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Common Viruses Causing Your Chronic Fatigue + Other Health Issues

Homocysteine Levels: What They Mean + Why They Matter Dr. Will Cole

I see it all the time – through the years, from people of all different backgrounds from all different places. They tell me they can’t understand why one day they woke up feeling like “a train hit them,” no matter how much they slept. They are exhausted, craving caffeine and sugar foods just to get through the day.

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The Viral-Fatigue Connection

Viruses are often the underlying missing link because they can be triggers for many health conditions. Chronic viral infections can wreak havoc on your health months or years later in life and they can be difficult to eradicate once they get a foothold in your system.

Viral infections can range from the common cold to HIV and hepatitis. Viruses are oftentimes the underlying missing link to triggering many health conditions. I am not talking about acute viral infections like the flu (influenza virus) although it could be the case. What I am speaking about are chronic viral infections. Long standing infections that wreak havoc on your health months or years later in life.

The viral infections that I see most are actually part of the same family: The herpes family. When most people hear the word herpes they think of the sexually transmitted disease (STD) or cold sores. There are actually eight identified members of the human herpes virus family so far, though many in the integrative health world consider there to be more varieties. This is also the group of viruses that cause chickenpox and shingles! Herpes is one rough family.

The four members of the herpes family that I see being an underlying trigger with seemingly unrelated health problems are:

  • Varicella zoster virus (VZV) /Human Herpes Virus (HHV)-3
  • Epstein-Barr virus (EBV)/ HHV- 4
  • Cytomegalovirus (CMV)/HHV-5
  • Human herpes virus type 6 (HHV-6)

EBV is one of the biggest contributors I see the most often in my clinic. In fact, a small-scale study (1) published in the medical journal PLoS One explored the link between antibodies against Epstein-Barr and chronic fatigue syndrome. Another 2015 Polish study (2) looked at the ability of EBV to “hide” in the thyroid and, once reactivated, stimulate the immune system to attack the thyroid, triggering autoimmune thyroid problems or Hashimoto’s disease, which is another common cause of fatigue.

Almost all of us have one or more of these viruses in our bodies, so the variable is not IF we have it, but will it be triggered and when? The name herpes comes from the Greek word ‘herpein’ or ‘to creep’ and that’s exactly what these viral infections do. They can stay dormant for years until an opportunity to strike occurs. A stressful time in your life, leaky gut syndrome, candida overgrowth, adrenal fatigue, or Lyme disease can all be the perfect time for the sleeping, latent viral infection to rise up, reactivate, and wreak havoc throughout your body.

Brain Problems

1. Depression and anxiety

Depression and anxiety are two of the top disabilities worldwide. Multiple studies (3) including one in 2014 found an association (4) between anxiety and depression with CMV, although we still don’t understand exactly the mechanism of how it does so. Similar studies have linked EBV (5) with forms of anxiety such as panic attacks and attachment disorders. The virus is also implicated in Lyme disease.

2. Chronic fatigue

Epstein-Barr is the cause of “Mono” (mononucleosis) which causes extreme exhaustion, but it doesn’t stop there. More than one million Americans (6) have Chronic fatigue syndrome (CFS). These viruses have also been implicated (7) in this debilitating condition.

Autoimmune Conditions

1. Autoimmune thyroid problems

The most common cause of low thyroid dysfunction in the west is autoimmune reactivity against the thyroid. The most common is Hashimoto’s disease or autoimmune thyroiditis. Hashimoto’s disease or autoimmune thyroiditis. Hashimoto’s is also the most common autoimmune disease in the world. One 2015 study hypothesized (8) that latent EBV hides in the thyroid tissue, and once reactivated, stimulates the immune system to attack the thyroid.

2. Systemic lupus erythematosus (SLE)

A Journal of Clinical Rheumatology study (9) found that CMV was a possible trigger for Lupus.

3. Inflammatory Bowel Disorders (IBD)

study (10) out of the Scandinavian Journal of Gastroenterology actually found that the higher the level of HHV-6 and CMV that was found, the higher the severity of Inflammatory Bowel Disorders such as ulcerative colitis and Crohn’s disease.

