Diagnosing Epstein-Barr Virus Infection

Diagnosing EBV in chronic fatigue syndrome is fraught with controversy. Dr. Lerner and Dr. Glaser believe that increased levels of antibodies to nonstructural proteins indicate a smoldering but still problematic EBV infection. Dr. Montoya believes that high IgG levels are indicative of EBV reactivation (not a first-time infection). The CDC believes neither of these tests are indicative of an important infection.

Since the issues revolve around antibodies a short primer on the antibody response and antibodies is below.

The Epstein Barr Virus Series on Phoenix Rising

 The Antibody Response

Immunoglobulins or antibodies are produced by B-cells when they are triggered by the presence of antigens. Antigens are anything that stimulates the immune system but typically they are proteins produced by pathogens.  Not necessarily dangerous in themselves, they are signs of danger that provoke the immune system to attack.  antibodies in chronic fatigue syndromeAfter a B-cell is activated it turns into a plasma cell which produces antibodies designed to attack anything carrying the antigen which activated that B-cell.

Antibodies neutralize pathogens in various ways. Quite large in size they can stop pathogens from infecting cells simply by attaching themselves to pathogens and blocking their docking mechanisms.  Once they are attached antibodies also send signals to phagocytes and to the complement system to attack and remove the invader. Antibodies only attack pathogens found outside of cells they are unable to attack intracellular pathogens except when they are dispersed in the bloodstream. Antibody production is a hallmark of the humoral or Th2 immune response responsible for killing extracellular pathogens. Antibodies can also neutralize toxins.

Since pathogens typically carry several antigens the immune system typically produces multiple types of antibodies for each pathogen. Since the different antigens are often associated with different stages of the pathogens life cycle, assessing the types of antibodies present can help physicians chart the course of an infection.

Antibody Tests

  • IgM antibodies – because IgM antibodies usually appear early in an infection and then disappear they are often a sign of a recent infection or reactivation.
  • IgG antibodies – since IgG antibodies to a protein on the viral coat (viral capsid antigen) peak early in an infection and usually persist for life they usually denote nothing more than that a person has been exposed to a pathogen. IgG antibodies to an antigen produced early in EBV’s life cycle (early antigen) are produced only for 3-6 months and are a good indicator of an active infection. Since about 20% of healthy people carry this antibody for years the IgG early antigen test is, not definitive. Dr. Montoya believes, however, high IgG levels found in combination with other clinical signs of chronic fatigue syndrome accurately  reflect EBV reactivation. The success of the B-cell depleting drug Rituximab in post infectious mononucleosis ME/CFS patients with high IgG titers but no other evidence of infection ( including serological tests) suggests Dr. Montoya may be correct (see EBV Part II).
  • EBV nuclear antigen (EBNA) – since EBNA antibodies are found two to four months following the onset of EBV infection and persist for life they simply indicate that a very recent infection has not occurred. Assessing the EBNA test is complicated by the different ways of measuring it; while the standard immunoflorescent test does not detect EBNA for two to four months some immunoassays can detect within a few weeks of the initial infection.

There’s obviously some real grey area here and situation is quite complicated. The CDC posts the following guidelines for assessing EBV tests. The CDC believes EBV reactivation plays no role  in chronic fatigue syndrome.

CDC Guidelines for Assessing EBV Infection 

First-Time or Primary Infection - A first time EBV infection is indicated if IgM antibody to the viral capsid antigen is present and antibody to EBV nuclear antigen, or EBNA, is absent. A rising or high IgG antibody to the viral capsid antigen and negative antibody to EBNA after at least 4 weeks of illness is also strongly suggestive of primary infection. In addition, 80% of patients with active EBV infection produce antibody to early antigen.
CDC Logo
Past Infection - If antibodies to both the viral capsid antigen and EBNA are present, then past infection (from to 6 months to years earlier) is indicated. Since 95% of adults have been infected with EBV, most adults will show antibodies to EBV from infection years earlier. High or elevated antibody levels may be present for years and are not diagnostic of recent infection.

Reactivation - In the presence of antibodies to EBNA, an elevation of antibodies to early antigen suggests reactivation. However, when EBV antibody to the early antigen test is present, this result does not automatically indicate that a patient’s current medical condition is caused by EBV. A number of healthy people with no symptoms have antibodies to the EBV early antigen for years after their initial EBV infection. Many times reactivation occurs subclinically.

Chronic EBV Infection - Reliable laboratory evidence for continued active EBV infection is very seldom found in patients who have been ill for more than 4 months. When the illness lasts more than 6 months, other causes of chronic illness or CFS should be investigated

The Phoenix Rising website and most of the articles in it are created by a layman. It is not a substitute for a physician and is for informational uses only.

Maja July 19, 2013 at 8:09 pm

My VCA Igm is >0.2, the ED is 0, the Ebna1 is 0.8 and VCA Igg is 5.8.
Can you please tell me what it means?

Dominic October 22, 2013 at 7:57 pm

so if someone has had memory loss, fatigue and blood pressure issues over the past four years, and they find out there EPSTEIN BARR VIRUS CAPSID AB.IGg and EPSTEIN BARR VIRUS NUCLEAR AB.IGG were high, does that mean they have chronic fatigue or some kind of immune system issue? the EPSTEIN BARR VIRUS CAPSID AB.IGM was normal.

