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In most situations, the person asking this is simply using a polite formality. Usually, something along the lines of "I've been well, thank-you. And yourself?" will suffice, even if you really haven't been that well.

Of course, you have to judge each situation on its own merits. If you are in the doctor's office and an assistant with a chart comes in, you should of course describe your health in detail. If it is someone you just pass by on the way to work everyday, you shouldn't go into any detail about your health. If it's something in between, you should make a judgment call as to whether they are genuinely asking for a recitation of your medical conditions or just being polite.

Incidentally, the proper response to "How do you do?" is always "How do you do?" It is not really a question.

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14y ago
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1w ago

You can respond with a brief answer such as "I've been doing well, thank you" or "I've been good, how about you?"

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Q: What to answer to how have you been?
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