If you’ve ever wondered what triggers an autoimmune disease, you’re not alone. This question has been a mystery since the discovery of autoimmunity. Normally, our immune system protects our bodies against infection. But with autoimmune disease, that same faithful system malfunctions and attacks healthy cells.
The exact mechanism that gives rise to an autoimmune disease still puzzles medical minds. However, evidence suggests that the cause can often be traced to a genetic susceptibility triggered by one or more environmental factors. These can include chronic stress, poor diet, gut dysbiosis, infections, environmental toxins, as well as other stressors.
Recent research points to various infectious agents (viruses and bacteria) as being major triggers for several autoimmune diseases, including the following:
| Autoimmune Disease | Infectious Agent |
| Guillain-Barré syndrome | Epstein-Barr virus, cytomegalovirus, Campylobacter (bacteria) |
| Hashimoto’s thyroiditis (hypothyroidism) | Epstein-Barr virus |
| Lupus | Epstein-Barr virus |
| Lyme disease | Borrelia burgdorferi (bacteria) and Borrelia mayonii (bacteria) |
| Multiple sclerosis (MS) | Epstein-Barr virus and measles virus |
| Myasthenia gravis | Hepatitis C virus, herpes simplex virus |
| Myocarditis | Coxsackievirus B3, cytomegalovirus, chlamydia (bacteria) |
| Rheumatoid arthritis (RA) | Epstein-Barr virus, hepatitis C virus, Escherichia coli (bacteria), mycobacteria |
| Type 1 diabetes | Coxsackievirus B4, cytomegalovirus, mumps virus, and rubella virus |
Medical researchers and clinical practitioners have different theories on how infections trigger autoimmune diseases. Some suggest that the antibodies produced in response to certain infections attack healthy cells in the body that resemble, in some way, the bacteria or virus that caused the infection.
Others note that many viruses infect the immune cells in order to reproduce and that this infection alters the immune response. A third possibility is that the infection flips a switch in the host’s genes that negatively impacts immune function.
Focusing on the Epstein-Barr Virus
As you skim through the table above, you may notice that one virus in particular — the Epstein-Barr virus — is implicated in a number of autoimmune diseases. Epstein-Barr virus may play a role in many autoimmune diseases for the following reasons:
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Epstein-Barr virus (EBV) is associated with lymphomas — cancer that begins in the infection-fighting cells of the immune system, called lymphocytes.
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EBV remains in the body throughout one’s life, remaining dormant for long periods of time with the possibility of reactivating later on. This follows the course of autoimmune diseases that exhibit a worsening of symptoms later in life.
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EBV alters the host’s genes in a way that may negatively impact immune function. In 2018, scientists at the Center for Autoimmune Genomics and Etiology (CAGE) at Cincinnati Children’s Hospital Medical Center published a study showing that “a protein produced by the Epstein-Barr virus, called EBNA2, binds to multiple locations along the human genome” associated seven autoimmune diseases.
These include multiple sclerosis (MS), rheumatoid arthritis (RA), inflammatory bowel disease (IBD), celiac disease, juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE), and Type 1 diabetes.
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EBV may infect healthy organs, triggering an immune response that damages healthy cells as the immune system tries to eradicate the virus. Biopsies of the thyroid glands of patients with Hashimoto’s disease and EBV show massive amounts of the virus inside the thyroid gland.
In addition to the autoimmune diseases already mentioned, EBV may cause or contribute to the following illnesses:
- Guillan-Barre Syndrome
- Facial nerve palsy (Bell’s palsy)
- Chronic fatigue syndrome
- Encephalitis
- Myocarditis (inflammation of the heart)
- Optic neuritis
- Pancreatitis (inflammation of the pancreas)
- Paralysis on one side of the body
- Pneumonia
- Transverse myelitis
- Viral meningitis
- Cancers, including Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, nasopharyngeal carcinoma, and Burkitt’s lymphoma
What is the Epstein-Barr Virus?
The Epstein-Barr Virus (EBV) is a herpes virus (herpes 4) transmitted by saliva, which causes mononucleosis, often referred to as “mono” or “the kissing disease.” EBV can also be transmitted via semen during sexual intercourse, by blood, or by a blood transfusion.
Most people get infected in their youth — after their first kiss or after drinking from the same cup or glass.
If you’ve ever had mono (and there’s a big chance you have — even if you were never diagnosed), you’re familiar with the symptoms:
- Fatigue
- Sore throat
- Fever
- Headache
- Swollen lymph nodes in the neck and armpits
- Rash
- Swollen liver and spleen
The initial infection lasts about two to four weeks but can linger for months. After the immune system fights off the virus, it goes dormant, usually for the rest of the person’s life. This period is often referred to as the latency phase.
