Guest post by Dr Laura Villa; Image by Anastasia Gepp from Pixabay 

The link between Epstein-Barr virus (EBV) and Hashimoto’s

What is Hashimoto’s thyroiditis?

Hashimoto thyroiditis is a chronic, autoimmune inflammation of the thyroid. It results when the body attacks the cells of the thyroid gland — an autoimmune reaction.

It often begins with painless, firm enlargement of the thyroid gland or feeling of fullness in the neck. If the thyroid is under-active, people may feel tired and intolerant of cold and have other hypothyroid symptoms.

The diagnosis is based on the results of a physical exam, blood tests, and/or an ultrasound. 

The etiology, or cause, remains unclear, but it is believed that both genetic and environmental factors contribute to the development.

Viral infections are frequently cited as major environmental factors involved in the development of autoimmune processes.

What is Epstein Barr Virus?

Epstein Barr Virus, also known as the kissing disease, is a common viral infection, causing mononucleosis.

Approximately 95% of the world’s adult population is infected during life and become lifelong carriers.

When the infection is symptomatic, the most common symptoms include fatigue, sore throat, and swollen lymph nodes. In some cases, the fatigue lingers, and the virus may contribute to the development of Chronic Fatigue Syndrome and multiple autoimmune conditions.

Once your immune system fights off the virus, it becomes inactive or dormant. However, it can reactivate later in life resulting in autoimmune diseases such as Hashimoto’s.

Just because you never had the kissing disease, doesn’t mean you can’t have the virus. Some people get infected and never develop symptoms.

Testing for EBV is fairly straightforward but treatment can take a long time.

Epstein Barr Virus and Hashimoto’s

A 2015 study found that 80.7% of people with Hashimoto’s showed EBV positive cells.

The virus can take up residence within our thyroid gland where it can live and be inflammatory to our immune system. It can call our immune cells to come into the thyroid gland and attack the virus along with the thyroid gland.

Although EBV is not the only agent responsible for the development of autoimmune thyroid diseases, it can be considered a contributory factor.

Addressing EBV can help Hashimoto’s

Addressing the virus may be helpful to you and reduce your symptoms. Whenever we address the reactivation, we see thyroid antibodies go down and many people feel significantly better.

What is the best test for EBV?

Blood tests are used to find out if a person has been exposed to EBV.

Recommended tests:

    • EBV Viral Capsid Antigen IgM: appears early in infection and usually disappears within four to six weeks.
    • EBV Viral Capsid Antigen IgG: appears in the acute phase of infection, peaking at two to four weeks, then it begins to drop and stays positive for life. However, during active infection, the numbers should remain significantly elevated over baseline, whereas an old infection will show only slight elevation over baseline. 
    • EBV Nuclear Antigen IgG: this is not positive in the acute phase but starts to elevate 2-4 months after infection. IgG stays positive for life. However, during active infection, the numbers should remain significantly elevated over baseline, whereas an old infection will show only slight elevation over baseline. 
    • EBV Early Antigen IgG: positive in the acute phase of infection and then begins to drop for 3-6 months after infection. A positive test indicates active infection. Again, during active infection, the numbers should remain significantly elevated over baseline, whereas an old infection will show only slight elevation over baseline. 

To summarize, the presence of VCA IgM indicates a recent infection, while having VCA and/or Nuclear Antigen IgG indicates either past or current infection, depending on how high the IgG count goes. If a person has only mildly elevated IgG antibodies with negative IgM antibodies, that indicates that her person had a past infection, and the EBV is in a dormant state.

Suppressing EBV the Natural Way

It is important to note that if someone has a dormant cause of EBV, then treatment usually isn’t indicated.

It is possible to suppress the virus back into a dormant state by supporting your body’s natural antiviral defenses or using targeted antiviral herbs or medications. Several natural compounds are useful for fighting EBV, including monolaurin, curcumin, olive leaf extract, berberine, and more.

Taking any of these will not necessarily result in successful treatment. Merely attacking the virus does not solve the underlying reasons why your immune system can’t control it. A successful treatment plan involves a comprehensive approach, including treating gut health, hormone balancing, reducing inflammation, etc.

If you would like to investigate the possibility of Epstein Barr virus as part of the trigger for your Hashimoto’s or suspect that reactivated EBV may be causing your fatigue, please make an appointment. The starting point is to get the correct lab testing done, and then we will move forward with treatment.

References:

  1. 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
  2. Hershman JM, By, Hershman JM, Last full review/revision Aug 2019| Content last modified Aug 2019. Hashimoto Thyroiditis – Hormonal and Metabolic Disorders. Merck Manuals Consumer Version. https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/thyroid-gland-disorders/hashimoto-thyroiditis. Accessed July 13, 2020.
  3. Dittfeld A, Gwizdek K, Michalski M, Wojnicz R. A possible link between the Epstein-Barr virus infection and autoimmune thyroid disorders. Cent Eur J Immunol. 2016;41(3):297-301. doi:10.5114/ceji.2016.63130
  4. Pender MP. CD8+ T-Cell Deficiency, Epstein-Barr Virus Infection, Vitamin D Deficiency, and Steps to Autoimmunity: A Unifying Hypothesis. Autoimmune Dis. 2012;2012:189096. doi:10.1155/2012/189096
  5. Niller HH, Bauer G. Epstein-Barr Virus: Clinical Diagnostics. Methods Mol Biol. 2017;1532:33-55. doi:10.1007/978-1-4939-6655-4_2
  6. Epstein-barr. Centers for Disease Control and Prevention. https://www.cdc.gov/epstein-barr/laboratory-testing.html. Published May 10, 2018. Accessed July 13, 2020.
  7. Wang C, Wang H, Zhang Y, Guo W, Long C, Wang J, Liu L and Sun X: Berberine inhibits the proliferation of human nasopharyngeal carcinoma cells via an Epstein-Barr virus nuclear antigen 1-dependent mechanism. Oncol Rep 37: 2109-2120, 2017
  8. Liu L, Yang J, Ji W, Wang C. Curcumin Inhibits Proliferation of Epstein-Barr Virus-Associated Human Nasopharyngeal Carcinoma Cells by Inhibiting EBV Nuclear Antigen 1 Expression. Biomed Res Int. 2019;2019:8592921. Published 2019 Oct 7. doi:10.1155/2019/8592921
  9. Gargouri B, Amor IB, Tlili K, et al. Antimicrobial, antioxidant and anti-EBV activities of olive leaf (Olea Europea) extracts from Tunisia. Research Square; 2020. DOI: 10.21203/rs.2.20335/v1.

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