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 UVA Pediatric Integrative Medicine: https://childrens.uvahealth.com/specialties/integrative-health Want more Dr. Linda Bluestein, MD?Website:  https://www.hypermobilitymd.com/YouTube: https://www.youtube.com/@bendybodiespodcastInstagram: ⁠⁠⁠⁠https://www.instagram.com/hypermobilitymd/⁠⁠⁠⁠Facebook: ⁠⁠⁠⁠https://www.facebook.com/BendyBodiesPodcast⁠⁠⁠⁠X: ⁠⁠⁠⁠https://twitter.com/BluesteinLinda⁠⁠⁠⁠LinkedIn: ⁠⁠⁠⁠https://www.linkedin.com/in/hypermobilitymd/⁠⁠⁠⁠Newsletter: ⁠⁠⁠⁠https://hypermobilitymd.substack.com/Shop my Amazon store ⁠⁠⁠ https://www.amazon.com/shop/hypermobilitymdDr. Bluestein's Recommended Herbs, Supplements and Care Necessities: https://us.fullscript.com/welcome/hypermobilitymd/store-start Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them. Join YOUR Bendy Bodies community at ⁠⁠https://www\.bendybodiespodcast\.com/⁠⁠. YOUR bendy body is our highest priority!⁠⁠ Learn more about Human Content at ⁠⁠⁠http://www\.human-content\.com⁠⁠⁠ Podcast Advertising/Business Inquiries: ⁠⁠⁠sales@human-content.com⁠⁠⁠ Part of the Human Content Podcast Network Go http://www.AquaTru.com now for 20% off (your purifier) using promo code BENDY. FTC: This video is not sponsored. Links are commissionable, meaning I may earn commission from purchases made through links Chapter: 00:00 EBV Everywhere00:29 Welcome and Episode Roadmap02:10 Corey’s PEM Question02:52 What EBV Does in the Body06:03 Healing PEM From the Ground Up10:37 Vagus Nerve Breathing Tools16:31 Mitochondrial Supplements and Dosing29:36 EBV Labs Reactivation vs New Infection40:58 IgM and Monospot Memory42:07 Cold Sores and Antivirals44:47 Why Reactivation Varies49:21 Holistic Medicine Not Silos51:11 Vagus Nerve Breathing Basics55:00 Stress Hormones and Inflammation01:00:54 Urolithin A and Mitophagy01:08:49 PEM Recovery and Wrap Up Learn more about your ad choices. Visit megaphone.fm/adchoices