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Dear Roach: A flu shot is the best way to prevent the flu

Keith Roach
To Your Health

Dear Dr. Roach: I’ve caught a flu. That’s despite taking vitamin C, garlic and oil of oregano. I gave up on echinacea a long time ago. I try to get enough rest and live a relatively healthy life. I take no prescription drugs, and you’d think at age 59 I’d have built immunity to the latest bug.

If there’s a cold or flu circulating, I always get it. Why do I have such a bad immune system? I am diligent with handwashing and hygiene, but still, I get sick. Could it be related to extreme stress in childhood, which diminished my immune system?

— S.M.

Dear S.M.: Influenza, the “flu,” is a contagious virus. Keeping your hands clean provides some protection, but the virus can be transmitted through the air in addition to hand-to-hand contact. The best way of improving your immunity to influenza is by taking the vaccine, which changes every year to best match the strains that are expected to circulate. The vaccine provides only partial protection. It’s still possible to get the flu after vaccination, but any protection is helpful. The vaccine helps reduce hospitalizations and deaths from influenza.

High amounts of stress do take their toll on the immune system, although I don’t know of proof that stress in childhood would affect you 50 years later. Unfortunately, vitamin C, garlic, oregano, echinacea and other supplements have limited if any value in preventing influenza or any of the other viruses that cause respiratory symptoms during the colder months.

Dear Dr. Roach: I have been taking ranitidine successfully for years to treat acid reflux. Recently I have read some very scary things about a chemical in it, and some drugstores are pulling Zantac off the shelves. I have heard nothing from my doctor so far. I am wondering what my options are and if the ranitidine scare is warranted. In the past I have used PPIs with success, but stopped when I heard a lot of alarming data about long-term use.

— J.R.

Dear J.R.: In September 2019, the Food and Drug Administration found evidence of small quantities of a contaminant, NDMA, in generic forms of ranitidine. Brand-name Zantac has also now been recalled. NDMA is a probable carcinogen, although the amount present in medications (the contaminant has also been found in some heart medications, the angiotensin receptor blockers) is so small that it is unlikely to cause significant harm in the short term.

Until noncontaminated ranitidine is available, there are other over-the-counter options, such as famotidine (Pepcid is the common brand name).

My major concern about taking ranitidine and medicines like it — called H2 blockers, for the histamine type 2 receptor, which stimulates acid production — for years is that the “acid reflux” you have been treating might be something more concerning. People who have had persistent symptoms should be periodically re-evaluated and considered for an upper endoscopy.

I routinely hear from people who have really made a significant change in lifestyle and were able to stop medication entirely. Identifying and stopping dietary triggers, not eating a couple of hours before bed, elevating the head of the bed and, for some people, losing weight are among the most effective behavioral strategies.

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