Hashimoto’s and Epstein-Barr Virus (EBV)

When I was taking my pharmacy licensing exam after graduation, I remember thinking that I could never possibly know more than I did at that time, but I have learned so much more since then- learning is one of my biggest passions- and I’ve found that the more I learn, the more I want to learn. I’m proud to say that I’ve now been a pharmacist for ten years- I graduated from pharmacy school in 2006.  I hope to spend the next ten years learning even more!

I decided to become a pharmacist at age 16, because I was fascinated by science, chemistry and medicine, and because I wanted to help people for a living! I was a very determined and motivated student, but at one point, during my freshman year of my undergraduate studies, I almost gave up on my dream of going to pharmacy school … I didn’t know it at the time, but it was because of Hashimoto’s.

Without going into too much detail, one of the crucial defining moments in my disease development may have started during my undergraduate studies at the University of Illinois. Due to the communal living setting of dormitories (and less than stellar hygiene habits of most college students, myself included!), I had recurrent strep throat infections and even contracted mononucleosis, a viral infection caused by the Epstein-Barr Virus (EBV), which is implicated in triggering many autoimmune conditions.

To add to the “perfect storm”, I received multiple courses of antibiotics, my first flu shot, and started birth control for menstrual cramps. At the time, my diet consisted of Easy Mac, soda, candy, Ramen noodles, carbs and the occasional rum and Coke. It is my belief that this combination had a profound impact on my gut flora, and thus weakened my immune system.

What is the EBV?

Epstein-Barr (EBV) is a virus that causes mononucleosis (also known as “Mono” or “glandular fever in the UK), a debilitating viral infection that is common among college students, and is also known as the “kissing disease”, because individuals are thought to be exposed to the virus through saliva of those who are infected.

While >90% of people worldwide have been exposed to the EBV, interestingly, the timing of infection seems to be very significant. Children in developing countries usually contract the Epstein-Barr Virus when they are under the age of 10, and this usually results in an asymptomatic infection – one that does not cause them symptoms. In contrast, in developed countries, where individuals are not usually exposed to the virus until they are in high school or college, the infection is asymptomatic only 50% of the time.

When the infection is symptomatic, the most common symptoms include fatigue, sore throat and swollen lymph nodes. Weight loss is also common. In some cases, the condition resolves in a few weeks, and the person goes back to normal. In other cases, the fatigue lingers, and the virus may contribute to the development of cancers, chronic fatigue syndrome and multiple autoimmune conditions, including Hashimoto’s.

A 2015 Polish study found the Epstein Barr Virus in the thyroid cells of 80% of people with Hashimoto’s and 62.5% of people with Graves’, while controls did not have EBV present in their thyroid cells. (1)

Specific immune cells known as CD8+ T cells are needed to fight off the Epstein-Barr virus, however, some individuals may have a low baseline level of these types of immune cells. CD8+ T cells decrease with age, are lower in women, and when vitamin D intake is low. (2)

When levels of these fighter cells are insufficient, the Epstein-Barr virus may take up residence in our organs (such as the thyroid) and essentially hijack the organ to help the virus hide and multiply.

Thus, it makes sense that people who are exposed to EBV in college are more likely to have problems – this is because by the time we reach college age, CD8+ T cells, the ones that fight EBV, have declined threefold compared with the number of cells we had in childhood.

Reactivation

The Epstein Barr virus creates a latent infection in the body, where it lies dormant until the right time, when it reactivates and awakens.

The reactivated virus has the potential to induce the production of thyroid antibodies and has been implicated in many debilitating autoimmune symptoms.

Testing for viral reactivation may be done through your doctor.  You need to be sure to ask for the Epstein Barr Virus Early Antigen test, as this is a test that will let us know if the virus is actively replicating.

While eradicating the virus is much more challenging than getting rid of a bacteria or parasite, you can suppress the virus back into a dormant state by supporting your body’s antiviral defenses, or through the use targeted antiviral herbs or medications.

Additionally, animal fat and broths, soups and stews support the body’s ability to suppress the viruses. Monolaurin/lauric acid, one of the components of coconut oil, has been found to be active against the Epstein-Barr virus. Replication of many viruses including Epstein-Barr is inhibited by glycyrrhizic acid, an active component of licorice root. Quercetin and Coenzyme Q10 were also reported to be helpful in chronic fatigue syndrome because of their antiviral properties. (3)

Natural Antiviral Protocols for Epstein Barr may include the use of immune supporting mushrooms, Lomatium, monolaurin and colloidal silver. I recommend working with a natural health-care practitioner for specific dosing protocols.

Antiviral medications: some people with chronic fatigue induced by the Epstein Barr Virus have reported a major improvement in symptoms after taking the antiviral drug Valacyclovir. When taken for at least six years, this medication has also shown the potential of eradicating the virus from our bodies(4). Some individuals with chronic fatigue, which is often thought to be triggered by Epstein Barr and other viruses, have reported remarkable improvement in energy levels on antiviral medications.

Emerging research: Rituximab (brand name Rituxan), is medication used for rheumatoid arthritis and certain cancers.  A few research reports have suggested that this medication may also induce a remission of Hashimoto’s(5), Graves’ disease (including Graves’ associated eye disease) as well as an improvement in chronic fatigue syndrome (CFS), which is often connected to EBV as well. (6, 7)

Perhaps this improvement in Hashimoto’s and CFS is due to the drug’s ability to destroy B cells, a type of immune cell that harbors the latent Epstein Barr Virus. (8)

Please note that Rituximab is associated with very serious side effects that have resulted in death and disability. Some examples include: heart attacks, immune toxicity, as well as reactivations of other viral infections, This medication is a chimeric monoclonal antibody, which means it’s made from crossing mice and human genes, and it destroys B cells, which can be infected with Epstein-Barr Virus . As a pharmacologist, I would not recommend this medication as a first line choice for most people with Hashimoto’s due to the significant associated risks.  There are much safer interventions, like the ones I mentioned above!

Beyond EBV

In reviewing health timelines of numerous people with Hashimoto’s, I’ve found that many of them, like me, will report getting EBV, then irritable bowel syndrome a few years later, followed by a Hashimoto’s diagnosis a few years after that.

I’ve found that many of these people, with a history of EBV in adulthood, also have the gut infection Blastocystis hominis, which has recently been connected to irritable bowel syndrome, hives AND Hashimoto’s. Interestingly, EBV is fueled by the amino acid arginine, while arginine depletion can cause Blastocystis hominis to be more pathogenic. In the last few years, I’ve noticed that getting rid of the Blastocystis hominis infection can help people to get their Hashimoto’s into remission. Read more about it in myBlastocystis article.

It took me a long time to get my health back, and so I hope that this article shortens the learning curve for you. I hope that this article was helpful, and most of all, I hope that you won’t let Hashimoto’s hold you back from your dreams.