Canker Sores BEGONE!

Canker sores have a wide array of contributors which are often mistaken for causes. But eating lemons is not a surefire path to a canker sore. As we will explore, canker sores are increasingly understood as a T-cell-mediated inflammatory response in the oral mucosa, meaning that your immune system is overreacting to normal stimuli. This shows up strongly in behçet’s disease, celiac disease, and inflammatory bowel disease – but of course, you do not need to have one of these to get a canker sore!

Research also shows links between canker sores and oral streptococcus sanguinis overgrowth, reduced microbial diversity, and fungal involvement – especially in stubborn cases. In most cases, however, improving lymphatic drainage, addressing pH imbalance, and addressing nutritional deficiencies will cause canker sores to rapidly heal. Let us now explore all of this together.

What is a canker sore?

A canker sore is a small ulcer in your mouth. An “ulcer” just being a fancy term for a breakage of your skin. Sores inside your mouth feel different than sores outside your mouth – and you can’t use a bandage to protect them. Canker sores (or “aphthous ulcers”) can also be thought of as “shallow lesions” that develop on the inside of your cheeks, tongues and/or on your gums. Unlike cold sores, canker sores don’t occur on the surface of your lips and they aren’t contagious.

What causes canker sores?

Not everyone gets canker sores from drinking orange juice – because acidic foods are not the root cause. Historically, most research around canker sores focused on creating topical treatments and drugs to cure them – not on what causes them. Now, however, we have some more information on the cascade of events which leads to these painful, pesky oral sores. It is important to note that something can contribute to a canker sore forming without causing irritation at the time.

Canker Sore Causes:

• Immune activation (from gluten, dairy, cacao, benzoates, nuts, and/or sulfites).
• Injury within the mouth, such as biting one’s cheek or tongue (although this will often heal very quickly unless one or more of the other items on this list are at play!).
• Sodium Lauryl Sulfate, a common toothpaste ingredient, has been shown in studies to thin the mucosal barrier and increase ulcer frequency and severity. 
• L-lysine deficiency.
• L-glutamine deficiency. 
• Vitamin deficiencies, particularly B₁₂ (cobalamin) and B₉ (folate/folic acid), and zinc.
• Sensitivity or allergy to cinnamaldehyde which is found in cinnamon and cinnamon essential oil. 
• Emotional trauma related to verbalizing, speaking, being creative, or being authentic.

Canker Sores Irritators:

• Excessive consumption of acidic or spicy foods such as vinegar, hot peppers, ascorbic acid (synthetic vitamin C), and citrus.
• Excessive consumption of foods with enzymes that break down the lining of the mouth, namely kiwis and pineapples.
• Consumption of refined sugars, particularly in large quantities or when combined with acidic foods.
• Overload of stagnant lymph fluid stored in your cheeks and gums – often caused by toxic diet combined with a sedentary lifestyle.
• Dehydration from any combination of breathing dry air, not drinking enough water, and/or eating dehydrating foods such as nuts, cheese, certain fried foods (French fries, etc), meats, and excessively salty food (especially pure sodium-chloride).
• Stress and the hormonal imbalances that accompany stress.
• Low progesterone and high prostaglandins – as is often the case right before menstruation. 
• Oral pH imbalance caused through diet or stress.
• Autoimmune disorders.

Canker sores generally don’t require treatment – they’ll heal on their own . . . eventually. Meanwhile, they’re painful. But more than that, they indicate something isn’t right. If your body is mysteriously breaking out in open lesions, something is out of balance! 

While you have a canker sore you want to abstain from exacerbating foods such as oranges to some extent, and certainly from pineapples, but know that these are likely not the root cause unless they are specifically an inflammatory trigger for you. If you have mast cell activation syndrome (MCAS), then certain foods high in histamine can trigger a wide variety of inflammatory symptoms – including canker sores.  

Preventing Canker sores

If you are reading this page, you are probably unsure why you get canker sores. Any symptom (from running nose to aching feet) can come from myriad sources, and canker sores are no exception. For this reason, you will likely want to employ many of the strategies on this page. Some of them may only work when synergistically combined with others.

Furthermore, emotional patterns create physical patterns. As most recently summarized in the masterpiece book, The Myth of Normal, our physical diseases manifest from our unresolved negative experiences. While this idea still feels radical to many people today, it is increasingly scientifically verified. However, this does not mean that going to talk therapy is going to heal your canker sores. What it does mean is that addressing a symptom in one way often leads to another symptom arising in a similar way, or even the same symptom returning even though you continue to use solutions which did work for years. 

With my clients, I have found that approaching a symptom from multiple angles actually begins to address unmet emotional needs. We can speculate as to why this is, but one simple explanation is that using a wide array of healing, nourishing modalities in your life is self-loving.

If you would like to be more proactive about healing emotionally and connecting with your subconscious, consider looking into the wide array of consciousness alchemy practices. 

Hydration 

Stay hydrated! And not just in your mouth. Signs of dehydration include: dry skin, constipation, canker sores (heh), fatigue, irritated eyes, bleeding sinuses, and headaches.

