“I feel like I’ve been hit by a truck.”
“I can barely drag myself out of bed to get to the kitchen, and that’s all the energy I can master. Then, I’m totally spent for the day!”
These are the exact words I hear so often from new EBV Recovery Program students when they first find our community. I also hear this from the EBV global community at large, when people reach out to me in Clarity Sessions, describing their EBV fatigue or what feels like chronic fatigue syndrome. This is how it feels to have CAEBV, indescribable exhaustion day in and day out. This fatigue is extreme and debilitating, preventing a person from living their life and performing the simplest daily activities most people take for granted, often leading to depression, isolation, and destitution. But there is hope!
What does medical literature
say about fatigue and EBV?
According to medical literature, fatigue is present in 90% of cases of mononucleosis, the acute infection stage of EBV (Odumade et al., 2011). However, while Epstein-Barr Virus is often the infection that triggers this chronic fatigue syndrome (the type of heavy exhaustion that is much different than just the “traditional” feeling of fatigue or exhaustion), doctors do not often make this connection. This is despite the fact that medical literature says so. Doctors have no time to read medical literature.
It is established in studies that many cases of
chronic fatigue syndrome follow an acute viral infection (Eligio, 2010).
Studies of patients with infectious mono caused by EBV show that a small proportion will not recover from post-infection fatigue and later develop chronic fatigue syndrome (Chronic Fatigue Going Viral, 2010), it is at that point that many of those people reach out to us seeking help. There is a medical term for it called “chronic mononucleosis syndrome” or “chronic Epstein-Barr syndrome” (Buchwald et al., 1987). The substantial overlap between chronic active EBV and chronic fatigue syndrome has been proposed by Eligio (2010).
Are doctors aware of this? Mostly they are not.
In one family medical practice, 21% of 500 unselected patients seeking primary care for any reason were found to be suffering from chronic fatigue syndrome consistent with CAEBV infection.
Symptoms included severe fatigue, usually cyclic, for a median
of 16 months (ranging from six to 458 months). Not a typo: that is
up to 38 years! Associated with sore throat, myalgias (muscle pain),
or headaches; 45% of the patients were periodically bedridden,
but they did not have a recognizable illness (Buchwald et al., 1987).
I wish they had done proper EBV testing in that study! You can do proper testing direct-to-consumer here.
The unreal, heavy, indescribable fatigue (and brain fog) is THE hallmark symptom of chronic EBV and the number one complaint in a person with this virus.
Why is fatigue one of the main presentations of EBV?
The shortest answer is: oxidation.
Simply put, Epstein-Barr Virus produces
massive amounts of oxidation.
The longer answer is: it’s complicated. I will map out some other areas of concern for you that I find most relevant.
Let’s start with oxidation…
Oxidative stress is a fact of life. In the 1950s, a new paradigm called free radical damage was introduced, saying that…
Free radicals cause premature aging and cellular damage.
We have learned that bad quality oils in diet, smoke,
radiation, and environmental toxins cause oxidative stress on your cells.
Oxidation cannot be avoided. We see this in nature when you leave a bike out in the elements for a few months and watch it rust. Or when you slice an apple and leave it out on a plate to brown. It’s why we squeeze lemon juice onto mashed avocado: the antioxidants in lemon will stall the process of oxidation.
How does the human body deal with this ongoing oxidation?
Normally, we do not notice this oxidation when we are healthy and eat well. Why? Because in a healthy diet, you consume antioxidants. Humans are supposed to consume antioxidants daily! Antioxidants are THE main way a human body deals with ongoing oxidative stress. And they have to come from food. After reading this you will never look at food the same way, especially fruits, which have the highest antioxidant value (see the ORAC chart on our EBV Diet page for more details). Many minerals and amino acids are antioxidants too, for example, zinc, selenium and N-acetyl cysteine (which are all important components in our EBV Supplement Bundles)…
Free radical damage from this ongoing oxidation driven by EBV
is predominantly the reason why you feel so exhausted.
You may not have known to load up on antioxidants (fruits but also nuts, seeds, vegetables, and antioxidant supplements) for EBV. But now you know, so let this inform your food choices moving forward! You need so much more protection than an average person.
In extreme cases of oxidative stress, such as with seasoned marathon runners you see a high risk of dropping dead with a cardiac arrest and you will notice premature aging. Exercise creates oxidative stress. A marathon is a very long, extreme insult of oxidative damage.
In the early stages of healing from chronic EBV many will notice that exercise triggers reactivation due to the increased amount of oxidation and other factors I’ll elaborate on below.
