Shingles

Shingles is an acute inflammation of nerve ganglia caused by the herpes zoster virus. The pain experienced in acute shingles can be debilitating and about 18% of people with confirmed shingles develop postherpetic neuralgia (PHN) which can linger for many months.1

Treatment with vitamin C infusions

We have treated a range of people for shingles at our clinic over many years. Here we summarise our experience of 12 patients presenting with acute shingles over the 40 months ending March 2018:

The age range at presentation was 44-87 years old. The most common presenting symptoms were rash, pain, and decreased energy. The time from onset of symptoms to presentation at IHO ranged from 3 days to 6 weeks, with an average of 15 days.

Eleven of the twelve patients had already started or completed a course of antiviral treatment when initially seen at IHO. The majority of patients (10/12) were given immune support doses at 25 gram intravenous vitamin C (IVC) with 1235 mg Magnesium sulphate, and B vitamins from the second infusion onward.

Ten of twelve patients reported clear benefits including increased energy, reduced pain, and quick healing of rash within 1-8 immune support treatments given over 1-3 weeks, with an average of 3.4 treatments per patient.

One patient was “delighted at improvement” after one treatment. Three patients noticed a marked improvement in energy relatively quickly within 4 treatments.

Seven of the eight patients who reported pain at presentation had improvement in pain within 4 treatments, and one of these eight patients reported considerable benefit within 8 treatments.

Of the remaining two patients who did not report clear benefit, one reported 90% recovery 6 weeks after presentation with ongoing occasional sharp pains. The other person had ongoing pain for 3 months which then completely resolved. This patient had started the IVC at 4-6 weeks post rash and had no antiviral treatment.

The IHO experience is that patients having IVC treatment for acute shingles have reported clear benefit in terms of reduced pain, increased energy and healing of rash. No significant side effects with treatment were reported. IVC can be considered a useful adjunctive treatment to help improve symptoms and reduce pain.

What the research says

Antiviral medication is effective in reducing acute herpetic pain, particularly when started within 72 hours of onset of rash.2

Intravenous vitamin C can be used with antiviral medication. There is some evidence of an effect on acute herpetic pain when IVC is combined with standard therapy.1,3,4 A study of IVC alone showed no effect.5

There is evidence that intravenous vitamin C can reduce the incidence and severity of postherpetic neuralgia.3,5,6,7

References

  1. Schencking M., Sandholzer H., Frese T. Intravenous administration of vitamin C in the treatment of herpetic neuralgia: two case reports. Med sci monit. 2010;16:CS58-CS61. https://www.ncbi.nlm.nih.gov/pubmed/20424557
  2. Saguil A., Kane S., Mercado M. Herpes Zoster and Postherpetic Neuralgia: Prevention and Management Am Fam Physician. 2017;96(10):656-663. https://www.aafp.org/afp/2017/1115/p656.html
  3. Schencking M., Vollbracht C., Weiss G., Lebert J., Biller A., Goyvaerts B., et al. Intravenous Vitamin C in the treatment of shingles: Results of a multicenter prospective cohort study. Med Sci Monit. 2012;18(4):CR215-CR224. http://www.ncbi.nlm.nih.gov/pubmed/22460093
  4. Byun S. H., Jeon Y. Administration of Vitamin C in a Patient with Herpes Zoster – A case report -. The Korean journal of pain. 2011;24:108-111. http://dx.doi.org/10.3344/kjp.2011.24.2.108
  5. Kim M. S., Kim D. J., Na C. H., Shin B. S. A Study of Intravenous Administration of Vitamin C in the Treatment of Acute Herpetic Pain and Postherpetic Neuralgia. Annals of dermatology. 2016; 28:677-683. http://dx.doi.org/10.5021/ad.2016.28.6.677
  6. Chen J.-Y., Chang C.-Y., Feng P.-H., Chu C.-C., So E. C., Hu M.-L. Plasma vitamin C is lower in postherpetic neuralgia patients and administration of vitamin C reduces spontaneous pain but not brush-evoked pain. Clin J Pain. 2009;25(7):562-569. http://dx.doi.org/10.1097/AJP.0b013e318193cf32
  7. Chen J.-Y., Chu C.-C., So E. C., Hsing C.-H., Hu M.-L. Treatment of postherpetic neuralgia with intravenous administration of vitamin C. Anesth Analg. 2006;103(6):1616-1617. https://insights.ovid.com/pubmed?pmid=17122283