Investigate the reason behind fluid retention

Dear Dr. Gott: My wife has to urinate a lot. She is tired most of the time and has no desire to do anything. She’s too grouchy too often, doesn’t have much sex drive, her ankles are swollen and she’s unusually puffy up to her waist.

She has mitral valve prolapse, but the doctor says it is of no danger to her health. She eats a lot of salt and sugar but is really healthy. She is 44, weighs about 120 pounds and is 5 feet 4 inches tall. Could you tell me what could be wrong with her? Dear Reader: Fluid retention, called “edema,” can be the result of a variety of health issues, including heart disease, kidney disorders, inappropriate salt consumption, and vein blockage. Your wife’s frequent urination and swelling of the legs and lower body suggest that the kidneys are not clearing out excess fluid, perhaps because of weak heart action, which could be worsened by excess salt in her diet.

I urge your wife to meet with her primary-care physician for an exam, which should include an analysis of her legs and heart, followed by appropriate blood tests to check for anemia, kidney failure and mineral levels. Her doctor may choose to refer her to a specialist, an option I would endorse, depending on the lab findings. Also, some scanning procedures should be carried out, such as a chest X-ray and possible CT scan. Your wife’s edema should not be ignored.

In addition to the appropriate medical follow-up I have suggested, she should place herself on a low-salt, low-sugar diet. This would include no table salt or salty foods.