When I was taking my pharmacy licensing exam after graduation, I remember thinking that I could never possibly know more than I did at that time—but I have learned so much more since then! Learning is one of my biggest passions, and I’ve found that the more I learn, the more I want to learn. I’m proud to say that I’ve now been a pharmacist for more than ten years. (I graduated from pharmacy school in 2006). I hope to spend the next ten+ years learning even more!
I decided to become a pharmacist at age 16 because I was fascinated by science, chemistry, and medicine; and I wanted to help people for a living! I was a very determined and motivated student, but at one point, during my freshman year of my undergraduate studies, I almost gave up on my dream of going to pharmacy school… I didn’t know it at the time, but it was because of an underlying viral infection that affected my Hashimoto’s.
Without going into too much detail, one of the crucial defining moments in my disease development may have started during my undergraduate studies at the University of Illinois. Due to the communal living setting of dormitories (and less than stellar hygiene habits of most college students, myself included!), I had recurrent strep throat infections and even contracted mononucleosis, a viral infection caused by the Epstein-Barr virus (EBV), which is implicated in triggering many autoimmune conditions.
More than 90 percent of the world’s population has been exposed to this human herpes virus. The virus can take up residence within our thyroid gland where it can live and be inflammatory to our immune system. It can call our immune cells to come into the thyroid gland and attack the virus along with the thyroid gland.
Many people say that this is something that they’ve recognized on their personal health timeline with autoimmune disease—they were perfectly normal until they were exposed to the Epstein-Barr virus. Many people say they never quite felt like themselves again after contracting it, and this was my story too. I was a bright-eyed and bushy-tailed student until it triggered my chronic fatigue syndrome during my freshman year in college.
I believe EBV may have played a huge role as one of my underlying triggers that exacerbated my Hashimoto’s symptoms. I suspect that many people with Hashimoto’s may be suffering from a hidden Epstein-Barr infection in the thyroid gland. When I conducted a survey of 2,232 people with Hashimoto’s, 11 percent of them reported that they started feeling unwell after an Epstein-Barr infection!
In this article, you’ll learn the answer to the following questions:
- What is EBV, and how is it related to autoimmune thyroid disease?
- How can I test for EBV?
- Could EBV be the root cause of my Hashimoto’s?
- What are the conventional and natural treatments for EBV?
- Are there other infections related to EBV?
What is EBV?
Epstein-Barr (EBV) is a virus that causes mononucleosis (also known as “mono” or “glandular fever” in the UK), a debilitating viral infection that is common among college students and is also known as the “kissing disease” because individuals are thought to be exposed to the virus through the saliva of those who are infected.
While over 90 percent of people worldwide have been exposed to EBV, interestingly, the timing of infection seems to be very significant. Children in developing countries usually contract the Epstein-Barr virus when they are under the age of 10, and this usually results in an asymptomatic infection (one that does not cause symptoms). In contrast, in developed countries, where individuals are not usually exposed to the virus until they are in high school or college, the infection is asymptomatic only 50 percent of the time.
When the infection is symptomatic, the most common symptoms include fatigue, sore throat, and swollen lymph nodes. Weight loss is also common. In some cases, the condition resolves in a few weeks, and the person goes back to normal. In other cases, the fatigue lingers, and the virus may contribute to the development of cancers, chronic fatigue syndrome, and multiple autoimmune conditions—including fibromyalgia, multiple sclerosis and Hashimoto’s.
EBV, the Immune System and the Thyroid
In fact, a 2015 Polish study found the Epstein-Barr virus in the thyroid cells of 80 percent of people with Hashimoto’s and 62.5 percent of people with Graves’, while controls did not have EBV present in their thyroid gland. Furthermore, cells suggesting a continually proliferating state—a slowly growing infection—were found in the Hashimoto’s group as well.
When a person is infected with the Epstein-Barr virus, the body’s natural defense mechanisms begin to take aim at the virus. Unfortunately, in a person with poor nutrition and vulnerabilities, the virus may defeat and deplete the body’s immune response, resulting in a low-grade latent infection, as well as multiple deficiencies and imbalances that pave the way for the autoimmune process to take hold.
Moreover, specific immune cells known as CD8+ T cells are needed to fight off the Epstein-Barr virus. However, some individuals may have a low baseline level of these types of immune cells. CD8+ T cells decrease with age, are lower in women, and are also decreased when vitamin D intake is low. When levels of these fighter cells are insufficient, the Epstein-Barr virus may take up residence in our organs (such as the thyroid) and essentially hijack the organ to help the virus hide and multiply.
Thus, it makes sense that people who are exposed to EBV in college are more likely to have problems because by the time we reach college age, CD8+ T cells, the ones that fight EBV, have declined threefold compared to the number of cells we had in childhood.
