Preface: The increased incidence and hospitalization rates of "Herpes Zoster" and "Postherpetic Neuralgia" are medical phenomena observed in various countries during and after the COVID-19 pandemic. The reasons for this, apart from neglecting Herpes Zoster vaccination, may also be related to the disruption of T-cell immune function by the coronavirus infection. As we enter the autumn and winter seasons, we are about to face a new peak of COVID-19. In addition to taking necessary preventive measures, this clinical observation published more than 20 years ago may also be worth our reference.

 

（https://doi.org/10.1142/S0192415X98000415）

 

Scientific discussions on the improvement of Herpes Zoster-related symptoms by Ganoderma lucidum first appeared in a report published in the American Journal of Chinese Medicine (AJCM) by Yasuyo Hijikata, a physician at a clinic in Osaka, Japan, in 1998. This report documented the experiences of two patients with "Postherpetic Neuralgia" who were unable to relieve pain despite conventional treatment, and two patients with "Neuralgia during the onset of Herpes Zoster". They used Ganoderma lucidum to alleviate pain, accelerate recovery, and even prevent or reduce the severity of recurrence.

 

Since the process involved doctors' diagnoses and long-term tracking, the patients' health information and medical procedures were clearly recorded. The source, dosage, and usage of Ganoderma lucidum were also clear, and no other drugs were used concurrently. Therefore, it is very suitable for understanding the help of Ganoderma lucidum for Herpes Zoster-related symptoms - especially acute neuralgia during illness and chronic neuralgia left after recovery.

 

However, before we delve into the main topic of the article, let's first introduce what herpes zoster is and its common sequelae - postherpetic neuralgia.

 

About Herpes Zoster and Its Sequelae - Postherpetic Neuralgia

 

The virus that causes Herpes Zoster, like chickenpox, is the "Varicella-Zoster Virus". Initial infection with this virus will cause chickenpox, but the virus does not disappear with the healing of chickenpox. Instead, it goes dormant in the sensory ganglia (a collection of nerve cells that transmit sensory signals to the central nervous system), hiding from immune system attacks. When the host's immune function weakens one day, it re-emerges as Herpes Zoster.

Since the sensory nerves are often arranged in a band-like distribution on the body surface, the skin symptoms caused along the nerve pathway are named "Herpes Zoster".

 

Given the characteristics of neural distribution, this band-shaped lesion generally does not cross the midline of the body, at most it forms a semi-circle; unless the virus invades multiple groups of nerves, and the patient's immunity is really too poor, it may form a full circle. Therefore, immune dysfunction and immunodeficiency are the keys to making herpes zoster life-threatening.

 

 

The process of herpes zoster from rash to scabbing is as follows:

The affected area hardens (usually located where a large number of nerves are distributed) and feels swollen, and it is also very easy to feel pain.

1. After one or two days, small red rashes appear (most patients' neuralgia will also disappear at this time);

2. The red rash turns into blisters similar to chickenpox;

3. The fluid in the blisters turns from clear to purulent and ruptures;

4. Scabs form and then gradually disappear.

5. Some patients still have pain symptoms after the herpes zoster scabs, which is the so-called "postherpetic neuralgia". It is generally believed to be caused by nerve damage. (Image source: Wikimedia Commons)

 

The process from the growth of red rashes from the epidermis, the transformation of red rashes into blisters, the transformation of blisters into pustules, to the rupture, healing, and scabbing of pustules, takes approximately 2 to 4 weeks. Whether pigmentation or blemishes remain after scabbing varies from person to person, but the most annoying thing is the strong pain that still exists after the blisters heal. This is the most common sequelae of herpes zoster - postherpetic neuralgia.

 

The diagnosis of postherpetic neuralgia varies slightly from country to country. In China, it is typically diagnosed when neuralgia persists for one month after the healing of the herpes. This pain primarily results from abnormal nerve impulses produced by nerve fibers after viral invasion, which may manifest in various forms of pain such as stabbing, burning, or knife-like pain. In milder cases, symptoms may only include itching or a numb sensation.

 

In clinical practice, pain relievers such as non-steroidal anti-inflammatory drugs are commonly used to alleviate the pain, but a considerable proportion of patients still cannot achieve pain relief. A report from a Japanese clinic describes two cases of postherpetic neuralgia patients who used Ganoderma lucidum to relieve pain; these were patients who could not find relief from other treatments. The other two cases had significant neuralgia during the onset of herpes zoster.

