DEAR DR. DONOHUE: About two and a half years ago, I had congestive heart failure. An angiogram of my heart arteries revealed only minimal clogging. My cardiologist prescribed Toprol, quinapril and spironolactone for high blood pressure and to strengthen my heart. I have never had high blood pressure. I take Vytorin for cholesterol.

About six months after the congestive heart failure attack, my doctor discovered that my blood sugar was high and put me on diabetes medicine. Recently he increased the dose of my heart medicines. My blood-sugar count rose. I believe there is a direct relationship between my heart medication and my having diabetes, as well as its getting worse. I am afraid the complications of diabetes will kill me before my heart does. What are my alternatives? – D.G.

ANSWER: Congestive heart failure indicates the heart has become so weak that it cannot pump blood effectively. Blood backs up, and fluid leaks into the lungs and the ankles. That’s the “congestion” part of congestive heart failure.

The medicines your doctor put you on are standard and effective ones for heart failure. They’re also used for blood pressure control, but the dual use is an example of medicines that get things done for two different conditions. Toprol is a beta-blocker, and beta-blockers have been cited as a possible cause of new onset diabetes. So has the class of medicines to which quinapril belongs. Spironolactone is a diuretic, a water pill. Some diuretics are implicated as having a hand in the appearance of diabetes. Spironolactone is not one of them.

All these medicines are taken by millions. Only for a few do they bring on diabetes or upset diabetes control. They’re very effective in rescuing a failing heart. I would not hesitate to be on your program. Diabetes complications – nerve damage, kidney impairment, vision loss – occur when blood sugar isn’t controlled. If you control both blood sugar and heart failure, your future looks bright.

The ins and outs of congestive heart failure are discussed in the booklet of that name. To order a copy, write: Dr. Donohue – No. 103, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: For the past six years I have a problem of being cold. My bones feel chilled. My hands are always cold. I dread air conditioning. I mentioned this to my doctor, and he had my thyroid checked. It is fine. I would appreciate your opinion. – M.C.

DEAR DR. DONOHUE: My 82-year-old mother is in excellent health and takes few medicines. Her problem is feeling cold when the temperature is below 75. Why? Does she need vitamins? – K.L.

ANSWER: I have to disappoint both of you – and the many others, mostly women – who have written to me with this complaint. If the thyroid gland is working well and if a person isn’t anemic, I don’t have an answer, especially when there are no other signs or symptoms of illness. Vitamins are not the answer.

I ask the help of both doctors and lay readers to come to the rescue.

DEAR DR. DONOHUE: Quinolones are not antibiotics. Check your “Physicians’ Desk Reference.” – F.S.

ANSWER: If you’re a purist, you are correct. An antibiotic is a substance produced by microorganisms (bacteria or fungi) that suppresses the growth of or kills other microorganisms. Quinolones – Cipro, Levaquin, Floxin and others – are made in laboratories by humans.

In common usage, medicines that are used to kill bacteria are termed antibiotics, regardless of where and how they’re made. I intend to continue observing common usage. Such use is endorsed by the premier pharmacological text “Goodman and Gilman’s The Pharmacological Basis of Therapeutics.”

Many of the commonly used penicillins are altered in the laboratory. They’re still called antibiotics.

DEAR DR. DONOHUE: I am a 29-year-old woman in pretty good health. My grandfather on my father’s side battled heart problems for many years. He had five brothers and one sister, all of whom died before the age of 35 from heart problems. Could this be something in the family that I might get? – J.D.

ANSWER: You make a strong case for heart disease based on genes. Seven children in one family dying of heart disease, and six of them dying at an early age, should raise everyone’s eyebrows. How about your father and his brothers and sisters? Do they have heart trouble? If they don’t, that weakens the heredity link.

Is there any way to retrieve the death certificates of your relatives? If there isn’t, let your doctor know about the family history, and he or she can look for inherited heart illnesses.

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