(WebMD) If you have shingles symptoms, get treatment now and you may avoid permanent nerve pain.
Shingles, a viral infection of the nerve roots, affects 1 million people in the U.S each year. Most people recover from their bout, but for as many as 50% of those over age 60 who have not been treated, the pain doesn’t go away. It can last for months, years, or even the rest of their lives.
These people have what’s called postherpetic neuralgia (PHN), the result of the shingles virus damaging the nerves of the skin. In some cases, the pain is mild. In others, even the slightest touch — from clothing or even a breeze — can be excruciating.
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“PHN causes a great deal of suffering and high social costs,” says Robert H. Dworkin, PhD, a professor in the department of anesthesiology at the University of Rochester Medical Center in Rochester, N.Y. “It can severely disrupt people’s lives.”
But the good news is that there are drugs that can help treat and even prevent PHN, and doctors are learning more about who is at greatest risk of developing this debilitating condition.
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What Is Shingles and Postherpetic Neuralgia?
Shingles is caused by the varicella-zoster virus, the virus that also causes chickenpox. In a person who has been exposed to chickenpox — or its vaccine — the virus never really goes away. It can lie dormant in the body’s nerves.
In most cases, it stays that way. But in some — especially people with immune systems weakened by disease or treatment — the virus can reappear. This is likely to happen years or decades after the person had chickenpox.
However, the most noticeable symptoms are blisters and pain.
Healthline: The outward symptoms of shingles look a lot like a case of chickenpox. Both diseases feature raised blisters that open, ooze fluid, and crust over.
But unlike the chickenpox rash, which can occur on different parts of the body, shingles usually affects one area of your body. Shingles blisters are most prevalent on your torso, where they wrap around your waist on one side of your body. In fact, the word “shingles” comes from the Latin word for “belt.”The shingles rash may also appear on one side of your face. If this happens, you need to see a doctor immediately.
Shingles travels along a nerve path, causing pain and strange sensations. Your skin might tingle or feel like it’s burning before the blisters appear. Itching and sensitivity to touch are also symptoms of shingles.
Shingles pain varies in severity and can be difficult to treat with over-the-counter pain medications. Your doctor might prescribe antidepressants or steroids. These two types of drugs can successfully relieve nerve pain in some people.
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WebMD: For reasons that experts don’t really understand, the pain of shingles lingers for some. If the pain lasts for at least 3 months after the shingles rash has healed, a person is diagnosed with PHN. In some people, the pain will subside. In others, it won’t.
“We don’t have any idea why the pain goes away in some people and not others,” says Dworkin. But the longer you have PHN — especially after a year — the less likely it is to resolve, he says.
Risk Factors for Nerve Pain After Shingles
Researchers have long known that older people are more likely to get PHN, the nerve pain after shingles, but recent studies have found other factors that increase risks.
In one study published in the journal Neurology, researchers — including Dworkin — looked at data from 965 people with shingles. The researchers identified five risk factors for developing PHN in people who had been recently diagnosed with shingles:
- Presence of symptoms before the rash appeared, like numbness, tingling, itching, or pain
- Severe pain during the illness’s initial stages
- Severe rash
Importantly, the researchers found the more risk factors you have, the greater the risk of developing PHN.
For instance, 17% of women with shingles and 26% of those who had severe pain went on to get PHN. But 50% of women who were over age 60 and had symptoms before the rash, severe rash, and acute pain went on to get PHN.
The Emotional Toll of Nerve Pain After Shingles
Researchers are not just looking at biological and neurological risk factors for PHN. Dworkin was also a co-author of a study looking at psychological risk factors, too. The results were published in the Journal of Pain in 2005.
“It certainly looks like psychological stress can be a potent risk factor for PHN,” Dworkin tells WebMD.
The study showed that people with shingles who went on to develop PHN were more likely to have had symptoms of personality disorders, hypochondria, intense worry about their disease, and other bodily complaints.
