Stress, diet, STIs and more: Medical risks in Westeros

Game of Thrones recently aired its epic season finale after almost a decade of bloodthirsty on-screen deaths, fire-breathing dragons and intertwining tales of regal family history, bloodlines and royalty.

While some viewers may be disappointed it’s over, they can look forward to planned spin-offs and future book releases. In the meantime, the content team at Treated.com have been considering some of the themes surrounding health and nutrition in the television programme and novels.

To get some expert insight, we spoke to Maeve Hanan, Registered Dietitian at
DieteticallySpeaking.com, and Treated.com GP Clinical Lead Dr Daniel Atkinson.

Just a warning that if you haven’t gotten around to watching Game of Thrones, you may encounter
spoilers (and interesting information about health and nutrition) ahead.

Stress

When you play the Game of Thrones, you may encounter high levels of exposure to stress which can have a detrimental impact on your physical and mental health.

Take the Mother of Dragons, Daenerys Targaryan. Throughout the programme her character is subject to many stressful situations.

She is sold as part of a marriage transaction to a brutal leader of the Dothraki tribe. Attempts are made on her life from plotting forces in the West, namely Robert Baratheon. After the Khal dies, she leads a tribe through the scorching desert climates as they come close to starvation – and most of this occurs before we even reach the third season.

But what would these levels of stress do to your physical and mental wellbeing? Well, chronic stress over a long-period of time can cause problems in the blood vessels and affects blood pressure.

It’s likely the Khaleesi would may have suffered from headaches, low energy, digestion problems, chest pains and a rapid heartbeat. More severely, she may even have developed depression and insomnia.

“Starting out as a teenager, through a combination of the above, it’s possible Daenarys would not have reached 30 without running into very serious health problems,” Daniel comments.

If you feel like you are not coping well with stress do not suffer alone. Reach out to a family member or friend and they may be able to offer you help and advice. If stress is having an unhealthy impact on your mental or physical wellbeing, don’t hesitate to make an appointment with your GP.

Alcoholism

“It’s only wine”, Tyrion Lannister once claimed. But, as we know, drinking in excess can play a big role in determining your life expectancy and mental health. Lots of characters like to drink alcohol on Game of Thrones, but the Lannister children, namely Tyrion and Cersei, drink lots of wine.

We see Cersei drinking red wine in a lot of her time on-screen, and it’s likely she uses it as a vice to cope with the death of her children. Women are not advised to drink more than 2-3 units of alcohol a day overall, something we’re sure Cersei surpasses.

“This level of alcohol consumption is very bad for health and would be associated with a higher risk of: liver disease, cancer, heart disease, dementia and depression,” Maeve Hanon notes.
To keep risks from consuming alcohol low, it is recommended to drink no more than 14 units a week on a regular basis. This should also be spread out over 3 or more days so there are a few alcohol-free days during the week.

Daniel adds that “alcohol abuse can have a significant impact on your physical and mental health. Having an addiction problem is nothing to feel ashamed of, but it is important to address the problem. Speak to your friends and family, have an open and honest conversation. Then seek medical help”

Unprotected Sex

In the Game of Thrones universe, characters have a lot of sexual intercourse. Their understanding of contraception, the spreading of diseases and infection is likely quite limited.

Characters like Theon (before his unfortunate encounter with Ramsey Bolton), Bronn the talented sell-sword, and, of course, Tyrion have very promiscuous lifestyles.

Certain STIs are symptomless and the effects won’t make life-threatening impacts on your health.
However, they can cause generally unpleasant symptoms — bad smells and discharge from the genitals, for example — and lead to infertility.

Some STIs like syphilis can be life-threatening, so it may seem surprising that none of the many deaths on the show had anything to do with sexually transmitted bacterial infections.

“Fortunately, in the last few decades, research and treatment into sexually transmitted infections has improved significantly and helped many thousands of people in the Western world live STI free lives. The same cannot be said of the Game of Thrones universe,” Daniel notes.

Lots of characters who practice promiscuous lives would be at likely risk of contracting one, if not several, sexual infections. While it’s evident they have some understanding of health and medicine, if we’re to take this world to be an historic equivalent of medieval times, it’s doubtful legitimate understanding of STIs could exist.

A character like Tyrion, engaging in unprotected sex with several partners regularly throughout the first few seasons, would have encountered at least one STI (such as syphilis or chlamydia)

The North / South Diet

In Westeros, there is a clear divide between Northern and Southern people. Economic wealth is
concentrated in the capital city of Kings Landing.

People in the aristocratic South, like the Lannisters and Baratheons, enjoy huge feasts with exotic fruits, red meats, cheese, cakes and lots of wine.

In the North, their diets are more basic — they eat things like bread, pastries and brown stew. Because clean water is harder to come by compared with the South, mead and ale are healthier alternatives.

“Southern characters seem to have a slightly more balanced intake of nutrients. This is because the Southern diet includes food from each food group (fruit and vegetables, dairy, protein, fats, grains and starchy carbohydrates),” Maeve tells us.

“Whereas the Northern diet seems low in fruit, vegetables and wholegrains, and is likely to be high in saturated fat from all of the pastry. The availability of food would also play a big role in health and life expectancy as malnutrition leads to poor overall health – again it seems that there is a more reliable supply of food in the South.”

Because the Northern folk’s diets are slightly less varied — and they eat a lot of red meat — it’s not unlikely they would encounter serious cholesterol and bowel problems by the time they reach middle age.

“That being said,” Maeve adds, “neither of these dietary patterns are ideal as both seem high in fat and alcohol, and the Southern diet seems high in sugar.”

Daniel adds, “A balanced diet is paramount. Certain organs and bodily processes depend on certain
nutrients. If you deprive yourself of fibre, for example, it may cause bowel and digestive problems. If your diet consists mainly of red meat and saturated fat, like the people in the North, you’d be building yourself up for some pretty serious cholesterol and heart problems. Don’t misuse your body or deprive it of the nutrition it needs.”

Untreated Wound Infection

Throughout the show and in the novels, there are many instances of wounds inflicted during battle. Characters in royal houses, like Tyrion when his face is slashed, will have the luxury of having their wounds treated.

But take an example where a wound is left to fester. After Khal Drogo slays a leadership rival he may be victorious, but he is left with a small flesh wound near his shoulder. It becomes infected after some days and causes him to become very ill.

“This teaches us a valuable lesson about getting treatment for infected wounds,” Daniel notes.
Things start to go down-hill when germs interact with your open wound, which wouldn’t be unlikely in a world where general hygiene does not exist in the same way it does in the real world.
Again, it may be surprising that not more characters die from infected wounds, dysentery and gangrene.

Signs of infection may be visible from throbbing sensations, swelling, feeling generally sick, a temperature and puss or ooze pouring from the wound.

Infected wounds can become very serious, so if you suspect you have one seek medical attention — a luxury the characters on Game of Thrones wouldn’t have had.

“Fortunately, we are well-equipped in the modern age to deal with and understand scratches, grazes, cuts and all other general wounds.” Daniel comments. “The best protocol is to wash the wound immediately with soap and water, cover it with antiseptic ointment, cover the wound with a bandage or dressing depending on its size, keep it dry and clean. Finally, change the dressing every day with sterile gloves until it has healed.”

He concludes, “If you’re unsure it’s always advisable to make an appointment with your GP. In cases were bleeding will not stop, it’s important you get to A&E as soon as possible to have it treated by a professional.”

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