Don't recall having chickenpox? Get shingles vaccine anyway

By Dr. Keith Roach, M.D.

DEAR DR. ROACH: I am almost 88 years old. All seven of my children came down with chickenpox at different times. I took care of them all, and never contracted the virus. I didn't have it as a child or as an adult. Should I get the shingles vaccine? I have lupus and thyroid disease. I don't need to take medication for either of them anymore. I have had my yearly flu shot with no problems, and I take the double senior dose.

       I have been on self-quarantine going on nine months to avoid the coronavirus. I am in good health. What are my chances of ever getting shingles? Is there a blood test I could take, that would tell me if I ever had chickenpox and didn't know it? -- T.E.

       ANSWER: It is almost a certainty that you had chickenpox, probably as a small child, when occasionally the symptoms are so mild they are not recognized. Given the number of exposures you had, you would have come down with chickenpox if you had not been immune from previous exposure.

       Shingles comes not from exposure to chickenpox, but from a reappearance of the dormant virus, often at a time when the immune system is weaker. This can be at times of stress, or just as we get older. At age 88, you are at relatively high risk, and if you got shingles, you are at high risk for complications.

       Although there is a blood test to determine whether you were ever exposed, in my opinion, and according to recommendations from the Centers for Disease Control and Prevention, you don't need it. I'd recommend you get the shingles vaccine as soon as convenient.

      DEAR DR. ROACH: I am 66 years old and I recently had my yearly health screen. My cholesterol numbers were above 200 for the past two years. I have taken red yeast rice to keep the numbers below 200. My doctor told me that red yeast rice has been changed and is not what it has been in the past, not as effective. 

       Do you have any information on this? Is there a source that has a standard for red yeast rice? Would I have to buy this in Canada or China in the future? My near-term plan is to go to my doctor and obtain statins and a calcium scan to determine the level of calcium in the arteries. -- M.M.

       ANSWER: Red yeast rice has been used for many centuries in China. It contains a substance called monacolin K, which is the active ingredient in the statin drug lovastatin. However, red yeast rice is a natural product with a great deal of variability. In a study that evaluated the content of 12 preparations of commercially available red yeast rice, the monacolin K (lovastatin) content ranged from 0.10 to 10.09 mg/capsule (or comparison, the usual dose of lovastatin is 20-40 mg). I suspect you have been getting red yeast rice that is on the weaker end of the very wide spectrum. I don't know of any brand or supplier that has consistent levels.

       If you need medication treatment to reduce risk of coronary disease, I do recommend a statin, as the dose is precisely regulated. If you aren't sure whether you need a statin, a calcium score is a good way to get additional information about your personal risk of having a heart attack.