Dworkin says previous studies have already shown a connection between stress and shingles development.
“One study even found that the risk of developing PHN was higher in people who were living alone when they developed shingles than people living with others,” Dworkin says, perhaps indicating that social isolation increases the risks of PHN.
Preventing Nerve Pain After Shingles
But if you’re worried about PHN, don’t despair. There are medications that can cut your risks of getting the condition. There are three antiviral drugs used: famciclovir (Famvir), valacyclovir (Valtrex), and acyclovir (Zovirax). These medications need to be started within two to three days of the onset of shingles.
“If you look at the clinical trials with any of these drugs in people over 50,” says Dworkin, “they cut the rate of pain at six months in half. That’s a very significant improvement.” They are also very safe and have few side effects, he says.
But who needs the drugs? Dworkin says there’s not a clear consensus yet.
There are some obvious cases. “I think everyone would agree that someone who is over 50 and has severe symptoms should get preventative treatment,” he tells WebMD.
But for younger people or those with fewer risk factors, the course is less clear.
“Some people think that everyone who gets shingles should get preventative treatment with antiviral medicines, because the medicines are so safe and have such few side effects,” he says.
Others argue that preventative treatment should only be given to those at greater risk. The main reason for this, Dworkin says, is cost.
Have Shingles? Get Treatment, Take Action
If you have shingles, it’s important to talk to your doctor about your risk for developing PHN. Ask whether preventative treatment with antiviral drugs makes sense. If your doctor says it’s not necessary, ask why.
The full implications of the psychological risk factors for PHN aren’t clear yet, says Dworkin. But he suggests that people with shingles should try to stay active and connected.
“If psychological distress is a risk factor for PHN,” he says, “then we think that people who have shingles might benefit from getting out and not being isolated and homebound.”
You might make an effort to stay connected to family and friends and not to dwell on your symptoms. Also, keep in mind that even if you do develop PHN, there are treatments that can help.
“We have about a half dozen types of drugs that are used as first-line treatments for PHN,” says Dworkin. They include lidocaine patch (Lidoderm), pregabalin (Lyrica), gabapentin(Neurontin, Gralise, Horizant), capsaicin (Qutenza, Zostrixcream), carbamazepine (Tegretol), tricyclic antidepressants, and painkillers.
The most important thing is to get prompt medical attention if you think you might have shingles.
“If you have a one-sided rash — especially if you’re over 50 — see your doctor right away,” says Dworkin. “It could be shingles. And we know that prompt treatment can dramatically reduce the likelihood of developing long-term pain.”
( Dr.Abdikarim Ahmed Warsame Dr.Daaha) Management : Early antiviral treatment (within the first 3 days ) may reduce the pain and duration of symptoms and is recommended for any facial shingles ,the immuno compromised and the elderly ,Severe cases require IV acyclovir and occasionally systemic steroids , Symptomatic treatment with analgesics ,topical calamin lotion or povoiodine can be used .Oral antibiotics (e.g flucloxacillin or erythomycin ) will be required in secondary infection . Analgesics may not be sufficient in postherpetic neuralgia and use of tricyclic antidepressants , carbamazepine or sodium valproate may be helpful . Maternal shingles does not adversely affect the fetus or newborn as they are protected by the passively acquired maternal antibody .
HOW SHINGLES SPREAD?
Healthline: A person with shingles can typically spread the varicella-zoster virus to someone who has never had chickenpox. This is because if a person has had chickenpox, they usually have antibodies against the virus in their body.
Shingles causes open, oozing blisters, and the varicella-zoster virus can spread through contact with unscabbed shingles blisters. If you haven’t had chickenpox, you can get the varicella-zoster virus from contact with someone else’s oozing shingles blisters. This could lead to chickenpox.
The virus doesn’t spread after the blisters have formed crusty scabs. Once the blisters scab, they’re no longer contagious. The virus also doesn’t spread when the blisters are well-covered.