Drink at least a quart of water every twelve hours. Tea and coffee are not hydrating. Be sure you are actually drinking water.

If your lips, mouth, hands, or eyes are getting dry overnight, use a humidifier.

Address Constipation 

If you struggle with recurring constipation, I urge to you find solutions that work and incorporate them into your daily lifestyle. If you don’t poop on a single day, that’s constipation. A tremendous amount of conditions go back to bowel dysfunction – because if you are unable to eliminate toxins and absorb nutrients effectively, there will be spillover affects in every organ of your body.

Chronic constipation is more common than you likely realize. Daily poops are not actually proof that you are not constipated, as material can still be stuck in your colon and upper intestines whilst still allowing some material to pass through. Furthermore, diarrhea can be thought of as a subset of constipation, as this also generally involves some material being stuck while a watery slurry passes on through. This is common with small intestinal bacterial overgrowth (SIBO), and hypermobility disorders such as Ehler's Danlos (EDS), and hypermobility spectrum disorder (HSD) – the latter of which being a condition which has caused me constipation struggles since birth.

Improving colon transit is very individual. I have devised numerous different protocols over the years for a wide variety of clients. In some cases, increasing soluble fiber is enough: hydrated chia and flaxseeds. Lettuce and leafy greens in general tend to help as these are not only rich in fiber and water, but also alkaline minerals. Taking magnesium citrate daily can be used as a colon stimulant. For years, I took magnesium citrate in kombucha or sparkling water and called it my daily “mag-fizz”.

If increasing magnesium is insufficient and/or fiber is not practical due to your particular digestive complaints, there we turn to high vitamin-C foods like bell peppers, kiwis, or vitamin C supplementation (from whole foods). Fruit, in general, helps many people stay regular: blueberries, bananas, and apples. If these do not work or are not optimal for your body, then Ayruvedic herbs can be utilized. 

Remember that this is all very individual. In my case, bananas do help me poop, but they are a canker sore trigger for me (likely due to causing an immune response)! Depending on which flora are imbalanced in your gut, prebiotic foods may be triggers in general. Side effects from bananas may be bloating or skin irritation. Plantains can be a powerful motility regulator, but for some people, these prebiotic foods can lead to inflammatory joint pain. Prunes (dried plums) are a common remedy for constipation, but these are very sweet and they can cause gas. If a food is giving you gas which is painful, especially foul-smelling, and especially abundant, then that food is making things worse rather than better and should be either omitted or reduced.

In addition to food, it is also worth looking at the emotional causes perpetuating any health condition. You can learn more about the emotional causes of constipation in this article.

Maintaining Oral pH Balance 

Since a thorough solution means keeping the pH balance in your mouth at a healthy 7 to 7.2, you’ll want to pay special attention to keeping your stress levels down. It’s been scientifically proven that negative moods lower the pH of the saliva. If your saliva’s pH gets below 5.5 you begin to lose minerals from your teeth, and this has also been associated with the generation of canker sores.

You can compensate for this by rinsing your mouth with an easy solution of water and baking soda. Just drop a pinch of baking soda in quarter-pint of water and then swish the solution in your mouth. If you do this every time you feel stressed and after meals, you’ve solved the pH problem in your mouth. Unfortunately, this doesn’t compensate for all the other devastating impacts of eating a demineralizing and demoralizing diet. While a rinse with baking soda is a great measure against acute problems (like removing bile from your mouth after vomiting), it isn’t something you should have to rely on multiple times each day. Also, if acidic saliva or tooth decay is a concern for you, you may be interested in: Raederle’s Teeth Remineralizing Master Class. 

Maintain Levels of B₁₂

Take a sub-lingual B₁₂ once per week. (I used to be opposed to supplements, but I changed my mind over time. To understand why read this other article of mine.)

Consume L-Glutamine

Consume foods rich in l-glutamine at least once every other day, such as red cabbage, spirulina, asparagus, and parsley.

Consume L-Lysine 

Consume foods rich in l-lysine at least once every other day, such as spirulina, parsley, spinach, leeks, horseradish, onions, and radishes. I found that I was not able to get enough lysine through food alone and began supplementing with it daily in 2022. This has resulted in myriad benefits, including being able to eat cinnamon in moderation without a canker sore immediately forming.

If you want a whole food source, I recommend ordering organic spirulina tablets right away; these are a fantastic source of l-lysine and other amino acids which help you rapidly repair your skin – including internal skin on the inside of your mouth, your stomach lining, and your intestinal lining. When I was introduced to spirulina tablets it felt like a miracle. I had tried incorporating spirulina powder into my diet, but the strong flavor only paired well in limited contexts and thus, I didn’t consume it regularly. Having the tablets on hand made it easy to take them daily and to up my intake if a canker sore started to develop.

