DEAR DR. DONOHUE: I am a 39-year-old woman who has lumpy breasts. My doctor calls it fibrocystic breast disease, but she never gives me anything for it or suggests anything I should do about it. If it’s a disease, I feel something should be done. What? – K.R.

ANSWER: Fibrocystic breast disease shouldn’t be called a disease. It’s a harmless condition for most women. Some, however, do have pain because of it, and those women merit treatment. It is common. About 10 percent of women younger than 21 have it. By the time women reach the years prior to menopause, 40 percent have breast cysts. After menopause, the cysts tend to disappear.

Pain is the troublesome aspect of fibrocystic breast disease for some women. The pain intensifies before menstrual periods. Aspirin, acetaminophen (Tylenol) or ibuprofen might be the only medicine needed for pain control. If those don’t relieve pain, some doctors tell their fibrocystic breast patients to abstain from caffeine. That means giving up everything that has caffeine in it – coffee, tea, chocolate, many soft drinks and anything that lists caffeine on its label of ingredients.

Birth control pills and other hormonal medicines are reserved for the few women who have incapacitating pain from fibrocystic breasts.

The decision for treatment is best made by the woman and her doctor. The woman can quantify the severity of her pain, and the doctor can choose a regimen that is most likely to work and least likely to cause side effects.

DEAR DR. DONOHUE: I would like your opinion on fish oil. – F.K.

ANSWER: Fish oil’s rise to fame began in the 1970s, when studies were made on the Eskimo population of Greenland. These people have very little heart disease, yet their diet is a high-fat diet. The source of their protection against heart disease was tracked to their intake of fatty fish. The fat of the fish that were a staple of their diet contained omega-3 fatty acids.

Omega-3 fatty acids (don’t let the “acid” throw you; consider it just another term for fat) have a calming effect on heart muscle and can therefore eliminate potentially dangerous abnormal heart rhythms. The same fatty acids prevent the buildup of plaque – the mound of cholesterol, platelets and blood protein that clings to artery walls and obstructs the flow of blood to heart and brain. That’s how fish oil prevents heart attacks and strokes.

Fish oil might have an effect in preventing Alzheimer’s disease and in easing the pain of rheumatoid arthritis. These claims need more proof before definite statements can be made.

Fish oil can thin the blood, something that also prevents heart attacks and strokes. People who take blood thinning medicine such as Coumadin have to make sure their blood is not getting too thin when they combine fish oil and their medicine.

DEAR DR. DONOHUE: I discovered that my tongue had turned black and asked my doctor what it was. He recognized it immediately and told me I had black hairy tongue. However, he could not tell me how I got it or how to cure it. Can you shed any light on the subject? – H.M.

ANSWER: Waking in the morning, looking in the mirror and unexpectedly seeing a tongue with a black coat on it gives everyone a start. However, such a tongue is most always a harmless phenomenon.

The tongue is covered with minute projections called papillae. Elongation of one kind of papillae produces black hairy tongue. No one can tell you why such elongations happen.

It usually goes away on its own, but the time that takes is unpredictable. Brushing your tongue with a soft toothbrush and toothpaste can hasten the departure of black hairy tongue. Brushing with a dilute solution of 3 percent hydrogen peroxide is another way to get rid of it.

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.

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