The Sleeping Giant – Tips to Treat Reactivation of Epstein-Barr Virus

The Sleeping Giant – Tips to Treat Reactivation of Epstein-Barr Virus

Did you know, you probably have virus lurking in the shadows? It’s called the Epstein-Barr virus (EBV) and an estimated 90 percent of us have it. Fortunately, for most of us it lies dormant, like a sleeping giant. Only when something triggers a reactivation of EBV does this virus rear its ugly head.

Epstein-Barr virus is part of the herpes family and also known as human herpesvirus 4. Usually passed through saliva, EBV is the cause of infectious mononucleosis – also known as “mono” or “kissing disease.” Typically, teenagers come down with this condition and first notice there’s a problem when they experience extreme fatigue. Interestingly, extreme fatigue can also cause a reactivation of Epstein-Barr virus.

Though there are many conditions where EBV is the cause or a trigger, extreme fatigue is a unifying symptom that occurs in most cases. Symptoms of an active Epstein-Barr virus, include:

  • Extreme fatigue
  • Fever
  • Sore throat
  • Swollen lymph nodes
  • Enlarged spleen
  • Swollen liver
  • Rash
  • Emotional disturbances and stressors
  • Autoimmune diseases, like Hashimoto’s thyroiditis


How Epstein-Barr Virus Causes Autoimmune Disease

Autoimmune conditions are caused when an overactive immune system begins attacking healthy tissue. We are learning more and more, what often sets off the immune system response in the first place can be a variety of infections, including EBV.

CD8+T cells are types of white blood cells your body uses to keep the EBV virus in check. When there’s an impairment or a deficiency of these cells, the EBV virus is free to run rampant. The amount of CD8+T cells you have can be negatively impacted by age, estrogen levels, and vitamin D deficiency, certain medications and treatments, and poor immune system function. This is important because autoimmunity is on the rise and we need a better understanding of its underlying causes.

If you want to know more about What to Do if You Have an Autoimmune Disease, check out my free guide.

So, what can be done to treat Epstein-Barr? If it’s so common, surely there’s a simple explanation or cure? Actually, the best way to tackle Epstein-Barr is similar to how we deal with an imbalance of gut microbes – manipulate the environment so balance is restored. The most important thing I find is to support the natural immunity and decrease exposures to environmental toxins and other infections.  Let’s take a closer look.


Treating the Epstein Barr Virus

There is no known cure for the Epstein-Barr virus, and therefore treatments should focus on returning the creature back to it’s sleeping or dormant state. So, in order to treat EBV the approach needs to focus on getting the virus back in check, not killing it. This means manipulating the condition of your body – the environment where the Epstein-Barr virus lives.  

When I discover a patient of mine has Epstein-Barr virus, here are the things I consider:

    1. Clean diet and proper nutrition – This reduces inflammation and immune system burden. We eliminate gluten, dairy, allergens, and start a plant-based Paleo diet. Sugar is one of the most powerful immunosuppressives so that must be eliminated at all costs.
    2. Heal the gut – Healing the gut is a priority for anyone dealing with EBV. Toxins can leak through damaged gastrointestinal lining and cause the immune system to overreact.  This process is also known as endotoxemia, driven by LPS.
    3. Eliminate any infections – Check for any coexisting infections and work to treat these. I often think of it as “infectious burden” and work to decrease the load on the immune system.
    4. Reduce toxic burden –  We are bombarded by tens of thousands of chemicals everyday, find out how to Reduce Your Daily Toxin Exposure. It is critical also to decrease total toxic load by eliminating any toxic exposures.
    5. Optimize detox pathways – This includes supporting the liver, kidneys, and colon and may be supported by various nutritional supplements and other homeopathic drainage remedies.
    6. Improving sleep habits – This is essential because so many repairing and detoxification processes occur during the deepest stages of sleep.   I advise no less than 8 hours per night or as much sleep as required to wake up refreshed without an alarm clock.
    7. Reduce stress – Stress is a major cause of immune system dysfunction, it could even be what awakened your EBV in the first place. You must work to reduce stress – your health depends on it. Try prayer, meditation or spending time in nature. Self care must be a priority.   
    8. Herbal supplements – Herbs such as Ashwagandha, licorice, St. John’s wort, lemon balm, ginseng, and holy basil may be used for immune system support and for their antiviral and adaptogenic properties.
    9. Supplements  – I use these for suppressing EBV reactivation
      1. Monolauren: 1800 mg twice daily
      2. Olive Leaf: 1000-1500 mg twice daily
      3. L-Lysine: 1000-1500 mg twice daily
      4. Cat’s Claw tincture: 30-60 drops twice daily

When viruses diminish due to these treatments it isn’t because any of these things attack the virus, but instead they help put your body in a state that isn’t ideal for the virus to reproduce. Hopefully, this strengthens your immune system and returns this typically harmless virus back to it’s benign state.

