Shingles Shingles (herpes zoster) is an acute and painful infection with the varicella-zoster virus (VZV), the organism that causes chicken pox. Nearly everyone in temperate climates is exposed to the virus by the age of 15, although in many cases it does not cause symptoms. After infection the virus hides in the ganglion, or "root," of sensory nerves for the face, trunk, and neck. It stays dormant for years, or, more often, decades, until a disturbance to the nerve reactivates the virus.
When the virus is awakened in the nerve, the first symptom is usually a tingling or an itch. Within 48 to 72 hours the itch becomes persistent deep aching, burning pain, and itch along the course of the affected nerve. The skin over the nerve is covered with rash. In persons with normal immune systems, the skin lesions usually clear up within 7 to 10 days, although complete healing can take up to 4 weeks. Persons with immune deficiency, the rash covers a much larger area, and healing can take weeks or never be fully achieved.
The bad news about shingles is that the disease sometimes presents devastating complications. The most common complication of shingles is postherpetic neuralgia, persistent pain at the site of inflammation lasting for a month or longer. Studies associated with drug testing claim that up to 50 percent of people who suffer shingles after the age of 60 might develop this complication. One of the most serious complications of shingles occurs when the virus is activated in the trigeminal nerve, lying over the corner of the cheek bone nearest the nose. When herpes spreads along this nerve, vascular inflammation and infection affect the eye and can even cause blindness. Open skin can be superinfected with Streptococcus and/or Staphylococcus bacteria causing cellullitis, bone infections, and lingering wounds.
The good news about shingles is the bad news about shingles is probably overstated. A long-term study of 421 herpes zoster patients reported in the British Medical Journal reported that the risk of developing postherpetic neuralgia was slight. Only 2 percent of patients under the age of 60 had pain associated with shingles three months after the first outbreak, which was mild in all cases. About 7 percent of patients over the age of 60 had moderate to severe pain three months after the first appearance of a rash, but in all cases the pain had abated within a year. In this study, only one in 25 patients received any antiviral drugs.
The antiviral drugs used to treat shingles are acyclovir, vancyclovir, famciclovir, and foscarnet. The more strongly antiviral the medication, the worse the side effects. Foscarnet stops replication of all known strains of the herpes virus (under laboratory test conditions), but can cause kidney failure, destruction of the heart muscles, and seizures. Nutritional measures can ease side effects when these drugs are medically required.
Older patients sometimes are given relatively high doses of steroids such as prednisone to control pain, although only one of several studies indicated that this class of drugs leads to shorter dependency on pain medications and better sleep. Interestingly, the only drug approved by the FDA for treatment the pain of postherpetic neuralgia is herbal, capsaicin.
Nutritional supplements are as effective as antiviral drugs in most cases of shingles. Persons who take corticosteroids or who have diabetes or HIV, and anyone experiencing an outbreak affecting the eyes, however, should consult a physician about necessary medical treatment.
There is some scientific evidence that shingles can be relieved by proteolytic enzymes, the chemicals that help digest the proteins in food. The two richest plant sources of these enzymes are pineapple and papaya, which produce bromelain and papain, respectively. The presence of proteolytic enzymes in these fruits has been long recognized in their use as "natural tenderizers" for meat. The body itself produces chymotrypsin, which is extracted from the pancreases of various animals.
Proteolytic enzymes were compared to the standard antiviral drug acyclovir in a double-blind study involving 192 people. The participants in the test were given either the natural enzymes or the drug and evaluated on the seventh and fourteenth days of the study. Both groups had similar pain relief, although reddening of the skin was reduced more by acyclovir. Similar results were found in a study involving 90 people.
Proteolytic enzymes can be broken down by stomach acid. For this reason, most brands are "enteric coated," covered with cellulose so that it does not dissolve until the tablet reaches the intestine. Make sure the brand you use is coated. Chymotrypsin is usually a pork product, so vegetarians and other persons who do not eat pork may prefer bromelain or papain. Holding the pill in the mouth can dissolve soft tissues, so always take proteolytic enzymes with water. You can also get bromelain and papain by eating pineapples and papayas, but far less of the needed enzyme will enter your bloodstream.
Digestive enzymes are safe for almost everyone. However, enteric-coated pancreatic enzymes given to children with cystic fibrosis have been known to cause a serious complication known as fibrosing colonopathy, probably due to an interaction between the enzymes and the coating of the tablet. Frequent use of proteolytic enzymes can cause pale or pungent stools, and occasionally allergic reactions, such as sneezing, wheezing, or tearing. Hypersensitivity reactions to the enzyme preparations are usually caused by allergies to the pineapple, papaya, or pork from which the product was derived.
Physicians have been reporting for 50 years that vitamin B12 and vitamin E help relieve the pain of post-herpetic neuralgia. While no systematic studies have confirmed that these vitamins help outbreaks, laboratory experiments have shown that vitamin E, sodium pyruvate (a sports supplement), and membrane-stabilizing free fatty acids work together to stop lesions in herpes simplex. It is possible that vitamins B12 and E act as antioxidants to similar benefit in this condition. For this reason, eliminating saturated fats and fortifying the diet with sources of omega-3 fatty acids may be helpful in treating the aftereffects of shingles.
How do you get vitamin B12, vitamin E, and omega-3 fatty acids in a single meal? Beluga caviar is an excellent source of all three nutrients, but for day to day, choose bluefish, cod, eel, herring, mackerel, octopus, pollock, salmon, or even catfish, although catfish is a relatively poor source of omega-3 fatty acids. If you follow a vegan diet, vitamin B12 supplementation is more practical.