Viral Factors
I’ve written, at length, about chronic constipation before. In recent years the viral component has been brought to my attention. Furthermore, the big picture of how these viral components impact your microbiome is starting to take shape. On this page I’ve compiled a sketch of what we know about these interlocking conditions and a long (although not exhaustive) list of what you can do about it.
Epstein-Barr and Chronic Constipation
Epstein-Barr virus (EBV) and Cytomegalovirus (CMV) are members of the herpesvirus family which is known to cause a range of illnesses, including infectious mononucleosis and certain cancers, as well as having potential links to autoimmune conditions.
Herpesvirus family viruses also affect your microbiome. While the exact microbial species affected by these viruses are still being studied, there is emerging evidence that these viruses can alter the gut microbiota by promoting certain species and suppressing others. The shifting of this microbial balance can influence a range of health outcomes, from gastrointestinal function to immune system regulation, and even mental health.
First, let’s look at how Epstein-Barr can lead to chronic constipation.
Vagal Nerve Tone
The autonomic nervous system (ANS) plays a critical role in regulating gut motility.
EBV has been shown to have a potential neurotropic nature, meaning it can affect nerves. The vagus nerve, which is crucial for parasympathetic regulation of the gut, can be affected by viral infection. This can lead to a reduction in vagal tone, which may result in slowed gastric emptying and impaired motility in the intestines. This would manifest as constipation, as a reduction in parasympathetic activity typically leads to a decrease in gut peristalsis.
In plain English, Epstein-Barr and Cytomegalovirus can both negatively impact your body’s ability to manage stress, and stress contributes to constipation.
Immune Dysregulation
Epstein-Barr infection can lead to persistent immune activation, even after the initial infection resolves. Epstein-Barr can dysregulate the production of certain cytokines (such as TNF-α, IL-6, and IL-1β). These inflammatory mediators can alter the normal functioning of the smooth muscle and nerves in the intestines. Elevated levels of pro-inflammatory cytokines can lead to impaired motility, contributing to constipation.
Microbiome & Serotonin
Epstein-Barr and other herpesviruses can disrupt the microbiome balance. This can affect the fermentation of dietary fiber, the production of short-chain fatty acids, and the synthesis of neurotransmitters (like serotonin) – all of which influence gut motility.
Localized Infection
While Epstein-Barr primarily infects B lymphocytes and epithelial cells, the virus may also affect epithelial cells in the gastrointestinal tract. Viral replication within the gut lining could lead to localized inflammation, which in turn could impair motility and contribute to constipation.
Visceral Hypersensitivity
In some cases, chronic viral infections can lead to increased sensitivity of the gut to normal stimuli (known as visceral hypersensitivity). This can lead to altered motility patterns, including slow transit time.
Fatigue
Regular physical movement is important for normal bowel function, but chronic Epstein-Barr infection is associated with malaise. This fatigue leads to reduced physical activity, which contributes to constipation.
Overall Health Consequences
Epstein-Barr’s and Cytomegalovirus’s impact on your microbiome doesn’t just lead to constipation, of course.
Reduction in Beneficial Bacteria
Chronic Epstein-Barr and Cytomegalovirus infections commonly include a reduction in beneficial bacteria like Bifidobacterium and Lactobacillus, which are known to play a crucial role in gut health, immune modulation, and digestion. These bacteria help maintain gut barrier integrity, produce short-chain fatty acids (SCFAs), and modulate immune responses.
Increase in potentially Harmful Bacteria
Epstein-Barr infection is associated with an increase in potentially pathogenic or opportunistic bacteria including Firmicutes, Proteobacteria, and Bacteroidetes. Some of these bacteria are linked to gut dysbiosis, inflammation, and autoimmune diseases.
Cytomegalovirus infection may encourage the proliferation of Proteobacteria, Enterobacteriaceae, and Clostridium species, which have been linked to chronic inflammation and dysbiosis.
