DEAR DR. DONOHUE: My grandson, who is 13 years old, has refused to eat any meat since he was 5. He is on iron pills, but they are not doing him any good. He is anemic. Is there a solution to this problem? We are very worried. — J.D.

ANSWER: I assume a doctor has examined the boy and is following his progress. If this isn’t the case, one should be consulted. Iron lack is only one cause of anemia.

Does the boy’s meatless diet explain his anemia? In our part of the world, strict vegetarians rarely develop anemias from iron deficiency if they eat a well-balanced vegetarian diet. Meat iron is better absorbed than plant iron, but plant iron provides enough of the metal to keep people in good health. Iron-fortified cereals are a good source of iron; slightly less than 1 cup of some such cereals provides 18 mg of iron. A boy between the ages of 9 and 13 needs only 8 mg a day. Beans (soy, lima, kidney and navy) contain a good supply of iron. So do spinach and raisins. Vitamin C enhances iron absorption.

Since the boy takes iron but is anemic, either the iron isn’t absorbed or the anemia is caused by something other than too little iron. Meat is the only reliable source of vitamin B-12. Your grandson’s anemia could be the result of a lack of that vitamin.

The issue of malabsorption also must be addressed.

If your grandson’s anemia isn’t corrected shortly, I would take him to another doctor for a second opinion. He’s at an age when a growth spurt is occurring or is about to occur. He needs iron to support growth. I would urge the boy’s parents to find a doctor who will get to the bottom of this problem quickly.

DEAR DR. DONOHUE: I was diagnosed with a Morton’s neuroma in my foot.

I have had cortisone shots and physical therapy, but nothing has helped. The pain is excruciating.

What more can I do? — J.R.

ANSWER: A Morton’s neuroma is the entrapment of a foot nerve in a ball of scar tissue. The nerves are in the front of the foot, in the fleshy part directly behind the toes — the ball of the foot.

A Morton’s neuroma most often is found in the area corresponding to the space between the third and fourth toes. Early on, treatment includes wearing shoes with a wide toe box so the nerve isn’t squeezed by both the scar tissue and the shoe. Metatarsal pads serve as cushions for the same purpose. The metatarsals are the bones that connect the toes to the bones at the back of the foot. Cortisone shots can lessen any swelling around the nerve and thereby lessen pressure on the nerve.

You are at a crossroads now. Surgery can rid you of the neuroma and the pain. With as severe pain as you have, you should talk to the doctor about surgery soon.

DEAR DR. DONOHUE: I am a 59-year-old woman. When I was 22, I was running around and had to be treated at the hospital. Around the same time, I worked as a health care worker. I had two accidental sticks with needles used on an infected person. Beyond this, I was OK.

Now hepatitis C has come up again. I am married to a man who is 73. The doctor says he is all right. My doctor wants me to have lab tests to see if my liver is suffering. How nice! — P.C.

ANSWER: There are some information gaps in your letter. Am I wrong when I read into your letter that you were told you had the hepatitis C virus? Was it from the “infected” patient, the one from whom you had the needle stick? You need current testing. There are treatments now that were not available then, if you do test positive.

The hepatitis story is complicated. The booklet on that topic explains it in detail. To obtain a copy, write: Dr. Donohue — No. 503, 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.

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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