Ask the Experts

Natural Health, April, 1999 by Andrew Weil, Joseph E. Jr. Pizzorno, Judith Lasater, David Kennedy

Irksome Cold Sores

Two things trigger cold sores in me: stress and sunlight. Besides avoiding these, can you suggest other ways to prevent cold sores?

DR. ANDREW WEIL: Cold sores are caused by activation of the herpes simplex virus (HSV), which resides in nerve-cell bodies after an initial infection. Besides stress and sunlight, other viral infections--colds, for example--might be triggering your outbreaks. HSV is also stimulated by the amino acid L-arginine. Foods rich in L-arginine include seeds, nuts, peas, and chocolate, so it makes sense to minimize your consumption of these. It is also worth taking L-lysine as a supplement, which you can find at most natural food stores. Because you would be taking L-lysine as a preventive, you would need to take it indefinitely. Try taking 1,000 mg a day on an empty stomach.

There is no end of other herbal and nutritional products that advertise themselves as preventives of and treatments for herpes attacks. In general, I have not found any to be reliably effective. There are several pharmaceutical drugs that work against HSV, the oldest being acyclovir (Zovirax). Newer drugs are variants of that compound. If you start on one of these drugs at the first sign of an outbreak--within the first 24 hours--it will significantly shorten the length and severity of the attack. These antiviral agents are relatively safe (cautions include a potential negative effect on liver metabolism and unknown long-term effects). But they are also quite expensive, so I would suggest trying the L-lysine supplement first.

One other strategy may help you. Because HSV has a tendency to remain dormant in cells for long periods and to be activated by stress, you can take advantage of the mind/body connection and try to persuade it to remain quiescent. Using meditation, hypnotherapy, or guided imagery, try to talk to this uninvited guest in your system. Make it feel welcome, but only as long as it behaves. I'm serious: I know a number of people who now have infrequent outbreaks as a result of doing this work.

Better Breathing

I have emphysema and have to use oxygen on a regular basis. I know other people with chronic respiratory problems, such as asthma and bronchitis, often must do the same. Are there supplements that would lessen my time spent breathing oxygen? What is your opinion of the oxygen products at the health food stores?

DR. JOSEPH PIZZORNO JR.: Although some nutritional and herbal products claim to increase the level of oxygen in the blood, I don't believe they work and would not recommend them. Indeed, once your lungs are debilitated to the extent that you need an oxygen tank, supplements cannot reverse the damage. However, certain supplements can help the lungs respire, improve anemic blood's ability to carry oxygen, facilitate the more efficient use of oxygen at the cellular level, and protect tissues from the damaging effects of inadequate oxygenation.

One suggestion is to check for a magnesium deficiency, which can further weaken your lungs and make it even more difficult to breathe. I'm not sure how old you are, but magnesium deficiencies are common in people over 50, especially those with emphysema and asthma. In this group, supplementation with magnesium has significantly increased the strength of the lung muscles with a corresponding increase in the blood's oxygenation. Although more rare, younger people also may have such a deficiency, so it would be worth checking even if you are younger. Dosage for magnesium is 500 mg a day.

Anemia may also aggravate your breathing problem because your blood cannot carry as much oxygen. If you are older than 65, you may want to test for anemia due to iron and vitamin [B.sub.12] deficiencies resulting from gastric atrophy. More common among the elderly, this loss of stomach function results in inadequate or no secretion of hydrochloric acid and intrinsic factor (a chemical secreted by the stomach lining), making it difficult for your body to absorb [B.sub.12]. In this case, daily supplementation of [B.sub.12] (1 mcg) and of hydrochloric acid (one 10-grain tablet) with meals can be helpful. Another group that suffers from low hydrochloric acid is asthmatics, so they, too, could try taking both supplements.

There are several other supplements that could help. Ginkgo (Ginkgo biloba) increases blood supply to poorly vascularized areas, improves cellular utilization of oxygen, and helps to get rid of the free radicals produced by oxygen. Typical dosage is 40 mg three times a day of a standardized extract. Coenzyme [Q.sub.10] (25 mg a day) can improve the heart's ability to use oxygen. And carnitine (500 mg daily) and pantetheine (100 mg daily) help poorly oxygenated tissue produce energy.

Finally, using oxygen produces excessive free radicals in the lungs, which over time can cause further damage. Therefore, I highly advise you to supplement with antioxidants: vitamin C, 1,000 mg twice a day; vitamin E, 400 IU of a natural mixed tocopherol daily; and carotenoids, 25 mg of a natural mixed tocopherol daily.