ready for a wind-down in the afternoon, try out a massage or facial in one of the two treatment rooms available at the manor (but be sure to book your treatment in advance as space fills up a week or more in advance). Then relax in the barrel sauna, steam room or heated pool that stretches over 13-metres long, before a dip in the hydrotherapy tub. 

During the day, once you’ve had a stroll through the picturesque town and a bit of lunch (we recommend The Shack for seafood or the balcony at the WindJammer for harbour views), head back to the multi-award winning Rastella restaurant for dinner. There’s the conservatory for a more sociable, relaxed feel or the classic dining room. Both spots should be experienced at least once during your stay. As should the exquisite tasting menu at £55 per person. It’s complete with hand-picked Cornish flavours that you’re very unlikely to find elsewhere, like fresh sea greens and beef from the oldest farm in the county. With seven different themes, it’s a sensational experience. We won't ruin it - but chocolate-lovers are in for a treat in the final course especially. 

3. Best for spa deals: Frederick’s Hotel, Restaurant and Spa, Berkshire 

Double rooms from £160 per night. 

VISIT FREDRICK'S HOTEL, RESTAURANT AND SPA

If the coven of dense trees and silence that surrounds Fredrick’s in Maidenhead isn’t enough to get you to relax, the spa treatments on offer just a stone’s throw away from your room are sure to do the trick. 

While guests rave about the dining experiences on offer, it’s the pool that you’re after at this spa. The space starts small inside but then you swim through an open door that extends into the ground’s gardens, complete with a jet and waterfall fountain. There’s also a steam room, sauna, rain showers and a complete gym to keep you busy during your stay. 

Frederick’s offers 137 rooms for overnight guests, complete with 5-star dinner service at the double AA Rosette-winning restaurant and breakfast in the morning. However, their selection of deals for day visits is certainly worth a look too. Whether you’re staying in Maidenhead and looking to escape for an hour (60-minute treatment - £75) or want to get out of the city just for the day (Tempting Tea and Treatment - £75 for midweek, £85 for the weekend), you can make full use of spa without breaking the bank. 

4. Best for activities: Water Women Weekend, Newquay

From £249 per person, not including accommodation. 

VISIT WATER WOMEN WEEKEND

Organised by surfing collective Women + Waves, the Water Women Weekend is a two-day retreat to Cornwall’s luscious coastline. While another spa and wellbeing getaway on our list will offer more of a package deal, starting at £249 each, this is definitely one of the best deals if you’re truly looking to escape and do something totally new. 

Along with picking up the basics (or progressing to the next level) on a surfboard alongside like-minded individuals, you’ll get the opportunity to paddle board your way through Newquay’s famous waterways and take a dip in some of the stunning wild swimming spots in the area. 

Accommodation-wise, it’s a book-your-own situation. The group has links to various hotels in the area - from Lewinnick Lodge with its amazing views to the more budget-friendly Smarties Surf Lodge - alongside campsites and of course, there’s always the Airbnbs dotted around Fistral Beach. And when you’re in the area, check out The Boathouse for food - there’s everything from crab sandwiches to vegan katsu curry available to buy and eat in their picnic-style set up. 

Whether you’re on your own or coming in a group, this is a great option if you’re looking to get away from the grind and into nature. 

5. Best for treatments: Y Spa, Bedfordshire

Two Night Hideaway Spa Break from £488 

VISIT Y SPA HERE 

Don’t let the dreary exterior of Wyboston Lakes put you off everything that the Y Spa at Wyboston Lakes has to offer. Once you’ve checked in, head straight to pick up your wristband for the spa and head over to the outdoor hydrotherapy pool. Here, enclosed by trees and next to a Nordic-style sweat lodge, you’ll find perfect relaxation. There’s also two different saunas at various temperatures, a steam room and salt room. So whatever stress you’re looking to get rid off, you’ll sure sweat it out here. 

If not, take a look at the spa’s range of treatments on offer - they’re not to be missed. Experience an energising facial with the ELEMIS Superfood Pro-Radiance or the Murad H20 facial among others, each available with options for sensitive skin or blemishes. For the body, there’s the Neom Wellbeing Treatment Sleep - a must-have if you’re looking for an evening treat - or a traditional full-body Y Spa Massage, designed to push away tension for just £80 per hour. 

Plus if you book your spa and wellbeing getaway online, you can save up to 10% on overnight stays. 

In the morning, head across the road to the gym and wellness centre - which includes a decently-sized swimming pool. While it’s no state-of-the-art gym, it’s got everything you’d have in your own gym to get a good workout in before you head home. 

6. Best setting: Ockenden Manor, Hotel and Spa, Sussex

Cosy rooms from £214 per night

VISIT OCKENDEN MANOR, HOTEL AND SPA

Looking for a spa with a historic twist? Set in the heart of Sussex is the centuries-old Ockenden Manor, Hotel and Spa. While it’s a good choice for those looking to celebrate (you may even see a wedding party or two during your stay), the relaxing views and spa packages make it a good choice for a peaceful weekend away. 

10 minutes away from Haywards Heath station, you’ll need a car to navigate the tight country roads - or grab a taxi. But with Brighton just 16 miles away, it’s a great choice for locals or those looking for a side of the seaside with their pampering spa and wellbeing getaway. 

Come in the winter and a real, open fire will greet you at reception on arrival. Before heading up to one of the Tudor-style rooms, complete with roll-top baths and deep oak panelling, have a drink in the bar. If wine’s your thing, there’s an ever-expanding wine list to choose from - or your standard selection of spirits, beers and soft drinks - along with complimentary canapés. 

For the spa alone it’s worth the £200+ fee per night on the weekend. After a short walk from the main house, you’ll arrive at the contemporary treatment centre - a stark contrast from the dark wood finishing of the manor. There’s a pool with an open hatch so you can swim out into the outdoors, along with whirlpool tubs, steam rooms, saunas, rainforest showers and lounge area. Along with signature treatments that range from the signature massage to “floating therapy”. 

7. Best for a city break: Balmoral Hotel, Edinburgh 

1 Night Spa Experience from £628

VISIT THE BALMORAL HOTEL

Wellness, 5* spa treatments and city breaks can, believe it or not, go hand in hand. And if you’ve got a spare weekend in your diary designated to doing something new, why not take a trip to Scotland’s cultural capital? 

While a two-night stay at The Balmoral is something out of a gothic fairytale, at hundreds of £ per night, it's not an option for everyone. Luckily, you don't have to stay to enjoy the retreat-like urban luxury of the hotel and spa. Perfectly placed on Prince’s Street, a stone’s throw away from Edinburgh Waverley Station and just around the corner from Edinburgh Castle itself, this hotel takes relaxation to the next level. Along with a range of classic treatments, including a 50-minute Swedish massage (a must-have if you visit), there's a heated pool, sauna, steam room and sizeable walk-in shower room. 

Afterwards, make a reservation for tea in the iconic Palm Court room. Soothing in style with flashes of green decor, its menu features scones, sandwiches and cakes, along with the option for a champagne-infused alternative to traditional afternoon teas. If you're going in the afternoon, book a spot for dinner in the Michelin star restaurant, Number One, set within the historic building itself for their signature 7-course menu.

Also during your stay in the city, we also recommend visiting The Witchery by the castle for an incredible Sunday lunch before a walk through the Old Town.

8. Best for food: The Pig, New Forest

From £195 midweek to £215 at the weekend

VISIT THE PIG

While there's technically no spa at The Pig, you can experience everything from a powerful full-body massage to a hydrating facial in one of their scenic cabins on-site - complete with your choice of aromatherapy oil. Set within the New Forest and multiple other locations around England, The Pig has been a huge hit with those looking to get out of the city since 2011.

While the newly-opened spa and wellbeing getaway in the South Downs, close by to the ancient market town of Arundel, boasts incredible customer service and a stellar food experience, we've picked the original New Forest retreat for our list. All because of the food.

Bringing a farm-to-table approach to all their hotels, ingredients for the ever-changing menu here are all sourced within a close 25-mile radius and much of the vegetables come from patches scattered around the site itself. There are, of course, pig-themed dishes and nibbles like cuts of cured meat, terrines and succulent pork belly to enjoy in abundance - and you definitely should make the most of these. Breakfast is served throughout the morning and includes the essentials like juices, yogurt and cereals, pastries, cakes and more, alongside hot dishes made-to-order. The Eggs Benedict are the winners here, arriving piping-hot and on a bed of delicious sourdough toast.

Once you've eaten your fill, you can explore the surrounding areas of the New Forest.

9. Best for camping: Fforest, South Wales

Price dependent on experience and accommodation choices

VISIT FFOREST 

On a farm near the River Teifi, by the coast on Penbryn Beach or in Cardigan town? That’s the only question you have to answer when choosing your experience with Fforest. The retreat company offers total detachment from reality with their three different experiences - all set within the deep countryside of South Wales. 

Take on challenges with this spa and wellbeing getaway like Gran Ffondo - a four-day cycling adventure with pub pitstops, sauna stations and films round a firepit. Dive into a community of women with the women’s-only Fforest Glow retreat. Or bring the whole family along for Fforest Gather - a two-week long celebration of the simple pleasures in life, including music, tree climbing and arts activities like ceramics and printmaking. 

Where you’ll sleep at night all depends on the option you choose. If you go for the Farm experience, you have eight incredible spots to pick from - including a stunning Georgian farmhouse. While the Town stay will have you sleeping in vintage granary lofts. By the coast, you’ll stay the night in cabins or glamping-style domes. 

Can lateral flow tests be false positive or negative? With isolation still mandatory for those who test positive until the end of February at least, it's the question everyone is asking. 

Throughout the pandemic, lateral flow tests - otherwise known as LFTs or lateral flow devices (LFDs) have been one of the quickest and easiest ways to check for Covid-19. They take just 30 minutes to develop, a significantly shorter wait time than the 24-hour turnaround of a PCR test. And while they're mainly supposed to be for those without symptoms, the warnings around cold-like Omicron symptoms have people using them more often.

So, as the rules on when you can come out of Covid isolation have changed in England, can a lateral flow test give out a false positive or negative? And following the latest change in the guidance around testing, when should you opt for a PCR test instead?

Can you get a false positive lateral flow?

It’s unlikely that lateral flow tests (LFTs) will give out a false positive, research indicates. A Cochrane review from March 2021 assessed over 60 studies, all of which looked at the accuracy of various lateral flow tests. They found that the specificity of the tests was high, meaning they had a strong ability to accurately diagnose those who were not infected with the virus. 

This means that if you get two red lines on your lateral flow test, you’re almost certainly positive for Covid-19. In those who did not have Covid-19, the lateral flow tests correctly gave a negative result to 99.5% of people with symptoms and to 98.9% of people without symptoms. 

The UK Health Security Agency (UKHSA), an executive agency sponsored by the Department of Health and Social Care, also says that the chances of a false positive result are low - especially when there’s a high number of cases in the population. “The LFDs that we are using have a high specificity, that means the number of false positives are extremely low - less than 1 in 1000 tests conducted from our studies,” they say. “However, as the prevalence of Covid-19 reduces to low levels in the population, the chance of a false positive result increases - though still remains unlikely.” 

During these periods where the virus presence is low in the community, the UKHSA have urged people to confirm a positive lateral flow test with a PCR test. These are more accurate - by up t0 100% according to this Nature study. This is because the sample goes to a lab, rather than being tested at home. Here, it goes through a process that turns the virus' RNA into DNA and makes of copies of the DNA. This in turn allows for the better identification of the virus.

There is naturally a very small chance that the lateral flow tests can be false positive - as with any test. But when the virus is highly present in the community, it’s highly likely that a positive lateral flow test is a real positive. 

You can also get Covid twice in a month, according to health experts, as the variants of Delta and Omicron differ and two jabs is no longer enough to ensure protection. So if you get a positive result but you've already had it, don't just assume it's a false result.

Can lateral flow tests be false negative?

It’s significantly more likely that lateral flow tests will give out a false negative result, however. The same Cochrane review found that in people with confirmed Covid-19, lateral flow tests correctly gave a positive test to an average of 72% of people with symptoms. They correctly gave a positive test to 58% of people without symptoms as well. 

This means that 28% of people with symptoms who have a negative result have an incorrect reading. While 42% of people without symptoms have an incorrect reading with a negative lateral flow test. Although, the research suggests that when you take the test has a big impact on your result. Tests were most accurate when they were used in the first week after symptoms first developed. This is likely because people have the highest viral load in their system in the first few days after infection. 

When should you have a PCR test?

You should only take a PCR test if you have classic symptoms of Covid-19. These include (a cough, fever or a loss of taste or smell). And you should isolate while you wait for the result. If you don't have symptoms and you test positive via a lateral flow test, you must isolate. But you don't have to confirm the result with a PCR test.

In England, the self-isolation period can end five full days after the date of your first positive test. However, you must have two negative lateral flow results, 24 hours apart. In the rest of the UK, the self-isolation requirement is seven days with two negative results, 24 hours apart.

The government have suspended the advice to follow up a lateral flow test with a confirmatory PCR. This is because Covid levels are high in the UK at the moment. While this is the case, most people who test positive are likely to have coronavirus.

It comes at the same time as the reintroduction of Plan A restrictions. Cases of Omicron declined in January following a few weeks of increased restrictions under Plan B. As part of the new guidance, the government have advised on when the work from home rule will end and when we can stop wear face masks in public places.

How long are you contagious with Covid-19?

If you’re confirmed to have Covid-19, you’re likely to be contagious for between four to eight days after infection. This is why the isolation period for those testing positive is 10 days in the UK, just to make sure. 

The incubation period for Covid-19 lasts for between one and fourteen days. This is according to new data from the Office for National Statistics (ONS). While average time to develop symptoms is between five and six days. And 97.5% of those who do develop symptoms experience them within 12 days of infection. 

Video of the week:

Dandruff can be unsightly and embarrassing, but it's very common and generally easy to treat. If you have an itchy or sore scalp, start with these home treatments for dandruff.

Dandruff is often a medical skin condition but it can also be caused by not washing your hair properly or washing hair too much or too little.

Here, we also explain the different types of dandruff so you can determine what treatment is most likely to work, although you may need a doctor's advice to eradicate the issue.

Dr Simmy Kaur told us, 'Dandruff affects around 1 to 5 percent of the population. It’s more common in males, though. This is due to the higher ratio of androgen hormones in men that have an effect on the production of the natural oil sebum.

While most of these home treatments for dandruff are natural, some do contain medicated ingredients.

Home treatments for dandruff

1. Take preventative action

Prevention is nearly always better than cure. Keep your scalp in good condition and you may not need any home treatments for dandruff. You may also save money on products in the future.

Most hair issues start with the scalp. 'This is because each hair grows from, and through, an individual follicle which surfaces on your scalp,' says Lisa Shepherd, the most awarded female hair colourist in the UK and owner of The Hair Boss. 'Each follicle produces sebum and some people have more natural sebum than others,' she explains. It’s crucial that the follicle and the scalp remain clean and healthy, not full of sebum or blocked by dead skin, as this can result in dandruff or infection, ultimately impacting the quality of hair growth.'

Certified trichologist Stephanie Sey, told us, Every day, our scalps and hair are exposed to environmental pollutants and dirt. This can make hair look dull and cause build up and unsightly flakes, so it’s more important than ever to adopt a regular scalp routine.'

In a nutshell, if your scalp is healthy you're less likely to suffer from dandruff.

2. Change your hair washing habits

Washing your hair too much, or too often, could be making your dandruff by affecting the levels of oils in the skin. Depending on each person's hair type and length, hair should be washed between 2-3 times a week.

Hairstylist Mariano Ruiz of the Flow & Co Salon in Kent explains, "With dandruff, the cause is very often too much oil in the scalp. The more you wash your hair, the more you remove the natural oils your body produces in order to keep your scalp healthy.

"At the same time, if you don’t wash your hair very often, the oily scalp builds up and generates flakes. With this in mind, you need to find a balance. So, if you have an oily scalp and wash your hair most days, you could be exacerbating the issue. Likewise, if you wash your hair less regularly, you could be causing the same problem. Try to find a middle ground to see if that makes a difference to your dandruff."

3. Use a daily anti-dandruff shamp00

If you have mild dandruff and just want to keep the condition at bay then a gentle but effective shampoo can work.

Sanex’s new anti-dandruff shampoo contains wheat protein and antibacterial agent that cleanses the hair to remove dandruff and restore the scalp’s pH balance, while soothing your scalp.

It's dermatologically tested so it's suitable for all hair types and gentle enough to use daily.

We recommend: Sanex Anti-Dandruff Shampoo, £3 for 350ml, Waitrose.

4. Use a shampoo with coal tar or zinc

Shampoo containing coal tar or zinc include ingredients derived from natural sources.

Dr Derrick Phillips, a consultant dermatologist at the Cadogan Clinic told us, 'Coal tar shampoos such as Polytar help to reduce the build-up of scale,' The smell isn't to everyone's taste (though some of us love it).

We recommend: Polytar Coal Tar Shampoo  - Boots | £6. For a milder condition, try Neutrogena's T/Gel Therapeutic Shampoo - Boots | £7.

To reduce scale build-up you could also try a shampoo with selenium sulphide, Dr Phillips recommends: Selsun -Lloyds Pharmacy | £4.99

Alternatively, use a shampoo infused with zinc. 'Try an anti-dandruff shampoo contain pyrithione zinc [a complex of the mineral zinc], which is one of the most common anti-fungal ingredients,' says Dr Melegh.

We recommend:  Clever Soap Shampoo with 2% Pyrithione Zinc and Argan Oil - Amazon| £9.99

A word of advice: 'Overuse of anti-dandruff shampoos can lead to a dry and sensitive scalp and cause different sorts of dandruff. Limit their use,' says Dr Melegh.

5. Use a medicated shampoo

If you need something a little stronger, medicated shampoos are one of the home treatments for dandruff that usually work.

Dr Adam Friedmann, consultant dermatologist at Stratum Clinics told us. 'I’d always advise patients suffering with scaly scalp to wash their hair with medicated dandruff shampoos containing salicylic acid, which dissolves away the skin cells,' says

You'll find salicylic acid in a number of regular, everyday shampoos. For example, search for  'salicylic acid' on the Superdrug site and the results will show the shampoos available with this ingredient.

We recommend:  Alpecin Double Effect Shampoo - Boots | £7.99

Ketoconazole-based products have also proved to be very effective. 'The fungus Malassezia exists on everyone’s scalp; however, some people can have a sensitivity to it which causes dandruff,' says certified trichologist Stephanie Sey. 'So, use a treatment with the active ingredient ketoconazole in it, such as Nizoral, as cosmetic shampoos and haircare don’t treat the root cause. You can use your regular shampoo in between.'

What is ketoconazole, you may ask? 'It's an antifungal agent that stops the growth of the yeast Malassezia.' Using a ketoconazole-based product helps control and effectively treat the cause, as well as the symptoms, Stephanie says.

We recommend: Nizoral Dandruff Shampoo Boots | £9.30.

In general, all dandruff shampoos should be left in for longer than normal shampoos.

Consultant dermatologist Dr Derrick Phillips told us, 'It's important the shampoos are used correctly so the active ingredients have enough time to work. After massaging onto the scalp, the shampoo should be left to work for at least 10 mins before rinsing it out.'

6. Exfoliate your scalp with a hairbrush

A simple scrub with a clean hair brush will massage and exfoliate your scalp, making this option one of the easiest home treatments for dandruff.

Certified trichologist Stephanie Sey recommends using a hairbrush – but not any old hairbrush.

'Regularly removing dirt, sweat, excess product and environmental pollutants using the Tangle Teezer will help keep your head and hair looking their best,' she advises. 'In the shower, the teeth help to exfoliate the scalp, removing product build-up and flakes. Then you can use it dry as a massaging tool to relax tense, tight scalps and ease tension overall.'

