EBV Epstein-Barr Virus


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 thousands of 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!

What Is EBV?

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 EBV 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 EBV Autoimmune Connection

EBV 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.

How Does One Get Infected with EBV?

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. EBV 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 EBV

Conventional medical tests are readily available and generally reliable for testing for EBV. 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 EBV 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 Support To 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.

Wishing you health,

Get the first chapter of my new book The Adrenal Thyroid Revolution, FREE right here.

  • This field is for validation purposes and should be left unchanged.


Ader, R., Cohen, N., & Felten, D. (1995). Psychoneuroimmunology: Interactions between the nervous system and the immune system. The Lancet, 345(8942), 99-103. doi:10.1016/s0140-6736(95)90066-7

Allahverdiyev A, Duran N, Ozguven M and Koltas S: Antiviral activity of the volatile oils of Melissa officinalis L. against Herpes simplex virus type-2, Phytomedicine. 11(7-8):2004; 657–661.

Astani A, Navid MH, and Schnitzler P. Attachment and penetration of acyclovir-resistant herpes simplex virus are inhibited by Melissa officinalis extract. Phytother Res. England; 2014;28(10):1547-52.

Astani A, Reichling J, and Schnitzler P. Melissa officinalis extract inhibits attachment of herpes simplex virus in vitro. Chemotherapy. Switzerland; 2012;58(1):70-7.

Barzilai, O., Sherer, Y., Ram, M., Izhaky, D., Anaya, J., & Shoenfeld, Y. (2007). Epstein Barr Virus and Cytomegalovirus in Autoimmune Diseases: Are They Truly Notorious? A Preliminary Report. Annals of the New York Academy of Sciences, 1108(1), 567-577.

Benvenga, S., Guarneri, F., Vaccaro, M., Santarpia, L., & Trimarchi, F. (2004). Homologies Between Proteins of Borrelia burgdorferi and Thyroid Autoantigens. Thyroid, 14(11), 964-966.

Benvenga S, Santarpia L, Trimarchi F, Guarneri F (2006). “Human Thyroid Autoantigens and Proteins of Yersinia and Borrelia Share Amino Acid Sequence Homology That Includes Binding Motifs to HLA-DR Molecules and T-Cell Receptor”. Thyroid 16 (3): 225–236.

Costenbader, K.H. & E.W. Karlson. 2006. Epstein-Barr virus and rheumatoid arthritis: is there a link? Arthritis Res. Ther. 8: 1186–1193.

Eo SK, Kim YS, Lee CK and Han SS: Possible mode of antiviral activity of acidic protein bound polysaccharide isolated from Ganoderma lucidum on herpes simplex viruses, J Ethnopharmacol. 72(3):2000; 475–481.

Fujinami, R. S., Herrath, M. G., Christen, U., & Whitton, J. L. (2006). Molecular Mimicry, Bystander Activation, or Viral Persistence: Infections and Autoimmune Disease. Clinical Microbiology Reviews, 19(1), 80-94.

Ghaemi A, Soleimanjahi H, Gill P, Arefian E, Soudi S, and Hassan Z. Echinacea purpurea polysaccharide reduces the latency rate in herpes simplex virus type-1 infections. Intervirology. Switzerland; 2009;52(1):29-34.

Glaser, R. (2005). Stress-associated immune dysregulation and its importance for human health: A personal history of psychoneuroimmunology. Brain, Behavior, and Immunity, 19(1), 3-11. doi:10.1016/j.bbi.2004.06.003

Harley, J.B. et al . 2006. The curiously suspicious: a role for Epstein-Barr virus in lupus. Lupus 15: 768–777.

Lennette, E.T. 2003. Epstein-Barr virus. In Manual of Clinical Microbiology. vol. 2, 8th ed. P.R.Murray, E.J.Baron, J.H.Jorgensen, et al . Eds.: 1331–1340. ASM Press. Washington , DC .

Nolkemper S, et al. Antiviral effect of aqueous extracts from species of the Lamiaceae family against Herpes simplex virus type 1 and type 2 in vitro. Planta Med. 2006; 72: 1378-1382.

