DEAR DR. DONOHUE: I have osteoporosis, and I’m only 36. That’s not all. I have celiac disease too. I have never smoked or drunk alcohol, and I have exercised since I was in high school. I am married and have three healthy children. How did all of this happen to me? – J.M.
ANSWER: You are a victim of circumstances over which you have no control. Celiac disease, once thought of as a rare bird, is anything but. It affects 1 percent of the population. That’s a whole lot of people. It’s a gene-influenced condition that makes people sensitive to gluten, a protein found in wheat, barley and rye. In adults, diarrhea and abdominal pain are its most common signs, but other tipoffs are almost as common. Gluten sensitivity leads to poor absorption of many nutrients. Calcium absorption is a case in point. Your malabsorption of calcium, due to celiac disease, led to your osteoporosis. Malabsorption of iron can bring on an anemia. Today’s signs and symptoms of celiac disease often don’t follow what used to be considered its standard signs and symptoms. Celiac disease can masquerade as irritable bowel syndrome, or its first manifestation could be osteoporosis.
The diagnosis can be made by finding peculiar antibodies in the blood. It is these antibodies, the product of a wayward immune system, that attack the small intestine and interfere with nutrient absorption. Proof positive of the illness is obtained with a biopsy of the small intestine, which can be obtained by a scope examination.
Treatment is a diet that excludes gluten. Symptom relief occurs quickly once the diet is followed. You should get a reversal of your osteoporosis after adopting the gluten-free diet. Such a diet is not an easy task. These grains are ubiquitous and are found in products you might not imagine them to be in. A trained dietitian has to be part of the team that’s treating you.
You’ll also benefit from contacting one of the associations dedicated to this illness. The toll-free number of the Celiac Sprue Association is 877 CSA-4-CSA, and its Web site is www.csaceliacs.org.
DEAR DR. DONOHUE: I have hepatitis C. My doctor says I don’t need any treatment. Why? If the virus is still with me, as the doctor says it is, shouldn’t I be treated? I feel quite well. – T.P.
ANSWER: For about 80 percent of those infected with the hepatitis C virus, the virus remains in their liver for life.
Treatment, however, is instituted only when there are certain indications for it. One indication is the presence in the blood of viral particles. Another indication is elevation of liver enzymes – a sign that liver damage is occurring. And a third and often the most important indication for treatment is a liver biopsy showing scar-tissue formation in the liver.
If you don’t have any of these indications, then treatment is deferred.
The hepatitis booklet goes into detail on all three kinds of hepatitis – A, B and C. Readers can obtain a copy by writing: Dr. Donohue – No. 503, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Please give your opinion about my right middle finger. It makes a clicking noise when I bend it, and sometimes I can’t fully bend or straighten it. Do you know what this is? – A.K.
ANSWER: You paint a picture of trigger finger. Such a finger makes a snapping noise when bent or straightened, and sometimes it locks in place and the person cannot bend or straighten it for a time. You might be able to feel a painful, beneath-the-skin bump at the base of that finger.
It’s due to inflammation of the sheath of tissue that covers the tendon involved in bending the finger and, for reasons not understood, it affects more women than men.
Injection of a cortisone drug can quiet the inflammation. If that fails, surgically freeing the tendon solves the problem.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com
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