DEAR DR. DONOHUE: My doctor wants me to take extra vitamin D and calcium. I tried Citracal, but it didn’t agree with me, so I stopped it. I am a 71-year-old woman.

What is my alternative? I like dairy products, especially yogurt. Can I get the needed calcium and vitamin D from eating foods? What should I eat? How much of each do I need? — C.H.

A: You need 1,200 to 1,500 milligrams of calcium a day. If you put your mind to it, you can get all your calcium from food. Food calcium is better absorbed than tablet calcium. Dairy products are the best source of calcium. Eight ounces of plain, low-fat yogurt has 415 millilgrams of calcium, one-quarter of your daily requirement. Two helpings give you more than half of what you need. One cup of milk (including skim milk) has 300 milligrams of calcium; 1 ounce of cheddar cheese, 204; 6 ounces of orange juice fortified with calcium, more than 200; 1 cup of cottage cheese, 138. Examples of nondairy foods with significant calcium include 3 ounces of sardines with bones, 325; a cup of cooked rhubarb, 340; a cup of spinach, 291; an ounce of almonds, 70.

Vitamin D is the sunshine vitamin. If you get 15 minutes of sunshine daily on your face and hands, your skin produces almost all the vitamin D needed. However, in winter, during cold weather, you cannot rely on sunlight for your vitamin D, and even in summer, it’s hard for some people to get outside. The daily intake of vitamin D is 800 IU to 1,000 IU, higher than the often-quoted 400 IU. Many cereals and just about all milk and yogurt are fortified with this vitamin. You have to read the label to see how much a food contains.

DEAR DR. DONOHUE: For the past few weeks I have had sudden nosebleeds. No pain. They happen at home, occasionally when I wake in the morning. Can you explain the probable cause? I was told to buy a humidifier. — M.H.

A: Most nosebleeds originate in the front of the nose, in the area just inside the nostril, where the covering layer becomes dry. The dry layer flakes and breaks off with the slightest trauma. Furthermore, in older people, that layer thins out and becomes even more vulnerable to breaking and bleeding.

Moisturizing the front of the nose with a dab of petroleum jelly (Vaseline) on a cotton-tipped applicator keeps the lining healthy. A humidifier is a great idea if your house is dry.

Should nosebleeds recur and recur, report to the family doctor, who can check for any clotting disorders, high blood pressure or other rare illnesses.

To stop a bleeding nose, sit or stand and lean slightly forward while pinching both sides of the nose between the thumb and index finger, and hold pressure there for 15 minutes. You will have to breathe through your mouth.

DEAR DR. DONOHUE: Is there any benefit to drinking pure gelatin? I’ve been told it goes directly to the bones and prevents osteoarthritis. — D.R.

A: I can’t find any support for that benefit of gelatin. I wouldn’t bet the family farm on it.

DEAR DR. DONOHUE: I am 80 and have taken Fosamax for years for osteoporosis. I am told it stays in your system for years. I have a cousin who had severe problems from dental work and the problems were caused by Fosamax. How long do you have to take it? — S.B.

A: Fosamax is one of the bisphosphonate drugs used for osteoporosis and a few other bone diseases. These drugs do stay with a person for years after they have been discontinued.

Women who have taken Fosamax for five years and are at low risk for suffering from a broken bone can discontinue therapy for the next five years if they have regular tests showing that their bones are remaining strong. Women who still have somewhat-weak bones even after taking Fosamax are encouraged to stay on it.

Your cousin’s problem is osteonecrosis of the jaw — death of a small section of the jawbone. This happens mostly to people who were given high doses of intravenous bisphosphonates for the treatment of cancer that had spread to the bones. It occurs when dental procedures like tooth extractions or dental implants are done. It has happened to people who took bisphosphonates by mouth for osteoporosis, but it rarely does so.

DEAR DR. DONOHUE: There are medicines for erectile dysfunction. Are there any for low or nonexistent libido? — G.S.

A: For loss of libido brought on by depression, antidepressants work. For men whose libido has waned because of low production of testosterone, testosterone replacement is a possible solution.

You should start with your family doctor, who can check for any physical or psychological problems that cause a diminution in sexual desire. If no physical problems are found but there are indications that psychology might be involved, the family doctor can put you in touch with a specialist in dealing with these matters.

DEAR DR. DONOHUE: Can a tuberculosis skin test on a pregnant woman render her unborn child mildly retarded? — F.K.

A: It is virtually impossible for a TB skin test to have any ill effect on an unborn child.

DEAR DR. DONOHUE: My son, 36, has severe reactions to his cats. His breathing becomes labored. He finds relief by going out of the house and using Claritin and an inhaler, prescribed by a specialist.

I suggested that he and his wife find good homes for these cats, but they received this advice with much anger. What do you say about all this? — P.J.

A: Your advice makes a lot of sense to me, but I understand owners’ devotion to their pets.

Protein in cats’ saliva appears to be the allergy trigger. Since cats are constantly grooming themselves with their tongues, saliva gets on their fur and skin. Shed skin cells — dander — that are covered with dried saliva are also allergy triggers. Dander clings to carpets, upholstered furniture, woodwork and walls, so the home environment is never free of this allergen. Your son should make his bedroom off limits to the cats so there is at least a period of time he’s not exposed to allergens. If possible, carpeting ought to come off the floors. Wooden floors, when kept clean, don’t become a depository for cat allergens. Walls, woodwork and furniture should be cleaned frequently. A high-efficiency particulate air filter (HEPA) on the furnace and air conditioner keeps allergens from circulating throughout the house. A third, non-allergic party (his wife?) can come in handy by taking the cats outdoors for a weekly brushing.

Staying on the medicines won’t hurt him. Asthma attacks, which are what “labored” breathing implies, are not pleasant and can be dangerous. If they are getting worse and if the use of the inhaler becomes more and more frequent, he should speak with the specialist again. At that stage, serious consideration ought to be given to finding a new home for the pets.

DEAR DR. DONOHUE: What is lipoprotein (a), Lp(a)? — A.F.

A: It’s similar to LDL cholesterol, or bad cholesterol. High levels of it promote artery clogging and heart attacks. Not every doctor checks for this substance, since its place in prevention of heart attacks has not yet been fully defined.

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.

c. North America Syndicate