DEAR DR. DONOHUE: I had a little trouble breathing, so I saw my doctor, who ordered a chest X-ray. It showed fluid on the right lung. The doctor said he would have to do more tests to find out why the fluid appeared. Could you guess for me what those tests might be? What brought this on? — R.H.

ANSWER: A double-ply covering, called the pleura, encases each lung. A small space between the two leaves of pleura allows the lung to inflate and deflate effortlessly. The fluid you have is in the pleural space. The condition is a pleural effusion. The fluid is not actually in lung tissue.

Infections, illnesses like rheumatoid arthritis, heart failure, blood clots in the lungs, liver cirrhosis and chest trauma are some of the causes of pleural effusions. Cancer is another cause.

Shortness of breath, chest discomfort and cough are some of the things that a pleural effusion engenders. Some people with an effusion have no symptoms at all. The fluid is discovered when a person has a chest X-ray, as was the case with you.

The doctor is most probably planning to obtain a specimen of the fluid from the pleura. It’s not a difficult procedure. Analysis of the fluid provides information that determines what caused it. That information also allows the doctor to determine a treatment plan and provide you with a prognosis of what to expect.

I’d like to speculate further for you, but I can’t. I need more information too.

DEAR DR. DONOHUE: I was given Avodart to treat an enlarged prostate gland. During the six months of taking it, I went from a fully functioning man with a strong libido to 99 percent impotence and no interest in physical intimacy.

My physician does not seem to care. What kind of treatment should I seek? — H.L

ANSWER: Avodart (dutasteride) is a medicine that can shrink an enlarged prostate gland. Achieving that allows free passage of urine. Impotence and decreased desire for sex are its side effects for a small number of users. Other drugs, without these side effects, exist. Furthermore, a number of office procedures can open the drainage canal of the bladder. You return home after the procedure.

You should see a urologist immediately.

Prostate enlargement and prostate cancer are discussed in the booklet on those topics. Readers can order a copy by writing: Dr. Donohue — No. 1001, 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: Help. My doctor does blood work every three months. For a good while, my vitamin B-12 level has been so high that the lab couldn’t get an exact reading. I used to take vitamin B-12 and a multivitamin daily, but I have stopped both. The level is still way too high. No one can tell me why it’s high or what to do. Can you help? — E.F.

ANSWER: The Institute of Medicine, a panel of experts that provides advice to the government and citizens on medical topics, sets the standards for acceptable daily intake of vitamins and minerals. It also determines potential dangerous levels of these materials. It states that “no adverse effects have been associated with excess vitamin B-12 intake from foods or supplements in healthy individuals.” The Institute sets no dangerous upper levels for B-12.

Your body is saturated with this vitamin. It could take years before the vitamin level returns to normal. You don’t have to be rechecked often for a B-12 value. It will eventually come down. It’s not harming you.

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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