To Your Good Health

DEAR DR. ROACH: I’m a 54-year- old male who works out three to four times a week with weights. I eat healthy, with a very low sugar and restricted carb diet. At my age can I still increase muscle mass, and does testosterone have any play in it.

After my recent physical bloodwork, I had a 670 total testosterone score and thought maybe with that result and increased protein intake I could still add some muscle mass. — M.C.

ANSWER: Healthy men and women can add muscle mass at any age. It is true that low testosterone levels can cause loss of muscle mass. Men who have concerns about losing muscle should be evaluated for low testosterone. Since your level is in the middle of the normal range, there is every reason to expect you can add muscle mass with strength- building exercises. Age 54 is quite young — even those in their 80s and beyond can improve muscle mass, strength and tone with exercise.

DEAR DR. ROACH: I’m a 75-year- old man with no serious health issues. My problem is nighttime bathroom visits. I feel the need to urinate six or seven times each night. However, I have a weak stream and a soreness in my lower stomach while urinating. I don’t usually have anything to drink after 6 p. m. What could be the problem? — H. S.

ANSWER: Enlargement of the prostate is extremely common among 75-year- old men, and the weak stream you note is a strong indication that this is the problem. The urethra — the tube coming from the bladder that urine flows through — goes right through the prostate in men. Enlargement of the prostate compresses the tube, making urinating difficult.

The discomfort could be due to enlargement of the prostate, but it could also be a urine infection, a common complication of an enlarged prostate. A urine test and a prostate exam are likely to lead to an answer. Your regular doctor or a urologist can easily do this, and there are several effective treatments.

DEAR DR. ROACH: Is it advisable to get the Shingrix vaccine at the same time as the annual influenza vaccine? — T. H.

ANSWER: It can be done, but whenever possible, you should get the new Shingrix vaccine by itself. The side effects of this vaccine are more pronounced than with most approved vaccines, and more people may not feel well and will have low grade fever, muscle aches and fatigue that can last a day or two. Anecdotally, it seems that getting multiple vaccines the same day may worsen that reaction. I advise patients to get the Shingrix vaccine on a day where they have nothing critical planned that day or the next, just in case.

If you haven’t gotten this year’s flu vaccine, get it right now. Today, if possible.