Q: I was diagnosed with Epstein-Barr virus in September. I've been sick on and off with a cold for the past few months and heard this is...

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Q: I was diagnosed with Epstein-Barr virus in September. I’ve been sick on and off with a cold for the past few months and heard this is the body’s way of fighting off the virus. Is this true? What are the best ways to deal with this virus, especially the fatigue?

A: Epstein-Barr (EBV) is a common virus that affects a lot of people. In fact, about 90 percent of adults worldwide have had it. People often don’t even know they have the virus because their symptoms are mild or nonexistent. The only way to tell is by testing their blood for antibodies. (Antibodies are proteins made by the immune system in response to an infection.)

On the other hand, sometimes Epstein-Barr does cause more debilitating symptoms. It can be associated with cold symptoms such as fever, sore throat and big swollen glands. This can progress to swelling in the spleen, along with extreme fatigue.

When people come in with these types of symptoms, they are often tested for Epstein-Barr virus, and given the diagnosis of mononucleosis. Although people usually get better from the acute “cold” symptoms within a few weeks, the fatigue can last for months.

Conventional medical treatment is to wait it out and use medication only if you need it for symptoms — just like with a cold. So far, there is no vaccine or cure, though researchers are working on it. EBV is also thought to be a latent virus, which means it stays in your system. In most people that isn’t a problem — though that certainly isn’t always the case.

Holistically, there are lots of ways to help support recovery. However, one common theme is to strengthen the immune system. Many providers start by recommending a diet higher in protein, water, fruits and vegetables, while eliminating all refined sugar, caffeine, alcohol, junk food and fast food.

Adding immune-supporting herbs such as echinacea and garlic can also be helpful. Most providers would also recommend a quality multivitamin and vitamin C, though other supplements may also be helpful, depending on your exact situation.

I have seen some people improve with homeopathy, while others respond well to acupuncture and traditional Chinese herbal medicine. If one paradigm isn’t getting results, keep your mind open to others, because sometimes you will be pleasantly surprised — and then everyone learns.

Some herbs have a traditional history of use for fatigue. Panax ginseng, for instance, is well known for boosting energy. The downside, though, is that it interacts with a lot of different medications. Other examples include rhodiola and ashwaganda.

As a reminder, though, I always recommend you talk to your doctor and holistic provider to decide the best course of action for you.

Dr. Astrid Pujari is a Seattle M.D. with an additional degree as a medical herbalist; she practices at the Pujari Center and teaches as part of the residency programs at Virginia Mason and Swedish/Cherry Hill hospitals. Send questions to apujari@seattletimes.com for possible use in future columns. All information is intended for education and not a substitute for medical advice. Consult your doctor before following any suggestions given here.