Epstein-Barr Virus (EBV) can be a stealth cause of fatigue, chronic aches and pains, depression, and Hashimoto’s thyroiditis. Unfortunately, the medical community has long marginalized its role in chronic symptoms, and therefore, most doctors never think to check for it, leaving many women suffering with mysterious symptoms without an obvious cause or diagnosis.
I began testing for EBV in my patients with the chronic symptoms I mentioned, and with Hashimoto’s, because early on in my medical practice I made the startling discovery that it’s way more common than one might expect, certainly than I was taught in medical school, and something more doctors should pay attention to. However, because it’s so overlooked by conventional medicine, it’s important for women to take their own health in their hands by being informed about EBV basics – what it is, how to identify whether you have the infection, and what you can do, naturally, to kick this bug!
Epstein-Barr Virus: What Is It?
EBV is a virus in the herpes virus family. Other infections in this family include herpes (including the kind that causes cold sores and the type that causes genital sores), shingles and chickenpox. EBV is specifically responsible for causing mononucleosis (“mono”). Most of us have actually been exposed to Epstein-Barr Virus at some time in our lives, even if we didn’t have mono. In fact, up to ninety-five percent of the population has been infected and most of us just go through life as carriers, totally symptomless, never knowing we have it.
Unfortunately, contrary to the association we make with mono and “kissing teenagers,” we can get infected at any age, and the virus can get reactivated at any time in our lives. While a robust immune system can usually fight off the virus by creating antibodies, periods of stress and fatigue, going through major life changes, or even menopause, for example, may cause us to be particularly susceptible to infection with or reactivation of the virus, and therefore to symptomatic infection.
The Epstein-Barr Virus And Autoimmune Connection
Epstein-Barr Virus has been linked to autoimmune disease, including Hashimoto’s thyroiditis, systemic lupus erythematous, and also to a form of lymphoma (a type of cancer affecting B-cells of the immune system).
Several theories raise possibilities for how these infections can cause autoimmune disease. In the molecular mimicry theory, the immune system remembers specific proteins on the viruses, and then looks for similar proteins as targets for an attack; in the case of Hashimoto's, the thyroid becomes that target in a case of mistaken identity for the virus. This can happen even after the body has cleared the organism. Another possibility is called the bystander effect, in which virus either enters the body’s cells and the immune system attacks the cells along with the virus, or, the virus stimulates the release of specific immune cells that are primed to attach the body itself. Finally, chronic infections keep your body in a state of low-level chronic alarm, activating the stress response and your adrenal system, leading to dysregulation in the immune system.
What’s clear is that autoimmune conditions are on the rise, are especially common in women, and there is a role for infection in triggering autoimmunity. Further, it’s clear that being chronically overwhelmed and exhausted makes it more difficult for our body to contain infection and inflammation.
In my book, The Adrenal Thyroid Revolution, I show you how a multitude of seemingly unrelated symptoms share one source, what I call Survival Overdrive Syndrome (SOS) – a condition that occurs when the body becomes overloaded by stress, poor diet, lack of sleep, toxic overload and chronic viral infections that are inescapable in our world today. EBV is commonly “picked up” or reactivated when we’re in SOS, and it’s also harder for your immune system to kick it when you’re already on overdrive.
Epstein-Barr Virus: How Does One Get Infected?
Quite simply, EBV is transmitted through intimate contact, which includes “sharing” saliva. This can happen through drinking out of the same cups, kissing, or passing joints or cigarettes, for example.
Once you have EBV, it remains dormant in your system indefinitely. Epstein-Barr Virus reactivation can persist for months, much like mono can, though it’s usually significantly milder than mono, which is typically the worst when contracted in our teen years and early twenties.
Symptoms of new infection and reactivation include fatigue, which can be quite intense, aching muscles and joints, swollen lymph nodes and other persistent flu-like symptoms. It can cause malaise and even outright depression. A physical exam may find a swollen liver and spleen, though a physical exam may also be completely normal, and liver function tests may be abnormal.
Testing for Epstein-Barr Virus
Conventional medical tests are readily available and generally reliable for testing for Epstein-Barr Virus. Testing includes getting both a complete EBV acute panel and a chronic infection panel. Positive tests for current infections will be indicated on your lab results with a very specific pattern of results that your doctor can review with you. Positive results typically include positive IgM and or positive Early Antigen; a PCR test can also be done to look for the presence of virus, but I usually just test acute and chronic infection panels.
Can I Treat Epstein-Barr Virus Naturally?
It is totally possible to send Epstein-Barr Virus into dormancy and remain symptom free. It's one of the most reversible causes of Hashimoto's I've seen in my practice. I encourage a four-part program to heal and nourish yourself so your immune system can more easily do its job of keeping this virus in check. This includes:
Rest and Repair: It’s important to get plenty of restorative sleep and to incorporate relaxation techniques to help reset a stressed immune system.
Nourish with Foods: I emphasize immune boosting foods including plenty of dark green leafy vegetables, Vitamin-A rich carrots and sweet potatoes, dark blue and black berries, nuts and seeds, and good quality protein.
Support the Immune System & Fight the Virus: Use immune supportive, antiviral and anti-inflammatory herbs and supplements that have been shown to be effective in fighting against the EBV virus (or viruses in the herpes family). Examples include:
- Zinc Citrate: Immune supportive; in excess of 60 mg/day can be toxic. Take 30-60 mg with food daily to avoid nausea.
- St John’s Wort: Antiviral and relieves depression. Take 300-600 mg/day of products standardized to 0.3% hypericin and/or 3-5% hyperforin.
- Lemon Balm: Antiviral and relieves stress and anxiety. Take 300-1200 mg daily in tea or capsules, or 40-60 drops of tincture 1 to 3 times daily.
- Licorice: Antiviral, anti-inflammatory and an adaptogen. Take 150-300 mg daily.
- Echinacea: Anti-inflammatory and antiviral. Take 300-500 mg up to three times daily.
- A daily probiotic containing Lactobacillus and Bifidobacterium strains.
Provide Deep Stress Response and Immune System SupportTo reset and restore immune system and stress response regulation, I favor the use of the adaptogen herbs such as ashwagandha, holy basil, and reishi for general immune support. You can learn more about these herbs here and find a complete EBV and hidden viral infection protocol in my book, The Adrenal Thyroid Revolution.
I usually recommend a daily protocol combining the herbs and supplements under Support the Immune System & Fight the Virus, plus your choice of adaptogen(s) to be taken daily for up to 3 months. These are all safe while breastfeeding; only zinc, Echinacea, and St. John’s wort are safe in pregnancy.
No specific conventional medical treatments have been established for treating recurrent or chronic EBV. Many functional and integrative medicine doctors use an antiviral medication called Acycovir, which is also used in the treatment of herpes and shingles. While this treatment is considered “off label,” meaning not intended for this purpose, anecdotally patients have reported it to help with symptoms and shorten the duration of their illness. It is also considered relatively safe. However, given the overall safety of the herbs and supplements I've mentioned, they are generally my first go-to with patients with EBV.
Please check with your health practitioner before using any supplements if you're pregnant, if you're on medications, or if you have a serious medical condition.