When & How to Treat Chronic Viruses in Lyme: A Brief Guide.

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How to treat viruses in a Lyme disease treatment image from Marty Ross MD

About Chronic Virus Infections in Lyme Disease

Treating chronic viruses is controversial. See why.

In this article I describe the best virus tests to help determine if treating chronic viruses will help. I also describe when and how to treat chronic active virus infections. When chronic viruses are active, I find the best treatments include herbal antivirals and natural immune boosters.

In chronic Lyme and associated diseases there are a variety of infectious agents that may cause health problems. For some to recover requires treating Lyme, other infections transmitted by a tick like bartonella, babesia, ehrlichia, and anaplasma, parasites, yeast, and chronic viral infections.

Chronic virus infections occur in healthy people too. The trick is to determine if they are causing a problem when they exist in someone with Lyme disease. These germs are kept under control in healthy people and do not usually cause any ongoing health problems. However, in chronic Lyme disease, they can become active due to immune suppression. This can can lead to ongoing fatigue, body pain, and many other Lyme disease symptoms.

If a person is not recovering from Lyme disease after 6 to 9 months of treatment then test for the viruses and treat if testing is positive.

The known viruses that cause chronic illness are: human herpes virus 6 (HHV-6), the mono Epstein Barr virus (EBV), cytomegalovirus (CMV), and Parvovirus B19. Some science indicates enterovirus infections may cause problems too. In addition to these, there likely are other viruses that cause health problems in Lyme like retroviruses.

Marty Ross MD Explains Virus Controversies 


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Testing for Chronic Viruses in Lyme Disease

IGG Antibody Levels

There are two ways to test for chronic active virus infections. One is to measure IGG antibody levels. These are available for HHV-6, EBV, CMV, and parvovirus. IGG antibodies develop and remain in the body after the acute phase of an infection. IGG antibodies are the memory of the immune system, so they will always remain present for the virus infections, even if these germs are not active as the immune system controls them.

There is a theory, with very limited science, that very elevated IGG levels indicate viruses are active leading to help problems. In 2012, Montoya and his colleagues tested this theory in people with chronic fatigue syndrome. They studied people who had large increases in IGG levels for HHV-6 and EBV. People in the study where placed on a prescription antiviral medicine called Valcyte for six months. At the end, some had small improvements in chronic fatigue syndrome symptoms.

So the Montoya study suggest for some people, marked elevations of IGG antibodies indicate an infection is active and not controlled by the immune system. However, IGG antibodies can also be elevated because the immune system is doing a good job of keeping the viruses under control. No one has replicated the Montoya study to know if its findings were accurate.


Others have proposed using nagalase testing as an indication of increased viral activity. This is an enzyme made in the covering of viruses. It deactivates Gc-MAF which is supposed to turn on macrophage white blood cells to fight viruses. In theory, an elevated nagalase is an indirect measurement of increased viral load. Unlike IGGs that just show the immune system is working to control viruses, nagalase could suggest increase viral load. Nagalase testing is available from Health Diagnostics Laboratory.

Clinically, I find benefit in using this test to guide virus treatment decisions. Generally, treating when levels are above 1.2 is helpful. However, there is not any useful science about testing nagalase for chronic viral infections in Lyme disase.

When to Treat Viral Infections in Lyme Disease

At six to nine months of Lyme disease treatment, if there is not adequate progress, I test IGG viral antibodies and nagalase. It is not clear to me yet if nagalase is always elevated in a chronic active virus infection and specifically for each of the known chronic virus infections. However, I test for nagalase because in theory it can detect activity from known and unknown chronic active virus infections.

How to Treat Viruses in Lyme Disease

There is limited science about what works to treat chronic viruses. The approach below comes from my medical practice. I have found it helpful for many of my patients.

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Turn on the Immune System

The best way to treat the chronic active viruses is to follow all of the steps in The Ross Lyme Support Protocol which collectively turn on the immune system. Often the immune system will work more effectively and control the chronic active virus infections when Lyme disease and the co-infections are under control.

