Reducing Oxidative Stress in Epstein-Barr Virus

Video Details
Experts

Content provided by

William Pawluk, MD, MSc

Guest experts

Kasey Holland, ND

Summary

Why addressing oxidative stress is crucial for healing from Epstein – Barr virus.
Mechanisms of oxidative stress and EBV in chronic illness.
How to pinpoint EBV reactivation and describing the stages of EBV infection.
The cyclical nature of EBV reactivation.
PEMFs as a way to combat oxidative stress and chronic inflammation that predisposes to EBV reactivation.
Natural treatments to control EBV.

Transcript

Disclaimer This transcript was generated using artificial intelligence and may contain typographical errors. If you have questions, suggestions, or corrections, feel free to contact us at [email protected]

William Pawluk, M.D., MSc

Hi, Dr. Pawluk here again. And today, I have a very special guest, Dr. Kasey Holland, and we’re gonna be talking about another one of our favorite topics and that’s Epstein-Barr virus. So, we’re gonna have Dr. Holland talk about her background and her history, and then we’ll jump right in.

Kasey Holland, N.D.

Sounds good. Thanks for having me, Dr. Pawluk. I am Dr. Kasey Holland and I started seeing Epstein-Barr virus actually when I was still a student in school. And I just kept having patients where they had all these symptoms of chronic fatigue, joint pain. Some of them had herpes, presentations of cold sores on their face. And the only thing that really showed up was their Epstein-Barr virus titers were elevated. And at that point in time, there wasn’t… Medical Medium hadn’t published his book about Epstein-Barr virus. There wasn’t really a lot of talk about it like there is right now, and it was just well, support your immune system, hope that they do better. And I also struggled with Epstein-Barr virus my entire life. When I was a child, I had a very severe case that knocked me out of school for three months. So, it was always in my mind. And I think, that’s why I would always look into it with patients, but from there, it grew. And I started in my first year out during residency, I saw just tons and tons of patients. And it was no surprise when their Epstein-Barr virus titers were positive or elevated.

And it was really interesting to see who got better and who didn’t because some people were doing very extensive IV therapies, everything under the sun, had tried pharmaceuticals, and they had no relief. And others did a few things and some did a mix of things and they did better. So, I just really started paying attention to what benefited my own health. During that time, I also had a very severe mold exposure that caused my EBV to reactivate. So, I got to live through it again and really experience it myself. And through that, and then working with patients, seeing what was working and what wasn’t, I really developed a passion for working with patients with chronic fatigue and reactivated Epstein-Barr virus, because I got tired of them hearing that their only option was maybe a pharmaceutical that technically, isn’t for that, or to just go home and rest and hope that it got better when they were unable to do their daily routine and their life. And so, through that, I have just wanted to share with people their options and help them understand what’s really going on with Epstein-Barr virus. And that’s what I’ve been focusing on ever since.

William Pawluk, M.D., MSc

Well, let’s go back into your background,

Kasey Holland, N.D.

Okay.

William Pawluk, M.D., MSc

Before about the college. So, you got your bachelor’s degree, right? And tell us what.

Kasey Holland, N.D.

That was in cell biology and neuroscience from Montana State University.

William Pawluk, M.D., MSc

So, why didn’t you go into basic science? Why didn’t you go and get your PhD?

Kasey Holland, N.D.

Well, I actually was in the process of doing that and I was working in a lab and we talked, we were working on showing how liver cells can regenerate and heal. And we were using mice models and I just really wanted to work with people more. And I wanted to test natural therapies because the therapies that we were using were always pharmaceutical-based. And I wanted to work with people and apply it more specifically to patient care and not have to wait through grant process writing and years and years of this research to see it. So, I guess, I was a little impatient.

William Pawluk, M.D., MSc

Well, we’re lucky for that. So, after that, you went into naturopathy. Did you have a break between your BS degree and going to naturopathic school?

Kasey Holland, N.D.

No, I didn’t. And actually, when I was sick growing up, a naturopathic doctor was really what helped me. So, I had thought that that’s what I would do. So, I just went straight ahead for it.

William Pawluk, M.D., MSc

Directly. Wonderful. So, because of your experience, your personal experience, and also obviously having worked with a lot of people with this condition, you decided to become a, you wrote in your bio, dealing with what you call the toxic trio.

Kasey Holland, N.D.

Mm-hmm. Yeah. So, the one thing with Epstein-Barr virus that I’ve really noticed is that a lot of times, people think that it’s causing all their symptoms and it’s the only thing that is causing problems, but usually, there’s other things involved, rarely do I see it ever be just Epstein-Barr virus. So, we see a lot of Lyme disease associated and depending on who you’re working with, a lot of people actually consider EBV almost a co-infection of Lyme disease. And then, we also see mold illness, a lot. Mold causes EBV to reactivate. And I know that we’ll talk more about just what causes EBV to reactivate and why it does that. But in a lot of patients that I saw in my first years out in clinic, that was part of the problem is we were only focused on Epstein-Barr virus and we were missing what was causing it to reactivate in the first place.

William Pawluk, M.D., MSc

So, what percentage of the population has EBV?

Kasey Holland, N.D.

Greater than 95% is what they are estimating at this time.

