Hi Everyone,
Here are my notes from this 1-hour webinar.
It was an interesting presentation and you can find the suggested "anti-EBV nutrients below". My personal thought is that most of the research presented was in vitro (cell culture) and it is questionable if these nutrients, many of which are polyphenols that are known to be poorly absorbed, could reach concentrations in the body to directly inhibit EBV and lower viral load.
However, many of the nutrients below do have clinical (human) studies showing they have benefits on other aspects of health. Perhaps they could have a synergistic effect on EBV management or help through pathways other than direct inhibition of viral replication (personally, I didn't find any relief from EBV until I took valacyclovir). The use of Lauric acid does intrigue me, when I tried it, I didn't tolerate it, but it seems absorption would be decent.
If anyone has thoughts or experience, I would love to hear them!
Notes: Epstein-Barr Virus Management Strategies. Dr. Nick Hedberg DC
EBV Antibody Titer testing
(Note: LabCorp Removed EA from their EBV panel, but it can be added to the lab req with the panel as an individual test)
Below are examples of EBV results showing a likely reactivation and info on how to interpret EBV titer results (I have also seen that some docs will consider very high VCA IgG as a potential reactivation, even in the absence of EA IgG)
Primary Pathology
- EBV infects B-Cells and reprograms them
- Also infects epithelial cells and nerves
- EBV is primarily controlled by CD8+ T cells, NK cells
In order to fight EBV infection, you need a strong TH1 response. The goal with chronic EBV is to prioritize Th1 response, this can mean trying to resolve Th2 and Th17 responses since having these active will dampen Th1
Adequate glutathione is needed for Naive T cells to differentiate into Th1 immune cells
Nutrient Therapies for chronic EBV
Magnesium
Magnesium regulates cytotoxic functions of NK and CD8T cells in chronic EBV infection through NKG2D. Chaigne-Delalande, 2013.
“We show that decreased intracellular free Mg(2+) causes defective expression of the natural killer activating receptor NKG2D in natural killer (NK) and CD8(+) T cells and impairs cytolytic responses against EBV. Notably, magnesium supplementation in MAGT1-deficient patients restores intracellular free Mg(2+) and NKG2D while concurrently reducing EBV-infected cells in vivo”
Thymoquinone (Black Cumin Seed Oil 500mg bid with food)
Thymoquinone efficiently inhibits the survival of EBV-infected B cells and alters EBV gene expression. Zihff 2013.
“We report here, for the first time, a promising selective inhibitory affect of thymoquinone on EBV-infected B cell lines in vitro, compared with lower activity on EBV negative B cell line and very low toxicity on human peripheral blood mononuclear cells and periodontal ligament fibroblasts. Moreover, the drug was found to efficiently suppress the RNA expression of EBNA2, LMP1, and EBNA1 genes. Specifically, EBNA2 expression levels were the most affected indicating that this gene might have a major contribution to thymoquinone potency against EBV infected cells. Overall, our results suggest that thymoquinone has the potential to suppress the growth of EBV-infected B cells efficiently.”
Quercetin
Quercetin Interrupts the Positive Feedback Loop Between STAT3 and IL-6, Promotes Autophagy, and Reduces ROS, Preventing EBV-Driven B-Cell Immortalization. Granato 2019.
“The results obtained indicated that quercetin inhibited the activation of signal transducer and activator of transcription 3 (STAT3) induced by EBV infection and reduced molecules such as interleukin-6 (IL-6) and reactive oxidative species (ROS) known to be essential for the immortalization process. Moreover, we found that quercetin promoted autophagy and counteracted the accumulation of sequestosome1/p62 (SQSTM1/p62), ultimately leading to the prevention of B cell immortalization. These findings suggest that quercetin may have the potential to be used to counteract EBV-driven lymphomagenesis, especially if its stability is improved.”
Resveratrol
Inhibitory Effects of Resveratrol on the Epstein-Barr Virus Lytic Cycle. Yiu 2010.
“Our results show that resveratrol inhibits the transcription of EBV immediate early genes, the expression of EBV lytic proteins, including Rta, Zta, and EA-D and reduces viron production, suggesting that this compound may be useful for preventing the proliferation of the virus.”
EGCG
Inhibition of Epstein-Barr virus lytic cycle by epigallocatechin gallate. Chang 2003.
