DEAR DR. DONOHUE: I am a 16-year-old girl with a wonderful life: good grades, good family, good friends and good health. My problem is panic attacks – that’s what my doctor says they are. I found out I have a heart murmur, a very tiny one. I constantly worry I am going to have a heart attack or another equally unlikely death. The attacks involve my heart banging in my chest. An echocardiogram shows my heart to be fine. How can I get myself over this panic hurdle? – P.

ANSWER: First, the heart murmur. Heart murmurs don’t always mean there’s something wrong with the heart. Little whirlpools in blood generate those sounds. Defective heart valves or holes in the heart can generate those eddies, but quite frequently the swirling of blood comes about from perfectly harmless reasons. An echocardiogram shows that your heart is OK. Your doctor hasn’t told you anything is wrong. Forget the heart murmur. You’re mulling over something that doesn’t merit a second of mulling.

Panic attacks are sudden, intense feelings of overwhelming fear that make a person short of breath, accelerate the heart rate and cause sweating, shakiness and nausea. The stricken person feels on the brink of death or of some other catastrophe.

You can try abolishing the attacks on your own. When you feel one coming on, begin to inhale deeply and slowly through your nose. Distract your thoughts to something else.

Often, panic attacks come about from things you aren’t consciously aware of. You identify the heart murmur as the switch that turns them on, but it could be something buried more deeply in your brain, something that you need help confronting. If you’re not making any progress on your own, ask your doctor for a referral to a professional who can help you conquer your attacks. You have far too much going for you to waste any of your time being upset by something that isn’t a threat to you.

DEAR DR. DONOHUE: I am a 48-year-old woman. For more than a year and a half I have lost lots of hair. My hair has become brittle and coarse. I am extremely tired all the time. I fall asleep after meals and have put on weight. Thyroid problems are prevalent on both sides of my family. I think my problems might be related to my thyroid. My thyroid tests are normal, however. My doctor thinks they’re stress-related. What do you think? – P.J.

ANSWER: On reading your symptoms – coarse, dry hair, hair loss, fatigue, weight gain without eating more – I thought you were a model of hypothyroidism, too little thyroid hormone. But with your normal thyroid tests, I have to backpedal.

It’s hard to know where to begin the search for answers. Anemia, adrenal-gland malfunction, liver disease and many other conditions could give you symptoms similar to those of hypothyroidism. This entails a long, arduous undertaking, one for which you need to have patience. It might take your doctor a long time to unearth the place where trouble lies.

The thyroid booklet explains in details both an overactive and an underactive thyroid gland. To order a copy, write: 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.

DEAR DR. DONOHUE: Recently, my son and I were watching a game show, and the answer to one question was “geophagia.” The host explained it, but my son wants to know more. Is it genetically passed down? What does it do to a person internally? Can a person die from it? – A.Y.

ANSWER: Geophagia is dirt-eating. “Pica” describes eating disorders that have to do with ingesting substances that aren’t food – clay, plaster, starch, paper and dirt. Picas can lead to poor absorption of other nutrients. Eating dirt can give rise to parasitic infections if the dirt contains parasites or their eggs. Earth can also contain lead, and that can be a real problem. I don’t know if anyone has ever died from pica. Sometimes it is a sign of iron deficiency. I also don’t know if there’s a hereditary component to it. If there is, no one has declared what the genetic pattern is.

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