Does smoking increase hemoglobin count?

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DEAR DR. DONOHUE: What is the best way to get rid of tonsil stones, besides sticking my finger down my throat as far as I can and trying to dislodge the smelly things? More importantly, what is the way to prevent tonsil stones? I never had them until a year or so ago. — S.M.

ANSWER: Tonsil stones, or tonsilloliths, are the not uncommon (one study reported them in 7 percent of young adults) but seldom discussed clusters of calcified material that lodge in the tonsils. Your tonsils, those oval-shaped swellings on the sides of the back of your throat, are important for the cells of the immune system.

Tonsilloliths form in the crypts (deep valleys) of the tonsil, and sometimes are visible as white or yellow spots when looking in the mirror. They become bothersome if they are large enough to cause discomfort or difficulty swallowing, but often they are noticed because of their unpleasant odor. Tonsilloliths often spontaneously come out of the tonsils; they usually are described as waxy or hard, with a peculiar odor.

I don’t recommend sticking your finger in the back of your throat. The gag reflex can be very strong, and the tonsils have a very good blood supply, so damaging them can be very bloody. Some authorities recommend removal using the tongue attachment of a Waterpik (or similar device), but I have had general success with saltwater gargles. Very large or recurrent tonsilloliths are an indication for a visit to the ENT doctor.

DEAR DR. DONOHUE: My blood count showed that my hemoglobin is too high. Everything else is normal. My doctor says the hemoglobin is high because I smoke.

The doctor is on me, every time I see him, to stop smoking. I want to, but I haven’t been able to. Is he putting me on with another scare tactic? — S.C.

ANSWER: Hemoglobin is the stuff inside red blood cells that grabs onto oxygen as the blood cells pass through the lungs. Determining a person’s hemoglobin is a surrogate for determining the number of red blood cells.

The carbon monoxide in cigarette smoke prevents the attachment of oxygen to the red blood cell. The body senses an oxygen deficit. It ups the production of red blood cells to compensate. The hemoglobin count rises. Your doctor is telling you the truth. Now you’ve got two doctors harping on 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. © 2014 North America Synd. Inc.