DEAR DR. DONOHUE: I am a 52-year-old female and have diabetes. I have burning mouth (tongue) syndrome. I have been to three doctors, but none has been able to help me. There are no sores on my tongue. I have had this for a few years. Help! What causes it, and is there a cure? – C.H.

ANSWER: Burning mouth syndrome strikes mostly people older than 50, and it is seven times more common in women than in men. The tongue, the palate and the lower lip are the places where burning is most severe. It intensifies during the day, reaching a peak in the evening and often making falling asleep difficult. During the night, the burning sensation eases.

The cause is a mystery. Poorly fitting dentures can aggravate it. Sometimes a lack of iron or vitamin B-12 is the root of the problem. It has been suggested that a deficiency of vitamin B-1 (thiamine), B-2 (riboflavin), B-6 (pyridoxine) or zinc can contribute to it. A multivitamin, therefore, might help, but be sure to first get the B-12 or iron deficiency issue settled.

Some medicines can be involved, and ACE inhibitors are among them. Your Accupril (a deleted part of your letter) is an ACE inhibitor. Don’t stop taking it until you speak with your doctor.

By and large, most people never find a cause and are left to grope for a satisfactory treatment. Some people respond to low doses of Librium, Klonopin or Elavil. Neurontin, a medicine for seizure control, has had success in dousing the burning pain for a few.

If you are into self-experimentation, anecdotal testimony says the use of dilute Tabasco sauce as a mouthwash might work. Be prepared to spit it out quickly if it worsens matters. Dilute a portion of the sauce in twice the volume of water, swish a teaspoon of it in the mouth and then get rid of it. Don’t swallow. If it doesn’t work, you can try a less dilute solution – one-to-one dilution.

DEAR DR. DONOHUE: I had a cancer lump removed from my left breast, and the doctor said all the cancer was caught. He wants me to take the drug Tamoxifen. Why, if all the cancer is gone? And should the entire breast have been removed? Many people tell me so. – R.T.

ANSWER: Your doctor recommends taking Tamoxifen because it has been shown to prevent cancer recurrence if a cancer lump is of a certain size and if it is the kind of cancer whose growth is influenced by female hormones. Some microscopic cancer cells could still be left in the breast. Tamoxifen blocks the effect of estrogen on those cells.

In most cases, removal of a cancerous lump is as effective as removing the entire breast. The decision is based on the size of the lump and the extent of its spread.

DEAR DR. DONOHUE: Although I am not a diabetic, I have always been interested in the disease because of a strong family history of it. My father, an aunt and an uncle were diabetics.

Recently a diabetic friend told me a couple of things I had never heard before, and I wonder if they are correct.

She said that absolutely everything we eat turns to sugar in the body.

Also that, in type 1 diabetes, eating causes blood sugar to rise, but in type 2 diabetes, eating causes blood sugar to fall. Is she right? – C.R.

ANSWER: Everything we eat does not turn into sugar. Some foods turn into protein and others into fat. And some turn into other compounds – nucleic acids and hormones.

Carbohydrates, one of the main sources of calories in the diet, cause a rise in blood sugar in both type 1 and type 2 diabetes.

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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