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The Sleeping Giant – Tips to Treat Reactivation of Epstein-Barr Virus

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reactivated Epstein Barr Virus

Did you know, you probably have virus lurking in the shadows? It’s called the Epstein-Barr virus (EBV) and an estimated 90 percent of us have it. Fortunately, for most of us it lies dormant, like a sleeping giant. Only when something triggers EBV reactivation does this virus rear its ugly head.

Epstein-Barr virus is part of the herpes family and also known as human herpesvirus 4. Usually passed through saliva, EBV is the cause of infectious mononucleosis – also known as “mono” or “kissing disease.” Typically, teenagers come down with this condition and first notice there’s a problem when they experience extreme fatigue. Interestingly, extreme fatigue can also cause reactivated Epstein Barr virus symptoms.

Though there are many conditions where EBV is the cause or a trigger, extreme fatigue is a unifying symptom that occurs in most cases. Symptoms of an active Epstein-Barr virus, include:

  • Extreme fatigue
  • Fever
  • Sore throat
  • Swollen lymph nodes
  • Enlarged spleen
  • Swollen liver
  • Rash
  • Emotional disturbances and stressors
  • Autoimmune diseases, like Hashimoto’s thyroiditis

How Epstein-Barr Virus Causes Autoimmune Disease

Autoimmune conditions are caused when an overactive immune system begins attacking healthy tissue. We are learning more and more, what often sets off the immune system response in the first place can be a variety of infections, including EBV.

CD8+T cells are types of white blood cells your body uses to keep the EBV virus in check. When there’s an impairment or a deficiency of these cells, the EBV virus is free to run rampant. The amount of CD8+T cells you have can be negatively impacted by age, estrogen levels, and vitamin D deficiency, certain medications and treatments, and poor immune system function. This is important because autoimmunity is on the rise and we need a better understanding of its underlying causes.

If you want to know more about What to Do if You Have an Autoimmune Disease, check out my free guide.

So, what can be done to treat Epstein-Barr? If it’s so common, surely there’s a simple explanation or Epstein Barr virus cure? Actually, the best way to tackle Epstein-Barr is similar to how we deal with an imbalance of gut microbes – manipulate the environment so balance is restored. The most important thing I find is to support the natural immunity and decrease exposures to environmental toxins and other infections.  Let’s take a closer look.

Treating the Epstein Barr Virus

There is no known cure for the Epstein-Barr virus, and therefore treatments should focus on returning the creature back to it’s sleeping or dormant state. So, in order to treat EBV the approach needs to focus on getting the virus back in check, not killing it. This means manipulating the condition of your body – the environment where the Epstein-Barr virus lives.  

When I discover a patient of mine has Epstein-Barr virus, here are the things I consider:

    1. Clean diet and proper nutrition – This reduces inflammation and immune system burden. We eliminate gluten, dairy, allergens, and start a plant-based Paleo diet. Sugar is one of the most powerful immunosuppressives so that must be eliminated at all costs.
    2. Heal the gut – Healing the gut is a priority for anyone dealing with EBV. Toxins can leak through damaged gastrointestinal lining and cause the immune system to overreact.  This process is also known as endotoxemia, driven by LPS.
    3. Eliminate any infections – Check for any coexisting infections and work to treat these. I often think of it as “infectious burden” and work to decrease the load on the immune system.
    4. Reduce toxic burden –  We are bombarded by tens of thousands of chemicals everyday, find out how to Reduce Your Daily Toxin Exposure. It is critical also to decrease total toxic load by eliminating any toxic exposures.
    5. Optimize detox pathways – This includes supporting the liver, kidneys, and colon and may be supported by various nutritional supplements and other homeopathic drainage remedies.
    6. Improving sleep habits – This is essential because so many repairing and detoxification processes occur during the deepest stages of sleep.   I advise no less than 8 hours per night or as much sleep as required to wake up refreshed without an alarm clock.
    7. Reduce stress – Stress is a major cause of immune system dysfunction, it could even be what awakened your EBV in the first place. You must work to reduce stress – your health depends on it. Try prayer, meditation or spending time in nature. Self care must be a priority.   
    8. Herbal supplements – Herbs such as Ashwagandha, licorice, St. John’s wort, lemon balm, ginseng, and holy basil may be used for immune system support and for their antiviral and adaptogenic properties.
    9. Supplements  – I use these for suppressing EBV reactivation
      1. Monolauren: 1800 mg twice daily
      2. Olive Leaf: 1000-1500 mg twice daily
      3. L-Lysine: 1000-1500 mg twice daily
      4. Cat’s Claw tincture: 30-60 drops twice daily

When viruses diminish due to these treatments it isn’t because any of these things attack the virus, but instead they help put your body in a state that isn’t ideal for the virus to reproduce. Hopefully, this strengthens your immune system and returns this typically harmless virus back to it’s benign state.

Other more extreme therapies have have been tried in a few cases, with some success and include:

  • Antiviral medication, Acyclovir or valcyclovir
  • Immune cell therapy when used in a person after a transplant.
  • Bone marrow transplant is an extreme therapy that has been documented in two life threatening cases.
  • Cord blood stem cell transplants.  This is a new but emerging treatment that may be very successful in tough cases.

Ineffective Epstein-Barr Treatments

Though I prefer to offer solutions to health conditions, I want to briefly touch on some treatment protocols of EBV are not effective because there’s a lot of misunderstanding surrounding this virus. In general, the follow treatments only temporarily stop symptoms and only in some people:

  • Antiviral therapy such as ganciclovir and vidarabine.
  • Immunosuppressive agents such as cyclosporine and corticosteroids.
  • Immunomodulatory therapy such as interferon alpha and interferon gamma.
  • Cytotoxic chemotherapy such as anthracyclines, etoposide, cyclophosphamide, vincristine, and prednisone.
  • Infusions of cytotoxic T and lymphokine-activated lymphocytes.

This isn’t to suggest that your doctor shouldn’t temporarily recommend some of these, however, none of these are by any means a Epstein Barr virus cure and you should proceed with extreme caution.

Find a Functional Medicine Doctor with Experience in Epstein-Barr Treatments

The science surrounding the Epstein-Barr virus is developing daily. If you think you might have a condition due to EBV, it’s important to find a doctor who’s experienced in conditions related to the reactivation of this virus. If you need help finding a functional medicine doctor, I’ve made a helpful guide to get you started – How to Choose a Good Integrative and Functional Medicine Doctor.

