DEAR DR. DONOHUE: My 14-year-old daughter was diagnosed with Crohn’s disease in January 2005. She is also dealing with anemia. It doesn’t matter how many iron pills she takes, the anemia doesn’t get better. She stays cold, dizzy and weak. Could there be something wrong with her thyroid gland that is causing the anemia? Can you give me any information on Crohn’s and anemia? – T.M.

ANSWER: An underactive thyroid gland isn’t the likely cause of your daughter’s anemia. Crohn’s is the more probable cause.

Crohn’s is an inflammation of the digestive tract, and it can affect any part of the tract, from mouth to rectum. Most often, the inflammation strikes the small intestine, the colon (the large intestine) or both. The speculation is that bacteria in the intestine set off an alarm that turns on the immune system, which then provokes the inflammation.

Crampy stomach pain, diarrhea that is sometimes bloody and weight loss are Crohn’s most prominent symptoms. Weight loss comes from the swift passage of food through the tract and from malabsorption of nutrients due to a barrier created by the inflamed intestinal wall.

Anemia is all but expected in Crohn’s disease. It’s partly from the loss of blood in the bloody stools; partly it comes from malabsorption of vitamins and minerals, particularly iron; and partly it’s a consequence of many chronic illnesses, as Crohn’s is.

Cure of your daughter’s anemia hinges on taking control of her Crohn’s and supplying her with whatever minerals she needs, iron being the chief consideration.

I’ll not give you the list of medicines used for this illness, but I’ll mention a newer one, Remicade, which inactivates body chemicals that cause inflammation. I suggest you consult a dietitian for the proper planning of your daughter’s meals.

If you haven’t contacted the Crohn’s and Colitis Foundation, do so. It’s a storehouse of information. The number is: 1-800-932-2423 (in Canada, 1-800-387-1479).

DEAR DR. DONOHUE: I am an unmarried 32-year-old who’s been dealing with an annoying and embarrassing vaginal infection for five years. The doctor calls it bacterial vaginosis. No antibiotics have worked for me. What’s left? – V.G.

ANSWER: Bacterial vaginosis occurs when the population of normal vaginal bacteria is upset and new, unfriendly bacteria take over. Those bacteria irritate the vaginal lining and cause itching, pain and a thin, white-to-gray discharge with an unpleasant odor.

Metronidazole, an antibiotic, can usually effect a cure. It comes as an oral tablet or a vaginal gel. Clindamycin, another antibiotic, is a reliable backup. It comes in an oral form or a vaginal cream. Five years is too long to battle bacterial vaginosis. It’s time for a fresh opinion about the nature of your condition. You could have something else.

The booklet on vaginal infections provides information on the different varieties of infections and their treatment. To order a copy, write: Dr. Donohue – No. 1203, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 (U.S.) $6.75 (Can.) with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have tried everything to lose weight, but I don’t lose. I can’t give up my beer, seven every day and sometimes 20. – K.

ANSWER: Work with me on this, K., will you? You can’t believe you can drink that much beer and lose weight. Seven beers gives you 1,050 calories; 20 is 3,000 calories. To burn 1,050 calories, you have to jog for at least 105 minutes at a good clip, and more than three times that for 20 beers. You have a more important problem than weight – alcoholism. You should address that problem first. Alcoholics Anonymous is a good place to start.

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