Doctors disagree over shingles shot

Q. I had shingles many years ago. So did my friend. Her doctor gave her a shingles injection so she won’t get it again. My doctor said that by having shingles, I built antibodies to it and don’t need the shot. Which doctor is correct?

A. Chickenpox during childhood can lead to shingles later in life. The virus (varicella zoster) can lie dormant in nerves near the spinal cord for decades. The virus can be reactivated and trigger an intensely painful skin reaction.

Zostavax was developed to prevent shingles in people over 60 years old. The company excluded anyone who had previously experienced a shingles attack from the study. Consequently, the Food and Drug Administration does not allow the company to promote the vaccine for anyone who already had shingles.

We’re not surprised that the doctors disagree. Many were taught that shingles only happen once. That is not completely true. Although quite rare, some people can experience another bout with this virus (American Family Physician, April 15, 2000). The Centers for Disease Control and Prevention call for vaccination even for people who already had one attack.

Q. I had acid-reflux surgery because stomach acid was irritating my throat. After the surgery, the correct diagnosis of celiac disease was finally made. Eating wheat caused the acid in my throat.

People often write you about chronic heartburn. They should be told that surgery and drugs aren’t always the answers. If I’d gotten the celiac-disease diagnosis sooner, I might have been spared an unnecessary operation.

A. Celiac disease is an inability to tolerate gluten, a protein found in wheat, barley and rye. The immune reaction to this protein begins to destroy the gut and can cause a wide range of symptoms, from heartburn and migraines to fatigue and osteoporosis.

Celiac disease was once thought to be rare, but more recent research shows that it is far more common, perhaps one in 100 people (Proceedings of the Nutrition Society, November 2005). It runs in families, so relatives of patients should definitely be tested. There are no medications to treat celiac disease, but it can be controlled with a gluten-free diet.

To learn more about the symptoms, diagnosis and treatment of celiac disease, we offer an hourlong CD of our radio interview with a leading expert, Peter Green, M.D. Anyone who would like the CD may send $16 to: Graedon Enterprises, Dept. CD-594, P.O. Box 52027, Durham, NC 27717-2027. You also can order show No. 594 from www.peoplespharmacy.com.

Q. I’m responding to a column in which a young woman committed suicide after starting Cymbalta. I worry that others will use this tragedy to say that antidepressants are dangerous.

I take the same pills she did: clonazepam and Cymbalta. These drugs allow me to have feelings again, beyond just the agony of despair. With counseling, I was able to step back and survey what had become of my life when I was most depressed: ruined relationships, lost money and jobs.

These drugs can be lifesaving for many people. I truly feel, though, that medication must be combined with therapy. It is not the doctor’s fault for giving out samples of the medication. They usually come with the full information packet.

A. Many people do indeed benefit from antidepressants. Nevertheless, patients and families must be told to contact the prescribing physician if suicidal thoughts occur when starting a new medication.

XIn their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of The Vindicator or e-mail them via their Web site: www.PeoplesPharmacy.com. Their newest book is “Best Choices From The People’s Pharmacy” (Rodale Books).

2008 King Features Syndicate Inc.