The Epstein-Barr virus is a significant condition I wish more people knew about – Share this article to spread awareness of this sleeping giant.

Has there ever been a time in your life when you’ve felt alone or unsure where to turn for answers?

In Unexpected: Finding Resilience through Functional Medicine, Science, and Faith, Dr. Jill Carnahan shares her story of facing life-altering illness, fighting for her health, and overcoming sickness using both science and faith so that others can learn to live their own transformative stories.

Dr. Jill’s riveting and compassionate exploration of healing through functional medicine demonstrates how to replace darkness and fear with hope and find profound healing, unconditional love, and unexpected miracles in the process.

Resources:

https://www.cdc.gov/epstein-barr/about-mono.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250620/

https://www.cdc.gov/epstein-barr/about-ebv.html

https://www.ncbi.nlm.nih.gov/pubmed/2169064

https://www.ncbi.nlm.nih.gov/pubmed/15906243

https://www.hindawi.com/journals/ad/2012/189096/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776035/

https://www.ncbi.nlm.nih.gov/pubmed/18266798

https://www.ncbi.nlm.nih.gov/pubmed/11960276

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776035/

* These statements have not been evaluated by the Food and Drug Administration. The product mentioned in this article are not intended to diagnose, treat, cure, or prevent any disease.   The information in this article is not intended to replace any recommendations or relationship with your physician.  Please review references sited at end of article for scientific support of any claims made.

Category: Autoimmune HealthBy Dr. Jill C. Carnahan, MD, ABIHM, IFMCPJanuary 25, 2018114 Comments
Tags: autoimmune diseaseEpstein-BarrEpstein-Barr TreatmentsEpstein-Barr VirusFunctional Medicinegut healthherpesstresssupplements
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Author: Dr. Jill C. Carnahan, MD, ABIHM, IFMCP

https://www.jillcarnahan.com/

Dr. Jill is Your Functional Medicine Expert! She uses functional medicine to help you find answers to the cause of your illness and addresses the biochemical imbalances that may be making you feel ill. She'll help you search for underlying triggers contributing to your illness through cutting edge lab testing and tailor the intervention to your specific needs as an individual. She may use diet, supplements, lifestyle changes or medication to treat your illness but will seek the most gentle way to help your body restore balance along with the least invasive treatment possible. Dr. Jill is a functional medicine expert consultant and treats environmental and mold-related illness as well

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114 Comments

  1. Amy says:
    January 31, 2018 at 12:08 pm

    Thank you! This is such helpful information. Bloodwork confirmed that I had somehow reactivated EBV almost 2 years ago and because of some very bad medical advice, I fell into a dark hole of paralyzing ill-health. Through discovering functional medicine (working with Sarah Zielsdorf here in IL) and a lot of research and self-care, I had practiced most of the action points you have mentioned, and have recovered very well with some remaining sleep issues. THANKFUL! I have recently been using Monolaurin (flu season) and have noticed that there are pretty heavy energy dips at the end of the day when I use it, which is otherwise very uncharacteristic of me. Can monolaurin bring about a Herx reaction of fatigue – even this far out from reactivated EBV?
    Thanks for reading – and for all of your great posts! Bless you

    Reply
    • Jill Carnahan, MD says:
      January 31, 2018 at 4:41 pm

      Monolauren doesn’t usually cause herx with anti-viral effect but the anti-fungal effect may be more potent and cause die-off type reactions

      Reply
      • Yvonne Fulciniti says:
        January 3, 2019 at 10:06 pm

        This is interesting and I’m grateful to find this one question and comments. I have two autoimmune conditions and started doing an even stricter diet than I was on before….doing AIP now and I did find out from my ND that my EBV is reactivated. We’re treating with monolaurin for 6 weeks and buffered Vit C (I’m adjusting dosing daily b/c of its affects on other things). Interesting, I have a terrible rash on my torso that has developed and I wondered if it’s some kind of healing crisis. My Naturopath thought that or allergic reaction to something. Admittedly, the holidays brought a bit of cheating with small amount of maple syrup and coconut sugar and perhaps it’s that. Anyway, makes sense about die-off symptoms even with some of those natural sugars and yeast. I know you can’t give advice but could the rash be related to the monolaurin? I have 10 more days of my 6 weeks taking it.

        Reply
        • Jill Carnahan, MD says:
          January 4, 2019 at 10:21 pm

          Monolauren will also treat fungal dysbiosis and the fact that sugars trigged rash makes it likely related to die off of yeast

          Reply
        • Stacy says:
          October 16, 2019 at 9:22 am

          I also get a rash on my torso with monolauren! Its very itchy, raised, red and annoying.

          Reply
      • George says:
        September 15, 2022 at 2:53 pm

        Jill,

        Great article. High grade coconut oil has some Lauric acid, also fights viruses.

        A young Woman, the new girlfriend of a guy I know, came down with very severe
        Mono from her old boyfriend. This guy went to visit her, and gave her a 12 mg ivermectin and took one himself to avoid catching mono. She more or less recovered from mono the same day, and the guy never became infected. Wonder how much latent EBV ivermectin would clear out. Research shows ivermectin reduces sars-cov-2 about 5000 fold in 24-48 hours.
        https://pubmed.ncbi.nlm.nih.gov/32251768/

        Reply
    • Catherine says:
      April 28, 2019 at 11:18 am

      You are so lucky to have Dr. Z on your side! Sadly, by the time I found her she was no longer taking new patients. Hope you’re doing well.

      Reply
  2. Jill Wortman says:
    February 2, 2018 at 4:08 pm

    I appreciate this information as I’ve been reading 2 books that emphasize EBV as a likely culprit in Fibromyalgia/CFS. You mention Acyclovir, which I take when I get a cold sore. Is there any information on the dosage of Acyclovir and the duration to help combat EBV? I feel like I’ve tried everything else and nothing is helping. With 5 kids and a job, I’m pretty desperate!

    Reply
    • Jill Carnahan, MD says:
      February 2, 2018 at 6:57 pm

      Hi Jill,
      I cannot give medical advice on the blog – perhaps you can check with your doctor.
      warmly
      Dr Jill

      Reply
    • Stacey says:
      February 8, 2018 at 5:55 pm

      I took 3grams valcyclovair a day for almost 2 years. Otherwise I ran fever, swollen glands, extreme debilitating fatigue. I’m a 120 lb female.

