DEAR DR. DONOHUE: I am a 24-year-old college graduate, working in a fast-food restaurant because I can’t find a job in my field. One of my fellow workers asked me if I am on the birth control pill. I thought this was nosy beyond belief and asked why she was interested. She said that if I was not taking the pill, I should be taking folic acid or I could have a baby with spinal deformities. What is she talking about? This woman isn’t a reliable source of information, medical or otherwise. — K.D.

ANSWER: Folic acid, also called folate, is one of the B vitamins. If a pregnant woman has a low supply of this vitamin, the chances that her baby will develop neural tube defects are high. Neural tube defects are malformations of the spinal column, spinal cord or brain. The recommendation to prevent these serious defects is that all women planning to become pregnant or capable of becoming pregnant should be taking 400 to 600 micrograms (0.4 to 0.6 milligrams) of folic acid daily. Consumption of the vitamin needs to start one month before pregnancy. If a sexually active woman of child-bearing age is not on the birth control pill or not using some other method of reliable contraception, she should be taking folic acid.

Important developments of the brain, spinal cord and spinal column take place in the first six weeks of pregnancy, a time when many women don’t realize that they are pregnant.

Spina bifida is a neural tube defect, one in which parts of the backbones are undeveloped. That leaves a gap in the bone and exposes the spinal cord to possible trauma. A more serious anomaly is a bulging of the spinal cord coverings through this defect in the backbones. An even worse developmental abnormality is a protrusion of the spinal cord itself through the gap. That produces severe neurological problems.

Neural tube defects also include a variety of brain malformation, some of which are incompatible with life.

All of this is preventable by taking the recommended amount of folic acid vitamin.

DEAR DR. DONOHUE: Unless I remember wrong, doctors used to blame ulcers on stress. Well, I have an ulcer, and my doctor tells me stress has nothing to do with it. I also was under the impression that ulcer treatment involves a bland diet with lots of milk. My doctor says this, too, is outdated. I am taking three medicines, two of which are antibiotics. This is a new wrinkle. What has changed? — B.L.

ANSWER: Changes in ulcer treatment have come about because new knowledge of how ulcers develop has come to light. Two clever doctors, working in Australia, proved that a bacterium with the name Helicobacter pylori has a big hand in causing ulcers and in leading to their recurrence. That’s the reason antibiotics are incorporated into an ulcer treatment plan. Medicines that greatly reduce the production of stomach acid also are included.

Milk is no longer part of the program. At one time it was thought that milk coated and soothed the stomach and neutralized stomach acid. It does none of these.

DEAR DR. DONOHUE: For some reason I have gotten into the habit of taking my pulse daily, sometimes twice a day. It runs around 90. My husband’s pulse is in the 70s. Which of us has the healthier heart? — K.C.

ANSWER: The pulse and heartbeat are one and the same. When the heart contracts to pump out blood, the jet of blood causes expansion of arteries throughout the body. That expansion is what is felt as the pulse. The most convenient place to feel it is on the thumb side of the wrist.

The normal pulse beat ranges between 60 and 100 times a minute. Both you and your husband are within the normal range. Most people have a pulse in the 70s and 80s. Well-trained athletes have a very slow pulse, often in the 40s. Their hearts pump out more blood with each beat, so they require fewer beats.

The difference between your husband’s and your heartbeat can’t be used to judge whether his or your heart is healthier.

It also depends on when you take your pulse. Take it after resting quietly for five minutes.

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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