Trichologist recommends: Tangle Teezer Scalp Exfoliator & Massage - Boots | £8.

7. Use a scalp shield

Following on from the advice to change your shampoo, consultant dermatologist, Dr Eva Melegh recommends a 'scalp shield' to protect the skin on your head.

'If you suffer from small dry white flakes, with tight scalp and itching often worse soon after washing hair you may be experiencing a scalp allergy,' she says.

'Allergies are very common, with studies showing that around 10% of the population suffer from scalp itching from a common preservative frequently used in most shampoos called MITT (Methylisothiazolinone),' she explains. 'Additionally, strong detergents and perfumes in shampoo can set off scalp allergies.'

One way to avoid this is to cover your scalp in a preparation that will protect it. 'Use a chemical-free and reparative scalp treatment to reduce irritation, improve scalp moisturisation, and repair skin barrier function through the use of prebiotic ingredients,' recommends Dr Melegh.

We recommend: Hydrosil Scalp Shield Tonic - Skin Shop| £11.95

Containing natural ingredients such as passion fruit seeds, prebiotic chicory root and Australian tea tree, it's also free from from sulphates, parabens and perfume.

8. Use a scalp scrub

Just as you would use a body scrub to exfoliate dead skin cells, so should you use a scalp scrub to give your head a bit of extra love.

Colourist Lisa Shepherd, told us, '

'Healthy hair starts with a healthy scalp,' says Lisa. 'Hair Boss Scalp Scrub (Superdrug | £5) contains tea tree oil and rosebay extract, a patented scalp active proven to reduce dandruff and sebum, as well as sugar crystals to gently exfoliate and unclog pores.

Another of the home treatments for dandruff we like is Monpure's Clarifying Scalp Scrub (Monpure | £48) While it's pricier, it feels like a luxury product and there are no parabens, silicones or sulphates. 'The scalp scrub is great for exfoliating stubborn areas of scale that may develop over time in people with dandruff,' says GP Dr Simmy Kaur. It can also help alleviate the symptoms of psoriasis.

9. Invest in an anti-dandruff serum

A serum is another way to soothe and treat your scalp and provide it with some extra TLC. As well as counteracting the appearance of dandruff, a serum can help to reduce itching and burning. Most serums are used after washing your hair and left in to work their magic. When used correctly they won't make your hair greasy and, what's more, a little goes a long way.

If your scalp is in poor condition, apply on alternate days for 2-3 weeks. To prevent or maintain your scalp, use the serum weekly for up to six weeks.

We like the anti-dandruff range from Italian trichology experts EVERYGREEN. As well as being organic and sustainable, the company supports ActionAid, a charity which works to change the lives of women and girls around the world.

We recommend: Try EVERYGREEN Anti-Dandruff Treatment Serum, £14.95, Salon Business Solutions.

10. Try a tea-tree based product

Tea tea oil is well known for its anti-bacterial, anti-fungal, anti-inflammatory and anti-viral properties, and is one of the most natural home treatments for dandruff available.

One study found that when a 5% tea tree oil shampoo was used, 41% of participants saw an improvement to their dandruff.

If you can, opt for a natural product. Not only is this kinder to your hair, it's kinder to the environment. Odylique's herbal shampoo is a wonderfully scented combo of flake-fighting tea tree, biodynamic nettle for scalp health and reparative aloe vera juice – amongst other ingredients. It's also certified organic and vegan.

We recommend: Odylique Tea Tree & Herb Shampoo - Amazon | £12

11. Take supplements

Certified trichologist Stephanie Sey told us, 'Supplements are only required when you do not get the necessary nutrients from your diet, or you have a specific deficiency such as an iron or vitamin D deficiency.

'Shorter days and time spent indoors means that many of us are exposed to very little sunlight and, as a result, can suffer from a vitamin D deficiency,' she explains. 'Vitamin D supports the immune health of the scalp, whilst also retaining hydration and helping the skin fend off yeast or bacterial organisms.'

While Stephanie advises that it's always a good idea to get vitamin D through food sources, such as eggs, oily fish and red meat, if this isn't always possible take a supplement.

We recommend: Alive Vitamin D3 Gummies - Amazon | £14.99

12. Review your diet

We are what we eat, so when our diet is unhealthy parts of us can suffer – including our hair and scalp. So, one of the easiest home remedies for dandruff is to change what we consume.

Stephanie Sey told us, 'Processed foods like ready meals and fast food are typically high in sugar, salt and unhealthy fats, as well as chemical additives. These foods have very little in the way of the nutrients that our body needs to stay healthy, such as vitamins, minerals, and antioxidants.'

She continues: 'The hair is the very last system in your body to receive nutrients (as it's one of the least essential) so, if your body is not receiving adequate nutrients, your hair will likely be affected.'

To counteract this, Stephanie suggests eating a balanced diet comprising of carbohydrates, healthy fats, proteins, fibre, vitamins and minerals. 'Eating a diet that is rich in fresh vegetables, meat and fruit supports healthy growth for thick, full hair,' she says. She also advises you add more vitamin B-rich foods to your diet. 'B1, B2 and B7 will help with the maintenance of healthy skin and hair. These can be found in foods such as oats, bananas and avocado.'

13. Limit your alcohol intake

As well as contributing to dehydration, which can dry our skin (and, therefore, our scalp), alcohol has other effects.

'Drinking a lot of alcohol can put the body under excessive stress and that will not help in trying to keep the dandruff under control,' warns Stephanie.

14. Don't overload your hair with hair products

While we've recommended a variety of different products and product types, we would suggest you use all of them all of the time.

Similarly, if you wash, condition, use salt spray, hairspray, gel, serums and other types of products you could be overloading your hair – and your scalp – with products that irritate your skin.

Instead of using home treatments for dandruff simply give your scalp a break for a few weeks to see if your dandruff improves. Alternatively, switch to more natural products.

What causes dandruff?

There are a few reasons why you may develop dandruff. While dandruff is more common in people with oily skin (e.g. adolescents), and those with immunosuppressive diseases or taking immunosuppressive medications, it can affect anyone of any age.

'Dandruff is [often] what dermatologists call seborrhoea dermatitis,' says consultant dermatologist Dr Ophelia Veraitch. 'Seborrhoeic dermatitis causes red, itchy and flaky skin on hair-bearing areas of the body. Dandruff is seborrhoeic dermatitis of the scalp. It's an eczema-like reaction to an overgrowth of harmless yeast called Malassezia on the skin,' she explains.

Like many skin conditions, dermatitis has a link to our genes. 'Because the cause of dandruff/seborhoeic dermatitis is an eczema reaction to the yeast described, people with a family or personal history of any atopic disease (eczema, asthma, hay fever) are more prone to getting it,' says Dr Veraitch. 'Babies can also get a form of seborrhoeic dermatitis of the scalp (cradle cap) and nappy area.'

'Conditions such as psoriasis and eczema may also be the root of the problem as they not only affect the skin on the body, but can also affect the scalp giving rise to redness, itching and scaling,' adds Dr Friedmann. 'Severe dandruff can also indicate a weakened immune system – and stress and lack of sleep can lower the immune system and make your scalp worse.'

Dr Veraitch adds that our environment and lifestyle can also be a factor. 'Cold weather is also a trigger for seborrhoeic dermatitis,' she says, as are some medications.

What are the symptoms of dandruff?

Symptoms vary depending on what causes your dandruff but, says Dr Veraitch, what it shouldn't be is itchy or painful. 'If these symptoms are present it could signify that the diagnosis might be something else.'

Here are some of the reasons why you may get dandruff and the sort of symptoms you can expect.

Signs your dandruff is caused by seborrhoeic dermatitis:

'Affected areas are red with greasy skin flakes. The most common sites are the scalp, face (eyebrows, nose, cheeks, ears), chest and in the skin folds,' says Dr Veraitch.

Dermatologist Dr Elyse Love told us, 'Seborrheic dermatitis is becoming more common because people are washing their hair less and less. This leads to more build-up on the scalp because the sebum is sitting for longer and there’s an over-production of the yeast [Malassezia], which feeds seborrheic dermatitis.'

Dr Love continues: 'Seborrheic dermatitis spans every hair type. It used to be more common in kinkier hair types and that’s due to the sebum not travelling down coiled hair strands as easily but also because curly hair types tend to not wash as frequently.'

Signs your dandruff is caused by a psoriasis:

'If you're struggling with large silvery flakes with grey and red scaling on the scalp and hairline this may be a sign of scalp psoriasis,' says Dr Melegh.

'The scalp is one of the most common places for psoriasis to first appear, where it is often mistaken for normal dandruff,' she explains. 'Psoriasis, which affects around 2% of the UK population, is a result of an acceleration of skin cell production. Skin cells tend to mature in 21-28 days, psoriatic cells turn over in only 2-3 days. This causes such a profusion that the live cells meet the surface and join with the dead cells still in visible plaques,' she says.

While one of the best home treatments for dandruff is coal tar (especially if you have psoriasis), Dr Melegh warns that they can sometimes be 'messy, smelly and not particularly effective.'

Dr Melegh recommends: Oregon Shampoo and Conditioner  Skin Shop | £16.50).

'Developed by a UK trichologist and trialled at Bath University for use on scalps prone to psoriasis, 95% of users on the trial found that Oregon haircare products improved itching and dryness and softened and reduced scalp plaques.'

Signs your dandruff is caused by a vitamin deficiency:

If you notice small white flakes and increased and sudden hair loss, this could be sign of a vitamin deficiency, says Dr Melegh.

'Copper, iron, and zinc deficiencies coupled with a lack of essential fatty acids are common in a low-calorie weight loss diet and can cause your scalp to flake and hair loss,' she explains.

Dr Melegh recommends using a serum high in vitamin B12, biotin, zinc, and omega fatty acids supplements. 'This can help balance this deficiency,' she says.

We recommend: The Ordinary Multi-Peptide Serum for Hair Density (Look Fantastic £15.85).

Signs your dandruff is caused by acne:

Think acne only affects your face or back? Sadly not – it can appear on most parts of our body.

'Scalp acne occurs when hair follicles become blocked (folliculitis) with oil and dead skin cells, or bacteria, and subsequently become inflamed or infected,' explains De Melegh.

She continues: 'Hormonal changes such as puberty, pregnancy, and menstruation can be a trigger for scalp acne. In addition, sticky or pore-clogging hair products like gels and hair sprays can add to the problem.'

For this condition Dr Melegh recommends prescription medicated shampoos. 'Shampoos or scalp tonics containing tea tree oil or birch water can also help as preventatives for everyday use.'

When to see a doctor about dandruff

If none of our home treatments for dandruff seem to be working, it's time to see a doctor. You may have chronic dandruff or a consistently sore scalp, or another underlying condition. A GP can refer you to a specialist 0r prescribe 'anti-inflammatory treatments that require prescription, such as steroid shampoos and calcinneurin inhibitors such as Protopic,' says Dr Phillips.

'If your dandruff doesn't respond to common treatment regimens, then you might need to see a dermatologist,' advises Dr Veraitch. 'Sometimes, other skin or scalp conditions such as psoriasis and inflammatory scalp diseases can lead to alopecia.'

Alternatively, a trichologist can help. If you can afford it, look for a private qualified trichologist here.

Video of the week

Boris Johnson's easing of restrictions in England has the public wondering when can we stop wearing face masks?

They've become a staple of pandemic life, with the British public adhering to face mask rules in shops, supermarkets, hospitality venues and even face masks in cinemas. All in an effort to reduce the transmission of the virus to prevent us from going back into lockdown.

Face masks were made mandatory again in December, under Plan B measures brought in following the spread of the Omicron variant. However, the government have re-evaluated the situation this January and have shared an update on face covering use that comes into effect soon.

When can we stop wearing face masks?

People in England no longer have to wear face masks by law. An end to mandatory face masks came into effect on Thursday 27 January, with the rule being scrapped alongside other plan B restrictions. This means that it's now a matter of personal choice to wear a face covering or not.

Prime Minister Boris Johnson confirmed an end to face masks in his House of Commons address on 19 January:

"Having looked at the data carefully the Cabinet concluded that once regulations lapse, the Government will no longer mandate the wearing of face masks," he said.

Though no longer mandatory, Boris added that he "suggests" people to continue to wear face coverings. Especially in "enclosed or crowded spaces". But he was quick to highlight that this was a recommendation and not a rule.

"We will trust the judgment of the British people and no longer criminalise anyone who chooses not to wear one," he said.

Despite the government's new stance on masks, London Mayor Sadiq Khan has shared that they will remain mandatory on Transport for London (TfL) services. This means that those in the capital using the tube, buses, trains and other public transport must wear a mask.

"If we have learnt anything from this pandemic, it is that we must not get complacent and undo all our hard work and sacrifices," he said. "That’s why face coverings will remain a condition of carriage on Transport for London services.

"I’m asking everyone in our capital to do the right thing and continue to wear a face covering when travelling on TfL services to keep us all protected and to prevent further restrictions from being necessary later down the line."

Anyone not wearing a mask on public transport in London could face a £200 fine. Both TfL officers and the police are being deployed to deliver these fines.

Also under the Plan A measures, when the work from home rule will end in the UK has also been announced.

Face masks in Wales

At present, those in Wales still have to wear a face covering by law. This is despite the rule change in England.

First Minister Mark Drakeford has said that a review on Welsh covid restrictions - including face masks - will next take place on 10 February 2022. Despite this, Mr Drakeford shared that he hopes the Welsh people will continue to wear them, whatever the outcome after this date:

"I think there will be lots of people who will choose to go on wearing masks because it gives them confidence that they're keeping themselves safe," he said. "I would certainly consider that myself."

Until this review date, maks remain mandatory:

"Face coverings must be worn in all indoor public places, and public transport, including taxis," reads a statement on the Welsh government website. "You may remove your face covering in the part of the premises for eating or drinking, but only when you are seated to eat or drink. You must replace your face covering when you are no longer seated."

Face masks in Scotland

Scotland will continue to wear face masks in most indoor public spaces. This applies to all individuals aged 12 and over (unless exempt for medical reasons).

The Scottish government website have defined indoor public spaces as:

• Shops, supermarkets and department stores
• Public transport, taxis and hire vehicles
• Bars, cafes, restaurants, nightclubs and takeaways
• hair, beauty and nail salons, tattoo studios
• Churches and other places of worship
• Gyms, leisure centres, swimming pools and indoor fitness studios
• Libraries, museums and galleries
• Casinos, amusement arcades, soft play centres, indoor funfairs, among others

Diners in pubs and restaurants will be able to remove their mask when seated and eating. But will have to put them on again when in communal areas.

Face masks in Northern Ireland

Face masks continue to be mandatory on public transport, in shops and hospitality venues in Northern Ireland. However citizens are not required to wear coverings in gyms and other exercise facilities.

"Generally you must wear a face covering indoors in any premises that are accessible to the public," says the Northern Ireland governement website. "This includes when shopping, in a bank, in a restaurant or cafe unless seated at a table, and in some government buildings. If you are in any doubt, you should wear a face covering."

Those exempt from mandatory face masks in N Ireland include children aged under 13. And anyone who is unable to for medical reasons.

When can we stop wearing masks in schools?

Schoolchildren in secondary schools across England no longer have to wear masks in classrooms or indoor communal areas. The Department of England have confirmed an end to mandatory face coverings, which came into effect on 27 January 2022.

Masks in schools were reintroduced during mid December. When a spike in covid cases due to the spreading of Omicron symptoms led the Prime Minister to introduce Plan B measures.

Face masks in classrooms were the first to be scrapped. With this rule change coming into effect as of 2o January. The Department of Education explained that this move came about "because the national data shows the prevalence of Covid to be on a downward trajectory."

Whilst some have welcomed the move, others have criticised the government's decision:

"No one wants facemasks for any longer than they have to be on," says Mary Bousted, joint general secretary of the National Education Union. "Teachers and pupils much prefer education without facemasks. But I think this is premature — pupils have been back in full-time education for about ten days."

She feels that whilst covid cases are still prevalent, masks should remain in place. And that without them cases could rise again in schools causing "huge disruption".

“This will result in more education disruption which is extremely worrying particularly for pupils taking national exams this year whose education has been so badly disrupted already."

According to the Telegraph, headteachers at over 100 schools in England have written to parents saying that they will keep masks in the classroom until further notice.

An example is Uckfield College in East Sussex, who said they were keeping masks in force "for now" because the "last thing students want at the moment is more staff absence".

The Independent reports that those chosing not to follow the government's new rules will have to gain permission from the Department of Education.

Education secretary Nadhim Zahawi reportedly told regional health chiefs that schools going against new national guidance on face masks would need to consult him.

Elsewhere in the UK, secondary school students in Wales, Scotland and Northern Ireland will continue to wear face masks in schools. Both in the classroom and communal spaces.

Scottish First Minister Nicola Sturgeon asked for patience from pupils in Scottish Parliament this week on the matter:

"I know young people want to see the back of them as soon as possible," she said. "But I also know that many young people understand and agree - especially when cases in the younger age group are rising - that face coverings do provide important protection. So this is a matter that requires and will receive careful consideration."

Should I continue to wear a face mask after the rule changes?

Though face masks will cease to be mandatory after 27 January, the government "recommends" they still be worn in enclosed or crowded spaces. This is because mask-wearing is an effective way of preventing the spread of Covid-19.

The face mask or covering works as a barrier between the wearer’s nose and mouth and the space around them. If they have the infection and wear a mask, they can’t expel any droplets of infection from their respiratory system. This means they can’t transmit the virus onto people, surfaces or into the air when breathing or speaking.

Extensive research has confirmed that masks do work to prevent the spreading of the virus. With one 2021 study concluding that widespread use can reduce community transmission.

"The available evidence suggests that near-universal adoption of nonmedical masks when out in public, in combination with complementary public health measures, could successfully reduce R number (rate of infection) to below 1, thereby reducing community spread if such measures are sustained," said the study's researchers.

The World Health Organisation's advice on masks also advocates for continued wearing:

"Masks are a key measure to suppress transmission and save lives,” guidance on the website reads. "Depending on the type, masks can be for either protection of healthy persons or to prevent onward transmission."

Several health charities in the UK have also asked for face mask use to continue to help protect those medically vulnerable.

"The more people who wear masks and keep their distance in crowded places, the more that immunocompromised people will be able to live normal lives," says Helen Rowntree, director of research, services and engagement for Blood Cancer UK. "We welcome the fact in Scotland, Wales and Northern Ireland, people are still being required to wear masks in shops and other indoor public places.”

Though several agencies advocate for mask use to continue, it's ultimately up to the individual if they want to keep wearing them now they're no longer mandatory.

Face masks and face coverings: know the difference

There is a difference between the words ‘face mask’ and ‘face covering’. The latter is the one the government previously mandated as a must-have for the general public. This is because it’s effective at preventing the spread of Covid-19 by the wearer.

https://www.youtube.com/watch?v=esM_ePHn0aw

It’s simply something that covers your mouth and nose. This could be a scarf, a cloth face mask, a handmade face mask, or a piece of cloth.

A face mask is a surgical-grade mask that’s only required for medical staff.

Where to buy a mask online

You can still buy a mask at many local high-street stores. These include…

• Lloyds Pharmacy: Cloth and disposable face masks/coverings available to buy for adults and children, starting at £4.99.
• Aldi: Packs of three printed cloth face coverings for £3.49.
• Tesco: Pack of 10 disposable facemasks for £5.
• Waitrose: Re-usable masks from designers such as Mulberry. £15 for pack of three (available in store only).
• Next: Packs of three re-useable masks from a variety of brands from £25.
• Halfords: Re-useable face covering, pack of one, for £5.

Face masks are also available to buy online from marketplaces such as Amazon.