You may have heard that once you get EBV, you have it for life. The truth is, the Epstein-Barr virus and other herpes viruses persist in their hosts for many years after the initial infection. The Epstein-Barr virus creates a latent infection in the body where it lies dormant until the right time. It can awaken and reactivate itself, even many years after its original activation.
The reactivated virus has the potential to induce the production of thyroid antibodies and has been implicated in many debilitating autoimmune symptoms. In some, the virus may not be properly suppressed and may cause or exacerbate autoimmune diseases as well.
Diagnosis and Testing
Blood tests are used to figure out if a person has a reactivated infection. Testing for viral reactivation may be done through your doctor or through online self-order test kits. You need to be sure to ask for the Epstein-Barr Virus Early Antigen test, as this test will let us know if the virus is actively replicating.
For the most comprehensive look at your markers for EBV, I recommend taking the EBV Panel Plus test, which can be ordered here from Ulta Labs, as only one may come out positive:
- EBV-VCA IgG/IgM (viral capsid antigen): IgG positive means you’ve had or currently have the infection; IgM positive means the infection has been reactivated.
- EBV-EBNA IgG (nuclear antigen): A positive test result is usually associated with past infection.
- EBV-EA-D IgG (early antigen): Positive EA IgG may mean you have an active or reactivated infection.
However, there is emerging evidence that Epstein-Barr may still be problematic even when test results for viral reactivation are negative.
Conventional medical doctors will say that as long as your virus is not reactivated or active, it won’t be causing any problems. However, some experts in the integrative and functional medicine world claim that when the virus is present in the body, when you have a history of it, and when you have an autoimmune condition, the virus does not need to be positive or reactivated to be causing problems in your body.
How Addressing EBV Can Help Hashimoto’s
Addressing the virus may be helpful to you and reduce your symptoms, especially if you have Hashimoto’s. Whenever we address the reactivation, we see thyroid antibodies go down and many people feel significantly better.
The general consensus in both functional and conventional medicine is that you can’t really get rid of the virus, you can only suppress it; so the goal is to try to slow down its replication and reactivation. In recent years, however, I was able to come across some optimistic research finds. When utilizing antiviral medications for a very long time, you can actually eradicate the virus. If it’s not able to replicate anymore, you just end up killing it off.
If someone has a reactivated Epstein-Barr virus, I fully support and encourage following an antiviral protocol to address it. This is definitely also something to consider if you have had a past EBV infection, if your health timeline shows that your symptoms started after contracting the Epstein-Barr virus, or if you’re not in remission from Hashimoto’s.
Taking antiviral medications is one conventional treatment option. Some people with chronic fatigue induced by the Epstein-Barr virus have reported a major improvement in symptoms after taking the antiviral drug Valacyclovir. When taken for at least six years, this medication has also shown the potential of eradicating the virus from our bodies. Some individuals with chronic fatigue, which is often thought to be triggered by Epstein-Barr and other viruses, have reported a remarkable improvement in energy levels on antiviral medications.
There has also been emerging research regarding Rituximab (brand name Rituxan), a medication used for rheumatoid arthritis and certain cancers. A few research reports have suggested that this medication may also induce a remission of Hashimoto’s and Graves’ disease (including Graves’ associated eye disease), as well as an improvement in chronic fatigue syndrome (CFS).
It is possible that this improvement in Hashimoto’s and CFS is due to the drug’s ability to destroy B cells, a type of immune cell that harbors the latent Epstein-Barr virus.
However, it’s important to note that Rituximab is associated with very serious side effects that have resulted in death and disability. Some examples include heart attacks, immune toxicity, and reactivations of other viral infections. This medication is a chimeric monoclonal antibody, which means it’s made from crossing mice and human genes.
As a pharmacologist, I would not recommend this medication as a first line choice for most people with Hashimoto’s due to the significant associated risks. There are much safer interventions that I would recommend.
Suppressing EBV the Natural Way
While eradicating the virus is much more challenging than getting rid of a bacteria or parasite, you can suppress the virus back into a dormant state by supporting your body’s antiviral defenses or through the use targeted antiviral herbs or medications. I have an entire protocol dedicated to eradicating EBV in my new book, Hashimoto’s Protocol, starting on page 329, that you may want to check out!
One herbal treatment in my book involves lomatium, a broad-spectrum antiviral herb with potential therapeutic benefit in Epstein-Barr virus, HPV, herpes viruses, and CMV as well as for prevention of viral infections like the flu and the common cold. Please note: lomatium can cause a one-time rash, similar to a viral exanthem rash, that occurs as the body clears itself of a virus. Often, people will find that this can be reduced by starting off with MunityBoost, which helps to get the body acclimated, for two weeks before introducing the lomatium. You can find the lomatium and MunityBoost bundle here.
