This post is a sequel to my previous shingles post, where I wrote about climbing and camping for 5 days with shingles. Here I’ll share some information on shingles, as well as what protocol my doctors had me on while I was sick.
Shingles is a viral infection that causes a painful rash. It can occur anywhere on the body, but most commonly crops up in a strip of blisters that wrap around the left or right torso. It can also occur on the face, arms, chest, legs, head—anywhere, really. Typically, no matter where you get shingles, it tends to stick to one side of the body, because the virus follows one dermatome (nerve pathway). Sometimes people get additional shingles sores in other locations, or they get an unusual case of disseminated shingles where it goes systemic, but the typical case is limited to one dermatome.
Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After you’ve had chickenpox, the virus lies inactive in the nerve tissue near the spinal cord and brain. Years later, the virus may reactivate as shingles if the immune system is knocked down. Even if you’ve had the varicella vaccine, you can get shingles.
Shingles is also called herpes zoster, not to be confused with the herpes simplex virus which causes both the mouth sores common to Herpes type 1 (HSV-1) and the genital sores associated with Herpes type 2 (HSV-2).
Contagion, vectors, frequency
Shingles is typically less contagious than chickenpox. While chickenpox is spread via airborne vectors, shingles is not; you must come into contact with the weepy shingles sores to contract the virus.
The virus doesn’t spread after the blisters have broken open and formed crusty scabs, or when the blisters are well-covered.
If you’ve had chicken pox, you can get shingles. If you have not had chicken pox, you can’t catch shingles; however, if you have contact with someone’s weeping shingles sores, you can catch chicken pox. And then get shingles later.
Almost 1 out of 3 people in the United States will develop shingles (herpes zoster) during their lifetime. Shingles is most common in older adults and in people with a compromised immune system due to stress, injury, and certain medicines. Though many people think of it as an old person’s illness, there are a lot of people in their 30s-50s who get it.
As I’ve talked to people since my shingles incident, I’ve been surprised to hear how many people in that age range have had it. The popular theory is that since the advent of the chicken pox vaccine, adults who had chicken pox are not as frequently exposed to kids with chicken pox, so over the years the adults’ immune systems have not maintained the same viral immunity that used to occur when more kids had the pox. So now we are seeing increasing rates of shingles in younger populations.
Most people who get shingles will get better and not experience a relapse, but it is possible to have it more than once if the immune system is weakened.
Typically, a case lasts about 6 weeks, and aside from tending to pain and comfort, not much can be done to speed up the process. The pain, tingling, itching, and numbness on the skin can last for weeks, months, and even years. For some, it never goes away (see PHN below).
Cool graphic: go to this link for a really cool animated graphic that illustrates how the shingles virus spreads from the nerve root to create sores on the skin.
Post-herpetic neuralgia (PHN)
Post-herpetic neuralgia (PHN) occurs if your nerve fibers are damaged during an outbreak of shingles. The damaged fibers can’t send messages from your skin to your brain as they normally do, so the messages become confused and exaggerated, causing chronic symptoms that can last months or even years.
Many people experience these symptoms during and after a case of shingles, but it’s considered PHN if it lasts 3 months or longer. The signs and symptoms are generally limited to the area of your skin where the shingles outbreak first occurred:
- itching, numbness
- tingling, crawling
- sensitivity to light touch
- burning, stabbing or aching pain
Trust me, if you’ve ever laughed at jokes about people tripping on acid who freak out about “GET THE BUGS OFF ME! THEY’RE CRAWLING ALL OVER!”, you’ll understand how the skin feels after shingles. Every time I put on my climbing helmet I have to keep myself from ripping it off to get the bugs out of my hair… but it’s just the PHN kicking in.
I find that the itchy/crawly/numbness on my scalp is worse when I’m tired, under physical stress, or have consumed too much caffeine; I see it as a clear signal that my nervous and immune systems are telling me to chill out. It’s only been a month since I felt better (and about three months since I got shingles), so I hope the symptoms will dissipate in a couple months. I’ll post later once I know more!
There is a shingles vaccine available. Currently it’s recommended to people 60 and over, as it has a limited period of effectiveness. I recently heard there is a new vaccine coming out that is more effective than the current version.
Getting the vaccine will not prevent shingles, but it can reduce the chances of getting it. If you do get shingles, having had the vaccine is said to reduce the length and intensity of the illness, as well as reduce the PHN (above) that is so common. The CDC says even people who have had herpes zoster (shingles) should receive the vaccine to help prevent future occurrences of the disease.
There are other possible complications and issues with shingles; I encourage you to do your own research if you are curious.
What I did for my shingles
Below are the factors my Functional Medicine MD and my Naturopathic Doctor (ND) put me on to support my nerve pathways and immune function. Thankfully, my two doctors talk to each other so it’s easy to coordinate protocols.
My pharma meds list
- Acyclovir antiviral – I was on it for about 6 weeks.
- Norco painkiller (hydrocodone/acetaminophen combo).
If you are gluten free for medical reasons, do your research on ingredients. I read that Vicodin is GF, but the local docs wouldn’t prescribe it so I went with Norco. Be wary of high doses of acetaminophen, due to risk of liver damage.
- Ibuprofen NSAID to help w/pain between Norco doses.
Most ibuprofen brands contain corn starch. I am reactive to corn, but chose to take it anyhow because the pain was too great to handle. I heard that CVS Pharmacy has a corn-free, gluten free ibuprofen; check ingredients for reactive items.
A note on NSAIDS: non-steroidal anti-inflammatory drugs are not recommended for people with gut integrity issues, as they tend to support gut inflammation and degradation. I chose to use the ibuprofen anyhow, as the pain was so intense. My logic was that I can recoup my gut integrity after it’s over, and it was worth the risk.
