Nutritional Influences on Illness: Herpes Simplex

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Nutritional Influences on Illness: Herpes Simplex

This relatively large virus causes cold sores (also called fever blisters) and genital herpes infections. Not only are these common lesions quite painful but they tend to recur.

The most popular nutritional approach to treating herpes simplex is by increasing the ratio of lysine to arginine. In cell cultures, the multiplication of the herpes simplex virus requires arginine, but is inhibited by high concentrations of lysine. Moreover, these two dibasic amino acids share a single transport system in the gut, causing lysine supplementation to interfere with the intestinal absorption of arginine.

Not all clinical studies have reported positive results, possibly because the lysine to arginine ratio in the diet was not controlled, or because the lysine dose was inadequate. It does appear that lysine is ineffective at healing an outbreak once it has started.( 1) In one of the best studies, 52 patients received 1 gram of L-lysine monohydrochloride 3 times daily or placebo, and were instructed to avoid nuts, chocolate and gelatin (all of which have a low ratio of lysine to arginine). After 6 months, 74% of those who received lysine rated the treatment as effective or very effective as compared to only 28% of those receiving placebo, a significant difference. Other significant findings: for those who received lysine, the mean number of herpes outbreaks were 2.4 less, symptoms during an outbreak were milder, and healing time was reduced.( 2)

While supplementation studies have found lysine to be generally free of immediate side effects, there is concern that, chronically, too high a dietary lysine/arginine ratio (such as a diet high in animal protein) may increase the risk of atherosclerosis.( 3) Lysine should therefore be tapered to the lowest dosage that is effective in preventing recurrences. (Often 500 mg daily will be adequate.) As one of the mechanisms fostering atherosclerosis may be stimulation of the liver to increase the manufacture of cholesterol,( 4) serum cholesterol levels should be monitored during chronic lysine therapy.

Several other nutritional regimens have shown efficacy in controlled trials. One double-blind study gave herpes labialis patients 200 mg vitamin C along with bioflavonoids 200 mg three or five times daily starting within 48 hours after the onset of symptoms. While everyone in the placebo control group developed blisters, blisters developed in only 26% of the treated patients. Also, the average interval from initial onset to complete remission was significantly reduced from 9.7 days in the controls to between 4.2 and 4.4 days in the treated group.( 5)

A topical ointment has been developed that combines lithium, zinc and vitamin E, three substances that have shown some evidence of efficacy. This `lithium ointment' consists of lithium succinate 8% zinc sulfate 0.05% and d,l-alpha tocopherol 0.1%. In a randomized double-blind study, patients with recurrent genital herpes were treated with applications of the active ointment or a placebo ointment 4 times daily starting within 2 days of lesion-onset. By the fourth or fifth day, only 14% of treated patients were excreting virus compared to 55% of the placebo group. Moreover, in those still excreting virus, mean virus excretion was 30 times greater in the placebo group. These differences in viral excretion were reflected in the clinical results. Mean pain duration was significantly reduced from 7 to 4 days, and the time to complete healing was reduced from 8 to 7 days. No side effects were observed; however, the authors noted that the long-term safety of topical lithium is unknown.( 6)

If an episode has already begun, and you wish to try something simple, ask your patients to squeeze a vitamin E capsule onto a cotton roll and tell them to apply it directly to the lesions as often as they wish for at least 15 minutes per application. In open trials, this procedure has often provided pain relief within 8 hours -- sometimes even with a single application -- and lesions appeared to heal more rapidly.( 7-9)

Next Month: Hydrochloric Acid Deficiency

References
(1.) Milman N. Scheibel J, Jessen O. Failure of lysine treatment in recurrent herpes simplex labialis. Lancet ii:942, 1978.

(2.) Griffith RS, Walsh DE, Myrmel KH, et al. Success of L-lysine therapy in frequently recurrent herpes simplex infection. Dermatologica 175(4):183-90.

(3.) Sanchez A. Nutr Rep Int 28:497, 1983.

(4.) Schmeisser DD et al. Effect of excess dietary lysine on plasma lipids of the chick. J Nutr 113(9):1777-83, 1983.

(5.) Terezhalmy GT, Bottomley WK, Pelleu GB. The use of water-soluble bioflavonoid-ascorbic acid complex in the treatment of recurrent herpes labialis. Oral Surg, Oral Med, Oral Pathol 45(1):56-62, 1978.

(6.) Skinner GR. Lithium ointment for genital herpes. Letter. Lancet ii:288, 1983.

(7.) Fink M, Fink J. Treatment of herpes simplex by alpha-tocopherol (Vitamin E). Br Dent J 148:246, 1980.

(8.) Starasoler S, Haber GS. Use of vitamin E oil in primary herpes gingivostomatitis in an adult. NY State Dent J 44(9):382-3, 1978.

(9.) Nead DE. Effective vitamin E treatment for ulcerative herpetic lesions. Dent Survey 52(7):50-1, 1976.

Reprinted with permission from the International Journal of Alternative and Complementary Medicine, Green Library, 9 Rickett St., Fulham, London SW6 1RU, United Kingdom.

Townsend Letter for Doctors & Patients.

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By Melvyn R. Werbach

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