Epstein-Barr may cause an increase of pathogenic bacteria by affecting your gut’s immune system and thereby its immune signaling. This can encourage microbes which thrive in inflamed, low-oxygen conditions (like Candida) to proliferate. Furthermore, the inflammation can promote the growth of pathobionts (microbes that are normally benign but can become pathogenic in the presence of an inflamed environment) and impair your gut's ability to maintain homeostasis.
The impaired immune signaling can, in turn, make you more susceptible to infections, autoimmune diseases (such as rheumatoid arthritis, lupus, and multiple sclerosis), gut permeability (“leaky gut”), or inflammatory conditions.
Healthy gut microbiome is crucial for mental health, as it communicates with your brain via the gut-brain axis. Dysbiosis can contribute to mental health issues like anxiety, depression, and cognitive dysfunction.
Treatments for Epstein-Barr and Cytomegalovirus
Treating latent or chronic conditions, such as Epstein-Barr virus and/or Cytomegalovirus, seems to always require a multifaceted approach. Chronic conditions exist at many levels of our bodies – including in our psyche – and thus are most effectively tackled when we address many levels at once. Chronic conditions usually have self-reinforcing factors (as an “emergent system”) which make them hard to uproot, which unfortunately makes them risky to address because “slow and gentle” shifts are often insufficient.
Chronic conditions are also generally “not just one thing.” There is likely a mixture of viral, genetic, traumatic, and environmental factors working together to create your specific array of symptoms. All of that said, he’s some ideas for a multi-pronged approach.
Vitamin C
The antioxidant, Vitamin C. Ideally, look for food sources such as acerola cherry, kiwi, brightly colored (ripe) bell peppers, and citrus fruits. (Although, watch out if you have histamine sensitivities, as some fruits are either high in histamine, like strawberries, and others, like citrus, are histamine releasers. I personally do fine with citrus but have a huge boost in inflammation from strawberries!)
Food sources are critical because Vitamin C has an enzymatic component which is not present in “ascorbic acid” – which is just the wrapper that protects that enzyme. While ascorbic acid has some benefits, it is absolutely not synonymous with vitamin C!
That said, vitamin C is known for its immune-boosting properties: it supports immune cell function and helps reduce inflammation. It may also aid in fighting viral infections and improve general health.
Vitamin D
Studies suggest that Vitamin D may help modulate immune responses and potentially reduce viral replication. Some individuals report massive benefits from taking megadoses of vitamin D over long periods of time. This may or may not be safe for you, but I’ve personally taken as much as 50,000 IU (international units) of vitamin D daily for over a year without any noticeable negative side effects. I’ve seen many anecdotes of people who didn’t see benefits until they were taking 80,000 IU a day. This seems absurd, and yet, for some people, it makes a night-and-day difference for chronic problems such as insomnia and joint pain.
As I explain in my book, Raederle’s Teeth Remineralizing Masterclass, it’s also essential that vitamin D intake is balanced with vitamin A and other nutrients. Thus, as always, be cautious about buying any singular supplement and upping any nutrient in isolation. Ideally, seek food sources (such as fish oil) which contain vitamins D, A, E, and other co-factors.
Zinc
Zinc plays a key role in immune function and has been shown to support antiviral activity. It can also help reduce inflammation. And, as a bonus, if you’re increasing your C, D, and Zinc – along with vitamin K2 – you’ll be doing your bones and teeth a favor as well.
Echinacea
This herb is often used to support the immune system and has been traditionally used to combat viral infections. It may stimulate the production of white blood cells and improve the body’s antiviral response.
Elderberry
I personally find elderberry so beneficial that it became a part of my daily life in my early thirties. Known for its antiviral properties, elderberry can help boost the immune system and may reduce the severity and duration of viral infections, including Epstein-Barr. For myself, I find elderberries help with my motility, and weirdly, my nervous system regulation.
While elderberries are generally thought to be beneficial due to their extremely high quercetin content, many people find that isolated quercetin extracts don’t provide the same benefits.
Astragalus
While I have not personally tried it, this herb is known for its immune-boosting and adaptogenic properties. Studies in the States and China demonstrate that it helps regulate immune responses and reduce viral replication.
