DEAR DRS. DONOHUE AND ROACH: Recently, blood tests revealed that I have too few red blood cells. What would cause this, and what symptoms might I expect? I am 61 years old with diabetes and high blood pressure.

Please don’t tell me I have to be put down, like my neighbor’s pit bull, who had the same diagnosis. — J.R.

ANSWER: Too few red blood cells is anemia. Now the challenge is finding its cause.

One of the major causes of anemia is bleeding, of which the person often is unaware. The bleeding frequently is in the digestive tract. Tarry black stools are a sign, but more often than not, the stools do not change their appearance.

The bone marrow is the factory that produces red blood cells. Should the marrow be replaced by scar tissue, red blood cell production stops or slows, and an anemia becomes evident.

A too-meager intake of vitamin B-12 produces pernicious anemia. Too little intake of folic acid, another B vitamin, also produces an anemia, but not pernicious anemia. A deficit of iron is another anemia cause.

Sometimes the body destroys red blood cells well before their usual life span expires. Normally a red blood cell last 120 days. Premature death of red blood cells is yet another cause of anemia.

I think you get the message. The many causes of anemia have different treatments.

With the modern techniques available in medical laboratories, with the modern ways of viewing the digestive tract for bleeding sites, and with the medicines on hand for treating most kinds of anemia, you have no worry about being “put down.” Do you know what kind of anemia the pit bull had?

DEAR DRS. DONOHUE AND ROACH: In 2005 I was treated for H. pylori infection. Will you look at a copy of the blood test I had and give me your opinion of if I still have it or not? — P.M.

ANSWER: H. pylori is a bacterium that has a hand in producing ulcers, both stomach ulcers and duodenal ulcers. Modern ulcer treatment includes giving antibiotics to ulcer patients if those patients are shown to be infected with H. pylori. Thirty percent of the U.S. population carries the bacterium in their stomach. Far from 30 percent of the population has ulcers. Therefore, other factors are involved in ulcer genesis.

One test for the presence of H. pylori is a blood test that is positive for having antibodies against that germ. That’s the test you had — the antibody test. The immune system makes antibodies against any germ that invades our bodies. Your test is negative. It does not show that you have the level of antibodies consistent with infection.

A slightly more specific test is the urea breath test. A person drinks a solution of urea that has been labeled with a special kind of carbon, carbon 13. H. pylori metabolizes ingested urea to carbon dioxide. After drinking the urea, the patient is instructed to exhale deeply. If the exhaled air contains carbon 13, the test is positive. The person harbors H. pylori.

I’d be satisfied with the antibody test you had. It was negative. Be glad.

DEAR DRS. DONOHUE AND ROACH: I am a man in my late 80s. I expect my primary care doctor to check the following: carotid arteries, peripheral artery disease, blood analysis, urine analysis and the possibility of Parkinson’s. Is this asking too much? — R.

ANSWER: It’s not asking too much. Your requests are modest and are relatively inexpensive. The doctor can listen to your carotid arteries with a stethoscope for a rough estimation of their health. More-expensive tests would be done if you had any symptoms that aroused suspicion that those arteries might be obstructed.

Drs. Donohue and Roach regret that they are unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may write the doctors or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers also may order health newsletters from www.rbmamall.com.

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