4. Multiple Sclerosis (MS)

This neurological autoimmune disease affects 2.5 million people worldwide, and millions more have unexplained neurological autoimmune reactivity. EBV is clearly seen in the medical literature as a potential trigger to MS. According to the Journal of Infectious Diseases, a shingles outbreak can nearly quadruple the risk (11) of MS!

5. Guillain-Barré syndrome (GBS)

Another neurological autoimmune disease is Guillain-Barré. A Clinical Infectious Diseases study (12) found CMV triggering GBS although the other herpes viruses have also been implicated. Underlying Herpes zoster (shingles) can also be the culprit for other cases of unexplained nerve pain (neuropathy).

6. Alzheimer’s disease (AD)

Researchers have also looked (13) at the viral connection with yet another autoimmune-inflammatory neurological disease, Alzheimer’s. They found an increased risk of Alzheimer’s disease with CMV.

Functional Medicine Tools To Boost Your Immune System

If you suspect you have an underlying viral infection here are my top tips to reboot your immune system and start the healing process:

1. Get viral labs.

I suggest getting a full viral screen to see if you have these or other unexplained health problems. Labs are able to tell if there is an active or past infection.

2. Support methylation.

Methylation is a process that acts like a big biochemical superhighway, and facilitating a healthy immune system is one of its major functions. Studies have shown that EBV messes up methylation, (14) so those of us who have genetic changes such as MTHFR mutations and other methylation impairments can’t necessarily handle as much dysfunction in this area as someone whose methylation is normally unimpaired.

Support methylation with activated B vitamins and foods rich in B vitamins such as green leafy vegetables, onions, garlic, and grass-fed beef and liver.

3. Take high quality fish oil.

Research shows that the healthy fats (15) EPA and DHA from fish oil decrease the chances of EBV being reactivated.

4. Increase vitamin D intake.

A 2016 study found (16) that vitamin D was able to bring down Epstein-Barr antibodies in patients with the autoimmune disease multiple sclerosis. Make sure to have your vitamin D levels tested to determine dosage, and shoot for the optimal range of 60 to 80.

5. Supplement with the herb astragalus.

This root herb is used in traditional Chinese medicine (17) to fight off viral infections.

6. Heal your gut.

You can’t talk about the immune system without covering the area where the majority of your immune system resides: your microbiome. A study published in the Journal of Nuclear Medicine found (18) an increase in symptoms of fatigue and depression coinciding with an increase in bacterial endotoxins found in leaky gut syndrome.

I recommend having labs done to evaluate your gut health in the context of chronic fatigue. Endotoxins will raise immune labs, such as white blood cell count and inflammatory proteins such as C-reactive protein and IL-6.

7. Live your detox.

Chronic exposure to mold (19) and mercury (20) and other toxins have been linked to chronic fatigue. To fight off their effects, bring more detoxing foods into your daily diet. Garlic, cilantro, parsley, spirulina, and sage are some of my favorites. You can use them in smoothies, on salads, or to flavor your meals. Try rotating these foods throughout your week for comprehensive detox support.

8. Calm stress and sleep better.

Emotional suppression, psychological stress, (21) and a lack of sleep are all linked in the medical literature to a reactivation of EBV. Start and end your day with mindfulness meditations – apps such as Headspace and Calm are great tools to try.

An amino acid called theanine (22) has also been shown to improve sleep and helps you to feel rested and rejuvenated when you wake up. Low-caffeine teas like white tea or decaf green tea are great food sources for this sleepy-time medicine. I have a cup every night.

9. Test for and address nutrient deficiencies.

Low levels of iron, magnesium, (23) B12, and folate can all contribute to fatigue and weaken your immune system. Get labs to check your nutrient levels. If you don’t already, focus on eating a clean diet with a wide variety of nutrient-dense whole foods such as vegetables, fruits, organic meats, and healthy fats.

10. Try olive leaf.

The extract from the olive leaf has demonstrated (24) antiviral capabilities.

11. Consider ashwagandha.

Research published in the Journal of Ethnopharmacology saw this adaptogenic herb increased (25) helpful immune cells. Cortisol spikes (26) have been shown to trigger a reactivation of EBV, and ashwagandha also has a balancing effect on the main stress hormone.

