043 Everything You Need to Know to Interpret Epstein Barr (EBV) Results

The Case:

• Emily has 2 autoimmune diseases
• She decided to get tested for EBV (Epstein Barr Virus) which her doctor reluctantly did.
• Her doctor didn’t know how to interpret her results and dismissed her concerns.

What Emily experienced is very common. Conventional doctors often are hesitant to test for EBV and don’t truly know how to read the results. In some cases, they don’t even order the right lab tests.

Emily knew that there was more to the story than her doctor understood. She’d educated herself about EBV and knew that there could be a connection to her 2 autoimmune diseases. And, that her health could be on the line.

The Investigation

I was happy to help Emily better interpret her lab results. As we learned in the first case of suspected EBV, this can be a very complicated, confusing, and time-sensitive diagnosis. There are few people who understand it better than Dr. Kasia Kines, so I brought her back to discuss Emily’s case.

Dr. Kasia, she is a Doctor of Clinical Nutrition and the CEO of EBV Educational Institute and Holistic Nutrition Naturally. She is also the author of the Amazon Bestseller: The Epstein-Barr Virus Solution.

Four Markers to Test for EBV

Epstein-Barr Virus (EBV) is complicated. In order to get a full picture of what’s going on with the virus (and determine if it’s latent or new), there are four markers that should be tested. These are tested through blood tests that many labs offer.

The four tests are:

EA IgG (Early Antigen) - this is the most important test and it’s often missed. If your doctor skips this one you won’t know your true EBV status.

EBNA IgG (Epstein Barr Nuclear Antigen) - Indicates a history of infection in non-acute cases. This tells the story of the long term status of the virus.

VCA IgG (Viral capsid antigen) - Indicates an acute infection and will remain perpetually present after initial infection.

VCA IgM (Viral capsid antigen) - Is present in the early phase of an infection and usually disappears.

For what the results mean, see the chart in this week's show notes here: Health Mysteries Solved Podcast - Episode 43

[chart courtesy of Dr. Kines’ website]

The Often Missed EBV Test

The EA IgG early antigen test is the most important in getting a big picture of what’s going on right now with the virus. Unfortunately, it is often skipped by doctors. When you have EBV, the virus stays in the body (and we may not be able to ever kill it off entirely). Dr. Kines says that 90 - 95% of the population carries the virus and for many, it doesn’t impact their day-to-day health. Despite this, someone may wake up and feel like they’ve been run over by a truck. Could it be the latent EBV reactivating? The early antigen test is key in determining this - and it must be tested early on (within the first few weeks of the ‘flare-up’ or reactivation). If this test is not done, you could have active EBV and not know it which can be dangerous.

Symptoms of Active EBV

A reactivation of EBV can present in a variety of ways. I could seem like the flu with severe fatigue and feeling like you’ve been ‘run over by a truck’. It can also present with cold-like symptoms (sore throat, swollen lymph nodes), or skin rashes, and even gut or digestive issues. Digestive issues could present as constipation, pain, or symptoms related to leaky gut. If you have an autoimmune disease like Hashimoto’s, it might present as a flare-up of the autoimmune disease. The real challenge with symptoms of EBV is that there are so many potential symptoms that could easily be something else. This is why EBV is often not considered or caught.

How to Decrease Elevated EBV Markers

When there is a flare up, the results on the lab can be very confusing - especially when the level is shown simply as above the maximum lab result. Dr. Kines has a protocol she recommends (and I use it with my patients too). This recommends a restricted diet and a lot of rest. It is all outlined in her book. It is also important to continue to monitor the markers. However, Dr. Kines points out that everyone’s levels are going to be different. Some will decrease significantly with lifestyle changes while others may take longer. However, how you feel is more important than what the labs say. If you feel good, and your labs are elevated, then consider that a win. She says that it’s easy for people to get demoralized but it’s not all about the numbers.

Other Factors in EBV

If someone is following the protocol and not getting results (either in how they feel or their lab results), then there may be something else at play. Two of the most common culprits are heavy metals and molds. For more on heavy metals, listen to episode 024 and for more on mold listen to episode 006. Mold can really block any efforts to decrease EBV marker levels because it devastates the immune cells and system. In cases where mold or heavy metals are an issue on top of elevated EBV markers, the mold and heavy metals must be addressed first.

Negative Reaction to the EBV Protocol

Introducing a new protocol of supplements and dietary restrictions can trigger reactions. However, Dr. Hines recommends starting slow with the protocol. If there is a reaction, then you can stop the protocol and add in the different pieces one by one to determine if there is one thing that is causing an issue. She also recommends, as do I, that you always opt for top-quality supplements to minimize the chance that you’ll have a negative reaction.

EBV Triggers to Avoid

One surprising trigger the Dr. Kines mentioned comes from forest fires. This should be on your radar if you live near an area (like California) where there are a lot of forest fires. When fires burn, they give off a toxin called dioxin which has been shown to reactivate EBV. You can also be exposed to this toxin through cigarette smoke (even second-hand), campfires, fireworks, or the burning of debris. She also mentioned that wifi exposure should be closely monitored. This includes your own router but also the wifi used for smart meters that could be penetrating your walls. Additionally, she cautions against blue light exposure (commonly from TV, computer screens, and smartphones). Even your next vacation could expose you to EBV triggers (listen to the episode to find out how). All of these triggers can also reactivate the Epstein-barr virus.

Mystery Solved

Let’s take a look at Emily’s labs. Her VCA IgM was negative which made her doctor think the infection was not current, but she had an elevated early antigen. Her doctor completely missed that. While her symptoms weren’t dramatic, she knew something was wrong and the tests proved it.

Because of her sensitive stomach, we opted for the protocol that included the amino acids and antioxidants Dr. Kasia talks about in this episode (Lysine, NAC, Selenium and Zinc). She tired Monolaurin but experienced die-off symptoms so we stuck with the original protocol.

Happy Ending

Emily’s digestive issues subsided in about 3 weeks and her energy started to slowly come back...