What's Causing Your Fatigue: Pt. 2 - Hidden Viruses


We’ve all had a viral infection. It can be as mild as a rhinovirus that causes an annoying runny nose. It can be as severe as the Influenza virus, which can put you in bed for three weeks with coughing and weakness. The type of viruses I look for in patients that suffer from Chronic Fatigue Syndrome are very good at masquerading as mild infections.

But what distinguishes these viruses is that they have the ability to cause more chronic illness.

The viruses I evaluate especially in Chronic Fatigue are Epstein-Barr, Parvovirus B19 and Hepatitis (mainly B & C). In today’s post, I’m only going to discuss Epstein-Barr. Why? Because it’s been linked on and off as the cause of Chronic Fatigue in many patients.


Epstein-Barr is best known as the virus that causes Mononucleosis(aka Mono) among young adults. I know first hand about Mononucleosis: I came down with it in my first semester of college back in the late 70’s. Then, I became re-acquainted with it when my son (a freshman at UMichigan) developed it in his second semester. Fortunately for both of us, the illness was limited to a few weeks, and we both finished up our year back in good health.

However, when adults come down with Mononucleosis it’s a different story. I ask many patients who may be suffering from Epstein-Barr if they remember a high fever, swollen glands and a severe sore throat. The answer is no in many cases. Surprisingly, in many cases abdominal pain can be the presenting symptom along with muscle aches and fatigue.

I remember hearing a few years ago, Roger Federer (the great tennis champion), had Epstein-Barr for 6 months until he was finally diagnosed. I can’t imagine playing high-level tennis matches for hours with this infection. It wasn’t until Roger was rushed to the emergency room with severe abdominal pain that it was diagnosed. He realized after that his fatigue in the later sets of his tennis matches wasn’t due to poor conditioning, but this nasty virus.


  • Vitamin therapy
  • Gamma globulin treatment.

The goal in Vitamin therapy is to provide, at the cell level, enhanced nutrients so that mitochondria (the battery of the cell) can make ATP, the energy molecule that our body needs. Oral vitamins are important to stabilizing the body, but to really jump-start the process I use intramuscular vitamin injections with an array of B vitamins and antioxidants(see prior post on antioxidants).


1. Intravenous Vitamin C
Vitamin C is a key nutrient for collagen, the “glue” that holds are muscles together. It also enhances immune function to activate our natural killer cells to pick off viruses and bacteria.

2. Gamma globulin
Gamma globulin is a fascinating mode of therapy. Initially, it was used to treat immune deficient children so that they wouldn’t die from infections. It was very expensive back in the 80’s and 90’s: roughly $3,000 for every IV given.

Researchers then started purifying blood from patients that had Herpes Zoster infections and Hepatitis A and used these patients’ Gamma globulin to treat others that developed an acute infection. Now I’m told that the military uses Gamma globulin for the soldiers exposed to all sorts of infections in Afghanistan and Iraq. Personally, I use Gamma globulin injections to help ameliorate a patient with Epstein-Barr induced-Chronic Fatigue. Gamma globulin has the special ability to enhance immunity and also block inflammation in the tissues affected by a virus.

The toughest question in evaluating a patient with infection induced Chronic Fatigue is: Did the infection set off the severe fatigue, or was the patient’s immune system so run down that the virus was able to become active? It’s the old question: which came first the chicken or the egg? I usually don’t have time in my practice for philosophical debate, instead I have to reach into my black medical bag and find something that will help my patients.

So if you find yourself experiencing chronic fatigue. Contact us we are here to help you!

- Dr. Dean Mitchell
Mitchell Medical Group, NYC


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