12. Boost vitamin C.

An exciting study published in Medical Science Monitor found (27) that higher levels of vitamin C produced lower levels of EBV in people with mono and chronic fatigue syndrome.

13. Slay viruses with larrea tridentata.

Try to say larrea tridentata three times fast! This traditional Native American medicine is the ancient antiviral medicine of the desert.

14. Get a functional medicine perspective.

Navigating viral chronic fatigue can be overwhelming. Finding a qualified functional medicine practitioner to put the pieces of your health journey together can be invaluable to your health and well-being. You may need to try several different approaches before you find what works for you, but a functional medicine doctor can make this happen more quickly and efficiently, as he or she surveys your entire lifestyle holistically rather than simply trying to relieve your symptoms.

If you want to learn more about your own health case please check out our consultation process. We offer webcam as well as in-person consultations for people across the country and around the world.

Photo: Stocksy

References:

  1. Lerner AM, Ariza ME, Williams M, et al. Antibody to Epstein-Barr virus deoxyuridine triphosphate nucleotidohydrolase and deoxyribonucleotide polymerase in a chronic fatigue syndrome subset. PLoS One. 2012;7(11):e47891. doi:10.1371/journal.pone.0047891
  2. Janegova A, Janega P, Rychly B, Kuracinova K, Babal P. The role of Epstein-Barr virus infection in the development of autoimmune thyroid diseases. Endokrynol Pol. 2015;66(2):132‐136. doi:10.5603/EP.2015.0020
  3. Phillips AC, Carroll D, Khan N, Moss P. Cytomegalovirus is associated with depression and anxiety in older adults. Brain Behav Immun. 2008;22(1):52‐55. doi:10.1016/j.bbi.2007.06.012
  4. Simanek AM, Cheng C, Yolken R, Uddin M, Galea S, Aiello AE. Herpesviruses, inflammatory markers and incident depression in a longitudinal study of Detroit residents. Psychoneuroendocrinology. 2014;50:139‐148. doi:10.1016/j.psyneuen.2014.08.002
  5. Fagundes CP, Jaremka LM, Glaser R, et al. Attachment anxiety is related to Epstein-Barr virus latency. Brain Behav Immun. 2014;41:232‐238. doi:10.1016/j.bbi.2014.04.002
  6. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome CDC April 13, 2020 https://www.cdc.gov/me-cfs/
  7. Wallace HL 2nd, Natelson B, Gause W, Hay J. Human herpesviruses in chronic fatigue syndrome. Clin Diagn Lab Immunol. 1999;6(2):216‐223.
  8. Janegova A, Janega P, Rychly B, Kuracinova K, Babal P. The role of Epstein-Barr virus infection in the development of autoimmune thyroid diseases. Endokrynol Pol. 2015;66(2):132‐136. doi:10.5603/EP.2015.0020
  9. Pérez-Mercado AE, Vilá-Pérez S. Cytomegalovirus as a trigger for systemic lupus erythematosus. J Clin Rheumatol. 2010;16(7):335‐337. doi:10.1097/RHU.0b013e3181f4cf52
  10. Sipponen T, Turunen U, Lautenschlager I, Nieminen U, Arola J, Halme L. Human herpesvirus 6 and cytomegalovirus in ileocolonic mucosa in inflammatory bowel disease. Scand J Gastroenterol. 2011;46(11):1324‐1333. doi:10.3109/00365521.2011.605466
  11. Jiunn-Horng Kang, Jau-Jiuan Sheu, Senyeong Kao, Herng-Ching Lin, Increased Risk of Multiple Sclerosis Following Herpes Zoster: A Nationwide, Population-Based Study, The Journal of Infectious Diseases, Volume 204, Issue 2, 15 July 2011, Pages 188–192, https://doi.org/10.1093/infdis/jir239
  12. Orlikowski D, Porcher R, Sivadon-Tardy V, et al. Guillain-Barré syndrome following primary cytomegalovirus infection: a prospective cohort study. Clin Infect Dis. 2011;52(7):837‐844. doi:10.1093/cid/cir074
