Epstein Barr Virus and Mononucleosis
- Fever
- Sore throat
- Fatigue
- Anorexia
- Myalgia (muscle pain)
- Lymphadenopathy (enlarged lymph nodes)
- Splenomegaly (enlarged spleen)
Chronic EBV and Stealth Infections
A “stealth infection” is one that no longer is causing the classical acute symptoms. The patient seems to have recovered. However, the infection stays in the body, causing chronic symptoms.
Over the past few years people in natural health have associated EBV with chronic illnesses such as chronic fatigue and autoimmune disease. One popular author (Anthony Williams) has even written books citing EBV as the cause of autoimmune hypothyroidism. I like to avoid extreme statements. There is not just one cause of all autoimmune disease. However, EBV is more than something which causes mono in teenagers.
The book, The Epstein Barr Virus Solution by Kasia Kines lists many conditions which research shows is associated with EBV. A partial summary is as follows:
- Autoimmune disease (includes hypothyroidism, hyperthyroidism, multiple sclerosis, rheumatoid arthriris, scleroderma, sjogren’s, lupus)
- Brain related illnesses
- Gastrointestinal (includes H. pylori, inflammatory bowel disease, ulcer and GERD
- Acute hepatitis
- Numerous ocular symptoms
Blood Tests for EBV
Complete Blood Cell Count (CBD) with Differential
This the most basic type of blood test for the immune system is the CBD and differential. Doctors run this almost anytime blood worked it ordered.
We have two types of common blood cells. Red blood cells carry oxygen. White blood cell fight off infections. The CBC counts the total number of red and white blood cells. Since we also have several white blood cells, the differential tells how much of each kind we have.
Basic interpretation
The optimal range is where a healthy person should be. Reference range is larger, being outside of it shows there is a condition to treat.
WBC (white blood cell count)
Optimal is 5 to 7.5.
Reference range goes from about 4 to 11.
The WBC increases during acute infections. In case of long term chronic infections is may drop.
Neutrophils
Optimal is 40% – 60%
These help the body fight off bacterial infections. Just like the WBC, neutrophiles can increase at the start of an infection then over time decrease.
Lymphocytes
Optimal is 24% – 44%
Lymphocytes are more specific for viral infections.
In case of EBV there is an initial increase in lymphocytes, which then comes back down to reference range.
Eosinophils
Optimal is 0% – 3%
Conventional 0% – 8%
These can increase in cases of allergies or parasites. Not typically relevant to viral infections such as EBV.
Although the WBC does not say what specific infection someone has, it does show general information about how the immune system is doing. It can help to guide treatment.
Antibody Tests for EBV
Antibodies are made in response to specific infections. These are proteins which allow the immune system target and destroy specific infections.
There are 4 common EBV antibodies:
VCA IgG: During an acute infection these go up. After the infection subsides there stay positive for life.
EBV nuclear antigen (EBNA) IgG: Just like the VCA IgG these increase after the initial infection and then stay elevated for life.
EA (D): These are elevated later into the acute phase of infection and then go back down to normal.
VCA IgM: These increase during acute infection and then go back down to normal.
Problems with antibody tests
Unless someone comes back with a positive EA (D) or VCA IgM, the results can be inconclusive. False negatives are possible. Most people are positive against VCA and EBNA IgG as it is. Yet, people with inconclusive results may respond well to natural protocols for the immune system.
Total IgG and IgM
They can test blood to see if total amount of IgG and IgM are low. If these are too low, then false negatives are the above test are more likely.
PCR testing
PCR is a measurement for viral particles in the blood. This in another test to run in case the antibodies miss the infection.
Do lab tests for EBV really matter?
Testing may help in that if an infection is confirmed, then we know what needs to be treated. Often testing is inconclusive because the antibodies that show past exposure are elevated, but the ones that show recent activation are normal. However, since EBV can cause so many symptoms and it helps to confirm on labs what the problem is, testing for EBV should be done.
Often medical doctors are hesitant to order lab tests past the basics. Or even if they do, they don’t order complete tests. So you may need to tell your MD what tests to order. If that doesn’t work, a naturopathic doctor would probably be more willing to order such tests. Depending on your insurance and where you live, getting tests through a ND may be covered. There are also options in certain states to order labs directly out of pocket. Lifeextensions is one such option.
Coming from a traditional, naturopathic perspective the goal isn’t not to simply treat the infection. Rather we work on treating the whole person, which means working on the immune system (and overall health) in general.