Epstein Barr Virus and Hashimoto’s Disease

Epstein-Barr Virus or EBV is a herpes virus (Herpes 4) that is significantly connected to Hashimoto’s disease and many other autoimmune diseases.  It is the most common infection I see in my patients with Hashimoto’s thyroiditis.  Testing for Epstein-barr virus is fairly straightforward but treatment can take a long time. https://www.youtube.com/watch?v=WR96Gt9hWLQ How do you get infected? Epstein-Barr Virus is transmitted by saliva resulting in mononucleosis (“mono”) also known as “the kissing disease.”  EBV can also be transmitted via semen during sexual intercourse, by blood or blood transfusion. Most people get infected when they are young after their first kiss or if they exposed to another infected person’s saliva on a shared drinking glass. What are the symptoms of mono due to acute Epstein-Barr Virus infection? Fatigue Swollen lymph nodes in the neck Sore throat Fever Rash Enlarged liver and spleen The above symptoms are the usual result of the initial infection which lasts about 2-4 weeks but sometimes they can go on for months.  Once your immune system fights off the virus, it becomes inactive for life.  Epstein-Barr Virus however can reactivate later in life resulting in autoimmune disease such as Hashimoto’s thyroiditis, fatigue and many more illnesses.  This is similar to the Chicken Pox virus that stays in your body for life but it can reactivate resulting in painful shingles. Key point: Just because you never had mono, this doesn’t mean you can’t have the virus.  Some people get infected with EBV and never develop symptoms. You can infect another person no matter how old you are if the virus is reactivated in your body. ***Some people will have a “mono-like” illness and EBV antibodies are negative. This is due to another active infection including cytomegalovirus, toxoplasmosis, herpes 6, herpes 7, HIV or hepatitis B. What health problems can Epstein-Barr Virus cause? Many autoimmune diseases such as Hashimoto’s disease, Lupus, Rheumatoid arthritis etc. Weakened immune system making it more difficult to fight other infections Facial nerve palsy (Bell’s palsy) Guillan-Barre Syndrome Sleep problems Chronic fatigue syndrome Viral meningitis Transverse myelitis Optic neuritis Encephalitis Cerebellar ataxia Paralysis on one side of the body Pneumonia Pancreatitis (swelling of the pancreas) Myocarditis (swelling of the heart) Epstein-Barr Virus is also associated with a number of cancers including Hodgkin’s lymphoma, Non-Hodgkin’s lymphoma, nasopharyngeal carcinoma, and Burkitt’s lymphoma. What is the best test for Epstein-Barr Virus? Blood testing through all commercial labs such as Labcorp are readily available for testing. Let’s break down each test component: EBV Viral Capsid Antigen (VCA) IgM: Indicates an active infection and stays positive for 4-6 weeks. ***VCA IgM antibodies can cross-react with cytomegalovirus, toxoplasmosis, herpes simplex or rheumatoid factors. This must be taken into account due the potential of a false positive. ***VCA IgM antibodies have been shown to rise in those over 60 years of age. EBV Viral Capsid Antigen (VCA) IgG: Positive in the early stages of infection peaking at 2-4 weeks, then it begins to drop and stays positive for life. EBV Nuclear Antigen (EBNA) IgG: Not positive in the acute phase but starts to elevate 2-4 months after infection.  IgG stays positive for life. EBV Early Antigen (EA) IgG: Positive in the acute phase of infection and then begins to drop for 3-6 months after infection.