After a recent flu/Covid vaccine, a 5cm bruise appeared that took two weeks to disappear. I also developed a cold that still causes me shortness of breath four weeks later when I go for a walk. I’m usually very fit. I am 71 years old.
Richard Stratford South Chailey, East Sussex.
Dr Martin Scurr responds: This is a concern I’ve heard many times from people who got sick with a virus after a flu shot, for example. It seems logical to blame the jab. So I appreciate the opportunity to explain that there is, in fact, no medical evidence for this.
The vaccine does not contain a live virus and a more likely explanation is that his injections coincided with the incubation of a virus he had recently been in contact with.
It’s also worth noting that it’s not unusual for a respiratory infection to last up to four weeks, especially at your age, even if you’re normally fit.
People who get sick after a flu or Covid vaccine may be tempted to blame the vaccine
This is because respiratory viruses are often followed by sinusitis or bronchitis, which can cause symptoms of fatigue and shortness of breath to persist, as a result of residual inflammation.
Another possibility could be a secondary bacterial infection. In his longest letter, he suggests that the pneumonia he had in 1969 could have caused lasting damage that contributed to his current cold. If that were the case, I suspect you would have noticed it before, as it would have meant you would have had a hard time recovering from respiratory infections in later years.
If you continue to be breathless and unwell, see your GP and request a blood test to check inflammatory markers known as ESR and CRP.
Elevated levels of these are linked to a wide range of conditions, but could 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 a phlegm sample sent for laboratory testing to identify 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 takes lansoprazole for a hiatal hernia and should take it for life. I’m worried because I’ve heard it can cause stomach cancer.
Christine Thompson, Crawley, West Sussex.
Dr Martin Scurr responds: A hiatal hernia occurs when part of the stomach is compressed toward the chest through the diaphragm (the wall of muscle that separates the chest cavity from the abdomen).
In some cases, stomach acid spills into the esophagus; This acid reflux causes symptoms such as heartburn, nausea, or 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 as the acid can damage the cells lining the esophagus and cause a precancerous disease 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 (inflamed pancreas).
Lansoprazole is one of the proton pump inhibitors prescribed for patients with hiatal hernia.
More recently, concerns have been raised about a link between long-term PPI taking (more than three months) and increased risk of gastric, esophageal, colorectal and pancreatic cancer. One theory is that this is related to changes in the acidity or bacterial composition of the intestine.
Not all patients need to take PPIs for life; Treatment should be based on the severity of symptoms. One possibility is a “medication holiday”: with your doctor’s agreement, stopping the medication for a few weeks or months to see if symptoms persist or can be controlled 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, may also help. Another option is surgery to correct the hiatal hernia. I would suggest that your child speak to their primary care doctor.
In my opinion…vitamin you could need all year round.
I have taken vitamin D every day since the start of the pandemic, on the advice of an infectious diseases colleague. Not only is this nutrient vital for bone health, but research has linked low levels of vitamin D to cardiovascular disease, cancer, and infections.
Because our main source of vitamin D is exposure to ultraviolet light from the sun, the NHS recommends that adults take a supplement between October and March.
This may be especially important for people over 75 years of age. New guidelines from The Endocrine Society suggest that this age group take a supplement year-round because of its importance to health and because certain factors affect their vitamin D levels, including reduced dairy intake, less sun exposure, and As we age, the body becomes less efficient at creating the vitamin even when we are sunbathing.
Some doctors, including me, used to encourage older patients to take a large dose of vitamin D once a week, so they would be less likely to forget it. But we now know that high doses taken intermittently can cause nausea, vomiting and weakness, and the benefits may be reduced when doses are intermittent. So daily is probably best.
