When you’re dealing with a stream of sick days, it can be hard to remember what it was like to feel healthy. Sometimes you can just chalk it up to bad luck, particularly if you are a teacher, a caregiver for small children, or just come into contact with a lot of people in your daily routine. This is especially true during fall and winter when everyone seems to have a cold, the flu, or COVID.1
But if you’ve been coming down with, say, ear, sinus, lung, or even skin infections over and over and over again, that could be a potential sign that something’s up with your immune system, says Patrick Jackson, MD, an infectious disease physician at UVA Health. The average person’s immune system should be innately good at its job—so if you’re a young, seemingly healthy person, but you end up in the hospital with pneumonia more than once, that’s a major red flag, he says.2
I got Covid three months ago, and have been unwell ever since.
Your immune system is made up of specialised cells, proteins, and organs designed to protect you when an “invader”—pathogens like bacteria or viruses, for example—is detected. Even if you become sick as your body defends itself, you shouldn’t feel as bad if you cross paths with the same bug in the future. Your immune system should remember it and swiftly spring into action.3
If you’ve been sick a lot lately, you shouldn’t automatically assume you have a serious problem with your immune system—but it wouldn’t hurt to get your symptoms checked out. Here’s what you should know if you’re feeling a little worried about a recent string of infections.
First, it’s important to know what recurrent infections can look or feel like.
There is no single definition of “recurrent” infections, but your doctor may generally use this term if your illnesses are frequent, severe, hard to treat, or last longer than expected; having two or more severe infections in a year or three or more respiratory infections in a year can potentially point to an immune system problem. The same goes for needing at least two courses of antibiotics per year or regularly needing to receive intravenous (IV) antibiotics to clear up an infection.4
The experts we spoke with generally pay close attention to frequent cases of pneumonia and other lung infections, bronchitis and other upper respiratory infections, sinus infections, ear infections, urinary tract infections, and yeast infections.
For an adult, one bout of pneumonia “wouldn’t automatically prompt a work-up,” says Juan Salazar, MD, MPH, an infectious disease specialist and the physician in chief at Connecticut Children’s. But if you have two recent, well-documented lung infections, “that is more concerning.”
Plus, certain types, like ear infections, are much more common in kids, says Yasmin West Khan, MD, an assistant professor of pediatric allergy, immunology, and pulmonary medicine at Vanderbilt University Medical Center. Your doctor will probably start to ask questions if you’re dealing with one as an adult at least twice a year.5
Of course, all of these things can make you feel really unwell. Experts say, depending on your specific infection, you may deal with typical cold and flu symptoms like a cough, fever, or body aches; digestion problems like cramping, nausea, or diarrhoea; pain; sudden weight loss; and fatigue. These symptoms, among many others, can stem from the infections directly or from the frequent need to take certain medications like antibiotics, according to Kara Wada, MD, an allergist and immunologist at The Ohio State University Wexner Medical Center.
Being sick a lot also affects your ability to regularly go to school or work, take care of your family or yourself, tend to your relationships, and just live your everyday life, Dr. Jackson says.6 All of this can understandably take an emotional toll, triggering feelings like stress, irritability, sadness, and anxiety.
What are some causes of recurrent infections?
Certain habits can increase your chances of getting sick more frequently, including smoking cigarettes, not getting enough sleep, and not managing heavy or chronic stress—but these factors won’t directly cause recurrent infections.
To start, your anatomy could potentially be to blame. For example, research shows that having a “structural” problem like a deviated septum (a displacement of the wall of cartilage and bone between your nostrils) can cause trouble in your nasal passages and open you up to more frequent sinus infections.7,8
Some underlying conditions, like poorly controlled diabetes or asthma, also bump your risk, Dr. Jackson says. If you do have a chronic condition, certain treatments that can help manage it—say, chemotherapy or immunosuppressive medications like oral steroids—can weaken your immune system’s defences.
And while they’re fairly rare, you should be aware of primary immunodeficiency diseases (PIDDs), which are characterised by an increased susceptibility to infections. This is a diverse group of nearly 500 conditions that often have a genetic component, and each one affects at least one part of the immune system’s ability to function.9 They easily go undiagnosed—and it can take doctors years to confirm a diagnosis when they do ID one.10
“Many PIDDs [lead to] repeated or deep infections that occur in unusual places,” says Barrie Cohen, MD, an immunologist and assistant professor at Rutgers Robert Wood Johnson Medical School. “However, the type of infection—bacterial, viral, or fungal—will vary based on which part of the immune system is not working properly.”
When to see a doctor if you’re constantly sick
If you’re regularly feeling run down and missing work or school, can’t show up as a spouse or parent, or generally notice a dip in your quality of life because of your infections, it’s time to talk to your GP about what’s going on. They should ask about your personal and family health history and do a physical exam, along with certain tests like blood work, depending on your symptoms, Dr. Wada says. From there, you may be referred to an immunologist or another specialist if needed.
In addition to doing everything possible to support your immune system—like eating well, moving your body, and staying up to date on vaccines—there are treatments available that can help if you are diagnosed with a condition that’s making you more susceptible to illness.
We all get sick—it’s just a part of life! But dealing with infection after infection is not normal for most adults. Talking to a doctor can help you get to the bottom of it sooner rather than later, so you have a clear plan next time an unpleasant bug decides to stir up symptoms.
This story originally appeared on Self.