William Pawluk, M.D., MSc

So, we all have it.

Kasey Holland, N.D.

Yeah. Pretty much.

William Pawluk, M.D., MSc

Right?

Kasey Holland, N.D.

Yeah.

William Pawluk, M.D., MSc

And it’s because of that, that medicine discounts it.

Kasey Holland, N.D.

Exactly.

William Pawluk, M.D., MSc

Right? Because ubiquitous, everybody’s got it. So, why are we worried about this? It’s gotta be something else. It can’t be EBV.

Kasey Holland, N.D.

Exactly. Yeah. The medical community, the first time you get Epstein-Barr virus, it’s usually considered, we see it as mononucleosis, it’s considered self-limiting. You might have a more severe case, but you should be able to just rest and get better. And in textbook immunology and infectious disease, it’s thought that our body is supposed to be able to then keep it in a latent state. So, the virus stays in our body, but it’s in a state where it’s inactive. So, according to that, unless we’re severely immunocompromised, it shouldn’t be reactivating and it shouldn’t be causing a problem. And that’s where the disconnected with our conventional medical world right now is we have people that aren’t considered immunocompromised that have it reactivate and have severe problems with it.

William Pawluk, M.D., MSc

Well, most doctors I know when I was a medical doctor and practicing regularly, we almost never tested for it.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

So, the only time that we ever tested routinely before it was in what setting?

Kasey Holland, N.D.

When you probably, a younger child or somebody that first got it, and they did a Monospot probably.

William Pawluk, M.D., MSc

Right, but actually after that, the most routine time to test for it was in people with transplants.

Kasey Holland, N.D.

Oh, right.

William Pawluk, M.D., MSc

Right? ‘Cause they’re on significant immunosuppression. So, now, with somebody who’s immunosuppressed, we are worried about any viruses.

Kasey Holland, N.D.

Right.

William Pawluk, M.D., MSc

Right? All viruses can be a threat. Shingles virus, CMV viruses, hepatitis C vi… The list goes on and on. So, then, usually in these transplant patients, before they actually do transplants, they will do a barrage of these viral titers.

Kasey Holland, N.D.

Right.

William Pawluk, M.D., MSc

Just to be sure. And then, when you immunosuppress them and they start having fevers and they start having all kinds of other symptoms, vague symptoms like what you’re talking about, in that setting, you understand the vague symptoms and then you worry about it.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

‘Cause you worry about host responses, you worry about rejection problems in those individuals. So, what happens is medicine says that it’s only really important in that setting. It’s not important in any other setting. And we’re clearly saying, nah, it’s a bigger problem than that. If it’s that ubiquitous, it’s got to be a bigger problem than that. It’s just disguised.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

Right?

Kasey Holland, N.D.

Right, well, we also see now that it’s associated with seven different autoimmune conditions. There was new research published that it has a more direct role in MS, multiple sclerosis, than we thought. And it’s thought to be directly attributed to 200,000 cases of cancer each year. So, the literature for how it is affecting chronic diseases is there now, but like you said, how doctors present it and what they are trained to look for, that is still present in patient care.

William Pawluk, M.D., MSc

So, it’s a much more common problem. And how immunosuppressed do you have to be to have a problem with it?

Kasey Holland, N.D.

Well, that’s the interesting thing is I don’t think that patients would be conventionally considered to be immunosuppressed. They haven’t had an organ transplant. They’re not on immunosuppressant drugs or anything that are getting it. And things like mold illness can cause immunosuppression and immune problems that might not be a medical emergency at the time, but they are the setting the ground for problems. So, I guess, we don’t have a scale that says, if you have this, this, and this, it’s possible. And people that don’t have other diagnosed medical conditions, but maybe have a heavy toxin load or other infections like Lyme disease that haven’t been diagnosed or mold illness can be at risk of it reactivating, or even just people that were in a car accident and had a major stressor or life change, anything that can cause a stress on the body like that and shift the biochemistry can be enough to trigger Epstein-Barr virus to reactivate.

William Pawluk, M.D., MSc

So, is it probably, it’s more like a straws on a camel’s back?

Kasey Holland, N.D.

Exactly. Yeah. It’s like filling up that bucket that we all have until it’s overflowing.

William Pawluk, M.D., MSc

Have you ever seen mold by itself with no other antecedent causes or any other causes? Trigger it just by itself?

Kasey Holland, N.D.

Yes. Mm-hmm. Well, I don’t know, because I think, when people are exposed to mold, I can’t say, oh, they haven’t had any other toxins. They haven’t had any other things in their life. We always think of things in the immediate of what has happened, but what about when we were in our mother’s womb and the toxins that we were exposed to there. So, to measure all of that is really difficult. So, I can’t say with certainty that the only thing was mold, but I have seen EBV reactivate very quickly after a mold exposure. And that be when they had symptoms that were debilitating.

William Pawluk, M.D., MSc

Well, how does mold set the stage for triggering it?

Kasey Holland, N.D.

