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Shingles is a condition that happens when the varicella zoster virus (VZV) reactivates. VZV is the virus that causes chickenpox. One symptom of shingles is a blistering rash that’s often painful or tingly. Other symptoms can include:

  • headache
  • fever
  • fatigue

Sometimes, feelings of fatigue can last for a long time — even after the other symptoms of shingles have disappeared. This may happen for a few different reasons.

Keep reading to learn why fatigue can linger, as well as what can be done about it.

There are several reasons why shingles could be the reason you feel tired after you’ve gotten rid of it.

Post-herpetic neuralgia

Post-herpetic neuralgia (PHN) is a potential complication of shingles. People with PHN experience pain for 3 months or more after they’ve had shingles.

PHN occurs because of inflammation or injury that happens to nerves during shingles.

It’s unclear why some people develop PHN while others don’t. Some risk factors include increasing age and having severe symptoms during shingles.

The pain from PHN can be described as shocks that feel like they’re:

  • stabbing
  • burning
  • electric

The pain described above happens in the area affected by the shingles rash. The symptoms of PHN can eventually ease. However, this may take months to years in some people.

PHN and fatigue

PHN can be an indirect cause of fatigue in people who have had shingles. The area impacted by PHN is typically more sensitive than normal, and it’s possible that even a very light touch can lead to pain.

This can include the feeling or movement of bedsheets against the affected area. In fact, the symptoms of PHN can increase during the day and get worse at night.

Because of this, many people with PHN experience insomnia. These sleepless nights can lead to increased feelings of fatigue during the day.

Chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is a condition that’s characterized by extreme levels of fatigue. These feelings:

  • last 6 months or longer
  • get worse after physical or mental exercise
  • don’t improve with rest

The exact causes of CFS are currently unknown. Scientists continue to investigate several areas as potential causes of CFS, one of which is infections.

According to the Centers for Disease Control and Prevention (CDC), about 1 in 10 people who contract certain infections will develop symptoms that meet the diagnostic criteria for CFS. These infections are:

CFS and shingles

In addition to the infections mentioned above, scientists are also studying others as potential causes of CFS. Although scarce, some research has been performed on shingles and CFS.

A 2009 research review suggested investigating shingles as a potential cause of CFS because VZV lies dormant (inactive) in nerve cells of people who’ve had chickenpox. When VZV reactivates to cause shingles, some symptoms overlap with those of CFS.

In one 2014 study, a group of researchers compared the incidence of CFS in 9,205 people who’d had shingles and 36,820 people who hadn’t. They found that people who’d had shingles were more likely to either have or develop CFS.

It’s important to remember that research into this topic is still very limited. Scientists need to perform additional studies to determine whether these two conditions are actually linked, and if so, how they’re connected to each other.

If you’re experiencing fatigue during or after shingles, try out some of the suggestions below to help you cope.

  • Set up a sleep routine. Pain from shingles or PHN can make it hard to sleep. However, setting up a regular sleep routine may help you get to sleep a little easier. Try setting a firm bedtime, or doing something relaxing before going to sleep.
  • Reduce stress. Stress can really sap your energy. Additionally, if you have shingles, stress may make your symptoms worse. Because of this, try to find ways to effectively reduce your stress levels.
  • Eat often. Eating often may help you keep your energy levels up while you’re feeling tired. Try to space out meals and healthy snacks out so that you’re eating something every few hours.
  • Stay hydrated. Dehydration can make you feel fatigued or sluggish, so make sure you’re getting enough fluids.
  • Reach out. Try to reach out to family and friends for their support and understanding. If fatigue is significantly affecting your mood and daily life, it may also be beneficial to engage with a support group or a mental health professional.

Talking with a doctor

It’s important to talk with your doctor if you have symptoms of shingles or PHN. Your doctor can work with you to develop a treatment plan that can help to address your symptoms.

Antiviral medications can help to treat shingles. When these are started shortly after symptoms appear, they can reduce your symptoms and the duration of your illness.

There are also several types of medications that may help with PHN pain. Some examples include tricyclic antidepressants (TCAs), antiseizure drugs, and topical pain medications.

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The only way to keep shingles from making you tired is to not get shingles, and the only way to do that is to get vaccinated.

Getting vaccinated for shingles can help you to avoid shingles, PHN, and the fatigue that’s associated with these conditions. Vaccination is important, even if you’ve already had shingles or if you had chickenpox as a child.

The CDC recommends the shingles vaccine for all healthy adults 50+ years old. The vaccine is given in 2 doses separated by between 2 to 6 months. Speak with your doctor if you’re interested in receiving the shingles vaccine.

You may experience fatigue while you have shingles. However, it’s also possible to feel fatigued even after the shingles rash has disappeared.

Fatigue may happen indirectly due to PHN, a complication of shingles that involves lingering pain. Many people with PHN experience insomnia. Shingles has also been linked to CFS, although more research into this area is needed.

If you’re experiencing symptoms of shingles or PHN, talk with your doctor about receiving treatment. Overall, the best way to prevent fatigue due to shingles or PHN is to receive the shingles vaccine.