  13. Barnes LL, Capuano AW, Aiello AE, et al. Cytomegalovirus infection and risk of Alzheimer disease in older black and white individuals. J Infect Dis. 2015;211(2):230‐237. doi:10.1093/infdis/jiu437
  14. Caliskan M, Cusanovich DA, Ober C, Gilad Y. The effects of EBV transformation on gene expression levels and methylation profiles [published correction appears in Hum Mol Genet. 2012 May 1;21(9):2142]. Hum Mol Genet. 2011;20(8):1643‐1652. doi:10.1093/hmg/ddr041
  15. Akihisa T, Tokuda H, Ogata M, et al. Cancer chemopreventive effects of polyunsaturated fatty acids. Cancer Lett. 2004;205(1):9‐13. doi:10.1016/S0304-3835(03)00284-2
  16. Røsjø E, Lossius A, Abdelmagid N, et al. Effect of high-dose vitamin D3 supplementation on antibody responses against Epstein-Barr virus in relapsing-remitting multiple sclerosis. Mult Scler. 2017;23(3):395‐402. doi:10.1177/1352458516654310
  17. Du X, Chen X, Zhao B, et al. Astragalus polysaccharides enhance the humoral and cellular immune responses of hepatitis B surface antigen vaccination through inhibiting the expression of transforming growth factor β and the frequency of regulatory T cells. FEMS Immunol Med Microbiol. 2011;63(2):228‐235. doi:10.1111/j.1574-695X.2011.00845.x
  18. Hannestad J, Subramanyam K, Dellagioia N, et al. Glucose metabolism in the insula and cingulate is affected by systemic inflammation in humans. J Nucl Med. 2012;53(4):601‐607. doi:10.2967/jnumed.111.097014
  19. Brewer JH, Thrasher JD, Straus DC, Madison RA, Hooper D. Detection of mycotoxins in patients with chronic fatigue syndrome. Toxins (Basel). 2013;5(4):605‐617. Published 2013 Apr 11. doi:10.3390/toxins5040605
  20. Shin SR, Han AL. Improved chronic fatigue symptoms after removal of mercury in patient with increased mercury concentration in hair toxic mineral assay: a case. Korean J Fam Med. 2012;33(5):320‐325. doi:10.4082/kjfm.2012.33.5.320
  21. Stowe RP, Pierson DL, Barrett AD. Elevated stress hormone levels relate to Epstein-Barr virus reactivation in astronauts. Psychosom Med. 2001;63(6):891‐895. doi:10.1097/00006842-200111000-00007
  22. Vuong QV, Bowyer MC, Roach PD. L-Theanine: properties, synthesis and isolation from tea. J Sci Food Agric. 2011;91(11):1931‐1939. doi:10.1002/jsfa.4373
  23. Chaigne-Delalande B, Li FY, O'Connor GM, et al. Mg2+ regulates cytotoxic functions of NK and CD8 T cells in chronic EBV infection through NKG2D. Science. 2013;341(6142):186‐191. doi:10.1126/science.1240094
  24. Micol V, Caturla N, Pérez-Fons L, Más V, Pérez L, Estepa A. The olive leaf extract exhibits antiviral activity against viral haemorrhagic septicaemia rhabdovirus (VHSV). Antiviral Res. 2005;66(2-3):129‐136. doi:10.1016/j.antiviral.2005.02.005
  25. Bani S, Gautam M, Sheikh FA, et al. Selective Th1 up-regulating activity of Withania somnifera aqueous extract in an experimental system using flow cytometry. J Ethnopharmacol. 2006;107(1):107‐115. doi:10.1016/j.jep.2006.02.016
  26. Quaia M, Zancai P, Cariati R, Rizzo S, Boiocchi M, Dolcetti R. Glucocorticoids promote the proliferation and antagonize the retinoic acid-mediated growth suppression of Epstein-Barr virus-immortalized B lymphocytes. Blood. 2000;96(2):711‐718.
  27. Mikirova N, Hunninghake R. Effect of high dose vitamin C on Epstein-Barr viral infection. Med Sci Monit. 2014;20:725‐732. Published 2014 May 3. doi:10.12659/MSM.890423

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BY DR. WILL COLE

Evidence-based reviewed article

Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.

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