Fatigue and the Vagus Nerve hypothesis
The Vagus Nerve starts at the base of your brain and innervates much of the intestinal tract. Iit has been called a wandering nerve since it is so prevalent throughout the body. As you can imagine it is very important for the body. The hypothesis by VanElzakker states that EBV can infect the vagus nerve (2013). In that scenario, the vagus nerve receptors tell the brain about the EBV infection, which then causes the shutdown of the body by sending signals like fatigue, flu-like symptoms, pain, etc. The body is told to slow down and stop processing, eating, thinking, etc.
According to this hypothesis, EBV can cause localized immune system activation around the vagus nerve, and, since it is localized, it will not show positive in blood work and will be missed in medical practice. Interestingly, animal studies do show that infection of the vagus nerve causes fatigue and flu-like symptoms, while that doesn’t happen when the vagus nerve is cut off (I feel horrible about the animals used for this study, on a personal note).
The immune system under EBV insult
EBV is extremely taxing on the immune system. The body is trying to defend itself against the virus and works hard on this 24/7 even while you’re asleep.
However, when EBV goes chronic (causing oxidation),
and you continue to exercise (more oxidation)
because your doctor told you to in order to feel better, and you do not
take extra antioxidants in diet AND supplements (more unchecked oxidation!),
there are only so many immune soldiers the body can continue to produce for you.
Here are examples of how the stress on your immune system can keep the virus on with continued subsequent fatigue. Here is what we see in studies:
- IgA immunoglobulins: In a group of fatigued and over-trained elite athletes, there was a decrease in concentration of IgA immunoglobulin in the saliva, symptoms of fatigue consistent with EBV reactivation, and increased shedding of EBV (Clancy et a., 2006)
- Gamma interferon: In the same study, there was exercise-induced depletion of gamma interferon, one of the key anti-EBV fighters that we use therapeutically in our EBV Recovery Program. We have plenty of studies demonstrating how important gamma interferon is for EBV and that decreased levels have been seen in chronic EBV (Flavin, 2006)
- Natural killer cells – low cytotoxicity and elevation in numbers (Flavin, 2006)
- Peripheral lymphocytes – altered (Flavin, 2006)
- Elevated numbers of B cells (Flavin, 2006)
Deficiencies in diet
We have studies confirming that as your nutritional status drops, EBV will become more “virulent”, meaning more aggressive. You probably also remember times when you did not eat too well and you felt much more fatigued from EBV. This is true in general and with particular nutrients. I will give you three examples today: folate, selenium, and CoQ10. But these are just three examples!
Folate is a B-vitamin that is found in “foliage”, so think of foods that grow like lentils or lettuce. A substantial percentage of the US population has a genetic impairment and cannot methylate folate from food properly, and this can have detrimental effects on your ability to curb EBV and your fatigue.
I always recommend a fully methylated folate in supplementation for our EBV program students and suggest staying away from folic acid, a form that cannot be used much if you have this methylation impairment. We do not have studies on the fully methylated form (readily available in supplements), but we do have a study on an intermediate form available in supplementation called folinic acid.
In a group with chronic fatigue syndrome, with 100% being positive for prior EBV exposure and 72% for EBV reactivation, “a remarkable 81% of chronic fatigue syndrome patients experienced subjective improvement of their symptoms after treatment with folinic acid” (Lundell et al., 2006).
Deficiency of folate can be due to poor diet and the MTHFR gene SNP.
You may have higher needs for the more methylated folate due to EBV:
folate is a stress vitamin. It is depleted in stress and has to be replenished daily.
This is why all our students are recommended a solid B complex (that you can purchase from our Shop here), with methylated folate.
Deficiency in selenium can trickle into EBV reactivation and thus more fatigue. Selenium is very well studied for the various ways in which it curbs the virus. For today’s conversation, let’s just focus on the fact that selenium curbs NFkB that the virus uses to replicate (Maehira, 2003) and its deficiency leads to viral pathogenesis (Beck, 1999). Soil is depleted, so less selenium gets into the produce we eat, and so selenium deficiency is a global epidemic (see my video training on selenium). We have a nice infographic on Selenium here.
Coenzyme Q10 is an antioxidant that provides cellular energy and is affected if your mitochondria get hit by EBV (EBV targets your mitochondria- we discuss this below in more details). CQq10 decreases with age. It is also depleted by statin medications – which presents quite a risk since the highest concentration of CoQ10 in your body is in your heart. CoQ10 curbs NFkB as well, stalling EBV replication. Low COQ10 leads to more fatigue. My recommended CoQ10 supplements: in capsule form and in isotonix form.
Mitochondrial damage and your fatigue
Imagine one of your cells as a hard-boiled egg. You cut it in half and see the yolk—that is your nucleus. Then imagine miniature sausages suspended all over the white of the egg—these are organelles called mitochondria. Every cell has several. They are a little bit like the radiator in your home: their job is to produce cellular energy and distribute it, just like your radiator distributes heat in the room.