Prior to 2018 (when I was introduced to spirulina tablets), I had tried “everything.” I had tried increasing my vegetable intake. I tried taking out all the fruits that were “causing” me canker sores (oranges, tomatoes, kiwis, pineapples, raspberries, etc). I tried eliminating everything tart and sweet and yet I would still would get canker sores whenever I was even a little stressed or a little dehydrated. In other words, any time I traveled or had a busy day! Ugh.

In 2018 I learned that spirulina is a concentrated source of l-glutamine, the most critical amino acid for repairing ulcers in the mouth and stomach. Cabbage is also a high source which is one of the reasons that raw, fresh cabbage juice on an empty stomach is a long-standing cure for stomach ulcers. Spirulina, however, is also a good source of a wide variety of trace minerals and co-factors for l-glutamine, and much easier to keep “on hand” than cabbage. In the past I’ve sneaked spirulina powder into desserts since it seemed to clash flavors with everything savory. I found I could sneak it into raw banana ice cream and similar recipes. However, daily consumption never stuck because I couldn’t find a way to consume the powder in enough recipes. Then, I discovered organic spirulina tablets. For years I was able to keep the continual recurring canker sores at bay with just four spirulina tablets a day. Spirulina gives me more energy and improves my digestion to.

Spirulina may not be all it takes for you to get rid of a chronic canker sore problem, so I suggest employing other strategies as well, like taking any refined sweeteners out of your diet. Refined sugar products (cane sugar, brown sugar, molasses, etc) rob your body of minerals, hurt your pancreas, imbalance your hormones, and ultimately cause you to age far more rapidly. When you can use fresh or dried fruits to sweeten foods just as well, there really is no excuse for including refined sugars in your diet. They’re an addiction, and science has proven them to be more addictive than heroin! 

Avoid Chewing on Yourself 

Break any habits of chewing on your lips or cheeks. Use self-hypnosis if you have this habit. Repeat this to yourself several times each day: “My teeth, jaw and tongue are relaxed in every mood and situation.”

Eat Consciously & Compensate Accordingly

Whenever you eat cinnamon, spicy foods, citrus, pineapple or kiwi, immediately stop eating if you notice any discomfort in your mouth. Stay alert for discomfort. Eating consciously can help with a wide array of human health complaints. Follow-up with water and a baking-soda rinse if discomfort occurs. Also, take extra spirulina tablets, lysine capsules, glutamine, and magnesium accordingly – as getting the nutritional support before you have an established sore is much more effective than taking it after it is already established.

Read Labels

You may already be aware that you are sensitive to cinnamon or cayenne. But have you read all the labels of your tea blends, your toothpaste, and your supplements? Many clients discover that they have foods or herbs which they are sensitive to in multiple areas of their diet. Individuals have differing levels of sensitivity to cinnamaldehyde, so assess if cinnamon is a factor for you through observing any changes you experience when entirely avoiding it versus consuming it regularly. But in order to test this, you really must check all your supplements and oral products. It may be hiding in your mouthwash, your nutritional gummies, your protein powder. If reading labels is exhausting and annoying, then try reading just one label per day. 

Lymphatic Massage

Perform lymphatic self-massage on your face. You can use ecosia to look up videos on this. 

Lymphatic massage is something that came naturally to me as a child, long before I knew what it was called or what it was for. As someone with a hyperactive trigeminal (face) nerve since birth, I have always found facial massage highly beneficial. It helps reduce the frequency and severity of migraines, pimples, canker sores, sore throats, sinus infections, and ear infections. With the exception of migraines, these things all have one thing in common: stagnant lymph fluid in the face and throat. (The migraine bit has to do with the trigeminal nerve which spans your entire face. Thus, when you massage your face, you are doing lymph work and trigeminal nerve work at the same time.)

Reduce Stress

Reduce stress through regular exercise, taking breaks from computer work, deep breathing, reading relaxing fiction, meditation, journaling, and conversing with friends who uplift you. Everyone says we should reduce stress, but few people say how, so that is why I have chosen to open this section with specific suggestions. In particular, I have found it helpful to set an alarm for every half an hour while I am at my desk. When that alarm goes off, there is no particular agenda besides taking my eyes off the screen, checking in with my body, and addressing my bodily needs. This usually includes palming my eyes (trigeminal relaxation), using the bathroom, stretching my shoulders, and sometimes a brief visit to my yoga mat. If I have a cankersore at the time, this alarm can also serve as a reminder to drink water, to swish with baking-soda water, to spray the sore with silver, or to use CankerCare on the sore.

Consume Zinc

Consume foods rich in zinc at least every other day. Foods rich in zinc which are not dehydrating include alfalfa sprouts (be sure they’re organic), basil, broccoli raab, parsley, asparagus, cardamom, spinach, thyme, cilantro, dill, cauliflower, chard, arugula, sage, lettuce, peeled cucumber with seeds removed, and blackberries. 

Other foods rich in zinc – which may be dehydrating but still have good, noninflammatory properties and good mineral balance – include oysters, shrimp, hemp seeds, sesame seed (tahini), eggs (pasture-raised only!), and liver (from grass-fed cows or pasture-raised chickens). 