You can’t get shingles through contact with the saliva or nasal secretions of someone who has shingles, except in rare cases. That means you usually can’t get shingles if someone who has it coughs or sneezes on you.
Anyone who has had chickenpox can develop shingles. That’s because the virus that’s already in their body can reactive. People of any age can get it, but it’s most common in people who are in their 60s and 70s.
Shingles is common. Half of the American population will show signs of the disease by the time they’re 80 years old.
OUTLOOK FOR PEOPLE WHO HAVE SHINGLES
Healthline: Most people who have shingles experience pain and discomfort for a short period and then make a full recovery. People usually only have one episode of shingles in their lifetime.
Shingles outbreaks are temporary. They usually clear up within a month. However, they can have some lasting effects on your health and well-being.
The nerve pain of shingles can linger, lasting for weeks or even months in some cases. Generally, shingles pain is more persistent and longer-lasting in older adults. Younger people usually show no signs of the disease once the blisters have cleared up.
Medical advances, including the chickenpox and shingles vaccines, mean that fewer people will get chickenpox and shingles in the future.
You’re typically less likely to transmit the varicella-zoster virus with shingles than with chickenpox. However, you can spread the varicella-zoster virus from the time that your symptoms start until your rash and blisters have crusted dry.
If you have shingles and are otherwise healthy, you can still go out in public or to work. But you should be sure to follow these tips:
Keep the shingles rash clean and covered. This can help prevent other people from coming into contact with your blisters.
Wash your hands often. Also, try not to touch the blisters.
Avoid being around pregnant women. The varicella-zoster virus can cause serious health risks in both pregnant women and their babies. Risks include pneumonia and birth defects. If you realize that you exposed yourself to a pregnant woman, notify her right away so she can contact her OB/GYN for recommendations. Be especially careful to avoid pregnant women who haven’t had chickenpox or the vaccine for it.
Avoid other at-risk people. Stay away from premature babies, infants with low birth weights, and children who haven’t yet had chickenpox or its vaccine. Also avoid people with weak immune systems. These include people with HIV, organ transplant recipients, and people taking immunosuppressant medications or having chemotherapy.
THE SHINGLES VACCINE
The shingles vaccine is different from the chickenpox vaccine. It reduces the risk of getting shingles and the widespread nerve pain associated with it.
Adults older than 60 should consider getting the shingles vaccine. To find out if you’re a candidate for the shingles vaccine, talk to your doctor.
NATURAL WAYS TO PREVENT AND EASE SHINGLES
Natural News: Even though at least one in three people will develop shingles, or herpes zoster, in their lifetime, there are only a handful of effective remedies for the viral disease.
Image credit: Natural Awakenings
A person develops shingles when latent varicella-zoster/chickenpox virus reactivates along the sensory nerves in the skin. The symptoms of shingles include painful blisters that last for about two to four weeks.
The condition’s long-term complications include chronic pain that can last for several months or even years. This can severely affect a person’s quality of life. Other possible complications are blindness, hearing loss, meningitis, and neuropathy.
Unlike drugs that are linked to negative side effects, the following natural remedies can ease the symptoms or treat shingles effectively.
Acupuncture — Acute herpes zoster is a common condition and pain is one of its major symptoms. Even though effective pain therapy is limited, acupuncture can help ease the discomfort caused by the disease. In a Chinese study, acupuncture proved to be more effective than medication in treating pain – with acupuncture being at least 25 percent more effective than valacyclovir hydrochloride, a drug usually prescribed for shingles. The cure rate also followed a similar pattern: 75 percent for electroacupuncture, while that for the drug was only a measly 37.5 percent.
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Capsaicin — Postherpetic neuralgia is a complication of shingles that may persist even after the initial rash and blisters linked to the disease have disappeared. Postherpetic neuralgia affects the nerve fibers and skin, causing chronic, burning pain. Capsaicin, the compound in hot peppers that gives them their spicy taste, has been shown in studies to help treat postherpetic neuralgia. According to researchers, capsaicin doesn’t react to drugs and it isn’t linked to systemic toxicity, making it effective for treatment.