Yeah, so there’s a couple different reasons. First off, mold causes a lot of oxidative stress in the body and oxidative stress is when there’s an imbalance of reactive oxygenation species and not enough antioxidants to keep up with them. We want reactive oxygenation species. It’s actually what our body is creating in response to bacteria, viruses, toxin, stress. It’s how we are built to handle it, but we have to be able to clear it out. So, when we have an imbalance of that, we have a lot of oxidative stress. Now, EBV actually has a signal on it, a protein. It’s known as BZLF1. And when that-

William Pawluk, M.D., MSc

Say that again slowly.

Kasey Holland, N.D.

BZ-

William Pawluk, M.D., MSc

BZLF1?

Kasey Holland, N.D.

Yeah, B and then Z as in zebra, LF1. And when there is a certain amount of oxidative stress, that signals and tells EBV, hey, it’s a good time to be into an active seat now and it’ll start replicating. Now, the problem is that when that happens, guess what EBV is doing. It’s creating more reactive oxygenation species. So, it’s feeding back and creating more.

William Pawluk, M.D., MSc

It’s a cycle.

Kasey Holland, N.D.

Yep. And so, mold can start that just with a lot of oxidative stress because mold causes so much oxidative stress. The other problem with mold is that it can cause our B cells, which typically remember EBV and are helping fight EBV to forget seeing the virus. So, then when you have mold, you have a double whammy where you’re turning the virus on and then you are forgetting how to fight it. And so, really, if you’re in mold, I think, it’s probably very rare that you don’t have it reactivate.

William Pawluk, M.D., MSc

Well, what percentage of the population has been exposed to mold?

Kasey Holland, N.D.

Well, that’s a great question. OSHA estimates that there’s about one in four homes that have water damage that could cause health problems. But I think that we all estimate that it’s higher than that. So, a lot of us have been exposed to mold and some of us have genetic SNPs that can make us more susceptible to how we’re able to detox it. So, that’s the kicker there because some of us could be exposed to mold and be able to keep up with it and be okay with how we’re detoxing it, and others can’t.

William Pawluk, M.D., MSc

Are those SNPs just molds? Are they mold-specific?

Kasey Holland, N.D.

The HLA-DR is specific to mold, but there are other SNPs that aren’t just mold. Somebody might have SNPs that make it harder for them to break down other toxins. And some people are more susceptible to different things because of that as well.

William Pawluk, M.D., MSc

So, you could probably, most likely, most of us have multiple vulnerabilities, right? Relative to the SNPs.

Kasey Holland, N.D.

Right. Right.

William Pawluk, M.D., MSc

What other things activate? I know you talk about oxidative stress, so there’s a lot of stuff that could create oxidative stress. So, that’s a common denominator about… But you’re saying that’s a common denominator for activation or reactivation of EBV.

Kasey Holland, N.D.

Yep, so, even just daily stress of our life and a stressful job, a stressful relationships, things like that. Actually, when I talk to patients, stress is the number one thing that comes up and is what it’s known to reactivate from. Oh, they had an EBV-reactivated patient because of stress. But other things can reactivate it too. For example, COVID, we are seeing that most long haulers, patients, they’re finding higher titers of Epstein-Barr virus post-COVID, even if you’re not a long haul or post-COVID is possible that the oxidative stress from that infection could do that. The flu and other viral infections can do it as well. Lyme disease, parasites, other toxins. One toxin that I think, is getting attention more. And that has to do with a lot of this as well is glyphosate. We see-

William Pawluk, M.D., MSc

Oh, Roundup.

Kasey Holland, N.D.

Yeah.

William Pawluk, M.D., MSc

Roundup. Roundup.

Kasey Holland, N.D.

Mm-hmm. Yep. We are finding out now and more is being done now about the toxicity of that, but Epstein-Barr virus was originally most associated with Burkitt’s lymphoma and we see Roundup being associated with lymphoma and being extremely toxic, and the problem with it is that it’s been sprayed on so much of our food and in our soil. So, even if we’re going organic or things like that, we might still be getting a little bit of that. And being able to clear that out of our body and not have reactive oxygenation species building up and not have toxicities building up is really important. So, that’s another big one that I see. And like I said, other infections, other toxins, dental fillings, or mercury removal done improperly, root canals, intestinal permeability, or gastrointestinal problems because so much of our health is linked to our gut. If you have a chronic gastrointestinal infection, it’s going to be really hard to properly detox and have regular healthy bowel movements that are removing toxins. And so, the big hitter. So, really, anything in excess in our world can lead to oxidative stress that is not beneficial anymore.

William Pawluk, M.D., MSc

And again, that goes back to straws. How many straws can somebody take? And so, by the time you get sick enough to develop these symptoms, and I know I talk to people with regularly as well. Some of them are very young in their 20s and 30s where they get this trio that you’re describing. And others are in their 40s and 50s when they get the trio. So, it depends on the total burden of what you’re carrying. What percentage of us aren’t toxic?

Kasey Holland, N.D.

Probably zero, right?

William Pawluk, M.D., MSc

Unless you live on the mountains in Tibet and you-

Kasey Holland, N.D.

Yeah.

William Pawluk, M.D., MSc

And you might not have as much of a burden ’cause it’s in the air anyway, right?

Kasey Holland, N.D.

Mm-hmm. Yep.

