Once the cold sore virus has infected the body, painful lip blisters can reappear whenever the immune system is depressed. The action of the virus is inhibited by antioxidants, immunity boosters and the amino acid lysine, remedies which also help to heal the skin. 

What they are

Cold sore are fluid-filled blisters that usually appear on the lips, though they can also develop as ulcers on the gums or inner cheeks, on the roof of the mouth, on the skin around the nostrils or in the nostril lining. The cold sore virus can spread by touch to the mucuous membranes of the eyes, nose and genitals, and onto broken skin. The blisters break and form a scab before disappearing after a week to ten days. 

Symptoms:

• Initial outbreak: tender blisters on or near the mouth, sometimes accompanied by flu-like symptoms and swelling in nearby lymph nodes. 
• Recurrences: an itchy or a tingling sensation on the lips, followed in a day or two by one or more fluid-filled blisters. 

What causes them

Cold sores are usually caused by herpes simplex type 1 virus. (HSV-1). The virus is different from the one responsible for genital herpes – herpes simplex type 2 – which is generally transmitted through sexual contact. Because the cold sore virus lies dormant in nerve cells after the first outbreak, new sores are likely to recur as frequently as every few weeks or as infrequently as every few years. Sores often reappear when the immune system is depressed by a fever or a viral infection suchs as a cold

How supplements can help

A deficiency of any nutrient can impair the performance of the immune system, and anyone troubled by cold sores should regularly take a high-potency multivitamin and multimineral supplement. The supplements listed help to minimise outbreaks and speed up the healing process. They should be used in combination at the first sign of a cold sore, and should take effect within two or three days. 

The amino acid lysine suppresses the growth of HSV-1 when taken orally or applied to a sore in the form of a cream. It can be used long term and may help to prevent cold sores from forming. Melissa cream, made from the potent antiviral herb Melissa officinalis (lemon balm), should be used at the first sign of tingling. Vitamin C and flavonoids are powerful antioxidants which facilitate healing by eliminating the naturally occurring cell-damaging compounds known as free radical; both boost virus-fighting immune system cells. Clinical studies have shown that zinc helps the healing process, probably because it also enhances immunity. Flare-ups can be treated with the immunity-enhancing herbs echinacea and goldenseal, which are natural antivirals and antibiotics. 

How long should you use lysine to avoid cold sores

Lysine is termed an essential amino acid as it is one of the eight amino acids that our bodies can not make and so we are completely reliant on our diets to provide lysine. We require 2-3 g a day of lysine and it is most abundant in animal based foodstuffs such as meat. There is very little lysine in most vegetables and even vegetable proteins are not particularly high in lysine, and so some experts believe that vegetarian and vegan diets may provide rather low levels of lysine.

The amino acid lysine has been shown to interfere with the growth cycle of the herpes virus associated with cold sores.  Studies have shown that people with diets low in lysine tend to be more prone to cold sores, so supplementing this amino acid can be helpful.  We suggest that if you have a current infection, you take two tablets of lysine per day, around 30 minutes before from food.  You can then take one tablet daily as a maintenance dose if required. If your diet is low in natural sources of lysine, it is fine to take this supplement at 1000mg-2000mg daily long term as this is quite within the intake level that can be achieved from food – and there are no reported problems with it. The proteins taken with your diet should naturally contribute the rest of the daily requirement of lysine.  

Concomitant use of L-lysine and L-arginine

The use of lysine and arginine is indicated for some medical conditions (e.g., osteoporosis), but even then it is recommended that both amino acids be administered in equal amounts to reduce the possibility of competition for the same binding site. In many sports products, all amino acids are used in combination to provide a broad spectrum of amino acids. Together, lysine and arginine can increase cell activity, which contributes to bone building and collagen production. In this case, their interaction is positive – contributing to the healing of the skin and connecting tissues.

However, concomitant use of lysine and arginine is definitely not recommended during herpesvirus. Both amino acids are absorbed using the same type of receptors discussed above. Taking extra arginine during a herpesvirus outbreak contributes to herpesvirus symptoms as well as herpesvirus outbreaks – L-lysine has no antiviral effect over L-arginine as both compete for the same type of receptor and the effect of lysine when the two products are taken together may be negligible and growth-promoting effect of the virus. If a person wishes to use L-lysine to reduce the symptoms of the herpes virus, concomitant administration of L-arginine is not recommended. Arginine can be re-introduced after a course of lysine.

Supplement recommendations

	Dosage	Advice
Lysine	1000 mg three times a day for flare-ups. Avoid during pregnancy and breastfeeding	take on an empty stomach; not suitable for children
Melissa cream	apply cream to sores two to four times a day	melissa is also called lemon balm
Vitamin C/flavonoids	500 mg vitamin C and 200 mg flavonoids twice a day	standardised to contain 0.3% hypericin
Echinacea	200mg 4 four times a day
Zinc	15mg a day	if you take zinc supplement for more than one month, choose one that includes 2 mg copper

What else you can do

• Apply sunscreen (SPF 15 or higher) to the lips to prevent recurrences. In a study involvinf people with recurrent cold sores, those who did not use sunscreen developed a cold sore after 80 minutes in the sun. 
• Do not touch the blisters. This can spread the virus, as can sharing personal items such as towels, razors, drinking glasses or toothbrushes. 
• Try meditation, yoga or other forms of relaxation to reduce stress, which is thought to precipitate cold sores. 
• Avoid chocolate, gelatine, nuts and whole grain cereals. They contain a large amount of the amino acid arginine, which some doctors believe may trigger cold sores. Lysine is thought to counteract its effect. 

Recent findings

• Vitamin C may be effective when applied topically, according to a recent study in Finland. Researches soaked cotton-wool pads in a solution of vitamin C and applied them to cold sores. In those who were treated with Vitamin C, blisters cleared up faster (3.4 days) than in those who received a placebo (5.9 days). 

• The juice of the frangipani plant (Plumeria rubra) is a traditional African remedy for herpes infections. It is reputed to destroy the virus completely when applied to lesions, without leaving a scar; benefits are said to be felt within 20 minutes. 

Did  you know?

Holdin an ice cube to the affected area for a few minutes several times a day can help to reduce pain and dry out the cold sore. 

Facts and tips

• As an alternative to commercial melissa cream, try lemon balm tea, applied externally, to hasten the healing of cold sores. First, prepare a strong tea: steep 2 or 3 teaspoons of the herb in a cup of very hot water for 15 minutes, then cool. Dab it on the sores with a cotton-wool pad three times a day. 

See your doctor:

• If you develop eye pain or sensititvity to light – the virus may have spread to the eyes, where it can damage vision. 
• If cold sores last longer than two weeks or recur often – you may need a cream or an oral antiviral drug. 

REMINDER – IF you have a medical condition, consult your doctor before taking supplements. 

Reference: Practitioner´s Guide to Nutritional Supplements