Epstein-Barr (EBV) is a virus that causes mononucleosis (also known as “mono” or “the kissing disease”). EBV is part of the herpes family and classified as human herpesvirus 4. It is most commonly passed through saliva. Over 90% of people worldwide have been exposed to EBV, and the timing of infection seems to be very significant. Children in developing countries usually contract the Epstein-Barr virus when they are under the age of 10, and it usually goes unnoticed because they have no symptoms. In developed countries, individuals are typically exposed to the virus when they are teens or older, the infection has no symptoms 50 percent of the time.

Fortunately, for most of us EBV lies dormant (inactive) for life. Though not commonly recognized by mainstream medicine, physiological or emotional stressor may trigger a reactivation of EBV causing otherwise unexplained symptoms. The most common symptoms include severe fatigue, sore throat, fever, and swollen lymph nodes. Weight loss can also be a factor. For some people, the condition resolves in a few weeks. For others, the fatigue lingers, and the virus may contribute to the development of other conditions such as chronic fatigue syndrome, cancers, enlarged liver and/or spleen, emotional disturbances, and multiple autoimmune conditions- including chronic fatigue syndrome, fibromyalgia, multiple sclerosis and Hashimoto’s thyroid disease.

How Epstein-Barr Virus Causes Autoimmune Disease

When a person is infected with the Epstein-Barr virus, the body’s natural defense mechanisms begin to take aim at the virus. Unfortunately, in a person with poor nutrition and health vulnerabilities, the virus may defeat and deplete the body’s immune response, resulting in a low-grade latent infection, as well as multiple deficiencies and imbalances that pave the way for autoimmune processes to take hold.

Autoimmune conditions are caused when an overactive immune system begins attacking healthy tissue. CD8+T cells are types of white blood cells your body uses to keep the EBV virus in check. When there’s a deficiency of or damage to these cells, the EBV virus can flare back up. The amount of CD8+T cells you have can be negatively impacted by age, estrogen levels, vitamin D deficiency, certain medications and treatments, and poor immune system function. This is important because autoimmunity is on the rise and we need a better understanding of its underlying causes.

Notes:

A 2015 Polish study found the Epstein-Barr virus in the thyroid cells of 80% of people with Hashimoto’s and 62.5% of people with Graves’, while controls did not have EBV present in their thyroid gland. Furthermore, cells suggesting a continually proliferating state—a slowly growing infection—were found in the Hashimoto’s group as well.

Many people with autoimmune disease report that upon reflecting on their personal health timeline that they were perfectly normal until they were exposed to the Epstein-Barr virus and never quite felt like themselves again after contracting it.

Diagnosis and Testing

The following are the most common blood test options used to figure out if a person has a reactivated infection. However, there is emerging evidence that Epstein-Barr may still be problematic even when test results for viral reactivation are negative. Additional specialized testing may be necessary.

EBV-VCA IgG/IgM (viral capsid antigen): IgG positive means you’ve had or currently have the infection; IgM positive means the infection has been reactivated.
EBV-EBNA IgG (nuclear antigen): A positive test result is usually associated with past infection.
EBV-EA-D IgG (early antigen): Positive EA IgG may mean you have an active or reactivated infection.

EBV Interpretation

Marker	Non-Immune	Primary infection	Past infection	Reactivation
VCA IgM	N	P	N	N
VCA IgG	N	P	P	P
EBNA IgG	N	N	P	P
EA IgG	N	P	N	P

N = negative, P = positive
Patterns not falling within one of the above groupings are Indeterminate and it is recommended the patient be redrawn and retested in 1 month.

Treating EBV

There is no known cure for the Epstein-Barr virus, and therefore treatments are focused on returning the virus back to its sleeping or dormant state. This means manipulating or improving the condition of your body – the environment where the Epstein-Barr virus lives.

Clean diet and proper nutrition – The goal is to reduce inflammation and improve your immune system. For 30 days (to start) you will eliminate gluten, dairy, known allergens, and start a low carb mostly plant based diet. Sugar is one of the most powerful immune suppressors so that must absolutely be eliminated or strictly limited.
Heal your gut – Healing the gut is a priority for anyone dealing with EBV. Toxins can leak through damaged gastrointestinal lining and cause the immune system to overreact. This process is also known as “leaky gut”.
Eliminate any coinfections – Check for any coexisting infections and work to treat these. Think of it as “infectious burden” and work to decrease the load on the immune system.
Get control of any underlying conditions– if you have other health conditions they need to be healed or well managed
Reduce your toxic burden – We are bombarded by tens of thousands of chemicals everyday. It is critical to decrease total toxic load by eliminating or reducing toxic exposures.
Optimize detox pathways – This includes supporting the liver, kidneys, and colon.
Improving your sleep habits – This is essential because so many repairing and detoxification processes occur during the deepest stages of sleep. Aim for no less than 8 hours per night.
Reduce stress – Stress is a major cause of immune system dysfunction, it could even be what awakened your EBV in the first place. You must work to reduce stress – your health depends on it. Try Tai Chi, prayer, meditation, spending time in nature, or other methods of relaxation. Self care must be a priority.
Herbal supplements – Herbs such as Ashwagandha, licorice, St. John’s wort, lemon balm, ginseng, and holy basil may be used for immune system support and for their antiviral and adaptogenic properties. We recommend the optimal combinations for you during a visit.
Supplements – we use a combination anti-viral and immunes support supplements for suppressing EBV reactivation

Ineffective Epstein-Barr Treatments

Some treatments of EBV are not effective because there’s a lot of misunderstanding surrounding this virus. In general, the follow treatments may or may not temporarily stop symptoms and only for some people:

Antiviral therapy such as acyclovir, ganciclovir and valgancyclovir .
Immunosuppressive agents such as cyclosporine and corticosteroids.
Immunomodulatory therapy such as interferon alpha and interferon gamma.
Cytotoxic chemotherapy such as anthracyclines, etoposide, cyclophosphamide, vincristine, and prednisone.
Infusions of cytotoxic T and lymphokine-activated lymphocytes.

This isn’t to suggest that your doctor shouldn’t temporarily recommend some of these, however, none of these are by any means a cure for Epstein-Barr virus and you should proceed with extreme caution.