Diet and Herpes: Diet Recommendations and Counseling Suggestions

Kelsea O’Rourke, University of Tennessee Martin, Dietetic Intern

Introduction Challenging a Popular Theory: Lysine .v. The Lysine .v. Arginine Theory is Debunked!
Global estimates indicate that of people 50 years Arginine in the Treatment of Herpes Not quite…
and under, approximately 67% have herpes simplex ● There is an antagonistic relationship between Subjective data is valuable.
virus 1 and 13% have herpes simplex virus 2. 20-30 Arginine and Lysine in the body, meaning that We are working with people, not lab rats.
percent of the HSV2 population and 30% of the Lysine and Arginine compete for cellular
Compelling subjective Data:
HSV1 population are symptomatic (roughly 23.4% of absorption. Arginine is a precursor to nitric oxide,
the global population). which is needed for Herpes viral replication.6 ● “To test the effect of lysine supplementation on
herpes infection, 1543 subjects were surveyed by
Outbreak symptoms include painful lesions, swollen ● The popular theory is that by supplementing with
questionnaire after a six-month trial period… the
lymph nodes, body aches, fatigue, fever and or eating a diet high in lysine, and avoiding arginine
average dosage used was 936 mg of lysine daily. “Can We Talk?”
headaches. Those with a weakened immune rich foods, you could “starve out” the virus and
84% said that lysine supplementation prevented Tips on how to have a comfortable, open
system are at greater risk for severe and reduce the frequency and severity of HSV outbreaks.
recurrence or decreased the frequency of conversation about HSV and nutrition.
recurrent outbreaks. The severity of an outbreak This hypothesis is supported by in-vitro studies, but
herpes [outbreaks]… 79% described their
can vary from inconvenient to incapacitating. evidence is mixed in human trials. 1. Assess your own comfort and identify any biases
symptoms as severe or intolerable without lysine …
Common misconceptions exist suggesting that that you may have. If you are uncomfortable
90% indicated that healing took six to 15 days
reducing arginine and increasing lysine intake can talking about herpes, your patient will be too.
Lysine and HSV: Evidence [without lysine], but with lysine 83% stated that
reduce the frequency and severity of HSV Almost all studies came to this conclusion: lesions healed in five days or less..Overall, 88% 2. Try not to react overtly, even if you feel
outbreaks, but there is insufficient scientific evidence considered supplemental lysine an effective uncomfortable or embarrassed. Pay attention to
● “ L-lysine supplementation appears to be ineffective
to back these claims. An effective dietary approach form of treatment for herpes infection.” what your body language and posture
for prophylaxis or treatment of herpes simplex
to thriving with HSV would be to focus on supporting communicate.
lesions… Doses in excess of 3 g/d appear to ● Every HSV + person responds to a high
one’s immune system by consuming and anti- 3. Make your patient feel comfortable by establishing
improve patients' subjective experience of the lysine/arginine ratio differently. The placebo effect
inflammatory diet. a rapport before asking sensitive questions.
disease.” is still effective. Antiviral therapy is currently the
The goal of this literature review is to offer evidence most effective method of treating HSV, but as long 4. Gain consent. For example: Do you mind if I ask
● “We have evaluated the prophylactic effect of L-
based MNT for HSV and to provide guidelines on as a patient is well informed and their methods for you a few questions about a medication you’re
lysine 1g daily on recurrent herpes simplex labialis
how to have a conversations with clients in a way treating themselves are not causing them physical, taking/ your medical history? I ask all my patients
in 65 patients in a double-blind, placebo-controlled,
that is comfortable and supportive. mental, or financial harm, dietitians should be these questions.
crossover study….On the whole, lysine
prophylaxis had no effect on the recurrence rate supportive in finding creative ways to treat HSV. 5. Rephrase your questions or briefly explain why
of herpes simplex.” ● If someone recognizes a high arginine food as a you are asking a question if a patient seems
trigger for an HSV outbreak, believe them and offended or reluctant to answer.
Any studies indicating that lysine
support them in removing that food from their diet. 6. Start with “just the facts” to lessen discomfort. If
supplementation was prophylactic against
you speak with a positive, comfortable attitude,
HSV were based on subjective survey MNT For HSV: A Modified Anti-Inflammatory Diet your patient will take your lead.
responses and/or were poorly managed. Studies show that a pro-inflammatory diet impairs
immune function. Our goal is to fortify the immune
Arginine and HSV: Evidence References
system by reducing physiological stress through diet, 1) Whitley, R. J. (1996, January 1). Herpesviruses. Medical Microbiology. 4th edition. Retrieved March 25, 2022,
● In-vitro studies using arginine synthase showed that therefore reducing the rate and severity of HSV
from https://www.ncbi.nlm.nih.gov/books/NBK8157/
Greater than 4 out of 5 people carry antibodies for HSV, yet Less than 1 in 4 2) World Health Organization. (22AD, March 11). Herpes simplex virus. World Health Organization. Retrieved
people will ever have an HSV outbreak. in an arginine deficient environment viral replication outbreaks.
March 29, 2022, from https://www.who.int/news-room/fact -sheets/detail/herpes-simplex-virus
3) University of Santa Cruz, Ca Student Health Center. (n.d.). Herpes. Retrieved March 25, 2022, from
was inhibited and cell-to-cell transmission was https://healthcenter.ucsc.edu/services/forms/student -handbook/HC-700.pdf
● Eat the rainbow: Consume a wide variety of fruits, 4) Luiking, Y. C., & Deutz, N. E. (2007). Biomarkers of arginine and lysine excess. The Journal of Nutrition, 137(6),
reduced, effectively blocking “the classic cytopathic 1662–1668. https://doi.org/10.1093/jn/137.6.1662s
vegetables, herbs, and spices. 5) Becker, Y., Olshevsky, U., & Levitt, J. (1967). The role of arginine in the replication of herpes simplex virus.
effects of HSV.” Journal of General Virology, 1(4), 471 –478. https://doi.org/10.1099/0022 -1317-1-4-471
● Cut the sugar: consume a low glycemic diet. 6) Griffith, R. S., DeLong, D. C., & Nelson, J. D. (1981). Relation of arginine
-lysine antagonism to herpes simplex