 

[Case 1] The patient had postherpetic neuralgia for nearly a month. After taking Ganoderma lucidum for four days, the pain drastically reduced, and it completely alleviated after one and a half months.

 

Case 1 involves a woman who underwent thymoma removal surgery at the age of 55. At the age of 58 (June 15, 1992), she developed herpes zoster below her left breast. Even though the skin lesions had disappeared, the pain was still significant and even affected her daily life. During this time, she used non-steroidal anti-inflammatory drugs and other painkillers, but they were unable to alleviate the pain. As a result, she turned to Ganoderma lucidum for help.

 

According to the report, the “Ganoderma lucidum” that the patient took was a powder made from Ganoderma lucidum that was artificially cultivated. The Ganoderma lucidum fruiting body was boiled in 95°C hot water for 3 hours to obtain a water extract (1 gram of extract per 17 grams of fruiting body). This extract was then added to cornstarch (twice the weight of the extract) and spray-dried. The principle was to take it three times a day before meals, and if gastrointestinal discomfort occurred, it would be taken after meals.

 

Case 1 began taking Ganoderma lucidum preparations on July 17, 1992, consuming 6.4 grams per day (containing a concentrated water extract of 36 grams of dried Ganoderma lucidum fruiting body). After only 4 days of use, her pain rapidly decreased. She continued to take it until August 30 (about a month and a half later), when her pain completely subsided and she stopped using Ganoderma lucidum.

 

In early February of the following year, just as she was recovering from a mild common cold with a fever, her postherpetic neuralgia recurred. However, this time the pain index was only 1 (see table below). After taking Ganoderma lucidum for two consecutive days, the pain significantly eased. By the 10th day, she hardly felt any discomfort, but she continued to take it for another 21 days before stopping.

 

Pain Index

0: No pain

1: Feeling a bit abnormal within the range of a certain nerve (but no skin-related symptoms have appeared)

2: Between 1 and 3

3: Almost unbearable pain that has affected daily life

 

As of November 1997, prior to the submission of this research report, Case 1 has been maintaining a good condition, with no recurrence of postherpetic neuralgia.

 

[Case 2] The patient had postherpetic neuralgia for over two and a half years. After taking Ganoderma lucidum for four days, the pain was drastically reduced, and it was completely alleviated after one and a half months.

 

Case 2 is also a female. She suffered from hearing loss in her right ear due to a stroke at the age of 66. At the age of 67 (in September 1993), she was hospitalized due to shingles. The main pain area of her postherpetic neuralgia was in the forehead, especially above the right eyelid. The pain was so severe that she had to rely on anesthetics for pain relief, but even after a week, the pain did not alleviate. She later tried various painkillers, acupuncture, moxibustion (burning of mugwort), and physical therapy, but none were effective.

 

On February 26, 1994, when she was 68 years old, she tried Ganoderma lucidum for the first time. The dosage was the same as Case 1, but unfortunately, the pain persisted even after 20 days. Two years later, she tried Ganoderma lucidum again. This time, she doubled the dosage (12.8 grams per day, containing a concentrated water extract of 72 grams of dried Ganoderma lucidum fruiting body), and as a result, in just 10 days (from February 13 to 23, 1996), she reduced her pain index from 3 to 2 (see Table 1 above).

 

Less than half a month later, she stopped using Ganoderma lucidum for 10 days (from March 5 to 16, 1996) due to eczema on her scalp, and as a result, the pain index returned to 3. Fortunately, when she resumed Ganoderma lucidum (on March 17), the pain was quickly reduced. A month and a half later (at the end of April), the pain index finally dropped to 2; after another half a month (mid-May), the pain index had dropped to 1 - even though she did not take Ganoderma lucidum for 8 days during this period.

 

In the following three and a half months (until the end of August), her pain index mostly remained at level 1, with only a few days rising back to 2. After another four months (December 1996), she stopped taking Ganoderma lucidum because she felt that the pain had completely eased. As of November 1997, prior to the submission of this research paper, Case 2's postherpetic neuralgia had not recurred.

 

Case 3: The patient suffered from shingles (initial outbreak) with neuralgia. He started consuming Ganoderma lucidum on the 6th day after the onset of the disease, and his symptoms were completely relieved in less than a month.

 

Case 3 is a male who had no particular medical history prior to contracting shingles. His only issue was that he was constantly busy with work, leading to a lack of sleep. On April 1, 1983, when he was 69 years old, he suddenly experienced symptoms of neuralgia in his shoulder and neck area. As he was on a business trip at the time, he had to endure the pain until the 6th day when it became unbearable, and he sought medical attention.

