Herpes and Shingles
Targeted Natural Interventions
Although there is no effective cure for herpes virus infections, several natural interventions may help reduce the frequency of outbreaks. Both shingles and herpes can manifest when the immune system is unable to prevent the latent viral infection from reactivating. Therefore, natural interventions that maintain the health of the immune system may help prevent outbreaks.
Antioxidants help neutralize reactive oxygen species, which can damage cells of the immune system (Cannizzo 2011; Hughes 2000). This is especially important for the elderly, whose immune systems function less optimally than in younger individuals. Supplementation with antioxidants may help combat this age-related immunosenescence and help avoid nutritional deficiencies, which are common among the elderly (Chen 2012).
Vitamin C, also called ascorbic acid, is a potent antioxidant and has natural antiviral properties (Brinkevich 2012; Uozaki 2010; Lopez 2009). Laboratory studies show that vitamin C and some of its metabolites prevent HSV-1 from replicating (Furuya 2008; Uozaki 2010; Brinkevich 2012). A study on human volunteers with active HSV-1 lesions found that a formula containing vitamin C was able to prevent HSV-1 outbreaks when taken within 48 hours of onset of tingling or itching at the outbreak site. Moreover, even when the vitamin C formula was taken after this period of time, it helped reduce the severity and the duration of the outbreaks (Lopez 2009).
In addition to supporting the immune system and potentially helping prevent outbreaks, vitamin C may provide relief from the nerve pain that often accompanies shingles (Johnson 2004). Researchers found that intravenous administration of vitamin C can help reduce pain and skin manifestations of shingles (Schencking 2012; Byun 2011). The pain-relieving effects of vitamin C may be due to its ability to modulate levels of two inflammatory chemicals: interleukin-6 (IL-6) and interleukin-8 (IL-8) (Kapoor 2012). It also appears that people who experience severe pain after a shingles outbreak have lower levels of vitamin C, and vitamin C supplementation was shown to reduce the spontaneous pain that these individuals experienced (Finnerup 2005; Chen 2009).
The reishi mushroom, also known as Ganoderma lucidum, is a fungus that has been used medicinally for centuries in China, Japan, and Korea (Paterson 2006). Some of the components of reishi appear to have antiviral properties (Paterson 2006). Researchers have identified two different compounds in the reishi mushroom, known as GLPG (Ganoderma lucidum proteoglycan) and APBP (acidic protein bound polysaccharide), which showed strong antiviral activities against both HSV-1 and HSV-2 in vitro (Liu 2004; Li 2005; Kim 2000).
Preparations of the reishi mushroom have also shown promising results in human trials. Reishi was very effective in reducing pain caused by herpes and shingles infections that did not respond to standard treatment. Also, an herbal mixture containing reishi reduced shingles pain. In addition, another reishi-containing herbal mixture shortened the duration of symptoms in patients with oral and genital herpes infections (Hijikata 1998; Hijikata 2005; Hijikata 2007).
Much of reishi’s benefit may be due to its ability to combat immunosenescence – the normal decline of the immune system that accompanies aging. Reishi mushrooms attack and reverse immunosenescence through the combined effects of three compounds: first, a group of long-chain carbohydrates called polysaccharides, second, a unique protein named LZ-8 and third, a small group of steroid-like molecules called triterpenes (Bao 2001; Xu 2011; Yeh 2010).
Together, these three reishi components achieve the dual goals of promoting healthy immune responses against viral, bacterial, or fungal infections, while suppressing excessive or chronic inflammation that threatens long-term health.
Among its broad-spectrum immune-boosting effects are the following:
- Reishi promotes specialization of dendritic cells and macrophages. These cells are essential in allowing individuals to react to new threats, to vaccines, and cancer cells (Cao 2002; Lai 2010; Jan 2011; Ji 2011; Chan 2005).
- Reishi's effects on dendritic cells have been proven to boost the response to tetanus vaccine. The mushroom's proteins are also under investigation as "adjuvants" to emerging cancer DNA vaccines and other immune-based cancer treatments (Lai 2010; Chu 2011; Lin 2011; Zhu 2012).
- Reishi polysaccharide triggers growth and development of bone marrow, where most immune cells are born. Following bone marrow eradication by chemotherapy, reishi increased production of both red and white blood cells (Zhu 2007).