William Pawluk, M.D., MSc

Around the planet. So, your toxic trio is Epstein-Barr virus, Lyme disease, and mold. They’re the probably the most common activators and they’re the most common culprits. Interestingly enough, I don’t know if you’re aware of this, I’m sure you are, is that what I do, Western blot testing. And there are a lot of people who are Lyme-literate doctors who go down that full board down that road of a Lyme disease when they have two or three Western blot antigens positive, but they’re mildly positive. So, they don’t meet the CDC criteria. I know we can distrust the CDC anyway, but at least they don’t meet the CDC criteria. But they have mild activation of some Western blot antigens, but not enough. But I found that they, Western blot ask you if you read the tests for the labs, they said EBV cross-reacts.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

Right? Are you aware of that?

Kasey Holland, N.D.

Yeah.

William Pawluk, M.D., MSc

Can you tell us more about that?

Kasey Holland, N.D.

Well, first off, I think, it’s interesting how we approach the germ or bugs or disease in general because it’s like, what… Is it really… Are we ever not going to have any viruses or bacteria in our body? No. And we’re not supposed to. And so, what level does it take for spirochete to be positive? And with Lyme disease, there’s two trains of thought. And there’s also two types of Lyme disease, essentially. You have your acute where somebody was clearly bit by a tick, there’s a bullseye rash, it’s positive. We’re going to treat it acutely, whatever. They know they were bit by a tick. And then, we have this chronic picture where, well, I don’t ever remember being bit by a tick and I was well my whole life. And now, all of a sudden, I have symptoms. How did I get this in my body? How I get spirochete? Now, maybe they were bit by a tick and didn’t know it. Or maybe it was passed to them from when they were born. We don’t really know. And that’s controversial about that.

William Pawluk, M.D., MSc

Even supposedly sexually.

Kasey Holland, N.D.

Yes. So, is it possible that some of us have Lyme disease or spirochete in our body, but we’re still healthy? Yes it is. And then, when we have a trigger, it’s there and all of a sudden, we don’t feel well. And so, when we see this cross-reactivation and things like that, I think, it can be a sign that maybe we had this for a long time and we didn’t know it and whatnot. There’s so much that we don’t know about immunology and how the immune system is functioning. I think, a lot of times, what happens commonly is that people see they’re positive for Epstein-Barr virus. And they just focus on that and then they don’t test for Lyme. And when they see that that Lyme test is negative, they say, okay, it’s not Lyme, but there could still be Lyme affecting them because spirochete don’t hang out in the blood. They hang out in tissues. And it’s really difficult to test that. So, I think, that’s where it gets tricky. I do think that EBV and Lyme are different things. One’s a virus, one’s a spirochete. And there can be when we have both of them going on where the immune system is showing up different. But the tricky part is just the Western blot, it’s testing blood. And it’s difficult to see spirochete in the blood is what the real difficulty is.

William Pawluk, M.D., MSc

Unless you let you see the spirochete, you don’t know ’cause you’re just dealing with an immune reaction.

Kasey Holland, N.D.

Right.

William Pawluk, M.D., MSc

And there’s biological mimicry. So, somehow maybe, it’s possible that something of the spirochete antigen is a mimic with the antigens in EBV. And so, that test is just testing for those proteins and there may be again, mimicry. The test is cross-reactive. That doesn’t mean that the person is disease cross-reactive.

Kasey Holland, N.D.

Absolutely.

William Pawluk, M.D., MSc

We’re talking about a test. We’re not talking about disease.

Kasey Holland, N.D.

Right.

William Pawluk, M.D., MSc

Although obviously, when you’re vulnerable, when you have one disease, it’s easier to catch another one, right?

Kasey Holland, N.D.

Right.

William Pawluk, M.D., MSc

So, tell us a little bit about the history of EBV. How it progresses across the different stages.

Kasey Holland, N.D.

Yeah. So, it’s from human herpesvirus 4 and we’ve talked about how it’s estimated, that greater than 95% of us have been infected with it. It’s a DNA plasmid-alternating between a latent and a lytic cycle. And I’ve talked about that latent, the inactive lytic is the active. And it was the first human tumor virus discovered about 50 years ago. So, we’ve always had our eye on it for cancer, but at that time, it was really mainly just lymphoma. And then, from there, it was okay, let’s say you get infected with Epstein-Barr virus, you have different antibodies that are going to respond and that your first one is the IgM. And that’s the first one that shows positive. And then, after that, your IgG comes in. That’s several weeks later. With reactivation, we see the early antigen IgG will show positive again, even if you’ve been infected before. And that’s usually between three to six months. So if we-

William Pawluk, M.D., MSc

That’s reinfection or reactivation or both?

Kasey Holland, N.D.

