DEAR DR. DONOHUE: I am an otherwise healthy male, 33 years of age. Upon completing a strenuous training program, I consulted my doctor about complaints of minor weight loss and tiredness.

His diagnosis: low testosterone. He gave me a prescription for it and told me I will remain on it for life.

Should I be tested for other conditions? He asked if I had ever taken steroids. I have not and don’t drink or smoke. Why, at my age, would I have low readings? — L.K.

ANSWER: Wait a minute. You just finished a strenuous training program. It is almost expected that you would be tired out and have lost some weight. It’s unexpected that an otherwise healthy man of 33 would have low testosterone readings without other signs.

Illnesses that affect the production of testosterone include ones that involve the immune system targeting testosterone production, excessive use of alcohol, poorly functioning adrenal glands, pituitary gland problems, thyroid gland disturbances and an inherited illness called hemochromatosis. All of these conditions produce signs in addition to low testosterone. They should be looked for.

Three important factors about testosterone measurements have to be considered when such tests are done. The total testosterone measurement is the test that is more reliable in most labs. Free testosterone also is measured, but only a few labs give dependable results. Secondly, for a man your age, blood should be drawn at 8 a.m., the time when a young man produces the greatest level of testosterone. And third, if the test does show a low level, it should be repeated once or twice more, at 8 a.m., before a diagnosis is made.

I would seek another opinion before I’d embark on lifelong hormonal treatment.

DEAR DR. DONOHUE: I am a senior citizen. I recently suffered a bout of shingles. I tried to get the doctor to give me the shingles vaccine, but because I am on prednisone, he felt I should not have the shot. I did start antiviral medicine the day after I broke out. I find so many of my friends do not understand that you cannot catch shingles from an infected person. However, if you have not had chickenpox and contact an open blister, you can catch chickenpox. My friends are afraid to play bridge with me because they fear I might have the shingles germ on my hands. Will you settle this issue for me? — D.S.

ANSWER: The chickenpox virus and the shingles virus are one and the same. Once a person has had chickenpox, the virus lives in that person’s nerve cells for life. Later in life, when the body’s immune system temporarily lets down its guard, the virus escapes from the nerve cells and travels to the skin, where it causes shingles and the shingles rash. Almost every adult has had chickenpox, whether they can remember having had it or not. Your friends are not likely to catch the virus from a person with shingles. They’ve had chickenpox or have been exposed to the virus at other times and other places. People who have not had chickenpox, mostly very young children, and who come in direct contact with blister fluid from the rash could become infected, not with shingles but with chickenpox. This is an extremely rare occurrence. Your card-playing friends are not going to catch shingles or chickenpox from you. The exceedingly remote possibility of virus transfer is gone once the rash has dried. Tell your friends to trump that.

DEAR DR. DONOHUE: I just lost my husband to COPD (chronic obstructive pulmonary disease — emphysema and chronic bronchitis). While I was holding my husband, a nursing instructor allowed a student to close his eyes. He still had recognition in them. Is it proper to teach a student to do this? — C.M.

ANSWER: No, it’s not. It’s a breach of good judgment. The instructor must have believed that your husband had died, but she could have waited for a more opportune time to have the student close his eyes. I’m sorry you had to suffer through such an incident.

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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