DEAR DR. DONOHUE: I would like to know why you lose flesh with age, but not bone, nor skin, nor fat. One doctor told me that’s why people get colder when they get older. I am rapidly losing flesh. – L.J.

ANSWER: People lose muscle with age. The process is called sarcopenia (SAHR-coe-PEA-knee-uh). I never thought of it until you brought it up, but it could be a reason why older people chill quickly. Muscles generate heat, and they serve as insulation. Shivering is a response to a cold environment. Shivering muscles give off heat.

Lots of unpleasant things happen with aging. Metabolism slows, and that’s another reason why older people complain of the cold. Our bodies don’t repair themselves as well as they did when we were young. Bones do lose strength and size with age. Growing old is not for the faint of heart.

Sarcopenia and bone loss can be kept to a minimum and possibly reversed if people exercise. The kind of exercise they must do is “resistance” exercise –lifting weights. It sounds nutty, but it’s for real. Weights don’t have to be of the same magnitude that people use to prepare for a bodybuilding contest. You can start with one-pound weights and gradually increase the poundage when you become comfortable with that amount of weight.

DEAR DR. DONOHUE: I have a blood pressure monitor, which I have been using for two years. I find that my blood pressure is always high in the morning. Soon after breakfast it is lower, and by evening it is lower yet.

They say that blood pressure is typically low in the morning and increases in the late afternoon and evening. Why is mine acting differently? – J.S.

ANSWER: Blood pressure is not stable throughout the day or night. Actually, it’s at its highest upon waking in the morning, even in people who don’t have high blood pressure and who don’t wake up to an alarm ringing.

I was taught as you were – that blood pressure peaked later in the day. However, one of the world’s most knowledgeable blood pressure experts – one with whom I have no intention of arguing – says that the highest daily blood pressures are recorded between 6 a.m. and noon.

DEAR DR. DONOHUE: Not long ago, I had a blood test and was told I was anemic and low in iron. My doctor told me not to worry about it. Another doctor told me to take a ferrous sulfate pill (iron pill), 325 mg, three times a day. That’s 975 mg. It sounds like a lot to me. On the bottle of iron pills in the drugstore (same strength) it says to take one a day, and it also says people over 50 don’t really need to take iron. What’s going on? – G.S.

ANSWER: The dose of iron needed to correct an iron deficiency and an anemia depends on how great is the deficiency and the anemia. A usual dose is three or four 325 mg pills of ferrous sulfate every day. One 325 mg dose of ferrous sulfate has only 65 mg of iron in it. So you’d only be getting 195 mg to 260 mg of iron daily.

Your doctor is the only one who can give you the exact amount of iron you need. You must also find out why you have an iron deficiency. It might be that you have trouble absorbing it, or you might be losing iron from blood oozing out of your intestinal tract. The blood can be of such a small amount that you don’t notice it. But the deficit builds unless the ooze is stopped.

I can’t explain the instructions on the pills in the drugstore.

DEAR DR. DONOHUE: At age 75, I find that ejaculation is difficult. Does this have any effect on prostate cancer or prostate enlargement? – R.D.

ANSWER: Prostate gland enlargement is something that happens to all men. The frequency of ejaculation has nothing to do with it.

Two studies, however, suggest that a diminished frequency of ejaculation plays a role in prostate cancer. That suggestion has been questioned by other studies. More information is needed before a conclusion can be drawn. If it is a risk, it’s a slight risk.

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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