Shingles
shingles If you had childhood chicken pox, your parents probably told you that you’d never get it again. That’s good news to any kid who has just endured the little blisters, the itching, and the fever that are all signs of chicken pox.
It’s too bad that your parents were wrong.
The same virus that causes chicken pox—the varicella-zoster virus—can continue to live an undercover existence in your nerve cells, and it may emerge later. The second time around you don’t get the childhood version of itchy, blotchy chicken pox. Instead, you get the adult version, shingles, which is characterized by searing pain and lesions that can leave a good-size scar.
It’s hard to tell why the virus re-emerges in some people and not others and impossible to tell when it’s going to crop up again. Certainly, elderly people get it more often than young people, and some individuals are more likely to develop shingles when they’re under severe stress or when their immune systems have been weakened. Adults may get shingles after an illness. For cancer patients who are undergoing chemotherapy, compromised immune systems may be a factor in bringing on shingles.
What characterizes all of these situations is a weakened immune system in which your body’s disease-fighting soldiers, the antibodies, are in short supply.
"The virus looks for the right opportunity when your antibody production is down," says William Warnock, N.D., a naturopathic doctor in Shelburne, Vermont. "Stress is one of the biggest causes of reduced antibody production. When people become stressed, they don’t eat right, they don’t sleep well, and their immune systems just don’t function as well."
Typically, during a shingles outbreak, you have tingling and pain around your torso, neck, or face. Lesions, or small blisters, may break out on the skin near the site of the infected nerve. The pain often lasts from two to four weeks, but in some cases, it can last for months. If it does, you’ve moved from shingles to a condition known as postherpetic neuralgia.
Fighting the Virus
Once it gets loose, there’s no cure for the varicella-zoster virus, but there may be ways to slow it down or limit damage during the outbreak. Medical doctors frequently prescribe an antiviral drug such as acyclovir (Zovirax) or famciclovir (Famvir) to shorten the course of the infection.
In order to hasten healing, treatment should be started within two to three days of the first appearance of the small blisters. In addition, you may be able to boost your immunity and help fight the virus with some herbs, says Dr. Warnock.
Herbalists believe that astragalus and echinacea are most effective. They work best if you take them as soon as you know you have an outbreak of the virus, says Dr. Warnock. Although you can take an herbal tincture, he recommends taking one 300-milligram capsule of standardized extract three times a day.
If you use capsules of dried echinacea root, he recommends 2,000 milligrams three times a day. Since echinacea is also safe at higher doses, you can take even more than the specified dose if you find it effective. "I’d do a high dose for a short period—just a few days. That’s when it’s most effective," he says.
Support from Astragalus
While echinacea speeds white blood cells to the infection site, you can add astragalus to help with the healing process. This herb provides what is known as deep immune support, working within the bone marrow where immune cells are manufactured, says Anne McClenon, N.D., a naturopathic doctor at the Compass Family Health Center in Plymouth, Massachusetts. You can take astragalus in capsule form, following the directions on the label.
"Astragalus provides immune support on a long-term basis. That’s important because people who get shingles may have a weakened immune system that needs to be built up again," she says. "I’d recommend taking it for four to six months."
Some Licorice Aid
Licorice also has strong antiviral properties. During the course of the infection, Dr. Warnock recommends taking 500 milligrams of standardized licorice extract in capsule form three times a day. If you take powdered licorice root in capsules, however, the dose should be 2,000 milligrams three times a day. Continue the treatment for two weeks after the lesions have healed, Dr. Warnock says.
Take licorice with caution, and don’t take it at all if you are pregnant or nursing or if you have diabetes, high blood pressure, liver disorders, or kidney problems. In general, you shouldn’t take high doses of licorice for more than four to six weeks unless you’re under the supervision of a qualified health-care practitioner.
On the High Cs
High doses of vitamin C have been shown to keep the varicella-zoster virus from replicating, according to some studies involving people who were given intravenous injections. There have not been any studies that showed similar effects from taking oral supplements. Dr. Warnock believes, however, that you can help keep the virus from taking hold with a daily dose of 10,000 milligrams of vitamin C. Dr. Warnock recommends five doses of 2,000 milligrams each, taken three hours apart. "The dosage goes beyond being a simple immune booster," he says. "The point is to interrupt the virus."
