Epstein Barr Virus (EBV) is a type of herpes virus that causes infectious mononucleosis, also known as “mono.” While the symptoms of infectious mononucleosis will resolve over time, the virus stays dormant inside ones B lymphocyte cells (a type of white blood cell that developed in bone marrow, migrates to spleen, and circulates in lymphatic system) for life. EBV inside the B lymphocytes can become reactivated during times of other infections, or possibly, during times of immune depletion or stress. Due to EBV’s effects on B lymphocytes, EBV may have a role in the development of autoimmune disease in those who are genetically predisposed.
Hashimoto’s thyroiditis is one of the most common autoimmune diseases currently, and is the most common cause of hypothyroidism. The symptoms of Hashimoto’s include; fatigue, weight gain, dry skin, constipation, heavy menses, joint pain, hair loss and other symptoms. The diagnosis can be made by the presence of anti-thyroglobulin and anti-thyroid peroxidase antibodies on laboratory analysis. Elevated TSH and low thyroid hormones may also be found if the autoimmune damage to the thyroid has reduced the thyroid’s ability to create thyroid hormone.
A number of studies have correlated EBV exposure to the presence of autoimmune thyroid disease. These studies explain that proteins from EBV, along with other viruses, are more often found in the thyroid gland of patients with Hashimoto’s than in other patients. One article explains that autoimmune thyroid disease may begin with the presence of a latent EBV infection within the follicular cells of the thyroid gland, leading to the production of inflammatory cytokines (small protein released by cells that has a specific effect on interactions, communication, and behavior between cells). Cytokines includes interleukins, lymphokines and cell signal molecules like tumor necrosis factor and the interferons, which trigger inflammation in response to infections. This may lead to the presence of even more immune cells within the thyroid. Yet another article explains a theory where EBV infected B cells are not kept under control due to dysfunctional immunity, leading to EBV infection in the thyroid and an infiltrating of immune cells into the organ.
While the reason for EBV reactivation is not quite understood, it seems that controlling exposure to other infections keeps EBV latent within the B cells. One can prevent infections by regular hand washing and avoiding contact with those who are ill. Secondly, managing stress can help to prevent reactivation. Some tips for managing stress include regular exercise, adequate sleep, ensuring adequate daily downtime, eating regular meals, getting acupuncture and massage treatments, and setting achievable goals for yourself. Exercise should be performed for 45 minutes at least four times per week, and one should aim to sleep for 7-8 hours a night between the hours of 10 P.M. to 6 A.M. Relaxing and maximizing downtime during the work-week is especially important to manage stress, and one should aim to take short breaks every hour. Keeping the blood sugar regulated is another method for stress management. This includes eating snacks that are rich in protein and healthy fats every few hours in order to avoid blood sugar fluctuations, as well as avoiding simple sugars and high-carbohydrate meals. Remember that sugar can destroy white blood cells.
Keeping the immune system healthy is an important goal so as not to allow EBV infection and recruitment of immune cells into the thyroid. One study recognizes the role of vitamin D for supporting healthy immune function for this purpose. Reducing simple sugar intake and achieving some of the lifestyle goals mentioned above may also help to keep the immune system strong.
Antiviral botanicals and nutrients may be considered if active EBV infection is suspected. Epigallocatechin-3-gallate, also known as EGCG, the most abundant catechin in tea, and is isolated from green tea, helps to stop EBV infection in vitro. Extract from Glycyrrhiza glabra can also have some effect against EBV, as does the use of monolaurin (mono-ester formed from glycerol and lauric acid). High dose intravenous vitamin C has been demonstrated to have positive effects against EBV infection in humans. Extracts of the botanical Andrographis paniculata ( Green chirayta, creat, king of bitters, andrographis, India echinacea), may also have some inhibition on EBV. Anti-inflammatory supplements, such as curcumin, bromelain, and fish oil, may also be considered to help mediate the inflammatory cascade within the thyroid that is caused by EBV infection, as well.