What’s The Connection Between Lyme & Epstein-Barr?

Why do these two very distinct infections present so similarly, and how are they connected?

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I was at a Lyme conference a few weeks ago. This conference was based on using functional medicine to treat chronic/persistent Lyme disease, and a subject I’ve already given much thought to came up from Dr. Aristo Voldjani, a well respected researcher, scientist, author and head of Immunoscience Labs.

Dr. Voldjani presented a case in which a 63 year old woman was experiencing typical Epstein Barr/Lyme symptoms: extreme fatigue, fibromyalgia, body aches, insomnia, and joint pain. ELISA testing for Lyme showed IgM (current infection) markers for not only Borrelia Burgdorferi (the typical “Lyme” bacteria), but also two other types of Borrelia as well as Babesia, Erlichia, and Bartonella. In fact, there wasn’t a single pathogen on this test that wasn’t marked as a “currently active infection.” Her viral panel showed a current reactivation of four separate viruses as well, including Epstein-Barr, measles, Human Herpes Virus 6, and Herpes Simplex Virus. Dr. Voldjani’s conclusion was that reactivated Epstein-Barr can cause an overreaction to everything, and that this woman likely had reactivated Epstein-Barr as her primary infection, causing false results on these multiple other viruses and bacteria. Basically, her antibodies to the Epstein-Barr virus are the same antibodies to the other Lyme bugs, so they’re showing up on multiple tests as those Lyme bugs… even though they aren’t.

Her Western blot test, the main test for Lyme in conventional medicine, was negative. The conventional Western blot will be negative even in a positive Lyme infection about half the time, but this is another indication this may not be “true” Lyme.

It’s fairly well known that using the ELISA test to detect Lyme is a really awful way to do so because of the many antibody cross-reactions that can happen, and this case is another perfect example of that. So here’s a case of someone with likely reactivated Epstein-Barr causing a false positive on a Lyme test, but what about the other way around?

Not only can an Epstein-Barr infection cause a positive on a Lyme test, Lyme can cause a false positive on an Epstein-Barr test too.

As seen in this research article, an active Lyme infection can cause a positive result on an Epstein-Barr test.

This article presented two cases of Lyme which were initially “misdiagnosed” as mononucleosis, or Epstein-Barr infection. The first case was a 16 year old boy that developed fatigue, muscle pain, and fevers over a 2-3 week period. His Epstein-Barr test showed a positive VCA IgM (indicating current infection) and he was diagnosed with mononucleosis.

A couple of weeks later, the boy developed rashes and facial paralysis. His IgM immunoblot test was positive, indicating a likely Lyme infection. He was put on a 4-week course of doxycycline (the common antibiotic for Lyme) and recovered. His Epstein-Barr test was re-run and it showed no infection.


In the second case, a woman had developed fatigue, muscle pain, fever, rashes, and headaches in less than a week. She was diagnosed with Lyme based on ELISA and immunoblot. Twelve days into her illness she tested positive for mononucleosis/Epstein-Barr based on all four Epstein-Barr antibodies being elevated.

She was put on a 3 week course of doxycycline and recovered. Epstein-Barr antibodies were not retested until 3 years later, but they were negative.

The authors note that antibodies to Epstein-Barr can be non-specific, meaning they can cross-react with other pathogens like Borrelia (the common bacteria that causes Lyme). They have concluded that these two cases were Lyme and not Epstein-Barr because the patients responded well to doxycycline, a drug that treats bacterial infections but not viral infections.

How do we know the three cases presented in this article are actually what the author concludes they are, and not both Lyme and Epstein-Barr, each causing the other to “reactivate” ?

Roughly 95% of the population has the Epstein-Barr virus in their body. So what causes the virus to reactivate? Is it Borrelia, the Lyme bacteria, entering the body… causing immune system overload? Or is Epstein-Barr reactivating because of toxins/mold/parasites, causing immune system overload, and forcing the Borrelia bacteria to “reactivate?”

As we know, the Borrelia bacteria has been around since the days of Otzi the Iceman (5000+ years ago) and likely way before that as well. It’s inconclusive as to whether Otzi had actual “Lyme disease,” even though he did have the Borrelia bacteria in him, as he was very mobile at the time of his death by an arrow.

“Previous investigations of his skeleton and muscles had indicated that the Iceman had been a very active walker and had been constantly on the move.” –

The Epstein-Barr virus and Lyme disease from Borrelia present very similarly. Almost too similarly. They both include extreme fatigue, muscle aches, headaches, brain fog, and often joint pain. They’ve both been linked to multiple different autoimmune diseases including multiple sclerosis and Bell’s palsy/facial paralysis.

Does Epstein-Barr, the virus that’s in 95% of the population, become dormant after the Lyme bacteria is eradicated with antibiotics? Or does the immune system take care of the Lyme bacteria on it’s own after Epstein-Barr is put into dormancy with strong herbal anti-virals?

These questions also lead us to the more complex findings of Lyme “co-infections” like Bartonella, Babesia, mycoplasma, Erlichia, and more that present in a large majority of Lyme disease cases.

One theory is that the immune system is just too overwhelmed to handle any infection. The dormant ones become active and new ones invade by the day.

We may not know the exact right scientific explanation to the Lyme/Epstein-Barr connection for decades. The most important thing is to do the best we can with what information we have, and treat both Epstein-Barr AND the Lyme bacteria (Borrelia) + co-infections if necessary.

Testing is fairly accurate for reactivated Epstein-Barr, but Lyme disease testing can be a bit trickier. This is usually because the Lyme bacteria can hide well anyway, but conventional tests like the Western blot don’t account for ALL the different sub-species of Borrelia. We now know multiple species of Borrelia can cause Lyme. Because of this, my favorite test for Lyme is by Global Lyme Diagnostics. They run a blood test that looks for the outer surface protein that is present in ALL Borrelia bacteria, not just the most common one that the Western blot looks for. More info on this test can be found here. They can also run a co-infection panel for common co-infections.

I’ve found that because chronic/persistent Lyme always has many factors at play and not just the actual Borrelia infection, it works best to look at all of those factors first, up front, including Epstein-Barr. If Epstein-Barr has shown reactivation and we work to get rid of it with herbal anti-virals that I know work well, and nothing is happening after roughly 4 – 6 weeks… then I’ll look more closely at whether Lyme is an issue or not. I’ve found this is the best way to address the multiple other body systems involved in Chronic Fatigue Syndrome first without wasting too much time or money up front.

We may not know the exact connection between Epstein-Barr and Lyme for many years, but at the moment… there are strong and powerful functional medicine solutions to both.

Now I want to hear from you! Have you ever been diagnosed with reactivated Epstein-Barr? What about Lyme? Have you suspected both? Let me know in the comments below!

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