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Fruits and vegetables — Diets low in micronutrients (or antioxidants, vitamins, and minerals, etc.) can weaken the immune system, increasing an individual’s risk of developing shingles. In a British community-based case-control study, researchers isolated a connection between low fruit consumption and greater shingles risk. Individuals who consumed less than a piece of fruit weekly had over thrice the risk of shingles, unlike those who ate more than three pieces of fruit daily. The results were the same when the researchers combined the participants’ fruit and vegetable intake. Foods rich in vitamins include beans, chicken, dairy, eggs, leafy green vegetables, orange and yellow fruits, spinach, tomatoes, whole grains, and wild-caught fish.
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Peppermint oil — In a case study, a 76-year-old woman reported that standard pain therapies couldn’t relieve the pain caused by shingles. Doctors recommended the application of neat peppermint oil, which contained 10 percent menthol, to her skin. The woman shared that the peppermint oil almost immediately relieved the pain caused by the disease. She added that the oil eased the pain she felt for at least four to six hours after the oil was applied. (Related: Treating shingles with homeopathy.)
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Tai chi — The risk of developing shingles greatly increases with age since immunity to the chickenpox virus decreases as we get older. But based on the results of a study from the University of California, Los Angeles (UCLA), tai chi can help strengthen immunity to the virus that causes shingles. In particular, cell-mediated immunity to the varicella zoster virus went up by about 50 percent following the tai chi sessions.
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UVB Light (ultraviolet light) therapy — UVB light therapy can help reduce the pain caused by shingles. For a study that compared the effects of UVB light therapy with a drug called acyclovir, researchers discovered that after a month, 58.33 percent of the patients who received light therapy reported that they were pain-free, compared to only 38.46 percent of the participants who only took the drug. After three months, 83.33 percent of the participants from the first group were completely pain-free, with only 53.85 percent of the drug group reporting the same. Pain severity of pain was also recused among those in the light therapy group.
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Vitamin C therapy — Dr. Thomas Levy reports that vitamin C can effectively treat shingles. For a study, eight patients with shingles were given about 2,000 to 3,000 milligrams (mg) of vitamin C via injection every 12 hours. The dosages were supplemented by 1,000 mg of fruit juice every two hours. Seven of the eight patients reported complete pain relief in under two hours following the first injection.
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By Catharine L. Kaufman — (a.k.a. The Kitchen Shrink)
Once I laughed at Woody Allen’s joke identifying his then wife in a photograph taken in front of their house, as “she is the one with the shingles.” But when my childhood chickenpox virus came roaring back recently with the excruciating pain of shingles, that story wasn’t funny anymore, just cruel.
Following Hippocrates’ sage advice, “Make food thy medicine,” I jumpstarted my self-healing campaign by taking daily doses of the best food-based probiotic supplements I could find, to replenish the friendly flora in my gut and boost my immune system.
All the above contain various amounts of essential bacteria, most brimming with billions of lactobacillus varieties, acidophilus and bifidobacterium.
The next step in my ‘self-healing campaign,’ was to drink one-to-three cups of calming chamomile tea the first few days to lower the stress that is known to be the main trigger of shingles outbreaks. I also found that a combination of chamomile and ginger tea fortifies both calming and digestive processes. Deep breathing exercises, yoga and meditation two or three times a day is known to increase the teas’ relaxing effect and help ease the pain and other symptoms of shingles. This, in turn, encouraged me to look for more information about nutritional remedies recommended by trusted holistic healthcare experts, which not only reduce the symptoms of shingles, but also shorten the course of this painful illness.
