Is Epstein-Barr Virus Reactivation the Underlying Cause of Your Fatigue?

As many as 9 out of 10 adults carry the Epstein-Barr virus, which is the pathogen responsible for the infamous “kissing disease”, or mononucleosis. But unlike other viruses, this pathogen isn’t completely defeated by your immune system once you catch it, and can hide dormant for years, waiting until something triggers its reactivation.

Functional medicine will help you understand what the Epstein-Barr virus is, which risks can trigger it’s reactivation, and why researchers believe this sneaky virus might be responsible for more problems than they thought.

Want to learn more?

What is the Epstein-Barr Virus?

Epstein-Barr (EBV) is a member of the herpes virus family, and is one of the most common viruses in the world–found in as many as 9 out of 10 adults. When exposed in early childhood, symptoms can resolve largely unnoticed. EBV spreads mainly through saliva, which is why mononucleosis–or mono–which is caused by EBV, is known as the “kissing disease”.

Initial EBV infection symptoms often include fever, sore throat, and swollen lymph nodes.

Exposure to EBV causes mono in about a quarter of all cases, but can also cause more serious and even fatal conditions which affect the brain, spinal cord, and nervous system–especially in those with compromised immune function (1).

Extreme fatigue is a common occurrence in mono infections as well as among other conditions caused by EBV.

Are you struggling with Chronic Fatigue or myalgic encephalomyelitis (ME)? Reach out to an integrative doctor at CentreSpringMD to resolve the root causes behind this misunderstood condition.

Epstein-Barr Remains Dormant After Initial Infection

Similar to other viruses in this family, once you’re exposed to EBV, it lies dormant in your body even after the initial symptoms subside.

Specialized immune cells (namely, CD4 and T cells) keep the virus dormant, and as long as you remain healthy, your immune system maintains control of EBV in its inactive state.

As many as 9 out of 10 adults carry the Epstein-Barr virus, which is the pathogen responsible for the infamous “kissing disease”, or mononucleosis. But unlike other viruses, this pathogen isn’t completely defeated by your immune system once you catch it, and can hide dormant for years, waiting until something triggers its reactivation.

However, if your immune system becomes compromised, like when it’s fighting another illness, undergoing significant stress, hormonal changes like menopause, or immunosuppressant drugs, EBV can take this opportunity to come out of hiding and attack your B cells, another important class of cells involved in immune function (2).

Unfortunately, symptoms of the reactivation of Epstein-Barr can be broad, and often mimic those of other problems, and that of aging or stress. This delays diagnosis and treatment options for many patients.

Symptoms of Epstein-Barr Reactivation:

  • Extreme fatigue
  • Fever
  • Sore of inflamed throat
  • Swollen lymph nodes in the neck
  • Enlarged spleen
  • Swollen liver
  • Skin rash (1)

Epstein-Barr can also cause autoimmune flares, or new or worsening autoimmune conditions like Hashimoto’s thyroiditis.

Other Conditions Linked to EBV

In addition to experiencing symptoms of EBV reactivation, sometimes Epstein-Barr can be an underlying cause of other problems, and it isn’t until those other problems worsen that a patient will finally seek medical treatment.

When EBV comes out of its latent state, it attacks your body’s B cells–a type of white blood cell–which can impact various organs and tissues, in addition to increasing your risk of some cancers.

EBV can be an underlying cause of:

Chronic fatigue syndrome

Thyroid disease

Autoimmune conditions

EBV is also linked to different types of cancer, including Hodgkin’s lymphoma, B cell lymphoma, Burkitt’s lymphoma, and nasopharyngeal carcinoma (cancer in the back of the nasal passage) (3).

These conditions all share a common link in the way EBV impacts immune function. Scientists believe it’s likely we don’t yet realize how often this virus is linked to more serious conditions that interfere with healthy immune function.

What Causes the Reactivation of Epstein-Barr?

Your immune system is effective at keeping EBV in its latent state, but certain things can weaken the immune system and increase the likelihood that Epstein-Barr comes out of it’s inactive state.

Triggers for the reactivation of EBV include anything that places an increased burden on the immune system, such as:

IV therapy is one effective way to support immune function and address nutrient deficiency,

ensuring higher absorptionand therapeutic benefits at concentrations far beyond that or oral supplementation.

How Epstein-Barr Triggers Autoimmunity

Infection with Epstein-Barr has been shown to trigger autoimmunity by essentially “switching on” the expression of genes involved in several autoimmune disorders.

One study done in 2018 showed that EBV may trigger some cases of (4):

  • Lupus
  • Multiple Sclerosis
  • Rheumatoid Arthritis
  • Inflammatory Bowel disease
  • Type 1 Diabetes
  • Juvenile Idiopathic Arthritis
  • Celiac disease.

This study shows that a protein produced by the virus, called EBNA2, binds to DNA and affects the expression of genes nearby.

The scientists in this study wanted to note, however, that this virus isn’t the only factor responsible for the activation of these genes. Other illnesses, exposure to toxins, an unhealthy lifestyle, and diet all play a role in the epigenetics of disease.

Diagnosing Epstein-Barr Reactivation with An Integrative Doctor

EBV infection can be confirmed with a blood test that detects antibodies, however, since about nine out of ten of adults have these antibodies from a past infection, it’s generally only when they’re elevated that indicates a reactivation of the virus.

Common tests for Epstein-Barr reactivation include (5):

VCA/IgM antibodies test

EBV Early Antigen (IgG) test

Treatment for Epstein-Barr Reactivation with Functional Medicine

There isn’t a cure for EBV, so integrative treatment for Epstein-Barr reactivation involves promoting conditions in the body which prompt the virus to return to it’s dormant state.

Functional medicine can treat EBV reactivation through:

  • Repairing leaky gut – This decreases inflammation and overall immune burden by removing inflammatory and immunosuppressive foods.
  • Correcting nutrient deficiencies – Providing the immune system with the fuel it needs to mount the appropriate defense against pathogens.
  • Reducing stress – Stress is a common driver of immune dysfunction, and can cause the resurgence of other immune conditions as well.
  • Addressing other current infections – This alleviates the increased burden on the immune system.
  • Optimizing detoxification – This includes digestion, the liver, kidney, and respiratory function.

Finding an Integrative Doctor to Treat Reactivation of Epstein-Barr

Many conventional doctors don’t think to test for EBV or it’s antibodies, especially because symptoms of Epstein-Barr virus reactivation can be broad, and so closely resemble those of other common conditions.

If you’re experiencing symptoms of Epstein-Barr reactivation, a functional medicine doctor will help address the need for pharmaceuticals, supplements, and diet & lifestyle that will help put the pathogen back into it’s dormant state.

Did you know that viruses like Epstein-Barr could be reactivated? What questions do you have about protecting your immune health? Contact a CentreSpringMD provider to learn more!


  1. https://www.cdc.gov/epstein-barr/about-ebv.html
  2. https://www.nature.com/articles/1210240
  3. https://www.cancer.org/cancer/cancer-causes/infectious-agents/infections-that-can-lead-to-cancer/viruses.html
  4. https://www.nih.gov/news-events/nih-research-matters/epstein-barr-virus-autoimmune-diseases
  5. https://jcm.asm.org/content/47/10/3204


EBV, Epstein-Barr Virus, fatigue, Immune health

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