DEAR DR. DONOHUE: Will you address Tourette’s syndrome? My granddaughter has developed body tics. She is 20. Where does it come from? Where can she get some information and help? – B.B.

ANSWER: Tourette’s syndrome consists of involuntary, repetitive and quick movements. That’s the definition of “tics.” These tics, unlike many childhood tics, stay for long periods, always more than a year. They can be persistent eye-blinking, throat-clearing or facial-grimacing. Or they may be more attention-getting, like twisting, twirling, touching. Vocal (also called phonic) tics are also common in Tourette’s – things like hissing, barking or the repetition of words, phrases or sentences. None of this is deliberately willed. An affected child might be able to stifle them for a short time, but they always break through in spite of the embarrassment they cause. The most likely explanation for them is errant brain chemistry.

The onset of Tourette’s lies between the ages of 2 and 21. Symptoms tend to decrease in adulthood, but some people are never completely free of them.

Medicines for Tourette’s include clonidine, guanfacine and risperidone. There are others. Not every person with Tourette’s needs to take medicine. If the tics are not disruptive, then they can be ignored.

Lest you think Tourette’s is an impediment to success, it is not. Doctors, lawyers, engineers and professional baseball and soccer players have had the syndrome and have achieved great distinction in their chosen professions.

Your granddaughter will be happy to learn she has a good friend in the Tourette Syndrome Association which she can reach at 888-4-TOURET and on the Web at www.tsa-usa.org. Canadians can get in touch with the Tourette Syndrome Foundation of Canada at www. tourette.ca.

READERS: Many readers are interested in fibromyalgia, the ache-all-over illness. The booklet on that topic discusses it in detail. To order a copy, write: Dr. Donohue – No. 305, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Hopefully you will write on the subject of low sodium. I have high blood pressure and take Diovan/HCTZ. After taking a blood test, I ended up in the hospital because of low sodium. I just had another test, and my sodium is again low. Why? – J.F.

ANSWER: Low sodium isn’t an illness in itself. It’s an indication that something else has gone wrong. Kidney diseases, adrenal gland problems, compulsively drinking large volumes of water, gastrointestinal illnesses with vomiting or diarrhea, or the inappropriate production of a hormone that keeps too much water in the body are examples of illnesses where low sodium is a feature. Almost never does it come from not getting enough salt (sodium chloride) in the diet.

It also can come from medicines that take sodium out of the body. You use one of those medicines – HCTZ, hydrochlorothiazide. It’s a water pill, and one of its actions is to force sodium’s excretion into the urine. Ask your doctor about trying another blood pressure medicine. Doing so might solve your low-sodium problem.

DEAR DR. DONOHUE: My urologist checks my PSA every year and then puts his gloved finger in my rectum. What is he feeling for, and what do you call this test? – C.A.

ANSWER: It’s called a digital (finger) examination of the prostate gland. With this exam the doctor gets an idea of the size of the gland, and he can detect any lumps on the gland, which might be cancer. It’s a standard examination.

DEAR DR. DONOHUE: I recently received a booklet on colon cleansing. It advertises a product that cleans out the colon, but it’s not FDA-approved. I am leery about taking things offered through the mail. Do you believe in colon cleansing? – L.S.

ANSWER: No, I do not. Colons clean themselves and do so most effectively.

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