Epstein-Barr, PEM & Why You Keep Crashing with Dr. Ina Stephens | Ep 215

What if the virus is gone, but your body still has not recovered?

Dr. Linda Bluestein is joined again by Dr. Ina Stephens, associate director of the UVA Health EDS and Hypermobility Disorders Center, to unpack what can happen after Epstein-Barr virus (EBV), especially when post-exertional malaise (PEM), autonomic symptoms, and repeated crashes continue long after the initial infection.

Starting with a listener question from someone recovering from EBV who keeps crashing after activity, Dr. Stephens explains how EBV testing is interpreted, what IgM, IgG, early antigen, and EBNA may tell you, and why a “reactivation” result does not always mean the virus itself is the main problem.

They also get into what may help recovery. The discussion includes antiviral treatment, pacing, sleep, anti-inflammatory nutrition, mitochondrial and muscle support, and supplements such as creatine monohydrate, HMB, taurine, glutathione, and urolithin A. Dr. Stephens also explains why deep diaphragmatic breathing may help calm the autonomic nervous system and what to do when you are already in a PEM crash.

Takeaways:

EBV testing can be confusing, and the pattern of antibodies matters more than any single result.

A positive marker for EBV reactivation does not necessarily mean active viral replication is driving symptoms.

Antivirals are most likely to help when active viral replication is actually occurring.

Pushing through PEM can make recovery harder, so pacing matters.

Sleep, nutrition, breathing practices, and selected supplements may help support recovery.

Want to learn more about the UVA EDS Center?

For Appointments and Questions: RUVAEDSCenter@uvahealth.orgUVA EDS: https://www.uvahealth.com/healthy-practice/advancing-care-through-ehlers-danlos-clinicUVA EDS FAQ: https://www.uvahealth.com/support/eds/faq