Other more extreme therapies have have been tried in a few cases, with some success and include:

  • Antiviral medication, Acyclovir or valcyclovir
  • Immune cell therapy when used in a person after a transplant.
  • Bone marrow transplant is an extreme therapy that has been documented in two life threatening cases.
  • Cord blood stem cell transplants.  This is a new but emerging treatment that may be very successful in tough cases.


Ineffective Epstein-Barr Treatments

Though I prefer to offer solutions to health conditions, I want to briefly touch on some treatments of EBV are not effective because there’s a lot of misunderstanding surrounding this virus. In general, the follow treatments only temporarily stop symptoms and only in some people:

  • Antiviral therapy such as ganciclovir and vidarabine.
  • Immunosuppressive agents such as cyclosporine and corticosteroids.
  • Immunomodulatory therapy such as interferon alpha and interferon gamma.
  • Cytotoxic chemotherapy such as anthracyclines, etoposide, cyclophosphamide, vincristine, and prednisone.
  • Infusions of cytotoxic T and lymphokine-activated lymphocytes.

This isn’t to suggest that your doctor shouldn’t temporarily recommend some of these, however, none of these are by any means a cure for Epstein-Barr virus and you should proceed with extreme caution.


Find a Functional Medicine Doctor with Experience in Epstein-Barr Treatments

The science surrounding the Epstein-Barr virus is developing daily. If you think you might have a condition due to EBV, it’s important to find a doctor who’s experienced in conditions related to the reactivation of this virus. If you need help finding a functional medicine doctor, I’ve made a helpful guide to get you started – How to Choose a Good Integrative and Functional Medicine Doctor.

The Epstein-Barr virus is a significant condition I wish more people knew about – Share this article to spread awareness of this sleeping giant.




18 thoughts on “The Sleeping Giant – Tips to Treat Reactivation of Epstein-Barr Virus

  1. Amy says:

    Thank you! This is such helpful information. Bloodwork confirmed that I had somehow reactivated EBV almost 2 years ago and because of some very bad medical advice, I fell into a dark hole of paralyzing ill-health. Through discovering functional medicine (working with Sarah Zielsdorf here in IL) and a lot of research and self-care, I had practiced most of the action points you have mentioned, and have recovered very well with some remaining sleep issues. THANKFUL! I have recently been using Monolaurin (flu season) and have noticed that there are pretty heavy energy dips at the end of the day when I use it, which is otherwise very uncharacteristic of me. Can monolaurin bring about a Herx reaction of fatigue – even this far out from reactivated EBV?
    Thanks for reading – and for all of your great posts! Bless you

  2. Jill Wortman says:

    I appreciate this information as I’ve been reading 2 books that emphasize EBV as a likely culprit in Fibromyalgia/CFS. You mention Acyclovir, which I take when I get a cold sore. Is there any information on the dosage of Acyclovir and the duration to help combat EBV? I feel like I’ve tried everything else and nothing is helping. With 5 kids and a job, I’m pretty desperate!

  3. Teresa says:

    Thank you so much for the article, Dr. Jill – your work is greatly appreciated! As one part of a EBV treatment plan, you mentioned optimizing the detox pathways. I was particularly interested in knowing if you would have any recommendations re: brands of homeopathic drainage remedies.


  4. Claudia K says:

    Hi Dr. Carnahan,
    thank youfor this very interesting article!
    What is your opinion in regards to the effectiveness of treating EBV, as well as other viruses and UV Blood Therapy (I am not sure about the official name for this treatment, when same amounts of blood is withdrawn, which is than exposed to UV light, and re-injected). Thank you very much!
    Best, Claudia

  5. Amber Smith says:

    Have you ever dealt with someone who has positive ebv positive cmv and swollen lymph nodes for two years. Cervical chain that hangs around 5 cm! Been to numerous specialist and get blown off!

  6. Brenda says:

    I’d be interested to see your opinion on the new MS treatment Ocrevus and it’s killing off of certain B cells and it’s effect on EBV.

  7. L Murray says:

    HI – I’m interested in the herxing process – During treatment of EBV, I’ve been told I will go thru this – can you elaborate on this – what is actually going on during this time and how long does it last – does it have a stop & go pattern or is it just one big party – Thank you

  8. CR says:

    I also have ebv, as well as positive rheumatoid factor. Is it possible that the positive rheumatoid factor, which I have read is an antibody, to the fc portion of an antibody, could be related to ebv? Any idea if stem cell injections could help rid ebv or cause harm? Also read EBV worsens copd. I am also a help b vacine non responder. Any recommendations?

  9. DEBBIE says:

    if I had mono in high school….now 60…with high EPV levels…are those levels from high school or new in reinfection?

  10. Emily Wood says:

    When you say “Sugar is one of the most powerful immunosuppressives so that must be eliminated at all costs”, do you mean all sugar including fruit or low glycemic like coconut sugar or just white, can sugar? Thanks!

  11. Naomi says:

    I’ve been struggling with EBV and reactivation over a few years. I’d been feeling well recently until a tooth fractured and I had to have it extracted. I feel like the dental work has reactivated my EBV to some degree. I’m wondering if you’d seen this before and any suggestions. Thanks!

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