Dear Dr. Roach: I’ve by no means gotten the flu vaccine. Years in the past, it was believed to be too harmful for anybody with an autoimmune situation. They mentioned that the physique couldn’t deal with the vaccine and that it was truly harmful to obtain it. I’ve Hashimoto’s thyroiditis.
Please inform me if that’s true. I had the flu in 1993 and haven’t been sick with something however a chilly since. I used to be not hospitalized in 1993.
Hashimoto’s thyroiditis is a situation the place the physique’s immune system assaults the thyroid gland, within the neck. The thyroid degree initially will increase within the physique, however then over time, it decreases. In most, it will definitely will come again to regular, however individuals require remedy with thyroid hormone, typically for years.
I don’t agree with the recommendation you acquired concerning the flu vaccine. The clearest motive to not give a flu vaccine (I imply particularly the flu shot, which doesn’t comprise stay virus) is that if individuals have a extreme allergy to any of the elements of the vaccine. People who’ve had Guillain-Barré syndrome inside six weeks of a earlier influenza vaccine usually are usually not vaccinated once more. Hashimoto’s isn’t a motive to keep away from the flu shot.
2017-2018 has been a extreme season for influenza, and whereas I’m glad you haven’t had the flu in a few years, I nonetheless suggest the vaccine yearly. It supplies safety, even when incomplete, for a illness that kills as much as 50,000 individuals per 12 months. People who’re vaccinated additionally assist shield these people who find themselves unable to be vaccinated.
Dear Dr. Roach: If an individual who’s 75 or older has hypertension — say, 175/80 — in what circumstances would you recommend not taking any hypertensive medicine to decrease stress (to 130/80 or much less)? Aren’t there some fragile individuals who require increased blood stress to satisfy the physique’s calls for?
It was once the case that older individuals with hypertension weren’t handled. In reality, the time period “important hypertension” (which now means “hypertension with no identifiable trigger”) initially was used to point that hypertension was important for enough blood circulation. However, examine after examine has proven that older individuals with systolic blood stress above 160 can have a dramatic discount within the threat of stroke with remedy.
It definitely is true that the blood stress ought to be introduced down slowly and judiciously. By utilizing low doses of treatment at first, we will scale back the signs of getting too low a blood stress. In individuals whose blood stress is chronically very excessive — resembling a diastolic (that’s the second quantity) stress over 110 — the blood circulation to the mind may not be regulated correctly, so the blood stress is introduced down very slowly certainly.
There have been many conditions the place what was considered widespread knowledge was upended by the outcomes of rigorously executed, giant scientific trials. How a large-scale trial applies to a given particular person isn’t all the time apparent, and it nonetheless requires a talented clinician with information of each the person affected person and an understanding of the biology of the situation. It could be a really uncommon state of affairs for me to not suggest treating a blood stress that top.
Dr. Roach regrets that he’s unable to reply particular person letters, however will incorporate them within the column each time attainable. Readers could e-mail inquiries to [email protected]