DEAR DR. ROACH: What exactly is collagen, and why do I see so many ads supporting its use as a youth supplement? — R.F.

ANSWER: Collagen is a structural protein found in your skin, bones, tendons and ligaments. Collagen is constantly broken down and replaced by the cells in the connective tissue of the body. We need adequate nutrition and the amino acids necessary to rebuild collagen.

However, I am not a believer in collagen supplements. You get the amino acids you need from a heathy general diet. Collagen supplements will be broken down rapidly into their component amino acids in the stomach and intestine, so the collagen you take can’t just be put into your body. It needs to be broken down and rebuilt in place. What is currently called “bone broth” — or what our parents’ generation called “stock” — is a much cheaper and effective way of increasing collagen intake.

Vegans should be careful to get the critical amino acids in collagen. Beans and asparagus are a good way to get the amino acid proline, which is low in many vegetable sources and necessary for collagen’s structure.

DEAR DR. ROACH: My father died at age 76 and his father at 46, both of pneumonia. When the first vaccine came out, I got the shot. But I had a severe reaction. My left arm at the site of the injection swelled up and became very inflamed. I could barely lift my arm for several days. It eventually went away. A decade later and I would like to get the new two-dose vaccine, but my doctor says it’s not a good idea in view of my adverse reaction to the first. Would I be further putting myself at risk and in harm’s way if I got it anyway? — R.Y.

ANSWER: Local reactions to vaccines are not uncommon and usually are not dangerous. Being unable to lift your arm for several days is worse than the usual, so I understand why your doctor is concerned. However, you have a point about a possible family susceptibility to pneumonia and an understandable natural desire to get as much protection as you can.

There are many types of pneumonia, and the vaccines protect only against the most common one, Streptococcus pneumoniae, also called pneumococcus.

As always, you must look at the risks and benefits of the procedure, and make a decision on the balance. The risk is of another local reaction. I think this risk is less than you may think, because the new vaccine (the two-dose 13 valent pneumococcal conjugate vaccine, Prevnar) is considerably different from the old one-dose 23-valent pneumococcal polysaccharide vaccine, Pneumovax). They stimulate the immune system in different ways, and you may not have the same kind of strong local reaction.

I would also be cautious that the person injecting the vaccine use an appropriate size needle and inject to the proper depth. A needle in the wrong spot or inserted too deeply can inject the vaccine into a bursa of the shoulder, causing shoulder injury related to vaccine administration (SIRVA), which is often not recognized.

Go back to your regular doctor and, if you decide so, say you are willing to take the risk of a local reaction. Certainly, if you develop a bad reaction to the first shot, you should not take the second.

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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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