Courtesy photo Dr. Keith Roach, M.D.

DEAR DR. ROACH: I am a 69-year-old male in good health. In 2017, I experienced a pulmonary embolism in my left lung. Following that episode, my cardiologist put me on a statin regimen of 40 mg Lipitor. This was to get my LDL numbers down to 60 or lower in order to counteract a buildup of plaque in arteries after an angiogram revealed less than 50% buildup in two areas of my heart. A year later, my LDL numbers were around 100, and my cardiologist doubled the Lipitor dose to 80 mg, still trying to reach the magic number of 60. I have been taking this dose for over a year now with a visit to my cardiologist scheduled soon.

Can lowering LDL numbers dramatically like this affect my immune system and therefore have negative effects if I were to contract a serious infection, such as the new coronavirus? — C.F.

ANSWER: The data are abundant that, in people with known blockages of the arteries in their heart, statin drugs reduce heart attack and stroke risk. I was not able to find data about the risk of viral diseases specifically, but a study from 2015 did demonstrate a lower bacterial infection rate in statin users compared with nonusers. An increase in deaths from causes other than heart disease has not been found in statin users.

However, there are side effects to be concerned about. Statins increase the risk of diabetes in those predisposed to it, and diabetes, especially if poorly controlled, has a negative effect on the immune system and the body’s ability to fight off infection.

DEAR DR. ROACH: A year ago, I purchased a distilling machine to make my own distilled water to save money. I add the necessary minerals to the finished product. What is your opinion of drinking distilled water versus bottled water? Also, would alkaline water be better than distilled? — D.H.

ANSWER: I recommend tap water for drinking, as the quality of tap water in the vast majority of North America is outstanding, and the cost in money and to the environment is much, much smaller than bottled or even homemade distilled. Minerals may make the water taste better but are not necessary for health. Food should be your source for trace minerals.

I get letters from people who want to drink the purest water, but it is my opinion that the medical benefit from this is at best minuscule.

There are no benefits from alkaline water. Your body maintains perfect pH balance through robust systems in the kidney and lungs. Save your money and the planet.

DEAR DR. ROACH: My beautiful hair is falling out in handfuls ever since my doctor increased my dose of lisinopril. The top of my head is almost all bald. Could this be the cause? — L.M.

ANSWER: There have been reports of hair loss with ACE inhibitor drugs such as lisinopril and captopril. In one case report, the person’s hair grew back within four weeks of switching to a different class, the angiotensin receptor blockers. Less than 1% of people report hair loss with lisinopril, but if the timing was as suggestive as you say, it would be worth asking your doctor about a trial on a new medicine.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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