Effective masks have at least two layers of fabric. They also completely cover your mouth and nose, have a snug fit against the sides of your face. They also have a nose wire or piece of elastic to prevent hair escaping from the top of the mask.

How to make a face mask

It's possible to make a face mask using simple fabric and everyday materials. To find out how to make your own face mask at home without the need for any sewing, follow our handy online tutorial.

Throughout the pandemic, many people decided to make their own face masks. This is so they are customisable for their own style and comfortable for their own needs.

Will we go back into lockdown again this year? It may be a new year but concern around the new Omicron variant and its high transmissibility has many people wondering about further measures in 2022. 

Despite emerging symptoms of Omicron just before the festive period, Prime Minister Boris Johnson confirmed that there wouldn't be any restrictions over Christmas - even going so far as to say that Christmas parties weren't cancelled. It was a decision that meant a repeat of 2020's last-minute celebration cancellation, when the PM introduced new measures on December 19, could be avoided.

Following this, the pandemic reached new heights in the UK as almost 219,000 people tested positive on January 4, according to the UK Health Security Agency. But with cases now appearing to be levelling off, will the prime minister be putting the country back into lockdown?

Will we go back into lockdown this year?

While we're still in the early days of 2022, the prime minister has confirmed that England won't go back into lockdown for the time being.

Speaking during a recent visit to a vaccination centre, Boris Johnson said that the country was in a "much better position" than last year thanks to the vaccines.

However, following the spike in Omicron cases over Christmas and New Year, he also warned it would be "folly" to think the pandemic was over and said that pressure on hospitals would be "considerable" in the upcoming weeks. For this reason, he kept Plan B restrictions in place following a review on January 5.

Now at the end of January, the Plan B restrictions are reaching their expiry date. If the PM wanted to continue with the measures, which include face masks in all public spaces and working from home guidance, he would have to pass them through Parliament again.

Boris Johnson has announced that he will not be continuing the restrictions and will commence with Plan A from January 20. This suggests above all that there is no plan to put England back into lockdown at the moment.

Moving from Plan B to Plan A measures includes:

• An end to the work from home rule in the UK - with advice that people speak to their employer about returning to the office.
• Pupils don't have to wear face masks in the classroom
• People can stop wearing face masks in indoor public spaces
• An end to mandatory Covid passes for some venues in England
• Easing of care home restrictions

It comes as the most recent data shows the number of people with Covid-19 has fallen in England significantly since the beginning of the Omicron wave. According to the Office for National Statistics (ONS), around 3.5 million people in the UK tested positive for coronavirus in the week ending January 15. While still significant, this is much less than the 4.3 million who tested positive the week before.

This now works out to be roughly one in 20 people infected with the virus or an estimated 5.3% of the population.

Boris Johnson has previously warned, however, that people should be "sensible" about their social interactions and take a lateral flow test before meeting people they don't normally see. This is especially important, health experts suggest, as the symptoms of Omicron resemble more of a common cold than previous strains. He also added that getting a first, second or a booster jab was imperative to stay safe.

"We've got to remain cautious, we've got to stick with plan B, we've got to get boosted," the prime minister said.

While many believed we were set for another Covid-themed Christmas, with restrictions limiting gatherings of family and friends, the prime minister opted for a "normality" of sorts with Plan B.

"The situation remains extremely difficult, but I also recognise that people have been waiting to hear about whether their Christmas plans, your Christmas plans, are going to be affected," he said at the time.

"What I can say tonight is that naturally we can't rule out any further measures after Christmas, and we're going to keep a constant eye on the date - we will do whatever it takes to protect public health.

"But, in the view of the continuing uncertainty about several things - the severity of Omicron, the uncertainty about the hospitalisation rates or the impact of the vaccine rollout and the boosters - we don't think today that there is enough evidence to justify any tougher measures before Christmas."

This announcement came just days before the Health Security Agency (UKHSA) announced that the rules on when you can come out of Covid isolation have changed in England. Those who tested negative on day six and seven of their quarantine didn't have to isolate for the full 10 days. This has now, at the time of writing, been reduced to five days in isolation following a negative test on day five and six.

Both the health secretary and the prime minister have encouraged people to take up their booster jab when it is available to them, saying it was "more vital than ever". The jab is now available to anyone over 16 years old, following updated guidance from the Joint Committee on Vaccinations and Immunisations (JCVI).

Health officials have also urged people to continue taking tests for the virus, which are now available again after a temporary shortage in December. Lateral flow tests can be false positive, however, this is highly unlikely to be the case according to new research. So, anyone without symptoms should also use these to test where possible.

The change in the rules came around the same time that reports emerged of gatherings taking place at 10 Downing Street over lockdown. Now being investigated by Sue Gray, who is a senior civil servant, the inquiry is expected to conclude in the coming weeks.

But while it looks like England won't be going back into lockdown at the moment, experts have wanted that a tighter clampdown could be on the way if people don't take to the measures.

Professor Greg Towers, Division of Infection and Immunity at University College London, said that if people treat the pandemic like "it's all over" then there will be higher infection rates - and more chance of a lockdown.

He told Times Radio, "If we don't wear masks and if we ignore social distancing rules, and if we pretend it's all over, then what's going to happen is we'll get another big wave of infection and we'll get put into lockdown again. So, if we don't want lockdown, we've got to try and stop the spread by easier means like mask-wearing and social distancing."

Plan A and B were announced earlier in the summer by the government as the way the country would handle Covid-19 in the winter.

Plan A prevented the NHS from experiencing serious pressure through vaccines for more age groups and more testing. As part of the plan, Track and Trace continued and the government encouraged businesses to consider using the NHS Covid Pass to check whether customers had a double vaccination.

Plan B was put into place by officials as they believed the NHS was coming under "unsustainable pressure" due to the Omicron variant over winter last year.

Earlier in October, following a rise to up to 40,000 cases for eight days in a row, doctors from The British Medical Association said ministers should begin their Plan B. They also accused the government of being "wilfully negligent" for refusing to reimpose Covid rules, such as compulsory face masks, before this date.

However, Health Minister Edward Argar said at the time that the NHS was not under the "unsustainable pressure" required to justify new restrictions. "We know how those numbers can rise swiftly, which is why we're looking at that day by day, hour by hour," he said. "But at the moment we do have the ability to manage."

On announcing the end of lockdown earlier this year, Prime Minister Boris Johnson suggested that when the measures did lift, it would be "irreversible". But there would also be "trade offs" involved.

He said, "We can begin safely to restart our lives and do it with confidence. But I want to be frank about exactly what that means and the trade-offs involved. The vaccines reduce the danger of Covid: they save lives and they keep people out of hospital.

"But no vaccine against any disease has ever been 100 per cent effective," he continued. "So whenever we ease the lockdown, whether it is today or in six or nine months, we’ve got to be realistic and accept that there will be more infections, more hospitalisations and therefore – sadly - more deaths, just as there are every year with flu. Even if we sustained the lockdown indefinitely, which would itself cost lives and do immeasurable harm to our children, we would not be able to eradicate this disease."

"And that is why it is so crucial that this roadmap should be cautious but also irreversible. We are setting out on what I hope and believe is a one way road to freedom."

Even when the government delayed the end of lockdown on June 21 2021 by four weeks, the message stayed the same. The prime minister continued to stress that England's approach was "cautious but irreversible". He also repeatedly referred to July 19 as the "terminus date" for restrictions. Following this, the public dubbed July 19 as "Freedom Day".

Health Secretary Sajid Javid also said earlier in the summer that there would be no further lockdowns after July 19. He told news outlets that he wanted the restrictions to lift "as quickly as possible". He added it was "going to be irreversible, there's no going back. That's why we want to be careful during that process."

On July 5, however, the PM did reveal that the government would keep some "contingency measures" in place. These would be "to help manage the virus during higher risk periods, such as the winter".

He said, "We will place emphasis on strengthened guidance and do everything possible to avoid reimposing restrictions with all the costs that they bring."

Announcing plans for how the country would "live with Covid", the government said that they intended to:

• Reduce the vaccine dose interval for under 40s from 12 weeks to 8
• Move away from legal restrictions to allow people to make their own decisions about managing the virus
• Continue with a "proportionate" test, trace and isolate system
• Maintain tough border controls (with the requirement to prove a double vaccination before travel)

In late July, experts were still cautioning the public that the situation could worsen in the winter. They didn't confirm whether we will go back into lockdown this year but said that if cases do rise substantially, the government may have no choice but to enforce restrictions.

Is Scotland going back into lockdown?

No, the most recent restrictions in Scotland came to an end on January 17 2022.

Previously, only 100 people could attend indoor standing events, with up to 200 people at indoor seated events and up to 500 people - either seated or standing - at outdoor events. This restriction is no longer in place in Scotland as of January 17.

Then from January 24, all rules on indoor events and venues will be lifted - including the need for table service in hospitality locations. Nightclubs will also be able to open from this date.

The change to the rules before the new year meant that various larger scale Hogmanay events were cancelled.

First Minister Nicola Sturgeon said that over the first week of January, everyone should "stay at home right now more than normal" and reduce social contact with people from outside of their household.

"The new protective measures relating to hospitality, public indoor places and live events that I set out last week are now in force," she said.

"We will review these on an ongoing basis - however, at this stage, our expectation is that they will be in force until 17 January.

Some social distancing measures were also re-introduced before Christmas, with Deputy First Minister John Swinney urging people to take "the greatest of care" when mixing households.

This included the guidance to only mix in groups of up to three households at a time and social distancing measures for shops and hospitality venues.

"We hope that we have done enough in the announcements that were made yesterday and we hope that members of the public and businesses will work with us in a cooperative spirit to make sure that we can take these provisions forward," Mr Swinney told Good Morning Scotland at the time.

Nicola Sturgeon had previously warned that she was prepared to enforce Covid restrictions in Scotland where necessary.

Speaking about the new restrictions, she said,  "Even if you feel angry with a politician just now, please remember just how important compliance is for the health and safety of you, your loved ones and the country."

Scotland was also the first to float the idea of a circuit breaker lockdown over the end of the summer. It was a potential option to stem the rise in cases before kids went back to school for the new year. However, it didn't happen and Scotland have retained their Level Zero Covid status since restrictions were lifted in August.

However, the FM used the SNP Conference in November - which occurred just hours after the diagnosis of the Omicron variant in Scotland - to double down on the fight against the virus.

"In recent weeks, we have had much in Scotland to feel thankful for. Compared to many countries across Europe, Covid cases here have been stable - indeed they have been declining slightly. To be frank, that’s a much better position that I had dared hope for a couple of months ago."

But she said, "There are big and very real challenges ahead over the winter months. Cases are rising in countries all around us. We know that colder weather, forcing us indoors, coupled with festive socialising will create increased opportunities for the virus to spread. And, most seriously of all, the Omicron variant is causing profound concern here and across the world.

"So we must not drop our guard. This is a time to be more vigilant, not less."

Ms Sturgeon said that a number of countries had been added to Scotland's travel red list and anyone arriving from these places must now go into a managed quarantine facility. Travellers also have to isolate until they get a negative result from the PCR test that they do on day 2 of their arrival, regardless of where they've come from.

"We are also asking close contact of any confirmed cases of Omicron to isolate," she said, " That none of this was even contemplated just a few days ago, is a reminder of how fast this virus can move and change. We must, all of us, therefore redouble our efforts to stop it in its tracks."

However, other ministers have previously noted that there would be issues with financially supporting another lockdown in Scotland. Finance Secretary Kate Forbes claimed earlier this year that the country doesn't have the money for further intense restrictions and would only be able to enforce them if the UK government was willing to fund a complete shutdown.

Ms Forbes said that there wouldn't be any money available for furlough if Scotland was forced to go into lockdown again, leaving people unable to work without financial aid.

Speaking a Holyrood's Finance Committee, she said, "One of the biggest challenges right now from a financial perspective is the fact that there hasn’t been that much additional consequential funding from the UK Government in the last few months.

"Right now we are trying to remobilise the health service, remobilise the justice system, remobilise a whole host of different public services, as well as deal with the ongoing covid impact from a budget that has not been supplemented by additional consequentials coming from the UK Government in the way that it was last year.

"That’s not what we’re discussing at the moment. We’re talking about trying to maximise the impact of the baseline measures. But if we were to, then we have no certainty that furlough will be in place. We have no certainty that self employed income support will be in place. And I have no certainty that there will be any additional funding in place.

She added, "I am not sitting on funds right now that I could deploy to support businesses. We would need additional help from the UK Government."

Is Wales going back into lockdown?

First Minister Mark Drakeford warned that some of the scrapped Covid-19 restrictions could come back and similarly to Scotland, enforced new measures before Christmas.

However, Mr Drakeford has now set out a plan for Wales to return to alert level zero on January 28 if cases continue to fall as they are.

The measures, put into place on Boxing Day 2021, included advice to limit social contact with others outside of the household - especially if seeing older or more vulnerable people. There were also changes so it is an offence to not work from home if you're able to. Only groups of up to 6 people are allowed to gather in hospitality venues with the requirement for table service, compulsory face masks and contact tracing in place.

Nightclubs also closed from December 27.

Anyone going to the cinema, theatre, or a concert in Wales from November 15 has to prove a double vaccination with a Covid pass. Pubs, cafes and restaurants also may require the passes as well.

Will Northern Ireland have another lockdown?

Northern Ireland has had one of the slower journeys out of lockdown in the UK. After only reopening nightclubs on October 31, executive ministers have reinforced some restrictions.

These included closing nightclubs again on December 26 and banning all indoor standing events. There also also now restrictions on hospitality venues and pubs, cafes and restaurants must provide table service only. Similar to Wales, only six people are allowed to sit together at a table - but this rule does not allow to wedding celebrations.

Proof of a double Covid vaccine is also required to gain access to some hospitality premises and indoor settings. But this rule has been in place in Northern Ireland since December 13.

In mid-November 2021, infection rates in Northern Ireland were the highest in the UK - above Wales.

While working from home is not compulsory in England, Health Minister Robin Swann said he believes anyone in Northern Ireland who was working from home during the height of the pandemic last year should do so again.

The rules on face masks were never dropped in Northern Ireland either. They remain mandatory on public transport, in shops and in all indoor attractions unless you are exempt.

Following a change in the guidance, the number of people who can get the Covid booster jab has dramatically increased again.

While initially only available to those over 50-years-old, a decision to widen the booster programme was made following data which showed that two doses of the Pfizer, Oxford or Moderna vaccine were not enough to stop people becoming unwell. The study, published by the UK Health Security Agency, suggests that a booster is necessary to maintain protection against the virus, preventing 3 in 4 people from developing any symptoms.

Anyone over the age of 18 became eligible for a jab late last year, after the emergence of new Omicron symptoms, but now another age group is being invited to have their booster jabs.

Who can get the Covid booster jab?

Those eligible for a third dose of the vaccine are:

• All adults (those over 18) living in the UK
• All teenagers aged between 16 and 17 years old

Those between 16 and 17 can book their booster jabs or go to a walk-in site from Monday January 17, NHS England has said. The NHS will send an invite to around 40,000 teens who had their second vaccine dose at least three months ago.

Appointments have been available for this younger age group since August last year but the Joint Committee on Vaccination and Immunisation (JCVI) only recommended that 16 and 17-year-olds who were clinically vulnerable have the vaccine at this time. Now, it's open to anyone aged 16 or over.

However, the wait time between the second and third dose of the jab remains at three months.

Children aged between 12 and 15 can also now have a second dose of the vaccine, with the NHS also making appointments now. While anyone who is immunosuppressed can have a fourth jab as well as the booster.

Anyone eligible for a booster jab will have either the Pfizer vaccine or a half-dose of the Moderna vaccine.

Deputy Chief Medical Officer Professor Jonathan Van Tam urged people to take up their booster jab in December. Following the arrival of the new variant, he said it "has never been more vital than at this point in time."

"We are asking everyone to play their part in the urgency now of the booster programme."

The urgency came as data from the UK Health Security Agency found that two weeks after receiving a booster dose of the vaccine, protection against symptomatic infections in adults 50 years and over who had the Oxford vaccine was at 93.1%. For those who had the Pfizer vaccine, protection levels were a little higher at 94%.

Professor Van Tam also reassured the public that the situation wasn't all "doom and gloom" quite yet. "I want to be clear that this is not all doom and gloom at this stage. I do not want people to panic at this stage," he said.

"If vaccine effectiveness is reduced as seems pretty likely to some extent, the biggest effects are likely to be in preventing infections. And hopefully there will be smaller effects on preventing severe disease.

"But that is something that is there for scientists to work out in the next few weeks."

Health Secretary Sajid Javid also confirmed that the country was not going back into lockdown this year - at least for the moment as the government was enabling Plan A restrictions. This means that face masks are no longer compulsory in many public indoor spaces and the work from home rule has ended.

Can I have the booster vaccine with a cold?

If you have a cold, you should not go to your vaccine appointment. According to guidance from the UK Health Security Agency, it's better to wait and have your vaccine at a later date if you feel unwell before your appointment.

But if you just have a mild cold, and have a negative Covid-19 test, you should go to your vaccine appointment.

If you do test positive for Covid-19, you have to wait four weeks (28 days) before getting your booster jab. This time starts from the day you had symptoms or the day of the positive test if you were asymptomatic.

It is vital that you rebook the jab after your recovery time as although there is evidence that having the virus can boost immunity, the extent of this is not fully understood.

Following updated guidance from the UKHSA, the self isolation rules have changed for England. Now, those who test negative on day five and six don't have to quarantine for the full 10-day period.

Which vaccine will they use?

Most people will have the Pfizer vaccine or the Moderna vaccine, the NHS says.

Some people might have a booster dose from the Oxford vaccine. However, this will only be in cases where they cannot have the other two jabs.

If the booster dose is a different vaccine from the first and second one, that's completely normal.

How long will it take for the booster to be effective?

It takes one to two weeks for the booster jab to be effective, according to recent studies.

A new trial by Pfizer found that from seven days onwards, a booster Pfizer jab is very effective at preventing symptomatic illness from Covid-19.

Another study, the first real-world research on the booster, looked at the Pfizer vaccine as well. They found that those who had the Pfizer booster were 10 times less likely to be infectious with the virus. And they were also nearly 18 times less likely to suffer with a severe infection.

They only began to measure protection levels against illness from two weeks after the booster. But, they found that protection levels were at a great level after this inoculation period.

Experts have also backed up the two-week theory. Dr Dan Barouch is the director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center. He told ABC News that the body begins to increase its antibodies against the virus within a few days. However, the best response happens after a fortnight.

He said, "There is a meaningful increase in antibody titers by one week. And peak responses at two weeks following mRNA boosting."

This is one of the reasons why health officials have continued to urge people to test for Covid-19. While lateral flow tests can be false positive or negative, this is not very likely according to new data. So, the government has urged those without symptoms to use the LFT for testing over the festive season.

There haven't been any trials of a similar scale looking at the Moderna vaccine. This is the other jab in the UK's booster programme. However, we know that the vaccines work in similar ways so the results are likely to be comparable.

Known colloquially as the winter blues, if you're feeling so down that it's affecting your work and relationships you may be suffering from seasonal affective disorder (SAD). We've asked the experts how you can cope.

It's common to experience low mood and fatigue in the colder months, as the days are shorter and the sunlight is more limited. The change leaves many searching for ways to cope with the dark mornings on the school run and beat the January blues, but for some the symptoms of seasonal affective disorder can have a greater impact on their day-to-day life. Those who suffer the most may experience feelings of despair, a lack of motivation and symptoms of anxiety.

Consultant psychiatrist Dr Natasha Bijlani explains, "It's well recognised that SAD may be related to changes in the amount of daylight during autumn and winter months, which can affect the levels of serotonin and melatonin in the brain that influence mood. In those susceptible to SAD, not being exposed to sufficient light – on dull winter days – can lead to the development of the symptoms of SAD."

