DEAR DR. DONOHUE: We were disappointed with a response you gave about celiac disease. You see, our 13-year-old son died from this disease in 2003. Neither you nor other doctors have gone far enough in alerting people to the fact that celiac disease can cause death. It can mimic the flu virus, as it did in our son’s case. By the time doctors knew what he had, it was too late. As many as 5 percent of people with celiac disease die if they are left untreated and do not change their diets. Please alert your readers to this fact. – M. and D.A.

ANSWER: My heart goes out to both of you on the tragic loss of your young son. No sorrow rivals that of parents who have had a child die. I don’t have words to comfort you.

Celiac disease, once thought of as a curious and rare disorder, is now recognized as being quite common. It’s an illness that comes about from some people’s inability to tolerate gluten, a protein found in wheat, barley and rye. Gluten acts as a poison to these people’s small intestine. It makes them unable to absorb food. The result is diarrhea, weight loss, fatigue, abdominal cramps and deficiencies of vitamins and minerals.

Eliminating the grains that contain the gluten protein brings recovery. It calls for a radical change in diet, and that is no small task.

I must admit I did not know the statistics on death from untreated celiac disease. After reading your letter, I carefully reread the celiac sections in three recently published, comprehensive internal-medicine textbooks, one newly printed pathology text and an up-to-date review of the illness, and none mentioned the death rate in untreated celiac disease. Yours is a message that needs to get out.

Two national groups provide help and information on this illness. They are the Celiac Disease Foundation, 13251 Ventura Blvd., Suite 1, Studio City, CA 91604 (www.celiac.org), and the Celiac Sprue Association, Box 31700, Omaha, NE 68131 (www.csaceliacs.org).

DEAR DR. DONOHUE: How come you never mention saw palmetto for the treatment of prostate enlargement? I have taken it for more than five years, and it has done a good job for me. I used to get up many times during the night to go to the bathroom. Now I get up only once or twice.

It’s a lot cheaper than the medicines sold for prostate enlargement and much, much cheaper than having surgery for it. – J.D.

ANSWER: I have mentioned it in the past. I am delighted that it works so well for you.

However, there is some bad news on the saw palmetto front. A new study shows it not to be effective, even when men take it for a full year. This study has me revising my thoughts about it. I believe others will do the same once the information is disseminated.

Saw palmetto is a small palm tree. The juice of its berries provides an extract that has been used for many medical conditions, including prostate gland enlargement.

DEAR DR. DONOHUE: 1. Can having three alcoholic drinks a day cause anxiety?

2. Can nasal drip increase due to lying in bed too long?

3. Is Ensure good, and can it take the place of meals? – D.M.

ANSWER: 1. Not usually. Three alcoholic drinks, however, exceed the recommended limit for alcohol. That limit is one drink a day for women and two for men. One drink is 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof whiskey.

2. No.

3. Ensure is a good supplement, providing protein, carbohydrates and fat along with many vitamins and minerals, including calcium, magnesium, iron, copper, zinc and manganese. It’s a source of nutrients for those who can’t manage solid foods or for those who need a nutritional boost. It’s not intended to supplant regular meals for healthy people.

DEAR DR. DONOHUE: Can a person eat too much calcium? If dairy products provide the calcium we need, how do they affect cholesterol? Is it better just to take calcium pills? – D.W.

ANSWER: If you can get your daily calcium requirement in food, it’s best to go that route, since food provides other nutrients.

The upper daily limit of calcium is 2,500 mg. Between ages 19 and 50, people should get 1,000 mg of calcium a day; older people, 1,200 to 1,500 mg.

Dairy products are the best sources of calcium. Your cholesterol won’t go up from eating and drinking low-fat dairy products. One cup of nonfat yogurt has 350 to 400 mg of calcium; a cup of skim milk, 300; an ounce of low-fat cheese, 200 to 270; 3/4 cup of fortified orange juice, 225; 3 ounces of sardines with bones, 324; 1 cup of cooked rhubarb, 348. It’s not too hard to meet the daily requirement with foods and dairy products.

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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