EBV IG Live recording

0:00play it on our podcast through the UltraCrood. So thank you to everyone who joins tonight. I think that this is a really important thing and especially it being something I have dealt with, it is, it's no joke and I've been in recovery with this for the past year. So that is pretty important. Let me get this adjusted just a little bit guys. Sorry. Oh no. I don't know what visual intelligence is. No. Okay. There we go. Why is that doing it? Sorry. I'm trying to get my stand back to where it needs to be. Okay. There we go. I said, I've got my computer in front of me and I am recording this so that you can relisten on the podcast if you want to. So again, thank you everybody. It's 6 o'clock. We're going to get started. I'm not going to sit here and waste your time. I said, I've got my notes in front of me. So I am not as disheveled as I

1:03usually am. So we're going to talk about Epstein Bar virus tonight that which is, it's what calls is mono. All right. So if you've had mono or EBV, then it stays in your system forever. It is a Herpes virus. Your body never gets rid of it. It is common in 90 to 90 for 95% of the entire population. So pretty much everyone has it. But for most people, it's going to stay dormant or latent in their system after they have had it. A lot of people get it when they're kids. So it can seem like it's just a bad cold, a bad flu. Not anything shows up as like a fever. Now when you get it as a teenager, that's typically where you get full blown mono. Okay. So that's the big difference. So you could have you could have it and never know. Your parents just thought you had a cold as a kid

2:08or you were sick for a few weeks as a teenager. All right. So I'm going to say I'm not a doctor, but I am a coach. I am a runner who has been dealing with this for what I was unaware of for years. And I've had it on a very extreme scale because I did not know what it is. But last year, one of our friends and athletes actually was dealing with it. And when they said, yeah, I've had an Epstein Bar virus reactivation. I went, wait, what did we hope? Epstein Bar, like I've had Epstein Bar. I had it when I was in high school. And that led me to a very deep dive into all of this. Okay. So this is all peer reviewed. Everything I'm about to tell you. And again, it's from my own personal research. And I will also happily send out anything afterwards for anyone curious or the things to ask, the panels to ask for, the test to ask for. I got it all for you if you want it.

3:08So if you have any comments towards in, I will ask otherwise I'm going to try and keep bouncing between these. All right. So it's mostly got from saliva. And that's also where it's going to test positive to when they do that. So it lives in the, and infects the cells in the lining in your throat. And then it moves to your B cells and your B cells are the white blood cells that make antibodies. So the virus literally moves into part of your immune system that which is why it's such a bitch. So it's going to hide and it's going to stay in your memory B cells. And I mean, you have those for years. It keeps in check your killer T-skit T cells that which are your natural killer cells. So basically they're out there, they're patrolling and they knock down any infection that starts acting up that which, you know, there's a percentage of your T cells that

4:13are assigned EVV full time. So think about this like it stays in your system all the time. It's just like a squatter and it's just live in there. You can't get rid of it. So we'll get on into the meat of this. I've already jumped ahead on my thing. So classic signs of mono are like a brutal sore throat often with patches of white on your tonsils. It gets mistaken for strep all the time. Feaver swollen lymph nodes especially in the back of your neck can also be in your armpits. Crushing fatigue not like oh I'm tired. It's like general malaise absolutely exhausted. Cannot get up. More common in men and we'll get into that later is an enlarged spleen and that's in about half of cases that come up and it is more on the extreme side. Sometimes in a large liver and elevated liver enzymes you can also get a rash and typically they will treat it like it's

5:17strep and give you a moxasillin and it's EVV. The incubation periods like four to six weeks. So you know you have it before you ever know acute systems can be two to four weeks. The fatigue can hang around for months. So this isn't something that you have and then you feel better after a week or two. You can have this and then six months just absolutely be gobsmacked exhausted on the floor. So a good way to find out if you've had it is an EVV antibody paddle antibody panel. You can ask your doctor for that. I'm not going to get too much into the ends and out of that. It's not a full diagnosis itself but it's a good indicator of whether you've had it or it is active. You can also do a mono spot chest check that which only does like if it's a recent infection or active.

6:21If you do have it or are active with mono particularly you know sharp pain the upper left belly or shoulder tip during or after mono that can be seen as a spleen issue. So you definitely want to get to the doctor but we're going to go ahead and get on into the reactivation and what it means. So basically EVV has two ways it lives. Lainton and Lytic. So Lainton it's sleep tied in your B cells. It's not doing anything. Then when it's awake it's going to flip this master switch and it's going to start copying itself in your system. That's one of the things that makes it so detrimental. It is just out there replicating and busting out of itself. And the immune system sees it and just like goes to war with it. So small reactivation happen in healthy people all the time but you shed bits of virus into your saliva now and then

