Shingles: I've posted previously about my GP... - Thyroid UK

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Shingles

Jingley profile image
16 Replies

I've posted previously about my GP reducing my Levothyroxine to increase my TSH and get me "in-range", and the subsequent return of symptoms.

I've now got shingles and the local pharmacist has given me a course of anti-virals (on my face of all places so I can't even hide it 😐).

I've managed to get a rare-as-hen's-teeth appointment at my surgery in a couple of weeks so can I use this latest illness to help back up my case?

Feeling very sorry for myself at the mo.

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Jingley profile image
Jingley
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16 Replies
helvella profile image
helvellaAdministrator

You have my understanding and sympathy.

In my location shingles is regarded as a disorder which requires an urgent (same day) GP appointment. (That may have changed now pharmacists appear able to prescribe antivirals.)

Take photos so that you have a record of how it progresses. All too easy to forget details in future. Seems pointless now but I need to look at my photos to remind myself how it progressed.

I was prescribed Zapain (co-codamol), lidocaine (or benzocaine) cream, and offered amitriptyline. Managed to avoid the amitriptyline for a few weeks then gave in. With hindsight, I wish I hadn't but it did help me sleep. And that had been a real problem.

Feel free to ask anything - if not on-topic, I'll reply to a Private Message.

Jingley profile image
Jingley in reply tohelvella

Thanks helvella

Under this new Pharmacy First scheme shingles is now classed as one of the common conditions to see your pharmacist for rather than seeing your GP

Been given acyclovir to take (5 times a day for 10 days) but nothing to help the itchy burny stingy feeling.

I'm just hoping it doesn't spread too much.

Found this while googling and hope it will back up my assertion that I'm currently under replaced with levo

ncbi.nlm.nih.gov/pmc/articl....

helvella profile image
helvellaAdministrator in reply toJingley

I went round and round trying to find anything that made sense. I'm not sure if I saw that paper or not! But I find it odd that they don't seem to make anything of the distinction between those with autoimmune forms - and those with other forms. As a starting point, I'd assume that this would be a pertinent factor. At least, pertinent enough to mention and discuss.

Once established, I don't think it tends to spread much.

Mine was mainly on my left shoulder and neck and I was concerned about spread. At one point I think it tried to go up behind my ear towards the crown of my head - but that was very brief and mild.

If yours goes anywhere near your eyes, or ears, get help immediately.

Jingley profile image
Jingley in reply tohelvella

Just had a read through, well, tried to an my head is now spinning.

Think I'll concentrate on this small sentence extracted from the conclusions section --

Together these findings supported the hypothesis that a constant level of TH would provide a layer of protection from contracting HZ

I'm taking that to mean that Levo doses shouldn't me messed around with...........well, why can't I just cherry pick the bits that I want to focus on. After all, isn't that just what doctors do 😁

helvella profile image
helvellaAdministrator in reply toJingley

:-)

I didn't change my levothyroxine dose throughout. Always difficult to know when you are feeling pretty awful whether it is the new thing or the old!

FancyPants54 profile image
FancyPants54 in reply tohelvella

I was going to say, if it gets anywhere near your eyes you must see a medic straight away. My nan got it in her scalp and it moved into her eye and she lost the sight in it and then the eyeball died. It was horrible. I don't want to scare you, but I do want you to be aware that this ridiculous "see a pharmacist" or wait 2 weeks for a GP is not possible if eyes are involved.

Tlflom profile image
Tlflom in reply toJingley

Valcyclovir is time released and taken 1x per day. There is also an ointment as well.

Good news, Acyclovir and its derivatives are effective for covid if caught early.

helvella profile image
helvellaAdministrator in reply toTlflom

So far as I can see none of the relevant antivirals is slow or time release - at least the products approved in the UK.

(I wouldn't want anyone to be confused by this when they are not. However it is always important for the patient to read the Patient Information Leaflet.)

Tlflom profile image
Tlflom in reply tohelvella

Sorry you are misinformed. Now the rationed social medicine may not approve the better meds for their people. Regardless, time released antivirals are our there.

