Epstein Barr Nuclear AG AB IGG result of over 600

Posted by lsh @lsh, May 3, 2020

Hello, I am searching for information and also input because of my hideously high lab results for EBNA Nuclear AB IGG. My result was given as over 600. The range is less than 18 is negative. Over 22 is positive. To restate, my lab result is over 600.

I am 52. I did have mono at age 11. For at least four years I have complained on numerous times to my PCP of fatigue. We suspected thyroid but that has been treated and I still have suffered from bouts of fatigue, feeling like I was coming down with a bug, dizziness, etc for 3 or 4 days out of just about every month for the last eighteen months. I finally saw a naturopath who tested me for EBV.

I love my Naturopath, but I am wondering if I should be seeing a specialist because of this high lab result.
I am on a treatment plan of antiviral supplements, and immune supporting vitamins and supplements which she said will probably need to be taken for at least three months.

Has anyone else had numbers this high? I am having trouble finding much information on reactivated EBV.

Thank you!
Lisa

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@texgarden

Thanks so much for your candor. Yes, for a long time this has been an issue. I'm an avid gardener, and that is my primary exercise...15-25k steps over a weekend. In the past two years I have figured out that for every one day (8-12 hours) heavy gardening, it takes three days to recover, sometimes even missing work. I am very, very sensitive to heat, and the longer this goes on, the less time I can do my regular activity without near collapse. The strategy of just "driving to the finish" just doesn't work anymore.

One thing I am starting g to wonder is whether I am referring to the correct "high number" in the EBV tests. Unfortunately, I haven't been able to reach my doctor to clarify. I also have some abnormal liver and kidney numbers from the same draw as my recent EBV.

When you first started this process did you see a rheumatologist?

I am thinking that self-care may start with asking my physician for a referral to a rheumatologist. I've had these symptoms for such a long time, and it was only learning my EBV antibodies are so high (750) that made me start to see that maybe these symptoms have a cause and are not just me whining.

Thank you.
Nela

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I was referred to rheumatologist immediately. He was a smart and conscientious. He, along with
my CFS doctor who happened to be an immunologist, immediately did all the blood tests thought to be essential 30 years ago. The Ebstein Barr test was elevated. At that time they didn't give me the titer. They also did the ANA and assorted other blood tests. Lyme
disease was also tested for as it had just come on the medical scene. A good rheumatolgist is a good bet, I think. You have nothing to lose and lots to gain if he or she comes up with anything.
ME/CFS at the current moment doesn't have a test that's a marker which seems amazing. According to what I've read, they can see brain lesions on very specialized MRI's or PET scans. Most doctors don't order these. Apparently they do in England. However, there doesn't seem to be any treatment being offered in England. All this is very discouraging, I know. Sorry to hear about your gardening as all my gardener friends say the activity does wonders for them psychologically. Perhaps you could break your gardening into small time frames that you could tolerate. I also have friends that garden very early in the morning when it's cooler. Good luck with everything. It is good to communicate with others facing the same challenge. Maybe if everyone keeps talking, the patients will come up with something. Who knows? And don't think of yourself as whiner-----

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@km7227

I had similar results from an EB panel. I had mono a little over a year ago and suspected a reactivation a month ago. The doctor I went to only took the heterophile test so there was no way to know if I tested positive because of antibodies or active infection. I recently asked my primary care physician for an EBV antibody panel because I have a recurrent sore throat, post nasal drip and fatigue and was suspecting ME/CFS. In the results of my EBV panel, the Capsid IgG was 133 and the nuclear IgG was >600. My primary care seems unconcerned and just said it means I had it in the past but don’t have an active or recent infection. Does the super high nuclear IgG mean anything? Does this signify CFS? Can CFS be mild? I do feel fatigue very often and I feel like I hit a wall of tiredness sometimes and I just can’t do anything. I am pretty much able to hold down a full time job but I have to take many days off and my employer has expressed concern about that. I might just be paranoid but I feel like something is off here. Thank you to anyone who reads and replies!

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It seems lots of us have a hard time getting information, especially when numbers don't clearly indicate a diagnosis...just what they say it is NOT. I am still trying to figure out which EBV panel is the "nuclear" IGG and which the "capsid" IGG!! How did you learn the difference? And what IS the difference? Which one is "abnormal"?

I certainly understand how tiresome the continual fatigue is!!

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@texgarden

It seems lots of us have a hard time getting information, especially when numbers don't clearly indicate a diagnosis...just what they say it is NOT. I am still trying to figure out which EBV panel is the "nuclear" IGG and which the "capsid" IGG!! How did you learn the difference? And what IS the difference? Which one is "abnormal"?

I certainly understand how tiresome the continual fatigue is!!

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great question Im interested as well.

