Should you get a shingles vaccine? Dr. Spreen helps sort the details

Want to prevent shingles?

You can ask your doctor for a shingles vaccine, or you can make sure you’re getting a good intake of a specific vitamin.

Your call.

Chicken pox comes home to roost

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.

And no one wants that. Which is why an HSI member named Flip wrote to ask: “Can you do a piece on the new vaccine for shingles, please?”

Actually, the vaccine (known as Zostavax) isn’t all that new. It was approved by the FDA in 2006. But in terms of what we know about adverse side effects, Zostavax is brand spanking new. Also relatively new: A 2008 official CDC recommendation that people over the age of 60 receive the vaccine.

So: To vaccinate or not to vaccinate? When I put this question to HSI Panelist Allan Spreen, M.D., he said 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.

Talk to your doctor before making changes in your daily supplement regimen.

Source:
“It’s Official: Get Your Shingles Vaccination” January W. Payne, U.S. News and World Report, 5/16/08, health.usnews.com