DEAR DR. DONOHUE: I am a 70-year-old man who has developed breasts. I am embarrassed to take my shirt off in public. I started weight training about three months ago, hoping it would help. So far, I do not see much improvement. Is there anything I can do outside of surgery? – W.O.

ANSWER: That’s gynecomastia (GUY-nuh-coe-MASS-tee-uh), growth of breast tissue in men. It happens in three periods of life: in newborns who have high levels of maternal estrogen in their blood; during puberty, when there’s an imbalance between male and female hormones; and in older ages, when the hormonal imbalance appears again.

It’s important to distinguish breast tissue from fat accumulation. Breast tissue is firmer and more rubbery than fat. If the breasts have become fatty, then weight reduction is the solution.

Most of the time, gynecomastia doesn’t demand a long, involved investigation. If it’s a matter of low male hormone level, testosterone replacement can help. Tamoxifen, an anti-estrogen medicine, causes regression of the male breast. You can talk this over with your family doctor. He or she can decide whether a more serious cause of male breast growth might be taking place. Kidney disease, an overactive thyroid gland and tumors of the testicles can bring it about. Testicular tumors are rare in someone your age. Some medicines can be responsible for breast growth – the water pill spironolactone and the blood pressure medicine nifedipine are two examples.

Weightlifting won’t reduce breast size, but stay with it; it provides other benefits.

You might want to reconsider your stand about surgery. Removal of breast tissue isn’t a daunting procedure, and the surgery doesn’t require a long convalescence. If breast enlargement causes you to inhibit what you want to do, the surgery route might be the route to take.

DEAR DR. DONOHUE: It’s taken me three weeks to get over something my doctor called a parvovirus B 19 infection. I thought I was developing arthritis. My joints hurt, and I had no energy. I also ran a fever. At first, the doctor wasn’t sure what I had, and he put me through many tests. He discussed me with a colleague, who suggested the parvovirus infection. Is this common? I never heard of the thing. – K.W.

ANSWER: Parvovirus B 19 is the cause of a very common childhood infection — erythema infectiosum, also called fifth disease, which is often mistaken for measles. One of the distinguishing characteristics of this rash is bright-red cheeks that look like the child has been slapped. Most children recover from it quickly.

In adults, the infection presents somewhat differently. Joint pains are a prominent feature, and a rash is less common. Most adults get over this in a matter of weeks. Lasting damage almost never occurs.

Infection of pregnant women can cause a miscarriage.

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.

DEAR DR. DONOHUE: Have clubfeet disappeared? When I was a child, I knew several children who were born with them. Now I never hear about it. I am 92. – R.T.

ANSWER: Clubfeet have not disappeared. It happens to about one in every 1,000 newborns.

This is something that happens during fetal development. The foot bones are misaligned. The result is the soles of the feet turn to face each other, like the position of praying hands with palm against palm.

Taping, strapping and casting are some of the ways used to treat clubfeet. Some infants require surgery to attain normal foot alignment.

DEAR DR. DONOHUE: We were told to drink six to eight glasses of water a day. A doctor on television said to drink water only when you are thirsty. Which is the right advice? – R.L.

ANSWER: It’s not necessary to drink six to eight glasses of water a day. Most people can let thirst be their guide for drinking water. In very hot weather, a couple of extra glasses of water keep a person hydrated.

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