If this sounds like you, rest assured you're not alone - the NHS estimates that SAD affects around 2 million people in the UK. We've spoken to Dr Bijlani and other experts to find out what causes it, what the symptoms are and natural treatments you can try to help beat the winter blues and cope with the symptoms of SAD.

What are the winter blues?

Seasonal affective disorder (SAD) is a type of depression that comes and goes in a seasonal pattern. The symptoms are usually more apparent and more severe during the winter, but some may have symptoms during the summer and feel better during the winter.

"SAD is a recognised mental disorder and classified as such," says Dr Shungu Hilda M'gadzah, director and lead consultant psychologist at Inclusion Psychologists. "Many people have SAD - especially the 18-30 age group. Women are four times more likely to get it than men and children can get it, too," she adds.

Figures vary but "SAD may affect up to 9% of the British population to some degree," adds Dr Bijlani. "Millions may suffer and many may not know they have the condition," she says. "It's more common in those living further north, where there are shorter daylight hours in the winter."

While these statistics sound alarming, most cases are mild. "For many, it really isn’t anything to worry about," adds Dr M'gadzah. "A few changes and adjustments to your daily routine can make all the difference."

Seasonal affective disorder symptoms

• Feeling low and depressed
• Feeling excessively tired during the day and needing to sleep for longer
• Having difficulty waking up in the morning despite having more sleep
• Social withdrawal and loss of pleasure and interests
• Loss of libido
• Feelings of anxiety, as well as irritability, tension and stress and anxiety
• Carbohydrate cravings, waking up in the night to eat, and weight gain
• Feelings of despair, guilt and worthlessness

11 natural ways to deal with winter blues

1. Use a light box

A study in the The Einstein Journal of Biology and Medicine showed that – especially for those of us living in the northern hemisphere – replacing the light we are deprived of in winter can have a positive effect on seasonal affective disorder. This is done by using a special light box such as a Lumie SAD Light, which mimics natural daylight to deliver a natural mood and energy boost.

Dr Bijlani told us, "People with SAD sometimes need four hours a day of special bright light at 10 times the intensity of ordinary lighting. It's a simple treatment. When it's used regularly throughout the winter months it can take away the worst of the feelings."

Another study published in the journal PLOS Genetics showed that using a light box can have a positive effect on the circadian rhythm (our sleep-wake cycle). "The light emitted from a SAD light box can help to regulate your natural circadian rhythm, thus helping to improve energy and mood," explains Dr Naomi Newman-Beinart, a nutritionist and chartered psychologist.

If you're prone to the winter blues, however, don't wait until you're feeling down to give this remedy a go. "I suggest starting to use the light box in autumn as a prevention and to continue until spring," Dr Newman-Beinart says.

Guidance for buying light boxes can be found on the SADA website.

• View Lumie Vitamin L Slim SAD Light - £70.54 | John Lewis

2. Talk about your feelings

If you're feeling low, an important thing to remeber is that you're not a burden to others. Keep in mind that a problem shared is a problem halved.

"Open up to someone you trust about how you’re feeling," says Liz Joy Oakley, a yoga instructor and head of wellness at MoreYoga. "Sharing what you’re experiencing can help take the weight off your shoulders and help you to get the support that you need."

In fact, talking may be a better cure than light therapy. A 2015 study published in the American Journal of Psychiatry found that, in the long-term, cognitive behaviour therapy (CBT) was even more effective at treating seasonal affective disorder than using the light method – so don't be afraid to reach out.

"Psychological treatment focusing around cognitive behaviour therapy – a talking therapy – can be helpful," says Dr Bijlani.

If you think CBT might be a good option, you can find a therapist on the British Association for Behavioural and Cognitive Psychotherapies (BABCP) website, or you can go through your GP. It doesn’t work for everyone, though, so if it’s not for you don’t be disheartened – there are other ways to manage low mood.

3. Step into the light

If you're prone to the winter blues, daylight can significantly improve your mood. Even on cloudy days, it's worth getting outside to enjoy some fresh air - try to take a walk around midday, when the sun is at its strongest.

You can also find ways to get more light even while you're still inside - whether you're working from the office or looking after the kids. "For some people with mild symptoms, these can be alleviated by working in more brightly lit areas. And keep blinds wide open during the day," says Dr Bijlani.

The south side of houses and buildings in the northern hemisphere see the most hours of sunlight each day, so keep this in mind next time you're choosing where to set up for the day.

4. Embrace the outdoors

Nature really does have the power to heal and one way of harnessing this is to practise a Scandinavian way of living called 'friluftsliv'. Translated as 'open-air living', friluftsliv can make a huge difference to your mental health all year round.

"Countless studies have shown that engaging in outdoor activities during the winter months is 99.9% effective in reducing the symptoms of SAD," says Oliver Luke Delori, author of The Nordic Art of Friluftsliv: Reconnect with Nature.

"Why not go for a walk, climb a mountain (and slide back down) or simply put on your boots and jump in a puddle? Give yourself a breath of fresh air by gazing up at the stars or singing in the rain. I promise you will forget about your problems for a while and feel much better about your life," he says.

And Oliver is definitely onto something, because a study in the Landscape and Urban Planning journal found that participants who went on a 50-minute walk in a natural setting reported decreased anxiety and improved cognition.

5. Take certain supplements

"Unlike real sunlight, a lightbox will not give you vitamin D, so I highly recommend that everyone takes a high-quality multivitamin and mineral complex including vitamin D throughout winter," says Dr Newman-Beinart. She points out that there are numerous studies suggesting that vitamin D deficiency is linked to depression.

Nutritionist Alexandra Emerson-White adds, "Even with sun exposure, in the UK sunlight doesn’t contain enough UVB radiation between October and March for our skin to make vitamin D." A daily supplement containing vitamin D can make up for this.

• View Holland & Barrett Vitamin D - £5.49

There's also some encouraging research that indicates taking a melatonin supplement can ease symptoms. Melatonin is a hormon used to treat sleep problems and one 2006 study from Oregon Health and Science University found that a melatonin supplement relieved the symptoms of the winter blues. However, it's only available on prescription in the UK as it can have unwanted side effects and interact with other medications. You should also bear in mind that melatonin is not usually recommended during pregnancy because little is known about its effect on babies.

6. Eat a balanced diet

A balanced diet is important in maintaining pretty much every aspect of our physical and mental health. But it's even more integral to your wellbeing if you're suffering from seasonal affective disorder. As well as consuming plenty of fresh fruit, veg and protein, consider cutting down on or giving up alcohol, fast processed food and fizzy drinks.

"Supplements alone cannot prevent seasonal affective disorder," says Alexandra."However, getting an optimal intake of nutrients such as vitamins B & D, and omega-3 fatty acids may help reduce symptoms. These nutrient deficiencies are associated with mood disorders."

Get your fill of omega-3 by eating fatty fish such as salmon, sardines, tuna and trout. Or eat nuts and seeds such as walnuts, chia and flaxseeds.

Green leafy vegetables also contain some omega-3 and you can also buy eggs fortified with this fatty acid. If you're a veggie or vegan and you're concerned about your omega-3 intake, you can take a supplement made from algae instead.

• View Holland & Barrett Vegan Omega 3 Oil 60 capsules - £15.99

7. Don't live in isolation

You may feel like going back to bed or not answering messages from friends and family when you're suffering from seasonal affective disorder, but keeping in touch with your loved ones is a big part of staying well.

"If we’ve learnt anything from over the past few years, it’s the importance of connection and the negative impact isolation can have on our health," says Liz Joy Oakley. If you've been feeling low, schedule a phone call with someone you trust and explain that you're feeling a bit wobbly, or go for a coffee or a walk with a friend, even if you don't feel up to it.

A 2022 study published in the scientific journal PLOS One found a strong association between a lack of social connectedness and the risk of depression, further highlighting the importance of not isolating yourself if you're struggling with low mood.

8. Get your sleep in order

Being excessively sleepy during the day, struggling to get up in the morning, and sleeping longer than you usually do are symptoms of depression and SAD.

"It’s recommended that adults from the age of 18-64 need 7-9 hours sleep and 65+ need 7-8 hours," says Liz. "Getting too much or a lack of sleep can negatively impact your mental and physical health, so it’s important to make sure you are sticking to a healthy sleeping pattern when the days are shorter and nights are longer."

Of course, a regular sleep pattern is not something many parents have control over. Trying to fit in life and raising kids doesn't equal eight hours of solid sleep a night, but the good news for mums and dads who are woken by their kids at the crack of dawn is that this could actually be a good thing when it comes to beating the winter blues.

This is because a 2021 study in the JAMA Psychiatry journal found that getting up an hour earlier than you usually do can cut a person's risk of major depression by up to 23%.

Another top tip for improving your sleep is turning off your phone an hour before you intend on turning in for the night.

9. Invest in some CBD oil

Sales of CBD oil have exploded in recent years, as more people turn to natural anxiety remedies to manage stress or low mood.

"Another natural solution to support SAD symptoms could come from CBD oil," Dr Newman-Beinart explains. "This wonder oil has recently made it to the forefront of popular wellness. It can help with anxiety, stress and poor sleep, some of which you may be feeling as part of SAD."

10. Take up yoga

While longer nights coupled with a low mood can also affect our energy levels and make us feel lethargic, yoga will not only help your body but your mind, says instructor Liz.

"A quick remedy is movement and yoga has so many benefits mentally and physically. It's a natural way to increase serotonin production and support your nervous system," she says.

In fact, one scientific review found a multitude of mental health benefits associated with practising yoga. Not only did individuals with elevated depression levels benefit from yoga, but depression symptoms also improved among caregivers, pregnant women and patients suffering from lower back pain too.

If you can't face going to a class, try an online session from the comfort of your own home. You can try one for free with a number of fitness apps, including Nike Training Club, Simply Yoga, Grokker and 5 Minute Yoga.

11. Go for regular exercise

You don't have to spend hours at the gym or do gruelling workouts to lift your mood. Even short bursts of cardio (such as a quick cycle or even just running up the stairs) can make a difference – as can a short run. Recent research from the University of Tsukuba in Japan indicates that even a 10-minute run of moderate-intensity can improve mood and cognitive function.

"Exercising produces endorphins in the brain, which stimulate feelings of happiness. Take a walk at lunchtime, play a sport or be active in a way you enjoy," advises Dr Bijlani.

Once again, apps like Nike Training Club can help you find a type of movement you enjoy - whether you're after a 10-minute stretch that can be completed in front of the TV, or a 30-minute strength workout for your next gym session.

When to see a doctor

If you think you might have SAD and are struggling to cope, you should make an appointment to see your GP. Your doctor might give you a diagnosis of SAD if there is a seasonal pattern, but if not they can still help with symptoms of depression and anxiety.

"There are several ways to treat SAD. If you think you have SAD, it’s important to speak to your GP and find a treatment that's right for you," says Dr Newman-Beinart. "You're likely to be told to get as much natural daylight as possible, or to try talking therapies."

However, if those remedies don't help medication is available, such as such as selective serotonin reuptake inhibitors (SSRIs), which are often used to treat depression.

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Pregnancy is one common cause, but there are many other reasons why you might feel sick in the morning.

By now, you've probably already considered (and Googled) all the reasons why you might be feeling unwell when you wake up - and often the answer that will come back will tell you that it's the start of morning sickness, one of the early signs of pregnancy. But what if you're not pregnant? Much like feeling sick after sex, there are varied causes of morning nausea, from anxiety and dehydration to low blood sugar or hormones.

Dr Deborah Lee from Dr Fox Online Pharmacy says, "Most of us have felt nauseated from time to time, and feeling sick, specifically in the morning, is not uncommon. In general, the best way to get rid of morning nausea is to identify and treat the underlying cause."

If you're struggling with feeling queasy when you wake up but don't know why, take a look below. We've asked the experts why you might feel sick in the morning and what you can do to stop it.

Why do I feel sick in the morning?

1. Fatigue

A lack of sleep wreaks havoc with our circadian rhythm, leading to exhaustion that can make you feel sick in the morning. Not having enough sleep can also make us feel grumpy, irritable and unable to focus on everyday tasks. 

This is because being sleep-deprived can lead to hormonal imbalance as well as inflammation of the intestines. In fact, one study in the Journal of Gastroenterology and Hepatology found a strong association between sleep disturbances and gastrointestinal diseases, as well as pro-inflammatory proteins linked to the immune system - which could be the source of nausea.

How to fix it: The first step to sleeping better is to fix your sleep schedule. Rob Hobson, author of The Art of Sleeping, advises, "Commit to a set wake-up time then work backwards to establish the time at which you need to go to sleep. If your goal is 7.5 hours’ sleep in total, and you aim to wake up at 6.30am, you should be looking to fall asleep at 11pm. A sleep starting point between 9.30pm and 11pm works in sync with the natural flow of your circadian rhythm."

Another top tip is to resist hitting the snooze button when your alarm goes off - even though it's tempting. "Falling asleep again will leave you feeling groggy and nauseous because you put your body and brain out of sync with their natural rhythm," Rob adds.

2. Anxiety

Feeling sick in the morning can also boil down to a symptom of anxiety. Dr Deborah Lee explains, "When you wake in the morning, your brain is immediately bombarded with all the issues of the day. This jolts you into reality and may mean anxiety symptoms are at their worst, first thing."

This anxiety can often be made worse by other factors, such as hormonal changes. According to Anxiety UK, around 98% of women feel anxious during menopause, due to oestrogen and progesterone fluctuations and changes in cortisol levels.

How to fix it: You could try some natural anxiety remedies, such as listening to relaxing music, diffusing lavender essential oil in your bedroom, or trying some breathing exercises. 

3. Low blood sugar

You may experience feelings of sickness if your blood sugar level – known as glucose level - is too low. This is called hypoglycaemia and happens when the body doesn’t have enough glucose to create energy. It mainly affects people with diabetes, especially if they take insulin, though people without diabetes can also experience hypoglycaemia due to alcohol or fasting.

How to fix it: To boost your blood sugar level when you wake, have something to hand in the kitchen while you make that first-morning cup of coffee or tea. Dietician Sophie Medlin says, "Ideally you want something that’s going to bring your blood sugars up a little bit and also maintain them there. So a savoury carbohydrate type snack would be the best thing to have."

If you have other symptoms of hypoglycaemia such as fatigue, headaches, and dizziness, see your GP. This could be a sign of another health problem such as diabetes and a professional will be able to give you more comprehensive advice.

4. Dehydration

Headaches, tiredness, and waking up feeling sick can all be attributed to dehydration. It's the body's way of letting us know how much water to drink, and that we are losing more fluids than we're taking in and we need to re-balance the scales.

Dehydration, nausea, and vomiting actually go hand-in-hand, says Aisling Moran, Nutritional Scientist at Thriva.co.uk. "Vomiting often causes dehydration because your body is losing fluids, so it can be a vicious cycle that nobody wants to experience."

How to fix it: "Drinking enough water, particularly if you’ve spent a lot of time in the sun or excised very vigorously will help prevent this," Aisling says. "You might find it hard to drink fluids if you’re feeling sick, so starting with little sips can help."

It is recommended you drink eight 8-ounce glasses, which is about 2 litres a day (also known as the 8×8 rule). If you try and stick to this, you may feel less nauseous in the morning.

5. Hormone imbalance

Dr Deborah Lee explains that cortisol levels can also be a cause of morning nausea, because cortisol levels peak in the morning.

She says, "Cortisol is a stress hormone, which is elevated in the 'fight, fright and flight' response. We sometimes say we feel ‘sick with fear’ – this is because the sudden activation of the sympathetic nervous system means the body is focussing on preparing to flee from danger, and switches off any relatively unnecessary function at this moment  - such as digestion."

How to fix it: Claire Barnes, Technical Advisor and Nutritional Therapist at Bio-Kult says the best way to fix this hormone imbalance is to eat set meals at the same time every day and stick to a good sleeping routine. "Sticking to a routine of falling asleep at the same time each night and waking at the same time each morning can also help to keep our hormones and metabolism in balance."

She adds, "Importantly, avoid eating late into the evening, and stop eating and drinking anything other than water or herbal teas at least 2 hours before going to bed."

6. Hangover

As you probably already know, feeling sick in the morning is a common hangover symptom. Dr Lee explains, "Alcohol causes gastritis - inflammation in the stomach wall. It stimulates the production of stomach acids and delays gastric emptying."

This can cause abdominal pain, nausea, or vomiting. Alcohol can also cause your blood sugar to fall, and as we already know this can also be a cause of morning nausea. Knowing how to prevent a hangover is key to making sure you feel fresh after a few drinks the night before.

How to fix it: Sleep and hydration will make you feel better, but there’s no ‘quick fix’ when it comes to how to cure a hangover. You can avoid them by giving up alcohol, or pacing yourself when you drink, and reducing the amount you drink in a session. You can also alternate water with alcoholic drinks. If you find yourself suffering regularly, it's worth looking at the benefits of giving up alcohol for good.

7. Acid reflux

Is heartburn making you feel sick in the morning? Acid reflux can cause a burning sensation in the chest, a sour taste in the mouth, burping, and a feeling of nausea.

Claire Barnes told us, "Whilst many believe excess stomach acid leads to heartburn, latest theories now suggest the symptoms may actually be associated with low levels of stomach acid."

She adds, "Our stomach acid is our first line of defence against harmful microbes entering the intestines, therefore low stomach acid could potentially lead to bacterial overgrowth and a decreased absorption of important nutrients, such as B vitamins, folate, iron, magnesium, calcium and zinc. As deficiencies of these nutrients could lead to changes in hormone and neurotransmitter production in the body, this can again link back to hormonal imbalances leading to stress, anxiety and feelings of nausea."

How to fix it: Avoid eating too close to bedtime and spend some time upright after meals to prevent stomach acids from rising. In addition, sleeping with your head and upper chest elevated can also help reduce symptoms in the morning and antacid tablets can also neutralise stomach acids.

8. Pregnancy

If you often experience nausea in the morning, it might be worth taking home pregnancy test. Feeling sick in the morning – with or without vomiting – could be a key sign of pregnancy, as the National Childbirth Trust reports that around 9 in 10 women experience morning sickness, which tends to start between weeks 4 and 9 of pregnancy.

How to fix it: Dr Deborah Lee told us, "It’s not known why sickness during pregnancy is worse in the mornings. Experts have suggested that it may be due to low blood sugar from not eating overnight and to the extra demands on the mother’s body exerted by the placenta." She advised eating the following foods and drinks to help ease symptoms:

• Anything containing ginger, including ginger biscuits, ginger tea and ginger beer.
• Fizzy drinks, especially lemonade.
• Dry crackers.

9. Inner ear infection

If you're experiencing dizziness and loss of balance alongside morning nausea, it could be due to Labyrinthitis.

This inner ear condition is caused by inflammation of the nerve that sends balance information to the brain and is usually triggered by a virus such as a cold or flu, or, more rarely, a bacterial infection.

Dr Lee explains, "The ear is closely involved in helping with balance and proprioception. When any part of the ear is inflamed, this upsets the natural equilibrium of the ear. Vertigo is often linked to nausea and vomiting and may be triggered by head movements, such as waking up and lifting the head off the pillow."

How to fix it: An anti-sickness drug keeps the nausea at bay for two to three days and, once that works, you’ll be encouraged to get up and about rather than stay in bed. 

But Dr Lee adds, "The most important thing is obtaining an accurate diagnosis, so the correct treatment for the ear infection can be given. An outer ear infection is treated with ear drops containing antibiotics and steroids, whereas a middle ear infection is treated with oral antibiotics."

10. Contraceptive pill

Dr Deborah Lee told us, "Nausea is a common side effect of the Combined Contraceptive Pill. The hormone estrogen is frequently thought to be the culprit. Many women take their pill first thing when they wake up in the morning, resulting in them feeling sick soon after taking it."