Well, I guess, it could be both. I tend to term it as reactivation, but I guess, it could be reinfection if you’re exposed to somebody that had a lot of titers or things like that, but usually, it’s termed reactivation with the early antigen. And so, if you catch that three to six-month window where the early antigen is positive, you know that you’re dealing with it again. The tricky part is that IgM can stay positive sometimes, which doesn’t align with what we know in our biochemistry and immunology textbooks. And for some people, it stays chronic for a really long time. That type of thing is a little bit more rare. EBV can also infect different cells, so it can infect B cells and K cells, and T cells, different immune cells. The most common is B cells. And that’s what we typically see and what I typically see with what we’re dealing with chronic fatigue and people that are having it reactivate and things. There’s different types that can be more rare. And they’re mainly not found in the United States where they’re very aggressive forms where cancer usually develops early on. But what I’m talking to is usually the reactivation and affecting B cells. So, then, after that six months, the early antigen might not show positive anymore. The IgM might not show positive anymore, but you might have elevated IgG response. And what conventional doctors will say is, oh, well, everybody has that because everybody’s had it. But what I see in people that have really chronic symptoms is that that level is 100 times the regular limit. Or even if it’s 10 times and they’re symptomatic, then that tells me that they’re probably still dealing with a high viral load and that it’s impacting their health and we need to figure out what is driving it, what is causing it and why that’s happening.

William Pawluk, M.D., MSc

Now, we don’t have a viral load test for EBV, do we?

Kasey Holland, N.D.

We just have the IgGs and then, there’s also stool tests that will look for signs of it, more related to gastrointestinal tract. And then, there’s the PCR test, but that’s just , it’s there, or it’s not. And doesn’t give you what you’re talking about with a viral load.

William Pawluk, M.D., MSc

Yeah, because for HIV, we can measure viral loads. For Hep C, we measure viral loads, but why aren’t we measuring viral loads for EBV?

Kasey Holland, N.D.

That’s a great question.

William Pawluk, M.D., MSc

Nobody cares.

Kasey Holland, N.D.

They should.

William Pawluk, M.D., MSc

Oh, we should now, right? We should really start looking at that because that’s been a frustration on my part as well. So, let me ask you, early antigen, we’re talking about early antigen as a reactivation, as a sign of reactivation. Do you have early antigen with initial infections too?

Kasey Holland, N.D.

Well, so most of my patients have had it before because most of my patients are in their adult age. So, I haven’t seen EBV panels from as many children or first presenting. And the other problem is I don’t really know because usually in that population, doctors don’t even run the early antigen. They just run the IgM. So, really running the early antigen is something that mainly functional doctors do. And naturopathic doctors conventionally, a lot of times when I suggest that, they ask me why I suggested or what it’s doing. So, I don’t really know because I haven’t seen panels where-

William Pawluk, M.D., MSc

Well, or studies that have actually looked at that question.

Kasey Holland, N.D.

Yeah.

William Pawluk, M.D., MSc

Okay. So, EBV lives basically after you get your infection. It seems to what, live on the lymphocyte. That’s where it’s primary source of life is, replication.

Kasey Holland, N.D.

Mm-hmm. Mm-hmm.

William Pawluk, M.D., MSc

So, it keeps multiplying. It keeps repeating itself, right?

Kasey Holland, N.D.

Yes.

William Pawluk, M.D., MSc

And lives in the lymphocyte.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

Does it live anywhere else?

Kasey Holland, N.D.

Yeah. There’s signs of it in liver cells. There’s signs of it in other cells, but it’s known for infecting immune cells. So, it can also affect the NK cells and T cells, like I said, but that’s a lot more rare.

William Pawluk, M.D., MSc

I didn’t realize that it infected NK cells as well. So, what are NK cells?

Kasey Holland, N.D.

Those are your natural killer cells. And again, that’s not very common and it’s thought of as a different strain of Epstein-Barr virus that’s more aggressive and typically not found in the United States, but those are the actual immune cells that usually respond to infections and especially viral infections.

William Pawluk, M.D., MSc

So, NK cells have basically two functions, right?

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

One is against viruses. And the other one is…

Kasey Holland, N.D.

Just your overall immune infection or immune function and responding to foreign pathogens.

William Pawluk, M.D., MSc

Cancer. I use it all the time in cancer cells. Somebody’s NK levels are very low, then they’re more vulnerable to cancer.

Kasey Holland, N.D.

Mm-hmm. Definitely.

William Pawluk, M.D., MSc

Wow. And of course, who knows then whether it’s viral, it’s the viral hypothesis of cancer.

Kasey Holland, N.D.

Yeah, it cycles back to germ or terrain or what’s happening where. Mm-hmm.

William Pawluk, M.D., MSc

Fascinating. What other cancers can EBV be associated with besides lymphoma?

Kasey Holland, N.D.

Well, that’s the thing is now that we’re testing for EBV more, we’re finding it in… Everything is oh, did EBV causes or did the disease cause it? Because we’re finding it in GI cancers and I’ve seen… You can find research on just about any cancer where, oh, we tested and this person had EBV titers? So, does that mean that it caused the cancer? And that’s where I think, if we go down that route and say, oh, EBV’s responsible for all of this, then we’re really going to miss out on helping people prevent chronic illness. And we really need to look at what it was that caused the reactivation of the Epstein-Barr virus, not so much Epstein-Barr virus itself. And I think, when we look at that, that that’s when we’re more successful with patients and healing.

William Pawluk, M.D., MSc

Well, and I think, from a research perspective, how can you get a control group if 95% of the population is positive?

Kasey Holland, N.D.

Yep. That also makes it-

William Pawluk, M.D., MSc

Right? You can’t have a negative. Can’t have a negative EBV group

Kasey Holland, N.D.

