by Chris D. Meletis, N.D.
If you’ve had shingles, you know all too well it’s one of the most painful conditions anyone can experience, especially if you develop nerve damage known as postherpetic neuralgia. And, even if you’ve never had shingles, if you had chickenpox as a child (or, in rare cases, if you’ve had the chickenpox vaccine), then you’re at risk of developing shingles.
Shingles—otherwise known as herpes zoster—is a painful, blistering skin rash caused by varicella-zoster (also called herpes zoster), the virus that causes chickenpox. Even after the chickenpox goes away, the virus remains, but goes dormant in certain nerves in the body. Years later, the virus can reawaken in these nerves, causing shingles.
Fortunately, there are several things you can do to not only treat shingles, but also work to prevent the virus from taking hold in the first place. In addition to a few simple lifestyle changes, there are also several targeted nutrients you can use to give your immune system all the support it needs to defend against a shingles attack.
But, before we dive into that, let’s take a look at what shingles are and how they affect your immune system and overall health.
The first sign that the shingles virus has become active—even before the rash appears—is usually pain, tingling or burning on one side. The pain and burning may be severe.
Next, red patches appear on the skin, followed by small blisters that break, forming small sores that begin to dry and form crusts. In two to three weeks, the crusts fall off.
The rash usually occurs in a narrow area from the spine around to the front of the belly area or chest, but it can also occur on the face, eyes, mouth and ears.
Anyone suffering from shingles may also experience abdominal pain, fever and chills, general ill feeling, genital sores, headache, joint pain and swollen glands (lymph nodes). You may also develop pain, muscle weakness and a rash involving different parts of your face if shingles affects a nerve in your face.
Shingles may cause nerve damage in the form of postherpetic neuralgia. When this happens, the pain in the area where the shingles occurred may linger for months, years or even decades after the rash disappears. In some people this pain is mild, but in others, it can be severe and can feel like a deep aching, burning or stabbing. Some people compare the pain to an electric shock. People with postherpetic neuralgia are also sensitive to touch or temperature changes.
On average, 10 to 20 percent of people with shingles develop postherpetic neuralgia. This percentage increases to up to 25 to 50 percent in patients over 50 years old.1-2 The incidence of herpes zoster and the postherpetic neuralgia that can follow it is expected to increase due to the fact people are living longer.2
Shingles is not contagious to anyone who has already had chickenpox. But if you’ve never had chickenpox or never had the chickenpox vaccine and you have direct contact with a shingles rash, you can develop chickenpox rather than shingles.
Viral Alarm Clocks
There are many factors that might dictate when the shingles virus might awaken and start to cause trouble. These factors include the following:
- You are older than 60.
- You had chickenpox before the age of one.
- Your immune system is weakened by medications, disease or stress.
Stress and Depression
Stress is another factor that triggers the shingles virus. Researchers in the 1990s published one study that investigated whether negative life events were risk factors for herpes zoster in 101 subjects with zoster and 101 healthy controls. Subjects who had herpes zoster experienced negative life events significantly more often before herpes zoster onset than healthy subjects in the control group.3
Further confirming this link between stress and shingles was one report in the medical literature of four cases of childhood-onset herpes zoster in kids who experienced severe, chronic child abuse when the herpes zoster first appeared.4 This led the study authors to conclude, “It is possible that the severe chronic psychologic stress resulting from the abuse, depressed the patients’ cell-mediated immune status and thereby predisposed them to herpes zoster.”
Recent studies also have established a link between depression and the reactivation of the zoster virus. In one study, published in October 2012, researchers found that a high depression score and a recent negative life event were significantly associated with herpes zoster.5
The link between depression and reactivation of the shingles virus is likely due to the reduction in cellular immunity that occurs due to depression. Researchers have found that this decline in immunity in depressed patients is equivalent to the same decline that occurs in adults 60 years or older, leading scientists to conclude that depression may be a significant risk factor for herpes zoster, independent of age.6
Nutritional Risk Factors
If you’re not getting enough vitamin B12 or are taking drugs that deplete B12 or interfere with its absorption, you could also be at risk for shingles. That’s why vegetarians may be at greater risk—they often don’t get enough B12 through their diet.
If you’re taking Metformin (which depletes vitamin B12) or proton pump inhibitors (which interfere with its absorption) for acid reflux, your body might not be getting enough vitamin B12.