How to fix it: Dr Lee advises changing the time of day you take your contraceptive pill if you take it in the morning and often feel nauseous afterwards. However, she adds that the nausea will likely settle with time as the body gets used to the pill. "If nausea doesn’t settle, your doctor will usually recommend a combined pill with a lower dose of estrogen," she says.

11. Premenstrual symptoms

If you often experience nausea in the mornings leading up to your period, this is completely normal. This is related to hormonal changes, and you also may experience headaches and fatigue. According to the Office on Women's Health, 90% of menstruating women experience at least one or more premenstrual symptom.

How to fix it: Dr Lee says, "Treatment includes the use of nonsteroidal anti-inflammatories (NSAIDs) such as ibuprofen, naproxen and diclofenac, all of which have anti-inflammatory properties. Natural remedies include ginger or chamomile may also help to ease feelings of nausea.

12. Gastric reflux

Dr Lee told us, "Gastric reflux occurs when acid from the stomach passes up the wrong way - from the stomach into the lower end of the throat. This causes a burning sensation in the chest often accompanied by nausea."

She adds, "Gastric reflux may be worse in the mornings after lying down in bed overnight."

How to fix it: Dr Lee suggests that changing your lifestyle is the best way to prevent gastric reflux from occurring, and this can include losing weight and stopping smoking and drinking. Symptoms are also helped by taking antacids, which counteract the acid in your stomach to relieve indigestion and heartburn.

13. Hunger

It may sound strange but being hungry can make you feel sick, and this is linked to low blood sugar levels. 

Dr Lee explains, "When your stomach has been empty for many hours, it can fill up with stomach acids which causes stomach contractions. Your blood glucose level may be low, and nausea is a sign of this." 

How to fix it: Make sure not to skip breakfast, and you could try eating your dinner later in the day the night before. If 12 hours have usually passed since you had dinner by the time you wake up, it might be a good idea to reconsider your dinnertime. 

Dr Lee adds, "One option is to eat six small meals a day, with much smaller portions."

14. B12 deficiency

Dr Deborah Lee tells us that up to 15% of the population are vitamin B12 deficient, and it’s more common with increasing age, affecting 6% of those over age 60.

She says, "B12 is a vital vitamin needed for DNA synthesis and because the body cannot make B12 itself, it must be ingested in the diet. Most often, B12 deficiency is due to inadequate dietary intake, but it can also be caused by conditions such as pregnancy, alcoholism, pernicious anaemia or surgery."

Other symptoms of B12 deficiency include having a sore mouth or tongue, weakness and tiredness. 

How to fix it: B12 is found in meat and dairy products, as well as fortified products such as some types of cereal, bread and yeast. You could also take B12 supplements, and Dr Lee explains this is particularly important for vegans and vegetarians, because those with a meat-free diet are at increased risk of B12 deficiency.

What to eat when you feel sick

• Have a cold drink – some people find fizzy drinks best, but be sure to sip them slowly.
• Drink ginger or peppermint tea.
• Eat foods containing ginger – such as ginger biscuits.
• Eat smaller, more frequent meals, rather than larger ones every few hours.

GP Sonal Shah adds, "Mild nausea can be remedied with changes to your diet and by avoiding eating larger meals right before bedtime, which can trigger a blood sugar crash, causing nausea. Have ginger tea and something dry to eat like toast, granola or some fruit if you can. Avoid coffee if feeling sick as this can dehydrate the body more."

Why do I feel sick every day?

If you find that you're feeling sick regularly, this might indicate that there's a wider problem at hand.

If you suffer from insomnia, stress, anxiety or you've been eating poorly, this could contribute to more regular feelings of nausea. Lifestyle improvements such as a regular sleeping pattern, drinking more water and eating a balanced diet might help to banish nasty feelings of sickness.

Dr Deborah Lee says, "If you find yourself feeling sick in the mornings there could be any number of underlying causes, but if this is persisting, it's time to see your GP. Once a diagnosis has been made, you can take the necessary steps to feel better."

If you liked this article, you might want to check out our expert-approved tips to cure a cough, the best natural flu remedies and how to get rid of a headache fast.

Are Christmas parties cancelled? It's the question everyone is asking as Plan B restrictions come into place from Friday December 10. 

Last year, Christmas was effectively cancelled just days before celebrations were set to begin and we were going back into lockdown in time for the new year. So, it's fair that we'd be looking to make up for lost time in 2021. However, along with early excitement, there have been concerns that the new variant - named Omicron - could scupper plans before they've even begun. At a press conference earlier this week, Prime Minister Boris Johnson announced that England would be taking on Plan B measures, which includes guidance to work from home, compulsory face masks in many public indoor spaces, and the requirement to show proof of a double vaccination in some venues.

But many events have still been given the green light to go ahead despite the new rules. So will you be able to celebrate with friends, family and even get to have an office party this year? Here's what government and health officials have said about the upcoming festive season.

Are Christmas parties cancelled?

No, Christmas parties can still go ahead for 2021. 

Health Secretary Sajid Javid has confirmed that there are no plans to prevent Christmas gatherings this year. 

Speaking to Sky News earlier this week, he said, “I think people should continue to behave in the way they were planning to behave over Christmas.

“I don’t think there is any need to change those plans.” 

The prime minister has also said that other in-person events can happen over the festive period, including school nativity plays.

But the health secretary has urged people to remain vigilant and take “sensible precautions” against spreading the virus to others, especially in light of the new variant. 

“I think that we can go ahead with whatever we planned for Christmas. I think that’s absolutely fine,” Mr Javid said. “But what I will add to that is that we have always said even before this variant came along, that as we get into the colder, darker days of winter, Covid likes that and that flu viruses like that.” 

“So...it’s just a sensible time for everyone just to remember that and take whatever cautious measures that they can.”

For similar reasons, health experts have been giving advice on whether you should go to work with a cold during the Covid-19 pandemic.

An official from SAGE has warned that the Omicron variant is spreading "very fast" and the UK faces a "very large peak" of cases soon. Professor Andrew Hayward from University College London said, "It's a bit like if you think of a month's worth of rain falling in a few days. That leads to flooding and it's a similar type of scenario."

It may take several weeks before scientists really know the true impact of the new variant, however.

Before heading out to a Christmas party, Mr Javid said that he would advise taking a Covid-19 test. Lateral flow testing kits, for example, are still available for free from the government's website. While lateral flow tests can be false positive or negative, this is highly unlikely according to new research. So people should use them, along with sticking to the host of new measures, to help to combat the spread of the virus. 

The new measures Covid-19 measures introduced from December 10 2021 include: 

• Compulsory face coverings in most public indoor venues, including cinemas, theatres and places of worship.
• Anyone who can work from home should do so, as of December 13.
• From December 15, the NHS Covid Pass will become mandatory for entry into many indoor spaces. This includes nightclubs and settings where there are more than 500 attendees. As well as events where there are 4,000 or more people unseated outdoors. And events where there are more than 10,000 people indoors or outside.

There is no requirement to wear a face mask in hospitality venues, however. As the PM said in a statement, "There will be exemptions in venues where it is not practical to wear [a face mask], such as when you are eating, drinking or exercising. For that reason, face masks will not be required in hospitality settings."

A Covid Pass is also not a requirement in hospitality venues with a capacity lower than 500 people. However, a venue can request customers show a Covid Pass.

As well as this, the government has announced a huge extension of the Covid booster jab roll-out and are now encouraging everyone over the age of 18 to get the vaccination.

The decision to carry on ahead as 'normal' comes just days after allegations of parties held at Downing Street over Christmas and spring 2020, through to 2021. Now being investigated by Sue Gray, who is a senior civil servant, the report is expected in the new year.

Are you more likely to get Covid-19 at a party?

Unfortunately, you are more likely to get Covid-19 at a party than elsewhere in your daily life.

As the government ads on television suggest, people can easily spread Covid-19 indoors. Especially where there is little ventilation and everyone is in close proximity to each other.

Recent research from the University of Cambridge and Imperial College London found that in badly ventilated spaces, Covid-19 spreads faster through talking than it does coughing. Working out to more than two metres in just seconds. This is because when we speak, we produce small droplets which spread very quickly around an enclosed room. They can accumulate if there isn't any way for the droplets to escape. While coughing does expel droplets too, these are likely to be much larger. They settle on surfaces rather than travel through air.

https://www.youtube.com/watch?v=HoQdh0WpeFA

Published in the Proceedings of the Royal Society A, they also show that social distancing measures alone won't be enough protection.

As well as face masks and Covid-19 vaccinations, research has highlighted the need for thorough ventilation - even if it's a bit nippy outside.

If you want to see how fast Covid-19 can travel, you can use the same tool in the study's research. Airborne.cam allows you to input the environment, including whether anyone is wearing a face mask, and it will give you a percentage of how likely infection is.

Should I cancel my Christmas party?

If you're worrying about going to a Christmas party this year, here are some things to consider:

• Does the space have good ventilation with open doors, windows and outside space?
• How many people will there be at the party? And is there the requirement to proof a negative Covid test before entry?
• What date is the party? I.e. if you tested positive following the event, do you have 10 days to isolate before Christmas - even after the self isolation rules have changed?
• Are you (or someone you're seeing within days of the party) clinically vulnerable?

Government officials - including Boris Johnson - have urged people not to change their plans ahead of the festive season. But some health officials have warned otherwise.

Dr Jenny Harries is the chief executive of the UK Health Security Agency and head of NHS Test and Trace. She told the that people could prevent the spread by reducing their social contacts.

She said that the "vaccines appear to be effective" against the new variant but if "we find that the variant is more highly transmissible, [it] could still be a significant impact on our hospitals."

Urging caution, she said, “So I think being careful. Not socialising when we don’t particularly need to and particularly going and getting those booster jobs. Which, of course, people will now be able to have at a three-month interval from their primary course.”

With numerous strains of colds, flu and Covid-19 to contend with, it's helpful to know what the main flu symptoms are and how to treat the virus.

'Flu is an infection of the respiratory system caused by the influenza virus and each year up to 15% of us will catch it,' says Dr Henderson, a GP and independent expert for Olbas. 'It's very common, highly infectious and takes longer to recover from than a cold,' he explains.

'It's much more severe than the common cold,' adds clinical pharmacist Mike Wakeman from herbal medicine brand Schwabe. 'It often results in at least 2-3 days in bed, leading to missed work and school days.'

While flu is usually manageable at home it can be a cause for concern. 'For some at-risk groups, flu can be very dangerous,' warns Mike. 'Flu complications lead to tens of thousands of hospital stays and an average of 600 deaths in the UK every year.'

Lloyds Pharmacy describes December-March as peak season for flu. In general, it appears from October and occurs up right up until around May (though this is unusual). While flu is seasonal in the UK "in other parts of the world flu never goes away" says an article by the University of Cambridge.

What are flu symptoms?

A cold is uncomfortable and frustrating but – unless it's particularly bad – sufferers usually work or go about their daily lives if they 'dose up' with over-the-counter medicines. Flu is much more severe and can make a healthy person have to stay in bed for a week.

This is due to the severity of symptoms and the speed at which they appear. Dr Henderson told us, 'Unlike a cold, flu symptoms start suddenly and are more severe – high fever (38°C/100.4°F or more), extreme fatigue and aches are all common.'

If you have flu it will develop within one to three days of becoming infected. Flu symptoms usually peak after 2-3 days and you should start to feel better again after 3-5 days. Typical flu symptoms include:

• Fever or temperature of 38C or above
• Sweats
• Aching muscles
• Dry cough
• Tiredness and weakness
• Sore throat
• Sneezing
• Headache
• Runny or blocked nose
• Chills
• Limb or joint pain
• Diarrhoea and tummy ache
• Nausea and vomiting
• Loss of appetite
• Difficulty sleeping

Some other illnesses start with symptoms similar to these - but can be a lot more serious (such as meningitis, malaria or pneumonia). If you have any additional symptoms, you should contact your doctor.

Flu treatments

Flu is a virus so – unlike an infection caused by bacteria – it can't be treated by antibiotics. These days, doctors will only prescribe antibiotics if you're suffering from secondary complications of the flu, such as sinus or ear infections, or pneumonia.

Antivirals are available. However, these are usually given to vulnerable patients. For those of us in good health, it's a case of taking good care of yourself.

'There is no miracle cure,' says Dr Henderson. 'If you come down with flu, go to bed! Rest is essential to help you get better. As well as resting, eating well – with lots of fresh fruit and vegetables – and drinking fluids to boost your hydration levels helps speed up recovery,' he says.

You can also try pharmacist Rita Ghelani's suggestions to ease your flu symptoms:

• Steam inhalation. This is one of the best ways to relieve the symptoms of a stuffy nose. Steam helps to loosen up mucus in the nostrils, so it is easier to clear away when blowing the nose.
• Blow your nose regularly. This removes infected mucus from the nasal passages.
• Use a saline nasal spray. It will help to break up mucus in the nose. Rita recommends Xlear Nasal Spray (£11.15, Amazon). It contains saline with Xylitol, which "almost acts like soap for your nose" to alleviate congestion.
• Suck on cough or throat lozenges. These keeps the back of the throat lubricated.
• Gargle with salt water. This can clear viruses lurking at the back of the throat.

There is a variety of over-the-counter medicines that can ease your discomfort.

'Paracetamol and ibuprofen can help with symptoms such as a temperature and aches and pains (check with your doctor it's safe for you to take these),' says Dr Henderson. 'And there are plenty of cold and flu remedies available that can be helpful for relieving symptoms – though get advice from a pharmacist as to which are most appropriate for relieving your symptoms.

For example, decongestants such as Olbas Oil (£4.49 for adults or £4.45 for the children's version – from Boots), can relieve stuffiness and clear airways.'

When should you see a doctor about flu?

Flu is tolerated by most of us, but some are more vulnerable than others. Higher risk groups include young children, pregnant women, seniors and those with certain medical conditions.

'Flu symptoms for the majority of people are managed quite effectively at home,' says Mike. 'However, if, in addition to the symptoms above, you are experiencing any of the following you should see a doctor or call 111 as you may be among those considered at high risk of complications.'

Get medical help if...

• You have shortness of breath
• You feel pressure in your chest or abdomen
• You're vomiting often
• You suffer from severe neck stiffness
• You lose consciousness
• You're pregnant
• You have asthma
• You have heart disease
• Your cough begins producing thick mucus
• You develop pain in a single area such as your ear or sinuses
• Seek urgent medical attention if you have any difficulty breathing, confusion or dizziness, chest pain or persistent vomiting.

If your symptoms get better then come back worse, or you don't improve after 7-10 days of having your first flu symptoms, seek medical advice.

Is flu contagious?

In a word, yes. 'People with flu can spread it to others up to about six feet away,' says Mike. 'Most experts think that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs,' he explains.

The common cold is spread the same way but the viruses differ in how long you are contagious for:

• If you have flu, you're contagious 1 day before symptoms start and are no longer contagious 5-7 days from the first signs of illness.
• If you have a cold, you're contagious 1-2 days before symptoms start and are no longer contagious 2 weeks from the first signs of illness.

Like colds and flu, Covid is a contagious respiratory illness. Research shows that Covid seems to spread more easily that flu. 'However, as more people become fully vaccinated against COVID-19, the spread of the virus that causes it should slow down,' says Mike. 'COVID-19 can also take longer before people show symptoms and people can be contagious for longer,' he adds.

How to prevent catching flu

Prevention is better than cure so it pays to take precautions during cold and flu season.

As well as a vitamin D3 supplement – which is a must in the cold, dark winter months – taking vitamin C and zinc can also help, as can echinacea.

A.Vogel's echinacea range is probably the most researched brand available in the UK. There are currently 32 pieces of published research to support its ability to reduce the risk of catching a cold or flu, reduce the duration and severity of cold and flu symptoms, and lessen complications. Try the tablets (£4.99, Superdrug), throat spray (£10.99, Lloyds Pharmacy) or hot drink concentrate (£10, Boots).

You can stop a virus in its tracks with a nose and throat spray such as Cold & Flu Guard (£9.99, Oraldent). It contains Flavobac, which has antiviral properties that act as physical barrier trapping viruses – including flu and Covid – and helping to neutralise and inactivate them, so they can't cause harm.

'Using this spray will help to protect against viral respiratory infections by killing the viruses in the mouth,' says Dr Sarah Brewer. 'Use the spray together with wearing a face mask for double protection. Or – if you develop symptoms of a viral infection – it helps alleviate the severity of symptoms and reduce the number of viruses we breath out so we are less infectious,' she explains.

We approached doctors for advice on how to soothe a sore throat during pregnancy and they shared their expertise and suggestions with us for how to manage the symptoms of a common sore throat at home.

When you’re pregnant, things like getting rid of a cough or soothing the sniffles become a little more difficult, as some of your usual go-to cold remedies or other bathroom cabinet medicine may not be suitable or safe to take during pregnancy. 

Having a sore throat is no different, so we consulted GPs Dr Paul van der Westhuizen and Dr Sanjeev Kalia, and consultant obstetrician and gynaecologist Dr Keith Duncan for their advice on how to soothe a sore throat during pregnancy.

“Throughout pregnancy, your immune system is adapting to support both you and your baby,” explains GP Dr Paul van der Westhuizen. “This makes the chance of catching a viral throat infection or cold higher.” Reassuringly, Dr van der Westhuizen and the other doctors we consulted for this article said that if you develop a sore throat while you're pregnant, you can often treat this yourself at home and usually it’s nothing to be too concerned about.  

However, Dr van der Westhuizen also said that if your sore throat is a symptom of a more serious illness, such as flu, then it is really important you seek medical advice from a doctor, “It’s important to note that the proper flu (influenza) in pregnancy can cause serious complications for you and your baby. For this reason, the NHS recommends a flu vaccine for all pregnant women. If you are concerned that you have the flu or your cold symptoms are not resolving, it’s important to contact your doctor or antenatal team.”

The information in this article is for general purposes only and does not take the place of medical advice. It is essential to be guided by your GP and take note of official NHS advice. You should immediately seek medical attention if your symptoms worsen or you are concerned about any element of your pregnancy. If you are unsure, concerned about your symptoms or feel unwell, then it is always best to seek personalised advice from a doctor as soon as possible.

​​How can you soothe a sore throat during pregnancy?

The options for soothing a sore throat during pregnancy are unfortunately quite limited. Aside from following NHS advice to rest and drink lots of water, Dr Keith Duncan told us that a simple hot lemon and honey drink is one of the best things you can drink (or gargle) to help soothe a sore throat: “I find the best way to get rid of a sore throat [during] pregnancy is to gargle with hot lemon and manuka honey which are natural antiseptics.” 

Dr Duncan also added that the type and strength of the honey you buy will impact how well it works to soothe a sore throat and promote healing: “you need to get the highest strength manuka honey for the bee for there to be a reasonable antibiotic effect.”

While the doctors we consulted all said that it was generally safe to eat honey whilst pregnant, Dr Kalia noted that in some instances you need to be mindful about the amount of sugar in the honey: “Some patients do have gestational diabetes (which is where you have high sugar levels during your pregnancy). If you do have this condition, you should be wary of taking anything that contains large amounts of sugar.” If you are at all in doubt, consult your doctor or antenatal team for personalised medical advice. 

Apart from trying a hot honey and lemon drink as suggested by Dr Duncan, Dr van der Westhuizen says, “The safest option for treating a sore throat throughout pregnancy is paracetamol.” The NHS states: “Paracetamol is the first choice of painkiller if you're pregnant. It is commonly taken during pregnancy and does not harm your baby.”

“Unfortunately, there are a whole host of medicines that normally would be safe to take, but during pregnancy are best avoided,” says Dr van der Westhuizen.

“Due to being pregnant the majority of medicines we rely upon to help with sore throats are unfortunately not appropriate,” says Dr Sanjeev Kalia. “This is because they could have an adverse effect on the foetus.”

