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DEAR DR. ROACH: I read in your column and elsewhere that vitamin supplements have no realized benefit. I've mostly read about how it doesn't hurt, but there is no evidence that they help. Does this include fish oil (omega-3) supplements? I also take an iron supplement. Both of these had a net positive impact on my blood work. Could you expound on this once again? -- D.A.B.

ANSWER: I said that taking vitamins and supplements solely for the purpose of improving your health isn't likely to help. In people who have medical conditions, there are often alternatives to prescription drugs. For example, in people with moderate to severely high triglyceride levels (500-1,000 mg/dL), a physician might prescribe a statin drug, a fibrate, or omega-3 fatty acids, sometimes in combination with each other. However, in people with a low to average heart disease risk and normal triglyceride levels, omega-3 supplements probably have little or no benefit.

Iron supplements are part of the treatment for iron deficiency, but before prescribing iron, you should know why your iron is low. I have seen far too many people taking iron for low iron levels without the person ever having had a careful evaluation. Serious causes of low iron include tumors in the gastrointestinal tract, especially the colon. Most people do not need iron supplements, but there are some people who do not get enough iron through their diet. This may require blood testing.

Iron supplementation in absence of iron deficiency isn't necessary and can sometimes have unpleasant side effects.

DEAR DR. ROACH: I am an 82-year-old man. I don't know if I had measles or was ever vaccinated. My wife and I are going to Athens, as well as a cruise to the Greek islands, all of which may have had an outbreak some time ago.

I have prostate cancer and had radiation treatments. I am not having any treatments at this time. My PSA is much lower now at 1.3 ng/mL, but the recommendations concerning vaccinations are confusing. In particular, I am concerned about the risk of a stroke with certain manufacturer's vaccines.

If you have any thoughts about being vaccinated prior to trips outside of the United States, I'm sure it would be helpful for us seniors who are going on a trip to foreign lands. -- R.I.C.

ANSWER: When I have a patient heading out of the country, my first stop is CDC.gov/travel. You simply select the country you are going to and the experts there provide up-to-date information on the necessary vaccines and other information a traveler needs to know about. Most of what is on the site is easy to understand for people without any medical knowledge, but your own regular doctor can help.

Some destinations (not Greece) require a yellow fever certificate, in which case you should be seeing an expert in travel medicine.

For Greece in particular, the Centers for Disease Control and Prevention recommends being up-to-date on your regular vaccines, including flu and COVID. They would also have you consider a hepatitis A vaccine, which I recommend to all my patients who are traveling internationally. It's particularly important for those visiting rural areas or those who eat food from street vendors. Two doses of hepatitis A vaccine are a lot safer than a case of hepatitis.

As far as measles goes, anyone born before 1957 can be safely assumed to have lifelong immunity to measles due to having had this extremely contagious disease. They do not need lab testing or a booster shot.

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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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