7:23and you never really feel it you're healthy enough and you're rested enough that your immune system kind of puts it to bed. It's not a big deal. It's able to overcome it. The problem is when the reactivation is bigger and keeps happening and your immune system is too worn down to shut it off and this is something that happens to athletes a lot and it is confused with chronic fatigue syndrome or adrenal fatigue or it's just mixed diagnosed completely. We're going to get into that. So it's the inflammation from the fight from your body fighting it off that makes the symptoms and the fatigue and the swollen glands and sore throat, brain fog, aches and bad sleep. So like if you just feel shy and exhausted and you know you can't focus it doesn't matter how much you sleep you are just exhausted. This is this is a sign. We're going to keep diving into that. It is most of the time what you're feeling is not necessarily the reactivation. It is your body

8:29fighting the reactivation and trying to heal from it. The inflammation is a symptom. So that can mean you're super sore things are tighter hurt more than they do. You can even the inflammation you can go to your brain a lot of other things can get into all that but you can feel it. If it keeps going you can end up with a chronic reactivation and that is way less fun and that can actually be pretty serious and it really affects some of your organs. So why is this EBV happening? It's autoimmune. So the common thread is immune suppression and so runners are really prone to a lot of these things and that's really what I'm about to get into. So one of the triggers is chronic stress. Cortisol and adrenaline kind of tamp down on T-cell surveillance.

9:33So you know they're they're not doing as big a job as they usually are. Stress hormones can also directly flip the viruses switch. So yep you're super stressed that can be training that can be life and here's the thing it doesn't have to be from a big training block it doesn't have to be post-race it can be from a very stressful period. For me I have found it gets retriggered by very stressful times in my life mostly emotional and mental. For my spot here in students they had higher EBV antibody levels after like exam periods and stuff like that. Poor sleep or short sleep so sleep is when a lot of the immune system like T-cell repair is happening. So when you have short sleep it drops those killers cell levels and the EBV

10:34itself like rec sleep so it becomes a loop. So it's wrecking your sleep and your immune system suppress because you can't get good quality sleep. Big training loads hard sessions sudden jumps in volume back to back hard days races temporarily lower your immune defenses. There was actually a study in elite swimmers and runners that found EBV showing up in the saliva more often after during or more often during heavy training blocks intended to come and intended to come before upper respiratory illness. So if you find yourself getting cold or sickness or chest colds around big training blocks it is something to make note of. Underfueling is another big driver. The immune system it's expensive to run it it requires energy on top of your day today. So not enough calories or carbs means higher quarters all levels and fewer resources for your

11:36immune cells. Low carb and long effort increases the stress hormones. That was a mistake I made in this when I didn't know what was going on. I was gaining weight due to my thyroid stuff that which will get on into that too. But I was staying in a chloride deficit that which was just wrecking my body and making everything worse. But I again I did not know what was going on. Other infections such as COVID this is a big one especially since everyone's had COVID. Long COVID I think a lot of this is tied to EBV. Flu viruses and stuff like that they can all trigger a reactivation as well. Hormone shifts for women pregnancy postpartum. You know, period menopause but also EBV can mimic signs of perimenopause. So medications such as prognosome, transplant drugs and there's

12:38some other autoimmune drugs. It basically anything that suppresses immunity can cause this. Just age and life you know your immune system wanes as we get older and just with stress. Again chronic stress, grief, divorce, caregiving, a move, new job all counts as stress and your body can't differentiate between strength training stress and life stress. So since your body doesn't have a separate bucket for those life stressors it all goes into one and it overflows and the virus takes a hold. When it wakes up in the immune system it signals certain proteins that will make you feel sick. Same chemicals make you feel like garbage when you have the flu. And it's really going to increase the inflammation in your body and what the inflammation does is it increases your fatigue and it acts on the brain. The sickness behavior your brain is telling you to lie down so your body can fight and that's why you can't push through it. You're tired. You need to rest.

13:41Brain fog, immune inflammation in your brain affects focus, memory and word finding. That was a big thing for me personally the brain fog was insane. Remembering to text someone back I would constantly be trying to figure things out and it just felt like I hadn't slept in a week. It didn't matter how much I had slept. Muscle and joint aches just wide body like inflammation and it's worse after an effort. Running five miles can make you feel like you were in a 50k and runners oftentimes neglect mobility and things like that. So you know you're not stretching you're probably maybe not taking notes of the inflammation like you should. So you have the muscle and joint aches. Your lymph nodes, neck, armpits, groin can all get tender and swollen. When you're in a reactivation and you're inflamed. Soar throat and low grade fevers are another thing.