Christina McClain March 14, 2014 at 8:04 pm

IIwonder if the CDC thinks differently about a link between chronic fatigue and the EBV. Since there ishas been a recent study in EBV that have chronic fatigue. I dont know whenvthey actual study was done but they posted the studies and Pubmed posted the studies also in 2014.

Dianne Galster April 4, 2014 at 6:48 am

My EBV Ab VCA, IgG > 8.0 . Also EBV nuclear antigen Ab, IgG > 8.0. Also EBV early antigen Ab, IgG 3.8 and EBV Ab VCA, IgM <0.2 – can you please interpret in layman's terms. I have been extremely fatigued for long periods. Also my EOS is elevated 7 and EOS absolute is 0.5 thank you

Lori April 5, 2014 at 5:07 pm

I was wondering what it means when my EBNA is 5.31; EB-VCA IGG is 5.25; EB-VCA IGM. I have been ill since 2006 and dr thought it was lymes but til this day all tests come back negative. My doctor has been saying that it’s the beginning stages of MS. Any suggestions would be greatly appreciated! Thanks in advance!!!

Lori April 5, 2014 at 5:08 pm

Oops my EB-VCA IGM was 0.14

LeeAnn May 5, 2014 at 2:55 pm

I’ve been on what I refer to as my “Medical Mystery Tour” since 2008. I married an Air Force Officer& moved 11 times- my medical records are all but completely missing. Until ’08, I was a very well person, except for the few things I’ve had in my life that were “doozies”. So it would be VERY helpful to have all of that. (Chickenpox at 7, then hospitalized for over a week in at age 17(1982) with mono& tonsillitis. I was out of school 2months. Then at 27, some unknown flu-like illness hospitalized for a week again- Aseptic Meningitis was the final verdict. And 3 years later after having my 2nd son, husband had strep& I was admitted again with peri-orbital cellulitis- from scratching a bump on my forehead- and the strep…long story. So yes, those were bad but other than that- just a physical each year. But- my medical record had been list pieces at a time. I’m so sick of being shuffled from doc to doc giving history OVER and OVER. (and catching things in my record that are wrong) I thought at least now w/online records for access by the physicians I’ll see, I could stop stressing about falling through the cracks. BUT when I finally accessed it- I found so many incorrect entries- and a summer’s worth of hematology and investigation by hematology not even included! Luckily I have copies of every test or visit since ’08 in my hands now.
There’s no way I can ask all Id like to, so my main question is about EBV tests that were done 5years apart. (My GP never saw the need to retest or dig deeper into the results found in 2009 when I wondered if there could be other reasons for the Nuclear Antigen Ab, IgG to be so high. Didn’t seem to match up with other results I’ve seen. late ’09 results were:
EBV Ab VCA, IgM ———— [H] 0.9
EBV Early Antigen Ab, IgG—0.3
EBV Ab VCA, IgG————-0.6
EBV Nuclear Antigen Ab, IgG [H] >8.0