      Reply
      • Regina Redmond says:
        March 9, 2019 at 12:54 pm

        How long do you recommend doing this protocol for reactivated EBV? Will there be die off symptoms?

        Reply
        • Jill Carnahan, MD says:
          March 9, 2019 at 8:06 pm

          Hi Regina
          I generally treat EBV for 6-12 months
          warmly
          Dr Jill

          Reply
      • DR. Thomas Hiatt says:
        May 7, 2019 at 11:09 am

        CBDA has some promising effects in strengthening the immune system, controlling inflammation, working as a prebiotic.

        Reply
        • Jill Carnahan, MD says:
          May 8, 2019 at 10:17 am

          thank you Dr. Haitt

          Reply
  3. Teresa says:
    February 8, 2018 at 11:53 am

    Thank you so much for the article, Dr. Jill – your work is greatly appreciated! As one part of a EBV treatment plan, you mentioned optimizing the detox pathways. I was particularly interested in knowing if you would have any recommendations re: brands of homeopathic drainage remedies.

    Blessings,
    Teresa

    Reply
  4. Claudia K says:
    February 8, 2018 at 11:57 am

    Hi Dr. Carnahan,
    thank youfor this very interesting article!
    What is your opinion in regards to the effectiveness of treating EBV, as well as other viruses and UV Blood Therapy (I am not sure about the official name for this treatment, when same amounts of blood is withdrawn, which is than exposed to UV light, and re-injected). Thank you very much!
    Best, Claudia

    Reply
  5. Amber Smith says:
    February 11, 2018 at 9:07 am

    Have you ever dealt with someone who has positive ebv positive cmv and swollen lymph nodes for two years. Cervical chain that hangs around 5 cm! Been to numerous specialist and get blown off!

    Reply
    • Jill Carnahan, MD says:
      February 11, 2018 at 11:09 am

      Yes, you may try infectious disease or functional medicine doctors.

      Reply
  6. Brenda says:
    April 2, 2018 at 3:21 pm

    I’d be interested to see your opinion on the new MS treatment Ocrevus and it’s killing off of certain B cells and it’s effect on EBV.

    Reply
  7. L Murray says:
    May 19, 2018 at 7:07 am

    HI – I’m interested in the herxing process – During treatment of EBV, I’ve been told I will go thru this – can you elaborate on this – what is actually going on during this time and how long does it last – does it have a stop & go pattern or is it just one big party – Thank you

    Reply
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  9. CR says:
    June 27, 2018 at 11:59 am

    I also have ebv, as well as positive rheumatoid factor. Is it possible that the positive rheumatoid factor, which I have read is an antibody, to the fc portion of an antibody, could be related to ebv? Any idea if stem cell injections could help rid ebv or cause harm? Also read EBV worsens copd. I am also a help b vacine non responder. Any recommendations?

    Reply
  10. DEBBIE says:
    July 18, 2018 at 7:26 am

    if I had mono in high school….now 60…with high EPV levels…are those levels from high school or new in reinfection?

    Reply
  11. Emily Wood says:
    August 2, 2018 at 2:16 pm

    When you say “Sugar is one of the most powerful immunosuppressives so that must be eliminated at all costs”, do you mean all sugar including fruit or low glycemic like coconut sugar or just white, can sugar? Thanks!

    Reply
    • Jill Carnahan, MD says:
      August 2, 2018 at 3:44 pm

      Processed sugar is the biggest culprit, real sugars from fruit and other natural sources in moderation are fine.

      Reply
  12. Naomi says:
    August 13, 2018 at 9:10 am

    I’ve been struggling with EBV and reactivation over a few years. I’d been feeling well recently until a tooth fractured and I had to have it extracted. I feel like the dental work has reactivated my EBV to some degree. I’m wondering if you’d seen this before and any suggestions. Thanks!

    Reply
    • Jill Carnahan, MD says:
      August 13, 2018 at 9:26 pm

      I would treat the same way

      Reply
  13. Deanna says:
    August 28, 2018 at 7:50 am

    Do you suggest taking all four of the supplements listed in the article at the same time or only one of the four?

    Reply
    • Jill Carnahan, MD says:
      August 28, 2018 at 11:36 am

      You will need to individualize treatment with your physician

      Reply
    • Alie says:
      March 14, 2019 at 1:43 pm

      Hello! As for kids treatment. What doses of supplements can you advice for them?

      Reply
      • Jill Carnahan, MD says:
        March 16, 2019 at 8:47 pm

        Hi Alie
        Unfortunately I cannot give medical advice online
        warmly
        Dr Jill

        Reply
  14. Amy says:
    September 25, 2018 at 10:55 pm

    Dr. Carnahan- I was a patient of yours in Peoria. I’ve had recurring EBV infections. Just as an FYI, I’ve had some good treatment with Dr. Shawn Schmidt at Natural Health Omaha. They use BioMeridian testing with a functional medicine focus. Found out I had a weird parasite and lots of Candida that no other tests picked up, plus the EBV. I was taking your protocol and had a super clean diet, but those things in my gut weren’t allowing the protocol to do it’s job right. Herbal and homeopathic tinctures have killed that stuff and a lot of the EBV, now maybe if I go back on the protocol, it will keep killing the virus. I wish all the good EBV docs could all share their info together so more patients could benefit from all the knowledge! Thanks!!

    Reply
    • Scott Barnhill says:
      August 26, 2019 at 10:03 am

      Hi Amy,

      May I please ask what specific ‘weird parasite’ was discovered in you? I ask because your profile fits my situation to a tee, so knowing what ‘weird parasite’ of which you speak could possibly help me.

      Thank you!

      Reply
  15. Jennifer Jackson says:
    October 5, 2018 at 5:41 pm

    Hello,
    Do you think Ozone Therapy (blood–systemic) is a good method of treating EBV virus. Also, do you think the homeopathic desbio is a good protocol to use to treat EBV.

    Reply
  16. Barb says:
    October 31, 2018 at 8:59 pm

    Do you feel the Homeopathic Desbio for REBV is a good protocol to use?