14:47The throat is where the virus sheds. So if you're like, oh my throat, I just keep getting a sore throat. Maybe it's allergies. Maybe it's this another indicator. Your liver enzymes or could possibly bump up. Some people feel nausea or appetite loss. Spleen. Again, this is found more in men than it is women. But the spleen can swell because your spleen is what filters blood and houses your immune cells. So it takes a big hit. You're got some people get digestive upset food sensitivities and bloating. That I was very bloated. Can it test that your mood inflammation is strongly linked to low mood, anxiety and irritability. It's not just in your head. It's your immune system. Your iron gets locked away. So inflammation raises

15:48a specific hormone which pulls iron out of circulation. And we're going to get more into a section just on iron. And as a runner, you need iron and a lot of runners suffer with low iron. So if you feel like you have the flu without having the flu, especially after a hard training block, you need to pay attention because that flu feeling is inflammation and inflammation is inflammation. Sleep. Sleep in EVB are a two way street. Bad sleep helps to wake it up. And once it's awake, it wrecks your sleep. That is how people end up stuck for months. What that's going to look like is some unrefreshing sleep eight or nine hours and you wake up like you've never slept. This is a hallmark of it. Needing to sleep 10, 11, 12 hours and still dragging. Now it also could be the complete opposite where you're wired and tired exhausted but can't fall asleep. You're having insomnia. You wake up at two or three o'clock in the morning with

16:49your heart just racing and have night sweats. Why is this happening? Because the inflammation changes your sleep structure basically. You spend less time in deep restorative stages. Your sleep architecture. That's the word I typed. Your stress hormone rhythm gets thrown off. Cortisol is supposed to be high in the morning and low at night and with chronic stress and inflammation, it can flatten or flip. The nervous system just kind of gets stuck in this fight or flight. So you're you're just on this loop. You know, if you're a runner wearing your watch at night, tracking your resting heart rate and seeing it creep up and your HRB dropping for several days in a row for no obvious reason is one of the earliest signs your body is fighting something. Sleep scores that tank while you're training. Hasn't changed or a clue.

17:52So if you're sleeping nine hours and waking up right, you don't need more caffeine. You need to figure out why. Another thing that comes from EBB is thyroid issues. This for me specifically was something that I was struggling heavily with that which has been the biggest thing to overcome this past year with that. Hashimoto's is also caused. Well, it's all to a mean, but one of the big causes is EBB because your immune system will start attacking your thyroid. It is Hashimoto's is the most common source of hypothyroidism in the US and it's far more common in women that which is why women are going to see things that also mimic more hormonal things with like your parrymina balls or your menstrual cycles and stuff like that. So multiple studies have found EBB inside thyroid tissue

18:59with people that have had Hashimoto's and great disease. So that's worth noting if you have been diagnosed with either of those. So one of the things EBB can do is molecular mimicry which means the pieces of the EBB look similar enough to your own tissue that your immune system actually attacks your immune system attacks of iris can end up attacking its own cells by mistake. That is how this thyroid stuff goes on. Basically it's bystander damage when affected immune cells set up shop in the thyroid the inflammation from fighting these fighting them damages thyroid tissues that are just sitting there. So the thyroid takes a hit from the stress response and the inflammation which can slow conversion of T4 that which is your storage hormone into T3 active hormone. So EBB is a suspected trigger of Hashimoto's and graves.

20:06It's not proven to be the cause but it has been linked also MS we're going to do that later. So it's so so sneaky because low thyroid and EBB reactivation look almost identical fatigue, weight change, cold intolerance, brain fog, hair shedding, low mood, constipation, feeling slow. Runners often feel that their paces are getting harder and the heart rate won't come up in heavy legs. That's that's one of the signs also the low body temperature. It's not a direct sign but it is a common thread in autoimmune diseases. So if you just feel constant cold it's worth noting you may have something else going on. If you take your temperature and it's consistently 97 rather 98.6 it's worth taking note of. Underfueling another thing with low body temperature underfueling can also

21:13impact that. So when runners don't eat enough the body turns the metabolism down to save energy and your body temperature drops. That's pretty well documented athletes that are underfueling or suffering with reds. Post viral nervous system trouble, poor temperature control, cold hands, cold feet, trouble warming up are common. In that low iron can also make you feel cold again. All of these can also be related to EBV. So keep listening. Women, their body temperature naturally runs lower and the first half of their cycle. So compare readings at the same point in your cycle. So I'm just saying low body temperature isn't a direct sign of EBV but if you're always cold it's a clue to check your thyroid, your iron and whether you're eating enough. Those things tend to go alongside with a reactivation. We're going to get on to the nerves attack. So EBV can also affect your nervous system. That's

22:18the inflammation has now moved to your nervous system up in your brain. I have also been impacted by this. So it's another reason why I want to speak on it. It is considered more rare or more the chronic cases but it happens. One of the things is acute cerebular or cerebular attacks. So basically it's where the part of your brain that runs your balance and coordination gets inflamed. So after some viral infections such as EBV you can experience this. It's also been documented in COVID. So some of the signs are sudden wobbly, wide stance like your drunk, clumsy hands, shaky movements when reaching, slurred speech, eyes jerking. It usually improves over weeks to months but always needs a doctor because you have to roll out stroke or anything like that. Which was one of the fears that I had. I was like,

23:20did I have a stroke here? What's going on? One of the other signs of cerebral or taxia is you lose where you are. This was one of the things that I had several years ago, apparently when I was having a really bad reactivation. I would be driving then not know where I was. Just sitting at a red light going, I don't know where I am and I don't know how I got here. It's terrifying. But in this most recent stint I had where I was having issues. I started tripping like when I was running. I would just trip or just walking. I would just trip. No explanation. My balance and coordination seemed to be really off. I actually talked to an athlete a few weeks ago that she was having a hard time with coordination, being able to get food and stuff in her mouth. I experienced not as serious as hers but some of that as well. There were times, John would be like, are you drunk? What's going on? I'm like, no, I just,

