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Is Reactivated Epstein-Barr Causing Your Chronic Fatigue? Here’s How To Tell (And What To Do About It)

Laura D’Itri
Jul 27, 2018 · 8 min read

Hey there! I’m Laura. I’m a certified functional medicine practitioner and I specialize in helping women recover from Chronic Fatigue Syndrome (CFS). Some research has suggested reactivated Epstein-Barr Virus plays a role in CFS1, although findings are somewhat controversial. Clinically, however, I find reactivated EBV is at least partially responsible for CFS in around 30% of the women I work with.

Epstein-Barr is the virus that commonly causes mononucleosis, a.k.a. “mono” or glandular fever, but it can stay in the body and silently wreak havoc long after the mono phase is over. This virus can live in someone for decades, sneaking in and out of activity because of stress or other imbalances in the body.

Reactivated Epstein-Barr can cause fatigue/exhaustion, anxiety and depression, systemic inflammation, muscle and joint pain, brain fog, swollen glands in the neck, Hashimoto’s or hypothyroidism, and it’s linked to fibromyalgia, chronic Lyme disease, and multiple other autoimmune diseases as well.

By the time you’re done reading this article, you’ll know if you most likely have reactivated Epstein-Barr, AND you’ll learn my favorite botanicals and supplements for recovering.

How To Test Yourself

First, talk with your doctor or practitioner about getting a lab that shows all four EBV antibodies. These antibodies include EBV VCA IgG, EBV VCA IgM, EBV EBNA IgG, and EBV EA IgG.

Interpretation of the EBV blood test in the way I’ll describe is pretty accurate, but not 100% accurate according to the medical literature. There are no definitive results when it comes to most lab tests, but these four antibodies give us a pretty good picture.

The most common picture of reactivation will be when the EBV EA IgG marker is raised beyond normal limits. This is the most important marker for understanding reactivation, and has been shown to be elevated in 10 out of 11 cases of reactivated EBV. The issue with this marker is that it’s also elevated in 20–30% of patients that are perfectly healthy now but did have a past Epstein-Barr infection like mononucleosis.

The EBV VCA IgG and EBV EBNA IgG markers will generally stay elevated for life. If only these two are elevated, you’re likely looking at a past infection. However, if either of these are in the triple digits, you may be “prone” to reactivation. Take note if you experience flu-like symptoms that come in waves, as this could be a sign of EBV rearing it’s head!

I find VCA IgM is rarely raised in reactivation and is usually raised in initial infection only (mononucleosis/glandular fever).

The typical picture of reactivation will be elevated EA IgG, VCA IgG, and EBNA IgG. If your antibody picture varies from this a bit but you’re still experiencing exhaustion, brain fog, swollen lymph nodes in the neck, hypothyroidism, and a sore or dry throat… EBV may still be reactivated. Talk with a practitioner that’s fluent in understanding EBV for more info.

Now that you know if you’re likely dealing with reactivation of EBV, let’s take a look at specific, scientifically studied botanicals and supplements to help get rid of it.

Note that the goal of recovering from reactivated EBV is to get the virus to go back into a “dormant” state.

Which Supplements & Botanicals Kill EBV?

Multiple different vitamins and minerals have scientific links showing their benefit to boosting up the immune system to attack viruses. These include vitamin A, D, methylated B12, C, and zinc.

The best direct anti-viral herbs and supplements for EBV include boswellia, turmeric, ginger, licorice (not DGL), selenium, alpha lipoic acid (caution if you have amalgam/mercury fillings), CBD oil, baicalin/Chinese Skullcap, passionflower, reishi, berberine, and lysine.

Some of the best herbs and supplements to support methylation and detoxification for EBV include Hawaiian spirulina, NAC, P5P, and methyl groups such as SAMe, methyl-, adenosyl-, and hydroxycobalamin.

I generally recommend incorporating standard daily values of vitamin A, D, and zinc, although more may be needed if a blood test shows deficiency. If alkaline phosphatase (part of a standard blood test) is lower than 70 u/l, that is generally a fairly good indication of magnesium and/or zinc deficiency. I recommend incorporating fairly large doses of vitamin C and B12 as they are water soluble and can be taken in higher concentrations than vitamins A and D without risk of toxicity.

For the direct anti-viral herbs and supplements, I recommend starting with a heavy dose of 3–5 of these products and rotating or adding in as you recover.

Supporting methylation and detoxification is usually necessary as genetics play a role in these processes as well. It’s especially important if you have the MTHFR gene. So as not to overdo it with supplements, I generally recommend just 1–2 of the methylation & detoxification products at a time.

Other Considerations In The Big Picture Of Reactivated Epstein-Barr

It’s incredibly important to note that “killing” the EBV virus is just the first step. The bigger picture is bringing your body back into a state of balance so the immune system isn’t compromised and the EBV doesn’t take over again. In the greater picture of so many conditions that tend to have “layers” like chronic Lyme, reactivated EBV, adrenal fatigue, hormone imbalance, and Chronic Fatigue Syndrome (CFS), it’s incredibly important to make sure not only are you killing the bad guys, but also supporting detox and methylation pathways, understanding if gut bugs are present, if environmental or mold illness is a factor, if food allergies are present, if autoimmunity against the thyroid or other organs is at play, and if there’s systemic inflammation that’s halting the healing process.

If the big picture of your health is complicated, I highly recommend seeking out a functional medicine practitioner who is well versed in Chronic Fatigue Syndrome (CFS).

Reactivated EBV can start to turn around in as little as 2 weeks, although many need a longer-term program that lasts multiple months to notice a huge difference. If you’re on the right track, you should see your antibodies decrease after 2 months.

After this time, go back to step one and retest yourself for EBV antibodies. If you are moving in the right direction, your antibodies (ANY of the four) should go down. Of course, the most important part is to get you feeling radically better, but seeing absolute proof that what you are doing is working can be a wonderful support!

As with any advice you read on the internet, this info is for educational purposes only. Before implementing any changes in your diet/lifestyle/supplement routine, be sure you talk with your own doctor to understand if these suggestions are appropriate for you.

All the best in your radical recovery from reactivated EBV,

Hey there! I’m Laura. I’m a certified functional medicine practitioner and I specialize in helping women recover from Chronic Fatigue Syndrome (CFS). Some research has suggested reactivated…