However, EBV can be reactivated later in life and cause one or more of the illnesses mentioned earlier in this post. EBV’s ability to reactivate later in a person’s life is like the chicken pox virus, which, after the initial infection, remains dormant but can reactivate later, causing shingles.
Note the following:
- You can be infected with EBV and not develop any symptoms.
- You can have symptoms without testing positive for EBV antibodies; similar symptoms are associated with other viral infections, including cytomegalovirus, toxoplasmosis, herpes 6, herpes 7, HIV, and hepatitis B.
- Regardless of how old you are, whenever the virus is reactivated, you can infect someone else.
Can I Be Tested for the Epstein-Barr Virus?
Yes, blood testing is available through a number of commercial labs. We use an EBV test from LabCorp that examines the following four components:
| Component | Result |
| EBV Viral Capsid Antigen (VCA) IgM | Indicates active infection and stays positive for 4-6 weeks |
| EBV Viral Capsid Antigen (VCA) IgG | Positive in the early stages of infection, peaks at 2-4 weeks, then 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 and stays positive for life |
| EBV Early Antigen (EA) IgG | Positive in the acute phase, begins to drop for 3-6 months after infection, and becomes positive again during reactivation |
If you’re testing or being tested for the Epstein-Barr virus, be sure the test includes all four components. Many EBV tests omit the EBV Early Antigen (EA) IgG component, which is essential for a diagnosis of reactivation and for monitoring treatment effectiveness.
Note that in very rare cases, someone can have an active EBV infection, even though the test results show that no EBV antibodies are present in the blood.
Treating Autoimmune Conditions
Because EBV and other infectious agents are often at the root of autoimmune diseases, the treatment for these diseases must identify and address any underlying infections while restoring healthy immune function.
In that manner, the immune system can more effectively control the infection while scaling back its attack on organs and tissues in the body. Successful treatment requires a holistic approach that begins with a thorough exam and testing.
For example, when treating an individual who has Hashimoto’s thyroiditis, we test first for EBV reactivation. If the test result for EBV reactivation is positive, we first look for reasons why the immune system is unable to control the virus, such as the following:
- Anemia
- Poor sleep
- Chronic stress causing adrenal and autonomic nervous system imbalances
- Gut dysbiosis and/or infection
- Inflammation
- Nutrient deficiencies, including protein, vitamin D, and zinc
- Protein deficiency
- Insulin resistance
- Low ferritin levels (ferritin is a blood protein that contains iron)
- Other undiagnosed infections
- Too much estrogen
- Toxic mold or other environmental toxins
Eliminating or significantly reducing all factors that may be stressing the immune system is often enough to deactivate the Epstein-Barr virus.
However, targeting the virus — in addition to restoring healthy immune function — is often helpful for a quicker and more successful outcome.
A number of compounds are helpful for treating an active EBV infection, including the following:
- Artemisinin
- Berberine
- Cordyceps
- Curcumin
- Epigallocatechin gallate (EGCG)
- Monolaurin
- Olive leaf extract
- Reishi
- Vitamin C (high-dose, intravenous)
Note: Attacking the virus with these supplements isn’t enough for long-term success. You must address the underlying causes of immune system dysfunction.
Taking these supplements may help to control the virus temporarily, but if you don’t restore healthy immune function when you stop taking the supplement, the virus will reactivate.
At BioDesign Wellness, a Tampa functional medicine practice, we take a similar, holistic approach to treating all autoimmune disorders. We first test for underlying infections and look for other factors that may have triggered the illness.
Then we examine the various systems of the body to identify any dysfunction that may be impairing the body’s ability to heal itself, such as immune system dysfunction or the body’s inability to detox itself.
We then identify and address all causes of dysfunction and provide additional treatment, as necessary, to combat the infection or any other factors, such as toxic mold, that may have caused or contributed to the disease.
Perhaps you have an autoimmune disease, and you’re receiving treatment that doesn’t look at all like what is described in this post. If so, and if you’re not getting satisfactory results, we strongly encourage you to consult a functional medicine doctor.
A doctor trained in functional medicine will dig down to the root causes of your illness and provide your body with everything it needs to achieve and maintain optimal health and fitness.
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Disclaimer: The information in this blog post about autoimmune disease and Epstein-Barr Virus is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from the medical staff at BioDesign Wellness Center, Inc., nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.