24:22I can't, I was very worried personally because my dad has Parkinson's and at one point I was very worried that I was getting the signs of early onset Parkinson's. That's how EBV can affect your brain with the inflammation. Other nerve issues. Let's see. Are going to be like glaine bar syndrome. Basically your immune system attacks the nerves, weakness and tingling that starts in your feet and then climbs. That's a big one you need to seek help. Bells paulzy, one side of your face, droops, optic nerve issues. Now I also had neuropathy and this is something I noticed during Georgia Joule last year. Of course it was late in the race so it was very easy to ride off but I knew that something was different. It wasn't just foot pain. It was

25:26shooting nerve pain, tingling pain that I had not had before doing a hundred mile or a long thing. Again, your feet hurt and it would have been easy to discount but it then also proceeded afterwards. I also had nerve, just weakness. I would be trying to carry just a bag of groceries and I would lose all strength in my arm. I couldn't even push a vacuum. This is how bad it got over the winter. Again, I didn't know what was going on and basically everything I tried to do to fix it just made it worse. I wasn't helping myself. That nerve pain though, it's not going to be just aching. It's nerve pain from inflammation feels different than muscle soreness. It's going to be a burning buzzing stabbing, almost like electric skin crawling pain and it can even hurt when you touch

26:28it. It can move around. It's often worse at night or after exertion. Plus if you've got fatigue and swollen glands, mention all that to your doctor. All of those things are no good. Your vagus nerve. Your vagus nerve is the main highway from your parisynthetic nervous system. It signals like rest and digest. It's the opposite of fight or flight and it runs from your brain stream down to your neck, chest, belly and controls heart rate, digestion and the part of the brain that reads inflammation. The vagus nerve is the immune system's messenger to the brain. It senses information in the body and it tells the brain that it's part of why you feel sick and inflamed. It also runs the anti-inflammatory reflex. When it's working right, the vagus signaling actually calms inflammation down. When it's infected, it can't do its job. It keeps getting stuck

27:29with the signal on. It's signaling your brain, inflammation, inflammation. That's what they think leads to some of the chronic fatigue. It's not proven but it is their hypothesis on that. It is well documented that after viral infections, a lot of people develop dysautomia. It's basically your nervous system isn't regulating right. One of the ways I experience vagal nerve malfunction, whatever you want to call it, was with my heart rate, which we're about to get into that. I couldn't swallow. EBV also depletes you vitamins and nutrients that you need in order to fight it and cause a whole imbalance there. I also couldn't take my multivitants because I couldn't swallow. One of the things that happened at Crueljoule this year was I was choking. Again, this was something that I thought had to do with maybe early onset Parkinson's

28:30or something because I was having trouble swallowing. I was choking on water. I was choking on small things. During the race, I started choking on my salt pills and throwing up and couldn't stop because even just swallowing water, I couldn't get it down because my vagus nerve was just like switched on reaction, empty the body, we're being attacked. No, clear everything. Other issues of vagal nerve are your heart rate jumping up, when you stand up and you get dizzy and lightheaded, you have low HRV that just won't recover and your resting heart rate is just staying sky high. Your heart is racing on easy runs. A pace that should feel easy, that is easy, feels like a tempo run. You're out there hanging on digestive issues, bloating, slow digestion, nausea, feeling full fast, your temperature regulations off. You can't warm up or you overheat easily.

29:34Trouble swallowing or voice changes, an anxiety that feels physical, wired or exhausted. Your runs are suddenly feeling hard and your heart rate is way higher than normal for the same pace. It could be linked to your nervous system telling you something is off. Again, that is something I experienced personally. John and I would go for an easy run, six miles, Percy Warner 5.8, and I would be dying. My heart rate would be through the roof and I would just be huffing and puffing. Or even if my heart rate was normal, it just felt like I could not keep up on an easy run and I was holding on for dear life. Let's see. We'll move on to the autoimmune connection and MS. So basically everyone who's ever been diagnosed with MS has had EBV. It's

30:36you have EBV before you get MS and that also has to do with the found low vitamin D. And we'll touch on that later. I do want to skip over that. It is, EBV is also been linked to Lupus. So if you have had Lupus or have Lupus, let's see. All right, men versus women. So women have stronger immune system responses overall. That's partly from estrogen and partly from RMune genes on the X chromosomes. Women have two X chromosomes. So just saying they are better at clearing infections, but they are more prone to autoimmune infections. They are also about 80% of autoimmune patients are women. MS is roughly two to three times more common in women and nine times. Lupus is nine times more common. Hashimoto's is also much more common in women.

