# Have High EBV antibodies--Now What?



## TaniaF

Just convince a dr to test my blood for EBV. Does anyone understand these results:IgG 111(H) should be less than 20IgM 5 this is normalEBV nuclear antigen 57(H) should be <20EBV Early antigen IgG PositiveMy doctor says I don't have active mono but that my body has a lot of EBV antigens. There is no cure, but this is why I have FM and CFS. He was no help! Is there other tests I should take to confirm CFS. Susan I read your posted info and I do have some of the symtoms. Should we be taking any meds or special supplements?Thanks,Tania


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## Susan Purry

Hi Tania. I'll get back to you tomorrow with some info about EBV, it's relation (or non-relation!) to CFS. In the meantime, you were asking about testing. Here is some info on CFS which explains about the diagnostic criteria, and how there is no test to diagnose CFS, just tests to exclude other conditions. (FYI, 'ME' stands for myalgic encephalomyopathy, which is the name often used in Britain for CFS).*Is there a diagnostic test for ME/CFS? * http://www.meassociation.org.uk/fgeninfo.htm


> quote:No. The diagnosis has to be made on the typical pattern of symptoms with exclusion of numerous other causes of chronic fatigue. Anyone who is suspected of having ME/CFS should have a number of routine blood tests by their GP as well as more specialised investigations if the diagnosis remains in doubt.


* CFS Diagnostic Criteria used in the USA * http://www.fmnetnews.com/pages/criteria.html


> quote: CHRONIC FATIGUE SYNDROME (CFS) Chronic fatigue syndrome is diagnosed using the CDC 1994 guidelines published in the Annuals of Internal Medicine 121(12):953-959. A copy of this article can be downloaded from the CDC (Centers for Disease Control and Prevention) Internet site at: http://www.cdc.gov/ncidod/diseases/cfs/defined.htm To meet the criteria, patients must have: A. Fatigue Severe, unexplained fatigue that is not relieved by rest, which can cause disability and which has an identifiable onset (i.e., not lifelong fatigue). It must be persistent or relapsing fatigue that lasts for at least six or more consecutive months. B. Four or more of the following symptoms: impaired memory or concentration problems tender cervical or axillary lymph nodes in neck region (note that they do not have to be swollen but just tender; this can be a problem for people with FMS who have tenderness in these areas as well) sore throat (but may not show signs of infection) muscle pain multi-joint pain (but not arthritis) new onset headaches (tension-type or migraine) unrefreshing sleep (wake up in the morning feeling unrested) post-exertional malaise (fatigue, pain and flu-like symptoms after exercise


*Diagnosis and Description of CFS: National Institutes of Health 09-01-1999 * http://www.immunesupport.com/library/showarticle.cfm?ID=1181


> quote:Chronic fatigue syndrome (CFS) is an illness characterized by prolonged, debilitating fatigue and multiple nonspecific symptoms such as headaches, recurrent sore throats, muscle and joint pains, and cognitive complaints. Profound fatigue, the hallmark of the disorder, can come on suddenly or gradually and persists or recurs throughout the period of illness. Unlike the short-term disability of an acute infection, CFS symptoms by definition linger for at least 6 months and often for yearsï¿½ï¿½Despite multidisciplinary investigations into the cause of CFS, its etiology remains unknown. Similarly, no specific diagnostic tests or therapies for CFS exist. A supportive program of patient management--including symptom-based treatment, education about the disease, and regular follow up visits to rule out alternative diagnoses--can offer reassurance, dispel unfounded beliefs about CFS or its treatment, and help patients and their families adjust to living with this chronic illnessï¿½ï¿½Besides a debilitating fatigue unrestored by rest, common symptoms of CFS include more intense or changed patterns of headaches; reduced short-term memory or concentration; recurrent sore throats; tender lymph nodes; muscle discomfort or pain; joint pain without joint swelling or redness; unrefreshing sleep; and postexertional malaise lasting more than 24 hours (table 1; see appendix for detailed list). The severity of CFS symptoms varies broadly among individualsï¿½ ï¿½Although CFS can persist for many years, longitudinal and followup studies indicate that CFS generally is not a progressive illness. The symptoms usually are most severe in the first year or two. Thereafter, the symptoms typically stabilize and then persist chronically, wax and wane, or improve. Most patients partially recover, some fully recover, and others recover and relapse. Currently, an individual's course of illness cannot be predicted. No long-term health risks, such as an increased risk of cancer, have been associated with having CFS.