Foods rich in zinc which are only appropriate in moderate due to other issues with these foods include poppy seeds, pumpkin seeds, and pine nuts.

Bell peppers and goji berries are also relatively rich in zinc and vitamin C besides, but these are nightshades which can be a strong irritant and immune stimulant for some, so eat these with some caution if canker sores are a recurring issue for you. Most humans are at least a tiny bit sensitive to eating large amounts of nightshades (peppers, potatoes, eggplant, etc), especially if they are raw.

Peas, zucchini and lentil sprouts are also rich in zinc, but some clients seem to be reactive to their lectin content. All people are sensitive to lectins to some degree, which is why raw kidney beans are toxic to humans. Gluten is also a lectin, by the by. As always, dietary needs are very individual.

If you’re intolerant of gluten, have stomach ulcers, irritable bowel syndrome, acid reflux, arthritic pain, or chronic lethargy, then you may be interested in my article on eating a low-lectin diet: My First Three Weeks on the Plant Paradox Program.

If you’re looking to figure out what foods are rich in what substances in a reliable, easy way, I created my own mega-reference for my own personal use (because no tool out there met my exacting needs and impatience for learning accurately how foods compared to one another). The charts I created turned out to be so useful that I turned them into a book, The Ultimate Nutrition Reference. If you’re ready to understand foods as you never have before, get yourself a copy right now.

If you are looking to buy zinc as a supplement specifically for canker sore prevention, look for zinc carnosine, which is zinc bound to L-carnosine (a dipeptide involved in tissue repair). While regular zinc supports immune function broadly, zinc carnosine adheres to damaged tissue and releases zinc slowly at the site. Thus, it is specifically used in healing ulcers (both of the mouth and stomach).

Oral Probiotics

As I have mentioned elsewhere, I have found the fermented coconut water product known as Inner Eco to be very effective for many oral complaints, including reducing the occurrence of canker sores. You can also specifically look for chewables or lozenges which contain streptococcus salivarius K12 and/or lactobacillus reuteri. These are meant to colonize your mouth and throat, compete with harmful microbes, and modulate immune signaling locally.

Treating Canker Sores

Many common tips are actually really bad. Don’t suck on popsicles to numb them. Do not add sugar to a problem that is clearly exacerbated by sugar because it “feels good” in the short run. That is akin to the bad advice my mother received as a child from her doctor – ice-cream for a sore throat! Also, don’t use alum. Alum is a remedy that was going around in my childhood, but this sketchy product includes trace amounts of aluminum which is not a beneficial trace mineral. Okay, okay, enough about the bad ideas, and let us progress to good ones!

Water Floss 

For immediate treatment, I’ve found that a water flosser one of the most powerful interventions. I originally purchased my water flosser when I had a case of pericoronitis due to the gum flap that was still hanging out over my wisdom tooth. The water flosser is an amazing device; the horrible pain I had been experiencing was reduced even on the first use, and continued to diminish with each use and was entirely gone within a few days. I’ve found the water flosser to be similarly useful for canker sores.

A water flosser can mechanically break up the biofilms that bacteria have made to protect themselves, making this technique a powerful combination with any other topical treatment. It will also clean out other debris in the sore and help restore hydration to an area of your mouth which may be chronically dry.

To use a water flosser on a sore: set your flosser to the lowest setting, aim the stream of water at the sore. Slowing increase the setting so that the pain is where you can barely tolerate it. At first, this is usually speed three or four for me (out of ten). Hold the stream of water on the sore for a minimum of ten seconds. Repeat this several times a day. While this will hurt at first, relief is usually very rapid after the fact.

If you do not have a water flosser and do not wish to buy one, you can also use the stream of water in your shower. Of course, spit out the water afterward – in either case.

Silver 

In 2020 I discovered silver spray, which can be used to spray the canker sore to decrease bacterial imbalances in the area and in your mouth in general. This is something easy, odorless, and (nearly) flavorless which you can use during a long car ride or while on an airplane.  

Deglycyrrhizinated Licorice (DGL)

Ddeglycyrrhizinated licorice is, well, licorice – with the glycyrrhizin removed so it doesn’t raise your blood pressure. Taking this in capsule form may help some, but contact with your mouth will be most effective for rapid treatment. It will increase mucus production, promote skin repair, and have mild anti-inflammatory effects. I primarily recommend this to clients with stomach complaints, but it can be quite useful for the oral cavity as well. For oral treatment, get chewable tablets. For stomach upset, get capsules. You can open the capsules if you happen to already have some, but the flavor is earthy bitterness with tree root notes.

Melatonin

We think of melatonin as a sleep hormone, but like all hormones (including neurotransmitters), it does a vast multitude of things. Melatonin serves as a mitochondrial repair molecule throughout your body. A generally safe range is 0.3 milligrams to 3 milligrams. While more is sometimes used in studies, higher amounts can backfire – especially in sensitive systems. Melatonin helps by reducing oxidative stress, modulating immune response, and by supporting tissue regeneration.