Turmeric
Curcumin is a potent anti-inflammatory compound found in turmeric. It may help reduce chronic inflammation associated with viral infections and promote overall immune health. If you’re sensitive to raw turmeric (as I am), try cooked turmeric or a turmeric extract. If you’re sensitive to histamines, you may need to avoid powdered spices, and in these cases I recommend buying fresh turmeric root, peeling it, and frying slices in a fat that you’re not reactive to. (For me, the safest fats are organic avocado oil and organic lard.)
Garlic
As you’ve undoubtedly heard a thousand times, garlic has antimicrobial and immune-boosting properties and may help support your body’s defense against viruses. It can also reduce inflammation and help balance your immune system.
However, if you’re sensitive to FODMAPs or have an overgrowth of Desulfovibrio or Bilophila wadsworthia then garlic may cause you extreme distress. In the case of an overgrowth, consuming certain prebiotic foods (such as garlic, onions, eggs, and cruciferous vegetables) will result in hydrogen sulfide gas, which is toxic in high amounts. Symptoms include gas which smells like rotten eggs, shooting pains, brain fog, bloating, and gas pains.
Slippery Elm & Marshmallow Root
These herbs have soothing properties for the gastrointestinal tract and may help reduce gut inflammation while supporting mucosal healing. However, like garlic, if you’re sensitive to prebiotics, these may be a poor choice for you.
Prebiotics?
Everyone will tell you that prebiotics are good for you. Prebiotics, found in foods like onions, garlic, leeks, asparagus, and artichokes, feed beneficial gut bacteria and help maintain a healthy microbiome. However, they also feed detrimental gut bacteria. If you have gut dysbiosis, the chances are good that the last thing you need is more prebiotics. In my case, eliminating prebiotic food from my diet was the difference between crippling inflammation that left me unable to walk and being able to run and play without any pain at all. So please choose wisely what makes sense for your personal gut condition!
Fermented Foods & Probiotics
Fermented foods like kimchi, sauerkraut, kefir, and yogurt are rich in probiotics that support gut health – mostly through genetic material being absorbed in your gut. Your stomach acid kills the live microbes presented in probiotic tablets and foods, but the genes from those microbes actually still benefit your gut! Once again, your gut is a major part of your immune function, so maintaining a healthy gut microbiome is essential for managing chronic infections.
But once again, if you have issues digesting FODMAPS or an overgrowth of Desulfovibrio or Bilophila wadsworthia then many fermented foods will be off the table, especially any cabbage-based foods. Also, if you suffer from chronic constipation, note that yogurt will probably make it worse. Instead, opt for kefir – preferably goat kefir, as there are many elements of cow-based dairy which can worsen inflammatory conditions.
Long-Chain Fatty Acids
Foods rich in long-chain fatty acids (the beneficial thing which omega-3s can be converted into) can dramatically reduce inflammation and support immune health. In fact, my practitioner told me that I needed to stop consuming fish oil prior to testing because it was so anti-inflammatory it could suppress the inflammation markers they needed to test me for!
The primary source of long-chain fatty acids is fish, and fish oil. You can get the precursor (omega-3) from flax oil and chia seeds. However, back in my days working as the chief editor for The Vegetarian Health Institute, one of the things we stressed a lot for our non-fish-eating students was how low conversion from omega-3 to long-chain fatty acids really is. Wrose, omega-6 competes for the same enzyme as omega-3, and thus, overconsumption of omega-6 rich seeds (like walnuts and pumpkin seeds) can make matters far worse (even if those foods also contain some omega-3).
Hence, I often tell my vegan and vegetarian clients to make an exception for fish oil. If you’re unwilling to do this, then seek a supplement with seaweed-based long-chain fatty acids – eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Mushrooms
Reishi, shiitake, and maitake contain compounds that boost immune function and have antiviral properties. These can be added to soups, stir-fries, or smoothies.
L-Glutamine / Meat Broth
This amino acid helps support the gut lining and may improve intestinal permeability (leaky gut), which is often exacerbated by chronic inflammation. As always, seeking food sources is an ideal way to start.