Dr van der Westhuizen advises checking with your doctor if you aren’t sure about what medicines are safe to take during pregnancy: “As well as asking your doctors, a good place to check if the drug you are using is safe for pregnancy is by checking the BUMPS (Best Use of Medicines in Pregnancy) website. This is a free, evidence-based website that provides medically accurate information about which medicines are safe to use throughout pregnancy.”

The NHS also has useful information about what’s safe to take during pregnancy here.

Dr Kalia also added that you should be wary of taking herbal remedies if you are pregnant, as not all herbal remedies are safe for use during pregnancy and some can contain substances such as lead which can be harmful for you and your baby. 

“You can however try some simple remedies like gargling with salt water, using steam inhalation which can open up any congestion you have to soothe your throat. You can also drink hot lemon and honey drinks. In addition, drinking camomile or ginger tea can also help,” says Dr Kalia. 

When should you see a doctor if you have a sore throat during pregnancy?

Dr Duncan describes having a sore throat during pregnancy as "very common", but he adds that in certain circumstances, you should get checked out by a doctor: “If you get more severe and you are struggling to swallow or have any breathing trouble then it’s essential you seek medical care and get reviewed by a doctor immediately.”

Dr Kalia agrees stating, "If the symptoms affect your breathing or cause difficulty in swallowing these are red flags."

Dr Duncan also adds that, "if you are struggling with a sore throat that appears to be going on for more than three or four days" you should also see a doctor.

This advice is echoed by Dr van der Westhuizen, who says, "A sore throat during pregnancy shouldn’t be anything to worry about unless your symptoms persist or are causing unmanageable pain and difficulty breathing." He also reiterates how important it is to get advice from a doctor if you think you might have the flu: “If your symptoms don’t improve after two or three weeks, get suddenly worse, or your temperature rises to 38°C or above, this could be a sign of the flu.

"Feeling hot and shivery, unmanageable throat pain, as well as difficulty and/or pain when breathing through your chest are also symptoms of flu to be on the lookout for, so make sure to get in contact with your GP if you notice any of these in yourself."

If in doubt, always speak to your doctor. Dr Kalia says, "As a general rule: if simple measures are not managing your symptoms, make an appointment with your GP."

The information on GoodTo.com does not constitute medical or other health advice or diagnosis and should not be used as such. Although GoodtoKnow consults a range of medical experts to create and fact-check content, this information is for general purposes only and does not take the place of medical advice. Always seek the guidance of a qualified health professional or seek urgent medical attention if needed.

Our experts

The powerful combination of colder weather and flu season means that many of us will definitely be feeling the sniffles before the Christmas break - so, should you go to work with a cold?

While we’ve done just about everything over the last two years to avoid Covid-19 infection, we’ve simultaneously managed to ward off any other infection too. Coming out of lockdown with a lower immune system, this means we’re much more likely to pick up a lurgy. 

It’s why there have already been discussions about whether Christmas parties are cancelled this year and even chat about whether schools are closing early like last year.

Should you go to work with a cold?

No, you shouldn’t go into work if you have a cold.

Originally, the three main symptoms of Covid-19 were a continuous cough, high temperature and a loss of taste/smell. However, new research on the Delta variant symptoms from the Zoe Symptom Study shows that infections are now more likely to present as similar to a cold. I.e. the classic sneezing, runny nose, sore throat and headache. 

So if you’re feeling under the weather, the first thing to do is take a PCR test. You also must self-isolate while waiting for the result to come through, advice from the NHS reads. While you may be convinced it’s just a cold, you’re still likely to be displaying symptoms resembling Covid-19. So, it’s better to be safe than sorry and find out if you actually have the virus.

Much like the rules on sending a child to school with a cold, if you test negative for Covid-19 then legally you can still go into the office. However, it’s unlikely that your colleagues would thank you for passing on a nasty cold just before the Christmas season. 

And with our immune systems lowered thanks to the long periods of lockdown, GP and Olbas expert Dr Roger Henderson says colds really are inevitable this year. 

“Colds and flu are caused by viruses that usually affect the nose, throat, ears and sinuses. The infections are contagious, transferable by tiny droplets and hand contact. And [they] are much more common during the winter months. This is partly because central heating dries out the normally moist nasal mucosa which defends against invading viruses.” 

Because there are “hundreds of different viruses that can cause a cold”, he says, it’s not possible to have a cure for them all. Normally, exposure wards off the common ones. 

“However, as many of us have not had as much exposure to normal colds and flu, there appears to be a spike in tougher, more aggressive forms of cold and flu-like viruses. These are so-called ‘super cold’ symptoms and include an extremely sore throat, a hacking cough and headaches.” 

If you feel you’re well enough to work, you may just work from home for the day. Especially if that's what you were doing over lockdown anyway. However, if you’re feeling really under the weather or can’t work from home, you’ll have to call in sick.

Who should work from home?

Everyone should work from home as of December 10, latest government guidance says.

Boris Johnson has approved Plan B for England. This includes:

• People being asked to work from home if they can.
• Face coverings are compulsory in most public indoor venues, such as cinemas, theatres and places of worship.
• The NHS Covid Pass will become mandatory in some spaces, such as nightclubs.

Boris Johnson also said, "Everyone should test using a lateral flow device, particularly before entering a high-risk setting involving people you wouldn’t normally come into contact with, or when visiting a vulnerable person. Lateral flow devices remain free of charge and can be collected from local pharmacies."

Although lateral flow tests can be false positive or negative, this is very highly unlikely according to research from earlier this year. If you have symptoms, always get a PCR test instead.

How to call in sick for work

The first step to calling in sick is notifying your employer before the usual start time for work on the day you’re unwell, says Pranav Bhanot, litigation solicitor at Meaby & Co Solicitors. 

“If your employer has a sickness absence policy, the employee should follow this in terms of notification,” he adds. 

The process is normally as simple as emailing or messaging your manager, letting them know that you’re too unwell to work. It’s also best to give an estimate as to when you’ll be back to work. Plus, any other information that they’ll need to know for when you’re back.

But there’s no need to stress about providing evidence, Pranav says. “In terms of evidence, employees generally do not have to be bed bound to be off sick. Therefore, if an employee has a cold this may be sufficient reason to call in sick. Especially given the current pandemic." 

It’s only when you’ve taken a full week off work that you may have to worry. Legally, “an employee must provide an employer with a doctor’s ‘fit note’ if they are sick for more than 7 days. This is non-working days taken in a row,” our expert explains. 

Although cold sores usually clear up on their own, they can be painful while they heal, so we asked the experts for their recommendations for natural remedies for cold sores, as well as treatments that can be used to help soothe discomfort and promote healing.

Cold sores are caused by the herpes simplex virus (HSV), which is a very common infection. As many as seven in 10 people in the UK are infected by HSV1 and you can experience a cold sore break out when you're feeling run down, stressed or from exposure to UV light.

"Winter temperatures and harsh winds tend to dry out the lips. This can lead to the reactivation of the herpes simplex virus; the cause of cold sores," says Dr Anjali Mahto of the British Association of Dermatologists. "A lack of vitamin D, which is a common problem during darker and colder months, can also weaken the immune system and result in more frequent outbreaks," she explains. Other triggers include injury to the area and hormonal changes.

An outbreak can cause painful sores or blisters to develop on the face and they will usually last up to 10 days before clearing up on their own. For advice on how to help ease the pain of a cold sore while waiting for it to heal and clear up, we consulted Dr Anjali Mahto, as well as GP Dr Sanjeev Kalia and Marian Nicholson, who is the director of the Herpes Virus Association.

Remember that cold sores are contagious from the moment you first feel tingling or other signs of a cold sore coming on. Avoid kissing anyone (especially children and babies, who are particularly at risk) while you have a cold sore, and don't share towels, cutlery, make up, lip balm or anything that may have come into contact with your cold sore until it has completely healed.

​​The information in this article is for general purposes only and does not take the place of medical advice. It is essential to be guided by your GP and take note of official NHS advice. If you are unsure or concerned about your symptoms, then it is crucial to seek personalised advice from a doctor as soon as possible.

Natural remedies for cold sores

Here the experts explain what you can do to help ease cold sores while they heal and potentially avoid triggering another outbreak. 

1. Cool compress

"A cool compress can help speed along the healing process," recommends Dr Mahto. "It works by reducing inflammation and the pain associated with it."

Marian Nicholson of the Herpes Virus Association also explains that a cool compress could help to avoid triggering a cold sore outbreak: "There are various things you can do to prevent the cold sore if you start when you are feeling the warning tingles," she says. "Hold an ice cube off and on the skin for 30 minutes. Or maybe try a pack of frozen peas!"

2. Lemon balm

Essential oils have been used medicinally for centuries, and one such oil thought to ease cold sores is lemon balm.

"My favourite is lemon balm (melissa officinalis)," says Marian. "Research shows it has molecules to block the virus getting into the skin cells. Apply lemon balm cream such as Lomaherpan well into the place where you feel the cold sore coming about five times a day to prevent the sore."

The NHS recommends that you do not rub creams into a cold sore and dab them on instead.

3. Used tea bags

You can also try a humble tea bag - yes really! Marian says that as well as acting as a cold compress to reduce inflammation and redness there's evidence to suggest that terpenes – an active ingredient in tea – promote healing.

"A cold damp tea bag may be a bit messy but the terpenes in tea are effective," says Marian. Terpenes are naturally occurring compounds known to have a number of medicinal qualities, including antiviral and anti-inflammatory properties.

4. Petroleum jelly

As far as healing salves go, you can't do much better than Vaseline. One of the many uses of Vaseline, using a mineral-based barrier like petroleum jelly can help seal in moisture and keep the skin protected while it heals.

Dr Mahto says, "Using a greasy moisturising cream on the skin like petroleum jelly can help in getting rid of cold sores faster."

5. Salt water

Salt water is an age-old cure-all, thanks to its mineral content. We gargle it to soothe a sore throat, use it for cold remedies, and it may also help heal cold sores. "Washing the area gently with salt water can help," says Dr Mahto. "Though remember to dry the area gently but thoroughly after washing."

According to medical brand Zovirax "Salt water affects the environment around the virus so it can't thrive, which might help dry up the cold sore, but it can also be painful on your skin."

The NHS also warns, "do not eat acidic or salty food if it makes your cold sore feel worse."

6. Take care of yourself

"Once the cold sore has broken your skin and caused a blister, it will only get better when your body has built new skin cells to fill the hole," explains Marian. "This will be quicker if you get enough sleep, good food and don’t do anything that is bad for your body," she says.

What treatments do doctors recommend for cold sores?

"The drug treatment of oral herpes simplex depends on the person's age; how often they have [cold sore] attacks and how severe they are, as well as where they [the cold sores] attack and if the person has any underlying health conditions," explains Dr Kalia. 

"Most people need no treatments at all but you can get over the counter products from your pharmacy such as aciclovir or penciclovir," Dr Kalia continues. "These products are mainly useful if started before vesicles appear (eg taken when you feel the tingling sensation before the cold sores appear)."

Aciclovir is possibly the most recognised medication for cold sores. It works by speeding up the healing process and easing the tingle and blister. "Aciclovir is an antiviral medicine, prescribed by a GP in tablet form; however, you can buy it in cream form at pharmacies or other stores without a prescription," says Dr Mahto.

The NHS recommends taking, "paracetamol or ibuprofen to ease pain and swelling." 

Consult your GP or speak to a doctor before using any medicine or treatments for cold sores. 

How long does a cold sore usually last?

"Without treatment, a cold sore will disappear in roughly 7-10 days," says Dr Mahto. "If you're getting cold sores frequently, visit your GP to see if you can get antiviral prescription tablets," she advises.

When to see a doctor about a cold sore

GP Dr Sanjeev Kalia recommends making an appointment to see your doctor if:

• a cold sore has not started to heal within 10 days.
• if you're unsure that is in fact a cold sore or think it's something else (as some serious skin lesions can look similar to cold sores).
• you find the lesion is sore or is covering a very large area or more painful than expected.
• you find that your gums are either swollen or painful or if the sore is present inside the mouth (gingivostomatitis).
• you have any condition that means you may have a weak immune system e.g. for people who have HIV or are being treated with chemotherapy.

If you want more information and general advice about oral herpes simplex infections you can check out the following resources:

• The Herpes Viruses Association 
• The British Association of Dermatologists leaflet on Herpes simplex

The information on GoodTo.com does not constitute medical or other health advice or diagnosis and should not be used as such. Although GoodtoKnow consults a range of medical experts to create and fact-check content, this information is for general purposes only and does not take the place of medical advice. Always seek the guidance of a qualified health professional or seek urgent medical attention if needed.

Our experts

Cold remedies can help you soothe symptoms, ease discomfort and recover from a cold at home.

"A cold can usually be managed by yourself at home for the first few days (unless you suddenly get very unwell in which case you should speak to your GP sooner)," says NHS and Private GP Dr Aarthi Sinha, one of the doctors we consulted for this article. 

In addition to Dr Sinha, we also consulted GPs Dr Paul van der Westhuizen and Dr Roger Henderson, as well as Naturopathic Nutritionist Jessica Shand, all of whom shared their recommendations for remedies that could help soothe symptoms of a cold and help you on the way to recovery. 

Dr Sinha cautions that while some cold remedies may be suitable for adults, they are not suitable for coughs and colds in babies and children, and are also not recommended for the elderly, pregnant people or those who are immunocompromised. "The following home remedies may be helpful for adults – it is always best to seek medical advice for children, the elderly, pregnant women, those who are immunocompromised and anyone who suffers from significant long term health conditions," says Dr Sinha. 

The information in this article is for general purposes only and does not take the place of medical advice. It is essential to be guided by your GP and take note of official NHS advice. If you are unsure or concerned about your symptoms, pregnant, elderly, immunocompromised or have a child who is unwell, then it is crucial to seek personalised advice from a doctor as soon as possible. You should immediately seek medical attention if your symptoms worsen.

Cold remedies experts recommend to help get rid of a cold fast

1. Rest

One of the best remedies for a cold is sleep and plenty of rest. We tend to try and go about our daily tasks when we have a cold, when we really just need to rest up and help our bodies recover. 

"Getting a cold can make you feel fatigued and rubbish, however, you can often treat it yourself without seeing a GP," says Dr Van der Westhuizen. "The best thing you can do is to support your body so it can heal on its own accord," he says, adding, "make sure to get plenty of rest."

Ensuring you get enough sleep is an important factor in helping to prevent and fight colds, says Dr Sinha, "The best natural remedy for a cold is rest, to allow your body’s defence mechanisms to fight off the cold."

2. Eat a healthy, balanced diet

It’s important to ensure you are getting plenty of good nutrition while you have a cold. "This involves making sure you drink plenty of fluids (water) and eating small amounts of healthy food regularly. Avoid excessive oily or heavy foods at this time," says Dr Sinha. 

"Continue to eat healthy food that is rich in vitamins and minerals to support your immune system," advises Dr Van der Westhuizen.

3. Drink plenty of water

The benefits of drinking water are well known, but if you have a cold or you feel unwell, it’s extra important to ensure you are drinking enough water throughout the day.

Dr Van der Westhuizen and Dr Sinha both advise drinking, "lots of fluid to avoid becoming dehydrated" to help your body recover while you have a cold. This is also important for helping to ease other symptoms you may have, such as if you want to get rid of a headache.  

4. Try steam inhalation

Inhaling steam to ease cold symptoms is a traditional remedy for colds, sore throats and blocked noses that’s been used for many years. The idea is that the steam from the water helps to open nasal passages, relieving the symptoms caused by inflamed blood vessels and helping with congestion by loosening mucus in the airways.

"Steam inhalation is very simple to do and quite effective at helping to decongest a blocked nose," says Dr Sinha, with Dr Van der Westhuizen agreeing and saying, "Breathing in steam can also help to ease any congestive symptoms such as a blocked nose."

The NHS suggests, "try sitting in the bathroom with a hot shower running."

Do not let children breathe in steam from a bowl of hot water because of the risk of scalding. Remember to always exercise caution with hot water and do not add anything to the water as this may irritate the lining of the throat. 

5. Drink hot water with honey and lemon

A hot honey and lemon drink is one of the most well-known home remedies for a cough and cold, and was recommended by all of the doctors we spoke to as an effective way of soothing a cold. 

"Honey has antibacterial properties, which helps to fight infection. It also has a demulcent effect: relieving irritation by forming a cooling film around the throat," explains Dr Henderson. A squeeze of fresh lemon will further boost the natural power of a warm honey drink. "Lemon is packed with vitamin C, which the immune system needs, and contains antibacterial and antiviral properties to help fight infection," he adds.

To make a hot honey and lemon drink the NHS suggests: 

1. Squeeze half a lemon into a mug of boiled water
2. Add 1 to 2 teaspoons of honey
3. Drink while still warm

Do not give hot drinks to children. Do not give honey to children under 12 months old.

6. Gargle salt water

It may not sound appealing, but gargling with salt water can really help with the severity of cold symptoms. A natural, low-cost way to ease uncomfortable cold symptoms, gargling with salt water can also help soothe a sore throat.

"The two best things for a sore throat are gargling salt water and having hot water with honey and lemon," says Dr Sinha.

The NHS suggests the following method to gargle with salt water:

1. Dissolve half a teaspoon of salt in a glass of warm water (warm water helps salt dissolve).
2. Gargle with the solution, then spit it out (do not swallow it).

Children should not try this. 

7. Sup chicken soup

There’s a reason why chicken soup is a dish synonymous with colds and cooking when you feel under the weather. Not only is soup a go-to food when you’re congested and have a sore throat, but the dish contains all sorts of beneficial vitamins and nutrients needed to help your body get back to full health. Naturopathic Nutritionist Jessica Shand explains, "Chicken soup is brimming with vitamins and incredible nutrients to help support the immune system when it’s fighting cold and flu symptoms. The warming element to the soup is not only lovely and comforting when you’re not feeling your best, but it also helps to soothe the throat and may help clear nasal congestion."

Research also backs up the suspected benefits of chicken soup, with a study featured in the peer-reviewed journal of the American College of Chest Physicians finding, "chicken soup may contain a number of substances with beneficial medicinal activity including an anti-inflammatory mechanism that could ease the symptoms of upper respiratory tract infections."

8. Try green tea

Sipping on warm drinks can help rehydrate lost fluids and soothe sore throats, but certain drinks are better than others. If you fancy a break from hot honey and lemon, Naturopathic Nutritionist Jessica Shand suggests trying green tea.

"Rich in antioxidants, green tea is beneficial to drink when you’re suffering with a cold," says Jessica. "And it has antiviral properties, so whilst it won’t cure you, it’s a great drink to help improve symptoms and provide your body with the extra goodness."

"Green tea can also help to soothe the inflammation and irritation that can cause a sore throat," adds Dr Henderson.

Remember, do not give hot drinks to children.

How long does a cold last?

"It’s normal for a cold to clear up after one or two weeks. If the symptoms persist longer than this period despite you taking appropriate medication and looking after yourself, it’s important to see a doctor," advises Dr Van der Westhuizen.

When to see a doctor about a cold

It is always best to seek medical advice for children and see a doctor if you are elderly or pregnant. 

The NHS states that you should also see a GP if:

• you have a high temperature for more than 3 days
• your cold symptoms get worse
• your temperature is very high or you feel hot and shivery
• you feel short of breath or have chest pain
• you're worried about your child's cold symptoms
• your cold symptoms do not get better after 10 days
• you have a cough for more than 3 weeks
• you get cold symptoms and you have a long-term medical condition (for example, diabetes, or a heart, lung or kidney condition)
• you get cold symptoms and you have a weakened immune system (for example, because you're having chemotherapy)

The information on GoodTo.com does not constitute medical or other health advice or diagnosis and should not be used as such. Although GoodtoKnow consults a range of medical experts to create and fact-check content, this information is for general purposes only and does not take the place of medical advice. Always seek the guidance of a qualified health professional or seek urgent medical attention if needed.