31:42In women, EBV is more likely to show up as an immune style autoimmune style trouble. So basically it's going to start in your thyroid, joint pain, rashes, nervous systems. It's also going to show up with hormone swings, many women report a flare around their period postpartum or period men of balls. Pregnancy reactivation is documented. So tracking your cycle alongside of that is important. For women, especially iron, women start with lower iron stores, during menstruation, add on inflammation, blocking the iron absorption, add what you lose during running and fatigue and your head and recipe for disaster. Women are also more often told stress and anxiety and sent home and told to push for labs. Men generally have a less aggressive immune response. So autoimmune complications are less common, but higher reports of spleen

32:49ruptures during mono, and EBV reactivations. So if you are a man and you are in a reaction, your testosterone is also going to take a hit illness, inflammation, chronic stress, all lower it anyways and low T shows up as fatigue, low drive, poor recovery, low mood and trouble building fitness. It can also look like overtraining. Men are more likely to push through and ignore it, with more of a grind mindset. So proceed with caution. Let's see. Runners and endurance athletes. So this is probably why most of you are listening. Why are athletes at risk? Well, it's the open window. After hard or very long efforts, some immune markers dip for hours,

33:50say after a marathon or ultra-finishers get sick, in a wee or two after a race, how big that window is can be debatable, but the pattern of illness after a big effort is pretty well documented. After heavy training blocks is when you are also at risk. Elite swimmer studies have found EBV DNA showing up in saliva during heavy training, and they were more likely to get respiratory illness afterwards. The stacking effect, high volume, low fuel, short sleep, race travel, plus life, every one of those is a trigger on its own. We are wired to push as endurance athletes. We are wired to push through things that are uncomfortable. So that trait that makes us good at ultras is the saying that also leads us to ignore a flare for several weeks. So what it's going to do to your training if you are in a flare-up? You'll notice an easy

34:57pace feels hard. What's happening is inflammation and auto-autotomic changes push heart rate up. Low iron availability limits oxygen delivery. Another thing you'll notice is your heart rate won't come up in workouts or at sky-high at an easy effort. So it's going to be either one of those. Both can happen. Again, it's the autonomic dysfunction and fatigue can blunt your heart rate response or spike it. You'll also notice resting heart rate is up and your HRV is down for those days. So it means your body is fighting something. It's the earliest signal most people have. So where your stuff when you sleep at night? So you know what's happening when you are asleep. Recovery will take three to five days instead of one. So you do a hard workout and usually the next day you can rest and you're back at it. No, it is three or four days before you feel normal.

36:04Why that's happening is your immune system is using the resources. It usually dedicates to recovery to fight this active infection. Soarthroader swollen glands after long runs. Again, very classic. The virus sheds in your throat. It also affects your lymph nodes. Hard efforts are knocking your immune control down and the virus is flaring. That's what's happening. Crash the day after after a race or a hard session, you just are wiped. You're achy and not like doms or anything like that. Like you just feel wrecked. 24 to 48 hours after a session, it's called post-exertional malaise. And that is that's a big red flag. If you were feeling that because something is going on, your body is fighting hard to kick this infection or this flare. Motivation gone, low mood inflammation directly affects move and drive.

37:05Obviously because it impacts multiple other systems. Heavy legs, workouts, regress. It's not that you're losing fitness, but it's that your body just doesn't have enough available to express to execute what you want and actually express your fitness. So for runners, you know, this overlaps heavily with overtraining syndrome and reds and iron deficiency and low thyroid and low testosterone. They all often travel together. So you can't tell which one it's how you feel, but that's what labs are for. And for anyone interested in what labs you need to have specifically, I have a PDF for that. I am happy to send it to you. So you also know how to interpret them. All right, training through it. Don't just don't. You know, it's really important to take it easy during that time and it is important to make sure that if you're working with a coach that they understand what's going on and they look

38:07into that because your training does need to look different. If you are struggling with an active Epstein bar virus reactivation, I had you know, a common let's say sports medicine role of them. You know, symptoms above the neck, mild stepping nose, little scratchy throat, easy running, maybe okay, short, easy, stop it if you're worse. Below the neck, fever, body aches, swollen glands, chest, sister, symptoms, gut issues, extreme fatigue, no training, rest. Like your body needs to rest. It needs to take all that energy and direct it towards your immune system. If it's mono, it's no good, but you don't need to be running, lifting, nothing high contact, especially for guys because you do risk, your spleen, rupturing, for three to four weeks, you know, your your comebacks going to be pretty gradual. Like that's the time to work on your walking. If you run out of choice, you need to be able to

39:10walk short, easy runs and then build from there, you know, getting back to it. If it is full blown mono, it can take you weeks to months and you just have to be patient. That's the season you're in and does it suck. Yeah, but you have to grant yourself grace. You have to learn to listen to your body and you have to just embrace that season, you know, and hopefully it happens during the summer. So you don't have to do all these hot ass runs. All right, if it's a suspected reactivation, like you haven't been tested yet, it's not full blown mono, but you think something's going on, you're having a lot of these symptoms that I am talking about. You should pull intensity. Don't do hard workouts. You can raise, I still would not, but if you want to take it easy at the race, that's fine. Still be in the community. You're definitely going to want to cut your volume. So you can get where you don't crash the next day with that malaise. So if you're like, well, I'm supposed to be doing 13 miles today, well, you know what? Maybe it's just six. Keep pushing that

