Submitted by David Overton, Natural Medicines & Family Practice
Ebstein Barr virus (EBV) is a parasite. It’s one of the herpes viruses, specifically herpes type 4 (see my article on the website on herpes types). EBV is transmitted by close contact with other humans and starts as a “cold”, viral infection, flu or sore throat. EBV is spread in saliva, respiratory secretions and possibly other secretions. The initial infection starts in the nose, throat, tonsils or neck lymph nodes. It can spread to the deeper lymph nodes or lymph system throughout the body, which we cannot feel but we may see on scans. Common symptoms of EBV include malaise, fatigue, disturbed appetite or just swollen lymph glands. Other symptoms can involve the immune system, inflammation, fatigue, fibromyalgia, circulation problems, heart problems, nervous system problems, eyes, esophagus, lungs, eyes, liver, kidneys, bone marrow or spleen.
EBV infects the white blood cells (B lymphocytes). Infected or activated B lymphocytes are not seen on standard blood tests, but are occasionally seen as “atypical lymphocytes”. These B cells spread into the circulation and secrete antibodies, cytokines (interleukins, TNF or tumor necrosis factors, many others), chemokines and may cause a positive “mono” test. However, the mono test is quite inaccurate or only positive for a few weeks in the initial phases. After the initial infection, a latent or dormant phase is established.
The atypical lymphocytes are quite specific and mainly EBV infected CD 8 T cells (lymphocytes) and CD 16 natural killer cells (lymphocytes). CD 8 and natural killer cells are designed to coordinate immune responses to suppress or kill infections. These functions can be suppressed by viral, mycoplasma, Chlamydia or other infections.
CD 8 and natural killer cells increase in number in the lymph tissues and may cause infected or enlarged lymph nodes, liver or spleen. Initially, IgM antibodies rise to suppress the infection, then IgG antibodies rise and remain elevated. However, since EBV, like herpes and other viruses, infects the B lymphocytes that produce antibodies, several things can happen. EBV infections may compromise the immune system all by itself. In addition, the infected B lymphocytes may suppress antibody production and the test patterns may not be what we thought, allowing the virus to escape detection by the immune system and limiting symptoms to subtle problems that come and go. In addition, specific genetic defects some people have limit the symptoms and immune system responses.
This may be why EBV is linked to many conditions that are hard to treat unless you think about and then treat EBV. I got into testing and treatment of EBV because viral infections are the #1 cause of enlarged heart (seen with cardiac ultrasound or sometimes with an ECG). I got into testing and treatments of infections for circulation problems and heart disease, then found the research and treatments about other infectious problems. While no tests are required, I‘ve noted most people want tests to confirm the diagnosis before committing to treatments.
As if that weren’t enough, EBV often overlaps with cytomegalovirus, other herpes strains, parovirus, coxsackie virus, mycoplasma, Chlamydia pneumonia and other infections. Just see my articles on sore throat or When to Suspect Immune Problems or Infections (on the web site) to get the concepts. See my article on Tests to Detect Infections (on the web site) to see how we get clues or put the picture together.
Medical references will invariably say EBV only rarely causes problems in immune compromised individuals but remember EBV, like other infections, compromises 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, 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.
EBV potentially involves the immune system, inflammation, circulation problems, heart problems, nervous system problems, eyes esophagus, lungs, eyes, liver, kidneys, bone marrow or spleen. You can see how EBV could cause wide spread symptoms but not be diagnosed or treated. In a few cases, it can progress to specific forms of cancer. In fact, around the world, EBV is a primary cause of cancer in third world countries, proving it can suppress and alter immune functions. It just seems to alter immune functions differently in developed countries and not so severely as to cause cancer.
How do we diagnose EBV, other viral and 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. 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. Sanford Guide to Antimicrobial Therapy, 37th Edition, 2007.
