Submitted by David Overton, Natural Medicines & Family Practice
Cytomegalovirus is a parasite that only grows in human cells. It’s also known as herpes type 5 or CMV. It’s implicated in immune dysfunction, inflammation, fatigue, viral infections, “candida”, “fungal infections”, congenital problems, genetic damage, circulation problems, cardiovascular diseases, clotting problems, fibromyalgia, musculoskeletal problems, chronic pain, neurological problems, gynecological infections and problems and more.
In fact, viral infections such as CMV are the #1 cause of enlarged hearts (seen on cardiac ultrasounds and sometimes with an ECG). I got into testing and treatments of CMV and other infections for circulation problems and heart disease, but saw the patterns, found the research and treatments about other infection problems. CMV and other viruses (see my articles on the website) can produce a wide variety of problems, especially if your immune system is not optimal. CMV and other infections may infect white blood cells (lymphocytes, monocytes, macrophages, others) and can suppress immune responses. CMV infection initially causes “cold” symptoms, sore throats or mononucleosis like symptoms than can be minor or more significant. It may clear up or become dormant and cause subtle problems later.
CMV is transmitted in saliva, respiratory droplets, urine, stools, vaginal secretions, semen, breast milk, infected blood and other secretions. It’s a common, widespread and easily caught infection. 2.5% of children have CMV in the neonatal period, with classic or not so obvious symptoms.
The initial infection can be severe but is commonly quite mild and may induce immune suppression by infecting the white blood cells. It can either resolve or progress slowly over time. Like other infections, CMV can avoid immune system responses by:
- infecting white blood cell, stem cells or bone marrow cells
- down regulating (turning off or down) immune defenses, such as the cytokines (interleukins) or tumor necrosis factor (TNF) and other immune signals.
Like other viruses, CMV can either activate (cause problems) or avoid immune detection by:
- lymphocytes (natural killer cells, antibody producing cells)
- monocytes (white blood cells that fight or suppress infections and mop up inflammation)
- eosinophils (specialized white blood cells that predominate if tissues are invaded)
- macrophages (have functions similar to lymphocytes and monocytes)
- dendritic cells (specialized white blood cells imbedded in many tissues, such as the digestive tract, nervous system, others)
This means CMV can hide from immune defenses and actively suppress immune responses. If so, you may not develop classic symptoms or have only mild symptoms that can come and go. Once a person is infected, the virus remains latent (dormant) in the white blood cells or other cells. CMV, like other infections can reactivate from time to time. Since it can turn down immune responses, the symptoms may not be obvious, unless the clinician is trained to consider them and/or tests are done to diagnose and manage the infection.
As if this wasn’t enough, CMV often overlaps with Ebstein Barr Virus, other herpes strains, parovirus, coxsackie virus or other infections, such as mycoplasma or Chlamydia pneumonia. See my article on Sore Throats or other infections (on the website) to get the concepts. See my articles on When to Consider Immune Problems or Infections (on the website) to see how we get the clues or put the picture together.
Childhood infections: In 95% of congenital infections there are no symptoms, but the infection may silently progress. Problems that suggest CMV or other viral infections include neonatal illness or infection, small birth weight or size, jaundice, anemia, bleeding or bruising, rashes, pneumonia, failure to thrive or hepatitis. Despite a lack of symptoms, infected children continue to shed the virus in urine or saliva for months to years, potentially infecting parents, other children and child care providers. Hearing problems, intelligence problems and neurological problems can develop.
In young healthy children or adults, CMV is almost always without obvious symptoms and 50-100% of people have antibodies to CMV. CMV overlaps with the common cold, sore throats, sinus problems, mononucleosis and various other infections (see my article on sore throats on the website).
Medical references will invariably say CMV only rarely causes problems in immune compromised individuals but remember, CMV like other viruses and infections may compromise the immune system all by itself. In addition, immune compromise is now defined as being caused by or associated with obesity, a bulging belly, insulin resistance (“blood sugar problems”), high cholesterol, emotional states, a variety of medical conditions, smokers (nicotine and marijuana), a variety of over the counter or prescription drugs, street drug use and other common problems.
CMV can infect the skin (rashes), saliva glands, lymph glands, throat, eyes (pink eye), nose and sinuses, lungs, arteries, heart, digestive tract (colitis), liver, kidneys, testicles, cervix, red blood cells, nervous system, joints and musculoskeletal system. This may cause very subtle or sometimes obvious symptoms that may come and go.
The latest CMV research from Harvard (Associated Press, 5/09) involved injecting CMV into mice. Those mice with high cholesterol developed high rates of arteriosclerosis and high blood pressure. Furthermore, CMV caused release of kidney hormones resulting in high blood pressure. We commonly use ACE, ARB drugs or spironaldactone cardiovascular drugs to block these hormones in humans. Perhaps patients taking these drugs have a treatable CMV infection.
How do we diagnose CMV, other viral or subtle or chronic infections? First, no tests are needed. It is acceptable to just treat symptoms. Next, various tests are available to help with diagnosis and management of infections. You may want to read my article Tests to Detect or Manage Chronic Infections on the website. Some of the best tests check
- antibodies for infections. Older and newer methods of antibody detection have pluses and minuses. This is critical because antibody tests have not been standardized from lab to lab. IF I ORDER ANTIBODY TESTS, ONLY DO THEM AT THE LAB WE DIRECT YOU TO.
- Activated lymphocyte (white blood cell) panel
- Natural killer cell panel. Natural killer cells kill infections and mutant cells to prevent cancer.
David Overton, PA-C works at Natural Medicines & Family Practice integrating conventional and alternative approaches under the supervision of Dr. Richard Faiola, MD, ABFM.
References: Pathological Basis of Disease, 8th Edition, 2010, Robbins and Cotran.