“at concentrations exceeding 50 microM, EGCG inhibits the expression of Epstein-Barr virus (EBV) lytic proteins, including Rta, Zta, and EA-D, but does not affect the expression of EBNA-1. Moreover, DNA microarray and transient transfection analyses demonstrated that EGCG blocks EBV lytic cycle by inhibiting the transcription of immediate-early genes, thus inhibiting the initiation of EBV lytic cascade.”
Cordycepin (use CS4 type which is standardized to cordycepin) Supports T1
Cordycepin is a novel chemical suppressor of Epstein-Barr virus replication. Ryu 2014.
“These results suggest that cordycepin has antiviral and antitumor activities against gammaherpesviruses and host cells latently infected with virus.”
Curcumin
Curcumin Inhibits Proliferation of Epstein-Barr Virus-Associated Human Nasopharyngeal Carcinoma Cells by Inhibiting EBV Nuclear Antigen 1 Expression. Liu 2019.
“Curcumin induced the cycle arrest of the HONE1 and HK1-EBV cells positive for EBV.”
Berberine
Berberine inhibits the proliferation of human nasopharyngeal carcinoma cells via Epstein-Barr virus nuclear antigen 1-dependent mechanism. Want 2017.
“Viral titer experiments demonstrated that berberine decreased the production of virions in HONE1 and HK1-EBV cells. In a mouse xenograft model of NPC induced by HONE1 cells, berberine significantly inhibited tumor formation. Altogether, these results indicate that berberine decreases the expression of EBNA1 and exhibits an antitumor effect against NPC both in vitro and in vivo.”
Ginger
Anti-tumour promoter activity in Malaysian ginger rhizobia used in trauditional medicine. Vimala 1999.
“Seven rhizomes were found to possess inhibitory activity towards EBV activation”
NAC
N-acetylcyseine (NAC) ameliorates Epstein-Barr virus latent membrane protein 1 induced chronic inflammation. Gao 2017.
“Reducing the degree of inflammation achieved through NAC treatment, had the knock on effect of reducing leukocyte recruitment to the inflamed site, thereby slowing the progression of the pathology. These data support the idea that NAC could be considered as a treatment to alleviate chronic inflammatory pathologies, including post-viral disease.”
Sodium Selenite
Inhibition of Sodium Selenite on transformation of the Human B lymphocytes by Epstein-Barr Virus. Luo 1997.
Astragalus
The effect of Astragalus polysaccharide on the Epstein-Barr virus lytic cycle. Guo 2014.
“Astragalus in a non-cytotoxic concentration of 30mcg/ml significantly suppressed the expression of Zta, Rta and EA-D during EBV lytic cycle. Our observations indicate that astragalus is potentially useful as an anti-EBV drug.”
Andrographis
Inhibition of the epsstein-barr virus lytic cycle by andrographolide. Lin 2018.
“This work demonstrates that 25 microg/ml of ethanolic extract from A. paniculata (EEAP) and 5 microg/ml of andrographolide, a bioactive compound in EEAP, effectively inhibit the expression of Epstein-Barr virus (EBV) lytic proteins, Rta, Zta and EA-D, during the viral lytic cycle in P3HR1 cells. Transient transfection analysis revealed that the lack of expression of Rta, Zta and EA-D is caused by the inhibition of the transcription of BRLF1 and BZLF1, two EBV immediate-early genes that encode Rta and Zta, respectively. This study finds that the inhibition prevents the virus from producing mature viral particles.”
Monolaurin
A Review of Monolaurin and Lauric Acid. Lieberman et al 2006.
Foundation Supplementation
Vitamin D and K
Optimize B12, magnesium, vitamin A, selenium, and zinc status
EBV Protocol:
Curcumin 500mg bid
Black Cumin Seed Oil 500mg bid
NAC 700mg tid or liposomal glutathione 500mg qd
Resveratrol 225mg bid
Quercetin
Lauric Acid Protocol (see above)
Cordyceps (Cs-4) 500mg tid
Probiotic
OVERVIEW: In this webinar, Dr. Hedberg will cover detailed management strategies for Epstein-Barr Virus including: -EBV pathophysiology -Associated conditions -Laboratory Interpretation -Supplements that target EBV -Herbal medicines that target EBV -A case study KEY LEARNING POINTS: All attendees will come away with a complete understanding of how to identify, diagnose, and manage Epstein-Barr Virus in practice.