Valcyclovire time released and is 1 per day. Acyclovir is 3 to 4 Per day.

helvella profile image
helvellaAdministrator in reply toTlflom

The UK documentation for Valaciclovir expressly says that it needs to be taken three times a day for shingles.

3. How to take Valaciclovir Tablets

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are

not sure.

The dose that you should take will depend on why your doctor has prescribed Valciclovir Tablets for you. Your

doctor will discuss this with you.

• Treatment of shingles

The usual dose is 1000mg three times a day. You should take Valaciclovir Tablets for seven days

mhraproducts4853.blob.core....

And a couple of USA products say similarly:

VALACYCLOVIR HYDROCHLORIDE tablet, film coated

dailymed.nlm.nih.gov/dailym...

VALACYCLOVIR HYDROCHLORIDE tablet, film coated

dailymed.nlm.nih.gov/dailym...

There might be some form of sustained or extended release products. But, so far as I can see, not in the UK. And I have not yet found a USA product but I have not looked through all the documentation on DailyMed and elsewhere.

It is taken in three doses where acyclovir is in four, even five doses. But not - again, so far as I can tell - once a day.

BASIC PHARMACOKINETICS

Valacyclovir has three to fivefold greater oral bioavailability (about 55 percent) than acyclovir; it then undergoes rapid and extensive first-pass intestinal and/or hepatic hydrolysis to yield acyclovir and L-valine [2,3]. Food does not affect absorption

Valacyclovir, at a dose of 250 mg four times daily, generates essentially the same acyclovir AUC (area under the curve, or exposure over 24 hours) as oral acyclovir at a dose 800 mg five times daily [3]. Valacyclovir, at a dose of 1000 mg three times daily, produces a similar acyclovir AUC as intravenous acyclovir at a dose of 5 mg/kg every eight hours [4].

uptodate.com/contents/valac...

Tlflom profile image
Tlflom in reply tohelvella

Acyclovir requires 5x per day for shingles. Unless the UK says something different? I would choose the time release version and take 3x/day for this.

Fritatta profile image
Fritatta

I also have just had possible silent shingles (just a couple of blisters, swollen glands and lymphs) took antivirals fairly early I hope. I'm also being tested for MS and stroke as it has affected my leg (numbness over bum and inside leg on the same side). I noticed at the start that there was a slight rash but my hypo symptoms came in with a vengeance so I upped my dose and told.my GP. It seemed to help a lot. (75-100 levo) They didn't seem to care that I self medicated but I'm sure it's different for different people, so I'm not advocating that! I am now getting a reduction in numbness, pins and needles and the electric shocks replaced with very sore skin where it was numb and hope that is a good aign. I am hoping obviously that this was/is shingles and after three and a half weeks I feel I am improving. I hope you continue to improve too. X

humanbean profile image
humanbean

I remember reading the experience of one person who got shingles. It was in one or possibly both eyes. Her local hospital was dismissive and utterly useless despite the seriousness of shingles in the eyes.

To get taken seriously and treated properly she eventually went to a specialist eye hospital :

nhs.uk/service-search/other...

One of the unexpected symptoms of shingles in the eye for this woman was that they changed colour from brown to blue, and never went back to their original colour. Her eyesight was affected too although I can't remember how much.

Jingley profile image
Jingley in reply tohumanbean

Oddly enough, Liverpool Royal which has a well known and excellent eye centre isn't listed.🤔

humanbean profile image
humanbean in reply toJingley

That's bad news. Then people should just google rather than use the search link from the NHS.

Perhaps people should search for eye A&E or eye clinic or eye unit or eye casualty in their nearest city or large town. It seems ridiculous that it doesn't have a standard name at the places I found.

My closest NHS hospital has an eye A&E. My husband used it once. He got the help he needed, but discovered he was lucky to be seen because the place closed in the evenings and during the night, as well as at weekends.

Jingley profile image
Jingley in reply tohumanbean

That's the modern day NHS for you.

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