DEAR DR. DONOHUE: Will you please explain Hashimoto’s disease? My daughter has it. What steps should be taken? – L.S.

ANSWER: Because Hashimoto’s disease sounds exotic, it perceived as being a rare illness. It is not. It’s an immune attack on the thyroid gland that, over time, stops the production of thyroid hormone and leads to hypothyroidism – too little of that hormone. (Dr. Hashimoto was the Japanese physician who was the first to describe it.)

The gland’s destruction occurs slowly, so signs and symptoms creep up on a person almost imperceptibly. When they reach their maximum, people know for sure something is quite wrong. They are tired all the time, their skin dries, they’re cold when others are warm, they gain weight without taking in additional calories, their hearts beat slowly and their hands and feet become puffy. Menstruating women have fewer periods, and sometimes no periods. Constipation is another common sign. Often, the gland enlarges – a goiter.

The proof that the immune system is to blame can be shown by examining thyroid gland tissue microscopically. Lymphocytes, one variety of white blood cells and an important part of the immune system, have infiltrated the gland. In addition, antibodies against the gland are found in the blood. Antibodies are products of the immune system. The treatment of Hashimoto’s disease is straightforward. Replace the missing hormone in pill form. Once treatment starts, signs and symptoms go.

The thyroid booklet deals with the major problems of this gland. Readers can obtain a copy by writing: Dr. Donohue – No. 401, 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: What information can you give me on Huntington’s disease? I am 62, and I may have it. My doctor’s office said they can’t help me. I went to the hospital for the genetic test, but I was told I needed counseling before and after the test. I understand it is expensive. I know the illness gives people tremors. – J.D.

ANSWER: Huntington’s disease is an inherited illness whose signs typically don’t appear until a person is between the ages of 30 and 50 (but the range is between 3 and 70). The principal sign is involuntary movements of the face, trunk, arms and legs. The movements are much more than tremors. They are quite big and disruptive. Speech is often affected, and control of eye motion can be lost. Personality changes and a diminution of thinking ability also take place. The genetic test confirms the diagnosis. Since this is such a devastating illness, counseling before the test is essential, and counseling after a positive test is also required. Does this illness run in your family? It does in 97 percent to 99 percent of those who have the illness. Contact the Huntington’s Disease Society of America at 800-345-4372 or on the Internet at www.hdsa.org. The people there can tell you if you are wise to pursue testing for it.

DEAR DR. DONOHUE: I am 53 and have had an insane genital itch for three years. I finally found a doctor who performed a biopsy and diagnosed lichen simplex chronicus. I am on a steroidal cream, and it has changed my life. Can you give me any more information? – R.R.

ANSWER: “Lichen” is a word attached to many skin conditions, and most of them feature itching. Lichen simplex chronicus can occur on any part of the body, but mostly it shows up on the genital skin, the anal skin, the back of the wrist, the neck, the scalp and the back. Its cause hasn’t been found. The itching is so profound that scratching leads to skin thickening and sore formation. I really can’t add anything to what your doctor told you. It responds to the kind of treatment you are getting – cortisone steroid creams and ointments – but it can and often does come back.

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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