Yeah.

William Pawluk, M.D., MSc

unless you use cutoff for titers.

Kasey Holland, N.D.

Yeah, or the other thing is bringing in the symptoms of a patient into the trial, which is really hard in a control group because people’s symptoms, how do you standardize that? That just makes it so much more complex.

William Pawluk, M.D., MSc

All right. So, what else do we have to say about this? All right. What causes EBV to reactivate?

Kasey Holland, N.D.

So, I mentioned that marker, the BZLF1, when oxidative stress happens, that is a protein that turns on and it can reactivate. There’s other proteins involved too. That’s one of the big ones. So, that oxidative stress is the thing that is in common with everything. So, then, again, we go back to our long list of things that can cause oxidative stress, and then it can feel very overwhelming because well, anything could reactivate Epstein-Barr virus. And I think, that’s what also makes research and things that difficult, but really, anything that is causing an increase in reactive oxidation species and a host, person, patient that does not have the antioxidant status to keep up with that, or has other things in their health picture that they didn’t know can be susceptible to that reactivation.

William Pawluk, M.D., MSc

Tough. How do you measure oxidative stress?

Kasey Holland, N.D.

Well, there are some functional labs like 8-OHdG. I think I said that marker right. And you can do that on an organic acid test and see what the oxidative stress levels are like. You can look at somebody’s glutathione levels. One marker that I think is really helpful is reverse T3 because when the body starts to not create T3, reverse T3 is a thyroid marker. So, usually, we check T3 to see how your thyroid is doing. If the body’s really stressed, it will say, hey, you need to take care of yourself. We’re going to convert to reverse T3 instead of regular T3, you need to save your energy, you need to save your money. So, when that is elevated, a lot of times, I take that as a sign of oxidative stress. And so, also, we can see it just in symptoms, if somebody is having a hard time recovering after working out and it’s taking them, they might feel like they have the flu after they work out or they’re sore for weeks instead of a couple days. So, it depends on the person, but those are some of the ways that I look for oxidative stress.

William Pawluk, M.D., MSc

What was the first one that you mentioned? Can you spell it please?

Kasey Holland, N.D.

8-O-H-D-G. I think that’s the right marker.

William Pawluk, M.D., MSc

Eight, the number eight?

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

O-H-G-3?

Kasey Holland, N.D.

D as in dog, and then G as in go. And it is the deoxyguanosine marker. And we can measure that in urine. And usually, that’s a functional lab that we’re doing.

William Pawluk, M.D., MSc

Okay. So, let’s talk some more about activation and the EA.

Kasey Holland, N.D.

Mm-hmm. So, early antigen?

William Pawluk, M.D., MSc

Right. So, how many different tests are there for EBV?

Kasey Holland, N.D.

So, if we do the full panel, which is what I suggest if somebody’s really… Because even if we just do… When you do the full panel, you can at least try and get a timeline or idea of what’s been going on. And when you put that with the patient’s history and their symptoms, that can be helpful. So, our viral capsid antigen IgM, VCA IgM, the early antigen, and then the viral capsid antigen IgG and then the nuclear antigen IgG. And there is one other one that sometimes you will run, but those are the four that I find the most beneficial. Yeah. Four, five. Yeah. Those are the ones that I find the most helpful for diving it in.

William Pawluk, M.D., MSc

Do you have thresholds?

Kasey Holland, N.D.

It’s usually either just a really mild elevation and it does look like this was a past infection and it’s not really bothering them or it’s 2,200 times upper limit. It’s usually one or the other. I don’t see a lot of, oh, it’s elevated, like it’s 50 points above. It’s usually either very mild or very, very elevated in my experience.

William Pawluk, M.D., MSc

That’s the EA specifically.

Kasey Holland, N.D.

That’s the IgG. The EA, if that’s positive, then that’s a sign that the EBV is currently reactivating. And I don’t typically see that be extremely high. It’s usually mildly positive. The IgGs of viral capsid antigen and nuclear antigen IgGs are the ones that are usually either just slightly or very, very high.

William Pawluk, M.D., MSc

Yeah, the VCA and the EBNA. Yeah, the problem that I have with the labs is sometimes they give you a greater than 500 or something like that. You don’t know where it is. Looking to see whether something’s working to bring those antigen levels down. If you have high antigen levels, do they come down even with treatment?

Kasey Holland, N.D.

So, it’s interesting. Sometimes with early treatment, I will actually see them go up because I think, the immune system is responding better. And sometimes, people are feeling a lot better. I usually don’t test them until several months after we have finished a treatment and the patient is feeling better. Sometimes, they do come down. Sometimes it takes years for them to come down. And that’s something that we just don’t understand really well about the immunology of this. And so, when we are treating this, it becomes a symptom thing where oh, you had 2 out of 10 energy and couldn’t work. And now, you are exercising and working and leading on a daily life, titers might still be high. And we don’t have a good understanding of that, unfortunately.