Researchers also have found low levels of other nutrients in patients with postherpetic neuralgia. Concentrations of ionized calcium, zinc, vitamin C and vitamin B12 were significantly lower in postherpetic neuralgia patients compared to controls. The prevalence of either mild/marginal or severe deficiencies for any of nine selected circulating nutrients in postherpetic neuralgia patients was much higher (92 percent) than that in controls (46 percent). Additionally, lower concentrations of vitamin C, ionized calcium and zinc were found to increase independently the risk of postherpetic neuralgia.7
This led the researchers to conclude, “Thus, lower concentrations of circulating nutrients, namely vitamin C, ionized calcium or zinc, are probably a risk factor in Taiwanese patients with PHN.”
Other Reactivation Factors
Herpes zoster also occurs more frequently in patients with systemic lupus erythematosus (SLE).8
Additionally, researchers have linked reactivation to increasing age, cancer, fever, exposure to ultraviolet light and tissue damage. Researchers also have postulated that vaccinations might cause reactivation due to the way vaccines affect the immune system, but more studies are necessary to confirm this link.9-10
The conventional way of preventing the reactivation of the shingles virus is by administering a vaccine. A shingles vaccine, licensed in 2006, reduced the risk of shingles by 50 percent, and can also reduce pain in people who still get shingles after being vaccinated. In about one person in three, the vaccine can cause redness, soreness, swelling or itching at the site of the injection. Headaches occur in about one person in 70 who are given the vaccine.
If shingles has already developed, doctors will prescribe an antiviral drug, corticosteroids (to ease inflammation), antihistamines or pain medication. They may also give you Zostrix® cream, which contains capsaicin (an extract of pepper), as a way to reduce the risk of postherpetic neuralgia.
To reduce the pain, you can also try using cool wet compresses. And to help relieve the itching and discomfort, take colloidal oatmeal baths or starch baths or use calamine lotion.
It’s also helpful to rest in bed until the fever goes down, keep the skin clean, don’t reuse contaminated items and wash nondisposable items in boiling water or disinfect them before using them again.
Nutritional and Lifestyle Strategies
A number of natural options can help stop or reduce the severity of a shingles attack. First, take steps to support your immune system by getting enough restorative sleep. Going to bed by 11 p.m. ensures your body will receive enough immunity-boosting melatonin, which is produced after exposure to darkness.
Second, minimize stress levels by breathing deeply throughout the day, meditating and practicing yoga. Moderate exercise also reduces stress while supporting a healthy immune system.
Additionally, vitamin C levels drop during viral infections, and this deficiency may predispose the body to developing shingles infections and the development of postherpetic neuralgia. In one study published in April 2012, researchers evaluated intravenously administered vitamin C in patients with shingles.
Sixteen general practitioners provided data from 67 participants with symptomatic herpes zoster who received vitamin C intravenously for approximately two weeks in addition to standard treatment. The assessment of pain (VAS) and dermatologic symptoms of shingles were investigated in a follow-up observation phase of up to 12 weeks.
Mean declines of pain scores and improvement in skin-related symptoms between the study’s start and follow-up assessments were statistically significant. Overall, 6.4 percent of the participants experienced postherpetic neuralgia. Patients given the vitamin C also reported a reduction in common complaints such as general fatigue and impaired concentration. The effects and the tolerability of the treatment were evaluated positively by the physicians. Additionally, there was a reduced risk of developing postherpetic neuralgia in the vitamin C patients.11
According to the researchers, “The data presented here provide evidence that concomitant use of intravenously administered ascorbic acid may have beneficial effects on herpes zoster-associated pain, dermatologic findings and accompanying common complaints. To confirm our findings, randomized, placebo-controlled clinical studies are necessary.”
You can find an alternative health practitioner (more likely to administer intravenous vitamin C) at www.a4m.com—go to the directory tab—as well as www.functionalmedicine.org. Or, you can try taking 800 to 1,600 mg of vitamin C per day.
Resveratrol is another natural substance that has demonstrated antiviral activity against the shingles virus in cell culture studies as well as other viruses, such as influenza A. Resveratrol works by inhibiting viral DNA.12 Aim for 300 to 600 mg per day of trans-resveratrol, which is the more bioavailable form of this nutrient.
Finally, make sure your vitamin B12 levels are up to par. As noted above, vitamin B12 levels were significantly lower in postherpetic neuralgia patients compared to controls.
The best type of B12 is methylcobalamin, the active, functional form of B12. Taking 1,000 mcg of this form in a liquid delivery system, along with a B-complex vitamin, is an excellent way to keep the shingles virus at bay, as well as to stop or reduce the symptoms of postherpetic neuralgia, giving your immune system all the support it needs to defend you against a shingles attack.
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8. Hu SC, et al. Acta Derm Venereol. 2012 Sep 17. [Epub ahead of print.]
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11. Schencking M, et al. Med Sci Monit. 2012 Apr;18(4):CR215-24.
12. Berardi V, et al. J Exp Clin Cancer Res. 2009 Jul 1;28:96.