In addition to taking melatonin capsules for systemic benefit, you can also get it as an oral gel which is applied directly to the sore. This can promote faster healing while also reducing pain.

Bromelain

While eating 🍍 pineapples – a potent source of bromelain – is not advised when you have a canker sore, the bromelain itself may be quite helpful. Bromelain as an isolated enzyme reduces swelling and helps break down inflammatory proteins.

Vegetable Juice

Drink vegetable smoothies/juices that don’t contain anything acidic or overly sweet. This especially helps if you include cilantro, cabbage, parsley, kale, and/or spinach.

Water Swish

Sip water throughout the day and swish your mouth with every sip.

Baking Soda Solution 

Rinse your mouth with baking soda solution and/or hydrogen peroxide and/or aloe juice.

Salt Water 

Gargle with warm salt water. This is also great for sinus infections, sore throats, and ear infections.

Toothpaste

Brush your teeth with a mixture that does not include sodium lauryl sulfate. One of my favorites is Uncle Harry’s Toothpaste which has great flavor, texture, and results. Uncle Harry’s Toothpaste also has the benefit of being cinnamon-free. Another favorite of mine is The Dirt Toothpaste, particularly their cacao mint flavor. I have also sought options which are plastic-free and mint-free, and found the fabulous Dr Tungs Herbal Toothpowder Tabs.

Avoid Burns

Avoid burning your mouth with hot foods and hot drinks. However, warm green tea is usually helpful. You can refrigerate the tea bag after making and drinking the tea and then put the tea bag in your mouth on the sore for a minute at a time for even deeper relief.

Celery

Chew celery (gently). This tends to numb the sore while providing electrolyte balance to the mouth.
Brush your teeth consciously and don’t hit the sore. While using a water flosser directly on the sore is helpful, but brushing it is usually too abrasive. On the same note, avoid excessive abrasion from textured food (absolutely no chips or crackers).

Essential Oils (with Caution)

Apply a numbing, disinfecting substance or essential oil to the sore. Some great choices are silver, clove essential oil, or use an amazing blend like Quantum Health’s Canker Care. I personally use this product (since I discovered it in 2020) and wish it had been in my life earlier. It has ingredients that soothe and numb the sore, but also ingredients that help address common root causes of canker sores. Check out these ingredients: Aloe, Calendula, Myrrha, B₁₂, Dipotassium Glyrrhizinate (DGL, Licorice), Echinacea, Clove, Goldenseal, Lysine, Tea tree, Cajuputi, Peppermint, Propolis, and Zinc!

 

If you’re interested in learning more about healthy oral hygiene, read my extensive article called Cure Pericoronitis & Periodontitis Naturally. This article goes into a variety of unusual oral hygiene practices not mentioned in most readily available sources.

Wishing you healthy gums, tongue, cheeks, and psyche,

Raederle

The Consciousness Alchemist

Note: I originally drafted this article in January 2017. It was updated a lot in 2018, a little in 2020, and just went through an overhaul on May 5th 2026.

The Link Between Epstein-Barr and Chronic Constipation

 

Viral Factors

I’ve written, at length, about chronic constipation before. In recent years the viral component has been brought to my attention. Furthermore, the big picture of how these viral components impact your microbiome is starting to take shape. On this page I’ve compiled a sketch of what we know about these interlocking conditions and a long (although not exhaustive) list of what you can do about it.

Epstein-Barr and Chronic Constipation

Epstein-Barr virus (EBV) and Cytomegalovirus (CMV) are members of the herpesvirus family which is known to cause a range of illnesses, including infectious mononucleosis and certain cancers, as well as having potential links to autoimmune conditions.

Herpesvirus family viruses also affect your microbiome. While the exact microbial species affected by these viruses are still being studied, there is emerging evidence that these viruses can alter the gut microbiota by promoting certain species and suppressing others. The shifting of this microbial balance can influence a range of health outcomes, from gastrointestinal function to immune system regulation, and even mental health.

First, let’s look at how Epstein-Barr can lead to chronic constipation.

Vagal Nerve Tone

The autonomic nervous system (ANS) plays a critical role in regulating gut motility. 

EBV has been shown to have a potential neurotropic nature, meaning it can affect nerves. The vagus nerve, which is crucial for parasympathetic regulation of the gut, can be affected by viral infection. This can lead to a reduction in vagal tone, which may result in slowed gastric emptying and impaired motility in the intestines. This would manifest as constipation, as a reduction in parasympathetic activity typically leads to a decrease in gut peristalsis.

In plain English, Epstein-Barr and Cytomegalovirus can both negatively impact your body’s ability to manage stress, and stress contributes to constipation.

Immune Dysregulation

Epstein-Barr infection can lead to persistent immune activation, even after the initial infection resolves. Epstein-Barr can dysregulate the production of certain cytokines (such as TNF-α, IL-6, and IL-1β). These inflammatory mediators can alter the normal functioning of the smooth muscle and nerves in the intestines. Elevated levels of pro-inflammatory cytokines can lead to impaired motility, contributing to constipation.

