Why Epstein-Barr Virus Evaluation Should Be Part Of Your Graves And Hashimoto’s Treatment Plan

Why Epstein-Barr Virus Evaluation Should Be Part Of Your Graves And Hashimoto’s Treatment Plan

Inside: Why should EBV Virus evaluation be a part for your Graves and Hashimoto’s Treatment Plan. What is EBV reactivation and what’s the best treatment for EBV infection through Functional Medicine.

Graves’ disease and Hashimoto thyroiditis affects approximately 10% of the world population and collectively comes under the category of autoimmune thyroid diseases, according to this study [1].

In both of these diseases; the individual’s body starts to produce antibodies against the thyroid gland and which ultimately results in thyroid dysfunction.

The exact cause of these diseases are largely unknown but we now know that its an interplay between genetics and environmental factors [2].

An important environmental factor which can contribute to the development of this disease could be reactivated Epstein Barr Virus or EBV infection and thus it should be part of Graves and Hashimoto’s treatment plan.

Understanding different antibodies which are produced in Graves and Hashimoto’s disease

Different kinds of antibodies develop in Graves and Hashimoto’s disease.

In Grave’s disease, the most common antibody produced is the Trab ( TSH receptor antibodies), which causes overproduction of thyroid hormone and thus the symptoms because of that.

While in Hashimotos the antibodies that are produced are Thyroid Peroxidase (TPO) and Thyroglobulin (Tg) antibodies. These antibodies ultimately destroy the thyroid gland and cause low thyroid hormone production and cause symptoms opposite to Graves diseases.

Epstein- Barr Virus Testing

EBV infection is very common worldwide and most of the time it’s a latent infection so people don’t even know about the initial infection.

Once you get the viral infection, the virus stays in your body and never leaves. But it stays latent in your body, and what that means is that — it is not actively dividing in your body to give you an active infection.

We now know that even in the latent stages this virus has been linked to various kinds of autoimmune infections and cancers.

There is blood work which can be ordered through any lab to check for EBV infection, but a lot of times the most common test that is ordered is the Monospot test which does not show the complete breakdown of all the antibodies and very difficult to know about reactivation of EBV infection. The test that you need are :

  1. Anti- VCA IgM and IgG.
  2. Anti-EA IgG
  3. Antibody to Nuclear Antigen ( EBNA )

The interpenetration of these tests are complicated and should be done with the help of a trained medical provider.

EBV, Graves & Hashimotos

Is there real association between EBV virus and autoimmune thyroid diseases?

There has been speculation of EBV  linked to autoimmune thyroid diseases, but now we have studies which shows this correlation. One such study looked at patients with Graves’ disease who were positive for TRAb antibodies and measured the EBV antibodies [3].  

The results showed that people with Graves disease had a higher percentage of EBV reactivation as compared to people without it [4]. Another study looked for similar association in both Graves disease patients and Hashimoto’s patients.

It showed that 80% of patients with Hashimoto’s patient and 60% of Graves patients had EBV reactivation[5].

The underlying mechanism is thought to be the EBV virus infecting the B lymphocytes which in turn are linked to the development of antibodies. It was also shown that not only the B lymphocytes but the T lymphocytes were also affected with EBV infection and contributed to the underlying inflammation[6].

These B and T lymphocytes are part of your immune system which help to fight infections and by affecting them the EBV can modulate your immune system and contribute to inflammation.  

Most people feel that as the EBV virus is laying latent in a person’s system, it will not cause any damage, but even in the latent state it can produce inflammatory chemokine and contributed to autoimmunity.

Epstein Barr Virus reactivation and its treatment according to Functional Medicine protocol

So say someone has thyroid autoimmune disease and the blood work also showed that they might have EBV reactivation, the big question is — can something be done about it?

According to conventional medicine, unfortunately, there is nothing that can help with EBV reactivation. The antiviral medications are not helpful for EBV infection.

But through Functional Medicine approachyou can build your immunity to fight this infection. Now that doesn’t mean that the virus will go away from your system but it can certainly keep the infection in check.

1. Diet: a hypoallergenic diet that reduces inflammation in your system will be important which includes staying away from gluten, dairy, sugars, and eating plant-based paleo kind of diet. Foods to boost immunity like turmeric, ginger. Prebiotic and probiotic-rich foods for your gut immunity.

2. Gut Immunity: 80% of the body’s immune system is in your gut so we need to heal your gut and make sure its immunity is in good shape for high immunity in your body. So prebiotic and probiotic supplements and gut healing diet and supplements will be important.  

3. Stress reduction: Acute stress can lead to a reduction in immunity and sometimes the effect can last for a long time. For people who are already sick or have compromised immunity any kind of stress can be devastating. So stress reduction techniques like meditation, deep breathing can be very helpful. I also like herbs like ashwagandha, astragalus, lemon calm.

4. Supplements: There are some Supplements for Epstein-Barr virus which can help your body’s immunity against it :  

  1. Monolaurin 1800 mg twice daily
  2. Olive leaf 1000 mg daily in divided doses
  3. Cats Claw 450 mg twice daily
  4. Cordyceps 750 mg three times daily

Grave’s disease and Hashimoto’s are the most prevalent thyroid disorders and infections seem to be an important triggering factor in these diseases. There seems to be a correlation between EBV reactivation and thyroid disorders like Hashimoto’s and Grave’s disease.

So it does make sense to get yourself evaluated for EBV infection if you have either of these conditions. Also provided here are some suggestions that can help you with EBV treatment in a case testing does confirm its presence.

Related Reading:

Research-Based Hashimoto’s Diet

The Association Between Gluten and the Development of Hashimoto’s Disease

How much Vit B12 should you take for Hypothyroidism


1. Davies TF. Infection and autoimmune thyroid disease. J Clin Endocrinol Metab 2008; 93: 674–676.

2. Tomer Y, Davies TF. Infection, thyroid disease, and autoimmunity. Endocr Rev 1993; 14: 107–120.

3. Nagata K, Fukata S et al. The influence of Epstein-Barr virus reactivation in patients with Graves’ disease. Viral Immunol. 2011 Apr;24(2):143-9. doi: 10.1089/vim.2010.0072.

4. Kumata K1, Nagata K1 et al. Thyrotropin Receptor Antibody (TRAb)-IgM Levels Are Markedly Higher Than TRAb-IgG Levels in Graves’ Disease Patients and Controls, and TRAb-IgM Production Is Related to Epstein-Barr VirusReactivation. Viral Immunol. 2016 Oct;29(8):459-463. Epub 2016 Aug 16.

5.  Andrea Janegova, Pavol Janega.  The role of Epstein-Barr virus infection in the development of autoimmune thyroid diseases. Endokrynol Pol 2015; 66 (2): 132–136)

6. Kahan A, Lefloch JP, Charreire J. Normal suppressive T cell function of Epstein-Barr virus-induced B cell activation in Graves’ disease.. J Clin Endocrinol Metab. 1987 Sep;65(3):555-60.

Why Epstein-Barr Virus Evaluation Should Be Part Of Your Graves And Hashimoto’s Treatment Plan

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