Healthy mitochondria ward off free radicals and oxidation.
When CAEBV causes you to be extremely fatigued,
that stems from your cells being very fatigued.
Your cells may be fatigued because your mitochondria are weak.
When your mitochondria are tired, you are too.
What that means is that when mitochondria are not able to make the needed cellular energy (called ATP), neither can the body. ATP is the single most important energy currency in the body, a little bit like dollars in the U.S. economy.
What happens to the mitochondria?
They are extremely sensitive to oxidative stress and free radical damage, both of which are created by EBV, as well as your nutritional status (all of which we just discussed). Your mitochondria rely heavily on specific nutrients. When EBV invades your cells, it damages them, and that includes mitochondria.
In fact, mitochondria are so important to your cells that they are a target for all pathogens, including viruses. The EBV-induced damage to mitochondria from oxidative stress is fast: the host cell can be affected as soon as within 48 hours (Anand et al., 2013). Mitochondrial damage is responsible for many chronic diseases, aging, and death, but for most of my new clients, it also feels awful: you feel exhausted, as if that proverbial truck ran you over.
I discuss other mitochondrial functions in more detail in my EBV Solution book.
Other factors adding to your EBV fatigue
There are many other ways in which EBV can add to your fatigue, for example through environmental toxins, wi-fi technology, and stress. Actually the topic of “Why EBV Causes fatigue” could take an entire book to explain! This is probably why it took me this long to put this blog together.
Fatigue is the number one complaint and concern in the vast majority of those affected by both acute mono and chronic active EBV, and this is the topic I discuss in one form or another probably every single day in our free Facebook group “Dr.Kines EBV Community” where people reach out to me. I do weekly free live trainings there.
I hope you now can discern the important patterns to help yourself as you go about your day. I also hope you have a new appreciation for the natural tools this planet created for humans (antioxidants) to help with EBV (and other viral infections for that matter).
Our bodies are working so hard to turn off the virus,
but without your extra strategic and focused help, it is a losing game.
At the same time, may this be a message of hope:
because you have so much power in your hands
to start turning off the virus and turning on your energy!
One of my biggest joys in my professional life (which also spills into my deepest personal joy) is the fact that over the years, I have been able to hone in on exactly what lifestyle, diet, and what therapeutic dosages of multitaskers supplements we need to start turning off the virus so that in our EBV community, people like you are getting their energy and life back.
Seeing lives transformed is what keeps me going with my EBV advocacy.
If you want to get rid of your chronic fatigue completely, here are some of the stories of our students that did just that, to inspire you and give you hope that indeed, you too can live your life and leave EBV behind.
Anand, S.K. and S.K. Tikoo, Viruses as modulators of mitochondrial functions. Adv Virol, 2013. 2013: p. 738794.
Beck, M.A., Selenium and host defense towards viruses. Proc Nutr Soc, 1999. 58(3): p. 707-11.
Buchwald, D., J.L. Sullivan, and A.L. Komaroff, Frequency of ‘chronic active Epstein-Barr virus infection’ in a general medical practice. JAMA, 1987. 257(17): p. 2303-7.
Chronic fatigue syndrome: going viral? (2010). Lancet, 376(9745), 930. doi:10.1016/S0140-6736(10)61432-8
Clancy, R.L., et al., Reversal in fatigued athletes of a defect in interferon gamma secretion after administration of Lactobacillus acidophilus. Br J Sports Med, 2006. 40(4): p. 351-4.
Eligio, P., Delia, R., & Valeria, G. (2010). EBV Chronic Infections. Mediterr J Hematol Infect Dis, 2(1), e2010022
Flavin, D., F, Reversing splenomegalies in Epstein Barr Virus infected children: mechanisms of toxicity in viral diseases. J Orthomol Med, 2006. 21(2): p. 95-101.
Lundell, K., et al., Clinical activity of folinic acid in patients with chronic fatigue syndrome. Arzneimittelforschung, 2006. 56(6): p. 399-404.
Maehira, F., Miyagi, I., & Eguchi, Y. (2003). Selenium regulates transcription factor NF-kappaB activation during the acute phase reaction. Clin Chim Acta, 334(1-2), 163-171.
Odumade, O. A., Hogquist, K. A., & Balfour, H. H., Jr. (2011). Progress and problems in understanding and managing primary Epstein-Barr virus infections. Clin Microbiol Rev, 24(1), 193-209.
VanElzakker, M.B., Chronic fatigue syndrome from vagus nerve infection: a psychoneuroimmunological hypothesis. Med Hypotheses, 2013. 81(3): p. 414-23.