First, check that your symptoms aren’t due to anything more serious than poor circulation: your doctor may want to check that you don’t have high levels of “bad” cholesterol (low-density lipoprotein, or LDL) furring up your arteries.

But poor circulation with no underlying physical problem is common, particularly among women, the downsides for some being that they may suffer from pins and needles, as you do, while others may look pale, suffer from a sluggish digestive system and constipation and feel constantly washed out — the last thing you need when you have three children. Try to make sure that you’re exercising enough to keep the blood pumping around the body. I have patients who have suffered like you, but when they started doing formal exercise, such as Pilates or yoga, their pins and needles disappeared.

There are nutritional strategies that can help to improve your circulation. Vitamin E is an effective circulation-boosting nutrient and is found in vegetable oils such as sunflower and corn oil, sunflower seeds, sun-dried tomatoes, hazelnuts, peanuts, Brazil nuts and almonds. Oily fish, specifically fresh tuna, salmon, trout, sardine, mackerel and herring, are rich in omega-3 fatty acids, which prevent the blood from becoming too thick to travel easily through the blood vessels. I would ensure that you have two 140g portions of oily fish a week — men (and women past childbearing age) can have up to four a week, but because of the high levels of PCBs and dioxins, women and girls should stick to two. You could, of course, look to non-fish sources of omega-3, which include hemp, flax and walnuts. It can also help to boost your intake of chilli, fresh ginger, mustard, garlic and buckwheat, since all these foods stimulate blood flow. Make sure your diet is rich in antioxidants, such as vitamins C, D and E, betacarotene and selenium by eating plenty of fresh fruits. Most fruit is high in vitamin C, as are salads and vegetables, but you need to keep cooking time for vegetables to a minimum because vitamin C is heat and time-sensitive. Also include wholegrain products such as bread, muesli, seeds and nuts. Finally, try taking a ginkgo biloba supplement as this can help to improve blood flow to the feet and hands — but don’t take it if you’re pregnant. If you get a few moments to yourself, gently massage your hands and feet with essential oils such as geranium, or a blend of geranium, lavender and rosemary — within aromatherapy, these are considered to boost circulation.

My mum, 78, has just had a stoma bag fitted. She is also diabetic and is finding it difficult to know what to eat. Are there any tips to encourage her to eat and drink sufficiently?

This is tricky. I’m not a big fan of diabetic products as they’re often high in a sugar substitute that can, in large amounts, be a laxative — the last thing your mum needs with a stoma. But in sugar-free diabetic squashes, manufacturers tend to use a different sweetener that doesn’t have this effect, so give them a try. It’s best if your mum staggers her water intake as this maximises the body’s absorption. Drinking large quantities at a time can wreak havoc with stomas.

I suspect your mum has maturity-onset, non-insulin-requiring diabetes. This means she should eat a balanced diet similar to that of anyone her age: lean proteins, complex carbohydrates, food that is lowish in fat (especially saturated animal fats, as these can increase the risk of heart disease), plenty of fresh fruits and vegetables. But the fact that your mum has a stoma makes this more complicated. Smaller meals eaten often will sit more comfortably in her stomach and be more manageable stoma-wise. Try to make the snacks more nutritious than a nibble: a ham sandwich at teatime, or a cracker with a little butter and a slice of smoked salmon or cheese.

With the stoma you may find that her gut reacts badly to a diet rich in raw fruits and vegetables. Cooking them may be the answer — you could make an apple and pear purée to eat with yoghurt. Even slightly sweeter fruits such as berries will be fine: don’t be put off by the adage that diabetes prohibits eating fruit. Stewed apple with blackberries is delicious with custard. Serve steamed (or microwaved) veggies instead of salad. In summer, allow cooked vegetables such as French beans and butternut squash to cool down, and drizzle with a little olive oil. Make small appetising meals that you can eat together — having someone to keep her company may make your mum more inclined to eat.

DO YOU NEED ADVICE?

Send your nutritional problems to jane.clarke@thetimes.co.uk or to Jane Clarke, times2, 1 Pennington Street, London E98 1TT. Her replies cannot apply to individual cases and should be taken in a general context. Consult your GP with any health or specific conditions. Jane cannot enter into personal correspondence.

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