DEAR DR. DONOHUE: I was diagnosed with hypoglycemia 25 years ago. I have strictly followed the diet I was instructed to follow, a high-protein, low-carbohydrate diet with six small meals a day. The doctor who made the diagnosis has died, and I have a new one who doesn’t believe I have hypoglycemia. He told me I can eat whatever I want. What’s your opinion? – R.O.

ANSWER: Not so long ago, hypoglycemia – low blood sugar – was an in-vogue condition popularized in many magazines and adopted by many celebrities. It isn’t a common disorder, and far too many people were told they had it when they really did not.

To make the diagnosis, the following three conditions have to be met:

• Blood sugar has to be 50 mg/dL (2.8 mmol/L) or less;

• A person must exhibit the signs and symptoms of low blood sugar at the time blood sugar is low;

• Giving the person sugar quickly eliminates signs and symptoms.

Signs and symptoms of low blood sugar include sweating, tremor, nausea, a fast heartbeat, dizziness, confusion and headache. These things are common to many illnesses, so they aren’t distinctive for hypoglycemia.

At times, making the diagnosis of hypoglycemia entails hospitalization for a 72-hour fast, during which a battery of blood tests can be done, including measuring blood levels of insulin. When blood sugar is low, insulin production slows. If it remains high, then a pancreatic tumor that’s making too much insulin comes under suspicion. Such a tumor is extremely rare.

If you feel comfortable on your low-carbohydrate, high-protein diet, there’s no reason why you should abandon it. It’s a healthy diet. If you would like to try a more liberal diet, do so. The only way to find out what will happen is to experiment.

READERS: The often-asked questions about leg and ankle swelling are answered in the booklet on edema and lymphedema. To order a copy, write: Dr. Donohue, No. 106, 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: If I don’t use an antiperspirant, I sweat fiercely. I have wet marks on my blouse under my arms. The talk at work is that antiperspirants cause breast cancer and Alzheimer’s disease. That scares me. I am waiting for an answer from you before I throw mine out. – K.M.

ANSWER: If there were a strong link between antiperspirants and breast cancer and Alzheimer’s disease, warnings would be all over the place. There isn’t a proven link, and most believe there never will be a proven link. It’s the aluminum in antiperspirants that people who promote this idea fixate on. I am not stopping my use of antiperspirants.

DEAR DR. DONOHUE: Every evening, my wife and I take a long walk. It’s our daily exercise. I attract mosquitoes, but she doesn’t. Why? Is there a medical explanation for this? – L.P.

ANSWER: People who emit more carbon dioxide than others draw mosquitoes to them. The mosquitoes are attracted by it.

Mosquito magnets also have other compounds on their skin that entice mosquitoes. Cholesterol on the skin seems to draw them to a person. Skin cholesterol has nothing to do with blood cholesterol. Uric acid and lactic acid on the skin are other attractants.

Mosquito repellent will keep you free of mosquito molestation.

DEAR DR. DONOHUE: My sister, 59, has had a problem in her groin area since 1999 and has seen many doctors about it. No one diagnosed her problem until November 2007. It is called celiac disease. All she knows about it is to stay on a gluten-free diet. Can you give more information about the disease and some of the foods she can eat? – G.M.

ANSWER: Once thought to be a rare illness, celiac disease is anything but rare. It’s an intolerance to gluten, a protein found in wheat, barley and rye. Digestive tract symptoms are its hallmarks: diarrhea, stomach discomfort, bloating and weight loss. However, many symptoms not directly associated with the digestive tract also can occur – things such as anemia, early osteoporosis, iron deficiency, nerve disturbances and a skin condition called dermatitis herpetiformis.

Your sister shouldn’t be cut adrift with so little information and so few instructions. She needs a dietitian to guide her in how to avoid gluten foods. The Celiac Disease Foundation is a terrific source of information and help. Its phone number is 818-990-2354, and its Web site is www.celiac.org. Have her get in touch with the foundation quickly.

The “groin” problem leaves me puzzled. I don’t know what that might be or how it might be related to celiac disease.

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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