    Reply
    • Jill Carnahan, MD says:
      November 1, 2018 at 12:05 pm

      I am not familiar with it but I do like homeopathic

      Reply
  17. Taylor says:
    November 28, 2018 at 6:37 pm

    Have you seen instances of reactivated EBV causing severe muscle weakness and shaking? Almost like a tremor? I have recently been having some health issues. Severe bouts of vertigo, swollen lymph nodes, sore throat. Thought it was a chest cold and took antibiotics. Two days after finishing, I started experiencing severe muscle fatigue/shakiness and just overall muscle weakness. It has been over 3 weeks and still no better. PCP ran blood work that showed elevated levels of all markers except my IgM.

    Reply
    • Jill Carnahan, MD says:
      November 30, 2018 at 6:24 pm

      This is unusual and I do not think its related to EBV

      Reply
      • Sylvia says:
        April 16, 2019 at 5:04 pm

        I saw that you recommend treatment for 6-12 months. I’m wondering how long it takes to start seeing positive effects, plus will the ebv reactivate in the future?

        Reply
        • Jill Carnahan, MD says:
          April 16, 2019 at 5:12 pm

          usually some improvement in 1-2 months. If immune system is ever weakened it may reactivate

          Reply
    • Jill Carnahan, MD says:
      November 30, 2018 at 6:25 pm

      This does not sound typical for EBV

      Reply
    • bkk gil says:
      December 8, 2018 at 7:35 am

      did you use cipro ? that can cause many nasty stuff

      Reply
    • Don says:
      November 18, 2019 at 7:06 am

      Did you take one of the Fluoroquinolone antibiotics? Cipro, Leviquin, Avelox or one of the many generic clones that are now on the market. Research “Fluoroquinolone Toxicity Syndrome” If you Google it you will get about 3,000 or more hits in under a minute. Do your own investigating because most doctors seem to be clueless when you try to discuss this with them. Clueless by choice? Fluoroquinolone toxicity is a possibility if you took one of the above listed antibiotics. It is called being “floxed” or being a “floxie”. For some it only takes one pill but for others they can tolerate many doses of a Fluoroquinolone. Check it out because chances are that your doctor won’t.

      Reply
  18. Tammy Denise Adkins says:
    January 28, 2019 at 10:15 am

    I read on Dr. Weil’s blog that the amino acid L-arginine can trigger the EBV. He advised to lower intake of foods high in this amino acid. Chocolate, peas, nuts and seeds all have this amino acid. Do you support this? I thought a healthy diet would include nuts, seeds and veggies. Chocolate as Cacao also has health benefits.

    Reply
    • Jill Carnahan, MD says:
      January 29, 2019 at 10:58 pm

      l-lysine inhibits viral replication and high intake of l-arginine may lower lysine levels

      Reply
  19. Dutches says:
    January 29, 2019 at 9:00 am

    So are you saying that if I had mono in college that i probably still have EBV to this day? I often wondered if this was the case because ever since then, my lymph nodes swell every time I get a cold. Do you think this could be related?

    Reply
    • Jill Carnahan, MD says:
      January 29, 2019 at 10:59 pm

      EBV should remain dormant in a strong immune system but if stress or other factors weaken immunity it may reactivate

      Reply
  20. Lonna says:
    February 12, 2019 at 5:11 pm

    Dear Dr Carnahan, Thanks for this info. I’m a Functional Medicine doc. Recently have a patient who has been getting care with another doctor who straddles the line of conventional and functional medicine. He has been following my patient with Quantitative EBV viral loads: https://testdirectory.questdiagnostics.com/test/test-detail/10186/epstein-barr-virus-dna-quantitative-real-time-pcr?p=r&q=ebv%20dna&cc=MET. I had not used this test prior, nor seen it done previously. I am curious as to your comments on this test. I get your emails to practitioners, and in one sent earlier this week, you said, “If you are like me, you are frustrated by the lack of simple testing for viral load and specific viruses, particularly Epstein Barr”. Do you think this viral load test is not clinically useful? What is its place in following complicated EBV patients? Thanks so much for any light you can shed on this.

    Reply
    • Jill Carnahan, MD says:
      February 12, 2019 at 7:34 pm

      Yes, it may be useful but I think you can still have false negatives when virus is reactivated but not detected in blood

      Reply
  21. Janice says:
    February 17, 2019 at 3:34 pm

    Read several articles not to eat eggs,dairy,gluten and pork when fighting ebv. And some that say eggs are fine to eat. What is your opinion?

    Reply
    • Jill Carnahan, MD says:
      February 17, 2019 at 8:44 pm

      I generally recommend no eggs or dairy with viral issues

      Reply
      • Joanne Murphy says:
        April 28, 2020 at 9:31 am

        Why no eggs? Could you explain. I would appreciate it.

        Thanks and keep up the good work!
        Joanne

        Reply
        • Jill Carnahan, MD says:
          April 30, 2020 at 4:48 pm

          Patients with EBV should avoid egg and dairy which tends to trigger the viral reactivation

          Reply
  22. Tina says:
    February 22, 2019 at 10:09 am

    I’m not sure I understand the difference between reactivated, and chronic active EBV. My fill-in practitioner said I have CAEBV, but has offered no advice until I see my primary in two weeks. I was just told no lifting, stay away from high risk groups (elderly, infants, immunosuppressed folk) and to treat myself as if I’m immunosuppressed. I know I had a reactivation 5 years ago, at which point I was diagnosed with CFS/ME. Does it reactivating again constitute CAEBV?

    Thank you

    Reply
    • Jill Carnahan, MD says:
      February 22, 2019 at 8:54 pm

      Most of the population has had EBV at one time or another and will test positive for VCA IgG but that does not mean the virus is active. Reactivation means the patient has symptoms of EBV, such as fatigue or malaise and positive EBEA and EBNA titers.

      Reply
  23. Jane Woods says:
    March 6, 2019 at 12:42 am

    Awesome blog. It sound’s quite interesting to read this post.
    Thanks a lot for sharing this wonderful post.

    Reply
  24. Chelsea says:
    March 31, 2019 at 4:04 pm

    I’m wondering what you mean by “plant based paleo” – is it okay to have lean sources of protein like chicken, turkey, and fish while healing EBV?

    Reply
    • Jill Carnahan, MD says:
      March 31, 2019 at 10:29 pm

      of course! but you would still consume primary plants… this is how I eat! 😊

      Reply
      • Chelsea says:
        April 1, 2019 at 5:50 am

        Great! For some reason, I thought I needed to eat an entirely vegan diet to heal EBV. This is helpful!

