After a recent flu/Covid vaccination, a 5cm bruise appeared that took two weeks to disappear. I also came down with a cold that still left me short of breath while walking four weeks later. I am normally very fit. I’m 71.
Richard Stratford, South Chailey, East Sussex.
Dr. Martin Scurr replies: This is a concern I have often heard from people who, for example, have become ill with a virus after a flu shot. It seems logical to blame the shot. So I am grateful for the opportunity to explain that there is in fact no medical evidence for this.
The vaccine does not contain live virus and a more likely explanation is that your jabs coincided with the incubation of a virus you had recently come into contact with.
It is also worth emphasizing that it is not unusual for a respiratory infection to last for up to four weeks, especially at your age, even if you are normally fit.
People who become ill after a flu or Covid jab may be tempted to blame the jab
This is because respiratory viruses are often followed by sinusitis or bronchitis, which can cause symptoms of fatigue and shortness of breath to persist due to residual inflammation.
Another possibility could be a secondary bacterial infection. In your longer letter you suggest that a pneumonia you had in 1969 may have caused permanent damage that contributed to your current cold. If that were the case, I suspect you would have known about this earlier, as it would have meant you struggled to recover from respiratory infections in the years that followed.
If you remain breathless and unwell, go to your GP and ask for a blood test to check inflammatory markers known as ESR and CRP.
Elevated levels of these are associated with a wide range of conditions, but can also include a post-viral bacterial infection in the sinuses or lungs. If your levels are elevated, you should be referred for a chest x-ray and have a mucus sample sent for laboratory testing to determine the cause (you may need antibiotics). If shortness of breath is your only symptom, you may need to give your body more time.
My son is taking lansoprazole for a hiatus hernia and should take it for life. I’m concerned because I heard it can cause stomach cancer.
Christine Thompson, Crawley, West Sussex.
Dr. Martin Scurr replies: With a hiatal hernia, part of the stomach is pushed into the chest by the diaphragm (the muscular wall that separates the chest cavity from the abdomen).
In some cases, stomach acid enters the esophagus; this acid reflux causes symptoms such as heartburn, nausea, or a dry cough. Chronic symptoms should be investigated, but if there is no underlying problem, patients are often prescribed proton pump inhibitors (PPIs), such as lansoprazole, to reduce acid production.
This is important because acid can damage the cells lining the esophagus, causing a precancerous condition called Barrett’s esophagus. But all medications have possible side effects. Lansoprazole can cause dry mouth and fatigue, while rarer side effects include anemia and pancreatitis (an inflamed pancreas).
Lansoprazole is one of the proton pump inhibitors prescribed to patients with hiatus hernia
More recently, concerns have arisen about a link between long-term use of PPIs (longer than three months) and the increased risk of stomach, esophageal, colorectal and pancreatic cancer. One theory is that this is related to changes in the acidity or bacterial composition of the intestines.
Not all patients need to take PPIs for life; treatment should be based on the severity of symptoms. One option is a “drug holiday”: with the doctor’s permission, stopping the medication for a few weeks or months to see if symptoms persist or if they can be treated in other ways.
Research shows that up to 40 percent of acid reflux symptoms can be reduced with diet and lifestyle changes. Over-the-counter antacids, such as Gaviscon, can also help. Another option is surgery to correct the hiatal hernia. I suggest your son talk to his doctor.
I think…vitamin you might need all year round
Since the start of the pandemic, I have been taking vitamin D every day, on the advice of an infectious disease colleague. Because not only is this nutrient vital for bone health, research has also linked low vitamin D levels to cardiovascular disease, cancer and infections.
Because our main source of vitamin D is exposure to UV light from the sun, the NHS recommends adults take a supplement between October and March.
This can be especially important for people over 75. New guidelines from The Endocrine Society suggest this age group should take a supplement year-round because of its importance to health – and because certain factors affect their vitamin D levels, including reduced dairy intake, reduced sun exposure and, as As we age, the body becomes less effective at producing the vitamin, even when we lie in the sun.
Some doctors, including myself, encourage older patients to take a large dose of vitamin D once a week so they are less likely to be forgotten. But we now know that high doses taken intermittently can lead to nausea, vomiting and weakness – and that the benefits may diminish if the doses are taken intermittently. So daily is probably best.