Microbiome & Serotonin

Epstein-Barr and other herpesviruses can disrupt the microbiome balance. This can affect the fermentation of dietary fiber, the production of short-chain fatty acids, and the synthesis of neurotransmitters (like serotonin) – all of which influence gut motility.

Localized Infection

While Epstein-Barr primarily infects B lymphocytes and epithelial cells, the virus may also affect epithelial cells in the gastrointestinal tract. Viral replication within the gut lining could lead to localized inflammation, which in turn could impair motility and contribute to constipation.

Visceral Hypersensitivity

In some cases, chronic viral infections can lead to increased sensitivity of the gut to normal stimuli (known as visceral hypersensitivity). This can lead to altered motility patterns, including slow transit time.

Fatigue

Regular physical movement is important for normal bowel function, but chronic Epstein-Barr infection is associated with malaise. This fatigue leads to reduced physical activity, which contributes to constipation.

Overall Health Consequences

Epstein-Barr’s and Cytomegalovirus’s impact on your microbiome doesn’t just lead to constipation, of course.

Reduction in Beneficial Bacteria

Chronic Epstein-Barr and Cytomegalovirus infections commonly include a reduction in beneficial bacteria like Bifidobacterium and Lactobacillus, which are known to play a crucial role in gut health, immune modulation, and digestion. These bacteria help maintain gut barrier integrity, produce short-chain fatty acids (SCFAs), and modulate immune responses.

Increase in potentially Harmful Bacteria

Epstein-Barr infection is associated with an increase in potentially pathogenic or opportunistic bacteria including Firmicutes, Proteobacteria, and Bacteroidetes. Some of these bacteria are linked to gut dysbiosis, inflammation, and autoimmune diseases.

Cytomegalovirus infection may encourage the proliferation of Proteobacteria, Enterobacteriaceae, and Clostridium species, which have been linked to chronic inflammation and dysbiosis. 

Epstein-Barr may cause an increase of pathogenic bacteria by affecting your gut’s immune system and thereby its immune signaling. This can encourage microbes which thrive in inflamed, low-oxygen conditions (like Candida) to proliferate. Furthermore, the inflammation can promote the growth of pathobionts (microbes that are normally benign but can become pathogenic in the presence of an inflamed environment) and impair your gut's ability to maintain homeostasis.

The impaired immune signaling can, in turn, make you more susceptible to infections, autoimmune diseases (such as rheumatoid arthritis, lupus, and multiple sclerosis), gut permeability (“leaky gut”), or inflammatory conditions.

Healthy gut microbiome is crucial for mental health, as it communicates with your brain via the gut-brain axis. Dysbiosis can contribute to mental health issues like anxiety, depression, and cognitive dysfunction.

Treatments for Epstein-Barr and Cytomegalovirus 

Treating latent or chronic conditions, such as Epstein-Barr virus and/or Cytomegalovirus, seems to always require a multifaceted approach. Chronic conditions exist at many levels of our bodies – including in our psyche – and thus are most effectively tackled when we address many levels at once. Chronic conditions usually have self-reinforcing factors (as an “emergent system”) which make them hard to uproot, which unfortunately makes them risky to address because “slow and gentle” shifts are often insufficient.

Chronic conditions are also generally “not just one thing.” There is likely a mixture of viral, genetic, traumatic, and environmental factors working together to create your specific array of symptoms. All of that said, he’s some ideas for a multi-pronged approach.

Vitamin C

The antioxidant, Vitamin C. Ideally, look for food sources such as acerola cherry, kiwi, brightly colored (ripe) bell peppers, and citrus fruits. (Although, watch out if you have histamine sensitivities, as some fruits are either high in histamine, like strawberries, and others, like citrus, are histamine releasers. I personally do fine with citrus but have a huge boost in inflammation from strawberries!)

Food sources are critical because Vitamin C has an enzymatic component which is not present in “ascorbic acid” – which is just the wrapper that protects that enzyme. While ascorbic acid has some benefits, it is absolutely not synonymous with vitamin C!

That said, vitamin C is known for its immune-boosting properties: it supports immune cell function and helps reduce inflammation. It may also aid in fighting viral infections and improve general health.

Vitamin D

Studies suggest that Vitamin D may help modulate immune responses and potentially reduce viral replication. Some individuals report massive benefits from taking megadoses of vitamin D over long periods of time. This may or may not be safe for you, but I’ve personally taken as much as 50,000 IU (international units) of vitamin D daily for over a year without any noticeable negative side effects. I’ve seen many anecdotes of people who didn’t see benefits until they were taking 80,000 IU a day. This seems absurd, and yet, for some people, it makes a night-and-day difference for chronic problems such as insomnia and joint pain.

As I explain in my book, Raederle’s Teeth Remineralizing Masterclass, it’s also essential that vitamin D intake is balanced with vitamin A and other nutrients. Thus, as always, be cautious about buying any singular supplement and upping any nutrient in isolation. Ideally, seek food sources (such as fish oil) which contain vitamins D, A, E, and other co-factors.