        Reply
  25. Enrico says:
    April 5, 2019 at 5:43 am

    Dear Dr. Jill,
    Thank you very much for this article and the care you put around this subject.
    I’m a 34yo man and I suffered from a quite severe (15-20 days of fever) Epstein-Barr AND Cytomegalovirus (the latter was the apparent main player) infection 14 months ago, precisely after a period of time where I had to go through very intensive work shifts and sleep deprivation that were leaving me extremely exhausted.
    I recovered pretty well at that time, but then I went through a massive life-style change (moved back to Italy from London) to eliminate that work load that was affecting me so bad, that as a side effect caused me a lot of stress (which I’m working on, with good results).
    All the above is then to say that after three more months, I started experiencing extreme fatigue again, even without doing very much during my days. I have been trying to take more and more better care of myself but improvements seem to be very slow. Do you believe this process is “normal”? I have been checked in many ways: blood work, heart functioning, thyroid and all seems to be fine. What I experience is un-proportioned fatigue and sometimes a sense of being “ill”, without any actual symptoms nor fever.
    Anyways, I will implement the suggestions you give in your article (which I’m already partially doing), but I was also wondering if a short period of water fasting (like one day to start with) could be beneficial.
    Many thanks again for your attention, Dr. Jill.
    Bless,
    Enrico

    Reply
    • Jill Carnahan, MD says:
      April 5, 2019 at 8:39 pm

      short fasting can be extremely beneficial

      Reply
      • Catherine says:
        April 28, 2019 at 11:16 am

        This is great news! What is your definition of a “short” fast? 24 hours? I had been fasting (18-24 hours on average and found it quite easy) until I was diagnosed with EBV but feel well enough now to reintroduce it, for therapeutic purposes.

        Thank you so much.

        Reply
  26. Elena Nesterenko says:
    May 7, 2019 at 3:31 pm

    Another effective way of treating it is BIOMAGNETISM

    Reply
  27. Bryan Hayes says:
    May 15, 2019 at 11:53 am

    Thank you so much for this information.

    Stress is definitely a factor in my life. We have an epileptic 11 month old daughter and we’re in the process of moving to Los Angeles from Austin TX while I attempt to run a small online businesses from home. It can be tough but we hang on one day at a time.

    This is my current daily regimen:

    1gm tab Valacyclovir (Valtrex)
    10k iu Vitamin D
    3kmg Vitamina C
    60mg B-2
    250mg B-3
    700mg B-1

    I’m also not eating gluten, sugar, dairy, or grains. Although my biggest intake is meat at the moment, I do eat fruits and vegetables close to the same amount.

    I was diagnosed with Mono in January this year and I’ve had severe fatigue that comes for 3 days and then goes away for 2 days. During the 2 days that I don’t have severe fatigue, I’m still not 100% (closer to 40%) and I don’t entirely have the life style I had 6 months ago.

    I was an avid rock climber and easily capable of doing 20 pull ups a day. Now I can barely walk up the stairs to my apartment. Some days are better than others and those are the days I do the important things, other days I can’t seem to get off the couch or out of bed. I also just plainly feel like garbage 95% of the time. I get small breaks in the clouds of good feelings and normalcy, but not nearly what’s needed for a regular life.

    I just recently started the Valacyclovir and it seems to be giving me headaches and a sore throat. I’m hoping that means it’s working? haha

    For months now I’ve been experiencing weird tingling sensations in my face and up from my neck to behind my ears. My hands also getting the tingly feeling once in awhile. I’ve been told that these symptoms bay be related to stress and anxiety?

    I also have a weird sensation in my neck that feels full at times. When I stand up I can feel my pulse. It’s slightly painful and uncomfortable. It’s not pleasant.

    I’ve had ultrasounds of my neck that uncovered nothing out of the ordinary. My blood work all comes back “perfect” except for my VCA IGG that was 437.00 early February, and the the same result of 437.00 just a couple days ago. Both my EBNA and IGM were negative. Is this normal, to have the same readings 4 months a part. My PCP doesn’t seem to understand much about the blood tests and couldn’t give me a straight answer as to what these results indicate, other than that my body was recently infected with EBV.

    Reply
    • Krista Brown says:
      May 31, 2019 at 12:10 am

      I have been diagnosed with EBV in Sept. Chronic fatigue is getting worse and I have had other physical symptoms that have made me wonder if I have an autoimmune disorder as well. My PA said it was all from my high viral load. Do you know of any doctors in Texas that will work with a patient like me? I keep getting told “we don’t treat that”. The clinic I go to seems to have very limited resources.

      Reply
      • Cheri Beck says:
        January 18, 2020 at 4:48 pm

        Hello Krista, I know your post was a while ago but wondering if you found someone in Texas. I’m in Texas as well and looking. I was seeing a doctor in Dallas for a year but never got better under him. Austin and San Antonio are the closest big cities to me but willing to go to Houston if necessary or?

        Thanks

        Cheri

        Reply
        • Beth says:
          July 20, 2022 at 6:39 pm

          Were you ever able to find a doctor in the Austin, SA or Houston area?

          Reply
  28. Ontario Jay says:
    May 29, 2019 at 12:47 pm

    I’ve been battling health issues for years, and chronic insomnia was my first symptom. I’ve been off work for over two years, and about three months ago I found out I have EBV, and I also tested positive for Parvovirus. I’m currently being treated by a LLND, but I don’t feel like this is working well as I was hoping. I’m also on a plant based diet, which seems to help a bit with the inflammation, but not taking care of my problem. The cost of trying to maintain my health is a financial strain on my family, and I won’t be able to keep this up forever. I’m just not sure what to do?

    Reply
    • Jill Carnahan, MD says:
      May 31, 2019 at 11:56 am

      Hi Jay, best to find a functional medicine trained doctor to help you navigate.
      warmly
      Dr Jill

      Reply
  29. fatih says:
    June 24, 2019 at 10:26 am

    Dear Dr Carnahan
    I have been suffering from insomnia,indigestion,kidney and liver issues. for 5 years.these syptoms started after an unsafe sex.I took test in Armin lab.Ebv cmv elispot are positive.He says that these viruses makes me ill.But My igg evb cmv are positive ;igms are negative.Most doctors say there is no problem.I want to take valgansiclovir.Is valgansiklovir better than valtex for these viruses or they are same?These viruses make me such bad?