- Reishi increases numbers and functions of many cell lines in the immune system, such as natural killer cells, antibody-producing B cells, and the T cells responsible for rapid response to a new or "remembered" antigen (Jan 2011; Wang 2012; Jeurink 2008).
On the other side of the immunosenescence coin, reishi's various components work to suppress inflammatory cytokines produced during chronic inflammation, as seen for example in rheumatoid arthritis, while maintaining normal acute inflammatory responses (Ji 2011; Kohda 1985; Ho 2007; Ko 2008; Xi Bao 2006). Under conditions of chronic inflammation, reishi reduces inflammatory promoters (Dudhgaonkar 2009).
Vitamin A and its precursor, beta-carotene, are potent antioxidants (Cerezo 2012; Liebler 1996; Stahl 2012). In addition, vitamin A and beta-carotene may have some unique properties relevant in context of HSV infections: beta-carotene can help protect the skin from sunlight damage, which is a known trigger of HSV-1 outbreaks (Stahl 2012). In addition, serum vitamin A levels appear to have an effect on HSV viral shedding: it was reported that in non-pregnant women not taking hormonal birth control, low vitamin A levels were associated with increased shedding of HSV from the female genital tract (Mostad 2000). This suggests that vitamin A may help prevent the transmission of herpes to others.
While in the past vitamin D was appreciated for its role in maintenance of bone health, more recent evidence suggests it may be a potent immunomodulator as well (Aranow 2011; Lang 2012). For example, vitamin D deficiency is associated with impaired immune function and increased susceptibility to infections (Aranow 2011).
Several lines of evidence suggest vitamin D may help combat herpes and shingles outbreaks. In one study, dialysis patients who received iron and vitamin D supplementation were less likely to develop shingles outbreaks (Chao 2012). Vitamin D may also be able to alleviate the pain associated with shingles (Bartley 2009). In addition, as of the time of this writing, a study was underway to see if vitamin D can contribute to a more robust immune response to shingles vaccination (Ginde 2012).
With regard to herpes outbreaks, one group of researchers studied the relationship between the vitamin D status and antibody levels to several viruses, including herpes viruses, in children with multiple sclerosis and controls. They found that higher vitamin D levels corresponded with more antibodies against HSV-2 among children with multiple sclerosis, suggesting increased vitamin D levels may allow the immune system to better respond to the infection (Mowry 2011). Vitamin D is also able to increase the levels of an immunologic antimicrobial peptide called cathelicidin, which has antiviral properties against HSV-1 and other viruses (Beard 2011).
Zinc plays a role in many aspects of the immune system. Zinc deficiency has been associated with immune dysfunction and an increased risk of infection (Overbeck 2008; Prasad 2008). Studies reveal that zinc levels tend to decrease with age, in parallel with declining immune function (Haase 2009).
In laboratory studies, zinc sulfate caused up to a 98% inhibition of replication of HSV-1 (Gordon 1975). In addition, another form of zinc – zinc oxide – was found to be effective in preventing HSV-2 from entering cells (Antoine 2012). Animal models have shown that zinc solutions protect against vaginal or rectal HSV-2 infections (Bourne 2005; Fernandez-Romero 2012). Also, topical zinc ointments have been used successfully to treat cutaneous outbreaks of herpes simplex in humans (Gaby 2006). In addition, topical ointments containing zinc oxide along with other natural ingredients were shown to cause significant improvement in oral herpes lesions (Ulbricht 2012; Godfrey 2001; Singh 2005).
The herpes simplex virus requires large amounts of the amino acid arginine to replicate properly (Tomblin 2001). Lysine, another amino acid, has a similar structure to arginine and antagonizes its effects, making it harder for HSV to replicate (Tomblin 2001). For example, diets rich in lysine and low in arginine have been shown to help suppress HSV replication (Rubey 2010).
A double-blind, placebo-controlled study that included participants with oral-facial or genital herpes, found that consumption of one gram of L-lysine three times per day for 6 months reduced the frequency, duration, and severity of herpes outbreaks (Griffith 1987). Other studies have also found that lysine supplementation can reduce the frequency of cold sores that occur during HSV-1 infection (Ozden 2011). Overall, lysine appears to be able to reduce the intensity and the frequency of HSV flare-ups when it is used regularly (EBSCO CAM Review Board 2011).
