Question: I can't get good information on thalassemia minor. Since learning of my problem years ago, I have spent big bucks on iron, since I found that thalassemia is an anemia. A friend says she thinks it is a cancer. My doctor tells me the iron pills won't help me. My sister also has thalassemia minor, and was told it is common among people with a Mediterranean background. My doctor knows about this and says nothing need be done. Is it like leukemia?
- A.M.
Answer: Thalassemia is not like leukemia. It is not cancer. It's an inherited trait that can produce a mild anemia.
It is most prevalent among peoples of the Mediterranean rim. You're right on that part. "Thallassa" means "sea" in Greek.
Thalassemia comes in many forms. Your minor form is common and requires no special attention or treatment.
Too often, incomplete understanding can lead us into treacherous territory, and you seem to exemplify that. For instance, you are engaged in some flawed logic if you are assuming that all anemias stem from iron deficiency. Not so. In fact, your iron supplements can be worse than unnecessary; they can be harmful, given iron's reputation for buildup in organs.
In summary, you have a mild form of an essentially harmless metabolic irregularity. Stop worrying.
A follow-up appointment can settle any lingering doubts. And, please, check out your use of iron supplements.
Question: Will you please tell me what a renin test is? What is its importance in blood pressure?
- Mrs. M.J.
Answer: Renin is a chemical made in the kidneys. Its purpose is to convert another chemical, angiotensin, into a state that keeps blood pressure at a functional level. The kidneys produce renin when blood circulation fails to keep up with body needs, responding with a renin surge. The blood pressure rises appropriately.
The renin test checks the renin output of the kidneys to see if one or the other is overproducing, causing chronic high blood pressure. You confide in an edited portion of your letter that one of your kidneys is cystic. Perhaps your doctor suspects that kidney as the source of excess renin.
There's a sequel to the story: If the adrenal glands produce too much aldosterone - another hormone - the renin level in the blood drops, because aldosterone causes its own blood-pressure elevation. Therefore, low renin levels make the doctor suspect aldosterone as the cause of the high blood pressure.
To summarize: High renin levels point to the kidneys and low renin levels to the adrenals as the source of abnormally high blood pressure.
For more information, see my report on blood pressure. Send $3 and a self-addressed, stamped (55 cents) No. 10 envelope to: Dr. Donohue - No. 4, Box 5539, Riverton, NJ 08077-5539. enclosing $3 and a long, stamped (55 cents) self-addressed envelope.
Question: I have thrombocytopenia. My platelets are 50,000 to 75,000. My doctor says I also have myelodysplastic syndrome. Is it the same?
- Mrs. V.M.
Answer: Myelodysplastic syndrome symptoms can include a low platelet condition.
As the "myelo" tells you, the bone marrow is involved. In this case it's failing to meet its blood cell production quota, including that for platelets.
Your platelet count is low but not alarming. If it should drop dramatically, you could get a transfusion to boost the count.
You need to know that sometimes the syndrome develops into leukemia.
Bone marrow transplantation is an option.
Question: When bitten by mosquitoes, I used to suffer, swelling up and itching terribly. For the past two years I have tried vitamin B-1 pills. If it doesn't stop the biting, it at least eases the itching. I recommend vitamin B-1 to all.
- C.P.
Answer: Thanks. I cannot find support for your idea, but it crops up every year around this time, so I'll pass it along and wait for reports from my millions of research assistants out there.