    Reply
  30. Jan E. says:
    July 24, 2019 at 1:09 pm

    I just learned I have EBV, even though I was never diagnosed with it when I was a pre-teen (I am now 63). My EBV panel came back HIGH on every test (all 4 tests included in the panel : EBV Ab VCA, IgM; EVB Early Antigen Ab, IgG; EBV Ab VCA, IgG; and EBV Nuclear Antigen Ab, IgG). The interpretation chart indicates I have a reactivated infection. Am I contagious? Just wondering if I need to stop kissing and hugging people, etc.

    Reply
    • Jill Carnahan, MD says:
      July 24, 2019 at 8:57 pm

      No, reactivation of EBV is unlikely to be contagious

      Reply
  31. Kimberly LaBrie says:
    September 4, 2019 at 3:14 pm

    I’ve been reactivated for 3 months now with liver and spleen enlargement. Anyway to get them to go down? I’m in a lot of pain and no one has any answers 😞

    Reply
    • Jill Carnahan, MD says:
      September 5, 2019 at 9:06 am

      You need to see an infectious disease doc or functional medicine physician to find out why your immune system is suppressed

      Reply
  32. Mindy says:
    September 7, 2019 at 10:34 am

    Hi Dr. Jill! I have a weird question I was hoping you could answer for me. I’ve been dealing with reactivated EBV the past 18 months or so. Things have gotten much much better and it really feels like it’s on it’s last leg. That being said, I was wondering if you kiss someone when you have reactivated EBV, can that reactivate the virus in your romantic partner? I avoided dating the first year of this journey because of that very fear (and cause I was so friggin tired anyways!), but have a wonderful partner that I certainly don’t want to infect if I can avoid it. Any information you have on this matter would be greatly appreciated!! Thank you!

    Reply
    • Jill Carnahan, MD says:
      September 7, 2019 at 9:24 pm

      Hi Mindy,
      It is unlikely to reactive or infect another person unless it is the initial episode of mononucleosis or the parter is immune compromised.
      warmly
      Dr Jill

      Reply
      • Mindy says:
        September 8, 2019 at 9:46 am

        Thank you sooooo much Dr. Jill!!!!

        Reply
  33. Michael (NW) says:
    October 15, 2019 at 2:03 pm

    Hi. I really want to try monolauron. Someone mentioned it might not be as effective after having EBV for a long period of time but more for acute infections?

    Also, supposedly MCT oil which monolaurin is a piece of, can increase TH2 immune response supposedly triggering food sensitivities? I believe I’m already TH2 dominant so that concerns me.

    But I really would like to use monolaurin. I know it can help with other things as well.

    Is monolauron ok to take with Valacyclovir?

    Thank you!

    Reply
    • Jill Carnahan, MD says:
      October 15, 2019 at 2:58 pm

      You may take monolauren with acylovir and it is more effective than MCT

      Reply
  34. Gretchen says:
    November 25, 2019 at 3:08 pm

    Hi, curious whether the Cats Claw used for this scenario should be TOA free or not? Thanks!

    Reply
    • Jill Carnahan, MD says:
      November 26, 2019 at 9:06 am

      No there is no research validating this claim, however the most effective cat’s claw formulations can be made from strong tea or double extracted (water-alcohol) tincture.

      Reply
  35. sherry rays says:
    February 18, 2020 at 5:51 am

    hello

    Reply
  36. Wendy says:
    February 28, 2020 at 3:54 am

    Thank you for your information. I an an ebv survivor. As an ND, I i became extremely frustrated trying to find the correct herbs, homeopathic remedies, and the like to fix my sleep (lack of) and mysterious weight gain. I was labeled menopausal, hypothyroid, Lyme-infected. I swear: I went thru so many docs in my area I trying to find one who knew more than me, I even drove over 2 hrs away to see a physician! For me, the herbal and diet and remedies did not touch the virus. So, after 12 years of chasing methods and doctors I finally found one in May city who is ebv literate. I am in my 2nd month of anti viral meds. I am sleeping thru the nights! Yay! I haven’t enjoyed nights for a decade! I am also gluten free and sugar free. My husband and I are both ebv and are staying away from lectin foods as best we can. I have also recently added monolaurian to my protocol of conventional anti vitals….the trick is to find a doc who knows epv is the root of all evils. So, even though I show up with one marker for Lyme and I know I have Morgellons, I can feel my body responding to the meds protocol and feel intuitive that all the other critters will be gone as well.

    Reply
    • Jill Carnahan, MD says:
      February 28, 2020 at 6:06 pm

      Hi Wendy
      Yes, it can be hard to find appropriate treatment and doctors who understand the problem of viral reactivation and infectious burden. I am glad you found help and are feeling better! Monolauren is an excellent addition to your regimen and you can use doses from 1200-1800mg twice daily
      Warmly
      Dr. Jill

      Reply
  37. Cecilia Borders says:
    March 23, 2020 at 9:36 pm

    Dr. Jill,
    I have reactivatged EBV, and its being treated with a 3-month treatment plan by a wonderful functional medicine doctor in my area not far from Charlotte, NC. I also have Hashimotos thyroiditis managed well with a 10-year habit of a pretty strict Autoimmune Paleo diet, except for my very occasional bit of processed sugar intake. Along with these things, I have a low level of H Pylori and Klebsiella infections that are being treated as well with this 3-month treatment plan. I’m in Week Number 4 now, and feeling better energy than before Week 1. At that time, my comprehensive blood work showed the reactivated EBV level was at 95, with a normal range of 9 or lower, with no traces of Histamine Intolerance. Also showed insufficient (rather than deficient) levels of Iron, Vit D3, folate, and B12. In your opinion, which one of these factors has possibly been causing my very frequent and sometimes debilitating sinus migraines for almost 3 years now ? Is it the reactivated EBV ? I’ve not had swollen lymph glands, just fatique, some anxiety/depressive symptoms along with brain fog, and these awful sinus migraines even without any signs of sinus drainage or congestion.

