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Reactivated Epstein Barr Virus – What You Need to Know

Image illustrating Reactivated Epstein Barr Virus under a microscope.

Approximately 95 percent of us carry a pathogen called the Epstein-Barr virus (EBV). For many, this virus is caught in early childhood and largely goes unnoticed. EBV isn’t like most infections that are ‘conquered’ by our immune system but rather it ‘retreats and hides out’ in part of our immune system, called our B cells – a type of white blood cell. Unless you have something that triggers reactivation of the virus, you’ll likely go your entire life without ever realizing you have EBV.

Unfortunately, there are many factors at play in our modern toxic environment that are contributing to the reactivation of this virus. Like so many other chronic illnesses that are on the rise in America, we are seeing an increased incidence of reactivated or chronic Epstein-Barr virus in our practice.

So, what’s happening? What’s causing what’s normally an incredibly rare and benign condition to suddenly become such an issue for many? Let’s take a closer look.

Reactivated Epstein Barr Virus – Let's Take a Closer Look. Image of doctor looking through microscope.

Usually, people become infected with EBV as young children or as teenagers. In young children, the virus usually goes fairly unnoticed, however, the initial infection in teenagers is usually characterized by fever and extreme fatigue – better known as mononucleosis or “mono.” Sometimes teenagers call this “Kissing Disease” because it’s passed through saliva into the oropharynx and causes swollen glands. 

The Epstein-Barr virus is also known as human herpesvirus.¹ As with other herpes viruses (cold sores, genital herpes, chickenpox returning as shingles, etc.), you can have an infection once and never have another episode or you can experience reactivation of the virus and have recurrent bouts throughout your life. In the case of EBV, it can become a chronic infection that wreaks havoc in the system.

After the initial infection, Epstein-Barr is normally rapidly controlled and ultimately goes dormant by the body’s robust immune system – specifically by our specialized white blood cells called CD4 + T cells.² These cells are what keeps the virus mostly in check. As long as you remain relatively healthy, your immune system is able to keep EBV dormant.

If for some reason your immune system becomes significantly weakened, maybe due to stressors, toxins including mold/water damaged building exposure, hormone imbalances such as menopause, other infections, or immunosuppressive drugs, for example, this can cause the virus to come out of ‘hiding.’ At this point, it usually attacks your B lymphocytes – another white blood cell.³

Image of person holding their throat, experiencing a sore throat, symptom of Reactivated Epstein Barr Virus.

The 10 Most Common Symptoms of Chronic Active Epstein-Barr Virus

How do you know if your Epstein-Barr virus has been reactivated? The 10 most common symptoms of the Epstein-Barr virus include:

  1. Fatigue – chronic and often debilitating
  2. Severe achiness
  3. Headaches
  4. Sore throat
  5. Rash
  6. Lymphadenopathy (swollen lymph nodes)
  7. Splenomegaly (swollen spleen)
  8. Hepatomegaly (swollen liver)
  9. Liver dysfunction
  10. Thrombocytopenia (abnormally low levels of platelets)

Fever is typically seen in acute infection but not typically reactivated illness.

When we see Epstein-Barr virus in our office, usually our patient comes in thinking they have Chronic Fatigue Syndrome, which can be caused by EBV.⁵ This is the nature of complex, chronic conditions – they often have similar, bodywide symptoms that can be difficult to nail down.

Dr. Scott Antoine and I are both board-certified emergency physicians and Functional Medicine doctors, who have been exposed to thousands of complicated cases such as EBV reactivation. It’s why we are known as ‘medical detectives,’ because unraveling mysteries like the EBV virus takes careful sleuthing. We’ve also developed our Fully Functional® process to aid us and our patients in the careful methodology needed to solve puzzles like chronic active or reactivated Epstein-Barr virus.

Showing an image of blood collection tubes as they relate to testing for Epstein Barr Virus.

Testing for Epstein-Barr Virus

Because nearly everyone has this virus it can be difficult to determine if it has become reactivated. We are able to measure immunoglobulin levels which may help us determine the status of the virus but not always. There are other markers that can be measured but they aren’t specific to the virus and are often not easily accessible. These cytokines (proteins secreted by your immune system) are often elevated in reactivated/chronic EBV and include:

  • Interleukin-1β
  • Interleukin-10
  • Interleukin-13
  • Interleukin-15
  • Interferon-ɣ
  • Tumor necrosis factor-α
  • Transforming growth factor-β
  • Impaired natural killer cell activity (NK)
  • Lymphokine activated killer activity (LAK)
  • EBV-specific cytotoxic T lymphocyte activity

While not always possible, we do our best to IDENTIFY this virus as the underlying cause of your symptoms. From there we can move on through the next steps of the Fully Functional® process, which is critical for helping you become your most healthy, productive, joy-filled self.

Conditions Associated with Epstein-Barr Virus

In addition to various markers caused by an active Epstein-Barr virus, sometimes we find that the virus is an underlying cause in another condition. Often it isn’t until the associated condition gets bad enough that it causes a patient to see their doctor. This is why looking for symptoms and testing for untreated infections is something we always look for in our patients.

Conditions associated with Epstein-Barr Virus include:⁵

  • Chronic fatigue syndrome
  • Thyroid disease
  • Autoimmune conditions
  • Several cancers including:
    • Hodgkin’s disease
    • B cell lymphomas
    • Nasopharyngeal carcinoma
    • T-cell lymphoproliferative disorder
    • Burkitt’s lymphoma

It’s likely we don’t realize how often the Epstein-Barr virus is associated with diseases like cancer. In 2014, it was estimated that over 200,000 cancers were linked to active Epstein-Barr viruses.⁶ Could that number be more? As we get better at identifying reactivated/chronic EBV virus we may find that it’s not as benign as we once thought.

Image of person holding supplements in their hand.

Epstein-Barr Virus Treatment

Treating the Epstein-Barr virus is a complicated process that involves SUPPORTing the immune system. There is no specific cure so we need to do everything we can to help return this virus to its dormant state.

This is where the Fully Functional® process shines. We look at your life in its entirety to IDENTIFY any factors contributing to a dysfunctional immune system, and then we aim to REDUCE them as much as humanly possible. Next, we will OPTIMIZE your body through careful management but also adapting and changing factors until they suit you and improve your health in the best manner possible. Finally, we SUPPORT the immune system, the body, and you through this process. Lastly, we empower you with information and create a more PERSONALIZED long-term plan for you. Complex conditions require in-depth, individual treatment plans, which is exactly why we’ve developed this Fully Functional® process.

Together we will Identify, Reduce, Optimize, Support, and Personalize your Epstein-Barr virus treatment plan so you can experience a reversal of symptoms and a return to optimal health. You don’t have to do this alone, you can book an appointment by clicking here. We are also happy to speak with you at (317) 989-8463, Monday-Thursday, from 8AM – 5PM Eastern time.

Sources:
1
https://www.cdc.gov/epstein-barr/about-ebv.html
2 https://pubmed.ncbi.nlm.nih.gov/15906243/
3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4199828/
4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776035/
5 https://pubmed.ncbi.nlm.nih.gov/22104426/
6 https://news.cancerresearchuk.org/2014/03/24/developing-a-vaccine-for-the-epstein-barr-virus-could-prevent-up-to-200000-cancers-globally-say/

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The Center for Fully Functional Health® is led by a team of award-winning, internationally recognized physicians, committed to providing personalized, life-changing care.

40 North Rangeline Rd. Carmel, IN 46032