DEAR DR. DONOHUE: My 30-year-old daughter has just been told she has lupus. She has been married for five years and has two young children. Everything we hear about this disease discourages us. Will you address it and give us a candid appraisal of what the future holds for her? We are distraught. – E.D.

ANSWER: The immune system, mostly unidentified environmental factors and hormones work together to produce lupus. The fact that the immune system is on the attack is shown by the presence in the blood of many antibodies. Antibodies are the immune system’s bullets, and these antibodies are directed at an array of tissues and organs. An example of an environmental factor influencing lupus is sunlight, which worsens the illness. Hormones must be involved in order to account for the great difference in the number of women versus men who come down with the disease. Ninety percent of patients are women, often in their 20s and 30s.

Skin, joints, kidneys, digestive tract, heart, lungs and nervous system can come under siege. Fatigue is an all-but-universal complaint. Joints swell and hurt, mostly those of the fingers and the knees. Skin rashes also are a common consequence. The classic lupus rash is a redness of the cheeks connected by a red band crossing the bridge of the nose to give a butterfly silhouette. The covering of the lungs can become inflamed and cause painful breathing. The heart covering, the pericardium, also can become inflamed.

Quite frequently, lupus has long periods when signs and symptoms go away or become minimal, interspersed with periods of flares of symptoms. Lupus ranges from a bothersome intrusion on life to a progressive illness that can make a person an invalid.

However, and this is a fact, the outlook is quite optimistic for most. In the 1950s, only 40 percent of patients survived lupus. Today more than 90 percent do. Thanks to the many medicines now on hand, your daughter can anticipate dancing at her children’s weddings.

DEAR DR. DONOHUE: I am a 44-year-old black woman who has been put on thyroid hormone medicine for the rest of her life. I have some questions for you. Is one race more susceptible to thyroid problems than others? Does the thyroid gland ever rebound so that medicine can be stopped? How does this illness affect my life expectancy? – N.P.

ANSWER: You’re speaking of hypothyroidism, the condition where the thyroid gland puts out no to very little thyroid hormone. Thyroid hormone keeps all body processes running at their optimum speed. Without it, an assortment of symptoms arises, chief of which is loss of energy. Other symptoms include feeling cold when others are warm, having dry hair and dry skin, gaining weight without increasing calorie intake, constipation and erratic menstrual periods.

I have never seen any statement that hypothyroidism affects one ethnic group more than another.

Most cases of hypothyroidism are for life. Treatment involves taking only one pill a day.

Your life span is not affected by this disorder.

The booklet on the thyroid gland explains hypothyroidism and other common thyroid ills. To order a copy, write: Dr. Donohue – No. 401, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I served in the South Pacific with the U.S. Army in World War II. When I was there, I came down with hepatitis. In my younger days, I tried to give blood, but they wouldn’t let me because, they said, I showed that I had been infected with hepatitis. Does that mean my liver is damaged? No doctor has ever mentioned liver damage to me, and I have seen many of them throughout my life. – S.W.

ANSWER: I can give you pretty good assurance that your blood test indicated only past infection and not current damage.

Don’t make a special point of doing so, but for 100 percent assurance, bring this up to your doctor.

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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