 

The doctor observed that there were red spots and a few slightly raised blisters on the swollen area of his left shoulder and neck, and diagnosed it as shingles. As the affected area expanded and the pain worsened, he began taking Ganoderma lucidum from April 7, with a daily dosage of 6.4 grams (containing a concentrated water extract of 36 grams of dried Ganoderma lucidum fruiting body).

 

The day after he started taking Ganoderma lucidum, the blisters began to scab over and no new lesions appeared, and the pain was significantly reduced. After another 5 days (April 13), all the blisters had scabbed over and the pain had disappeared, so he stopped taking Ganoderma lucidum. However, in the following 7 days, he resumed taking Ganoderma lucidum due to a recurrence of pain (index 2) and once again alleviated the pain. To stabilize the condition, he took Ganoderma lucidum for an additional 7 days before stopping. From the end of April 1983, when he officially said goodbye to the pain, until November 1997, prior to the publication of this study, there was no recurrence.

 

Case 4: The patient suffered from a recurrence of shingles with neuralgia. He started taking Ganoderma lucidum on the 7th day after the onset of the disease, and his pain was significantly reduced after 3 weeks.

 

Case 4 is a male who has a congenitally smaller heart, making him physically weaker than the average person. At the age of 19, he developed shingles on the inner side of his left arm. Accompanying symptoms such as high fever, swelling of the lymph nodes under his left armpit, and severe pain lasted for more than 6 weeks. His sleep was greatly disturbed due to physical discomfort.

 

On February 10, 1993, when he was 65 years old, he experienced symptoms such as neuralgia, numbness, and itching in the area of his right scapula, shoulder, and chest. Five days later (February 15), the pain spread to his left upper abdomen. Two days after that (February 17), his chest and back were covered with large and small blisters, scabs, and erythematous edema, with the right side being more severe than the left. During this period, the pain index remained at level 2, his body temperature was slightly higher than normal at 37°C (normal is 36°C), and the most uncomfortable symptoms for him were the pain in the lymph nodes under his right armpit and extreme fatigue.

 

He began taking Ganoderma lucidum on February 17, with a daily dosage of 6.4 grams (containing a concentrated water extract of 36 grams of dried Ganoderma lucidum fruiting body). Initially, his skin lesions continued to spread, and new blisters appeared. However, by the fourth day (February 20), this spread stopped, and scabs began to form, and the pain was alleviated. According to the patient, compared to the first time he had shingles at the age of 19, the pain from this recurrence was significantly less severe.

 

When he returned for a follow-up visit on March 5, there were more scabs, but there was still slight pain. By March 10, the skin symptoms had almost completely disappeared, which was only three weeks after he started taking Ganoderma lucidum. Although mild neuralgia would still accompany any physical conditions that appeared thereafter, it no longer interfered with his life.

 

Doctor's Evaluation of Ganoderma lucidum's Assistance to Different Cases

 

The doctor who wrote this report stated that the reason they decided to use Ganoderma lucidum for patients with postherpetic neuralgia is because Ganoderma lucidum has been widely used for various diseases and is relatively safe for some difficult-to-treat conditions.

 

For Case 1, the doctor believes that the effect of Ganoderma lucidum is very clear. This female patient's postherpetic neuralgia could not be improved by other treatments, but was quickly relieved after taking Ganoderma lucidum. Later, when she had other illnesses, mild pain occurred, but it could also be relieved by Ganoderma lucidum and did not recur. These phenomena all indicate that the immunomodulatory effect of Ganoderma lucidum can cause the reactivated varicella-zoster virus to lose its activity.

 

The effect of Ganoderma lucidum on Case 2 is also very clear. Her postherpetic neuralgia had lasted for over two and a half years, and various treatment methods (including Western medicine, acupuncture, moxibustion, physical therapy, and a lower dose of Ganoderma lucidum) were unable to alleviate it. It was not until she doubled the dosage of Ganoderma lucidum that she gradually bid farewell to the pain.

 

As for Case 3, the blisters that were in the process of erupting quickly scabbed over the day after he started taking Ganoderma lucidum. The doctor believes that this phenomenon is difficult to explain with the natural course of shingles. If it is said that the recovery was so fast because the condition was mild, it is difficult to explain why the timing of "stopping Ganoderma lucidum" and "pain recurrence" coincided so closely.

