Ask Dr. Mike: Do You Need the Shingles Vaccine if You're Healthy?

Additional Info

• Segment Number: 5
• Audio File: healthy_talk/1522ht3e.mp3
• Featured Speaker: Mike Smith, MD
• Organization: Life Extension
• Guest Website: Healthy Talk MD
• Transcription: RadioMD Presents: Healthy Talk | Original Air Date: May 27, 2015
  
  It's time for you to be a part of the show. Email or call with questions for Dr. Mike now. Email AskDrMikeSmith@RadioMD.com or call 877-711-5211. What are you waiting for? The doctor is in.
  
  DR MIKE: That's AskDrMikeSmith@RadioMD.com. Send me your email questions. This is sometimes my favorite part of the show. Here's a question about shingles vaccine.
  
  "There are a few commercials promoting the vaccine. I'm 67 years old, healthy, but did have chicken pox as a kid. Should I consider the vaccine or are there alternatives for preventing shingles? Thanks. Dean from Texas."
  
  That's where I went to medical school. All right, so I think this is an opportunity to spend a little bit more time talking about shingles and what we have to offer as far as prevention and treatment for it, both conventionally and with supplements.
  
  Just as a reminder, the virus we're talking about here is a herpes virus. It's called varicella zoster. It causes chicken pox in kids, but it's a nasty little virus because once the chicken pox is over, the virus isn't gone out of the body. It just becomes dormant. It can hide in what is called lymph tissue, immune type tissue, lymph nodes that kind of stuff, in certain cells and it just kind of lays there inactive.
  
  Now, the good news, in most cases, as a person gets older and older and older, nothing really ever happens. Most people don't get shingles. But there is a risk once you've had chicken pox, as you do get older, there is a risk for the virus, this herpes virus, to reactivate and once it does, it causes a different type of disease--a disease that involves the nerves, specifically the nerves that supply the skin called dermatomes and that's why often you see this rash kind of like in a circle around like the trunk or the chest area, the buttocks, the arm, but the virus reactivates and causes this nerve/rash type symptoms along what are called dermatomes.
  
  What is the risk factor for this virus to reactivate and cause shingles? Well, its age. About half of all patients over 60 are at risk. Patients aged 80 to 89 are ten times as likely to develop shingles as children under the age of ten. So, you do see it in kids. Kids that have had chicken pox. There are rare cases of some of these kids, two or three years later, getting shingles. It's rare, it's usually something that occurs as we get older, 60s, 70s, 80s and it usually happens when our immune system becomes weaker and weaker as we get older. That's called immunosenescence, the weakness or the weakening, I should say, of the immune system.
  
  Other risk factors besides age would be anybody that's immune compromised either because of drugs, like steroid use, maybe infections like HIV, what have you, but people that are immunosuppressed are at risk and for whatever reason, I don't think we have a great answer for why but white women are at a greater risk of reactivating the chicken pox virus, varicella zoster. By the way, African-American individuals are at the lowest risk; haven't quite figured that one out.
  
  At least, I don't think. If you do get shingles, the common treatment is an antiviral drug called Acyclovir. That's pretty much the main one. It does reduce pain. It helps to increase recovery and the healing of the rash and it's only recommended in patients, I think, over 60--no younger than that, over maybe 40 or 50.
  
  You really can't have any complications from the shingles. Shingles can turn into some dangerous things like pneumonias and stuff. Once that happens, that takes hospitalization. That's a different treatment course, but as long as you're say, around 50 or older, you don't have any complications, you can take Acyclovir and it does work. Here's the big problem though, you have to start the drug within usually around 72 hours of the shingle outbreak.
  
  The longer and longer you wait, the less effective the drug is. That's the real problem with conventional treatment right there. Usually people will develop the rash and it hurts. That's why they notice it. You put a shirt on and you're like, "Ow. What is going on?" and you look in the mirror and there's a rash going around your breasts or around your stomach or your arm, whatever.
  
  It's usually you rub up against something, clothing, whatever, you feel that it hurts and that's when you notice it, but it could have started a week ago and you're kind of passed that deadline for starting Acyclovir. Now, most doctors in the community, if you're over 40, 50 and if you don't have complications, they're still going to put you on a course of Acyclovir. It's just not as effective as if you started it within 72 hours.
  
  You can do creams to help the pain a little bit, non-steroidal creams that can help. There's some research that capsaicin creams-- you know, capsaicin from hot peppers--may be able to help. Capsaicin, we know, increases a substance, a neurotransmitter, called substance P in the nerves and when that happens, it kind of deadens the nerves so it can control pain that way. That's capsaicin. But it does seem, it has be in the cream form, you can take capsaicin orally for like cardiovascular health, but it has to be in the cream form. Now, back to the question, though, about the vaccine.
  
  So, this gentleman wants to know, Dean from Texas, wants to know, he's pretty healthy. He had chicken pox. He's just worried about it. He's seen the commercials. Should I get the vaccine? Well, the vaccine, let's see. I have some information about it here. It is called Zostavax. It was licensed in 2006 by the FDA. When administered to individuals over the age of 60 with a healthy immune system, so you, again, have to have no complications.
  
  This vaccine reduces the risk of developing shingles by 55 percent. That's pretty good. Studies of this vaccine found it was safe for patients over 60 with the most common side effects being swelling, redness, warmth and pain at the vaccination site. A small percentage of participants in these studies developed a varicella-like rash, almost like a shingle-like rash, consisting of a small number of fluid-filled vesicles that occur at the site of the injection, but it did not spread. The biggest barrier to this vaccine is cost. It's very expensive. At this point, unless the cost comes down, it's not going to be used widespread. It's just not.
  
  Now, Dean, personally, I think this is a good vaccine. Knowing how devastating shingles can be for some people and the complications that can happen, it's something you might consider. Now, you tell me you're pretty healthy and all that kind of stuff. There might be some natural things you can do just to keep your immune system up. You might want to consider strengthening the immune system, especially against viruses: vitamin C, vitamin D, reishi, zinc, one of my favorites lactoferrin. There is even some evidence seaweed extracts. Seaweed has a compound that might have some anti-herpes properties to it. Dean, you have to definitely reduce stress.
  
  That's one of the best ways to prevent, besides the vaccine, is to reduce stress because usually it takes some sort of physical stressor, emotional stressor to reactivate the virus because the stress brings down your immune system. So, reduce stress, try some of those supplements, but listen, if you can afford it, the vaccine looks pretty good and it can reduce the risk of shingles by 55 percent, so it's not a bad choice if you can afford it, but try some of the supplements as well.
  
  This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.
• Length (mins): 10
• Waiver Received: No
• Host: Mike Smith, MD