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Writer's pictureJamie Sculley, ND

Understanding Mononucleosis: Symptoms, Testing, and Natural Recovery Tips


A cup of tea, tissues and glasses

The infection caused by the Epstein-Barr virus (EBV) is called infectious mononucleosis. In this blog, we’ll explore the symptoms, testing, and natural remedies to help manage and recover from this viral illness.


What is mononucleosis?

When you first encounter EBV you may or may not show signs of infection. If you do, it’s known as infectious mononucleosis. Usually children and adolescents get this infection but you can also get it later on as an adult. By the time we’re adults most of us have been exposed to this virus. EBV replicates in immune cells called B lymphocytes located in the throat and parotid glands and is spread by saliva. 


What does mononucleosis feel like?

Typical symptoms of mononucleosis can include:

  • Sore throat

  • Fatigue

  • Swollen lymph nodes in the neck, near the ears, in the armpits

  • Swollen tonsils

  • Red spots on the top of the mouth (palatal petechiae)

  • Body and joint pain 

  • Rare - swollen spleen, swollen liver, jaundice, ruptured spleen



How do you test for mononucleosis?

In general, if you have fever, sore throat, swollen lymph nodes, a positive monospot and high lymphocytes, then you have infectious mononucleosis. 


Monospot test - A common test to start with is a monospot test also known as a heterophile test. This test can have false negatives so it’s best used in the 2nd or 3rd week of infection. 


Antibody tests - Blood tests for viral capsid antigen IgM and IgG may show positive results before a monospot so would be something to consider if you need or want to know sooner. 


CBC - You can get a blood test called a comprehensive blood count (CBC) that will tell you your levels of white blood cells (WBC). These will be elevated in mononucleosis because your body is fighting the virus. If they’re above 50% then mononucleosis is likely. Other markers on this test are called atypical lymphocytes and an abnormal result would be a level above 10%.


Strep - Many people who have mononucleosis also have strep so it may be a good idea to get tested for this bacterial infection. This can be done in office with a throat swab and sent out for culture.  



What treatment strategies are recommended for mononucleosis?


Conventional Support for Mononucleosis

Since it’s a virus, the general recommendations are to treat mononucleosis like you would the flu. This could look like:


  • Staying well hydrated

  • Using pain relievers like NSAIDS and acetaminophen 

  • Using throat lozenges and sprays for sore throat

  • Reducing the fever with medication

  • Rest 

  • Bedrest isn’t strongly recommended so let your energy levels guide your activity 


Antivirals like acyclovir aren’t recommended. Corticosteroids aren’t usually recommended either unless you have a lot of throat swelling or severe respiratory issues. 


Because a possible complication can include a ruptured spleen, contact or collision sports should be avoided for at least 4 weeks or until symptoms aren’t present. 


Naturopathic Support for Mononucleosis

With a first infection it’s important to build a strong immune response so you’re less likely to have a recurrence later on. 


Using herbs like goldenseal, echinacea, myrrh, and elderberry can provide antiviral support. A couple combination products I’ve used are EHB by Integrative Therapeutics and Super Biovegetarian by Priority One. You want to do an intensive treatment so I suggest taking a dose 3-4x per day for 3 days, then continuing on a maintenance dose for up to a month. 



How long does mononucleosis last?

Symptoms like fatigue, body pain and the need for sleep may persist for several months and most people need about 2 months before they feel like they’ve recovered. 



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In health, 

Dr. Jamie 



This website is not intended for the purpose of providing medical advice. All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.



Resources

American Academy of Family Physicians. (2004, October 1). Epstein-Barr Virus Infectious Mononucleosis. American Family Physician. https://www.aafp.org/pubs/afp/issues/2004/1001/p1279.html 


Anderson, P. (2015, May 15). EBV diagnosis, treatment, and management [Webinar]. Consult Dr. Anderson. https://www.consultdranderson.com/courses/05-15-ebv-diagnosis-treatment-and-management





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