Our experts

The symptoms of menopause are varied and can affect women both physically and emotionally. While symptoms may differ depending on the person, and everyone will experience the menopause slightly differently, knowing the common symptoms can be helpful so you can get the right support and treatment. 

In the UK, one-third of the female population are perimenopausal or menopausal, and an estimated 1.5 million women – around 80% of those going through menopause – experience common menopause symptoms. The severity of these symptoms will vary from person to person, and while some people may find the menopause symptoms they experience to be mild, for others the changes will be severe. For example, a study from 2023 found that approximately 27% of women reported at least moderate problems coping with the menopause and found symptoms impacted their work. 

Dr Claire Phipps, a GP and Advanced Menopause Specialist at London Gynaecology, answered our questions about menopause and provided her expert advice on identifying and managing symptoms. Laura Southern, a nutritional therapist, also provided advice on supplements and vitamins to take for menopause in the FAQ section, and Dr Tomasz Lukaszewski, a senior consultant in reproductive medicine at London Gynaecology and IVI London, answers questions on the menopause and fertility in the FAQ section too. 

If you're concerned about the menopause, or think you may be experiencing early menopause, the best thing to do is see your GP and get

personalised advice from a doctor. You could also arrange to see a menopause specialist and there are specialist menopause centres in the UK that can offer treatment. You can find your nearest NHS or private menopause specialist on the British Menopause Society website here.

What age does menopause start?

The NHS defines menopause as, "when your periods stop due to lower hormone levels. It usually affects women between the ages of 45 and 55, but it can happen earlier."

Dr Claire Phipps explains, "The average age of menopause is 51 years, with the menopause meaning the day in which you can retrospectively determine that you have been without a period for 12 consecutive months. After this day, you are post-menopausal. Most women will have their last period between 47 and 53 years of age. This can be different for you depending on your ethnicity and genetics. Perimenopause is the transition to your last period and beyond and can start in your early 40’s but no two women are the same."

What causes the menopause?

Menopause is a natural phase in a woman’s life and every woman will go through menopause at some point as her reproductive phase ends. 

Dr Claire Phipps explains, "The menopause refers to one day in time when your periods have stopped for 12 consecutive months. Before this you are perimenopausal and after post-menopausal. The menopause is caused by the natural decline in production of the hormones oestrogen and progesterone from the ovaries. This marks the end of a woman’s reproductive stage. The ovaries (and the eggs within) produce oestrogen which is one of the hormones which drives the natural reproductive cycle in women. As the number of eggs declines with age, so too does the production of oestrgeon, before the ovaries stop producing it and women reach the menopause.”

Menopause can also be triggered or induced by other factors such as illness, injury, or medical treatment, although this is less common. 

How is menopause diagnosed?

The diagnosis of menopause will depend on your age, but if you think you have perimenopause or menopause symptoms you should speak to your GP.

"Women over the age of 45, who have any symptoms of the perimenopause, do not need any blood tests to diagnose the menopause," Dr Phipps says. She explains: "This is because at this age and beyond it is highly likely that the natural decline in oestrogen has started to occur. Prior to this age, and certainly in younger women, doctors may carry out some hormone blood tests and other blood profiles to rule in or out the menopause. This is because in some women, menopause can occur earlier, and for these women it is important to clarify the cause, in order to provide the most appropriate treatment."

What are common symptoms of menopause?

Both menopause and perimenopause (when you have symptoms of menopause but your periods have not stopped) can cause symptoms such as anxiety, mood swings, brain fog and hot flushes. These symptoms can last for varied amounts of time - from months to years - and can also change over the course of time. Perimenopause symptoms can start years before your periods stop. The primary symptom of menopause is that you have not had a period for 12 months.

Dr Phipps explains, "Perimenopause is the transitional period leading up to menopause, during which a woman's body undergoes hormonal changes that eventually result in the cessation of periods. This phase can last for several years and is characterised by a variety of symptoms, both physical and emotional. Around 80% of women will experience some degree of symptoms, and whilst some will not be severe, 25% of women will have significant symptoms."

There are many different menopause symptoms and no two women will experience the symptoms in the same way. Dr Phipps shared the following common symptoms to watch out for: 

• Irregular periods: Menstrual cycles may become irregular in length and flow due to fluctuations in hormone levels, particularly oestrogen and progesterone.
• Hot flushes and night sweats: These sudden feelings of warmth, often accompanied by flushing of the face and upper body, can disrupt sleep and cause discomfort.
• Sleep disturbances: Changes in hormone levels can lead to insomnia, difficulty staying asleep, or waking up frequently during the night.
• Vaginal dryness: Decreased oestrogen levels can result in vaginal dryness, itching, and discomfort during intercourse, along with recurrent urine infection, burning and bleeding after intercourse.
• Mental health / psychological symptoms: Hormonal fluctuations can affect neurotransmitters in the brain, leading to mood swings, irritability, anxiety, or depression.
• Changes in libido: Some women may experience a decrease in sexual desire or changes in sexual function during perimenopause.
• Fatigue: Hormonal changes, disrupted sleep, and other symptoms can contribute to feelings of tiredness and fatigue.
• Weight gain: Changes in hormone levels and metabolism can make it easier to gain weight, especially around the abdomen.
• Memory problems and difficulty concentrating: Some women may experience cognitive changes such as forgetfulness, difficulty concentrating, or "brain fog" during perimenopause.
• Muscle and joint pains
• Dry eyes and dry skin

"These symptoms occur because of the gradual decline in ovarian function and hormone production that characterises the perimenopause," says Dr Phipps. "Oestrogen is a master regulator of many processes in a woman’s body, and as the levels decline or fluctuate as they do (unpredictably), various physiological processes are affected, leading to physical, psychological and genitourinary symptoms."

There are things you can do to help with these symptoms, including taking medicines that can replace the missing hormones. The NHS advises seeing a GP or nurse if you think you have perimenopause or menopause symptoms.

Treating symptoms of menopause

Menopause can feel different for everyone and while some people may experience a number of symptoms, others may only experience them mildly or not at all. Whatever your symptoms of menopause, you don't need to go through any discomfort, unhappiness or pain alone. If any of your menopause symptoms are causing you worry or discomfort, seek help from a doctor. If you're having any symptoms that are impacting your life, you should talk to your doctor or a menopause specialist. They can advise you on treatment options. You may also want to consult a menopause nutritionist who can help you with more natural solutions. Talking therapies, like counselling or CBT (cognitive behavioural therapy), can help with symptoms of menopause and perimenopause and you can get NHS talking therapies without seeing a GP first.

The NHS recommends, "getting advice early" from a doctor on your symptoms because this, "can help reduce the impact perimenopause and menopause have on your health, relationships and work."

"An individualised approach is necessary in managing symptoms of menopause, with a variety of treatment choices available," says Dr Phipps. "Treatment options would usually depend on the symptoms. Options include hormonal pharmaceutical treatment such as Hormone replacement therapy (HRT), which is the mainstay of management and helps to provide long term health protection. Hormone replacement therapy is the gold standard treatment for managing most symptoms of the menopause."

What is Hormone Replacement Therapy (HRT) and when does someone need it?

The NHS describes HRT as, "a safe and effective treatment for most going through menopause and perimenopause. Your GP will discuss any risks with you."

"To support the body through menopause, many women choose hormone replacement therapy (HRT) which replaces the hormones that the ovaries were producing so that the symptoms and effects of menopause are minimised," Dr Phipps explains. 

"In addition to reversing symptoms of menopause and improving quality of life, HRT also helps with the prevention of osteoporosis (thinning of bones) and cardiovascular events such as heart attacks."

"The two main hormones in HRT are oestrogen and progestogen. HRT involves either taking both of these hormones (combined HRT) or, in the case of women who have had a hysterectomy, just taking oestrogen (oestrogen-only HRT)."

HRT can come in the form of skin patches, a gel or spray to put on the skin, implants or tablets. 

The NHS explains, "If you're having treatment for your symptoms of menopause or perimenopause, you'll need to return to the doctor or nurse who is prescribing your HRT for a follow-up review after 3 months…You may need treatment for a few years, until most of your menopause and perimenopause symptoms have passed."

HRT should always be started after a careful assessment of the risks and benefits. Speak to your GP about the risks associated with HRT and seek personalised advice from a doctor regarding the best treatment for you based on your symptoms. 

Alternatives to HRT

Following the standard guidance for a healthy lifestyle such as eating well, exercising and looking after your mental health can also help you manage the symptoms of perimenopause and menopause.

Dr Phipps says, "For women who choose not to use HRT or cannot use HRT, there are other treatments available which can help with individual symptoms of the menopause. These include antidepressant medications, herbal remedies, acupuncture and cognitive behavioural therapy for example. As ever, an individualised and holistic approach is key." You should always talk to a doctor before taking herbal supplements or complementary medicines and seek personalised advice from a doctor regarding alternative treatments for menopause symptoms. 

"Lifestyle changes can also help many of the symptoms of the perimenopause and if you would like to avoid taking conventional HRT, some lifestyle changes will help," says Dr Phipps.

Lifestyle changes and alternatives to HRT that may help with menopause and perimenopause symptoms include: 

• Eating a balanced, varied and healthy diet: This can help keep the body weight down and not put so much pressure on the joints. Focus also on improving your gut health which can often suffer in the menopause – eating fermented foods (if you can tolerate them) helps with this. A balanced diet with an appropriate amount of protein, calcium and foods containing phytoestrogens (plant sources of oestrogen) can help. Common foods containing phytoestrogens are soya, nuts, lentils, chickpeas and oily seeds.
• Regular exercise: Exercise such as resistance training and aerobics can help with joint stiffness and promote healthy bones and muscles. An increase of blood flow to the brain can help with brain function. Movement can also increase the levels of our ‘happy’ hormones – dopamine and serotonin and make us feel better. The NHS recommends including weight-bearing activities where your feet and legs support your weight like walking, running or dancing. 
• Manage stress: Reduce stress levels with relaxation and mindfulness. Yoga, massages and breathing exercises help with tension in the neck, back and shoulders as well as reducing anxiety and irritability.
• Stop smoking: Stop smoking and reduce alcohol consumption.
• Vitamin D: Vitamin D is important for the bones and checking and maintaining optimum levels reduces the risk of osteoporosis. You can either get some sunlight on your skin as this triggers the production of vitamin D or take vitamin D supplements.
• Rest: Get plenty of rest, including keeping to regular sleep routines.
• Try CBT: Cognitive behavioural therapy (CBT) is a type of talking therapy that can help with a low mood and feelings of anxiety. It can also help with sleep problems.
• Get support: As well as speaking to your doctor, talk to other people going through the same thing, like family, friends or colleagues.

Speak to your GP or a menopause specialist if you think you are experiencing symptoms of menopause. If you're finding going through menopause difficult and it's affecting your mental health, help and support is available here and you can access the NHS talking therapies service here. 

There are also many excellent support groups and charities to help women facing menopause, including: 

• Women’s Health Concern (WHC) - a trusted source of information on menopause for women and their partners
• Menopause Matters - an award winning, independent website providing up-to-date, accurate information about the menopause - including early menopause
• Earlymenopause.com - an online community providing a wealth of information
• The Daisy Network - a nationwide charity that offers support and guidance for women with premature ovarian insufficiency (POI)
• Menopause cafe - organises events where you can talk about the menopause and share experiences with likeminded women over a cup of tea
• Queer Menopause - finds and promotes inclusive menopause resources for people who are LGBTQIA+

Answers to frequently asked questions about menopause

The information on GoodTo.com does not constitute medical or other health advice or diagnosis and should not be used as such. Although GoodtoKnow consults a range of medical experts to create and fact-check content, this information is for general purposes only and does not take the place of medical advice. Always seek the guidance of a qualified health professional or seek urgent medical attention if needed.

Our experts

Vaccines Minister Nadim Zahawi has now confirmed when 12 to 15 year olds will get the Covid vaccine. It comes following new advice from the UK's chief medical officers (CMOs). 

While most children themselves only experience mild or asymptomatic coronavirus, certain factors tipped the scales this week and led health officials to approve the vaccine for children aged 12 to 15 as soon as possible. Professor Chris Witty, the head CMO for the UK, said it was a "difficult decision" to make.

While there are still concerns over whether all children should get the Covid vaccine, Professor Witty said that it would be "an important and useful tool" for reducing disruption to schooling in the coming months. Combined with the added health benefit of the vaccine in reducing illness and infection, it made sense to start vaccinating younger teens.

When will 12 to 15 year olds get the Covid vaccine?

The NHS will offer those between 12 and 15 years old one dose by September 22 2021.

Currently, the plan is to only offer the first dose of the Pfizer vaccine to children in this age group - rather than the two doses offered to all those over 16 years old old. According to data published in December 2020, just one jab is still 52% effective at preventing serious illness and infection.

Mr Zahawi said that the School Age Immunisation Service would offer "the bulk" of the programme. Separate vaccination sites will also be available for schools where this isn't available.

He said that all vaccinations delivered by the service would be subject to parental consent. However, he also noted that medical professionals would discuss the vaccine with parents. If there was a difference of opinion between parent and child, they would bring them together to try and reach an agreement.

If no such agreement can be reached, the clinician will decide whether the child is capable enough to make their own decision about whether or not to have the jab.

The new guidance to offer vaccinations to 12 to 15 year olds only applies to England. The Scottish, Welsh and Northern Irish governments have yet to confirm they will also offer the vaccine to the same age group.

Previously, only those aged 12 to 15 who were at serious risk from the virus were eligible for vaccination. This included children who had:

• A severe neurodisability
• Down Syndrome
• A severely weakened immune system, including some children with cancer
• Profound and multiple learning disabilities

Some healthy children over 12 who live with vulnerable people could also have the vaccine if they chose to. As could those "on the cusp" of turning 18. Anyone aged 16 or over is now eligible for both doses.

The NHS began offering the jab to all 16 and 17 year olds in August, on the basis that they would have built up 2 weeks worth of immunity before they returned to school in early September.

Health Secretary Sajid Javid, who has since resigned, followed up the announcement from the vaccines minister, saying, "I have accepted the unanimous recommendation from the UK Chief Medical Officers to offer vaccination to those aged 12 to 15. This will protect young people from catching Covid-19, reduce transmission in schools and help keep pupils in the classroom."

He has also urged anyone eligible for a vaccine, who has not come forward yet, to book in for their jab among warnings of a virus spike in the winter months.

No 10 has reportedly not ruled out the idea of a circuit breaker lockdown as a last resort in the coming months, if the NHS become overwhelmed with Covid-19 cases in England. They denied, however, that there was one happening over October half-term.

At the same time as 12 to 15 year olds are having their first dose, the government will announce how to book a booster jab for those eligible.

Will all 12 to 15 year olds get the Covid vaccine?

Yes, all those 12 to 15 years old will be offered just one dose of the Pfizer vaccine.

Those with underlying health conditions in this age group will be offered both doses of the vaccine.

This move by the British government to offer the vaccine to young teens falls in line with many other countries. This includes the US and Canada as both countries have started vaccinating all those over 12 years old.

However, the rollout of the vaccination programme to 12 to 17 year olds will be carefully monitored. In the initial rollout to those aged 18 and over, many attempted to get their second Covid vaccine early. Those who can prove a double coronavirus vaccination are allowed to travel to amber list countries without quarantining of their way home, increasing the demand of a speedy second jab.

When did the MHRA approve the vaccine for this age group?

The Medicines and Healthcare products Regulatory Agency approved the Pfizer vaccine for 12 to 15 year olds in June 2021. Following advice from the JCVI, the government have now confirmed that they will offer the vaccine to this age group.

In December, the regulatory body approved the Pfizer vaccine for those 16 and 17 years old. At the time, the JCVI advised that 16 to 18 year olds in the Phase 1 group have a vaccination. Those living in a household with someone who has a suppressed immune system were also eligible.

The regulatory body said the vaccine was safe to use in these age groups. They also said the benefits outweighed any risks when it came to vulnerable teenagers.

This statement followed a "rigorous review" of the safety and quality of the jab in those under 16 years old by the MHRA and the government's own independent advisory body, the Commission on Human Medicines (CHM).

"No extension to an authorisation would be approved unless the expected standards of safety, quality and effectiveness have been met," Dr June Raine, MHRA chief executive, said in a statement at the time.

In March, Pfizer published their own research on the effects of the vaccine on those in the 12 to 15 age group. They also suggested that the vaccine was highly effective (up to 100%) and produced "robust antibody responses".

These results were better than those of a trial of 16-15 year old participants in an earlier analysis". Young people in this age group also "tolerated" the vaccine well.

When will 16 to 17 year olds have the vaccine?

All 16 to 17 year olds are now eligible to have both doses of the Pfizer vaccine.

Vaccinations predominantly took place at walk-in clinics and GP surgeries for this age group, just the same as others. However, thousands of young people took up the chance to have the jab in August at Grab-A-Jab sites. Two of these were Reading and Leeds Festival.

As of September 2, the NHS reported that 50% of 16 to 17 year olds had taken up the offer. Only four weeks later, Health Secretary Sajid Javid said the programme was a huge achievement.

"It is fantastic to see the enthusiasm of young people to get the jab. And great news that more than half of 16 to 17s in England are now vaccinated with a first dose as they return to colleges and sixth forms," he said.

"Thank you for playing your part in helping us live safely with this virus. So we can continue to enjoy the freedoms we missed like seeing friends and family.

"Jab by jab we are building a wall of defence that has already saved more than 105,000 lives and prevented 143,000 hospitalisations in England alone. Do not delay – please come forward and get both of your vaccines as soon as you can."

What is a circuit breaker lockdown? It's the question everyone is asking as Scotland's ministers are reviewing potential changes to the lockdown rules. 

Despite an incredible uptake of the Pfizer, Moderna and Oxford vaccines, and attempts even by younger people to get the second vaccine early, Covid-19 cases are still rising in the UK. While this isn't surprising, as no jab is 100% effective, it's causing concern among health experts and government ministers. Especially since, along with infections, hospital admissions and deaths are also going up.

One of the measures ministers have employed before is a circuit-breaker lockdown, otherwise known as a firebreak lockdown. These lockdowns help to prevent infections, giving the NHS time to recover from the surge.

What is a circuit breaker lockdown?

A circuit breaker lockdown is a short, sharp lockdown that lasts just a couple of weeks. It's a short-term solution to reverse the tide of infections and bring case numbers down.

While the rules feel very similar to when we go back into lockdown, a circuit-breaker is only for a set period of time. After this period is over, people can go about their lives as before.

The idea is that circuit breaker lockdowns are less damaging to the economy, education and people's mental health as they allow people to plan ahead for restrictions.

However, it's debatable as to how effective they really are. Whether these lockdowns work or not entirely depends on how severe the rules are and how much people stick to them during the time that they're enforced.

What is a firebreak lockdown?

A firebreak and circuit breaker lockdown are the same thing.

In electronics, a circuit breaker is an automatic electrical switch that is designed to protect an electrical circuit from excess surges of current. While a firebreak is similar, its name comes from the fire prevention method of having a strip of land in a wood or forest where the trees are removed to prevent a fire from spreading.

While Wales called their short lockdown in October 2020 a 'firebreak' lockdown, Northern Ireland called their one in November a 'circuit breaker' lockdown.

Will there be a circuit breaker lockdown in Scotland?

A circuit breaker lockdown is one of the options that health experts are presenting to First Minister Nicola Sturgeon. The country is currently experiencing a rapid rise in cases of coronavirus, following the end of restrictions. However as of August 26, there's been no confirmation that Scotland will be in a circuit breaker lockdown.

Other options include new social distancing rules and vaccine passports, which allow people to prove a double vaccination before entering public events and travelling internationally.