    Thank you,
    Cecilia B

    Reply
    • Jill Carnahan, MD says:
      March 24, 2020 at 8:44 pm

      Hi Cecilia
      It could be hormonal, or related to other food intolerances such as salicylates or oxalates. Have your doctor check organic acids in urine
      warmly
      Dr Jill

      Reply
  38. Lynn says:
    April 4, 2020 at 1:17 pm

    I need a overall test of everything from EBV, histamines, oxalate, IBS-D, thyroid full panel. Just all too see what is the problems. Inflammation is one cause. I have not had a all in one test too cover everything in my body. Is there a legit test out there that can do that? I have had food intolerance test but none really honest about the foods I should eliminate. I use to be able to go on diets & etc for this but the older I get it is hard. I do not have the well power to do it. I like your article on EBV. I had mono when I was 17 and I am 67 now. I feel that it is reactive right now.

    Reply
    • Jill Carnahan, MD says:
      April 5, 2020 at 7:47 pm

      Hi Lynn
      Yes a functional medicine doctor should be able to test all of this for you.
      warmly
      Dr Jill

      Reply
  39. Nathan B says:
    April 13, 2020 at 10:51 pm

    I saw the recommendation of 1000- 1500 mg a day of olive leaf extract, what percent of Oleuropein would that be? Thank you.

    Reply
  40. Delmer J says:
    May 27, 2020 at 1:37 pm

    I had mono at 24. I am now 54, and my ND says I have Epstein Barr. My VCA-IGM was normal. The VCA-IGG came out 225.00 (positive being over 21.99), EBNA-IGG is 63.20 (positive being again over 21.99), and EBV early antigen – IGG at 18.00 (positive being over 10.99). I was recently put of valacyclovir 1g 3xday and took it for 5 days. In those few days I feel so down, depressed, angry, and cannot sleep. I don’t have much money and state insurance only covers so much.
    What should I do?

    Reply
    • Jill Carnahan, MD says:
      May 30, 2020 at 11:13 pm

      Hi Delmer
      Best to discuss treatment with your physician but anti-virals are often needed for longer periods of time than 5 days
      warmly
      Dr Jill

      Reply
  41. Keri says:
    July 17, 2020 at 6:29 pm

    I’m curious what homeopathic drainage remedies you use or suggest? All of the clients who I’ve supported through detox has felt soo much worse. Mag baths, castor oil packs, rebounding, vitamin c, milk thistle, ox bile, calcium d glucarate and full spectrum support like Paleocleanse powder from designs for health. Would love your insight.

    Reply
    • Jill Carnahan, MD says:
      July 18, 2020 at 2:07 pm

      Hi Keri
      I like Pekana Drainage remedies. Itires for lymphatic, Renelix for kidneys and Hepat for liver – they come in a package and we do carry if you’d like to order call 303-993-7910
      warmly
      Dr. Jill

      Reply
  42. Randy Ferell says:
    September 5, 2020 at 8:49 pm

    I agree with you

    Reply
  43. Panagiotis Tsintavis says:
    September 17, 2020 at 7:59 am

    Thank you very much for an excellent post!
    I am wondering how long after treating EBV reactivation would you re-test (mainly the EA-D IgG)?

    Reply
    • Jill Carnahan, MD says:
      September 17, 2020 at 10:09 am

      Hi Panagiotis
      I do not test prior to at least 6 months of treatment
      warmly
      Dr. Jill

      Reply
  44. Pingback: What You Don't Know About Epstein Barr Virus – All For Myself
  45. Julie Baldock says:
    November 28, 2021 at 11:45 pm

    Hi Jill,
    I’m so happy I came across this article. For 35 years I’ve been self coping with my illness which accrued after glandular fever. No doctors here in the uk know about treating this illness which is extremely overwhelming. My question to you is about oestrogen and it’s impact on EBV? I’ve noticed that since hitting menopause my EBV has been ripping havoc on me. I had early onset menopause at 42 & am now 57 & finding my menopause symptoms has pasted but the lack of hormones is making my EBV unbearable. What do you suggest? Would HRT help? I’ve had this illness since I was 22 and I’ve noticed the only times in my life my EBV seemed under control was when I was on the pill pregnancy or the short time I took cyclical HRT when I was 47 for a year or two. Is this related? Does it make any sense to you at all? Best wishes Julie

    Reply
    • Dr. Jill C. Carnahan, MD, ABIHM, IFMCP says:
      November 30, 2021 at 10:13 pm

      HI Julie
      I am not aware of any direct relation of menopause to EBV but hormones do affect the immune system and a relative deficiency of estradiol could change the immune system, causing EBV to be more active
      warmly
      Dr Jill

      Reply
  46. Sasa Hnitkova says:
    December 16, 2021 at 1:05 pm

    What is your take on prescribing ivermectin for reactivated ebv. My functional provider recommended this to me as I have high antibodies. We tried ldn for 2 years, but nada, they are not going down. Still high and one time they went even higher. And I cannot take supplements due to my upset stomach issues, acid issues. (genetic). She mentioned that CMV is helped by this too. From doing research, I actually found studies and support for ivermectin being looked at as broad spectrum treatment for many other viral infections. What do you think about this? I am doing the glutenfree, dairy free and natural sugars only. Eating healthy.

    Reply
    • Rob says:
      February 21, 2022 at 9:52 am

      Hi Sasa;
      Did you end up trying the ivm for your ebV? I would love to hear from a person who has actually tried. I think I have the same issue.

      Reply
  47. James Bell says:
    June 24, 2022 at 6:54 am

    HSV-1 and HSV-2. Both virus types can cause sores around the mouth (herpes labialis) and on the genitals (genital herpes). It’s also crucial to learn as much as you can about your diagnosis. Seek options, Find out about what’s out there that could help.

    Reply
  48. eli says:
    June 30, 2022 at 10:25 am

    Hi Dr. Jill
    I have two questions. The first question: my daughter has the negative EBV igm and the positive EBV igg, but her EBV DNA is positive in the blood. I want to know, Is it the reactivated EBV ? why EBV DNA is positive ? The second question: EBV can be cause multiple painless blister like mucocele in the soft palate of the mouth, if my daughter has not other viral infection and she has not autoimmune disease ? for example after eating chocolate bar.

    Reply
    • Dr. Jill C. Carnahan, MD, ABIHM, IFMCP says:
      June 30, 2022 at 9:31 pm

      EBV could be reactivated if titers on EBV VCA IgG, EBV NA and EBV EA are all positive and 4X normal.

      Reply
      • Beth says:
        July 20, 2022 at 7:10 pm

        Any particular brand recommendations for the supplements you listed above?