Here are some websites with info on CFS: http://www.cfids-me.org/ CFIDS Association of America: http://www.cfids.org/ www.immunesupport.comCFS & Fibromyalgia Information Exchange Forum: www.co-cure.orgHope this does for now whilst I'm getting some info on EBV!


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## TaniaF

Thanks Susan for all your time ---this will keep me busy reading.Tania


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## Susan Purry

Hi Tania, 1) Generally, any virus can trigger the development or relapse of CFS. About 70% of cases of CFS are acute onset, after a viral infection. 2) Antibodies to EBV is pretty common and 'normal', judging by this:


> quote:ï¿½Carriers of the disease [EBV] can even pass it on without developing it themselves. By the age of 30, nearly 90 % of all adults will have developed antibodies to EBV, indicating a full degree of immunityï¿½ Charles Shepherd ï¿½Living with M.Eï¿½ pp. 15 ï¿½ 16


Here is an article you may find useful:


> quote:*Chronic Fatigue Syndrome* by Burke A Cunha, MD http://listserv.nodak.edu/scripts/wa.exe?A...re&F=&S=&P=3784 INTRODUCTIONBackground: Chronic fatigue syndrome (CFS) is a disorder ofunknown etiology, which probably has an infectious basis. CFSis a state of chronic fatigue, which exists without otherexplanation, for a year or more, and is accompanied bycognitive difficulties.Various unrelated infectious diseases (eg, pneumonia,Epstein-Barr virus [EBV] infection, diarrhea, upper respiratorytract infections) appear to lead to a state of prolonged fatigue insome patients. If the condition is accompanied by cognitivedifficulties, the disease is termed CFS.While the cause of CFS is unknown, the disease probably is aninfectious disease with immunological manifestations. CFS isnot caused by EBV, one of the viruses that may lead to a state ofchronic fatigue. EBV definitely has not been shown to causeCFS, and CFS is not synonymous with chronic EBV or chronicinfectious mononucleosis.One or more viruses have been implicated as the cause of CFS,excluding EBV, but no causal relationship between any virus andCFS has been proven. Some have suggested that Chlamydiapneumoniae is the infectious agent responsible for CFS, whichmay become activated following prior contact with anotherinfectious disease agent...Pathophysiology: Because the immune system is up-regulatedin CFS, antibody titers to various previously encounteredantigens are increased. While increased titers do not indicate acausal relationship in CFS, nevertheless, the titers are useful aslaboratory clues, which, when taken together, occur regularly inpatients with CFS.Because so many patients with a possible diagnosis of CFSpresent with an elevated immunoglobulin G (IgG) viral capsidantigen (VCA) EBV titer, this determination should beconsidered consistent but not diagnostic of CFS. Most patientswith CFS demonstrate elevated IgG, coxsackievirus B, humanherpes virus 6 (HHV-6), and/or C pneumoniae titers. Patientswith CFS also commonly show a decrease in the percent ofnatural killer (NK) cells. Most patients with CFS have 2 of the 3above-mentioned immunological perturbations...* Patients with CFS often are referred to an infectious diseaseconsultant because of elevated IgG VCA EBV titers. IncreasedIgG titers to the VCA of EBV are common in the generalpopulation, regardless of whether the patient is fatigued or not.An increased IgG VCA EBV titer indicates past exposure toEBV but does not indicate acute disease or explain the patient'schronic fatigue state. EBV often is the precipitating event thathas triggered the patient's chronic fatigue state.


Others here may have some experience with the issue that they can share with you.Has your doctor given you a diagnosis? Did you both go over the diagnostic criteria for CFS at your appointment? Best wishes,


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## TaniaF

Thanks Susan, I will print this up. Most doctors here in FL refused to test me, I begged this nurse practitioner to do the EBV testing. I'm planning to see an infectious medicine dr and hope she will do further testing and use this criteria for a dx. I have had neutropenia for at least 25 years since the birth of my last child. I wonder if neutophils are what they call "natural killer cells"? I'll keep you posted when I get results--i just want answers--obviously there is no cure and I have had this illness for at least 25 years. If the drs won't help me, I'm just going to follow Dr. Teitelbaum's or Dr. Cheney's protocol on CFIDS with natural supplements. I already take guaifennesin (basically for my allergies) but this has kept my FM mild. This is Dr. St Armand's protocol. For me, it works!Tania


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## M&M

Bump for Miasue


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