40:14down until you get to a place where you don't feel like you ran 100 miles the next day. Easy means easy. Conversational, your heart rates, caps, walk rates, welcome. This is another reason why it's so important to know your body, know what your heart rate should be doing, and is it your watch, is it your hydration, whatever's going on that cardiac drift, knowing how to read your body, and knowing if like your watch is just malfunctioning, that heart rate is feedback. I know a lot of people don't want to hear that. A lot of people will argue it. Don't care. It's feedback. Listen to it. Watch for that 24 to 48 hour window. If you crash after a session and that session was too much, back it off further, build back slowly. If the symptoms come back, take a step back. Again, that sucks. You need to fuel the shit out of your body. Fuel more, not less. It's not the time to

41:17cut weight. And if you are dealing with a reactivation or suspected, and especially if you're a female, you are likely going to be bloated. You are likely going to be gaining weight. So it's going to be tempting to cut those calories. You cannot do that. That's that's way worse for your body. Again, a mistake I made and it made everything worse. Imagine being size zero and then all of a sudden you turn around and like you're having to be size six because your body is just it just keeps gaining weight. It doesn't matter what you do. It's a very hopeless feeling. I would not wish it on my worst enemy. If you have some of these symptoms and you suspect something may be going on or that your immune system is a little stressed, you're not going to lose your fitness in two weeks. So take rest days, take time. Like you can lose a whole season by running through a flare. That's it. Like you're going to push your body to a point where it's just going to crash and burn. So rest needs to be

42:23part of your plan. I will say I will take a healthy athlete who's a little under trained and sick over an athlete who's sick and fit every time. So let's see how to spot a reactivation. I'll check list for you here. Now no single symptom proves this but it's kind of like cluster and timing. Often after a big stressor. So your core signs are going to be fatigue that rest doesn't fix. Soarthroat that comes and goes tinder or swollen lymph nodes. There's going to be in your neck, armpits or you're growing low grade fevers or feeling feverish and chills. Unrefreshing sleep and night sweats, brain fog and word finding trouble, muscle and joynakes, crash the day after exertion and headaches. Also common during a reactivation or possible or oncoming.

43:26Your resting heart rate is up and your HRV is down. You're going to have dizziness when standing, tingling burning or nerve pain, low mood, anxiety and irritability, digestive upset, appetite changes, thyroid and autoimmune flares, upper right belly discomfort. That's going to be where your liver is or upper left side fullness. That's going to be where your spleen is. Again, guys, that's a big one you need to listen to. Rashes and just getting sick over and over again. The timing is really important to make note of because people very often say it started two to six weeks after a big race, a huge training block, COVID, flu or major life event, stretch of terrible sleep or a period of under-eating. How to tell it apart from normal tired is normal tired gets better with a few good nights of sleep or an easy week. This doesn't. Like a flare, reactivation, it just doesn't. The glances

44:29feel terrible. Let's see. At the doctor, what usually happens, if it's mono, they're going to check your throat, fill your neck, belly, they're checking all your lymph nodes, your liver, your spleen, they're probably going to run a strep test in a mono spot. The mono spot can miss it, especially in the first week of symptoms up to 25% false negative early, especially in kids. If it is, then you're going to ask for an EBV antibody panel. Treatment is supportive, rest, fluids, pain, fever relief. A lot of people during a reactivation, they will go get labs and they're going to be told labs look normal. It's probably stress. It's because a basic CBC and metabolic panel, they don't

45:30catch it. There are specific tests you need to have run and look at and I'll get to that. And again, if anyone is interested in that, I will send that information over to you. How to walk in prepared. If you do go to the doctor and use the sex list, suspect this. You're going to need to bring a timeline. You need to know when it started. Bring your data, your resting HR and HRV trends, training logs, sleep. Again, most doctors that you go to though in the system, they are not trained to treat this. They're just like rest. So really, you're going to want to look for a doctor with a more natural approach, a homeopathic doctor, sports medicine doctor. That's what you're looking for. Yes, me. They're probably going to take you more seriously and know what to look for. Also, a great girl, Monica. I'm sure she can set you up. Full body pharmacy is amazing. She was a

46:36person who I know what to call the people that hand you your prescriptions at the source. The My brain won't function right now. Anyways, we'll get on past that. I'm not going to get into the labs tests and panels just because that's that's nothing that needs to be read here. There is also a list of some supporting labs can get you. Now, here's what I'm going to say with some of the supporting labs. I am going to get into this just a little bit. An iron panel in Faritan. It's huge for runners. You need the full panel not just the Faritan. We'll get to that. Your full thyroid panel. Anybody's catch Hashimoto's before TAsSET moves. Consider reverse T through it. You don't need to know that. Vitamin D. Low vitamin D is linked to weaker control of EBV and increase your risk of MS. So that's a big

