By Ann J. Curley
CNN Medical Assignment Manager

Many of our readers are still asking questions about H1N1 and seasonal influenza. Today we’ve got a question from Patty:

I am a 63-year-old health care worker in relatively good health, and I’m caring for a 2-month-old infant (my granddaughter). I have had a reaction to thimerosal in the past. It was used as a preservative in contact lens solution.

Is thimerosal used as a preservative in either seasonal flu vaccine or H1N1 vaccine? Are there available alternatives to these vaccines? How would I access them?

Thanks,
Patty Holly

Patty,

Thank you for your question. It’s important that you make your health care provider aware of your sensitivity to thimerosal, which is a preservative used in many products, including some vaccines, nasal products, and eye solutions.

According to the Centers for Disease Control and Prevention, the 2009 H1N1 influenza vaccines approved by the FDA are being manufactured with and without thimerosal.

Multi-dose vials of flu vaccine need to contain a preservative to prevent bacterial contamination, which can occur when multiple syringes are inserted into the same bottle.  However, some manufacturers also produce single-dose flu shots, which do not require any preservatives.

The nasal flu vaccine – both for seasonal flu and H1N1 – is always thimerosal-free. However, it is recommended only for people ages 2 to 49 who have no underlying health problems. The nasal spray vaccine is made from a weakened live virus and is not recommended for people with autoimmune disorders, pregnant women, and patients with certain chronic health problems, including diabetes, heart disease, asthma, and lung disease. Unfortunately, you can’t take the nasal flu vaccine because you are 63. You can find more information about the live vaccine here.

Ask your doctor for a thimerosal-free flu shot. If he or she doesn’t have one, you can visit the CDC’s H1N1 Web site and check out its “flu shot locator” .  It has links to the Web site of each state’s health department, with specific information about where vaccine can be found.

The Centers for Disease Control and Prevention has a lot of useful information about both seasonal flu and H1N1 flu on its Web site. Also be sure to check out CNN.com’s flu page.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Ann J. Curley
CNN Medical Assignment Manager

Which came first, the chicken or the egg? The familiar question entered my mind as I was reading a study in this week's Journal of the American Medical Association regarding diabetes and depression. Why? Because the study found that patients with type 2 diabetes have a higher risk of developing depression and patients with depression have a higher risk of diabetes.

Lead study author Sherita Hill Golden, M.D. of Johns Hopkins University says her research involved two analyses of data generated by a study looking at heart disease and type 2 diabetes. The study involved over 5,000 men and women, ages 45 to 84.

First the researchers looked at people who began the study with symptoms of depression, but did not have diabetes. Those people had a 42 percent higher risk for developing diabetes during a three-year follow-up. Golden speculates that behaviors associated with depression, such as overeating, smoking, and not exercising, help to trigger the diabetes.

A second facet of the study looked at patients in whom type 2 diabetes was diagnosed, who had no symptoms of depression. Those patients showed a 54 percent higher risk for depression during the three-year follow-up period. Golden believes that the stress of managing diabetes can lead to depression for some patients. Although this study focused on type 2 diabetes, Golden says that depression is also common among type 1 diabetics.

Health care providers and patients must be aware of the double-edged sword of diabetes and depression. Identifying and treating both is critical. It’s important to understand that depression, when untreated, can lead to behaviors that can lead to, or worsen diabetes, because people eat poorly and don’t exercise. But there are many treatment options for both conditions that can keep patients healthy and happy.

Do you have diabetes or depression? Are you concerned that one might lead to the other? What are you doing to take care of yourself?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.