Naturopathic Approach to HSV Infections
David Hogg, ND
I find herpes simplex virus (HSV) infections one of the most easily treated infectious diseases. Although I’ll be focusing on genital herpes in this article, the same treatment guidelines follow for oral herpes, herpes zoster and post-herpetic neuralgia. The secret to treating herpes lies in suppressing viral replication and building the patient’s immune system.
HSV is one of the most prevalent sexually transmitted diseases. Many people suffer severe negative psychological stress in addition to the physical pain and discomfort caused by the disease. The recurrent infections are particularly upsetting to patients, and play a huge part in disrupting their social and sexual lives.
Currently, it is estimated that more than 75 million people in the U.S. have herpes, according to population estimates. It also is estimated that one in five men and one in four women have genital herpes; the higher incidence in females results from the woman being more likely than the man to contract a HSV infection. Thirty percent of those suffering from genital herpes have HSV-1; the remainder are infected with HSV-2. HSV-1 usually establishes latency in the trigeminal ganglion. From there, it tends to recur on the lip or face. HSV-2 usually sets up residence in the sacral ganglion at the base of the spine, where it recurs in the genital area. However, either type can reside in either or both areas of the body. Estimates suggest that 1.6 million new patients are infected annually. Most transmission occurs without intervention. Therefore, if patients receive treatment early, they will be able to decrease the likelihood of infecting their partners.
The conventional treatment is primarily antiviral chemotherapy. According to the Centers for Disease Control, three antiviral medications offer the best treatment outcomes: acyclovir, famciclovir and valacyclovir. They are used for first episodes and for chronic suppressive therapy.
Most patients do not understand that once infected, they will always test positive for the antibodies to the virus.
There is much shame attached to genital herpes. I have received e-mails from people saying this is the end of their life and they think they may commit suicide. They become desperate for a “cure.” As I will discuss later, the only “cure” is to prevent further outbreaks.
Culture is the preferred virologic method for diagnosis; however, it can only be performed during an outbreak. Some physicians use a Tzanck smear in their office to diagnose an HSV infection. The Tzanck preparation is done by smearing cells taken from a fresh blister or ulcer onto a microscope slide. The cells are stained and then examined under the microscope for characteristic changes caused by a herpes virus. Herpes causes giant cells with multiple nuclei. Tzanck smears are positive only 50% of the time that viral cultures are positive. Although culture is preferable, ELISA or HerpeSelect are much easier to perform in the physician’s office from a blood sample. They both detect HSV antibodies and can differentiate between Type 1 and Type 2.
Every patient should be educated on the natural history of the disease, recurrent episodes, asymptomatic viral shedding and risks of transmission. They should tell every current and future partner of their sexual disease history. Viral shedding is more frequent in HSV-2 than in HSV-1 and is most frequent in the first 12 months of infection. All patients with active lesions or prodromal symptoms should practice abstinence with uninfected partners. Latex condoms can reduce the risk of infection; however if the area of outbreaks are or have been outside the area covered by a condom, transmission can still occur. It is possible for partners of infected persons to become infected even though they show no signs of infection, and it is recommended that they be tested. Women and their partners need to be educated on the risk of neonatal infection. Just because an asymptomatic person tested positive does not mean they can transmit the virus.
Conventional treatment does not take into account or treat the immune status of the infected patient. Many people who have herpes have a co-infection with human papillomavirus (HPV). These patients will have a weakened immune system against viruses, and it is important that we help to strengthen it.
- Diet The most important dietary treatment is avoiding foods high in the amino acids arginine and lysine (Griffith, 1978). Foods that are high in the arginine-to-lysine ratio include beef, nuts, wheat germ and chocolate. Next, patients should avoid foods that weaken the immune system, and eat foods that strengthen the body and its immune system. Foods that can activate the virus are coffee, black tea and red wine, due to methylxanthines. Three important classes of methylxanthines are caffeine, theobromine and theophylline (Rodriguez, 1991). They will cause reactivation of the herpes virus. I have seen this over and over again in clinical experience.
- Lysine Lysine has been shown to greatly decrease healing time and has an average 2.4 times less recurrent infections (Griffith, 1978). Lysine competes with arginine on the herpes virus. Lysine suppresses viral replication, and arginine enhances viral replication (Griffith, 1978). Giving doses of 1,000mg tid is very effective treatment during infections, then 500mg daily for prevention.
- Botanicals/Topical Preparations Melissa officinalis prepared as an oil, salve or cream works very well for reducing herpes pain and decreasing the length of the infection. Melissa works by suppressing viral replication. Patients should apply the topical often and as needed, and for at least one week beyond the outbreak to formerly infected areas (Wolbling et al., 1994). I also find that combining Melissa with Glycyrrhiza and vitamin E is especially helpful. Topical vitamin E acts as an antioxidant, protecting healthy cells from infection.
- Botanicals/Internal Usage I find that Glycyrrhiza glabra is best given internally as a tincture because of 1) its powerful viral suppressing actions, and 2) its ability to inactivate viral particles (Pompei, 1979, 1980; Ikeda, 2005). Dosages as high as 30-60 drops 4-6 times daily are an extremely effective treatment. After infections have subsided, I prescribe 30 drops daily for prevention of future outbreaks.
Sambucus nigra is found to inhibit viral reproduction (Serkedjieva, 1990). I give 30-60 drops 4-6 times daily in active infections, then 30 drops daily for prevention of recurrent infections. Adding other known antiviral botanicals, such as Lomatium and Ligusticum, contributes to the effectiveness of treating herpes.
- Vitamins Prescribing vitamin C with copper has been shown to inactivate the herpes virus. However, vitamin C or copper alone did not inactivate the virus (Betanzos-Cabrera et al., 2004). Giving 1,000mg vitamin C 3-6 times daily and 25mg zinc with 2.5mg copper greatly helped to treat herpes infections and prevent future recurrences (Fitzherbert, 1979).
- Stress Reduction Encouraging stress reduction techniques of yoga, meditation, tai chi, qi gong, etc., will greatly assist building the immune system to protect against the herpes virus. Stress activates the sympathetic nervous system and, while encouraging stress reduction, will enhance the parasympathetic nervous system.
- Education It is very important as an ND to educate patients on the value of treating herpes naturally, and to explain that it is not necessary for them to suffer the rest of their lives with this infectious viral disease.
I feel that giving hope is our business. By educating patients and building their immune systems via these treatment options, the recurrence of infections can be reduced dramatically. Using this comprehensive approach, I believe NDs will find great success in treating herpes infections and helping patients avoid recurrent infections.
David Hogg, ND is a graduate of SCNM, and has completed additional education in homeopathy and botanical medicine. He has been in private practice in San Jose, Calif., for six years. Dr. Hogg is author of an electronic book, Stop Herpes Now and From Coming Back for Good.
Center for Disease Control. Herpes: www.cdc.gov/std/Herpes/default.htm.
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