However, after treating the Lyme infection (borrelia) and the co-infections for nine months or more without major improvements following all of the steps in Ross Lyme Support Protocol, then treat the chronic virus infections with natural medicines described below because they could be an ongoing source of health problems and immune suppression.

Natural Medicines

Olive leaf extract and monolaurin are antiviral herbs that kill the known and unknown chronic active virus infections. When treating these viruses it is also helpful to turn on the antiviral components of the immune system with reishi mushroomsthymic protein A, or transfer factors targeted against viruses. This treatment option is useful for those with elevated virus IGG antibodies or those with elevated nagalase levels or those who have both. Read the following articles on Treat Lyme for more information: Olive Leaf ExtractThymic Protein A, and Transfer Factors: Turn On The Army.

Mushrooms, like reishi, are shown to turn on TH1 cellular immunity. This means they activate immune cells that fight viruses. Thymic protein A also turns on cellular immunity. Transfer factors are proteins made by the immune system that target it to fight specific infections. A targeted transfer factor mix like the Transfer Factor Plasmyc I mention below, includes transfer factors against specific infections like HHV-6, EBV, and other viruses.

Use either monolaurin, olive leaf extract, or a combination of both to kill the viruses. Olive leaf extract is best and can work alone without the monolaurin, but if it is not tolerated, then switch to monolaurin. Generally a treatment with this approach is 6 months or more. I also suggest starting with Reishi mushrooms and Transfer Factor Plasmyc. If these are not working well enough in 1 to 2 months, then add the Thymic Protein A.

  • Olive Leaf Extract 500 mg 1 pill 3 times a day. Increase up to 3 pills 3 times a day as tolerated. Do not advance the dosing until any die-off-reaction or worsening of symptoms decline.
  • Monolaurin 300 mg 1 pill 3 times a day. Increase up to 3 pills 3 times a day as tolerated. Do not advance the dosing till any die-off-reaction or worsening of symptoms decline.
  • Reishi Gano Mushrooms 400 mg 1 pill 3 times a day.
  • Transfer Factor Plasmyc 1 pill 1 time a day for 7 days, then 1 pill 2 times a day.
  • Thymic Protein A 4 mcg 1 packet under the tongue 2 or 3 times a day. Three times a day is best.

Prescription Medicines

Some of my colleagues use antiviral medications like Valcyte, acyclovir, or Valtrex. I have tried these approaches and do not find them helpful. These antivirals only target a few of the viruses that can cause problems in Lyme. Valcyte is good for the EBV and HHV-6. While acyclovir and valtrex work on herpes viruses alone.

Final Word

Be careful treating the chronic active viruses. Killing viruses can cause a severe Herxheimer die-off like reaction. To manage this at a minimum take Curcumin 500 mg 1 pill 3 times a day and consider liposomal glutathione 500 mg 1 time a day or using nebulized or IV glutathione. For more information from Treat Lyme read Herxheimer Die-off Reaction: Inflammation Run AmokCurcumin, and Glutathione: The Great Fixer.


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  2. Lindequist U, Niedermeyer THJ, Jülich W-D. The Pharmacological Potential of Mushrooms. Evidence-based Complementary and Alternative Medicine. 2005;2(3):285-299. doi:10.1093/ecam/neh107.
  3. Omar SH. Oleuropein in Olive and its Pharmacological Effects. Scientia Pharmaceutica. 2010;78(2):133-154. doi:10.3797/scipharm.0912-18.
  4. Rosenbaum ME, Vojdani A, Susser M, et al. Improved immune activation markers in chronic fatigue and immune dysfunction syndrome (CFIDS) patients treated with thymic protein A. J Nutr Environ Med 2001;11:241–47.
  5. Watt T, Oberfoel S, Balise R , Lunn MR., Kar AK, Merrihew L, Bhangoo MS, Montoya JG. Response to valganciclovir in chronic fatigue syndrome patients with human herpesvirus 6 and Epstein–Barr virus IgG antibody titers. J. Med. Virol., 2012;84:1967-1974. doi:10.1002/jmv.23411
  6. White A. A Guide to Transfer Factors and Immune System Health. 2nd ed. North Charleston, SC: BookSurge; 2011.

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