I’m a 48yr old female (have NOT gone through menopause) and after almost 6 years now
have been stressed because I know something is wrong -they found I have full blown Osteoporosis. No known cause. Not are they LOOKING for a reason for my bone density to be so low- especially in my right hip- where I complained 4 years ago 3different GP visits that there was deep bone pain there and in my leg bone. I have NOW had a groin lymph node hard enlarged& fixed- for 14 months& they blow that off too! After my bone “pain” started making it’s way other places, I begged for a bone doc referral and the GP sent me to a Rheumatologist. (Need to mention that my symptoms began in the head& neck& as they come and go it’s been blown off as sinus by the ENT. (Even though 2CTs 2 years apart show odd changes to me-the 2nd report said “nothing to compare to” & the 1st SHOULD have been in the system (I have copies from their department why don’t they?!) I kept saying it was the right ear clogging cheek pressure, bulging eye&felt like my nose was being pushed BAD) That would come and go. Vision got worse- blurred. Saw Optho& the FIRST time I did have viral issues. It was a month after that my GP said AHA!!! It’s EBV- you’re just tired& that’s the reason. No more.
I saw HER one last time, when I found a dark round lesion in the conjunctiva of that eye. She sent me back to Optho- He said Lacrimal Gland Cyst& they’re common. But I had been taking pics& my whole face has changed shape. it’s very obvious the right eye pushed forward& down. (age is what he said…we all change) Well, I had a worsening astigmatism which he acknowledged but NO eye glass prescription has ever been right. I listen every time and stick w/them for 2wks- but things are warped. Rectangles look more narrow at the top- or crooked.) This time he did do a schrimmers test(after I had my DENTIST call him about my terribly dry mouth and thickening tissues. He asked if I had heard of Sjogrens. Well, I told him of all the ENT problems& he thought also that my tonsils- the right side more than left, pokes out- looks lumpy w/”yellowish” encased bumps. Back of the throat looked thick& bumpy w/lots of bright veins& some slightly white glossy patches! there is a dark area on the roof of my mouth as well as the right side thickening& midline slightly off. (Sorry these is so much) I just think this virus has lingered &been brushed off as common while my body breaks down.
Back to the bones- I did have some x rays when the bloodwork was done and Dexa Scan(sp?) sorry. Anyway, I have some bone spurs but the doc laughed that he could just “see through” my bones! I insisted on looking for a reason for it before just sticking me on Fosamax (when A panoramic dental x ray shows bone loss and my right side sounds like ground glass when I chew) But it was the hematologist who ordered blood work and the bone density after Calcium extremely high consistently, low vitamin D- (I AM taking D & he agreed stop the Calcium for now& let’s wait on the Fosamax) That was August. He ordered a few other things- (white count has been low ALL this time. It was at it’s lowest a year ago) but one was LDH- He’s a hematologist/oncologist- and wasn’t at all phased by the LDH being 380- there are TWO VERY different lab ranges from what I have found. They go by 313.0- 618.0. I DO NOT GET IT. I see dark spots on some bones- also on the skull from the topogram(?) from the last CT. How can there be 2 totally different ranges? the other one has me out of range on the High side-
Through all of this, I’ve trusted each of these docs& at the times, some years ago, these different symptoms and test results in and of themselves may not be a concern. But also Creatinine has been high- come back w/in range but high again. Bun/Creatinine ratio is back in range but was VERY high a few years ago.
I feel like I’m going crazy (that I went crazy… I’m BACK and finding out what is wrong and sticking up for myself and not being made to feel like a hypochondriac anymore!) – My marriage has certainly suffered. In these past 5 yrs my sons both graduated from high school& their last years home, their Mother was useless- sick with low fever on& off ALL the time& having these symptoms build, while my ability to do things dwindled to nothing as it seemed my body was breaking down. I did great moving all over in the military… and most of the time, ran the household, was pres. of two organizations, I was an Art teacher& have SO MANY creative interests , and I entertained all the time. I was really looking forward to an empty nest (laugh)! I did go to a psychiatrist& have been seen pretty much this whole time& have documented this was not depression, or that I need a hobby or anything to do with the boys leaving- 3years apart. They were here for most of this& saw their Mom become someone else. NOTHING I have been on anti-anxiety medication& an anti-depressant! Which is what the Rheumatologist said I should do (I TOLD her I had been for a long time, and yes, NOW I am depressed. It’s like “which came first, the chicken or the egg?”!
I’m so sorry I wrote so much& didn’t intend to but where it stands now, The rheumatologist saw me once- poked me in places UNTIL I said they did kind of hurt& she said “Fibromyalgia… have them switch you from Wellbutrin to Cymbalta (for the muscles that are ALL in spasm) I told her about osteoporosis- she read the report and paper reports from X-rays but never looked at any of the imaging. I did show her a photo printed from the CD of the shoulder x ray- because I thought she may be interested in what looks like bubbles and spots especially on the acromien (?) & what looks like no joint space on that side compared to the left! Who reads these things, monkies? And why have all theses docs passed paper reports without looking at any of the imaging themselves. (except the ENT but he only saw the one CT he ordered) that report noted a midline shift one side more forward than the other, a deviated septum (which WAS NOT present a yr&1/2- 2yrs prior. Also a spur in one nostral and large Concha Bullosa in the other- again- not in the prior report. Also, an underdeveloped frontal sinus ,”may be a congenital variant”. Nope- not on the prior report which as I said, didn’t seem to be in the system. I feel like everything has been a waste of my time and certainly added to the decline in health. These are the August EBV results- and as I said, other blood work has issues.
On 8/28/13 results:
EBV Ab VCA, IgM————–[H] 1.3
EBV Early Antigen Ab, IgG—- 8.0
I know I have confused you all- I’m sorry. I know I should get a 2nd opinion on the imaging- but what I HAVE done finally, is call my course, an internist in SC &the couldn’t believe the Rheum didn’t order further tests so he did, and I am having them done tomorrow and will see her again with the results. I know she won’t be happy- I do respect her& her knowledge, I just felt, and so did my cousin, that she didn’t consider at all the seriousness of the bones deteriorating, muscles drawing up, blood work that should make her question kidney function& and did functioning glands as well- mouth and eyes- and others. I think it was crazy not to consider autoimmune so he did order some test for that(?) but-whether or stress or years of just not being well- and not getting answers or having the virus lurk in me has my body in this state, is irrelevant at this point since I don’t feel any doc I’ve seen has told me ANYTHING about what is wrong- it is a serious state my body seems to be in now- and I have “”Fibromyalgia” not really stamped on my file- but “fibrosis and unknown connective tissue disorder” with no concern as to what it is? And I asked if she would be doing any blood tests at this next visit& she said no- it’s a follow up to see if Cymbalta and warm water therapy have helped- and the 2Aleeve 2times a day she said to take- I want to scream- but I barely have a voice to do that with- as I forgot to mention the hoarseness that is getting worse (started 4yrs ago- &not from pollen this time of year) it is getting worse as well as difficulty swallowing. Not just due to dry mouth. It’s even when drinking liquids.
I know I’ve gone off the subject of EBV, but I wanted to know if my test results could point to the numbers(especially Nuclear Antigen) being high due to something else- or maybe a simple validation that I’m not nuts for questioning a more serious issue with the bones- immune system or even bad issue linked to EBV. I just feel like all of this is a “recipe” for something that COULD be stopped if they can pinpoint it?