Padalko, E.Y. & X. Bossuyt. 2001. Anti-dsDNA antibodies associated with acute EBV infection in Sjogren’s syndrome. Ann. Rheum. Dis. 60: 992.

Pender, M.P. 2003. Infection of autoreactive B lymphocytes with EBV, causing chronic autoimmune diseases. Trends Immunol. 24: 584–588.

Poole, B.D. et al . 2006. Epstein-Barr virus and molecular mimicry in systemic lupus erythematosus. Autoimmunity 39: 63–70


  1. I was tested for EBV 13 years ago and I tested positive. I was very sick for about a year but I was able to strengthen my immune system and get well. Over the years however I’ve experienced a lot of “flair-ups” and I’m very susceptible to mouth sores, swollen lymph nodes and glands, and adrenal fatigue. Does this indicate that I still am carrying EBV? Should my whole family go through this protocol as well? Thank you for this information!

    • hi sarah, it could be that you’re reactivating EBV in small cycles, or it’s just as likely that something else, ie gluten, or underlying adrenal depletion, is causing these symptoms and that makes you also more vulnerable to concurrent EBV reactivation. My new book is written for YOU! 🙂 it will help you sort out your personal root causes to be able to effectively answer this question.

  2. I was diagnosed with mono nearly six months ago. I am a 35- year old woman. I was definitely having a lot of stress and anxiety in my life at the time. Six months later, 7 no longer feel the fatigue I had at first, but still have the “mono sore throat” and swollen lymph node on one side of my throat. If I’m understanding, does this mean I have EBV? I’ve been eating very clean for over a year yet have bad eczema and can’t seem to get over this mono. I’ve tried a combo of St.Johns Wart and other herbs in a tincture for 2 months but it did not get me over it. I’m now considering doing a liver cleanse but am feeling hopeless. What should I do?

    • hi arden, in my new book The Adrenal Thyroid Revolution I offer a much more specific and detailed approach to EBV and also adrenal support to get under the hood on the fatigue, etc that allowed it to reactivate in your life. could be a game changer for you! http://www.avivaromm.com/bookbonus. 🙂 Aviva

  3. Thank you for sharing information on this topic! When you say “These are all safe while breastfeeding; only zinc, Echinacea, and St. John’s wort are safe pregnancy.” Do you mean zinc, Echinacea, and St. John’s wort ARE safe during pregnancy or ARE NOT safe during pregnancy?

    • for echinacea I usually recommend the less allergenic root for those with EBV + an autoimmune condition. For the SJW it should be only aerial parts on the market. Warmly, Aviva

  4. Your article says that St. John’s wort, zinc and echinacea ARE safe during pregnancy. I think this is a very dangerous typo. Amazing and informative article otherwise! Thank you!

    • This is correct.These nutrients and herbs can be used in pregnancy. Of course, caution should be taken with all supplements in pregnancy, and if you’re not personally comfortable using them, definitely don’t.

      • Thank you for this post on EBV and for including references. I’d suggest a good edit of the post though to rectify the numerous typo’s.

        • Thanks for the heads-up, Hannah. I just gave the article another once-over and found a few. Fortunately there weren’t many typos but Aviva tends to write longer articles and it’s easy to miss a typo or two.

  5. Are there particular brands available at FullScript you would suggest for the list of herbs and such you mentioned in the article?

    • Hi Carmela!
      I am the nurse practitioner in Dr Romm’s practice, and I often hop in to answer comments and questions since Dr Romm doesn’t always have time to get to them all!
      If you peruse Dr Romm’s supplement formulary, you’ll see the products that she recommends and uses most. You can get access to her public formulary here: http://avivaromm.wpengine.com/supplements/
      Best of luck,
      ~amanda, APRN

  6. I’ve ordered your book but would like a doctor that supports your findings to assist me in healing. do you have any recommendations of anyone in the Grand Rapids Michigan area?

    many thanks,

Leave a Reply

Your email address will not be published. Required fields are marked *

clear formPost comment