        Reply
        • Dr. Jill C. Carnahan, MD, ABIHM, IFMCP says:
          August 6, 2022 at 8:04 pm

          Yes, all my favorites are here

          Reply
  49. centro tecnologico popular prefecture of guayas says:
    August 19, 2022 at 1:24 am

    En efecto. Y eso también me recordó a la función de reconstrucción de índices en línea reanudable de 2017, de la que tomé nota en la publicación. Gracias

    Reply
  50. Amy says:
    September 15, 2022 at 11:25 am

    Thank you for this great information! I used to see you in IL – still miss you! Thankfully I have another awesome FM doctor here now. Another point about the area of stress that I’ve found out personally is that past trauma (hard things, even if you might not categorize it as “trauma”) can also have a major effect on the health. So even if you’re doing your best with self-care in the present, any underlying trauma can definitely affect your body’s ability to do all the great things it’s supposed to do (fight infection, handle stress, etc.). Counseling/therapy has helped me a lot, and also EMDR, a type of therapy that helps to “re-train” the brain to not react in unhealthy ways to triggers (EMDR stands for Eye Movement Desensitization & Reprocessing). Just putting this out there in case it can help someone else, also! (After 30+ years of struggling, I finally had IGenX testing that showed Lyme & several other co-infections, so I’m finally getting those treated/killed down and starting to see a difference in how I feel… FINALLY!!!!!!!!!!!)

    Reply
  51. Alexandra Marks says:
    October 7, 2022 at 7:53 pm

    I think I’m missing 1 of the 4 blood tests I’ve heard Doctors talk about on the internet. My results are

    • EBV VIRAL CAPSID AG (VCA) AB (IGM) 42.20
    • EBV VIRAL CAPSID AG (VCA) AB (IGG) >750.00
    • EBV NUCLEAR AG (EBNA) AB (IGG) >600.00

    My new rheumatologist diagnosed me with chronic reactivation of Epstein-Barr virus. I thought I just had leaky gut with a nonspecific auto immune disorder when I first went to her. I have been treating myself since 2017 with a diet and lifestyle protocol. I struggle with being consistent bc modern day life is hard but I do NO vegetable & Canola oil, No soy bean oil, No soy, No Gluten …& I should do No Dairy but I do Grass Fed Dairy when I am not totally cheating on my own personalized Auto Immune Protocol. When My Rheumatologist diagnosed me with Chronic Reactivation of Epstein-Barr Virus I was VERY shocked. I’m educating myself on everything I can get my hands on. She prescribe me Valtrex 2 grams (— 3g) and said I will probably be taking it for at least 2 months. I had extremely horrible Epstein-Barr virus when I was 19. I wonder if the more extreme Epstein-Barr and initial viruses lead to a more likely reactivation… Anyway I am arming myself with so many supplements and lots of education but I have a scheduled second opinion with the head of immunology at Mount Sinai in three weeks. I’m 34 years old and an athlete (strong weightlifter). I’m confident I could beat this I’m just not positive on Valtrex over these natural remedies.

    ***Question 1*** Are there any health consequences of taking RX antivirals (like valtrex) for so many months? I am pretty hippie at heart so I am down for the natural remedies but my doctor did prescribe Valtrex & it’s waiting for me downstairs at my pharmacy and my 2nd opinion appointment is in 1 month.

    ***Question 2*** Am I missing a blood test to give me a better picture of my Epstein-Barr virus status? Thank you so much for all your help I’ll be scouring your blog for more information in general!

    Reply
    • Alexandra Marks says:
      October 7, 2022 at 8:00 pm

      Additional Info: I am big red flag for increase acute stressed — I ended a short but violent relationship last year and I have been in therapy deconstructing my privileged but very chaotic New York City childhood (aka what drew me to that—it’s going well though — finally 🍄♥️). Also I ordered a temporary rug that was emitting horrible VOCs semi recently that was giving me migraines (I NEVER woke up refreshed when that rug was under my bed — such a horrible decision) but I tried to tough it out for more than 1 week++. I saw you wrote back to a number of people about environmental toxins -_- 💔🥲

      Thank you so much for any insight you have! Wish you were in NYC!

      Reply
      • Dr. Jill C. Carnahan, MD, ABIHM, IFMCP says:
        October 9, 2022 at 1:45 pm

        Yes, you are so welcome, Alexandra! Thanks for sharing your experience with everyone.

        Reply
    • Dr. Jill C. Carnahan, MD, ABIHM, IFMCP says:
      October 9, 2022 at 1:44 pm

      Hi Alexandra
      Prescription anti-virals should be taken under physician supervision and also check blood counts and liver function to make sure no adverse effects. But otherwise they may be helpful if the virus is root cause of your symptoms
      Yes, you still need EBV Early Antigen (EA) as without it being positive, this may not indicate EBV viral reactivation.
      warmly
      Dr. Jill

      Reply
  52. Alexandra Marks says:
    October 7, 2022 at 8:02 pm

    Last Question: Any thoughts on using infrared sauna to help support the immune system and fight the virus?

    Reply
    • Dr. Jill C. Carnahan, MD, ABIHM, IFMCP says:
      October 9, 2022 at 1:45 pm

      Infrared sauna is a wonderful way to support detoxification and the immune system

      Reply

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Dr. Jill will help you search for underlying triggers contributing to your illness through cutting edge lab testing and tailor the intervention to your specific needs as an individual.
  • Address:
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| Dr. Jill works as a functional medicine consultant in conjunction with your current health care team and is not considered a replacement for your primary care physician. She requires all new patients to have a primary care physician to cover emergencies and routine care and screening.

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Flatiron Functional Medicine Newsletter
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Flatiron Functional Medicine Newsletter
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Functional Medicine Newsletter
Join Dr. Jills' health community today and receive health tips, recipes and recommended products for a healthier you!
Join today and get Dr. Jill's Paleo-licious Snack Ideas for free! We promise never to share your email with anyone.
Flatiron Functional Medicine Newsletter
Join Dr. Jills' health community today and receive health tips, recipes and recommended products for a healthier you!
Join today and get Dr. Jill's Paleo-licious Snack Ideas for free! We promise never to share your email with anyone.
Flatiron Functional Medicine Holiday Giveaway
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RESOLVE YOUR MOLD EXPOSURE SYMPTOMS
Dr. Jill's long-awaited Miracle Mold Detox Box is finally here. This handcrafted and researched bundle includes all of the crucial pieces you need to release and flush out toxins in 30 days.
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