For the Love of all things Natural

Saturday, November 17, 2012

Shingles... more than just roofing

    Does anyone still not know someone who has had shingles recently? I lost count some time ago of all the shingles cases I have heard of in recent years. I myself had a bad case a couple years back (which I am still fighting) which started off on my forehead (I initially went to the ER thinking I had a spider bite on my hairline!) and then jumped to my vestibulocochlear nerve (say it out loud: vest-ib-you-low-coke-lee-er..... also known as cranial nerve VIII) which supplies your inner ear. Not only did I have pain and burning in my ear but I got beyond horrible vertigo. The ER doc who diagnosed it as shingles initially put me on a 10 day prescription of acyclovir which is the most common anti-viral used for shingles. However, about day 2 coming off the anti-virals I started experiencing horrible vertigo which felt like the floor was pulsing up and down (maybe like an earthquake feels?). It was so bad at times that I had to sit down and I felt nervous driving as the attacks would come on out of nowhere. It was especially bad getting in and out of elevators, and in fact I still experience mild attacks getting off elevators, especially if I am tired or a little run down.
   I went to my primary care provider (the student health clinic at my undergrad university) and they put me back on the acyclovir and referred me to a neurologist. The neurologist I saw basically looked in my ear, said he couldn't see any blisters, and that I should go see an ENT. The ENT ordered all sorts of crazy vertigo tests to rule out tumors and various other causes of vertigo. This was despite it being quite obvious that every time I stopped taking the anti-virals the vertigo attacks immediately came back with full force, indicating clearly that it was due to the shingles. They also tested my hearing, which at the time was still fine, although it has since deteriorated in that ear. After all the crazy, nauseating, and invasive tests he told me that I would need to stay on the anti-virals... seemingly indefinitely since my system obviously couldn't clear the infection.....
    After six months (!!!) of doing 10 days prescriptions of acyclovir, trying to get off them, getting vertigo back, and going back on them I was beginning to feel hopeless. What was worse was that since the shingles were all interior (in my inner ear- the forehead spot never came back) I started to feel like people thought I was faking the horrible spinning and bouncing floor that I was feeling. Luckily during this time my dad's significant other suggested I try taking lysine which is a simple amino acid (one of the building blocks of proteins). In a simple phrase, lysine saved me. After only two weeks of taking 3-4 grams of lysine a day I was able to stop the anti-viral medications without increasing my vertigo and have been able to stay off the acyclovir ever since (although I still take daily lysine and increase my dose when I get flare ups).
    Now for a little background on this disease we call shingles. There are eight known species of human herpes viruses (HHV). Types 1 generally causes what we call "cold sores." Type 2 is mostly responsible for genital herpes. Type 3 is the Varicella-Zoster virus which is responsible for chicken pox, and later shingles. Type 4 is the Epstein-Barr virus behind the "kissing disease" of mononucleosis. Type 5 is known as cytomegalovirus and is mostly found as an infection of newborns. Type 6 and 7 cause forms of infant Roseola and type 8 leads to a type of cancer called Kaposi's sarcoma. What is special about herpes viruses is that although our bodies can clear the outward signs of infection, once you have contracted one of these viruses you never fully are rid of it. Unless your body is able to maintain constant guard the virus can wake back up at any time. Shingles is the re-awakening of the same herpes virus that causes chicken pox which most of us in my age group had as kids. I actually recall that the chicken pox vaccine arrived in my town about two weeks after I recovered from the disease during the first weeks of summer break after 2nd grade. My dad went ahead and got vaccinated because he had never had a full case and the doctors figured it would still be beneficial even though I had fully recovered. This is the trigger point for a whole further conversation on the link between MS and the chicken pox virus... but I think I will save most of that for another day. But do know that there have been multiple large studies which have implicated a link between MS and Varicella-Zoster, although there is not a definitive cause and link has not been proven as MS is a very complicated disease and is sort of a perfect storm kind of combination of triggers.
