According to the Centers for Disease Control, the Epstein Barr Virus (EBV) is prevalent throughout the world and is classified among the most common of human viruses. With nine  out of 10 individuals acting as carriers for EBV, chances are pretty high that you may have already contracted it. EBV is transmitted via saliva, and most people who become infected with the virus display no symptoms.

Despite the fact that an Epstein Barr Virus infection is more or less the norm, it is not among the viruses that most people recognize by name. EBV is a member of the herpes virus family and is also referred to as human herpesvirus 4. Discussion about EBV typically revolves around mononucleosis (commonly known as “mono”), a contagious disease associated with periods of fatigue lasting weeks. EBV is one of the viruses known to cause mono and most literature presents the Epstein Barr Virus infection as being synonymous with contracting mono. Mono’s symptoms include extreme fatigue, fever, sore throat, head and body aches, swollen lymph nodes, swelling of the liver and/or spleen, and rashes.

Children who become infected by EBV are less likely to present any symptomatic response. When symptoms are present, they are often indistinguishable from other childhood maladies. Teenagers and adults are more likely to manifest symptoms in the form of mono with an infection that lasts for two to four weeks (with a longer period of associated fatigue).

Once an EBV infection has run its course, the virus becomes latent and remains within the body in perpetuity. Meaning: once infected, that virus is always in your system.

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You Gotta Be A Monk To Escape Epstein Barr Virus

Prevention of the EBV infection requires the unlikely scenario of avoiding kissing, sharing drinks and food, and utilizing items that may have come into contact with saliva. There is no EBV vaccination and the ease of transmission elevates the risk of infection, making it nearly inevitable for us all.  

Once it becomes latent, Epstein Barr Virus retreats to the bodies “B Cells”.  B Cells are a type of white blood cell (specifically a lymphocyte) that mature into plasma cells or memory B cells. These cells are responsive to a particular type of antigen dependent on the antibody that stimulated their creation. Once positioned within B cells, EBV makes changes within both the body’s genome and its own viral genome through methylation, fueling its prolific propagation.

Long-Term Effects Of EBV

Aside from its connection with mono, EBV is an important virus to understand, given its larger health implications. In some individuals, EBV can create long-term issues with chronic fatigue associated with sustained activation of the virus. EBV serves as an environmental trigger for a number of systemic autoimmune diseases by creating persistent stressors within the body’s immune system. These stressors create increased opportunity for the initiation of autoimmune diseases and aid in the progression of other diseases. Most alarming is EBV’s association with cancer.  It was one of the first viruses linked to cancer and is known to cause cancers that originate from epithelial cells, lymphocytes, and mesenchymal cells.

The relationship between EBV and cancer can be simplified by understanding that EBV disrupts the delicate balance within the body’s complex system of autoimmune responses. EBV creates conditions that inhibit the body from identifying and eliminating the virus. Simultaneously, EBV ensures its own survival through aggressive replication through cell division. Neil J. Ganem, an Assistant Professor of Pharmacology and Experimental Therapeutics at Boston University’s School of Medicine highlights, “Cancer is just a disease of cell division gone wrong.” In a fundamental sense, the presence of EBV in the body creates a perfect storm of unchecked cell division that exploits the probability of cancerous cell formation and replication.

Kicking EBV’s Butt With Vitamin C

Nina Mikirova, director of research at the Riordan Clinic, and Ron Hunninghake, the Chief Medical Officer of the Riordan Clinic, have investigated treatment of EBV utilizing high doses of vitamin C. Their investigation stems from observations in previous studies that patients with viral infections are prone to vitamin C deficiency. Additionally, patients impacted with infections of other viruses have experienced improved recovery after receiving pharmacological doses of vitamin C.  

Over the counter vitamin C supplements, such as oral pills or the popular Emergen-C drink powder, offer 500 milligram to 1 gram of vitamin C per dose. The doses studied by Mikirova and Hunninghake range from 7.5 to 50 grams and are administered through intravenous infusions. The efficacy of such high doses has been “linked with benefits to endothelial function, cellular immune function, antioxidative capacity, pain relief, and treatment of cancer and other illnesses.”

The efficacy of vitamin C in the treatment of viral infections involves multiple biochemical processes, which aid in autoimmune response,reducing favorable conditions for viral replication. Vitamin C’s antioxidant properties combat the oxidant stresses induced from viral infection and work to detoxify and neutralize the reactive oxygen produced through the infection. Vitamin C also works to stimulate the body’s production of anti-viral cytokines (a family of small proteins that impacts interactions between cells including cell communication and behavior) and interferon (a specific form of cytokine that boosts immune system responses to viruses and inhibits their cell growth).

During the study, researchers found that patients treated with the high doses of vitamin C realized reductions in viral activity as measured through reduction in the presence of EBV antibodies. The study also documented other important factors related to high dosage vitamin C treatment.  

Patients who began treatment showed antibody reduction only to realize a rebound in antigen loads once treatment was paused.  Resumption of treatment again showed antibody reduction. This treatment induced fluctuation, demonstrating that sustained treatment is a factor in maximizing its efficacy. In addition, the study found that those who were experiencing higher EBV infection burdens (as measured through higher antibody concentrations) required a longer period of treatment in order to overcome the vitamin C depletion created by the virus.

This study is particularly important given the lack of current treatment options for EBV and its potential to wreak long-term havoc on the body. The researchers noted that their study is thought to be the first study conducted in a clinical environment assessing the role of vitamin C in the body’s response to Epstein Barr Virus. Additionally, while vitamin C was the focal point of the study, researchers also found similar correlations between vitamin D and EBV regulation. However, the role of vitamin D in EBV was not fully explored during the study given that it was not administered under any regulated or controlled conditions.

Given the study demonstrated a positive correlation between vitamin C and EBV activity reduction, it creates an important foundation for understanding how vitamin C could be utilized as a tool in combating EBV infection.

While the study focused solely on intravenous administration of vitamin C, there is discussion that similar effects can be achieved through other forms of vitamin C intake.  Individuals utilizing high dose intakes should seek the advice of the physician. The exact dosage for non-intravenous, high dose vitamin C can be determined by “titrating to bowel tolerance”. Simply put, vitamin C is taken in escalating doses until it causes symptoms of diarrhea appear (revealing the bowel tolerance for vitamin C).  

The dose is then scaled back until the symptoms of diarrhea subside. Liposomal forms of vitamin C show particular promise given that the delivery system improves bioavailability. Liposomal vitamin C reduces the stress on the GI tract given that absorption bypasses the stomach and small intestine.

Josh O’Conner is an urban/land use planner with a passion for urban agriculture. He can be reached at @kalepiracy or @joshoconner on Twitter

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