If you do not use lomatium, consider these other herbal treatments:
- Cordyceps 750 mg: 2 capsules, 3 times per day for 90 days
- Olive leaf extract: 1 capsule, 2 times per day for 60 days
One of my clients was able to get their thyroid antibodies down to zero and eliminate all of their symptoms. Another person reported that they stopped having cold sore outbreaks, which are caused by herpes one and two. I’ve also seen beneficial results with cordyceps and olive leaf extract, where people are able to significantly reduce their thyroid antibodies and thyroid symptoms.
Of course, medications do come with side effects, as do a lot of herbal protocols, so I recommend that you talk with your doctor about these options to find out which is best for you.
Here are some things that may support your EBV treatment:
- N-acetylcysteine (NAC): Recent studies have found that NAC may be helpful against EBV, as it has been associated with alleviating chronic inflammatory pathologies. I recommend taking 1,800 mg of NAC per day. (As a bonus, this antioxidant also turns into glutathione in the body, supports liver function, and promotes intestinal health!)
- ProBoost Thymic Protein A: Dr. Jacob Teitelbaum, a physician who specializes in chronic fatigue syndrome, recommends 3 packets per day for 90 days to help the body fight viruses.
- Adaptogens (ashwagandha, schisandra, astragalus): to boost the immune system.
- Vitamin D: 5,000 IU per day, tailored to lab testing, to help virus-fighting CD8+ cells.
- Tanning in the sun or at tanning salons can help boost your Vitamin D levels too!
- Vitamin C: 500–3,000 mg per day; or intravenous vitamin C. If you can find a functional doctor that is willing to give you intravenous vitamin C, then I would recommend working with them to determine the appropriate dosings for you. Doing weekly sessions, (ie. maybe two one or two times a week for six weeks), would be a really great start. They should monitor your levels by doing some testing before and after starting treatment.
- Massage therapy can boost CD8+ cells (as well as reduce stress :-)).
- Lysine: This amino acid, which has been used to combat the herpes virus, maintains healthy arginine production, promotes healthy protein synthesis, and boosts immune function.
Additionally, animal fat, broths, soups, and stews support the body’s ability to suppress the virus. The replication of many viruses including Epstein-Barr is found to be inhibited by glycyrrhizic acid, an active component of licorice root, too. Quercetin and Coenzyme Q10 were reported to also be helpful in chronic fatigue syndrome because of their antiviral properties. Furthermore, monolaurin, which is derived from lauric acid, one of the components of coconut oil, has been found to be particularly active against the Epstein-Barr virus. Four tablespoons a day of coconut oil may help break down the fatty, protective layer around the virus.
Other natural antiviral protocols for Epstein-Barr may include the use of immune-supporting mushrooms and colloidal silver. I recommend working with a natural healthcare practitioner to get specific dosing protocols tailored for your own needs. (Need help finding a practitioner who believes in the root cause approach to thyroid disease? Download my FREE clinician and practitioner list!)
Addressing Related Infections
In reviewing the health timelines of numerous people with Hashimoto’s, I’ve found that many of them, like me, will report getting EBV, then irritable bowel syndrome a few years later, followed by a Hashimoto’s diagnosis a few years after that.
I’ve found that many of these people, with a history of EBV in adulthood, also have the gut infection Blastocystis hominis, which has recently been connected to irritable bowel syndrome, hives, AND Hashimoto’s. Interestingly, EBV is fueled by the amino acid arginine, while arginine depletion can cause Blastocystis hominis to be more pathogenic. In the last few years, I’ve noticed that getting rid of the Blastocystis hominis infection can help people to get their Hashimoto’s into remission. Read more about it in my Blastocystis article.
Tracking down an infection can often feel like trying to find a needle in a haystack. It took me a long time to get my health back, and so I hope that this article shortens the learning curve for you. Successful identification and removal of a viral or bacterial infection and its cause can have the ultimate payoff: complete healing from Hashimoto’s—as well as the removal of other conditions and symptoms that may have developed as a result of the infection. So don’t let EBV and Hashimoto’s hold you back from your dreams!
Is EBV the Only Root Cause of Hashimoto’s?
In recent years, more awareness has been brought to Epstein-Barr as the root cause of Hashimoto’s. Some have even made claims that EBV doesn’t just cause every case of Hashimoto’s, but also every case of chronic illness.
While it’s true that most people have been exposed to this virus (some researchers cite as many as 90-95 percent of adults), the EBV is not always a root cause of Hashimoto’s. There are numerous other root causes such as nutrient deficiencies, food sensitivities, an impaired ability to handle stress, an impaired ability to handle toxins as well as a multitude of infections, such as H. Pylori, Lyme, Blastocystis hominis and SIBO, to name just a few.
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