DEAR DR. DONOHUE: For the past year, I have been dragging just to make it through the day. I have taken many days off of work, and I am afraid I am going to be fired. There’s hardly a place in my body that doesn’t hurt. The last doctor I saw – and I have seen several without any diagnosis – says I have fibromyalgia. I am not familiar with it. Can you give me some facts? – R.J.

ANSWER: Fibromyalgia is a mix of many symptoms, with an ache-all-over feeling and fatigue being its two prominent symptoms. In addition, most fibromyalgia patients don’t sleep well and, even if they sleep eight or night hours, they wake up feeling unrefreshed.

No test or X-ray makes the diagnosis of fibromyalgia. That’s why it’s a difficult illness to uncover. However, tender points are crucial to the diagnosis. They are specific body points that, when pressed on by the examining doctor, elicit pain far out of proportion to the amount of pressure applied by the doctor. There are 18 defined pressure points. Having 11 of them makes the diagnosis of fibromyalgia probable.

The cause of this condition has eluded detection, and that adds to the confusion of having it and treating it. Through the years, it has been found that the antidepressant amitriptyline is often a useful medicine. It’s prescribed not for its antidepressant action but for its ability to restore more restful sleep. Gabapentin is one of several medicines given to reduce fibromyalgia’s achiness.

Recommending exercise to a person who has no energy and hurts all over doesn’t make sense, but exercise is an effective treatment. It should be started in small doses with a gradual increase of tempo and time. Walking is an excellent starting exercise.

The fibromyalgia booklet describes this condition in greater depth. Readers can order a copy by writing to: Dr. Donohue – No. 305, 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 am a 74-year-old man who has not a single hair on his head. I read that there is a medicine that can restore hair. It’s called Propecia. Have you heard of it? If you have, what do you think about it? – E.G.

ANSWER: Propecia is a brand name of the drug finasteride. It stops the conversion of the male hormone testosterone to a more-potent male hormone. That hormone attacks hair follicles and eventually leads to baldness in many men.

The story actually goes back to the time when finasteride was marketed for prostate gland enlargement. (It still is.) Male hormones encourage prostate growth. Blocking the production of male hormones shrinks the gland. In the early days of finasteride, some men who used it noticed their hair was growing back. The manufacturer took note of this with glee. They brought to the public a reduced dose of finasteride and called it Propecia. (The higher dose medicine used for large prostate glands goes by the name Proscar.)

Growing hair on a scalp devoid of all hair follicles is asking too much of any drug. Propecia can slow the loss of hair and can induce a mild regrowth of hair, but expecting it to restore a full head of hair to a completely bald scalp is expecting miracles.

DEAR DR. DONOHUE: I share a cubicle with a woman who drinks water nonstop. It’s none of my business, but is it healthy to drink so much water? – V.R.

ANSWER: People with good kidneys can down lots of water without getting into trouble. It’s not necessary for health to drink so much water. It doesn’t flush toxins out of the body.

Perhaps the woman has to drink so much water because she urinates large volumes. Sugar diabetes makes people thirsty. So does another kind of diabetes, diabetes insipidus. It comes from a loss of the hormone that helps the body retain fluid. You might bring this up to her – discretely.

DEAR DR. DONOHUE: Before I leave this earth, I feel I should pass on this information. My wife was a champion snorer, an accomplishment that almost wrecked our marriage. She had occasion to have her thyroid checked, and she was hypothyroid – low on thyroid hormone. Replacement solved the snoring problem. – I.K.

ANSWER: I’m glad your wife’s problem was solved and your marriage saved. I never heard that snoring is a sign of hypothyroidism. Did she have other signs – cold intolerance, dry skin, sluggishness?

The thyroid booklet discusses underactive and overactive thyroid glands. Readers can obtain a copy by writing: Dr. Donohue – No. 401, 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.

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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