I self-diagnosed myself earlier this week with shingles. Shingles is caused by the same virus that causes chickenpox. The virus, herpes zoster, stays dormant in the body of those who have had chickenpox and can later develop into outbreaks of shingles. While it’s more common in people over 50, it’s not unheard of to affect people under 50 as well. Once re-activated, the virus attacks nerves and causes a skin rash which is painful.

Shingles is an odd ailment. Can we start with the name? Shingles. I have yet to come across an explanation for this creepy moniker. It’s also referred to as herpes zoster and zona. While shingles is caused by a member of the herpes family of viruses, it’s distinct:

  • Herpes Simplex Type 1 –  Cold Sores
  • Herpes Simplex Type 2 –  Genital Herpes
  • Herpes Zoster –  Chickenpox, Shingles

There are also several additional types of herpes viruses. That’s one kick ass family of viruses, isn’t it?!

At first, I thought the rash was just hives, perhaps caused by a reaction to some red wine I recently had (which I normally don’t drink due to a mild allergic reaction to histamines in red grapes.) But these were no normal hives. They persisted too long. They burned in a way that I haven’t experience with hives. The rash can be relatively pain free, then in an instant cause searing pain, like a match has been raised to your skin. The most identifiable aspect of the rash was the fact that it was only on one side of the body. A shingles rash will never cross your mid line and affect both sides of the body. Rather odd, isn’t it? Not surprisingly, the rash is on my left side—the side of my body that almost always gets the brunt of an injury or illness.

If the payload of shingles was just the rash, painful as it is, I could handle it. But shingles can cause a number of other symptoms, including intense fatigue and weakness, both of which I have. The one that’s really whipping me though is body pain. What I thought was a return of a nagging back/hip injury is actually pain caused by shingles. The pain radiates from my lower right back (the opposite side of where the rash is), around my torso, through my abdomen, and down into my hip. The abdominal pain is weird and disconcerting. It feels like my organs hurt. I can sit and stand with only moderate pain, but laying down and trying to sleep is another story. I have a lot more pain at night and I can’t get comfortable. Sleep is sporadic.

Once I pieced together that I was suffering from shingles, I called my doctor’s office and relayed my symptoms. The doctor felt confident in my diagnosis and advised me to call back if the symptoms had not eased by 3 weeks. If I’d called in within 72 hours of the rash’s appearance, then they may have prescribed an antiviral. I’m glad we didn’t have that chance because I’m wary of pharmaceutical antivirals and vaccines. I did start taking a daily dose of oil of oregano though, a natural antiviral.

1 week and 3 days after symptoms appeared I went to see a TCM doctor. He’s seen lots of cases of shingles, and said they’re on the rise, especially in younger people. Based on his observations, he didn’t think stress was the culprit. Despite calling myself “stressed out,” he said I didn’t show the physiological markers of stress. He also didn’t see any indication that I have unwellness that would compromise my immunity, and said that I appeared to be in very good health. He called my case of shingles “an anomaly.”

Does Testosterone Lower Immunity and Cause Shingles?

No one really knows for certain why herpes zoster stays dormant and what causes it to re-activate, but lowered immunity is certain to play a role. Immuno suppression can be caused by stress. Another cause of reduced immunity is long term use of steroids, such as… testosterone.

An article on the Mayo Clinic website tipped me off to the fact that prolonged use of steroids can weaken the immune system and cause shingles. Is 2 ½ years of testosterone therapy considered “prolonged” steroid use? Could testosterone have contributed to my lowered immunity, and ultimately be the cause of my shingles?

From the looks of it, there’s enough literature out there to suggest that stress and testosterone negatively affect immunity:

Testosterone may impede immunity (November, 2004)
Decreasing testosterone boosts immunity because testosterone helps control T-lymphocytes, the attack cells of the immune system, according to Mayo Clinic-led research in laboratory animals.

This theory is not without opposition though:

Testosterone, Stress May Not Suppress Immune System After All (October, 1999)
“…Braude came across a new body of research — about a dozen studies in all over the past five years — that questions the whole idea of immunosuppression and suggests that, instead of suppressing the immune system, testosterone and other steroids play a key role in what’s called immunoredistribution.”

Out of curiosity, I pulled out my blood work lab reports just to see if they could offer up any clues. In particular, I looked at the hematology numbers for WBC (white blood cells) and lymphocytes. My WBC is perfectly normal throughout all the reports, while my lymphocytes are low across the board, but still in range. (A low normal to low absolute lymphocyte concentration is associated with increased rates of infection after surgery or trauma. Indeed, my lymphocyte count over the past few years was at its lowest after my hysterectomy when I was dealing with the VVF complication. I did manage to avoid post-op infections though.)

My TCM doctor performed some acupuncture to help lessen my body pain. He put about 10 needles in around the hot spots of the rash. “Surrounding the Dragon,” he called it. He also prescribed Banlangen tablets, a Chinese antiviral formulation that’s ideal for clearing “toxic heat.” Coming from humble folk origins, Banlangen is a combination of Radix Isatidis root, Herba Violae, and Herba taraxaci (Dandelion.) It’s become one of the most popular herbal beverages in China—a staple in every household—due to renewed concerns about immunity stemming from the SARS outbreak. I’m taking 6 Banlangen tablets three times a day. They have that intense earth/root scent of medicinal herbs, mixed with a flowery aroma. Distinctively non-Western.

In addition to the Banlangen, I’m taking 6-8 ibuprofen a day for pain, a small dose of oil of oregano daily, and have more acupuncture scheduled for Tuesday. I may look into getting some Lysine. Apparently, it prevents the absorption of arginine which the shingles-causing virus needs to stay active, and can produce almost immediate improvement of symptoms.

Preventing Shingles

Unlike chickenpox, shingles can come back. The key to preventing their return is keeping your immunity up. It’s unclear whether or not testosterone has anything to do with my lowered immunity, but it makes sense for me to look into supplements that can boost my immune system. There are a number of adaptogenic herbs and fungi that fit the bill:

  • He Shou Wu
  • Eleuthro (Siberian Ginseng)
  • Panax Ginseng
  • Ashwagandha
  • Maca Root
  • Reishi mushrooms
  • Cordyceps

Of these, He Shou Wu and Eleuthro are recommended tonics for trans guys. Other supplements to boost immunity are vitamin D, which modulates immune function, and Zinc, which stimulates the synthesis of white blood cells and directly supports T-lymphocytes. Also, I can always eat more broccoli! It’s one of my favourite vegetables, and it contains Indole-3-Carbinol (I3C), which protects against the herpes family of viruses.

There is a shingles vaccine. However, it’s not recommended for people on steroid therapy, it’s about 50% effective and lasts about 6 years.

I’m curious about whether other trans men on testosterone have experienced shingles and/or have otherwise noticed decreased immunity? Please leave your comments below.