A few years ago, I went through a long bout of fatigue. And, I’m talkin’ bone-tired, 24/7 kind-of-fatigue. During that time, I did a lot of exploring “under the hood” with my Integrative, M.D. One possibility we looked into was the Epstein-Barr virus. Ever since, I’ve been wanting to talk with you about this incredibly common infection. Well, today’s that day.
What is Epstein-Barr Virus (EBV)?
The Epstein-Barr virus (EBV) is part of the herpes virus family. Other infections in this family include cold sores, herpes, shingles, and chickenpox. Infectious Mononucleosis (aka mono or the “Kissing Disease”) is probably the most commonly-known way EBV manifests itself.
Infectious Mononucleosis, also referred to as “Glandular Fever” manifests originally with these symptoms:
- Swollen glands
- Extreme fatigue
- Headache/body aches
- Sore throat
- Enlarged liver and spleen
The symptoms of Epstein Barr Virus are usually mild. Because EBV symptoms overlap with other illnesses (sore throat, fever, rashes, etc.), children are commonly misdiagnosed with strep throat or another virus.
And, up to 95% of the population is infected with the Epstein-Barr Virus. The majority of these people are going through life as unknowing carriers. Typically, carriers are symptomless (the virus just hangs around—dormant).
EBV Becomes a Problem When it Reactivates and Attacks the Immune System
The problem is if the virus reactivates due to a stressed immune system (we’ll talk about that in a moment!), it’s a real drag. You’re exhausted, achy, and feel under the weather—all the time. Many people can be misdiagnosed with Chronic Fatigue Syndrome.
Are you experiencing fatigue that no amount of sleep, nourishing food, exercise, or caffeine can shake? Do you often come down with persistent “flu-like” symptoms? If this is the case and you haven’t been able to get to the root of the issue, you may want to look into EBV with your doctor.
Understanding the Epstein-Bar Virus from the Lens of a Professional
To help us understand EBV, I’ve turned to our fabulous friend, Doctor Aviva Romm. Aviva is a Yale-trained M.D. and Board Certified family physician, midwife, and herbalist who is focused on helping women not only heal their bodies and minds but transform their lives. She covers the Epstein-Barr virus in her popular book, The Adrenal Thyroid Revolution.
Now, let’s dig into my conversation with Aviva…
How is the EBV Virus Transmitted and How Prevalent is it?
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). It’s highly prevalent. As you read above, about ninety-five percent of people worldwide have been infected with the virus.
Other modes of transmission can include:
- Blood transfusion (blood is not tested for the Epstein-Barr Virus)
- An infant can contract the initial infection if the mother has the virus
- Food contaminated when someone is cut
- Bodily fluids through sexual contact
You can even be exposed to Epstein-Barr from coming into contact with toys that have been drooled on by an infant that has the virus.
Who is Most Likely to be Infected by EBV and How is it Diagnosed?
Anyone can become infected by the Epstein-Barr Virus. Symptomatic infections with mono seem to be most common in the late teenage years and early 20s. Most of us have been exposed and are asymptomatic carriers in our adult lives.
Women going through major life changes, including the death of a loved one, a major move, a job change, or menopause, for example, may be particularly susceptible to reactivation of the virus, and therefore a symptomatic infection.
To diagnose, your healthcare practitioner can do a simple blood test called a “Complete EBV Acute Panel,” which includes: Viral capsid antigen (VCA)-IgM, VCA-IgG, D early antigen (EA-D), and Epstein-Barr nuclear antigen (EBNA). They can also run a chronic infection panel.
What is EBV Reactivation and What are its Symptoms?
EBV reactivation can persist for months, much like mono can, though it’s usually significantly milder. Reactivation of the virus often happens in times of prolonged stress. Symptoms typically include chronic fatigue, aching muscles and joints, swollen lymph nodes, and other persistent flu-like symptoms. It can also cause malaise and even depression. A physical exam may find a swollen liver and spleen, and liver function tests may be abnormal.
What is Chronic EBV Infection and What are the Signs and Symptoms?
While chronic Epstein-Barr is considered rare, the symptoms are similar to those dealing with reactivation and may be mild to severe. Liver and spleen abnormalities may not be observable or found in this case. Chronic infections occur when the infection remains persistent rather than going dormant, as it should when the immune system is able to keep it under wraps and you’d remain symptom-free.
There are a variety of chronic symptoms, some of which are:
- Muscle and joint pain
- Consistent fatigue
- Dizziness/Blurred vision
- Restless sleep
- Numbness of the hands and feet
There are many more seemingly unrelated symptoms associated with Epstein-Barr.
Is EBV Connected to Other Chronic Infections, like Cancer or Autoimmune Disease?
EBV has been associated with numerous autoimmune diseases such as Lupus, Hashimoto’s thyroiditis, Lyme Disease, and Rheumatoid Arthritis, and is a trigger for multiple sclerosis (MS). EBV is also associated with certain lymphomas (types of cancer affecting B-cells of the immune system).
Why Does EBV Cause Other Infections?
There are a few hypotheses as to why EBV causes other autoimmune conditions:
Also known as the “Bystander Effect,” this happens when the immune system attacks and destroys healthy cells alongside the virus. The virus can also lead to the activation of immune cells that attack the body itself.
Molecular mimicry occurs when your immune system attacks the virus. Some of your tissues may mimic the molecular structure of the virus, which can confuse the immune system, leading it to attack healthy tissue.
Dysregulation in the Immune System
If your body is constantly combating viral infections, it can activate the adrenal glands and lead to adrenal fatigue. In turn, this can lead to immune dysfunction.
Autoimmune conditions are on the rise and it appears that EBV can be linked to decreased immune function.