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@texgarden

It seems lots of us have a hard time getting information, especially when numbers don't clearly indicate a diagnosis...just what they say it is NOT. I am still trying to figure out which EBV panel is the "nuclear" IGG and which the "capsid" IGG!! How did you learn the difference? And what IS the difference? Which one is "abnormal"?

I certainly understand how tiresome the continual fatigue is!!

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From the research I’ve done, here’s what I believe. Early antigen and viral capsid antigen IgM are present during an active infection. Viral capsid IgG and nuclear antigen stay in your body after infection so elevated levels indicate a past exposure. The only difference I can find between those two are that viral capsid IgG is present during infection, drops, and remains stable and present for life. Nuclear antigen antibodies only appear once the infection has resolved and remain for life. So it is normal to have those antibodies present after mono but I wonder if it is normal to have them be so high! My primary care doctor can’t seem to give me a straight answer or maybe doesn’t understand my question. She keeps telling me that I don’t have mono, which I understand. Does anyone know what kind of specialist I should ask to be referred to?

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@max123jack

great question Im interested as well.

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I answered the question in my response to @texgarden 🙂

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@km7227

From the research I’ve done, here’s what I believe. Early antigen and viral capsid antigen IgM are present during an active infection. Viral capsid IgG and nuclear antigen stay in your body after infection so elevated levels indicate a past exposure. The only difference I can find between those two are that viral capsid IgG is present during infection, drops, and remains stable and present for life. Nuclear antigen antibodies only appear once the infection has resolved and remain for life. So it is normal to have those antibodies present after mono but I wonder if it is normal to have them be so high! My primary care doctor can’t seem to give me a straight answer or maybe doesn’t understand my question. She keeps telling me that I don’t have mono, which I understand. Does anyone know what kind of specialist I should ask to be referred to?

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km, howdy, been reading your posts.
IGM-active infection
VCA IGG present for life and high in 200-600 range-normal. Immune response numbers for if reactivation occurs. Shows healthy high number for future response.
EA IGG Early active-your immune response is kicking in. Active infection.
EBNA IGG-Present for life like VCA. B Cell/memory cell copy of nucleus protien made to kill virus. 95% of ppl have this titer in numbers same as VCA.
5% of ppl do not make EBNA IGG titer. Like myself... further testing needs to be done to see if you are IGG Avidity or ELISA blood test. Will show past infection or acute from what I have read.
My titers are always
neg IGM
neg EA IGG
Pos VCA IGG >600
neg EBNA IGG
Same for 30 yrs... I am always tired... I drive for UPS and always sore..

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@ish My IGG vca is like that too. Small percnt of us get CFS when we got mono. Its just a reality.. my GP told me years ago.. "Matt, your always gonna be tired and always sore like you jjust worked out. Best thing you can do is eat right and exercise." He was right.. if I go on vacation and do not walk a few miles or swim for 30 min a day then within a few days Im tired and asleep and napping. Sore muscles and foggy brain from doing nothing. You have to stay active... keep moving...

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@mattlovesheidi

km, howdy, been reading your posts.
IGM-active infection
VCA IGG present for life and high in 200-600 range-normal. Immune response numbers for if reactivation occurs. Shows healthy high number for future response.
EA IGG Early active-your immune response is kicking in. Active infection.
EBNA IGG-Present for life like VCA. B Cell/memory cell copy of nucleus protien made to kill virus. 95% of ppl have this titer in numbers same as VCA.
5% of ppl do not make EBNA IGG titer. Like myself... further testing needs to be done to see if you are IGG Avidity or ELISA blood test. Will show past infection or acute from what I have read.
My titers are always
neg IGM
neg EA IGG
Pos VCA IGG >600
neg EBNA IGG
Same for 30 yrs... I am always tired... I drive for UPS and always sore..

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So what I gather from your post is that it’s normal for my ENBA and VCA IgG to be that high as long as they both are positive? Is that correct?

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I am having the same problem. What can I do?

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@lisa191

Thank you for your reply! I'm due to visit Rheum next week and will try to research beforehand. I'm very sorry you and your wife have been ill with this condition for so long. I wonder if it is possible for a US citizen to participate in medical research abroad because I'm really very frustrated with my lack of results and that this has dragged on for so long already. It seems as though the majority of doctors I have spoken to act as though this has been happening to me all along and there has been no change of quality of life etc, and it makes me feel basically crazy. So I thank you again for validating my concerns.

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Hi,
I have suffered from Chronic reactivating EBV since age 14..I am 61 now..
Omicron in January ..long haul ever since
I have been to nearly all the specialists except for one..
Infectious Disease/Immunologist
Not referred, just sat down and figured it out on my own after being told my igG was 600
Just 2 more weeks …

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