DEAR DR. DONOHUE: I am 91 (and a worrier). The problem is not about me, but my daughter. She is 48 and, I dare say, has gained weight enormously in the past several years. I think it is her thyroid gland doing it. Besides being an embarrassment to her, her heaviness also is a burden, as she works where she must stand all day long besides housekeeping for a family of five adults. Now to my questions. How do you diagnose a case like this? What must she do to combat obesity? - Mrs. A.H.

ANSWER: Gland disorders seldom lie behind weight problems, but it happens every now and then, often enough so that you can't dismiss the idea out of hand.Your daughter can be tested for a sluggish thyroid gland. A simple blood test often provides evidence of a gland that is not up to par and contributing to weight. An adrenal gland disorder is another example of gland-caused obesity. That, too, is easy to prove.

Having said this, I have to add that most obesity stems from simple calorie imbalance - too many in, too few out. That doesn't mean the person has to be a big eater either. Your daughter may have a metabolism that simply doesn't burn calories very fast. That's why many perfectly healthy adults have such problems losing weight and keeping it off. Even so, the answer usually lies in counting calories and exercising. Anyway, I am sending you the thyroid report. Other readers may order it by writing: Dr. Donohue, Box 830, Gibbstown, NJ 08027-9909, enclosing a long, stamped, self-addressed envelope and $2.

DEAR DR. DONOHUE: About 14 months ago, I went on a low-fat, high-fiber diet and started walking two to three miles a day. I lost 40 pounds. I've had high blood pressure for 40 years. This program has not lowered the pressure, and it has raised my cholesterol from 200 to 259. Could you explain this to me, please? - N.N.

ANSWER: I can't explain it. Everything you've been doing is correct. Weight loss should bring blood pressure reduction, and a low-fat, high-fiber diet should lower cholesterol. Perhaps someone out there wiser than I will offer a theory. I promise to pass it on. The only suggestion I have is that you visit a doctor to find other ways to control the blood pressure and the cholesterol.

DEAR DR. DONOHUE: I am in the seventh grade. I think I might have thought of a possible treatment for AIDS. You know how the AIDS virus attacks the cells by going through the cell membranes. I was wondering if someone put blood that has viruses in it into a container and put it through a semipermeable membrane, would the viruses be removed? - N.F.

ANSWER: N.F., you amaze me. I hadn't heard of semipermeable membranes in the seventh grade. You want to filter the blood, right? It is a very imaginative idea, but I have to dampen your enthusiasm a bit. The AIDS viruses get inside all cells - both blood and body cells. So you can't filter them out. The thought is far beyond your years, and I hope you are considering a science career.

DEAR DR. DONOHUE: Define myelofibrosis briefly, please. - M.L.

ANSWER: In myelofibrosis, scar tissue has invaded bone marrow, the site of blood cell formation. In time, cell production falters, blood counts drop and anemia develops.

Currently, we have no way to stop the marrow destruction. When a blood count gets quite low, transfusions can be given. In some cases, androgens (male hormones) are given. They can stimulate blood cell production for a time.

Dr. Donohue welcomes reader mail but regrets that, due to the tremendous volume received daily, he is unable to answer individual letters. Readers' questions are incorporated in his column whenever possible.

1991 North America Syndicate, Inc.

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