Cook a meat broth which includes skin, ligaments, and organs for an optimal source, and consume both broth and meat. If you’re at all sensitive to bone broth (as often happens for those with histamine sensitivities), then remove the bones after the meat is cooked and be careful to avoid over-cooking.
Meat broth contains collagen and amino acids like glycine and proline, which help repair the gut lining and reduce inflammation. But please be sure to note this is not the same as bone broth! While bone broth is fine for healthy individuals, when you’re seeking to repair your gut lining, it is critical that your broth is based on meats including the organs (skin, ligaments, etc).
If you’re seeking a vegan solution, then seek dark leafy greens. If cabbage is an option for you, it’s an ideal source. If not, turn to a wide variety of leafy greens. I personally feel my best when consuming lettuce every day: while lettuce is not a dark leafy green, it contains many of the same properties with less irritants. If your system is very sensitive to most vegetables, see how you do with romaine and iceberg lettuce.
Stress Management
Chronic stress can exacerbate viral reactivation and immune dysfunction, so managing stress is important for improving overall health. Regular mindfulness practices and meditation can help reduce stress and inflammation. Yoga and breathing exercises can help activate the parasympathetic nervous system, promoting relaxation and reducing inflammation. A guided meditation on progressive muscle relaxation can be beneficial for overall well-being (as well as short-term tension release, as the name suggests).
Any technique which helps you get out of the fight-or-flight mode is beneficial. This may mean turning your cell phone off while you take a few hours to pamper yourself in a long bath and drip-dry in front of a heat-lamp with a good book.
Be wary of the modern habit of a chronically interrupted life. If you’re constantly being bombarded by buzzing and beeping notifications and alarms, how can you possibly relax?
Once upon a time I thought refined sweeteners were the most toxic thing a person could do to themselves (as these are scientifically shown to be more addictive than heroin – yet we feed them to babies) . . . But over time and a tremendous amount of research about physiological health, it’s become abundantly clear that the most toxic thing in our lives is stress.
Take time to relax. Your life absolutely depends on it.
Adequate Sleep
Chronic viral infections can impair sleep, leading to increased fatigue and immune dysfunction. Prioritize sleep to allow the body to repair and restore itself. Aim to develop a consistent sleep schedule and avoid blue light exposure before bed. In my case, I find it helpful to get off my computer by eight o’clock in the evening and turn my phone entirely off for the night before ten (aiming to use it only minimally between eight and ten).
Physical Activity
Moderate physical activity can help support immune function and improve energy levels. Light exercise, such as walking, swimming, or cycling, can help boost energy, improve mood, and enhance immune function. Start with extremely low-impact activities and gradually increase duration and intensity as tolerated.
Your tolerance level may be far lower than expected. If you suffer from chronic inflammation, it is really important to overrule your physical therapist, physical trainer, or whomever is telling you to push until it hurts. The concept of “no pain, no gain” absolutely must be thrown out the window in cases of chronic inflammation. You can’t afford to send your body into further inflammatory overdrive, which is exactly what will happen whenever you over-exercise your body.
To moderate how inflamed you get while exercising, avoid overheating or causing any part of your body to burn fiercely. If you need to, take a cold (or cool) shower to bring down your temperature after exercise. Also, try taking anti-inflammatory foods around times of exercise, such as fish oil. Furthermore, when trying a new exercise, give yourself more rest than other people. If “everyone else” needs one day of rest, you may need three.
In several cases I’ve been involved with, the solution has been gentle, daily activity. It can be tempting to just lay in bed all day when you have chronic inflammation. Unless you’re acutely sick, I don’t recommend letting yourself become sedentary. Instead, look for exercises that at least retain your muscles through gentle use. I like crunches, push-ups while standing and pushing away from the wall, and bicycle movements while lying on one’s back.
Acupuncture
While I have not personally tried it, acupuncture has been used to regulate immune function, reduce inflammation, and alleviate symptoms such as fatigue, pain, and gastrointestinal discomfort.
