DEAR DR. DONOHUE: I had a doctor for many years. When I first went to him, he sent me to a heart doctor for tests. The heart doctor put me on Lipitor, and I have taken it ever since. I have had yearly physicals. No one has ever told me that I needed to have liver tests. I recently read that everyone who takes this medicine should have liver tests. So I was given some tests, including pictures of my liver. A cyst was shown on the liver. I am pretty angry, so I left this doctor. The second doctor told me not to worry about it, because cysts don’t become cancer. I ditched the second doctor too. Please give me your opinion. – P.K.

ANSWER:
If everyone in the world had a liver scan or ultrasound, a great many would be found to have a liver cyst. A liver cyst almost never becomes cancerous. If there were any signs of cancer, the doctor who interpreted the scan would have said so.

Liver cysts are usually small, and they don’t often cause problems. They can be left alone.

Your cholesterol medicine didn’t cause the cyst. Your medicine is a “statin” drug. All statin drugs can cause a rise in the blood levels of liver enzymes. Enzymes are cell foremen who keep cell chemistry running at maximum efficiency. If liver cells die, they release their enzymes, and liver-cell death can be recognized through a rise in blood liver enzymes.

The manufacturers of statin drugs advise that liver enzymes be monitored when a person begins to take them. For your medicine, the manufacturer recommends that a liver test be done after three months of taking the medicine to see if any liver cells have been damaged. You missed the three-month test, but no damage was done to your liver. If there had been, it would have been detected in your recent tests. I repeat that your liver cyst didn’t come from your medicine. Every doctor you see will tell you that, and they aren’t trying to pull the wool over your eyes. (I’m not sure the exact meaning of that saying, but I think it fits.) Are you going to axe me too?

DEAR DR. DONOHUE: Recently I had a blood test for rheumatoid arthritis – rheumatoid factor. It came back high. How does this affect my health? – L.G.

ANSWER:
The rheumatoid factor is an antibody found in as many as 90 percent of people with rheumatoid arthritis. However, having it doesn’t mean a person has rheumatoid arthritis. People must have arthritis changes in their joints, and they must have early-morning joint stiffness that lasts for a full hour or more.

Rheumatoid factor is found in other illnesses – in some infections, in some cancers, in illnesses like Sjogren’s syndrome and hepatitis B. Four percent of healthy adults have a positive rheumatoid factor, and the number of adults with a positive test increases with age.

The positive test affects your life only if you have signs of the illness – swollen and painful joints, muscle weakness and evidence that other organs are affected – nerves, eyes, blood vessels, lungs or heart.

DEAR DR. DONOHUE: I don’t know where to turn. Am I destined to become a celibate? My husband can’t attain an erection because he doesn’t try. Even the new medicines don’t work. I love him, and I don’t want to lose him. – Anon.

ANSWER:
Someone – you are the likely candidate – has to persuade your husband to see the family doctor. His health could be at stake.

One of the major physical ailments that bring on erectile dysfunction is poor circulation. Blood cannot get into the penis, and that makes it impossible to attain an erection. If pelvic circulation is bad, heart and brain circulation is also bad, and that should prompt your husband to visit the doctor.

Heart disease, diabetes and inadequate production of testosterone can also be roots of the problem.

Psychological factors are often involved. Stress and anxiety foster erectile dysfunction. So does depression.

For his own good as well as for the good of his marriage, your husband needs to find out what’s going on and what can be done for it.

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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