Weather you are in the throes of a shingle attack right now, or merely want to arm yourself with information about self-healing methods, just in case, you probably won’t mind if I put on my Kitchen Shrink hat and guide you through some self-healing information you could adapt for your own ‘campaign’:
- Increase foods rich in stress-reducing B-vitamins, since the chickenpox virus that causes shingles ratchets up pain by tinkering with nerve endings. So crack some (organic) eggs and prepare them in your favorite ways; add goat cheeses to your grocery list; check out our other ‘Recipe’ pages on this site for ‘fast-and-easy’ chicken and turkey meals rich in B12’s; and look to bananas, brewer’s yeast and potatoes for calming B6’s.
- Load your diet up with foods brimming with vitamins A, B, C, D and E rich foods to prevent shingles, while also dialing up those with high folate, zinc and iron content. Reserve a meal or snack for the Mighty C, built around one or two selections such as oranges, pineapple, kiwi and lemons.
- Less acidic choices include broccoli, bell peppers and cabbage. Leafy greens provide a shot of Vitamin D to ward off invading viruses, while pomegranates and blueberries are dual-purpose weapons protecting cells from oxidation, along with revving up your immune system’s disease-fighting soldiers.
- A treasure-trove of essential nutrients harvested from oceans, provide minerals and vitamins (B complex among the most important) that have been found to be effective in the war against shingles.
- It is no exaggeration that the humble garlic is more powerful than any Marvel superhero. Chock-full of allicin—a potent antiviral compound of sulfur, vitamins A, B6 and C; selenium, magnesium, potassium calcium and zinc—this much praised “stinky rose” is also a busy antioxidant, immune system BFF and efficient healer of blisters caused by shingles. Sliced raw onto buttered toast, it’s a might anti-flu remedy, too. Crushed raw and added to vinaigrette dressing or yogurt dip (recipe below) is an ideal companion to salads and Mediterranean appetizers. Sautéed with broccoli rapini and olive oil, simmered in soups and sauces, or roasted whole and used as a spread on bread or baked potatoes, it is both a multi-tasking healer and celebrated flavor-enhancer.
- Other foods to avoid shingles pain are the ones filled with lysine, an amino acid that puts the skids on the cellular proliferation of the Zoster virus. To increase your lysine intake, go for wild-caught sardines, herring, salmon and other small and medium-size fish and deep-sea scallops. Also helpful in tamping down the pain and blisters of shingles are lamb (preferably pasture-grown in New Zealand), organic turkey, beans, dried apricots, raisins and figs.
- Remember to drink plenty of water to flush dead viruses and other toxins out of the body.
- Now for the equally important DO NOTs: foods to avoid during shingles attack, and even during the two or three weeks after symptoms disappear, it is best to avoid foods during shingles attack containing the amino acid arginine, which have been found to actually stimulate the replication of the herpes virus, a genetic relation to its shingles counterpart. Arginine-containing foods to stay away from are nuts, seeds, soy products, oats, coconut, wheat flours and, alas, chocolate.
Alcoholic beverages, too, are on the NO list since they interfere with the body’s immune responses; as are all caffeine-containing foods and beverages that intensify the already jangling nerves of shingles.
Fatty foods, sweets, empty (junk food) calories and processed foods tend to ratchet up shingles symptoms; as are foods and beverages served too hot or cold, which jar the nervous system. Although many dentists and other health practitioners recommend eating and drinking warm or room-temperature foods and beverages to protect the delicate tissues lining the mouth, throat and digestive track, this advice goes double during a shingles attack. Foods and beverages should be consumed at Baby Bear temperatures—not too hot, not too cold, just right—to prevent the already jumpy nerves from turning up the pain.
RECIPE: This zippy yogurt and garlic sauce is a Mediterranean wonder—not only does it make taste buds sing, but also lends each meal an anti-viral oomph.
1 ½ cups plain Greek or goat yoghurt
2 garlic cloves, crushed
2 Persian cucumbers, diced
Juice and zest from one Meyer lemon
1-tablespoon each fresh dill and mint, chopped
1-tablespoon olive oil
Sea salt and cracked pepper to taste
Blend ingredients in a glass bowl. Chill. Serve as a dipping sauce for fresh vegetables, drizzle on burgers, pitas or kebabs.