Zinc

Zinc plays a key role in immune function and has been shown to support antiviral activity. It can also help reduce inflammation. And, as a bonus, if you’re increasing your C, D, and Zinc – along with vitamin K2 – you’ll be doing your bones and teeth a favor as well.

Echinacea

This herb is often used to support the immune system and has been traditionally used to combat viral infections. It may stimulate the production of white blood cells and improve the body’s antiviral response.

Elderberry

I personally find elderberry so beneficial that it became a part of my daily life in my early thirties. Known for its antiviral properties, elderberry can help boost the immune system and may reduce the severity and duration of viral infections, including Epstein-Barr. For myself, I find elderberries help with my motility, and weirdly, my nervous system regulation.

While elderberries are generally thought to be beneficial due to their extremely high quercetin content, many people find that isolated quercetin extracts don’t provide the same benefits.

Astragalus

While I have not personally tried it, this herb is known for its immune-boosting and adaptogenic properties. Studies in the States and China demonstrate that it helps regulate immune responses and reduce viral replication.

Turmeric

Curcumin is a potent anti-inflammatory compound found in turmeric. It may help reduce chronic inflammation associated with viral infections and promote overall immune health. If you’re sensitive to raw turmeric (as I am), try cooked turmeric or a turmeric extract. If you’re sensitive to histamines, you may need to avoid powdered spices, and in these cases I recommend buying fresh turmeric root, peeling it, and frying slices in a fat that you’re not reactive to. (For me, the safest fats are organic avocado oil and organic lard.)

Garlic

As you’ve undoubtedly heard a thousand times, garlic has antimicrobial and immune-boosting properties and may help support your body’s defense against viruses. It can also reduce inflammation and help balance your immune system.

However, if you’re sensitive to FODMAPs or have an overgrowth of Desulfovibrio or Bilophila wadsworthia then garlic may cause you extreme distress. In the case of an overgrowth, consuming certain prebiotic foods (such as garlic, onions, eggs, and cruciferous vegetables) will result in hydrogen sulfide gas, which is toxic in high amounts.  Symptoms include gas which smells like rotten eggs, shooting pains, brain fog, bloating, and gas pains.

Slippery Elm & Marshmallow Root

These herbs have soothing properties for the gastrointestinal tract and may help reduce gut inflammation while supporting mucosal healing. However, like garlic, if you’re sensitive to prebiotics, these may be a poor choice for you.

Prebiotics?

Everyone will tell you that prebiotics are good for you. Prebiotics, found in foods like onions, garlic, leeks, asparagus, and artichokes, feed beneficial gut bacteria and help maintain a healthy microbiome. However, they also feed detrimental gut bacteria. If you have gut dysbiosis, the chances are good that the last thing you need is more prebiotics. In my case, eliminating prebiotic food from my diet was the difference between crippling inflammation that left me unable to walk and being able to run and play without any pain at all. So please choose wisely what makes sense for your personal gut condition!

Fermented Foods & Probiotics

Fermented foods like kimchi, sauerkraut, kefir, and yogurt are rich in probiotics that support gut health – mostly through genetic material being absorbed in your gut. Your stomach acid kills the live microbes presented in probiotic tablets and foods, but the genes from those microbes actually still benefit your gut! Once again, your gut is a major part of your immune function, so maintaining a healthy gut microbiome is essential for managing chronic infections.

But once again, if you have issues digesting FODMAPS or an overgrowth of Desulfovibrio or Bilophila wadsworthia then many fermented foods will be off the table, especially any cabbage-based foods. Also, if you suffer from chronic constipation, note that yogurt will probably make it worse. Instead, opt for kefir – preferably goat kefir, as there are many elements of cow-based dairy which can worsen inflammatory conditions.

Long-Chain Fatty Acids

Foods rich in long-chain fatty acids (the beneficial thing which omega-3s can be converted into) can dramatically reduce inflammation and support immune health. In fact, my practitioner told me that I needed to stop consuming fish oil prior to testing because it was so anti-inflammatory it could suppress the inflammation markers they needed to test me for!

The primary source of long-chain fatty acids is fish, and fish oil. You can get the precursor (omega-3) from flax oil and chia seeds. However, back in my days working as the chief editor for The Vegetarian Health Institute, one of the things we stressed a lot for our non-fish-eating students was how low conversion from omega-3 to long-chain fatty acids really is. Wrose, omega-6 competes for the same enzyme as omega-3, and thus, overconsumption of omega-6 rich seeds (like walnuts and pumpkin seeds) can make matters far worse (even if those foods also contain some omega-3).

Hence, I often tell my vegan and vegetarian clients to make an exception for fish oil. If you’re unwilling to do this, then seek a supplement with seaweed-based long-chain fatty acids – eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Mushrooms

Reishi, shiitake, and maitake contain compounds that boost immune function and have antiviral properties. These can be added to soups, stir-fries, or smoothies.

