Could canned tuna make a case of shingles worse?
Q: I have a friend who is suffering from shingles. She’s been told that canned tuna makes it worse, because canned tuna is rich in arginine that helps the shingles virus replicate. Is there any substance to such a contention?
A: Arginine is an amino acid that is essential for the replication of the herpes viruses that cause shingles and cold sores. High protein foods such as red meat, poultry, nuts, fish and dairy products are rich in arginine.
We found a case report of a healthy young man who developed recurrent shingles in his eyes (American Journal of Ophthalmology Case Reports, December 2019). His doctors attributed his unusual reaction to the L-arginine supplements he was taking as a weight lifter. Like other fish, tuna contains arginine. We don’t know whether cutting back on this amino acid will help shingles heal more quickly.
Q: My healthy husband went for a physical because he was going to retire. They found he had an irregular heart rhythm called atrial fibrillation and put him on amiodarone.
Within a few months, he could not function and went in for a cardioversion. They said he was not getting enough oxygen, and he was admitted to intensive care for three weeks. There, they diagnosed him with lung poisoning from the drug. He was intubated, and he never woke up. My beloved husband died, and I deeply regret watching him take that drug each day.
A: Your story is tragic and should never have happened. Amiodarone has not been approved for treating atrial fibrillation. The Food and Drug Administration has made it clear that this drug should only be prescribed for life-threatening heart rhythm abnormalities such as recurrent ventricular fibrillation.
Amiodarone can cause serious lung toxicity. It can also harm the liver and the thyroid gland. In short, this drug should be reserved for situations when other treatments have failed.
Q: Are home blood pressure moni
toring machines accurate? I have had some trouble with mine over the years. My readings fluctuate quite a lot. I know variability is normal, based on activity level, stress or whether one just drank coffee. My average with random readings over the last week: 133/87.
My resting heart rate is in the high 80s or low 90s. When I was taking a low dose of atenolol last year, my heart rate was usually in the 60s. What should I make of this? I am a 63-year-old woman with no known heart disease.
A: Home blood pressure monitors are generally very accurate. Consumer Reports has evaluated many different models over the decades. The Omron brand consistently ranks very highly for ease of use and accuracy. Prices range from roughly $50 to $100.
We recommend checking your device by taking it with you to your next in-person doctor’s visit. Have the nurse measure your blood pressure several times in the same arm with both devices to compare the readings.
Atenolol is a beta blocker that can lower blood pressure and slow heart rate. Beta blockers are no longer considered firstline treatment for high blood pressure by most cardiologists. Since your resting heart rate is a bit higher than usual, your physician may want to reconsider whether a beta blocker might be appropriate. Your blood pressure is slightly above the current target of 130/80s.