Naturopathic Treatments
A naturopath may suggest personalized treatment plans involving herbs, homeopathy, or detoxification protocols designed to support viral clearance and immune regulation. In my case, I was able to find a practitioner in Australia who led me through microbiome testing and protocols based on my specific results.
Ozone Therapy
Some practitioners believe that ozone therapy may help combat chronic viral infections by enhancing oxygen delivery and stimulating immune function.
Eliminate Processed Foods & Other Toxins
There is no amount of doing healthy things which will fully account for consuming processed “foods.” You will be more susceptible to dental decay, inflammatory problems, unwanted weight gain, diabetes, cognitive problems, depression, anxiety, emotional dysregulation, irritable bowel syndrome, liver disease, heart failure, and kidney stones (to name a few things that I know about off the top of my head) if you consume processed foods with any kind of regularity. It is not enough to “only eat a little” of these “foods.” If they’re a daily or weekly part of your life, you’re eating far too much of them.
The bottom line is that refined sugar and processed foods promote inflammation, weaken your immune system, and feed opportunistic pathogens in your gut – which leads to all of the problems discussed on this page, and more. For every thing you swallow, I admonish you to read the full ingredients list and be familiar with all of the ingredients. I know it’s hard, exhausting, disheartening, and sometimes so upsetting that you just want to collapse in the grocery aisle and cry on the floor (yes, I’ve been there, literally), but your health is you. Your brain, heart, liver, and kidneys are you. Take care of your you. It’s the best gift you can give to yourself and your loved ones.
In addition to the obvious additives on the ingredients list, it’s also advisable to avoid meat that isn’t certified organic or from a local, small operation. And, as you’ve heard hundreds of times, avoid alcohol and tobacco. Alcohol can suppress immune function and increase inflammation and if you’re sensitive to histamines it can be particularly explosive in its damage. Smoking cigarettes can also weaken immune function and promote chronic inflammation.
Why do some people smoke and drink into old age with obvious consequences to their health?
Those individuals likely had few to no antibiotic treatments in their life and an unbroken chain of inherited healthy microbiome. They also likely had a healthier upbringing that led them to have a better regulated nervous system, which is shown to be one of the biggest factors in who becomes chronically ill versus those who don’t. For more on that, I highly recommend reading Childhood Disrupted.
I’m Raederle, thanks for reading
I’m Raederle – a nutrition expert who has moved largely into neuropsychology. I was born with an impaired microbiome which was further imploded through infantile antibiotic administration (as my inadequate immune system / microbiome meant I became sick easily in the first place), and due to antibiotics, this condition could only be expected to get worse. This issue was further compounded when I bit a glass thermometer at the age of three, getting mercury poisoning for which my stomach had to be pumped. (I can still recall the glass being picked out of my teeth.)
Because of the total ineptitude of the allopathic medical system found in the States, my parents were not even briefed in the most basic way about mercury toxicity (even though it was well-researched enough by the nineties when this occurred). Also, despite the growing awareness of the microbiome’s role, nothing was said about what the repeated antibiotics (and mercury!) would be doing to my gut.
My childhood was filled with endless doctor’s notes, and repeated illnesses. My root problems were not diagnosed and my symptoms were often misdiagnosed. Because I was a child, my own perceptions and assertions were repeatedly invalidated and ignored – even though I was later able to confirm through testing that many of my theories were correct.
My case was a forerunner for what is now affecting the entire younger generation. Microbiome collapse in one’s teens was extremely rare in my generation (I was born in 1989), but now, for those born ten or fifteen years later, my lifelong struggles are becoming mainstream teen and early twenties problems. And still, allopathic medicine in the States sits back and twiddles its thumbs despite the overwhelming amount of research being done around the world about effective ways to treat and prevent this array of problems.
Please don’t give up on yourself. If the medications aren’t helping and/or you’re being misdiagnosed, then take matters into your own hands. Many amazing great books saved my life after a stream of doctors failed me. I wish you fruitful research and relief.
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