Despite the instant negative reaction to the thought of the Herpes virus and the association with sexually transmitted disease, there are a number of different Herpes virus, including those responsible for Chicken Pox, Shingles, and Epstein Barr (mono). Even the ones with the most negative stereotypes are much more common that people believe; around 90% of people have been exposed to HSV-1 (oral herpes, or cold sores), and the numbers for genital herpes are pretty close to the same. Once exposed to any of these viruses they can lie dormant in your body, reactivating at any time, usually as a response to stress. So, is there a connection between Fibromyalgia and Herpes?
Given the overlap in symptoms between Fibromyalgia and Epstein Barr, it’s not surprising that researchers would consider a possible connection; I know that I certainly did. I had mono when I was a junior in High school. I don’t remember much about it other than that I felt tired a lot. What I do remember was later (over the next couple of decades) that I would have what I referred to as “recurring mono” despite multiple doctors telling me that you can’t get mono more than once (something that has since been severely questioned by many doctors and researchers). My throat would get sore, my lymph nodes would get swollen, I would feel achy (like the flu), and worn out. This was usually after I’d been running on full steam for several weeks, and I saw it as just my body crashing after I’d pushed it too hard. Back in 2006 when I was fighting strep infections every couple of weeks I actually managed to get a doctor to test me for Epstein Barr and low and behold I tested positive for an active infection (so much for not being able to get it more than once). Blood work has come a long way in two decades. Fibromyalgia, to me, feels a lot like those episodes of mono, sometimes even including the swollen glands and low-grade fever that were common with the recurring mono. So, it’s understandable why I might question whether or not there may really be a connection between the two.
Research regarding the overlap of Fibromyalgia and Epstein Barr goes all the way back to (at least) 1987. Buchwald, Goldenberg, Sullivan, and Komaroff examined 50 patients with Fibromyalgia and tested them for Epstein Barr. The levels of the virus in their systems was not significantly different than those of the healthy and unhealthy controls. The methods used to diagnose Fibromyalgia, at this time, were much less stringent than the 1990 guidelines called for, and probably more similar to the currently accepted guidelines. Two control groups were used for this study, one group containing healthy controls, the other patients who had been diagnosed with at least one chronic illness. A large number of the patients (27%) reported frequent sore throats, as well as many of the other symptoms common to mono, but not common to Fibro. Testing showed no significant differences in the levels of EBV antibodies between the Fibro group and the health or unhealthy controls.
VCA-IgG indicating that the person has had the virus at some time existed in almost all participants (regardless of group). It’s important to note that many people can have Mono and never show any symptoms. VCA-IgM without EBNA antibodies indicates a recent infection; none of the Fibro patients tested positive for VCA-IgM. EBNA antibodies indicate a past infection; this was found in most participants regardless of group. Given the results it’s almost impossible to say that Herpes isn’t related to Fibro, or that it is. Since they tested against healthy (and unhealthy controls) and all showed evidence of past infections, it’s possible that their healthy controls were not as healthy as they thought, that the unhealthy control group may have had overlapping issues that were not diagnosed, and a number of other things, including limitations in the blood tests at that time.
Side Note – one really interesting thing in this study that jumped out at me was that even back in 1987 Rheumatologists were reporting that they believed Fibromyalgia patients may make up the largest percentage of their patients. This is back before the original diagnostic criteria were set, and long before most doctors really even believed Fibromyalgia existed. Evidently, the three doctors involved in this study did believe in Fibromyalgia. Perhaps, Fibro patients sought them out for that reason.
In 2012, Hedberg reported that latent Epstein Barr virus has been connected to many different auto-immune disorders including MS, Hashimotos thyroiditis, RA, Sjogren’s, Chrons, and a number of others that are often seen as overlapping disorders with Fibromyalgia. He also reported on a genetic mutation found in the blood that allows Epstein Barr to increase and maintain itself, possibly leading to autoimmune issues.
A great deal more research has been done regarding Chronic Fatigue Syndrome (CFS); both Epstein Barr and Herpes Virus 6 have been connected to Chronic Fatigue Syndrome; as many as 70% of those diagnosed with Fibromyalgia are also diagnosed with Chronic Fatigue Syndrome, and there is much debate as to whether Fibro and CFS may be two separate entities or two ends of the same spectrum.
Of course, all of that brings us to the recent findings o f Dr.’s Duffy and Pridgen at the University of Alabama (Roll Tide!). They have been researching the possibilities of treating Fibromyalgia, chronic pain, and IBS using a combination of anti-virals usually used to treat HSV-1 (cold sores). They stumbled upon this potential treatment almost accidentally and are now on their way to stage-3 trials. This could be the thing that ties the Herpes virus to Fibromyalgia (and related conditions) and may provide significant relief for many of us.
Buchwald, D., Goldenberg, D. L., Sullivan, J. L., & Komaroff, A. L. (1987). The ‘chronic, active epstein-barr virus infection’ syndrome and primary fibromyalgia. Arthritis & Rheumatism, 30(10), 1132. doi:10.1002/art.1780301007
Hedberg, N. R. (2013). EPSTEIN-BARR VIRUS & AUTOIMMUNE DISEASE: THE INFECTION CONNECTION. Original Internist, 20(1), 18-19.