Love is in the Air, But So is Mono?!
The Ominous “Kissing Disease”
The viral infection of many names, mononucleosis, EBV, mono, Epstein Barr Virus, the kissing disease. Whatever you want to call it, it can be problematic in more than one way. A new infection of mono can look asymptomatic, meaning, no symptoms at all. Or you may experience fever, sore throat, swollen lymph nodes, fatigue, enlarged spleen or liver (found on physical exam or imaging like ultrasound), rash, headache & loss of appetite. For the average bear these symptoms can last 2-4 weeks total and then the viral symptoms subside. For others symptoms such as fatigue and enlarged spleen or liver can persist.
Mono can be tricky because it is part of the herpesvirus family. The name “herpesvirus” comes from the Greek word herpein, meaning “to creep,” and boy do they! These viruses have the ability to establish lifelong, latent infections in the body after the initial infection instead of just going away. This means that, even after symptoms have resolved, the virus can remain dormant (inactive) in nerve cells. The problem is their ability to resurface later, causing recurrent outbreaks, reactivation or complications.
Who Are The Players?
This family of viruses are classified based on genetic similarities, and there are eight known types of herpesviruses that affect humans. They are:
Herpes Simplex Virus Type 1 (HSV 1): most known for cold sores
Herpes Simplex Virus Type 2 (HSV 2): most known for genital herpes
Varicella Zoster Virus (VZV): most known for chicken pox or shingles (reactivation result)
Epstein Barr Virus (EBV aka mono): the topic of our discussion
Cytomegalovirus (CMV): most known for being dangerous to pregnant momma’s and their babies
Human Herpesvirus 6 (HHV-6): most known for roseola
Human Herpesvirus 7 (HHV-7): also most known for roseola
Kaposi’s Sarcoma-Associated Herpesvirus (KSHV) / Human Herpesvirus 8 (HHV-8): most known for a certain cancer type associated with HIV/AIDS
Bonus info to think about; Parvovirus B19 is similar to this family of viruses but technicallydifferent in its genetic structure and how it establishes itself in the body. While it does not survive in nerve tissue after initial infection, it can reside in other tissue such as bone marrow and create problems for those with weaker immune systems. In these individuals we may see joint concerns or anemia from persistent infection.
So What If It Sticks Around?
Anywho- EBV is a virus we care about at initial infection and if it persists. In the event of persistent infection or reactivation we can see a myriad of symptoms arise including, everyone’s favorite, fatigue!
In these cases, EBV can lead to more serious complications or chronic conditions, including:
Chronic fatigue syndrome (a condition marked by persistent fatigue that doesn’t improve with rest)
Hodgkin’s lymphoma and other cancers, like nasopharyngeal carcinoma and Burkitt’s lymphoma, especially in people with compromised immune systems.
Autoimmune diseases, such as multiple sclerosis (MS), have been linked to EBV infection in some studies, although the exact connection is still being researched.
Treating reactivated EBV or persistent mono is not an easy thing to do but worth it when trying to protect your quality of life! Fatigue can get in the way of literally everything you may be looking forward to doing or feel you must to accomplish during the day. There are several components of where fatigue can be stemming from (even in the event of mono kicking your booty). Things we need to consider and support are your immune system, your adrenal function and protecting your overall endocrine function.
How Can We Support Your Immune Function?
Mono, since its part of the herpetic family of viruses, will always be with you once you have been exposed, we want to keep it in the background of our lives and not in the forefront. So that means we need to encourage that virus to become dormant. If you are managing a persistent infection, that means your IgM needs to convert to IgG. In these events we think about more of our acute approach to viral care.
Acute Care Considerations:
Vitamin A
Vitamin C
Vitamin D
B Vitamins
Minerals like zinc
Anti-viral herbs
When we are managing a mono reactivation, meaning your Early EBV is elevated in lab work we need to consider other options including those listed above but also:
Chronic Considerations
Pharmaceutical anti-virals
Monolaurin (from coconut)
Gut friendly foods to boost SCFA production
Along with other immune friendly choices to negotiate that marker back down into a normal position.
What About Adrenal Function?
Your adrenals are part of a symphony of organs that work together to help you manage stress, balance energy levels and run other important systems such as blood pressure management.
Infections such as mono and COVID-19 have been associated with the onset of dysautonomia (dysfunction of the autonomic nervous system- in part managed by adrenal function) including POTS. With adrenal function and your nervous system in flux we want to think about botanicals and sometimes animal products to help promote balance. Again we are thinking about vitamins and minerals but also something as simple as a good quality electrolyte can make all the difference!
Endocrine Functionality Matters Too!
Your endocrine system has a wide function from blood sugar control, thyroid function, hormone regulation and more. Mono has been linked to increasing your risk of developing Type I diabetesand we know those who already have diabetes (type I or II) have an increased risk of persistent infections including that of mono and all the fun it brings (obvious joke).
EBV or mono has a possible link to autoimmune thyroid conditions such as Hashimoto’s or Graves disease. We are seeking more evidence to further understand this potential link.
Furthermore we have some evidence to suggest that EBV can even impact fertility outcomes in both women and men. A 2021 study shows that sperm quality is impacted by mono. While these are more complex to treat, individualizing the plan of action to you specifically can bring us a long way in resolving your symptoms
Mono Can Be A Bit Intense…
All of these impacts from the kissing disease! I know right!? Pretty impressive little virus that so many of us come into contact with. Speaking statistically about 90% of us will come into contact this infection, other estimates are even higher. By the time we are 30 years old, the vast majority of us will have evidence of mono in our blood work, fortunately the majority of us, will not have persistent or reactivated infections.
However, those of us who do, need someone on their team willing to figure out why they are sooooo stinking tired! So if you or someone you love is struggling with fatigue with “normal” labs, maybe it’s time to investigate a little further?
If you are looking for a physician who is on your team and truly wants you to get back to living your life, see if we are the right fit for you. Give us a call today or sign up for an introductory callwith our awesome medical assistant to get your questions answered!
Other Blogs You May Be Interested In...