● There are no human-trial studies to date ● Keep it lean: opt for lean sources of protein to
growth in tissue culture. Chemotherapy, 27(3), 209 –213. https://doi.org/10.1159/000237979
7) Mailoo, V. J., & Rampes, S. (2017, June). Lysine for herpes simplex prophylaxis: A review of the evidence.

observing the effects of a low arginine diet/ avoid saturated fats.

Integrative medicine (Encinitas, Calif.). Retrieved March 25, 2022, from
https://www.ncbi.nlm.nih.gov/pubmed/30881246

enzyme-induced arginine deficiency on the ● More omega-3’s: increase omega-3 intake and
8) Milman, N.,Scheibel, J.,Jessen, O. (1980). Lysine prophylaxis in recurrent herpes simplex labialis: A double
blind, controlled crossover study. PubMed. Retrieved March 25, 2022, from
-

frequency and severity of HSV outbreaks. reduce omega-6 intake, which is pro-inflammatory.
https://pubmed.ncbi.nlm.nih.gov/6153847/
9) Grimes, J. M., Khan, S., Badeaux, M., Rao, R. M., Rowlinson, S. W., & Carvajal, R. D. (2021). Arginine depletion as

Furthermore, such a diet may have harmful side ● Healthy drinks: cut or reduce your consumption of
a therapeutic approach for patients with covid-19. International Journal of Infectious Diseases, 102, 566
https://doi.org/10.1016/j.ijid.2020.10.100
–570.

effects. Arginine is essential for growth, wound caffeine and alcohol.

10) Griffith, R. S., DeLong, D. C., & Nelson, J. D. (1981). Relation of arginine
growth in tissue culture. Chemotherapy, 27(3), 209
-lysine antagonism to herpes simplex
–213. https://doi.org/10.1159/000237979

healing, endothelial function, and nitric oxide ● Most importantly: reduce your mental and physical
11) Walsh, D. E., Griffith, R. S., & Behforooz, A. (1983). Subjective response to lysine in the therapy of herpes
simplex. Journal of Antimicrobial Chemotherapy, 12(5), 489 –496. https://doi.org/10.1093/jac/12.5.489
This is what you see if you google “nutrition and herpes”: a slew of marketing articles that
promise to get rid of your stigmatized condition if you buy their product, and natural
production, so prolonged deficiency could be stress and get enough sleep!
12) Aronson, D. (2009, November). Cortisol —Its Role in Stress, Inflammation, and Indications for Diet Therapy.
Today's Dietitian, 11(11), 38. Retrieved March 25, 2022, from
remedies that are not backed by science. The negative social stigma of herpes drives people
to believe these damaging publications. The truth is that herpes is not curable, and the
dangerous for those with cardiovascular disease, a https://www.todaysdietitian.com/newarchives/111609p38.shtml.
13) Centers for Disease Control and Prevention. (2019, October 21). Discussing sexual health with your patients.
stigma around it is often more harmful than the virus itself. weakened immune system, wounds and burns. Centers for Disease Control and Prevention. Retrieved March 25, 2022, from
. https://www.cdc.gov/hiv/clinicians/screening/discussing -sexual-health.html