Hiccups are thought to be related to phrenic and vagus nerve function. Picture: iStock 

I’m in my mid-40s and have started to get hiccups after my main meal in the evening. I drink a glass of red wine most days. Would it help if I cut it out?

While alcohol can contribute to cases of hiccups, it is typically a result of drinking too much rather than having a single glass. Carbonated beverages are another common trigger, but again this is not the case with your red wine.

It may be that the wine is triggering hiccups because you are taking it following your main meal rather than the drink itself being an issue. You could try switching around your meals so that you are eating your main meal at lunchtime and eat a lighter meal in the evening to see if that makes a difference.

Hiccups are thought to be related to phrenic and vagus nerve function. The phrenic nerve controls the diaphragm, sending signals for it to contract and expand the thoracic cavity. The vagus nerve triggers the parasympathetic nervous system (the relaxation response) for the thorax and abdomen.

There is a specific exercise used to stimulate healthy vagus and phrenic nerve function. This exercise is often referred to as belly or diaphragmatic breathing and is typically practised while lying on your back or sitting upright. Place one hand on your upper chest and the other on your belly, then breathe in slowly through your nose. The hand on your chest should remain still, while the hand on your stomach should rise. Exhale through your mouth — your belly hand should fall back to its original position when you do this.

The exhalation should feel relaxed rather than forced, and it is best to begin with three to four rounds of belly breathing as you become accustomed to it since deep breathing can lead to hyperventilation if you force or overdo it.

It is also worth noting that the vagus nerve is connected to your vocal cords and inner ear, so simply humming can stimulate healthy vagus nerve function. This is one of the reasons why mantras are used in meditation.

I’m in the final trimester of my pregnancy and feeling exhausted nearly all the time, even though I’m sleeping up to 10 hours a day. Is there a remedy I can take?

It may be worth having your ferritin levels checked via a blood test. Ferritin is a protein in the blood serum responsible for iron storage. Testing is crucial before taking an iron supplement since the symptoms of haemochromatosis can be similar to those of low iron.

Haemochromatosis is a metabolic disorder where iron accumulates in the body and is deposited in the organs. One-third of the Irish population carries the genes for this condition, so it is important to rule this out.

The normal range for ferritin is between 20-200ug/l, with levels below 40 considered to be on the low side of average. Low ferritin is linked with iron deficiency since the body will use up stored iron when the blood levels are low. One of the main symptoms associated with iron deficiency is the extreme fatigue you are experiencing. If you have lower (but not alarmingly low) ferritin levels, then Floravital is an excellent tonic to consider. The tonic has an iron absorption rate of 25%, compared to the average absorption rate of iron tablets at 2-10%, but without the unwanted side effect of constipation.

Take 15mls of Floravital twice daily until your ferritin levels are at least 25ug/L. Then take 10mls daily of Floravital until you feel you no longer need it (usually quite evident in your energy and mood levels), and have your blood tested to check your progress. Floravital is widely available in health stores, pharmacies, and some supermarkets.

Make sure that you are getting enough water. It is vital to remain well hydrated throughout pregnancy (and breastfeeding) since this assists in organ function, supports a healthy uterus, helps form the amniotic fluid, and assists in nutrient circulation for you and your baby.

NOTE: The information contained in this column is not a substitute for medical advice. Always consult a doctor.

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