Just want to feel better May 12, 2014 at 10:16 am

I’m not a physician and I don’t have any answers for you, but I feel compelled to comment because so much of your history is similar to mine. I’m also on a medical mystery tour.

Key similarities:

I too have moved many times. 2 countries, 11 states. I have always considered myself relatively healthy, with nothing but a few “doozies” over the years. Including a few strange strands of strep, occasional pneumonia, and meningitis back in 2002. The meningitis was interesting, as I was not in the usual risk category. A married mother of two who worked full-time in an office building. No other sick folks in the office. The hospital misplaced my meningitis results and were never able to tell me if I had bacterial or viral meningitis. I spent more than a week in a hospital and took several more weeks to recover. That was 12 years ago, and I have been relatively healthy since then.

Last October (seven months ago), I presented with sore throat, swollen glands in my neck, low-grade fever, muscle aches, nausea, night sweats, and fatigue. A strep test came back positive, so I was sent on my merry way with some antibiotics.

The sore throat/glandular swelling subsided, but I still had the remaining symptoms. I went back to my PCP for blood work and a physical. Blood work was normal. Physical was normal. Two months later, my husband discovered a large lump on my lower right back. I went back to my PCP who diagnosed a lipoma. Told me not to worry about it. Given that I still had low-grade fever, muscle aches, nausea, night sweats, and fatigue, I consulted with MD Anderson. They confirmed a lipoma (benign tumor). They also ran a host of other tests, including more comprehensive blood work.

VCA IGM: 1.1
VCA IGG: 7.4
EBNA: 4.0

Referred me back to my PCP. By this time, I had joint pain and my left hip hurts. PCP referred me to a rheumatologist who is running more blood tests. I had x-rays and MRI’s of my hip and other joints performed this week. Awaiting results.

Like you, I have been on anti-depressants since about the time all of this started… 7 months ago. Not sure which came first, depression or the other symptoms. Last week, the rheumatologist added a non-steroidal anti-inflammatory to my pill box.

I’ve lately noticed short-term memory and concentration issues as well as occasional vision impairment.

I have gained 20 lbs since this started, perhaps because I’ve quit going to the gym (too tired) and the nausea seems to be quelled by eating. It feels like I’m suddenly falling apart. I am still attending my martial arts class 4 days per week, but it takes a lot out of me. I’m only 38 years old.

Amy August 28, 2014 at 1:04 pm

Sounds like Lyme Disease. I strongly suggest that you research the disease extensively.

Anne Rush September 17, 2014 at 12:45 am

I’m not a Dr, etc etc, but With “very high calcium and low vit D” coupled with your severe osteoporosis, and aches and pains, you might want to check hyperparathyroidism. It’s a completely different gland than thyroid. You can have a Dr. Check your parathyroid level (Pth). I just went through a this. Parathyroid.com is a good source for information. I hope you find help.

Albert November 4, 2014 at 5:31 am

Hey there i used to be a sprinter in college with a good future and was forced to retire due to deteriorating health. Fibromyalgia, excessive fatigue, and emotional stress as being thought of as lazy as i put my body through hell, and had high igg ebv positive, a couple of episodes of cardiac arrest and retinal vasculitis all this by age 23 and now am bed ridden…i started finding better answers when i started to forget what everyone thought( including doctors cardiologist and primary doctors and “friends and family”) and started trusting on how i felt and accepting it and fighting for it by researching and finding doctors that were interested in my words as much as my lab results, remember these results and factual and solid but their interpretation is based on the “hunches” of docs when they make a diagnosis. just keep in mind they arent God, and keep going… Try seeing an immunologist..NOT a regular doc who can order t or b cell counts but an actual immunologist and not a rheumatologist, they same there in the same area but totally different ..might have igg deficiency…immunoglobulin. might be right might not…not sure but its worth a try. Keep going, your not alone, God bless you

LeeAnn May 5, 2014 at 3:59 pm

I completely screwed up the latest EBV results- somehow erased part- that should be:
I left out the two middle ones which were basically the same as in the earlier test. But to clarify,
in Oct.’ 09:

EBV Ab VCA IgG 0.9(H)
EBV Early Antigen Ab, IgG 0.3
EBV Ab VCA, IgG 0.6
EBV nuclear Antigen Ab, IgG >8.0(H)

Aug. 2013:
EBV Ab VCA, IgM 1.3(H)
EBV Early Antigen Ab, IgG 8.0(H)