Propolis is a resin-like substance obtained from beehives and has a long history of medicinal use (Natural Medicines Comprehensive Database 2012). It contains a mixture of several compounds, including flavonoids and polyphenols, many of which have anti-HSV-1 activity (Schnitzler 2010). The variety of effects that it has on the immune system, together with its anti-inflammatory properties, may allow it to help the body more effectively fight infections (Storcin 2007).
In one study, a constituent of propolis was found to significantly inhibit the synthesis of HSV in cell cultures (Amoros 1994). Another study showed that a propolis extract has potent antiviral activity against HSV-2 in cell cultures (Nolkemper 2010). Notably, an ointment containing flavonoids from propolis was more effective in aiding the healing of genital herpes lesions and reducing local symptoms than the antiviral medication acyclovir (Vynograd 2000). Propolis, as a 3% ointment, was also shown to reduce the duration of cold sores caused by oral herpes and decreased pain associated with the lesions (Ehrlic 2011a).
Lactoferrin is a protein found in both cow and human milk (Berlutti 2011). It has natural antimicrobial properties and is able to help protect the body from bacterial, fungal, parasitic, and viral infections (Valenti 2005; Berlutti 2011; Jennsen 2008). In particular, many studies have shown that lactoferrin is able to inhibit the replication of HSV-1 and HSV-2 and also block the virus from entering cells (Fujihara 1995; Välimaa 2009; Andersen 2004; Marr 2009; Jennsen 2008; Jennsen 2005). Although clinical trials are needed to corroborate these findings, lactoferrin appears to be a promising therapeutic agent against HSV infections.
Curcumin is a compound found in the spice turmeric (Aggarwal 2007). It is thought to help the body combat many infections, including those caused by viruses, and has anti-inflammatory and antioxidant activities (Chainani-Wu 2003). In addition, topical creams containing curcumin have been used in Indian traditional medicine for diseases causing blisters, such as shingles (Chainani-Wu 2003). Curcumin was shown to provide protection against infection with HSV-1 and HSV-2 (Zandi 2010; Khan 2005; Kutluay 2008). The activity against HSV-1 was shown to occur due to curcumin’s ability to keep the virus from expressing genes necessary for infection and replication (Kutluay 2008).
Fucoidans are naturally occurring sugar polymers found in edible seaweeds and some other oceanic sources (Fitton 2005). Fucoidans have been shown to stimulate the immune system (Fitton 2005). In addition, many fucoidans have potent antiviral activity against several common viruses, including HSV-1 and HSV-2 (Li 2008; Ly 2005; Feldman 1999; Lee 2004; Fitton 2005; Hayashi 2008). Animal models have found that fucoidans protect against HSV-1 by a combination of direct inhibition of viral replication and by stimulating the body’s immune response against the virus (Hayashi 2008). Human studies showed that oral fucoidan, administered for 10 days, can help speed the healing and inhibit the reactivation of lesions in HSV-1 and HSV-2 infections and in shingles (Fitton 2005).
Lemon balm (Melissa officinalis) is a form of mint used traditionally to treat numerous of ailments, including herpes outbreaks (Yarnell 2009). Several laboratory experiments have shown lemon balm extracts possess a variety of antiviral activities against both HSV-1 and HSV-2 (Mazzanti 2008; Astani 2012; Schnitzler 2008; Geuenich 2008; Nolkemper 2006; Allahverdiyev 2004; Dimitrova 1993). Clinical trials have evaluated the efficacy of topical lemon balm preparations and shown positive results. In one trial, a lemon balm ointment improved symptoms of oral herpes compared to placebo when applied 4 times daily for 5 days; the lemon balm treatment also prevented the spread of the outbreak, and the authors suggested that lemon balm may increase the time between outbreaks (Koytchev 1999). Two additional trials involving 115 and 116 patients, respectively, also found that local therapy with lemon balm extract effectively eases oral herpes symptoms (Wolbling 1994).
Licorice (Glycyrrhiza spp.) has demonstrated antiviral activity against several viruses, including HSV-1 and varicella zoster (Fiore 2008; Takahara 1994). In an animal model of herpes simplex encephalitis, licorice root extract reduced HSV-1 viral replication in the brain by 45% and significantly improved the survival rate of treated animals (Sekizawa 2001).
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