William Pawluk, M.D., MSc

Yeah, I remember seeing a patient once who I’ve monitored over a period of time and we treated her, got her a bunch of supplements, antioxidants, et cetera.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

And gradually, she got better. That took about three months or so to get better. And then, she came back about six months later and she’s feeling worse again.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

Repeat her titers and bang, they went up. So, when they went down, they went down maybe by 5 or 10%. When they went up, they went up by 20 or 30%.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

So, I tended to see it go up more than I saw it go down. And again, when it’s over the limit, the measurement limit of the lab, then you can’t tell what it’s doing, ’cause you don’t know how high it is.

Kasey Holland, N.D.

Right.

William Pawluk, M.D., MSc

Are there labs that give you more precision with getting these titers? Are you aware of labs that don’t have that greater than sign?

Kasey Holland, N.D.

No. I think, lab core goes up to 600. Most of them cut off at 600.

William Pawluk, M.D., MSc

Right. Yeah, I’ve seen that as well. I think, Quest did measure better above those upper limits, but they still probably still have an upper limit.

Kasey Holland, N.D.

Yeah.

William Pawluk, M.D., MSc

We just never reached it.

Kasey Holland, N.D.

Yeah.

William Pawluk, M.D., MSc

All right, so that’s EBV, can cause all kinds of habit, can be associated with all kinds of other problems. So, what do you do? How do you treat EBV?

Kasey Holland, N.D.

So, when I treat EBV, the first thing I do is look for what could have set the stage to a reactivation because if we don’t change that, then no matter what antiviral we take, as soon as we take it away, it can reactivate and start that cycle again. So, figuring that out is really important. I do use antivirals depending on patient needs. We might use natural antivirals. There’s a lot of different herbs like lomatium. One popular natural one is Lauricidin. Sometimes I don’t see that work as well with really chronic cases, but we do have lots of natural therapies available. Some people do IV vitamin C. I have seen ozone be used again. Ozone has an interesting relationship with oxidative stress. So, we really have to be supporting pathways if that’s what we’re using. We might use valaciclovir. That is a drug that is typically for herpes, but EBV is from the herpes family. So, for some people, that can really help knock that viral load down. But while we’re doing any of that, we have to be changing the body’s biochemistry and making sure that we’re not having increased levels of reactive oxygenation species. And we have to be combating the reactive oxygenation species that the body’s going to be producing while it’s responding to EBV or else we’re just gonna be stuck in that vicious cycle of it being active.

William Pawluk, M.D., MSc

What’s the longest you’ve ever used Valaciclovir for?

Kasey Holland, N.D.

I don’t use it as much mainly because a lot of people that seek me really are looking for natural therapies, but I have seen doctors that I have learned from and mentors that I really respect use it off and on for months. And they might take a break to do other therapies and then need to use it again. Usually, EBV is something that takes time to really get under control.

William Pawluk, M.D., MSc

Do you know of any antivirals, non-pharmaceutical, but natural antivirals that are actually virucidal?

Kasey Holland, N.D.

Anti Virucidal or-

William Pawluk, M.D., MSc

That are virucidal. So, we know that with HIV and with Hep C, there are antivirals that are available, prescription medications. Now, that knock down the load. There’s zero viral loads.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

We can’t measure viral loads, so we don’t know what’s gonna do that, but-

Kasey Holland, N.D.

Right, right. Yeah. A lot of the natural therapies are based on other doctor’s clinical experience with things that they have tried and what they have seen clinically. There are some that have… And then, we pick ones that are just seem to be antiviral in general and specific to that family of viruses. So, like lomatium has been used very commonly. Olive leaf has been used. It’s very commonly. And I like to pick herbs like andrographis that does have some of that property, but then it also has other properties and it has effects against oxidative stress. So, I like to pick things that have multiple actions with EBV where we’re getting things under control. So, no, we don’t have a clinical trial like you said, that says, oh, well, it dropped it this much. There is a really good… There is a study that did show a decrease in antibody titers with IV vitamin C with Epsetein-Barr virus though.

William Pawluk, M.D., MSc

IV vitamin C?

Kasey Holland, N.D.

Yes. Mm-hmm.

William Pawluk, M.D., MSc

Yeah. Good, good. When I was getting some training in New York and acupuncture from a pretty famous acupuncturist, he does a lot of resonance measurements, muscle testing.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

And he basically has discovered over time that what happens is that when you have an infection, the white cells, macrophages, white cells go to the fight. That’s their job. They see where inflammation is, and then they run to the inflammation to try to help the body to deal with the inflammation.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

Unfortunately, what happens at the inflammation is that they die. They undergo lysis.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

And if you got these scavengers that have been scavenging the body, looking for toxins and viruses and bacteria, fungi, parasites, or pieces of all of these things, when they go the fight, they actually die.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

And when they lyse, when they break apart, what do they do?

Kasey Holland, N.D.

They release all that yuck that they’ve been-

William Pawluk, M.D., MSc

They release all that stuff. And that’s how you get chronic inflammation often is because whatever you started with, now you’re compounding it with other secondary kinds of problems as well. So, your approach then using multiple herbs and supplements and antioxidants, et cetera, becomes really critical because you can’t… You go after one thing. And I think, modern medicine tends to do that. It tends to look at it from a single factor perspective where this is all multifactorial.

Kasey Holland, N.D.

Exactly.