Image credit: Pinterest
Image credit: Pinterest
There are several common foods to avoid with Herpes or Shingles. You may be adding these daily to your Paleo, Keto or Gluten-Free menu.
The ratio of the amino acids Arginine to Lysine is the key. Arginine promotes the growth of Herpes and Shingles viruses. Lysine suppresses it.
Meats, fats, dairy and vegetables are balanced in Arginine to Lysine. Beets, fish and avocado all score well on the Lysine side. Grains are high in Arginine and a Paleo Diet is better – it’s grain free!
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4 FOODS TO AVOID WITH HERPES OR SHINGLES
(Beverly Meyer On Diet and Health) 4 Foods to Avoid with Herpes or Shingles
Dark chocolate has many chemical properties, including some that are addictive and brain stimulating (PEA), and others that can support feelings of well-being. BUT, dark chocolate is high in Arginine. The good news is if you’re satisfied with a small amount, you’re probably OK – unless you’re already at the edge of an outbreak.
Gelatin and Collagen OK, don’t be alarmed, but gelatin is high in Arginine which is used for many beneficial purposes in the body, including the manufacture of growth hormone. While it may have beneficial properties for many, the Arginine in gelatin and collagen (and bone broth) may not be so great for Herpes sufferers.
Gelatin may also cause histamine problems too. If your allergies, headaches, skin rashes and random “what did I do wrong” issues are not under control, eliminate gelatin for a few weeks and see if things improve.
Nuts and Seeds
Sufferers of Herpes or Shingles don’t realize that high levels of Arginine in nuts and seeds provoke this virus. A client struggling to get over a persistent Shingles outbreak who quickly improved when she stopped almond butter, bone broth and coconut flour pancakes.
Cashews, pumpkin seeds and macadamia nuts have the best Arginine to Lysine ratio, although it’s still not great. Walnuts, sesame seeds, pine nuts, almonds and hazelnuts have the poorest ratio.
This puts a serious damper on almond flour foods and nut and seed snacks. But note….
Arginine is not in oils, so almond or macadamia oils are fine as far as Herpes is concerned.
Coconut meat, flour and milk
Coconut meat has a good amount of protein (amino acids) and unfortunately a high Arginine to Lysine ratio. Coconut meat is ground up to make coconut flour and canned coconut milk.
Coconut water and coconut oil have no proteins or amino acids and will not affect the herpes virus. They are OK.
Timing and quantity make the difference
Your stress levels, current health, and the cumulative amounts of these foods can alter their affect on your viral load.
If you’re badly stressed and prone to outbreaks, it’s best to avoid all of these. If you’re a little overwhelmed temporarily, and prone to outbreaks, you might tolerate a little almond flour that day, but be aware how much coconut milk or chocolate you have too. The effect is cumulative over a day or two.
Other foods that affect the virus
Grains have more Arginine than Lysine, so a Paleo Diet is already a big help. If you’re still eating wheat, rice and corn, reduce those while you eliminate the other foods listed. Sugars have no amino acids, but cause an acid load on the body and a temporary paralysis of white blood cells for a half-day after eaten. When the white cells are sluggish, they literally cannot move fast enough to chase and attack viral “foreign invaders” in your bloodstream.
Peanuts have high levels of Arginine and mold, and are off-limits completely.
Will taking Lysine help?
If you’re concerned about handling these foods, take (1) 500 mg. capsule of Lysine on an empty stomach the day you consume these foods. Amino acids will not work if you take them with food.
If you feel an outbreak coming on, take 1000 mg. of Lysine twice a day for a few days until better. But don’t take any amino acid consistently as we maintain a delicate balance of them.
Calcium and Vitamins D, A and K2 are very helpful during outbreaks, as well as extra DHA. Viruses attack the fatty cell membranes, and these membranes are stronger when nourished with fat-soluble vitamins.
Image credit: Pinterest
Image credit: Pinterest