Dear Dr. Roach: I’ve caught a flu, despite taking vitamin C, garlic and oil of oregano. I try to get enough rest and live a healthy life. I take no prescription drugs, and you’d think at age 59 I’d have built immunity to the latest bug, but 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 that diminished my immune system?
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 getting the vaccine, which changes every year to best match the strains 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 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 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.
In September 2019, the U.S. 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 made a significant change in lifestyle and were able to stop medication entirely. The most effective behavioural strategies include stopping dietary triggers, not eating a couple of hours before bed, elevating the head of the bed and losing weight.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers can email questions to ToYourGoodHealth@med.cornell.edu.