And again I’m so sorry to have typed so much. I get frustrated- as we all seem to with this. And I apologize if this isn’t the right forum :(. Very important thing I forgot to mention is that I started getting some type of skin lesion on extremities from time to time that looked like ringworm but was tested years ago- not fungal- “probably dry skin or eczema”, so sayeth a very unconcerned military flight surgeon- So I would take a photo of it at the beginning stage and then it would “run it’s course” of about a month and leave a white scar sometimes. This became more frequent- I chalked it up to stress- But I have one on my forearm that came and that one has been there almost 2yrs (never went away like the others) basically round but a little irregular darker outline, lighter center. Many have come and left scars- much more frequent now. 15 yrs ago I had the first one. Probably had 2 during a year until 6 yrs ago. they became more frequent. and I also get pitted places& have a lot of new very small dark brown moles and also get something that is pencil eraser size but smooth& pearly fleshy-white in color and just slightly raised- flat for the most part. I have photographed it all- and filed them away. And another important thing is when I do feel kind of feverish, and sometimes have a low fever, I get what the hematologist did say was a butterfly rash. not in the creases of the nose but just the nose& cheeks. My chest STAYS looking like it’s a bit sun burned but it isn’t. It is like a “bib” and often gets even redder at times. But has been this way about 6-8 years (even when I don’t get the face butterfly rash)
Again I’m so sorry- but thank you SO very much

AMY PASTOR November 11, 2014 at 8:24 pm


Dee June 1, 2015 at 12:34 am

Lee Ann, I replied earlier, but didn’t realize I could reply to your direct post. Sure hope you get this. I think I know at least one major thing wrong with you. Please go to parathyroid.com and join parathyroid disease support on Facebook. A lot of what you have mentioned screams primary hyperparathyroidism. Your doctors need to do further testing for this disease. It explains your low vit d, elevated calcium, bone wasting and pain, anxiety, fatigue, and the feeling that you are losing your mind. After years of trying to figure out my husband’s woes, I spotted a few slightly elevated calcium numbers (between 10-10.5) and demanded more testing. Finally I went directly to an endo surgeon who deals with this and he is now scheduled for surgery. I truly believe this might be a big chunk of your issues. Also, a lot of hyper parathyroid peeps have thyroid issues. Good luck!!

LeeAnn May 5, 2014 at 4:06 pm

y’all are going to kill me- it looks like it left those out again- Ill try once more with no extra info- this is what it left off from August 2013

EBV Early Antigen Ab, IgG <0.2
EBV Ab VCA, IgG 0.6

LeeAnn May 5, 2014 at 4:30 pm

seriously-do I need to wonder if my brain has been damaged?!… I am really sorry :( trying to clarify- forgive me please. it’s
VCA IgM 0.9
EA Ab IgG 0.3
VCA, IgG 0.6
Nuclear Antigen Ab, IgG >8.0

(The Early Antigen is not, and never was 8) It is the Nuclear Antigen that was, and still is >8.0 . That’s a mis-type in the very first post.

VCA, IgM (H) 1.3
EA Ab, IgG 8.0

LeeAnn May 5, 2014 at 4:41 pm

I’m going to try by “reply” and not re enter- it is NOT posting what I type. I am just about to give up on every bit of it

early antigen IgG in ’09 was 0.3 and in 2013 it was 8.0

LeeAnn May 5, 2014 at 4:48 pm

that’s not what I typed either. I think I’ve wasted an afternoon and taken up space here on the post. I do not know why it won’t post what I’m typing. My early antigen was NEGATIVE both times as well as my VCA IgG. My IgM HIGH both times w/slight increase and Nuclear Antigen IgG very High >8 both times

LeeAnn May 5, 2014 at 4:52 pm

now that’s what I typed- Hope to God there is not an out lash for so many attempts to correct. All I can do is hope for support. Thank you& love and good luck to all

Michelle May 12, 2014 at 11:34 am


I read your story and symptoms, I am so sorry for all you have gone through. I know the frustration of it all. It does seem that your EBV has been “reactivated”. My 18 yo daughter is in the same boat, just found hers has been also. She had almost 5 years of progressive health problems before FINALLY being diagnosed with Lyme and coinfections(babesia, bartonella, strep, many viruses, mycoplasma, etc) at age 16. Quite honestly, your story SCREAMS Lyme. It acts as an immune suppressant(hence the reactivated EBV and other opportunistic infections) much like HIV. It also “mimics” so many neurological and rheumatological diseases, as well as psychiatric problems. I strongly encourage you to seek out a LYME LITERATE(ILADS trained) MD for evaluation. Do NOT rely on blood tests for Lyme they are not reliable, especially in chronic cases. Run from any MD who tells you do NOT have Lyme unless it is a qualified LLMD. You do not have to recall a tick bite to have Lyme. I hope you find answers and help, we have been down that road!

Matthew June 28, 2014 at 9:30 pm

I don’t know if you guys have high levels of tigers to EBV but I have seen a
Lot of low levels compared too me. I have had chronic fatigue all my life. At least since I was about 18 that is. 35 now.