    Anyway, back to shingles... like I was saying it is the re-awakening of the chicken pox virus. Oh the chicken pox... did you have them? If so I bet you remember being miserable with a fever, intense itching, probably instantly start to smell calamine? Do you remember oatmeal baths and cold compresses and countless bowls of chicken soup? It was miserable, but we survived. In fact chicken pox was always considered one of the most benign of childhood diseases. The mortality rate was remarkably low compared to more serious maladies like scarlet fever and mumps. Chicken pox only killed 1 in every 25 million who got the disease. That is far less scary than the flu which kills an average 500,000 people each year (chicken pox at it's heyday killed 100-150 worldwide). Only older people and those with weak immune systems are "recommended" to get the flu vaccine. Yet every child since that summer I turned 10 has been "recommended" to get vaccinated against the chicken pox. A disease which was always considered a right of passage of childhood and killed very few. Interestingly, in it's pitch to the FDA the manufacturer cited parents missing too many days of work as a prime reason why the chicken pox vaccine should be approved.  While I understand this can be a hardship to many families, I also do not agree with the cost-benefit ratio and here's why. As I discussed before, chicken pox was a relatively mild disease which was common for kids to get prior to the development of the vaccine. By having this disease "active" in the community parents, aunts, teachers, neighbors, etc would be exposed every so often when they came in contact with a kid who had an active case of the chicken pox. By routinely exposing ourselves to the disease we were able to keep our immune systems alert to the virus. It was kind of like a cheap and easy booster shot vaccination. In this way as a society adults were able to keep the virus from coming out of hiding and becoming shingles. Only the elderly and those with very weak immune systems would lose this immunity and develop shingles. This is why historically, shingles was a disease of the elderly.
   However, an interesting phenomenon is becoming apparent as we have now moved beyond a decade of when the vaccine was introduced. It is now obvious that without periodic exposure our body's ability to recognize and stay alert against the varicella-zoster virus goes away on average of 8-10 years after exposure. This means that people my age who had chicken pox when we were... say 10... are now developing shingles if they come under situations where their immune system is even slightly compromised. I can't even tell you how many of my peers I have met who have had shingles in the last 4-5 years. It is crazy! And, what's even worse is the cases of chronic shingles which are now becoming far more normal in younger people (counting myself). By introducing a vaccine for a relatively benign disease we have created a far worse situation. I will not be surprised if very soon the shingles vaccine is recommended for everyone every 10 years just like tetanus. It is really the only way (other than stopping the chicken pox vaccine and having some major pox parties to get it back out in the community) that could keep shingles from becoming the new scourge of young adults. It is a rather hard spot we have backed ourselves in to for trying to wipe out a disease which was causing too many missed days of work for parents, even though staying home with a sick kid may have prevented them from getting shingles and missing even more days of work! (**** in case you are wondering where I am getting my information, most of this is directly from a lecture last year in Immunology on vaccines. Our Immunology teacher sits on the National Vaccine Safety Board as their Immunologist and she is beyond brilliant. Even the CDC themselves admit that concerns have been raised about increasing cases of shingles:
    Shingles is nasty. Not only does it burn, sting, itch, cause an ugly and oozing rash, but the nerve pain may last forever even after the rash is gone. Or it can damage the nerve, as is my case with nerve damage= hearing loss. It can flare up any time your guard is down. Personally, I have found that staying on a maintenance dose of lysine of 1500 mg a day is usually enough, but when if I start feeling a cold coming on, or nerve pain, or just know I am stressed or short on sleep, I take as much as 4000 mg in a day. Lysine has the amazing ability to block the replication of herpes viruses. There have been some studies in which lysine literally saved lives of those rare children who are unable to fight the chicken pox virus. I also try to avoid argenine (high in chocolate and nuts among other foods) which is another amino acid which competes for the same receptor as lysine in getting into your system so if you eat too much argenine your are much higher risk of being low in lysine. There has also been a great deal of research looking at lemon balm (Melissa officinalis) which have shown that it can be more effective than acyclovir in treating herpes viral outbreaks. I take an herbal tincture whenever I am concerned about my immune system to help keep the shingles at bay. It is also often applied in creams to treat the rash in outbreaks of any of the herpes viruses. Those are the two most commonly recommended naturopathic treatments for shingles.
    I hope this information is useful to everyone. We are going to continue to see cases of shingles increasing and we all need to be on guard and ready. I want to take this moment to state that I am NOT against vaccination (although I do take issue with some vaccines- like chicken pox- and the general CDC recommended schedule, but that is for another post). Vaccines have been an amazing development in medicine and to be able to claim that we have wiped out smallpox and are oh-so-close to wiping out polio is a major accomplishment and one that modern medicine should rightfully be proud of. I also want to reiterate from my first blog that I am NOT a licensed medical professional yet and am NOT licensed to diagnose or prescribe. If you or anyone you know has chicken pox or shingles please consult with a licensed medical provider.

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