I have Epstein-Barr. I take many vitamins and eat a high-protein diet. When I deviate from my diet I go right back to feeling exhausted. I have been taking care of myself for about five months. Will I have to eat like this for the rest of my life?
The New York Times carried a long article about chronic fatigue syndrome, including the various causes that have been considered and largely debunked over the years, and an approach to treatment through graded, increased exercise. That approach makes a lot of sense, since we have not yet found the cause of chronic fatigue. In fact, there may never prove to be a single cause.
One suggested candidate, popular in the 1980s, was chronic mononucleosis — also known as chronic Ebstein-Barr (EBV) infection. I’m not a believer in EBV as a cause of chronic fatigue. I think that this misconception came about when tests to detect the virus in blood were developed in the late ’70s and early ’80s. Doctors tested people who had chronic fatigue and — lo and behold — they showed evidence of EBV infection.
We now know through extensive studies on broad segments of the population that virtually 100 percent of American adults have EBV infection! EBV, like the other viruses in the herpes family to which it belongs, persists in our bodies forever once we are initially infected. It lies mostly dormant, but at any given time about 20 percent of the population has live virus circulating in their blood and probably being excreted in their saliva. Since practically everyone has chronic EBV infection, it is hard to say that it is causing the chronic fatigue in the small number of people who have this problem. You wouldn’t assume, I think, that having a checking account is the cause of bankruptcy, although almost everyone who becomes bankrupt has a checking account.
Infectious mononucleosis — which is due to the EBV virus — does cause severe fatigue in many people for a few weeks or even months. But this is the body’s reaction to the first infection by the virus. Once it becomes chronic, as it does in everyone, the body accommodates, and the fatigue disappears.
Since your diet and vitamins seem to be helping, go with them! Try a graded exercise program that starts out gently and very slowly builds up. Trying to overdo the exercise at first is likely to increase your fatigue and then may cause you to stop all exercise. Not exercising definitely produces chronic fatigue because of deconditioning of the muscles and cardiovascular system. Some experts believe that antidepressants help. Don’t be discouraged. You can get over it!