In this week’s podcast with Dr. Hedberg, we discussed the role of chronic viruses, their relationship to autoimmunity, and whether or not they need to be treated. Today we’ll break down some of the key points that Dr. Hedberg made so you can make more informed health decisions.
If you need help managing an autoimmune condition or virus, click here
Steps to Take for Overcoming a Chronic Viral Infection
There are several chronic viruses that the majority of people have been exposed to. Most of these viruses are in the herpes family, and once exposed, you can never get rid of them. They will always be in your body. Examples include Espstein-Barr (EBV), Cytomegalovirus (CMV), herpes simplex, and parvovirus.
In a healthy person with a strong immune system, these viruses usually remain dormant and don’t cause any symptoms. In other people, these viruses may reactivate and cause a host of unwanted symptoms. The question is, why do these viruses cause problems in some people?
According to Dr. Hedberg, the underlying reason for the virus reactivating is due to glucocorticoid resistance. This is an ongoing issue in a lot of people. In those with glucocorticoid resistance, their stress physiology is disrupted. In other words, their HPA axis and autonomic nervous system are disrupted. This is usually due to chronic stress.
The other issue is that treating the virus usually doesn’t work. It may deactivate or go away for a little while, but until the undlying issue is addressed, the virus usually ends up coming back.
The Role of Chronic Stress
We’ve all heard the term “chronic stress,” but what exactly does that mean, and how can you minimize the stress in your life?
Chronic stress comes in multiple forms, and we’ve become a society plagued by stress-related health issues.
Chronic stress can be caused by physical, mental, emotional, environmental, or electronic stressors. Examples of physical stressors include any type physical trauma or stress on the body. Mental and emotional stressors include difficult relationships, verbal abuse, an angry boss, negative thoughts and beliefs you’re telling yourself, and so on. Environmental stressors consist of the polluted air we breathe, the water we drink, and the toxic food we may be eating, such as GMOs, processed foods, sugar, and foods we’re intolerant to. Then, there’s a whole new category of stressors in the form of electronics. This includes email, social media, TV, the news, and so on. We are connected 24/7, and it’s overwhelming our body and mind. Chronic stress can also be related to events that happened years ago, such as childhood trauma, whether it was physical or emotional.
Chronic stress leads to chronic elevations in cortisol, which has detrimental effects long-term. Overtime cortisol receptors start to down regulate. They don’t respond to cortisol anymore. This creates a lot of inflammation in your body. Cortisol is very important for the immune system, and when it’s too high or too low, it can cause problems. In this state, the body can’t control and fight off chronic viruses because of the glucocorticoid resistance.
What’s the Solution?
Treating a chronic virus may require a multi-pronged approach, but the most important piece that you can implement now is stress management. Dr. Hedberg recommends daily meditation and journaling. Many studies have proven the benefits of meditation, and there’s been a lot of research demonstrating the effects of journaling on reducing inflammation.
Additional stress management activities to consider include:
- Walks in nature
- Epsom salt baths
- Listening to relaxing music
- Diffusing essential oils
- Expressing gratitude
In addition to stress management, treating the virus may be necessary. However, you don’t want to treat it super aggressively. Remember, it’s an issue not of eradicating the virus but of making sure your immune system is doing its job and supporting your body.
Some natural treatment options that Dr. Hedberg recommends when there is confirmed virus reactivation are:
- Monolaurin — very effective for variety of viruses, especially herpes virus
- fatty acid ester derived from coconut
- helps to decloak the virus and expose to the immune system so the immune system can fight it
- also supports the immune system
- works well for vast majority of people
- very well-tolerated and effective
- has antifungal properties as well
- Curcumin — studies supporting efficacy of curcumin for EBV
- Vitamin C — intravenous vitamin C is preferred but oral is helpful
- Reishi mushroom extract
Your doctor may recommend certain testing both for testing virus reactivation and cortisol levels.
In regards to testing cortisol, many functional medicine practitioners use salivary testing because it’s usually more accurate than blood testing. However, there are problems with salivary testing too.
According to Dr. Hedberg, salivary cortisol testing only gives you about 5% of total cortisol production. So this test might not be as accurate as we previously thought.
A more accurate way to measure cortisol is a urinary profile. Through a urine test, such as an organic acids profile, you can see the metabolized cortisol, which is the bulk of cortisol production. It’s typical to see high levels of cortisol metabolites in patients with chronic infections and inflammation.
An organic acids urinary test is probably the best option because it looks at several metabolites. This test provides information of overall metabolism including catecholamines, epinephrine, and norepinephrine, which is the other part of the adrenal gland. Ideally, you shouldn’t just look at cortisol; you need to look at the whole picture.
While a urine test is a more accurate cortisol test, it’s still missing a critical component. It doesn’t tell you much about the cortisol receptors. So it may be better in this case to treat the patient based on their symptoms rather than their lab values.
Adaptogenic herbs can be very helpful and supportive in managing cortisol levels. It’s interesting that the studies done with adaptogens were never based on lab values; they were based on symptoms. And the studies showed major symptom improvement across a variety of parameters.
There are a few markers that can be measured to test for a reactivated virus. Unfortunately, there’s no standard interpretation guidelines. Different labs have different guidelines.
Here are some general guidelines to consider:
- Most people will have high viral capsid antigen and nuclear antigen unless the person has never been exposed to the virus.
- Early antigen IgG seems to correlate best with reactivation. If that’s elevated, it denotes EBV reactivation.
- Cytomegalovirus uses a different panel. You can test for IgG, IgM, and PCR.
- PCR gives a direct view into the activity of the virus in the blood, which is pretty rare.
- It’s usually enough to just measure IgG and IgM.
- If IgM is positive, then it’s pretty clear that the virus is active because it usually hangs around for only about seven weeks.
- You also want to consider symptom analysis, such as muscle pain and muscle twitching.
- Inflamed salivary glands is a virus symptom of CMV and EBV.
When to Treat
There’s been shown to be a correlation with autoimmune conditions and chronic viruses, such as Hashimotos and EBV. It’s common to see people with Hashimoto’s and high EBV titers. But does that mean you need to treat the virus? Not necessarily. You must consider patient symptoms as well as other measures. For example, if someone has low ferritin (iron), then that must be addressed before trying to treat the virus. Sometimes you need to focus on immune system function and supporting the immune system rather than attacking the virus. It’s important to take an indivualized approach.
In general, it’s a good rule of thumb to work in the following order:
Level 1 — foundational dietary and lifestyle changes
Level 2 — testing for imbalances, GI work-up, ferritin, etc.
Level 3 — targeted antiviral therapy when necessary
Post-Treatment Action Steps
- Repeat bloodwork after three months
- CBC (complete blood count)
- Markers of inflammation, CRP
- Test viruses directly
- Measure symptom improvement
Other Things to Consider
The microbiome plays a significant role in overall immune function and inflammation, so you need to address any gut imbalances first such as infections, dysbiosis, and so on.
If you need help managing an autoimmune condition or virus, click here