Dr. Warnock thinks vitamin C might prevent the virus from multiplying and spreading along the infected nerve. At the same time, vitamin C may ease inflammation in the nerve and lessen the outbreaks of the lesions, he says.
With a dose this high, you might experience an upset stomach and diarrhea, which is a frequent side effect of excess vitamin C. If so, just reduce the dose until you reach a level that’s more tolerable, says Dr. Warnock.
"Also, you need to take this treatment early in the infection," he says. "Once there are millions of virus particles floating around, it becomes a much harder task to keep them from reproducing."
Starve the Virus
Varicella-zoster belongs to a larger family of herpesviruses, all of which share an important characteristic: They multiply with the help of the amino acid arginine and are inhibited by another amino acid called lysine. Lysine may work by blocking the virus’s ability to absorb and use arginine.
To keep shingles at bay, doctors advise, you should avoid arginine-rich foods such as chocolate, legumes, and nuts, especially peanuts, and eat more foods that are rich in lysine, such as fish, tofu, eggs, lean beef, and lean pork.
You can also boost your lysine levels by taking a supplement. Dr. Warnock suggests taking 2,000 milligrams of lysine daily until the infection runs its course.
Beat the Pain with a B Vitamin
Shingles is not just painful, it’s intensely painful. Because your nerves carry the virus and the virus causes inflammation, having shingles is like having a raw wound inside your nervous system. Even a light touch can give you a jolt, while something as innocuous as a tight shirt can give you a full day of misery.
Vitamin B12 seems to maintain the fatty membranes that sheathe and insulate the nerves, says Dr. McClenon. There’s also evidence that it reduces the inflammation of the nerve where the virus is causing pain, and it may even shorten the length of the illness.
Some people with shingles take vitamin B12 injections, says Dr. McClenon. If the idea of an injection doesn’t appeal to you, you can get B12 tablets to place under your tongue (sublingual). Although some people have difficulty absorbing B12, most people can absorb at least some of the vita min this way.
"It definitely speeds healing," says Dr. McClenon, "and it may lessen the chance of a person getting the postherpetic neuralgic pain." She suggests taking a 2,000-microgram dose of sublingual B12 each day during the course of the infection.
Limit the Lesions
The skin outbreaks and pain of shingles can sometimes be eased with herbal treatments that you can apply directly to the surface of the skin. Among these topical treatments are licorice root extract, capsaicin, and St. John’s wort oil.
Licorice root comes in a gel or ointment form that you rub directly on painful skin areas. It seems to interfere with the spread of the virus, says Dr. Warnock. Licorice gel (Licrogel) is available from your physician or chiropractor. You can also ask your health food store to order a brand called Licroderm.
Although naturopathic doctors find that St. John’s wort oil applied to the unbroken skin acts as an anti-inflammatory, it also is used to relieve pain and strengthen nerves, says Dr. McClenon. "Thus, it’s a good topical treatment for any kind of nerve pain. I would continue to use it for the residual pain that may linger after the outbreak."
Fight Fire with Fire
Many over-the-counter ointments for shingles contain capsaicin, the substance that makes hot peppers hot. Like St. John’s wort, capsaicin cannot be used on open lesions, so use it after they’ve cleared to relieve the pain of postherpetic neuralgia, says Dr. Warnock. Capsaicin cream is available in a number of different strengths, ranging from 0.025 percent to 0.075 percent.
Capsaicin works by stimulating and then exhausting Substance P, the nerve-related transmitter that sends pain messages to your brain, in the skin. After two to three days of applying capsaicin, you should begin to feel the pain subsiding. The cream itself is irritating to the skin, so start with a tiny amount, and if a high-strength concentration burns too much, just switch to a lower strength, says Dr. Warnock.
Because capsaicin can burn the skin, however, he advises people to use it carefully. "I tell them to apply it four times a day to the affected area," he says. "You should always wear gloves when you apply it, and if you get it somewhere where you don’t want it, don’t try to wash it off with water. That just reactivates it and makes it worse. Instead, you can lessen the burning by rubbing the area with olive oil."