Diseases & Conditions Archive

Ask the doctors

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Q. I've read that getting the flu shot annually will weaken my immune system over time. Is this true?

A. A study published in the March 1, 2017, issue of The Journal of Infectious Diseases investigated whether getting an annual vaccination against influenza (flu) can weaken your body's natural ability to protect itself from the disease. Past studies have raised similar concerns. Researchers at the University of Bergen in Norway followed 250 health care workers. Some of them got a flu vaccination every year from 2009 through 2013. The others only received the vaccine once in 2009 and not in the years from 2010 to 2013. The researchers then took blood samples before the influenza season (and before people were vaccinated that season), from the members of both groups and looked at different markers to gauge how well their immune systems would respond to the influenza virus. They found that getting an annual flu vaccination did not weaken the immune system. As a group, the people who got the flu shot annually appeared to have a better immune response to influenza than those vaccinated only once.

The awareness of the intersection between inflammation and chronic disease has spawned a plethora of diet plans, nutritional supplements, and lifestyle programs, many implying they offer new ways to improve your health by quelling inflammation. It's true that scientists are uncovering new complexities and expanding their knowledge of factors that may contribute to inflammation or help counter it. But much of the heavily hyped guidance for an anti-inflammation lifestyle boils down to the same no-nonsense health advice your grandmother might have given you. 

Make healthy food choices

Our diets play an important role in chronic inflammation because our digestive bacteria release chemicals that may spur or suppress inflammation. The types of bacteria that populate our gut and their chemical byproducts vary according to the foods we eat. Some foods encourage the growth of populations of bacteria that stimulate inflammation, while others promote the growth of bacteria that suppress it. 

They're not yet FDA-approved, but the devices are available and safe — if you know what to look for.

When Congress passed the Over-the-Counter (OTC) Hearing Aid Act in 2017, it opened up a new world of possibility for people with hearing loss. Instead of paying $5,000 for a pair of FDA-approved hearing aids and follow-up service, you could pay hundreds of dollars for an OTC pair from any seller — no doctor appointments, hearing tests, or fittings needed. The devices would have the same fundamental technology as traditional hearing aids, they'd be targeted to people with perceived mild-to-moderate hearing loss, and the FDA would ensure quality by regulating and approving the OTC devices.

But almost four years later, the OTC hearing aid category and its safety and labeling rules are still tied up in red tape.

News briefs

Hold off before you follow new recommendations to treat mild, persistent asthma — or at least consult your doctor first. The updated guidelines from the National Institutes of Health, published online in the December 2020 issue of The Journal of Allergy and Clinical Immunology, say it's okay for people with mild, persistent asthma to stop daily use of inhaled corticosteroids and instead use them only as needed, along with short-acting beta agonists ("rescue" medications). That's considered a major shift in guidance. But that may not be a good idea for some older adults, notes Dr. Anna Wolfson, an allergist and immunologist at Harvard-affiliated Massachusetts General Hospital. "A lot of people have a harder time with the occasional use of medications than a routine practice of daily use," she says. "And you may not want to decrease your asthma regimen during the pandemic. Poorly controlled asthma could lead to a flare or an ER visit, and perhaps an increased risk for complications if you develop COVID-19." Dr. Wolfson says there are some people who might benefit from using inhaled corticosteroids only as needed, but she urges you to speak with your doctor before changing your medication regimen.

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In the journals

Do you know if you have hypertension (high blood pressure)? And if you do, are you treating it effectively? Study findings published online Sept. 9, 2020, by JAMA found that people's awareness and control of their high blood pressure have both dropped in recent years, especially among older adults.

The study pulled data from the National Health and Nutrition Examination Survey. It found that the number of people who knew they had hypertension fell 8% from 2013 to 2018. Among those who were aware of their condition, more than half did not manage it adequately. In particular, adults ages 60 and older were less likely to control their high blood pressure than younger people. Lack of engagement could be a factor. Researchers noted that among people who hadn't been to their doctor in the past year, fewer than 10% had controlled their blood pressure.

In the journals

"Smell training" could help treat certain smell disorders, suggests a study published online Nov. 19, 2020, by the journal The Laryngoscope. Two common types of smell disorders are phantosmia, in which you smell an odor that isn't there, and parosmia, in which you smell strange and often unpleasant odors — for example, cinnamon smells rotten. Both disorders are believed to occur because of damage to the smell pathways (nerves that carry information from the nose to the brain), usually caused by a bacterial or viral infection. They also may result from a head injury or smoking.

The study enlisted 153 people who had experienced changes in their ability to smell after recovering from a viral infection, such as a cold or the flu. They were tested for how well they could smell a variety of odors. Smells related to phantosmia and parosmia also were identified. The people then received smell training kits that consisted of random odors as well as ones linked to their phantosmia or parosmia.

Ask the doctors

Q. I eat a lot of shellfish and recently developed gout in my knee. Did my diet cause the condition?

A. As you probably know, gout is a painful form of arthritis that occurs when high levels of a waste product called uric acid build up in the body. It can settle into joints, where it forms sharp crystals that can trigger inflammation, redness, and pain. Your diet may have aggravated the condition, but didn't cause it.

If you've had a stone, the problem is likely to recur — but it doesn't have to. Use these strategies for prevention.

The pain associated with kidney stones has been described by some as more excruciating than childbirth. Kidney stones are small, hard stones, formed when high levels of minerals in your urine start to crystallize in your kidneys, forming a pebble-like mass. The pain comes when these stones migrate from your kidneys through the ureters, which are the narrow tubes that carry urine from your kidneys into your bladder.

"Kidney stone pain is not subtle," says Dr. Gary Curhan, a professor of epidemiology at the Harvard T.H. Chan School of Public Health. It typically starts in the flank, at the side of the lower back. Sometimes if the stone moves, the pain migrates to the front of the body.