Chris Kresser: Yeah, so this is a bigger topic, and we’ll definitely cover it when we do the advanced module on chronic infections later, but the short version is virtually everyone has IgG antibodies for Epstein-Barr. About 90 percent of people have been exposed. Cytomegalovirus exposure is also very common. You cannot determine whether someone has an active Epstein-Barr or cytomegalovirus infection or a reactivated infection just by looking at IgG antibodies.
Now certainly, in some cases, if the IgG antibodies are extremely elevated, like in the hundreds, that can be an indicator that the infection is reactivated and may need to be addressed. But testing for viral infections is fairly complex and murky, and in many cases where you see this type of IgG antibodies, going after the viruses is not often going to be the most effective step you can take. With Epstein-Barr, we’re all exposed, and we never get rid of it. So, after we get over whatever initial symptoms there are, if there are any at all—some people don’t have them—then the Epstein-Barr virus just takes up residence in our body. What can happen is that later on, if the body becomes really taxed due to extreme stress, other infections, other problems like GI issues, or whatever, then the Epstein-Barr virus will become reactivated.
But that’s not because they were exposed to it again or they got a new infection. It’s just that their immune system has become unable to keep it in check as it used to be able to do. So, in that case, if you think about it from a functional medicine perspective, the solution is not necessarily to use antivirals to knock the virus down, although that can be necessary in some cases. It’s to remove or address all of the other problems that are making the immune system function poorly so that the immune system can do what it should be able to do, which is keep the virus in check in the first place. That’s the 30,000-foot view. Again, when we do that the chronic infection module later, we’ll go into more detail on that.