Routine Rejected

Routine Rejected

If you’re approaching your 60th birthday, or if you passed that mark long ago, don’t be surprised if your doctor recommends a shingles vaccine.

Last month, the vaccine advisory panel for the Centers for Disease Control and Prevention voted to make the new shingles vaccine “routine” for everyone over the age of 60. So while it’s certainly not mandatory, your doctor might make you feel as if it is. And if you’ve ever seen a friend or relative suffer the debilitating pain caused by shingles, you might be tempted to sign on for the vaccine.

But before you roll up your sleeve, we’ll check in with HSI Panelist Allan Spreen, M.D., to get his take on this new ounce of prevention.

Stormy seas

If you had chicken pox as a child, then you’re at risk of developing a case of shingles. Long after the chicken pox is gone, the virus that caused it (varicella zoster virus, VZV) lies dormant in nerve roots. VZV may rest quietly there for all your days. But for certain people whose immune systems are compromised by immunity-suppressing drugs or stressful events, VZV may suddenly come roaring back as a case of shingles.

Obviously, no one wants that.  So to vaccinate or not to vaccinate? When I put this question to HSI Panelist Allan Spreen, M.D., he said that although he doesn’t know exactly what the vaccine contains, he wouldn’t take it for a king’s ransom. Why? Dr. Spreen: “Because ALL vaccinations are suspect until they’ve been monitored for decades (for long-term dangers), and this vaccine obviously could not fall in that category.

“BESIDES, why not just prevent shingles with B-12 (which also is an excellent treatment for them once you get them) and lysine (which also can be used to treat them).

“I had shingles once and badly: Zoster ophthalmicus affects the eyes and can even cost you your vision. I was working on a ship (enclosed, recirculated air environment), and had had some poor dental work in port. From that I got the flu, had to stay up late treating patients, and that led to shingles. I was one miserable guy, but I had the nurse give me B-12 shots everyday for 3 days and that was the end of it (though my vision was foggy for a week before clearing).”

Bumping the ratio

When I asked Dr. Spreen about preventing shingles with vitamin B-12, he suggested that 500 mcg per day would probably be a good insurance policy because B-12 protects the nerves. Supplementing with lysine (an essential amino acid) is a little more complicated.

Dr. Spreen: “With lysine you have to be more careful, as you’re playing with something called the lysine/arginine ratio. Lysine competes with arginine in the body, and arginine is a stimulant of growth hormone, so you don’t want to drive that down unless you have a real reason. And an arginine supplement isn’t a solution because you’re trying to alter the ratio to make it less favorable to the virus.

“That said, if you GET shingles, then 3 grams (3,000 mg) of lysine daily can do a lot (a LOT) to shorten the duration and lessen the pain/itch right off). Given that a person has developed shingles (or, rather, gets them fairly often), at that point I’d go on 500 mg of lysine daily (between meals) as insurance after kicking the previous outbreak. But I wouldn’t take lysine just because I had chicken pox as a kid.”

In supplement form, high doses of lysine may raise cholesterol levels and increase the risk of gallstones, so lysine supplementation should be monitored by a nutritionally oriented physician. Dietary sources of lysine include meat, fish, dairy products, legumes and brewer’s yeast.