47:43one. You need to make sure you're staying tested on that B12 and is another one. It supports your energy, nerve health, red blood cells, low B12 alone can cause tingling and fatigue. So you're going to also want to know what's going on there. There's like seven different types of magnesium, but magnesium tests. Magnesium is usually low in athletes. Sarah magnesium misses most deficiencies. Let's see. You're mourning cortisol. So if you can do a daily cortisol test, check your stress hormone rhythm. Sex hormones obviously. Testosterone and estrogen. Let's see. If you are a runner and going to get labs, get labs at the same or do labs at the same time of day if you're doing multiple, be well hydrated. And ideally not within 24 to 48 hours of a hard or long run, hard efforts can temporarily bump liver enzymes, CK, inflammation markers,

48:46and white cell counts. So you're not getting a clear picture when you do go. So all right, when you are fighting a virus, it's an expensive toll for your body. Like that tags is high. So your immune systems multiply fast. They make antibodies and they produce oxidative stress. That would be your an athlete. You should know about oxidative stress. And that's going to use up a lot of the raw materials your body needs, you know, a lot of your vitamins, nutrients. And runners are often already running low on this stuff. So you know, it makes a reaction even easier. A lot of runners are going to be low on iron. And so what happens during this active flare up, inflammation raises a hormone which locks iron away in storage and blocks absorption from food. It's the body's way of hiding iron from the virus because EBV loves eating by like it. No, no, no, it will tank your iron. So you can have enough iron,

49:52but it's just not accessible for your body to use it. And if you're a runner, footstrike sweat, GI losses, all drain runners, less oxygen carrying capacity means everything feels harder. So when you have not enough iron available, your body cannot effectively transport oxygen. Zinc, it's pulled out of the blood into the liver during inflammation used heavily by T-cells, big part of EBV, for making new immune cells. Zinc can be lost in sweat and low zinc means weaker immune control and slower healing. Vitamin D is a regulator of T-cells and immune balance. And low levels are linked to higher EBV antibody levels and weaker viral control. So you know, the winter time when we're hitting the indoor treadmills and winter early morning runs, when it's still dark, sunscreen also block sure absorption of vitamin D. So vitamin D is a common deficiency that also makes that worse. Vitamin C, white blood cells, pack it in heavily and use it up during infection

50:56and oxidative stress levels drop this in illness. So hard training also increases oxidative stress. B vitamins, it's going to be your B12, full it, B6, needed rapidly for dividing immune cells and energy production. So your immune system leans harder on them when it is active. It's not proven that EBV itself drains them, but it does have an impact. And those cells or those vitamins, particularly they are used for your metabolism and red cell blood cell production. Magnesium, a bunch of reasons, literally hundreds of reasons. But low magnesium and chronic stress tend to show up together. Again, not proven ABV drains it, but still linked to it. Magnesium's lost in sweat and low magnesium versus sleep, cramps and nerve irritability. Selenium, it's tied directly to the thyroid piece of it and it is needed for

51:59thyroid hormone conversion. Glutathion also drained by heavy training and it is your main internal and antioxidant. And what your body uses to handle oxidative stress from inflammation and how much a reactivation lowers it hasn't been well measured, but it is impacted. And glutamine and protein, glutamine is the main fuel for immune cells and blood levels with heavy training and illness or blood levels drop with heavy training and illness. And bodies are built from protein. So low protein intake slows both immune response and muscle repair. Calories and carbs, the immune system burns a lot of energy. Okay, and training burns energy. So if you are under fueling, double dip in the end to reserves that you just don't have. Omega-3s are the building blocks and compounds of your body and they're made to shut inflammation down. It's not something that the virus burns through, but it definitely hurts not having enough on hand and oftentimes runners are low

53:04on omega-3s. All right, so we're going to move on to ferritin, which obviously linked to iron. And I do want every runner to hear this. Ferritin is the number one everyone checks for iron, but ferritin also goes up when you're inflamed so you can be fighting a reactivation and be functionally low on iron. Your ferritin can look normal or even high and your doctor says your iron is fine, but it isn't. Always get ferritin with a CRP in the full iron panel. Transfer, transparent saturation especially. A normal ferritin with a high CRP in low transfer and saturation is a red flag for iron being locked up by inflammation. So don't mega dose iron on your own during active inflammation. Absorption is blocked anyways and too much iron has its own risk, so work

54:09with a provider on timing and doses. Obviously, I'm a fan of supplements. Also good quality food. You know, always food first if you can, but I just don't have faith that we can, that our food is as nutrient dense as we need it to be. So I'm not going to go into all that again. There will be an PDF. Should you want me to share this with you? I am happy to just send a message. Let's see. What to do about it? You know, there is no magic pill for a reactivation and healthy people, but what works is putting security back on the job, lowering the load and giving your immune system what it needs. So to lower the load, we're going to cut the training intensity first, then the volume. So easy runs only and then drop that volume. No racing. You don't need to do that.