It's likely that freedoms of the summer months will be locked down as we approach winter, according to sources in The Times. During the winter months, health experts are expecting a surge in Covid-19 cases anyway, as there's less chance for ventilation in indoor spaces and the cold weather wears down the body's immune defence.

The changes in restrictions are likely to begin again with some of the most preventative measures. Scottish government guidance already says that face masks will be mandatory in crowded spaces until next year.

“There are two options: You could either put in a circuit breaker, you could shut down completely for a short period. Or you could move back through the stages and say we are going to limit indoors gatherings, we are going to reintroduce distancing,” the source told the paper.

Will there be a circuit breaker lockdown in England?

According to Vaccines Minister Nadhim Zahawi, there's the potential for England to go into a firebreak lockdown before the end of the year.

Mr Zahawi did not deny that a circuit breaker lockdown could be implemented if Covid-19 hospitalisations remain high. But, he said it depends on if people book a booster jab and the booster programme for the elderly and most vulnerable.

He said that the booster programme was his "absolute priority". This is because it would "absolutely help us to transition the virus from pandemic to endemic status". He did warn, though, that the "one-way road towards sustaining the opening of the economy" would only happen "if we do that well".

One idea is to extend the October half-term to two weeks. This would keep children away from school and allow room for the NHS to recover after an expected peak in early October.

But questions over whether we will go into lockdown again have been coming up since March earlier this year. There has been nothing concrete since then to suggest that more restrictions are on the way.

The PM has promised to keep "contingency measures" in place to "help manage the virus during higher risk periods, such as winter". But he also assured the public that the government would do "everything possible" to avoid restrictions.

England's short, sharp lockdown in November last year was to manage the surge of cases before Christmas. And as we know, it really wasn't all that effective. The government had to ditch plans to allow those in upper tiers to mix households over the holiday. They then put the country in a long lockdown in the new year, which only fully ended on July 19.

Importantly though, in November last year there weren't any vaccines available to the general public. We're in a very different situation now compared to even earlier this year. According to the latest government data, 47 million people in the UK have had a first vaccine dose. This works out to be 87% of those over 16-years old. Nearly 41 million people - 75% of those over this age - have also had both doses. This in turn gives 75% of the population a significant chance of avoiding seriously illness and death, shown by the dramatically reduced levels of hospital admissions during this ongoing third wave.

Although it's still important to bear conditions such as long-Covid in mind, it's hospital admissions and deaths that the government value when making decisions about restrictions.

With a circuit breaker lockdown being discussed, many are concerned about whether schools are going to close again before the winter holidays. And further along the line, whether Christmas parties are cancelled for another year.

Will there be one in Wales?

Similarly to England, there are no reports that Wales is going back into a circuit breaker lockdown.

Although, cases are rising in the country since ministers lifted restrictions earlier this month. Wales latest infection rate was 321.7 cases per 100,000 people - based on the seven days leading up to August 20.

First Minister Mark Drakeford has said that he's monitoring the situation and deciding whether to enforce restrictions again.

"We have never said in Wales a move away from restrictions is a one-way street and there was never any turning back," he said at a press conference recently.

However, the country has seen an incredible in coronavirus vaccines in newly-eligible age groups. Across the UK, some 12 to 15 year olds can have the vaccine and 50% of 16 to 17-year olds in Wales have now had their first jab.

The country had a firebreak lockdown starting from October 23 last year. It ended on November 9 and included a ban on all non-essential activity, except if you were a key worker.

Will Northern Ireland go into a circuit breaker lockdown?

There's no confirmation that Northern Ireland will go into a circuit breaker lockdown.

However, Northern Ireland recorded their highest number of coronavirus cases - ever - earlier this month. On Friday August 13, the Department of Health recorded 2,397 more cases and a further nine deaths from the virus.

Doctors are now warning ministers that people may lose their lives to other conditions.

Much like England, Northern Ireland's Stormont ministers announced a firebreak lockdown in October last year.

What would a circuit-breaker lockdown mean?

While it might sound like a good idea in theory, the circuit-breaker lockdown would involve the strictest measures.

In Northern Ireland last year, the hospitality sector closed - apart from takeaways and deliveries. Off-licenses and supermarkets couldn't sell alcohol after 8pm and there was no indoor sport other than at elite level. Close-contact services had to close too, as did mobile hairdressers and make-up artists. However, gyms could remain open for solo training - without any classes.

First Minister Mark Drakeford issued the Welsh firebreak lockdown last year. He told a press conference that all non-essential retail, leisure, hospitality and tourism businesses had to close. This meant that everyone had to work from home wherever possible and stay inside, except for very limited reasons. People could also not meet anyone outside of their households with exceptions for those who live alone.

The FM said at the time, "This fire break is the shortest we can make it. But that means that it will have to be sharp and deep in order to have the impact we need it to have on the virus."

Do circuit-breaker lockdowns work?

England has taken on a short, sharp lockdown before - with mixed results. In November, the government announced another lockdown temporarily to try and curb the virus.

According to research from the Zoe Covid symptom study, in association with Kings College London, the results of the lockdown varied across the country. Cases went down in areas of the north of England which had the highest infection rate. But they rose in the Midlands and continued to rise through the lockdown. Experts believed that this was due to reduced compliance, a result of months worth of restrictions, or a last-minute burst of socialising as the highest rates were in those aged between 20 to 39 years old. People in this age group are also most exposed. They are the most common age group working public-facing jobs, such as in restaurants and bars.

Also, schools didn't close during England's circuit breaker lockdown. This meant the levels of infection in children and young people under 19 at school and university stayed stable.

Can I get my second Covid vaccine early? It’s the question many are asking this week as more people become eligible for the jab. 

Throughout the pandemic, both the government and health officials have stressed the importance of a double Pfizer, Moderna or Oxford vaccine dosage. As well as helping to encourage herd immunity and cut transmission, all evidence points to a double vaccination as the best way to avoid serious illness and death. Data from this year shows that a double jab can reduce the risk of death by up to 80% in those over 80-years old.

It's more important than ever before, some experts say, as the government have now scrapped restrictions in England. This includes the requirement to wear a face covering, despite not all o the population actually being double jabbed yet.

Can I get my second Covid vaccine early?

Unfortunately, advice from NHS England and Joint Committee on Vaccination and Immunisation (JCVI) says that second doses of the vaccine have to be at least eight weeks after the first. 

Studies show that shorter intervals between doses offer a high level of protection - but "eight weeks is the sweet spot". Having the second dose earlier than this could even result in less protection from the vaccine.

Oxford University's Pitch study compared the immune responses of 503 NHS staff who had had their two doses at different intervals in late 2020 and early 2021. This was when the Alpha variant was the dominant one in the UK.

After one month and their second vaccine dose, they measured the staff members' antibodies. Researchers found that both short and long dosing intervals of the Pfizer vaccine created a strong immune response overall. However, they discovered that a three week wait between doses created fewer of the antibodies that bind the virus and stop it infecting cells than a 10 week wait.

Those who had the vaccine with less time between doses still developed high levels of T-cells, which are a different type of immune cell. Those with a longer amount of time between doses had fewer T-cells but a higher amount of "helper T-cells". These support overall immune memory according to the researchers.

Prof Susanna Dunachie, the joint chief investigator in the study, said that given the UK's current situation, "Eight weeks is about the sweet spot...because people do want to get the two vaccine [doses] and there is a lot of Delta out there right now."

"Unfortunately, I can't see this virus disappearing. So you want to balance that against getting the best protection that you can," she added.

Professor Anthony Harnden is the deputy chair of the Joint Committee on Vaccination and Immunisation (JCVI). He told The i paper that people receiving their second doses may have "less protection against infections in a potential fourth wave". And if you have the second jab early, "you're definitely less protected against asymptomatic disease if you have a shorter dose interval”. 

Another study published in May 2021 by the University of Birmingham found that older people (80 to 99 years old) who waited longer between doses (12 weeks) had an antibody response 3.5 times greater than those who only waited three weeks between doses. 

The research project was the very first one to compare the effect of short and longer waiting times between doses.

“Our study demonstrates that peak antibody responses after the second Pfizer vaccine are markedly enhanced in older people when this is delayed to 12 weeks,” Helen Parry, author of the study, said. 

A similar study published in June 2021 by Oxford University showed that a longer waiting time of 45 weeks between the first and second doses of the Oxford-Astrazeneca vaccine produced a better immune response as well. 

The research on the vaccine also indicated that a third booster jab would continue to create antibodies against Covid-19.

Having the vaccine a few days early is fine if it avoids wastage, Professor Harnden said recently. However, shorter intervals between doses were “not in the person’s best interest or in the population’s best interest”. 

He added, “Our policy is eight weeks so they shouldn’t be having [the second dose] early and if they’re having it early to get off on their holidays, it’s not a sensible idea really.” 

However, despite NHS guidance being clear on the subject, some people have managed to get their second vaccine early. With growing concerns over the transmissibility of the new Delta variant amid lockdown ending, some centres defied the rules and offered second vaccinations as early as 21 days after the first. 

Over the government's "Grab a Jab" weekend in June, many pop-up vaccination sites offered early second doses. Evidence on social media also suggests that walk-in clinics in England were offering second jabs. Some were providing vaccines with a gap of only three weeks between the first and second doses.

An NHS England spokesperson has now confirmed that they are contacting vaccination centres to ensure this doesn't happen again. They said that "every site should vaccinate in line with JVCI guidance". This means that "second doses should take place eight weeks after the first".

Can I choose which Covid vaccine I get?

No, you cannot normally choose your Covid-19 vaccine. 

When you book an appointment online, the NHS will only offer appointments for vaccines that you can have. If you're pregnant or under 40, then you will have the Pfizer or the Moderna vaccine. And following the approval of the Pfizer vaccine, if you're under 18, the service will only offer the Pfizer vaccine. The Oxford and Moderna jabs haven't been approved for this age group yet.

Will the government shorten the waiting time between jabs?

Getting the second Covid vaccine early could become a common practice, though. The government may halve the waiting time to four weeks anyway.  

Number 10 officials have reportedly asked the JCVI to offer urgent advice on reducing the time between doses from eight weeks down to four, in order to speed up the administration of second doses. It comes amid a general rise in Covid-19 cases across the country, which has led to some politicians to consider a circuit breaker lockdown. 

If the government approves the decision, it will be younger people who primarily benefit. If they are eligible under strict criteria, 12 to 15 year olds can get the Covid vaccine in the UK and so can those aged 16 and 17 years old, following changes to the guidance. 

Most of those aged 40 and over have now been offered both doses of the vaccine. So as well as providing better immunity for those who could be at risk of illness and conditions such as long Covid, it opens up the idea of quarantine-free international travel for more people. 

According to an ONS report, 62% of adults between 16 to 29 years old were looking forwards to booking a holiday abroad when the legal restrictions ended. Currently, anyone going abroad to a country that isn’t on the green list has to quarantine if they are not able to prove a double vaccination.

Those who can prove that they have had both doses of the vaccine will be able to travel to country on the amber list without having to quarantine on their return to the UK. 

The government has also urged many venues to consider using the NHS Covid Pass scheme as a condition for entry. If they do, only those who have had both doses (or proof of a negative test instead) can enter.

How long should you wait between vaccines?

The JCVI and other medical experts recommend that you wait 8 weeks between your first and second doses.

As Professor Anthony Harnden has said, “There is very good immunological and vaccine effectiveness evidence that the longer you leave that second dose the better for Pfizer and eight weeks seems to be a reasonable compromise.” 

At the start of the vaccine roll-out, health officials said a 12 week gap between doses is ideal for maximum protection. However, Deputy Chief Medical Officer, Professor Jonathan Van-Tam, explained that the changing nature of the new Delta variant led to the government decreasing the gap from 12 weeks to 8 weeks. 

“In the absence of any growing variant, the UK would have stuck to its plans to vaccinate with a 12-week interval."

“However, we now know that two doses of the vaccine are very much better than one dose for protection against infection with the Delta variant," he said. "We now find ourselves in a straight race between finishing the vaccination programme and how quickly the Delta variant will continue to grow.” 

He added, “That is why JCVI has now shortened the dosing interval back to 8 weeks as a response to an ever-changing situation.”

Those eligible for a third vaccine must book a Covid booster jab a minimum of six months after their second dose.

How to find a walk in centre

There are walk in centres around the country where you can get your second dose. You can go to one of these even if you have an appointment booked in the future.

Go to the NHS website and type in your postcode. This will give you a drop-down selection of sites where you can get your first or second doses.

Some sites are only vaccinating with one type of jab (Pfizer, Oxford or Moderna). So, you'll have to go to a different one to get the second dose of the jab you had before. Others are only offering walk-in vaccinations to those in higher priority age groups, such as people over 40.

Advice from NHS reads, "If you live in England and are aged 18 or over, you can get a COVID-19 vaccine from a walk-in COVID-19 vaccination site without an appointment.

"You do not need to be registered with a GP or bring any ID. It might help to bring your NHS number, if you know it.

"If you've already had your 1st dose, you need to wait 8 weeks before having your 2nd dose."

Can I mix and match my covid vaccine?

The government have not made a final decision as to whether people can mix and match Covid jabs. You must have the same vaccine for both, unless you had a serious allergic reaction to the first jab.

The effect of mixing Covid-19 vaccine is still being explored.

Mixing and matching Covid jabs means having different vaccines for your first and second dose. This might be a Pfizer vaccine for your first dose. Then, eight weeks later, a shot of the Oxford-Astrazeneca vaccine for your second dose.

At the moment, there are several ongoing studies looking into the impact of mixing and matching Covid-19 vaccines. Data has been released from trials in Spain and at Oxford University in the UK. Both suggest that mixing vaccines leads to a good immune response. Occasionally, mixing the vaccines produced a higher immune response than two does of the same jab as well.

A German study found that mixing jabs produced a better immune response than two doses of the Oxford-Astrazeneca vaccine. They also found that mixing vaccines was just as good as having two shots of the Pfizer vaccine.

Many countries are already mixing vaccines, due to unstable supplies of one type in many cases. These include:

• Thailand
• The United Arab Emirates
• South Korea
• Italy
• Canada
• Bhutan
• Bahrain

Public Health England quietly approved the method in January when there were questions over supplies in the UK. This could be an option in the future, especially for those eligible for a third jab.

Over in the States, the Centers for Disease Control and Prevention allowed mixing "in exceptional circumstances".

However, experts say there isn't enough clinical data to confirm mixing the vaccines is completely effective. Both the Spanish and English studies suggest that side effects from the vaccine are more severe when mixing jabs too.

The World Health Organisation (WHO)'s chief scientist Soumya Swaminathan also confirmed that people should wait for more information before going ahead and mixing vaccines.

She said, "Individuals should not decide for themselves, public health agencies can, based on available data. Data from mix and match studies are awaited - immunogenicity and safety both need to be evaluated".

So for now, it looks as though mixing and matching vaccines is not an option in the UK.

Will there be a third dose?

The government is currently creating the vaccine programme for "booster" third doses. These will be available to those particularly at risk from Covid-19 at the moment. This includes those in more vulnerable age groups and those who are more likely to be affected by the virus.

There are no plans to offer a third dose to anyone who had their second jab early, though. Responding to the question on BBC's Andrew Marr Show, Professor Harnden said that the programme is "designed to prevent hospitalisations and deaths." 

Therefore, he added, "targeting boosters with the most vulnerable first is clearly the right strategy."

Can you drink after the Covid vaccine? It's a question coming up everyday, now that over 41 million people have had their second dose. 

The NHS and the government have hailed the Pfizer, Moderna and Oxford vaccines as the sure-fire way out of the pandemic and towards a return to normality. It’s no surprise that people may want to celebrate getting their doses with a drink or two.

Whether or not you drink after your vaccine is completely at your own discretion. We've looked into what the experts have said, so you can make up you own mind.  Some evidence is very clear, however. If you do decide to drink after your vaccination, be sure not to go too overboard and stop drinking if you think you've had too much.

Can you drink after the Covid vaccine?

Some experts have urged people not drink alcohol after the Covid vaccine, as it may potentially reduce the vaccine's efficacy.

Chair of Drinkaware's medical advisory panel, Dr Fiona Sim, said in a statement recently, “As far as alcohol is concerned, we advise that you consider not drinking for two days before, and up to two weeks after you’ve been vaccinated, to try and ensure your immune system is at its best to respond to the vaccine.”

But Dr Sim also urged people to get the vaccine when possible, regardless of whether they consume alcohol or not. “We would reassure anybody who has already been vaccinated and has had an occasional drink since, that they should still benefit from the vaccination," she said. "And we would stress the importance of attending your appointment for the second dose when it comes around."

There is plenty of evidence to show that heavy alcohol consumption could inhibit the body's immune response following vaccination. Existing research on alcohol and the immune system shows that excessive alcohol consumption acts as an immunosuppressant. This means that people who drink a lot are not only more susceptible to infections, including Covid-19, but their bodies may not respond as effectively to the vaccine.

A recent Alcohol Research review also found, without a doubt, excessive alcohol consumption leads to “adverse immune-related health effects”. This includes impeding the body’s ability to fight against infection. In turn, this leads to a slower and less complete recovery from the infection. 

While much of the research on the Covid-vaccine has been conducted first-hand, like the studies into whether children should have the coronavirus vaccine, the cautionary advice to stay away from alcohol post-vaccination comes from other studies on vaccines more generally.

There is no evidence to suggest that drinking alcohol interferes with the effectiveness of Covid-19 vaccines specifically.

Both the NHS and the Medicines and Healthcare products Regulatory Authority (MHRA) have confirmed this, which in turn, has prompted the government to assure people they can return to their normal lives post-vaccination. "You should be able to resume activities that are normal for you as long as you feel well," the government's website reads. 

Other vaccine experts agree; there’s nothing wrong with having a few pints to celebrate your vaccination.

“There’s no evidence that drinking alcohol interferes with the efficacy of the vaccine, although you might feel a bit unwell after you have it,” Dr Jonas Nilsen, founder of the vaccination specialists Practio, says. “Headaches, muscle and joint pain as well as nausea are common side effects of the coronavirus vaccines, so drinking alcohol could make you feel even worse.

“We’ve had many reports of fainting during or shortly after vaccination at our vaccination centres, so one thing that is essential is that people eat and drink something before they go to their vaccination appointments. We also give people a full bottle of water and recommend they drink it before they receive the vaccine.”

Can you drink before the Covid vaccine?

The general advice is not to drink before having the Covid-19 vaccine.

There are logistical issues, of course, with having one too many before going to get your Covid vaccination. Safety issues include those involved with travelling to and from the vaccination centre. Before having the vaccine, you must be able to coherently answer questions about whether you have any symptoms of coronavirus. New symptoms of Covid-19 have been linked to the Delta variant, so vaccinators will also be aware of these.

Having the ability to consent to the vaccine is required before vaccination. Most people give their informed consent by turning up to the vaccination centre and in the pre-vaccine interaction with the health professionals on site, but the law and regulations around administering non-lifesaving medical care to people who are drunk is hazy - and mainly refers to doctors. It's unlikely, therefore, that vaccinators will inject someone who has had a few drinks.

It's also a good idea to avoid doing anything that may cause or worsen potential side effects of the vaccine.

What are the side effects of the vaccine?

The most common side effects of the vaccine are similar to those associated with a hangover. They include:

• Feeling tired or fatigued
• Headache
• Body aches
• Feeling nauseous or actually being sick

Above all, the most common side effect is having a sore arm. According to a symptom study using data from Kings College London, this accounted for just over 66% of all people who reported a side effect following their vaccination. However, one in four vaccinated individuals reported one of the above side effects.

There are very few hangover cures, apart from paracetamol, that work for vaccine side effects. So, it's best to delay a celebratory night out until a couple of days after your vaccination.

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