My levels are as follows: keep in mind these blood tests are from a two yr period:

Ebv ab viral capsid ag IGG: 750 < 18
IGM 10<36
IGG early ag diffuse 7.2<9
Ebv nuclear Antigen 13.2 <18

My labs before this one were less than 750 but not by much. My poco called me the next day went she got labs and asked if I was able to work? I still work and still do things and activities with my family but I feel tired all the time.. Muscle aches.. Feverish with no fever. Some months are good an some are bad. My pcp told me it will always be like this because the ebv is reactivating and causing body aches.

katie July 25, 2014 at 5:39 pm

My levels are quite high compared to most here a well.
IGM 600 u/ml (0-17.9) high
EBNA 409 u/ml (0-17.9) high
EARLY ANTIGEN Ab IGG 37.0 u/ml (0-8.9) high

I have felt ill for 6 months and seems like I’m only getting worse. Is a toxic feeling, almost feels like a horrible hangover that never goes away. Fatigue, malaise, muscle aches, tingling burning in legs, horrible month long headaches, upper back and neck pain, dizziness and just a general run over by a bus feeling. Its awful. If I exercise, i feel ill and faint afterward and that feeling lasts into the following days. Every doc has a different take on my results. In this day and age why can’t we have more definitive tests! Most recently i repeated the test and all numbers were the same except my EBNA which fell to 340. Hoping this is maybe an indication that i am in fact trying to get over a current or reactivated infection.

katie July 25, 2014 at 5:44 pm

Whoops, i meant to write IGG in place of IGM

tony September 22, 2014 at 12:08 pm

I had cebv for 29 years im 49 now the flareups get worse as you age total flulike symptoms

Stephanie July 31, 2014 at 10:58 am

i had mono after my gallbladder surgery. The dr. was a quack who never discussed the results except you have had mono in the past do not eat or drink after anyone and no kissing. no I am going for a colonoscopy to test for crohn’s disease. I was told mono and Chron’s are linked. can someone help me with these results I just had faxed from the CDC Dr.?

EB Virus Nuclear AG, IgG$EBNA result 62.8 (it is in all bold)


Patsy October 4, 2014 at 11:37 am

My daughter is 19 and will be having her colonoscopy on Oct 10th. She was diagnosed with mono on thanksgiving day, nov 28, 2013 and on nov 30, diagnosed with acute cholecystitis. Because her mono was so severe, she had developed severe anemia and her platelets were 74. The doctors decided to administer IV antibiotics for 48 hours and after that they removed her gallbladder. So she was fighting mono, anemia, and healing from surgery at the same time. She still suffers from severe fatigue and in June, she started having bowel problems and developing large burn-like sores on her body. She had a CT scan in August which shows something in her colon. They suspect with the sores and CT results, she might have Crohns or UC. Gastro dr also suspects chronic mono. I was just wondering how your colonoscopy turned out.

lea September 16, 2014 at 10:17 pm

My EBV IgG is 600.0 HIGH, normal range is 0-17.9—–My EBV nuclear Antigen IgG is 188.0 HIGH, normal rane is also 0-17.9… tested by the Asheville NC dr

Stephanie Holland September 24, 2014 at 6:50 am

My Ebv test as follows ebv early Antigen ab, igg 24.2 high, ebv ab vca, igg >600.0 high, ebv nuclear antigen ab, igg 500.0 high,my infectious disease Dr says i have chronic active ebv infection and in other words he said my body has NEVER CLEARED THIS VIRUS and everyday of my life my body is In a all out war trying to fight it?! Can anyone tell me what that really means?? Im having a difficult time as i also have lupus, srogren’s syndrome and hypogammaglobulinemia also known as CVID! Do i have cfs/me or the downright chronic active Epstein Barr virus, the rare one that often kills, because I’m very very confused with all this,not to mention there’s not anyone I’ve spoke with who seems to even understand! PLEASE HELP ME WITH THIS!!!

Iris October 12, 2014 at 2:14 pm

Stephanie…check into ProBoost (thymic protein A). It’s a powder, not terribly expensive. If you are sensitive to drugs, supplements, are chemically sensitive, etc., start slowly. Be prepared for possible die off reactions. Also, some CFS/EBV patients have done really well with gamma globulin shots. The IV is very expensive, so intra muscular shots are much more affordable (generally $75 to &125 per shot). A doc can teach you to inject yourself. Finally, one of the best things I’ve done for myself is to follow a diet based on genetics. Dr. D’Adamo makes it pretty easy to follow a plan; also supplements designed for blood type groups (ABO) and genotypes. I’m O+ and explorer genotype, therefore very sensitive… a little goes a long way for me. What I’m noticing most recently is my tolerance level has increased: I can now take more ‘normal’ doses of supplements, not as chemically sensitive, even able to have lightly brewed green tea, and not floored by detoxification symptoms. Hope this helps, dear. Best of luck!

Bonnie October 14, 2014 at 10:12 am

Absolutely no idea what to ask or what I’m seeking other than, what helps you guys??? Many thanks in advance!!! 2 migraines a week, extreme exhaustion, and neck and back pain. Blessings to you all :-)
EBV Early Antigen AB IGG is 65.9
EBV AB VCA, IGG is >600.0

Jeet November 15, 2014 at 5:10 pm

I have similar ebv vca igg counts >600 high which indicates a past mono infection. I feel extreme fatigue, headache, muscle aches, post nasal drips, burning eyes all together. Some time it gets better but it recurs quite often now. Is there any remedy to this? I have felt better with decongestants sometimes but not always.