 

Regarding Case 4, who had a recurrence of shingles, the doctor believes his situation is quite special. Although the range of shingles continued to expand at the beginning of using Ganoderma lucidum, the pain that came with the recurrence was immediately suppressed. Moreover, compared to the first time he had shingles when he was young, not only was the degree of pain significantly lighter, but the duration of pain (3 weeks) was also significantly shorter than the first time (more than 6 weeks). This seems to indicate that Ganoderma lucidum has the effect of accelerating pain relief.

 

Lessons Learned from the Use of Ganoderma lucidum

 

At the end of this report, the doctor expressed his views on the application of Ganoderma lucidum in the prevention and treatment of herpes zoster and its postherpetic neuralgia based on the aforementioned clinical experience. He believes that the timing of treatment, dosage of Ganoderma lucidum, and duration all have an impact on the patient.

 

Firstly, the sooner Ganoderma lucidum is taken after the onset of the disease, the faster the patient's recovery speed.

 

Secondly, for patients who do not respond to the initial dose, it is possible to reverse the decline by increasing the dosage of Ganoderma lucidum.

 

Furthermore, for severe postherpetic neuralgia, it may require continuous use of Ganoderma lucidum for more than 3 months to have a stable analgesic effect.

 

Lastly, the more severe the symptoms, the greater the dosage of Ganoderma lucidum and the longer the usage time required.

 

The speculation on why Ganoderma lucidum is effective

 

According to doctors, the effectiveness of Ganoderma lucidum in treating shingles and its associated neuralgia may be related to the immunomodulatory effects of Ganoderma lucidum. This effect can help patients with relatively low immune function suppress the reactivation of the varicella-zoster virus (the virus that causes shingles), rendering it inactive.

 

Compared to antiviral drugs, which are mainly effective in the early stages of the disease and are not suitable for patients with kidney dysfunction, doctors believe that Ganoderma lucidum can be used at any stage of herpes zoster, and it has good effects and no nephrotoxicity. Therefore, it is very suitable to be widely included in the treatment of herpes zoster and postherpetic neuralgia.

 

 

Useful hot water extract of Ganoderma lucidum fruiting body

 

In today’s scientific environment, which emphasizes consistent objective conditions in cell experiments, animal experiments, and clinical trials, this report, recorded by frontline doctors about patients’ personal medical experiences, undoubtedly provides us with professional observations that have a human touch, beyond the rigorous statistical data.

 

After all, no matter how much we pursue scientific consistency, we cannot avoid the differences that each person is born with. As we pursue the same success with full expectation, we should bear in mind that the path from illness to health is often not a straight line but winding and undulating, and the process each person goes through will not be the same.

 

The treatment times of the aforementioned patients were spread over a 13-year period (1983-1996), indicating that the hot water extract of Ganoderma lucidum fruiting body used by the patients had been on the doctor's medication list for a long time. The source stability and effectiveness of Ganoderma lucidum are naturally unquestionable. These four patients should be successful cases of this doctor treating herpes zoster-related neuralgia with Ganoderma lucidum.

 

The effective ingredients extracted from the fruiting body with hot water have accumulated a good reputation for Ganoderma lucidum's "universally effective" and "widely effective" since ancient times. According to related research, the hot water extract of Ganoderma lucidum fruiting body not only contains immune-enhancing polysaccharides and anti-inflammatory triterpenes but also calming nucleosides. It seems rough and unruly, but it integrates multiple ingredients into one, enabling it to open up all kinds of unexpected possibilities.

 

Existing medicine still has its shortcomings. If we can provide an additional option for this kind of disease that is "painful enough to be life-threatening", perhaps we have the opportunity to open a new gateway to health.

 

References:

1. Yasuyo Hijikata, et al. Effect of Ganoderma lucidum on postherpetic neuralgia. The American Journal of Chinese Medicine, 1998, 26(3-4):375-81.

2. Birun Guo et al. Progress in the study of the correlation between COVID-19 and herpes zoster. The Chinese Journal of Dermatovenereology, 2022, 36(5):593-598.

3. Peng Mao et al. Research progress on postherpetic neuralgia. National Medical Journal of China, 2022, 102(40): 3215-3218.

4. Zhibin Lin. Research on Ganoderma lucidum for the prevention and treatment of herpes zoster. Ganoderma, 2023, 99: 3-8.

5. Zhipeng Zeng. Oh my god, why is there a "snake" crawling on my body! Ganoderma, 2023, 99: 33-35.

 

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★ The original manuscript of this article was authored in Chinese by Wu Tingyao and subsequently translated into English by Alfred Liu. In the event of any inconsistencies between the English translation and the original Chinese text, the latter shall take precedence. For any queries, pls reach out to the original author, Ms. Wu Tingyao.