Shingles: Prevention and Treatment

As usual, the number one thing I advocate for in any condition is prevention. A weakened immune system is one of the major triggers for developing a shingles infection and there are things that all of us can do to keep our immune system in tiptop shape. In general, you will experience a weakened immune system if you are always stressed, short on sleep, eating an unbalanced diet, and lacking in exercise.

Keeping your stress levels manageable is a great place to start. If you haven’t done so already, de-clutter your life. Learn to say “no” if you are taking on too much and take on an activity that you find relaxing and stress-relieving such as yoga, knitting, meditation, or jogging. I also recommend to my patients that they learn to ask for help when needed. Create your own tribe within your circle of friends and family or even within your neighborhood to help you tackle your goals. If your stress seems unmanageable, I recommend seeing a counselor to work on your stress with an expert.

You may have noticed that you are more likely to get sick when you’re not getting enough sleep. When we lack sleep, our stress hormone levels rise and can also lead to increased inflammation in our bodies. Aiming for 7-9 hours of uninterrupted sleep each night will ensure that you are sleeping enough to keep your immune system boosted.

Our immune system is also dependent on an adequate nutritional status in order to carry out its role. Aim for eating roughly 2-3 cups of brightly coloured fruits and vegetables per day which are rich in immune boosting nutrients such as vitamin C, zinc, and beta-carotene. Further, eating or drinking too much sugar will curb the function of our immune cells for hours after consumption so I recommend removing added sugars as much as possible from the diet.

Lastly, try to get regular exercise such as a daily 30-minute walk or going to the gym every other day to keep your immune system strong. We aren’t sure exactly how exercise results in increased immunity, but there are a few theories. For instance, we do know that exercise causes changes in antibodies and white blood cells that are circulating through the bloodstream which may make them more efficient at fighting infections. Further, exercise slows down the release of stress hormones which may play a role in lowered immunity.

Aside from lifestyle interventions, the shingles vaccine is an effective preventative measure that is available to healthy adults who are older than 50 years old. According to a large study, Zostavax, the shingles vaccine, reduced the risk of shingles by 51% and the risk of post-herpetic neuralgia by 67% for 5 years. The Center for Disease Control and Prevention (CDC) recommends that the vaccine should preferably be given after the age of 60 due to increased prevalence in this population. It’s a one-time vaccine that offer increased immunity to shingles for 5 years after administration. No serious side effects have been identified with the shingles vaccine.

Unfortunately even amongst the healthiest of us, some of us are still going to get a shingles infection. Current estimates are that roughly 1 in 3 people in North America will develop a shingles infection in their lifetime. Ouch! So what can we do about it?

One of the most effective conventional medications for shingles in the early stages are anti-viral drugs such as famciclovir or valacyclovir. Treatment with oral antivirals decreases both the severity and duration of the infection and may also decrease the incidence of post-herpetic neuralgia. Anti-virals should be started as soon as possible as they are likely to be ineffective if given more than 72 hours after the skin lesions have appeared. In severe cases, these medications can also be given as an intravenous infusion. From a naturopathic perspective, I often recommend my patients get started on antivirals as soon as possible alongside some alternative treatments that may help prevent post-herpetic neuralgia. Side effects to antiviral medications tend to be mild and include abdominal pain, nausea, vomiting, dizziness and headaches.

Intravenous vitamin C therapy is a mainstay of treatment for shingles in the naturopathic community. This vitamin is often depleted in viral infections which may play a role in the progression of the infection as well as in the development of post-herpetic neuralgia. There is a limit to how much ascorbic acid (Vitamin C) can be absorbed when vitamin C is taken orally which is why in order to reach a therapeutic dose, the vitamin C must be administered intravenously. A study examining this therapy found that this treatment decreased the pain associated with shingles as well as reduced the risk of developing post-herpetic neuralgia.

Another therapy I often recommend to my shingles patients are local injections with methylcobalamin (active B12). B12 is an essential part of healthy nerve function and can function to repair damaged nerve fibers. In fact, one study looked at the efficacy rate of local methylcobalmin injections in shingles and found that it was effective at reducing the pain of shingles in the subacute phase (pain that persists about 30-120 days after the onset of the vesicles). Interestingly, taking methylcobalmin orally offered no benefit to the study participants.

Lastly, acupuncture is a proven beneficial therapy for those afflicted with shingles. One meta-analysis actually found acupuncture to be superior to western therapies such as antivirals.

Something that is really great about naturopathic medicine in British Columbia is that registered naturopathic doctors are trained and licensed to administer ALL of the above therapies for shingles. That’s right – we can prescribe antiviral medications, provide vitamin C IV therapy, administer local methylcobalmin injections and provide acupuncture all within one visit. In addition to this, your naturopath can recommend some personalized recommendations based on your health picture that may include effective herbs or nutrients for shingles.