A high an­ti­body count for chicken­pox doesn’t equal shin­gles immunity

Prince Albert Daily Herald - - OPINION - Keith Roach

shot. But he said he wasn’t sure how to weigh in on this one. He sug­gested I call the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, but I thought I’d ask your opin­ion. -- D.T.

AN­SWER: I wouldn’t test a per­son in your sit­u­a­tion for an­ti­body lev­els. Whether or not you had been ex­posed to chicken­pox, I still would rec­om­mend a shin­gles vac­cine, which is what the cur­rent guide­lines rec­om­mend.

How­ever, now that you have the re­sult, it isn’t clear from the CDC guide­lines what you should do. My rec­om­men­da­tion is that you still get the vac­cine. The rea­son is that an­ti­body lev­els are rep­re­sen­ta­tive of the part of the im­mune sys­tem called “hu­moral.” This part of the im­mune sys­tem is crit­i­cal for bac­te­rial in­fec­tions, and it is led by the an­ti­body-pro­duc­ing B cells. For vi­ral in­fec­tions like varicella zoster, it’s the cel­lu­lar im­mune sys­tem that is crit­i­cal. This is led by T cells. A high an­ti­body titer, a mea­sure of concentration, like yours may not pre­dict a strong cel­lu­lar immunity. Fur­ther­more, the down­side of get­ting a shin­gles vac­cine is small: It is not very ex­pen­sive, and the risk of se­ri­ous side ef­fects is very small. I don’t think that the high an­ti­body level you have will make it more likely that you will have a side ef­fect.

The in­jectable flu vac­cine con­tains no live flu virus. It isn’t pos­si­ble to get flu from a shot. Some peo­ple do get a re­ac­tion of low-grade fever and mus­cle aches, which rarely lasts more than a day or two: That’s the most likely ex­pla­na­tion in your case. Of course, you may have had very bad tim­ing and were com­ing down with the flu right when you got the shot, but the tim­ing makes me doubt that de­gree of co­in­ci­dence. Nonethe­less, flu shots save lives.

DEAR DR. ROACH: I may seem ig­no­rant, but I’ve tried to get a def­i­ni­tion of a “statin” from pro­fes­sion­als, with no sat­is­fac­tion. Statins are talked about but never de­fined. -- P.E.

AN­SWER: A statin drug is one that in­hibits the en­zyme HMG-CoA re­duc­tase. This is a crit­i­cal en­zyme in the syn­the­sis of choles­terol, which hap­pens in the liver. We all need choles­terol for im­por­tant body func­tion, such as mak­ing cell mem­branes and hor­mone syn­the­sis.

The generic names of this drug class all end in “-statin”: lo­vas­tatin (Me­va­cor), ator­vas­tatin (Lip­i­tor) and ro­su­vas­tatin (Crestor) are among the most com­mon. Some nat­u­ral com­pounds, es­pe­cially red yeast rice, act the same way that syn­thetic statins do, and have the po­ten­tial for both ben­e­fit and harm.

READ­ERS: The book­let on thy­roid gland prob­lems ex­plains this and other com­mon thy­roid ill­nesses. Read­ers can ob­tain a copy by writ­ing:

Dr. Roach

Book No. 401

628 Vir­ginia Dr.

Or­lando, FL 32803

En­close a check or money or­der (no cash) for $4.75 U.S./$6 Can. with the re­cip­i­ent’s printed name and ad­dress. Please al­low four weeks for de­liv­ery.

Dr. Roach re­grets that he is un­able to an­swer in­di­vid­ual let­ters, but will in­cor­po­rate them in the col­umn when­ever pos­si­ble. Read­ers may email ques­tions to ToYourGoodHealth@med. cor­nell.edu or re­quest an or­der form of avail­able health news­let­ters at 628 Vir­ginia Dr., Or­lando, FL 32803. Health news­let­ters may be ordered from www. rb­ma­mall.com.

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