- Lidocaine cream to numb the scalp (did not use).
It is recommended to go on antivirals within the first 72 hours of having shingles. Reportedly, it can:
1. Reduce the intensity and duration of the shingles rash.
2. Reduce the occurrence of post-herpetic neuralgia (PHN).
3. Reduce the recurrence of shingles.
It’s said that if you wait longer than 72 hours to start the antivirals, you may lose the benefits above. In my opinion, it’s still worth going on them: I waited 6 days (I didn’t know better at the time), and the day I started them, I had two sores starting on my cheek. Once on the drug, those two sores completely disappeared within two days. Thank goodness! If shingles gets near your eyes or ears, serious complications can result. Not to mention the potential of scarring on the face. The rest of the sores on my head, which were more well-established, took weeks to go away. I think the antivirals kicked down the movement of the virus so it stopped exploring for new places to party in my skin.
Shingles is really painful. If you are worried about becoming addicted to the painkillers, my recommendation would be to take the drugs and worry about that later. I went on Norco, similar to Vicodin—it’s a mix of hydrocodone and acetaminophen. Hydrocodone can be addicting, taken long-term. I was not worried about taking it for a month.
We tried two different doses, and I ended up needing the higher dose to even brush the edge of comfort. I used ibuprofen between Norco doses to dull the residual pain. I was not pain-free for about six weeks, except for minor periods of time.
The joke at my house was how they said to take the painkillers every 4 hours for “breakthrough pain”… it was more that I had “breakthrough comfort” briefly every 4 hours. Somehow we had a good laugh over that.
In the beginning, the low dose of Norco wasn’t doing it for me, so the doctor put me on liquid oxycodone which made me reallly verrry happy… but after two days I had a rash reaction. We thought I might have disseminated shingles, which could be very bad (it can go systemic and go to the brain), but thankfully it was only a drug reaction. I went back on hydrocodone at a higher dose and managed. Sadly, I opted to pour out the 6 oz of liquid oxycodone, instead of selling it for a million bucks on the black market.
After the stabbing pain had dulled to a constant headache, the worst was the nausea; the thought of food, touch of food or putting food in my mouth made me nauseated, so I didn’t eat much for 5 weeks. It didn’t help that I had two shingles sores inside my mouth. Incredibly painful and not conducive to eating or drinking. I used fresh ginger tea to help with the nausea.
Fresh Ginger Tea for Nausea (also works great for menstrual cramps!)
1″ of fresh ginger root, peeled (optional), and diced small
1-2 cups water
Place diced ginger in water, boil for 5-10 minutes. Strain ginger out (or keep it in for chewing) and drink. This tea is SPICY. You may want to boil for more or less time depending on your preferences.
The factors below helped to support my nerve pathways and immune function. I’m using some of these longer-term than others, and I’ve marked them in orange. For dosing, you’d need to ask your healthcare practitioner.
To fight the virus
- L-lysine (used by many doctors for shingles): this amino acid, like vitamin C, inhibits the replication of the herpes zoster virus.
- Monolaurin: sourced from coconut, it’s an effective antiviral and antimicrobial that breaks down the cell wall of the virus so the immune system can get to it more easily.
To support healing of the nerve pathways
Note: I’m already on these for neurotransmitter support, and simply increased my dose for a while to add more support for the nerves.
- NAC (N-acetyl cysteine)
- R-ALA (R form of alpha lipoic acid)
For skin pain, tingling and itching
- Pharmax Nerve cream (this stuff works!)
To support immune function
- Vitamin C in high doses: Vit C is water-soluble, so the body will release any amount it does not need. It is a powerful immune system booster. My ND had me do a tolerance test to see what my limit would be. If you try this, do it at your own risk; you may get the runs or some other digestive upset.
To determine individual tolerance: take 500mg every 15 minutes until digestive upset (I took a corn-free powdered version). Take 75% of that total dose, split into two doses per day (ie: my tolerance was 10,000mg: 7500 is the 75% dose, so I split it in two, and took 3750mg twice a day of powdered Vit C).
(NOTE: most Vit C is sourced from corn. If the bottle does not say corn free, it’s not corn free. Here’s a corn free powdered Vit. C).
- Increased Omega 3 fish oils to 10,000mg/day for a few weeks, then back down to my normal dose.
- Increase methylated Vit B12.
- Increase methylfolate (5-methyltetrahydrofolate) to help my liver detox the pharma drugs.
- Apex X-viromin for fighting viral load.
- Apex Adaptocrine to support adrenal function.
Sleep, stress management, diet
Shingles can really knock you out. I literally laid in bed for 5 weeks. Then it took another month to get back on my feet with exercise and work.
Below are key lifestyle and dietary factors that support healing, as well as ongoing immune system function:
- Sleep: lots of it. Plenty of quality sleep is one of the best ways to support balanced immune system function.
- Keep stress factors reduced: conscious management of this is key, as it’s easy to let things go. Then you crash.
- Proper nutrition to support strong immune function: In a nutshell: plenty of protein, carbs, and healthy fats; low sugars and caffeine.
Shingles happens when the immune system becomes weak. For someone with autoimmunity, maintaining balanced immune function can be a constant management issue. Having had shingles once, my intention is to be more aware ongoing of the factors that lead to overtaxing my immune function, so I can avoid a relapse.
In a future post, I’ll write about what specific factors I believe led to me getting shingles, and what I’m doing on an ongoing basis to prevent a recurrence.
If you want more detailed information on shingles, I found this resource very helpful.