William Pawluk, M.D., MSc

Okay. So, do you have a… Now, let’s talk a little bit about PEMFs. So, what do you understand about PEMFs and how they might help in infection?

Kasey Holland, N.D.

So, I think of PMFs as helping the body go back to its homeostasis and cleanup. So, I think of it as helping change the environment where it helps clean up oxidative stress and it helps cells go back to what we would call a healthy or normal processing because mitochondria and cells can get stuck in a dangerous state where even after we’ve been dealing with this infection, if that’s still there and they’re still not working optimally, and we have that oxidative stress there, then again, it’s going to reactivate. So, I think of it as calming all of that down, cleaning things up, almost like the same thing that we do. I tell patients to go barefoot and walk outside to ground and reset their body the way that it’s supposed to go and clear out oxidative stress. And I think, PEMFs help with that and getting the body back to its optimal natural state.

William Pawluk, M.D., MSc

You’re absolutely correct. I think, one of the most important things that PEMFs do is to help repair the damage.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

So, if you could improve circulation to the tissue, which unfortunately, increases oxidative stress as well.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

But then, you’re also bringing in more inflammatory cells to help with the fight.

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

But then, you need to increase DNA. You need to increase stem cells, you need to do all sorts of things to help to repair and make the tissue generally healthier. Where the tissue is healthier, it can put up a better fight, basically. There is a caveat and a lot of people are doing rife therapies. I don’t know what you’re thinking is on rife, but frequency-based PEMFs can be a problem.

Kasey Holland, N.D.

Mm-hmm, mm-hmm.

William Pawluk, M.D., MSc

Why?

Kasey Holland, N.D.

Well, they can be too taxing to the body and actually create more oxidative stress. And it’s creating a very acute burden on the body. And if the body isn’t ready for that, then people get a lot worse. That’s been what I’ve seen.

William Pawluk, M.D., MSc

And I think, you’re right. I think there’s another aspect to it too though. And that is that basically, these frequencies sometimes can activate latent viruses.

Kasey Holland, N.D.

Okay.

William Pawluk, M.D., MSc

And we’ve seen this basically in the face. Some people have shingles that could be reactivated by a PEMF, a frequency-based PEMF. So, probably, the best PEMF system is a single frequency, preferably a single pulse type PEMF. So, it’s just a pulse and it’s not really

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

frequency-based. It’s not providing the body with a lot of frequencies. That noise, that overload of frequencies, as you said, begins to overload the system. And when you have nerves especially, when you have a lot of pain with the symptoms, then you have a lot of nerves that are inflamed. And when you have nerves that are inflamed and they’re irritable, what happens when you throw a lot of noise at them?

Kasey Holland, N.D.

They get more irritable, usually.

William Pawluk, M.D., MSc

They get more irritable. So, you’re not helping them actually. You’re making them worse.

Kasey Holland, N.D.

Yeah.

William Pawluk, M.D., MSc

So, stable pulse systems tend to do a better job than these multiple frequency systems. So, that’s something to consider. And then, always with PEMFs, you need to go low and slow.

Kasey Holland, N.D.

I think, what you said about the oxygenation and recirculation is something really important to highlight because there are people that have had EBV and been so fatigued and not been exercising that the lack of circulation and lack of oxygenation is a big problem. Some of them have even had congestive heart problems because they’re not moving. They’re not getting that blood flow, that lymph isn’t moving. And so, especially when people are trying to heal and are trying to rebuild that, and they’re not able to exercise daily and regularly because of how sick they’ve been, I think like you’re saying, it done right and gently that that can be very beneficial for circulation and muscle function, and overall getting immune cells and blood circulating again.

William Pawluk, M.D., MSc

Yeah, you’re obviously correct. And I think, when you’re that depleted, when you’re that sick, when you’re that down under, when your immune system

Kasey Holland, N.D.

Mm-hmm.

William Pawluk, M.D., MSc

is that exhausted, then you have to go low and slow. You don’t jump in and do very high intensity magnetic fields that jerk your muscles and all that. Again, just gently see how your body’s responding and gradually increase the exposure time and intensity as you begin to recover.

Kasey Holland, N.D.

Absolutely.

William Pawluk, M.D., MSc

So, do you have any parting comments, thoughts, advice?

Kasey Holland, N.D.

I think, the biggest, if there’s one thing that you take away from this talk is the looking at the body in multi, different functions and what caused and what set the ground for EBV to reactivate, and to focus on restoring the body and nourishing it. And using therapies like considering PEMF and others that are going to rebuild it, and not just trying to kill the virus. Because if you just try and kill that virus, but you haven’t changed those things, it’s going to just come right back.

William Pawluk, M.D., MSc

It’s not gonna happen. You won’t recover.

Kasey Holland, N.D.

No, you won’t.

William Pawluk, M.D., MSc

You become sicker. And more depleted, unfortunately.

Kasey Holland, N.D.

Yes, exactly.

William Pawluk, M.D., MSc

Well, Dr. Holland, Kasey, thank you so much for being with us and sharing your wisdom and experience. And I think, EBV is an extraordinarily common problem. I think, we are beginning to recognize it more and more and more. So, it’s important to keep your eye, your attention on that topic. Do you have any books or any places that people could go to get more information?