DEAR DR. DONOHUE: I have what may be an unusual cholesterol problem – not enough of it. My total cholesterol is 151 mg/dL (3.9 mmol/L), and my LDL cholesterol is 91 (2.3). Both are good. My HDL is 32 (.82). That’s too low. I’ve looked online and talked with a number of people about this. Suggestions to correct it are all over the board. What do you suggest for treatment of low HDL cholesterol? — J.S.

You don’t have an unusual problem. Many people have a low HDL cholesterol – good cholesterol, the kind that keeps heart attacks and strokes at bay. The higher the HDL number, the better off that person is. Values less than 40 mg/dL (1.03 mmol/L) aren’t so good; those over 60 (1.55) are great, and those in between are just OK.

Exercise increases HDL. Half an hour of brisk walking daily is a goal within everyone’s grasp, and one that can raise HDL cholesterol. Weight reduction gives it a boost. Smoking lowers it, and not smoking raises it. A moderate amount of alcohol can push it up. “Moderate” is one drink a day for women and two for men. A drink is 12 ounces of beer, 5 ounces of wine or 1.5 ounces of whiskey. Fish oil – omega-3 fatty acids – gives HDL a boost. A diet that’s centered on whole grains, fruits and vegetables with low-fat dairy products and a substitution of olive oil for margarine and butter pushes HDL upward. Whole grains are grains – wheat, barley, rye and oats – that have not been refined. They still contain their outer coat – the bran.

If all of this gets you nowhere fast, then niacin can elevate HDL, as can the fibrate medicines (Gemfibrozil and Tricor).

Cholesterol is a national obsession. The cholesterol booklet explains it and its various forms. To order a copy, write: Dr. Donohue – No. 201, 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: My doctor wants me to reduce my cholesterol by taking 10 mg of Zocor (simvastatin). I don’t like what I have read about the statin drugs like Zocor. My LDL cholesterol is 186 mg/dL (4.8 mmol/L). My HDL cholesterol is 96 (2.4 mmol/L). I walk at least five days a week. I have lost more than 20 pounds by watching my diet. I feel healthy. My mother says there is a family history of high LDL cholesterol. Your opinion would be helpful. – K.O.

The desirable numbers for LDL depend on how many heart-attack risks a person has – risks are things like a family history of early heart attacks, diabetes, high blood pressure, obesity, a sedentary lifestyle and cigarette smoking. LDL is bad cholesterol, the cholesterol that blocks arteries and causes heart attacks and strokes. For someone with 0 to 1 risks (and I take you to be in this category), drug therapy for LDL is suggested at a level of 190 mg/dL (4.9). (For high-risk patients, the desired level of LDL is 70 (1.8).) You are approaching the level where drugs are advised. However, do what you’re doing right now for two or three more months and have your cholesterol checked then. Your LDL cholesterol may drop if you keep up your present regimen.

DEAR DR. DONOHUE: I can’t get rid of jock itch. I have tried over-the-counter medicines for the past six months. I still itch. What can I do? I’m losing erectile function. – R.P.

You can make certain that what you have really is jock itch, a fungal skin infection whose name is tinea cruris. A doctor can make the diagnosis for you by examining scrapings of the involved skin with a microscope. You might need prescription medicine, including oral prescription medicine.

The yeast infection Candida, the bacterial infection erythrasma and psoriasis look like jock itch. You could be treating the wrong condition.

Jock itch and the medicines used for it don’t cause a loss of erectile function. I can’t explain why it’s happening to you.

DEAR DR. DONOHUE: What is a mastoid? I had one when I was 23. The surgery went bad, and within a week I was back in the hospital. Today I am 90. – D.B.

The mastoid process is an extension of the temporal bone – the skull bone at the side of the head. People with a mastoid can feel it by putting their finger behind the ear at earlobe level. In the days before antibiotics, the mastoid often became infected when the middle ear was infected. They are in close proximity. Without antibiotics, the mastoid often had to be surgically removed. Such surgery is rare today. If I did the math correctly, your episode happened in 1940. Antibiotics weren’t available to the public then.

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

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