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Epstein Barr Virus and Thyroid Disease

Explore the connection between the Epstein Barr virus and thyroid disease, and how to manage both.
Epstein Barr Virus and Thyroid Disease
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In this article:

  • What is the Epstein Barr virus?
  • Connection between the Epstein Barr virus and thyroid disease
  • Does the Epstein Barr virus cause autoimmune thyroid disease?
  • How to test for the Epstein Barr virus
  • What to do if you have reactivated the Epstein Barr virus
  • Other treatment approaches for the Epstein Barr virus

What is the Epstein Barr virus?

The Epstein Barr virus, abbreviated EBV, is also known as human herpesvirus 4 or HHV-4. EBV is a member of the family of herpes viruses. Estimations suggest that as many as nine in ten people globally have been exposed to the Epstein Barr virus, most as children. 

When exposed to EBV at a young age, the initial infection (the "lytic" or infectious stage) typically causes no symptoms or a short, mild illness. Suppose the first exposure is as a teenager or adult. In that case, symptoms are evident about half of the time, with a diagnosis of infectious mononucleosis—often referred to as "mono," manifesting as severe fatigue, fever, sore throat, and swollen lymph nodes.  Most cases of mono resolve within two to four weeks, and the virus then becomes dormant for life—the "latent" phase.

In some people, however, EBV switches between the dormant latent phase and the active lytic phase. That means that some people become reinfected and experience symptoms of EBV more than once. 

Some of the factors that can lead to EBV reactivation include a suppressed immune system, exposure to other bacteria or viruses, taking steroid drugs, and physical or emotional stress.

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Connection between Epstein-Barr virus and autoimmune thyroid disease

EBV is a known trigger factor for a variety of autoimmune diseases. Specifically, a protein that Epstein-Barr produces attaches to locations on the human genome associated with seven autoimmune conditions: multiple sclerosis, rheumatoid arthritis (RA), juvenile idiopathic arthritis, systemic lupus erythematosus (SLE), inflammatory bowel disease, celiac disease, and type 1 diabetes.  

Researchers in Poland have also found a very high prevalence of EBV infection in both Hashimoto's thyroiditis and Graves' disease patients compared to the general population. Hashimoto's and Graves' diseases are the two most common autoimmune diseases. They are estimated to affect up to 10 percent of people worldwide. 

The Polish study found that 81 percent of Hashimoto's thyroiditis cases and 63 percent of Graves' disease cases had EBV proteins evident in the thyroid gland. These findings suggest that chronic EBV and EBV reinfection may cause autoimmune thyroid disease.

Is exposure to EBV a reason behind the prevalence of autoimmune thyroid disease? 

The question is still being studied, and determining the cause of any autoimmune condition remains complicated. 

Experts attribute from 60 to 70 percent of autoimmune thyroid conditions to your genetics. Genetics and family history are only part of the picture, however. Other factors also come into play, including radiation exposure, selenium deficiency, iodine excess, physical or emotional stress, nutrition, pregnancy, other hormonal imbalances, trauma to the neck or thyroid, smoking, bacterial and viral infections, and some medications.

While it's not definitive, the theory is that EBV-infected immune cells infiltrate the thyroid gland in people who are predisposed to autoimmunity, including autoimmune thyroid disease. Once they've gotten a foothold in the thyroid gland, the EBV-infected cells start producing antibodies and cause the surrounding immune cells to overreact and attack the thyroid gland. 

A healthy immune system typically stops this process quickly. But in someone with a genetically or environmentally affected immune system, the virus takes hold. Reinfections can periodically flare up and cause not only symptomatic EBV reinfection. Still, they can "switch on" autoimmunity in the thyroid gland itself.  

Let's be clear, however. You will likely come across information from armchair "experts" and so-called "medical mediums" who claim that EBV is the cause of all autoimmune thyroid disease and even thyroid cancer. That is not only unproven but also highly unlikely.