55:12The next day crash tests, cut live stress where you can and you're going to have to learn to say no to things. Your friends are going to want to go do things, so volunteer instead, give back. You can still be part of the community. You don't have to go run a 50K. You don't have to go do everything with everyone. You're going to need to protect your sleep. Your sleep is going to be your greatest ally. You need to do the same bedtime and same wait time. You need that routine. Let your body find a process, dark whole room. I think there are some science that like 55 degrees is the most ideal for recovery. Don't quote me on that, but I know it feels damn good. Or 65. Maybe 65. I may be saying that's too low. Morning daylight. It's going to be good. No hard workouts late in the day because you don't want your quarters all rising before you go to bed. Try and get that in early. Naps are allowed. Naps time. Bring it back. Get you a blankie. Get you a mat. Enjoy it. You're also going to refill the tank. That means eating enough every day,

56:16especially carbs and protein. I could do a whole thing on protein and how much protein people should be taking. Test and correct deficiencies. Hydrate and replace electrolytes. You need the electrolytes. It's not just water. You got to drink limit alcohol because alcohol does raise quarters all and those stress hormones. You're just going to keep feeding that process. Learning to calm your nervous system. Doing slow breathing long exhales, breathing exercises are your friend meditation throughout this time. Walks outside and time on the land. Just enjoy that. You don't have to go run and push your body for four hours. Do an easy hour walk. Easy movements that you actually enjoy. Track your HRV and resting heart rate to guide your training and see exactly where your body is at. See. All right. Question and answer cheat sheets.

57:21Is it contagious when it reactivates? You can shed the virus in saliva but nearly every adult has it. Still don't share bottles, especially with kids or anyone who hasn't had it. Kind of common sense there. Can you get mono twice? You can only get the first infection once. Later flares or reactivations. Can you get rid of EBV? No. It is for life. The goal is keeping it quiet and not active. Is there a vaccine? No. Not yet. Several clinical tries. I'm not even going to get on vaccines. Does COVID reactivate EBV? It says an EBV reactivation shows up often in long COVID cases. How long does a reactivation last? And that's just going to vary a lot. Weeks for some months for others. It's faster when you pull the load early and especially again, learning how to recognize what is going on and not dismiss it is going to be the fastest way to heal your

58:22body and go ahead and move towards recovery. What supplement should I take? Test first. Feel fine. What's actually low. There's no proven EBV supplement. It's going to look different. Like what I'm taking currently that I know makes a difference. It's going to be completely different than someone else. We may have some commonalities but it's not going to be the exact same for everyone. Can I race next month? Only if you're symptom free training without next day crashes and cleared of it. Mato, a race isn't worth a season and it will. It can put you back down. My labs came back high EBV. What does that mean? And that's going to depend on which anybody if it's a high BCA IGG alone, which means a past infection. You're going to want to look at EAD, IGM and PCR and those symptoms together with your doctor. Okay. What does EBV lower your body

59:26temperature? Not directly. But as we talked about earlier, EBV is tied to low grade fever and always running cold points to more thyroid issues and low iron or underfueling. So those all need to be checked. Can kids get it? Yeah. Most people catch it as kids. It's usually mild. Again. So, you know, if you take one thing tonight, your fatigue is information and it needs to be listened to. It's not weakness. It's not laziness. EBV is common. It's real and it responds to the same things. Good training does. Load recovery fuel sleep. Get the labs, bring the data and back off before your body makes you. If you need help figuring out a comeback plan, that's what I'm here for. I really appreciate everyone who tuned in or ends up listening to this. Again, I will share this with anyone who wants to know. I hate that so many athletes are out there

1:00:29dealing with so many of these symptoms or an active reactivation or flare and they have no idea. And unfortunately, our medical system, as it operates, is just not equipped to handle what this is. We treat symptoms, rest, go on and, you know, many people come to this sport for either recovery or a sense of community or to enjoy their, enjoy time with their friends or, you know, get away from their lives, whatever those reasons may be and pushing through a lot of these things can take that away. And it can be a really hard, dark place when you end up with a chronic reactivation or a flare and you can't run and you can't do those things. So learning how to navigate that can be a bit difficult. But if you learn to pull back before it gets to that point or recognize what's going on, then, you know, you can still keep maybe the next half of your season or the next season

1:01:34and still be able to do what you love. It just may not, the goals you had may not be the goals that you can chase this go around. And that's okay because you're going to have this the rest of your life. Like, once it's there, it's there. And if you plan to do this sport, like I do for the rest of my life, you have to learn how to work with your body not against it. And when it's giving you feedback and even if you don't want to listen to it, I mean, it's eventually going to push back so hard that you have to. So learn to recognize the symptoms and signs early and to give your body what it needs so that you don't end up in a position that you end up being robbed of your joy and spending months healing. So again, I appreciate everyone. Thank you so much. I'm going to go ahead and get off here. But I hope everyone has a good night.