Shingles at 43: Fit People Get It Too
Arwa Mahdawi was 43, fit, and by any reasonable measure, well.
Shingles at 43: Fit People Get It Too
There is a particular cruelty to getting sick when you have been doing everything right.
Arwa Mahdawi was 43, fit, and by any reasonable measure, well. Then shingles arrived — that specific, vicious pain that travels along a nerve like a lit fuse — and what followed was weeks of discomfort, a bill that ran into hundreds of dollars, and a question she hadn't thought to ask before: why do healthy women under 50 seem increasingly vulnerable to this?
The answer is not comfortable. Intense exercise — the kind we celebrate, the kind that earns you the label *fit* — can temporarily suppress the immune system in the days immediately after a hard session. The varicella-zoster virus, which caused your childhood chickenpox and has been quietly dormant in your nerve tissue ever since, watches for exactly that window. It doesn't care how many kilometres you logged this week.
This matters because the cultural story around shingles is wrong. We think of it as something that happens to people in their seventies, to people who are fragile or immunocompromised. The vaccine conversation follows the same logic — most public health messaging targets adults over 50. But the data is shifting. Women in their thirties and forties who train hard, sleep too little, and run chronically high cortisol are presenting with shingles at rates that are starting to surprise clinicians.
Stress is the other accelerant. Not dramatic, acute stress — the slow background hum of it, the kind that is so normal it doesn't feel like stress anymore. Cortisol suppresses T-cell activity over time, and T-cells are precisely what keep varicella-zoster dormant. The virus is not opportunistic in a random way. It is patient.
The shingles vaccine — Shingrix, a two-dose series — is currently recommended from age 50 in most countries, but the evidence for earlier vaccination in high-risk individuals is growing. If you are under 50, exercising intensely, sleeping inconsistently, and managing a life that runs at full speed without adequate recovery, it is worth having an honest conversation with your GP about your actual immune status, not just your age bracket.
What nobody tells you in the fitness content you consume every day is that recovery is not optional. It is the part where your immune system does its maintenance work. Skip it long enough and something that has lived in your nerve cells since you were seven years old will find its moment.
One thing to do: Book the conversation, not the vaccine — yet. Ask your GP whether your lifestyle and stress load put you in an earlier-risk category for shingles. The question costs nothing. The shingles does.
