If you’re still reeling from the Game of Thrones finale and aren’t quite ready to stop thinking about dragons, white walkers and epic battles between royal houses - you’re not alone. 

While many will be feeling similarly disappointed that Game of Thrones had drawn its epic conclusion, we thought it might be interesting to consider Martin’s universe in terms of health, medicine and nutrition. 

To get some insight, we spoke with Clinical Lead at Treated.com GP Dr Daniel Atkinson. We also spoke with registered dietitian Maeve Hanon at Dietetically Speaking about diet and nutrition in the programme. 

Stress

In Game of Thrones, a character never knows how far away he or she is from danger or even a grizzly end. The Seven Kingdoms have been proven to be a truly menacing and perilous place. This uncertainty would likely bring a lot of stress. 

At least our favourite characters can take comfort in the fact that once it is all said and done they can be laid to rest in their royal family crypts with their ancestors. Unless, of course, they are brought back to life, like Jon Snow, and forced to endure more battles, regal conflicts and seemingly perpetual stress. 

With the entire story of the show in mind, stress might be best embodied in the character of Daenerys Targaryan. 

The Mother of Dragons suffers a lot over the course of 8 seasons. Her journey to Westoros is paved with attempts on her life and those of her advisors and loved ones. At one point, she even has her dragons, which she considers to be children, stolen from her. The list of all the stressful events, hardship and loss she endures is long.

However, what would these constantly heightened levels of stress actually do to a person’s health and wellbeing? In reality, it would have an impact on many aspects of a person’s health. 

For instance, chronic stress in the short-term can cause severe headaches, bring about fatigue, and increase heart rate. People who suffer from chronic stress might also become irrational, jittery and suffer from mood swings. 

In the long-term it can create problems with the heart, blood pressure and blood vessels. Stress can lead to the development of depression and insomnia. 

‘The information above would suggest, in real-world health terms, that if a person was forced to endure these intense levels of stress as Daenerys must, then it’s quite possible to theorise she would not have lived to be 30 without suffering from both mental and physical medical conditions.’ Dr Atkinson comments

He adds, ‘If you’re feeling stressed and it’s affecting your everyday life, there’s lots of support you can access. NHS and Mind, for example, offer sound advice about what you can do to help improve your mental health. 

In many cases, you can access counselling without having to see your GP. Of course, if it’s more urgent don’t hesitate to discuss it with your doctor straight away.’

Alcohol Consumption

Cersei Lannister once proclaimed that an ‘unhappy wife is a merchant’s best friend.’ Which essentially means, that an unhappy person is the friend of, or depends on, those who trade in goods like alcohol. 

Certain characters in the Game of Thrones universe seem to use alcohol as a coping mechanism to help relieve symptoms of stress. 

But life expectancy and broader health problems have been linked with alcohol misuse.

High levels of alcohol consumption are dangerous and will likely serve to prolong and further deteriorate mental health. Alcohol may seem like a useful tool to help facilitate stress and relieve anxiety, but in reality it can cause significant damage to a person’s health. 

Cersei Lannister likes to drink a lot, and she is particularly fond of red wine. So much so it has actually become a trope of her character.  

In real world health terms, it’s strongly recommended to consume less than 2-3 units of alcohol a day, and observe at least two alcohol free days per week. Alcohol consumption should be spread evenly over the course of a week and should not exceed a total of 14 units over this time. These guidelines we would speculate Cersei comfortably 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.

Daniel comments that there are varied and complex reasons for alcohol misuse, it is often a symptom or coping mechanism of poor mental health. It’s important that people suffering understand this, and not to fall deeper into a problem because of the stigma that surrounds alcoholism. It is a legitimate health condition. The first step to finding a solution is to open up to a loved one. Then make an appointment with your doctor.’

There are certain studies that claim red wine, in strict moderation, may have health benefits in relation to the heart and blood. However, this is a widely debated area of research. It is important to remember that any alcoholic drink is still alcohol - and it’s been concluded any amount of alcohol is detrimental to health. 

Unprotected Sex 

When thinking about historical periods, Game of Thrones probably most resembles the medieval ages. Barrier contraception such as condoms were non-existent. And we would assume the same is true of Game of Thrones. 

Certain Game of Thrones characters partake in sexual activity a lot. Some, like Theon, Bronn and Tyrion even frequent houses of ‘ill reputation’ and engage in unprotected sexual relations with complete strangers. In reality, these circumstances would greatly increase someone’s risk of contracting an STI. 

‘Like many areas of medicine, our understanding by today’s standards of sexual infections is far advanced in comparison to our understanding in, say, the medieval ages.’ Daniel notes.

‘If we are to view Martin’s universe through a real-life scope and compare it with the medieval ages, it’s very unlikely that there would be any real medicinal grasp of these infections. 

Many characters in this Universe, some probably fan favourites, would likely be suffering from one, if not numerous, sexually transmitted infections.’ He concludes

The North / South Diet

Westeros in Game of Thrones might be perceived as being quite similar to the United Kingdom in certain ways. The North and South have their own distinct geographical and cultural identities, for example. Even the battle between House Stark (of the North) and House Lannister (of the South) is said to be inspired by the real world War of the Roses - the battle of the House York and the House Lancaster respectively. 

In Game of Thrones, there is also a significant difference between the diets of those in the North compared with those in the South. 

In the buiser, more populous South, diets seem to be more varied. They appear to consist of regal feasts, fruit imported from across the Narrow Sea, red meats, various cheeses and Dornish wine. 

In the North, however, diets are more hearty and basic. Northerners in Westeros eat food such as bread, pastries, potatoes and brown stew. A popular drink would be mead or ale, and it would likely be cleaner than water due to the way it is made. 

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.’

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 important because certain food types provide different parts of the body with the vitamins and nutrients it needs. Dairy products, for example, are a good source of protein and calcium as part of a varied diet. While the diet between those in the South and North differ quite a bit, both lack the entire spectrum of vitamins and nutrients the body requires in a balanced diet.’ 

 Infected Wounds

Characters who have the privilege of being in a royal house, like Stark, Lannister or Baratheon, will have the benefit of a Maester in the event of illness, disease or when wounded. A maester is a bit like a family doctor.

However, for the broader population they will not have this luxury, nor much of an understanding about health and medicine. 

Khal Drogo is a good example of what impact this lack of understanding can have. In a rival bid for leadership, a fellow member of the Dothraki tribe attempts to fight the Khal. 

While Drogo is the winner of the battle, he suffers from a small wound below his shoulder. The wound is of great concern for the more educated Daenarys, who is fearful it might become infected. The Khal does not wish to hear of it - but the wound does eventually become infected and causes him to become seriously ill. In the end, it leads to his death. 

An infected wound will feel itchy and possibly painful, it may turn green or yellow and puss may ooze from it. There will also be inflammation of the skin surrounding the infection. 

Daniel says that ‘If their severity isn’t too bad, many cuts and scratches can be easily treated at home. The most important thing to remember is to clean a wound, add some form of antiseptic and then dress it. A failure to do so could lead to infection.

If the wound doesn’t stop bleeding, however, get yourself to a minor injuries unit, urgent care centre or A&E Department to be treated by a healthcare professional’.