Autoimmune diseases are notoriously complex and typically involve many environmental and immune triggers. Everything from h. pylori gastrointestinal infections to gluten sensitivity to nutritional imbalances are all possible contributors to the risk of developing autoimmune thyroid disease.


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Does the Epstein-Barr virus cause autoimmune thyroid disease?

It's difficult to answer this question for sure, but in some cases, it certainly seems plausible. 

Take my situation, for example. I had a severe mononucleosis infection at age 17. I also had an equally debilitating EBV reinfection at age 30. In both cases, thanks to aggressive nutritional and holistic support, I recovered pretty quickly. 

About a year after recovering from my EBV reactivation, however, I started noticing weight gain, fatigue, and brain fog. I was soon diagnosed with Hashimoto's hypothyroidism

Were they connected? It's possible, given what we now know about the cause-and-effect relationship between EBV and autoimmunity. However, at the time, I was a cigarette smoker and was recovering from a neck injury from an auto accident. These are also known risk factors for autoimmune thyroid disease.

How to test for Epstein-Barr virus

The first step in exploring whether EBV is related to your autoimmune thyroid disease is blood testing. 

These two laboratory blood test panels can check for EBV reactivation:

  • EBV Early Antigen Test
  • EBV Antibodies Panel. 

You can request these tests through your doctor or order them yourself online.

What to do if you have reactivated the Epstein-Barr virus

If you do have reactivated EBV, the next question is obvious: what should you do?

First, be aware that conventional doctors rarely offer medical treatment for infectious mononucleosis, much less reactivated EBV. Some physicians, however, have had some promising results prescribing antiviral drugs, including acyclovir (Zovirax), valacyclovir (Valtrex), and ganciclovir (Zirgan). These medications may help reduce EBV antibodies. In turn, these medications may also help lower thyroid antibodies and calm autoimmune reactions, so it may be worth discussing antiviral treatment with your thyroid doctor.

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Other treatment approaches for Epstein-Barr virus

I have a complicated relationship with EBV and viruses in general. As I mentioned, at age 17, during the winter break of my senior year of high school, I came down with a terrible case of mononucleosis. According to my doctor, my blood test results were really bad. He warned I would be out of school to recover for the rest of the year, delaying my graduation and transition to college. He also said there was no treatment for mono other than "rest."

My mother, frustrated by the complete lack of treatment options, was determined to find a solution and turned to a knowledgeable friend who was an early adopter of natural medicine and nutritional approaches. 

Together, they quickly created an aggressive megavitamin, supplement, and nutritional protocol for me to follow. Two weeks after my diagnosis, with repeat blood work, the doctor said, "I don't know what you did, and I don't want to know, but whatever it was, the levels are almost back to normal." I was able to return to school a few days later.

Then at 30, I came down with a nasty upper respiratory infection, followed by what felt again like mono. The doctor confirmed that I showed very high reactivation of EBV. I was brain-fogged, exhausted, and unable to work. Under the guidance of a holistic physician, I again turned to various vitamins, supplements, and dietary changes. I was able to recover and get back to work in about a few weeks. (About a year later, however, after I started noticing weight gain, fatigue, and brain fog, I  was diagnosed with Hashimoto's hypothyroidism. Were they connected? Very likely.)

Since my reactivation and Hashimoto's diagnosis, I've become far too familiar with the other members of "the family" of herpes viruses. Along the way, blood tests have shown that in addition to HHV-4/EBV, I also carried HHV-3, the virus that causes cold sores, chickenpox, and shingles, and HHV-6, the virus that causes rashes, inflammation, and fevers. 

I could tell when I was going through a viral reactivation, as I would have a recurrence of mono symptoms, and my hypothyroidism would become much harder to manage. I learned to research and advocate for myself for my Hashimoto's, so I turned my efforts to combat the "family" of viruses that had moved in!