Sheila December 29, 2014 at 5:33 pm

LeeAnn!! You just told my story in full. Please don’t think you wrote too much. I’m struggling now after year’s and to read you was good for me. I have no idea like you folk’s what my level’s are but I know I just got very, very ill, again. My N.P. found I had Genetic igG. after chronic ENT infection’s for year’s. She actually had a stand by Leviquin at my pharmacy ‘cuz she knew I knew when I was sick w/ ENT. I had Mono at 17. My blood test’s just came back as EBV but not active for disease.
I had CFS(diagnosed) w/out test’s. in 1992. But I just went through so much fatigue, sore, no, tender throat, lymph node pain and neck pain. I had to take note’s to remember day to day convo’s and appt,s. My muscle’s hurt, joint’s(shoulder’s). Low grade temp. Unfortunately I broke my neck and am a quad as I was not suppose to go anywhere but to bed for 6 month’s after the CFS diagnosis. I fell asleep. BOOM! So it is so hard for me w all the residual’s from the car accident and what I had/have already have? I am alway’s tired, confused… I back in 92 was tested for Lyme, M.S., which my sis has. I suggest we all look at the previouse Mono, Genetic igG, and a brain injury. I think the clear thing is, we will alway’s be sick, ill. How do we deal w/it?

Lucky January 13, 2015 at 9:53 pm

Hello hi this is lucky .,
Since 3 months I feel fatigue,swollen lymph nodes neck,muscle aches,joint aches, ,
I feel tired all the time I am unable to concentrate on any work .,
So I consulted a doctor and doctor took blood for ebv serology
And test result is IgG -positive , IgM – negative .,
What does that mean ?
I still feel tired all the time , can’t even sleep ,
could you please reply me .,
Thanking you .,

Sheila January 23, 2015 at 5:14 pm

Lucky, I am 51 years old. I don’t know enough about you but.. : } …you do have igG like alot of us. We have EBV which I just found out is always present but not for active “Disease”. I would like you to get an EBV test, MS is hard to diagnoise as I know with my sister and a lyme Disease test. OKay, sweetie? For the rest of us, sounds like we have ALOT in common. I think we may know when the EBV has hit us even if the Doc’s say “present but not active for disease”. I told my Doc I have CFS going on. I remember it well and I know. nno they said I had a neuro prob. and reffered me. I did not go. I slept took Zinc , CoQ10, like I did when I had CFS the first time. I got better!!! Three month’s ago I couldn’t manage. Today I’m good after year’s of reaserch on what to do for CFS. Thank you all for being here. I know I’ll be sick again. Just know I carry EBV, igG, and probably a continuose viruse. Take care all.

Angie February 23, 2015 at 6:20 am

I Agree with Amy it sounds like Lyme and Co-INfections especially Bartonella. I would research chronic Bartonella and Lyme symptoms. I had my own 3 year medical mystery tour. I went thru alot of the same things. Dont give up, YOU ARE NOT CRAZY! I figured out on my own that I had Lyme, Bartonella, and Protomyxzoa Rheumatica then had to find a lyme literate dr to help me prove it. Long story short im in treatment gor all the above and about 60% better, on the road to recovery.
I hope what ever u have u find answers but remember you are your biggest advocate. Keep fighting 4 answers!!!!!

Ellie Rhoadss February 26, 2015 at 1:23 pm

Can anyone tell me what these results mean?
EBV Ab VAC IgG is 600.0
EBV Early Antigen Ab IgG is 16.2
EBV Nuclear Antigen Ab IgG is 363.0
Cytomegalovirus (CMV) Ab IgG is 8.20
Cytomegalovirus (CMV) Ab IgM is 30.0

Joe February 27, 2015 at 2:14 pm

Just wanted to mention I got bit by dozens and dozens of ticks in Northern Virginia (near Bethesda, around the same time Shyh-Ching Lo was working on Mycoplasma there). I was around 11 – 12 years old, and gradually I started to decline, starting at 14, and hitting big dips at certain points in my life, every 4 – 5 years. I’m in my 30′s now and I just got treated for low (titers 12/14 low) to Strep Pneumonia, which would activate about once a month from exposure to people who just pass it around and are immune to it after one time.

Anyway, I came up north to get treated for Lyme, and they found I was very high positive for mycoplasma pneumonia infection ( IGG 359 on a 0-99 scale), which is probably one of the main causes for my constant problems with all the issues I have today. Lyme tests are highly inaccurate (maybe 40% success rate?) and I was borderline on the Western Blot, with a double positive on band 41, and an IND on 39 (which is Lyme SPECIFIC, so I DO have Lyme), and so I’m being treated for that based on symptoms.

I got tested for MTHFR, and I have a single mutation (a1298c) and this causes me to have problems with my neurotransmitters, as well as slower detox rate based on my methylation cycle being screwed up. So, as I go I’m learning more and more over the past 2 years or so, as this is all within this time frame, some 20 years after my initial tick bites.

