NEW BOOKS by F. Tennant, MD, DrPH:
The Epstein-Barr Virus: A New Factor in the Care of Chronic Pain
Handbook for Epstein-Barr Virus Testing and Treatment
Available on Amazon/Kindle.
Our studies on EBV and severe chronic pain conditions have led to the discovery that EBV reactivation and autoimmunity (R&A) may be a major causative factor in the development of painful conditions. We recommend that every person who has had one or more chronic pain conditions for over 90 days that requires daily medication for relief be screened for EBV R&A.
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Screening Test for EBV Autoimmunity
EBV Antibody Test to Determine Reactivation and Autoimmunity
Prevention of EBV Reactivation
Epstein-Barr virus (EBV) Reactivation and Autoimmunity: Catalyst for Chronic Pain
EBV R&A is an internal disease state in which EBV has reactivated and produced autoantibodies that causes tissue inflammation, destruction, and pain. When EBV R&A occurs, it may preferentially injure small nerve fibers, neurons, membranes, fascia, and cartilage among other soft and fragile tissues to cause severe and lasting pain.
HOW EBV R AND A ORIGINATES: EBV usually enters the body and first activates during infancy (“sniffles”) or by contracting infectious mononucleosis as a teenager or young adult. After the initial activation, EBV settles in one’s throat membranes or lymphocytes to be a lifetime, harmless parasite. Unfortunately, EBV has the ability to reactivate, duplicate, and travel in the blood inside lymphocytes to harm tissues and cause pain.
HOW AND WHY EBV REACTIVATES?: Biologic stress, meaning a physical or psychologic situation that causes cortisol and adrenaline to elevate for more than a few hours, may lower one’s immune system and give EBV the “opportunity” to reactivate. The usual stresses that cause reactivation are trauma (i.e., accident, medical procedures, etc.), infection (i.e., pneumonia, etc.) or psycholgic (i.e., death in family, divorce). Some medical conditions including genetic connective tissue diseases (i.e., Ehlers-Danlos syndrome), diabetes, and stroke may have an immune deficiency and be more prone to EBV reactivation.
OTHER VIRUSES AND BACTERIA: EBV may be accompanied or enhanced by cytomegalovirus, herpes 6, rubella, covid, Lyme, or mycoplasma. EBV, however, is, in our studies, the dominant offender.
DIAGNOSIS: EBV R&A in chronic pain patients is determined by EBV antibody blood tests.
WHO SHOULD BE TESTED?: We recommend antibody testing for EBV R&A in any person who has had chronic pain for over 90 days and needs to take pain relievers on a daily basis.
TREATMENT: Relatively simple treatment measures have been identified to both inhibit reactivation and suppress inflammation and autoimmunity. In our experience and research, the measures to treat EBV R&A tend to provide about 20 to 50 % increased pain relief when used with standard pain therapies. Failure to take therapeutic measures to control EBV R&A, however, may allow increased disease deterioration and pain.
Epstein-Barr Virus Antibody Tests to Determine Reactivation and Autoimmunity
Test 1: Epstein-Barr Viral Capsid Antigen Antibody (VCA IgG). This test interprets whether there have been one or more past reactivations.
Test 2: Epstein-Barr Nuclear Antigen Antibody (EBNA IgG). This test interprets autoantibodies that produce tissue degeneration, inflammation, and pain are present.
Test 3: Early Epstein-Barr Antigen Nuclear Antibody (EA EBNA IgG). This test interprets if EBV is currently reactivated and causing active autoimmunity and tissue infiltration.
NOTES: Qualitative (positive or negative) are not specific enough to make a diagnosis of EBV R&A.
- The antibody tests to determine reactivation and autoimmunity are in the IgG and not IgM class of antibodies. Also, tests for chronic infectious mononucleosis (i.e., PCR and DNA) are not relevant to chronic pain conditions.
- We recommend that levels of VCA and EBNA IgG be two or more times the upper normal laboratory level plus pain in two or more anatomic sites to warrant a diagnosis of EBV R&A.
- If the EARLY antigen antibody (EA EBNA IgG) is elevated above normal, therapeutic trials of antiviral and corticosteroids should be considered to reverse reactivation.
- If both VCA EBNA IgG are elevated but the EARLY EBNA IgG is negative, we recommend the use of medicinals that inhibit EBV R&A.
- Information here only applies to persons who are in severe chronic pain.
Diagnosis and Inhibition of Epstein-Barr-Virus (EBV) Reactivation
EBV is a parasite that normally lives a dormant, harmless life in human lymphocytes and nasopharyngeal membranes. We are all carriers of the virus. In times of biologic or psychologic stress, defined here as cortisol and adrenaline elevation for several hours or days, EBV can reactivate, produce autoantibodies, infiltrate tissue, and silently produce a painful condition or cancer. Persons with chronic pain severe enough to require daily pain relief medication may have EBV reactivation as a cause of their condition and must take steps to inhibit it.
SYMPTOMS OF EBV REACTIVATION: EBV reactivation is similar to herpes or shingles (herpes zoster) reactivation. Herpes and shingles, like EBV, are usually dormant, harmless virus infections, but they may reactivate and cause blisters or a skin rash. EBV may reactivate and may or may not cause symptoms. Unfortunately, EBV reactivation can be totally asymptomatic and unknown to the individual until chronic or repetitive reactivations cause a painful condition (i.e., fibromyalgia, small fiber neuropathy, burning mouth, herniated disc, arachnoiditis) or a cancer (Hodgkin’s, lymphoma).
BLOOD TEST DIAGNOSIS OF EBV REACTIVATION: Two EBV antibodies are formed during each reactivation. When both are elevated above normal laboratory levels, a diagnosis of past reactivation is made, and the individual can properly be called a “chronic reactivator.”
- Viral Capsid Antibody (VCA)
- Epstein-Barr Nuclear Antibody (EBNA)
Note: IgG class and not IgM class of antibodies.
MEDICINALS TO INHIBIT REACTIVATION: These medicinals have been shown to inhibit EBV reactivation: vitamins C and D, astragalus, zinc, resveratrol, curcumin, selenium, luteolin, andrographis, lysine.