I started with a year-long course of antiviral medication—in my case, valacyclovir—but it didn't seem to reduce my frequent periods of reactivation or have much impact on blood tests measuring EBV antibody levels in particular.

I decided to go back to what had worked in the past, diving deep into my study of natural approaches. I discovered that nearly every natural medicine practitioner has their own "viral protocol." Even a quick search on EBV unearths dozens of different diets and supplement programs focused on eradicating EBV. 

Some of these programs are, frankly, dubious. For example, the "medical medium" who believes all thyroid problems stem from EBV also believes that daily consumption of large amounts of celery juice, blueberries, cilantro, and asparagus will "cure" EBV. I have yet to see any scientific evidence to support this questionable claim.

I did find, however, that there are some common recommendations found across the holistic and naturopathic spectrum. Together with a team of knowledgeable practitioners, we put together an approach that worked for me. I'm pleased to say that I no longer have antibodies to any human herpesvirus, including EBV, and no evidence of reinfection.


I have successfully used the following supplements. You'll find many practitioners recommending them to combat EBV and viral infections.

  • Monolaurin is a byproduct of coconut fat that contains antiviral and antibiotic properties
  • Cat's Claw is an antiviral botanical supplement derived from plants
  • Lysine is an amino acid with antiviral properties
  • Zinc is a mineral that helps regulate the immune system
  • Selenium is a mineral that helps reduce inflammation and regulate immune response
  • B Vitamins, especially B1 (thiamine) and B5 (pantothenic acid), help to support the immune system
  • Melatonin is a hormone that helps regulate the immune system response
  • Probiotic supplements help to maintain balance in gut health, for optimal immune response
  • Vitamin D and Vitamin C help to support the immune system and adrenal function


I follow a generally healthy diet that focuses on non-starchy vegetables, nuts and seeds, and good fats. I also make it a point to include sufficient healthy, lean protein with every meal. I make sure to eat probiotic-rich fermented foods, like yogurt, kimchee, and pickled vegetables. I generally avoid gluten and choose free-range and wild proteins and organic, hormone-free, and pesticide-free foods whenever possible.

Stress management

One factor known to cause reactivation and worsen viruses is steroid drugs and the body's stress hormones. Stress causes the body to pump out higher-than-normal levels of adrenal hormones–the body's own "steroids."  We've long known that stress is a precipitating factor for autoimmune disease. But now, we understand that stress hormones "feed" and promote viruses, and EBV triggers and worsens autoimmune disease. It explains how stress is a risk factor for autoimmune disease.

That's why I have also incorporated daily physiologic stress reduction into my antiviral protocol. By this, I mean practicing something that generates a genuine "relaxation response," including a reduced heart rate, lower blood pressure, and lower cortisol levels. This practice helps to inoculate my body against the effects of stress. My favorites are guided meditation, breath work, and gentle yoga.

Next steps

Receiving a diagnosis of Epstein-Barr virus (EBV) can be challenging, and addressing reinfection is not something to tackle on your own. While we understand the importance of managing EBV, it is important to note that at Paloma Health, our expertise and treatments are specifically focused on hypothyroidism, Hashimoto’s, and menopause.

We strongly recommend partnering with a knowledgeable healthcare provider to manage EBV. They can provide you with the appropriate guidance and support you need for the best possible outcome.

How we can help

While managing EBV with another provider, let us support you with our expertise in hypothyroidism, Hashimoto’s, and menopause. Partner with our specialized healthcare providers to address these conditions effectively. You can schedule a free info call to learn more about Paloma Health here:


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Mary Shomon

Patient Advocate

Mary Shomon is an internationally-recognized writer, award-winning patient advocate, health coach, and activist, and the New York Times bestselling author of 15 books on health and wellness, including the Thyroid Diet Revolution and Living Well With Hypothyroidism. On social media, Mary empowers and informs a community of more than a quarter million patients who have thyroid and hormonal health challenges.

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