Symptoms I have problems with on a regular basis (many diagnosed): Osteoporosis (yes I have this already in my 30′s as a male), a resulting “s” curve in my spine (kyphosis), myofascial pain syndrome, chronic fatigue, fibromyalgia, malabsorption, tremor, hypersensitivity, low levels of D, degenerating neck bones from the osteoarthritis (cervical spondylosis), various allergies, deviated septum with a spur, hiatal hernia, with eosinophils in my throat, which is very uncommon and the gastroenterologist was not sure what to make of those, as that is rare to have them there, since they result from allergy. Other symptoms: I have pressure urticaria, so my hands will turn red and itch if I use them very much. Cold and hot do this as well, and I have temp sensitivities, especially to heat. I have mild asthma, and also premature ventricular contractions in my heart. I also have General Anxiety disorder, and have been diagnosed with Bipolar Disorder, and Major Depressive disorder. I have a hard time falling asleep, averaging probably an hour or two when I try to “force” myself to sleep. I only get actually sleepy if I am up for at least 30 hours or more. I’m also alcoholic and have compulsions to risky behaviors (probably from the MTHFR and lack of proper neurotrasmitter activity).

As far as treatments, I’m working with LLMD near me, but trying to find another one who will prescribe more meds. Taking herbals for my pain (some really great legal opiates and such), and getting a prescription for a benzo called Clonazepam, which helps me immensely in almost every area of my life. I have to travel 640 miles because the state of New Jersey has something against prescribing scheduled anxiety meds unless you can pay at least $400 a visit to some shrink. My doc in SC charges me 70 bucks a visit and I travel there to get them, since this state is so “benzo-phobic” from what I have been able to gather so far.

Anyway, I am in the process of trying to heal, and it’s taken me over 20 years to get this sick, so it will take me years of herbals, antibiotics, and other treatments to get me any relief, aside from pharmaceuticals, which are temporary, and limited in their potential. Anti-seizure meds help me also feel less like my mind is plugged into a wall socket, or like my body is a cell phone on vibrate.
Anyway, after all my rambling off topic, I got tested for EBV recently and very high IGG numbers, and low IGM, indicating a severe prolonged infection and reactivation, from what I am understanding.

Have very high IGG to EBV AB/Capsid = 729.0 (0 – 21.9)
>10 ABV/Capsid IGM
Nuclear AG 248.0 (0 – 21.9)
AB Early D IGG 11.2 (0 – 10.9)

Anyway, I hope there is advice out there for dealing with this menace, as I have only found Lyme and Mycoplasma protocals slightly beneficial, but still early in this prolonged game for me of chronic infections galore. Best of luck to everyone, and I hope we can get better together!

Sheila John May 26, 2015 at 10:00 am

I’ve moved alot too. My doctor just checked my blood for Epstein Barr and found I had 600 viral count whereas 18 is the norm. I feel I’ve been fatigued most of my life. Sore throat alot. In the last 10 yrs my muscles ache, I have arthritis suddenly bad in knees, left hip, spine. ( in last 5 yrs) My doc has me going to therapy for my back- decompression, plus hip, also heat, electrical shocks to muscles. My doc’s daughter had EBV. He found Black Elderberry mfg by “GAIA” 1500 mg 3 times daily. Can get it on internet. This is my prescription. I’ve taken Wellbutrin long time. I’ve stopped because it is too expensive- the brand name purple pills are only ones that worked. My insurance won’t cover it $400 mo if I want to pay.

Mary May 29, 2015 at 10:28 am

I have not been tested for EBV/CMV or CFS as of now and I don’t know why or who I should ask. I’ve been seeing my PCP, a pain mgmt doc, oncologist and rheumatologist. I was just recently referred to a infectious disease specialist and I’m really hoping he can give me some answers so I can get back to living not just existing.

I have had an array of health problems through the years including childhood asthma, PCOS, endometriosis, hypothyroidism, hyperlipidemia, kidney stones, AVNRT/sinus tach, chronic sinusitis, ruptured disks (cervical & lumbar) from a car accident and a myriad of other things. I am 34 years old.

My current situation is extreme exhaustion, mid-grade fever (99.9-103) that will not fully reduce with Advil or Tylenol, general body aches (muscles & joints), livedo, headaches, pain in my upper left abdominal, insomnia, intolerance to heat/cold, night sweats. I have had many lab work ups. The only abnormal labs as of now are a High WBC (14.7), high lymphocytes (4.3),high creatine kinase(202).This has been going on since Dec 2013 when I had pluresy and pneumonia. I was on IV Levaquin for 7 days, oral Levaquin for 14 days and a Z-pak and I have no active bacteria or inflammation. I just can’t seem to get back to normal! With the appointment for the infectious diseases doctor coming up I was wondering if those of you with more knowledge can tell me what tests I should specifically ask for. Thank you and help will be apperciated!

Dee May 31, 2015 at 8:31 pm

LEE ANN, I don’t know if you will get this, but I think I know what’s wrong with you. I hope you find this. I’m pretty sure you have something called primary hyperparathyroidism. Please go on Facebook and join the parathyroid disease group. Also look and read everything on parathyroid.com. This is your answer!!!!! My husband is getting ready for surgery and doesn’t have it as bad as you and his calcium has only been in the 10-10.5 range and he was diagnosed. You need to find a good doc. The facebook page will help you. Good luck!

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