L-Glutamine / Meat Broth

This amino acid helps support the gut lining and may improve intestinal permeability (leaky gut), which is often exacerbated by chronic inflammation. As always, seeking food sources is an ideal way to start. 

Cook a meat broth which includes skin, ligaments, and organs for an optimal source, and consume both broth and meat. If you’re at all sensitive to bone broth (as often happens for those with histamine sensitivities), then remove the bones after the meat is cooked and be careful to avoid over-cooking.

Meat broth contains collagen and amino acids like glycine and proline, which help repair the gut lining and reduce inflammation. But please be sure to note this is not the same as bone broth! While bone broth is fine for healthy individuals, when you’re seeking to repair your gut lining, it is critical that your broth is based on meats including the organs (skin, ligaments, etc).

If you’re seeking a vegan solution, then seek dark leafy greens. If cabbage is an option for you, it’s an ideal source. If not, turn to a wide variety of leafy greens. I personally feel my best when consuming lettuce every day: while lettuce is not a dark leafy green, it contains many of the same properties with less irritants. If your system is very sensitive to most vegetables, see how you do with romaine and iceberg lettuce.

Stress Management

Chronic stress can exacerbate viral reactivation and immune dysfunction, so managing stress is important for improving overall health. Regular mindfulness practices and meditation can help reduce stress and inflammation. Yoga and breathing exercises can help activate the parasympathetic nervous system, promoting relaxation and reducing inflammation. A guided meditation on progressive muscle relaxation can be beneficial for overall well-being (as well as short-term tension release, as the name suggests).

Any technique which helps you get out of the fight-or-flight mode is beneficial. This may mean turning your cell phone off while you take a few hours to pamper yourself in a long bath and drip-dry in front of a heat-lamp with a good book.

Be wary of the modern habit of a chronically interrupted life. If you’re constantly being bombarded by buzzing and beeping notifications and alarms, how can you possibly relax?

Once upon a time I thought refined sweeteners were the most toxic thing a person could do to themselves (as these are scientifically shown to be more addictive than heroin – yet we feed them to babies) . . . But over time and a tremendous amount of research about physiological health, it’s become abundantly clear that the most toxic thing in our lives is stress.

Take time to relax. Your life absolutely depends on it.

Adequate Sleep

Chronic viral infections can impair sleep, leading to increased fatigue and immune dysfunction. Prioritize sleep to allow the body to repair and restore itself. Aim to develop a consistent sleep schedule and avoid blue light exposure before bed. In my case, I find it helpful to get off my computer by eight o’clock in the evening and turn my phone entirely off for the night before ten (aiming to use it only minimally between eight and ten).

Physical Activity

Moderate physical activity can help support immune function and improve energy levels. Light exercise, such as walking, swimming, or cycling, can help boost energy, improve mood, and enhance immune function. Start with extremely low-impact activities and gradually increase duration and intensity as tolerated.

Your tolerance level may be far lower than expected. If you suffer from chronic inflammation, it is really important to overrule your physical therapist, physical trainer, or whomever is telling you to push until it hurts. The concept of “no pain, no gain” absolutely must be thrown out the window in cases of chronic inflammation. You can’t afford to send your body into further inflammatory overdrive, which is exactly what will happen whenever you over-exercise your body.

To moderate how inflamed you get while exercising, avoid overheating or causing any part of your body to burn fiercely. If you need to, take a cold (or cool) shower to bring down your temperature after exercise. Also, try taking anti-inflammatory foods around times of exercise, such as fish oil. Furthermore, when trying a new exercise, give yourself more rest than other people. If “everyone else” needs one day of rest, you may need three.

In several cases I’ve been involved with, the solution has been gentle, daily activity. It can be tempting to just lay in bed all day when you have chronic inflammation. Unless you’re acutely sick, I don’t recommend letting yourself become sedentary. Instead, look for exercises that at least retain your muscles through gentle use. I like crunches, push-ups while standing and pushing away from the wall, and bicycle movements while lying on one’s back.

Acupuncture

While I have not personally tried it, acupuncture has been used to regulate immune function, reduce inflammation, and alleviate symptoms such as fatigue, pain, and gastrointestinal discomfort.

Naturopathic Treatments

A naturopath may suggest personalized treatment plans involving herbs, homeopathy, or detoxification protocols designed to support viral clearance and immune regulation. In  my case, I was able to find a practitioner in Australia who led me through microbiome testing and protocols based on my specific results.

Ozone Therapy

Some practitioners believe that ozone therapy may help combat chronic viral infections by enhancing oxygen delivery and stimulating immune function.

Eliminate Processed Foods & Other Toxins

There is no amount of doing healthy things which will fully account for consuming processed “foods.” You will be more susceptible to dental decay, inflammatory problems, unwanted weight gain, diabetes, cognitive problems, depression, anxiety, emotional dysregulation, irritable bowel syndrome, liver disease, heart failure, and kidney stones (to name a few things that I know about off the top of my head) if you consume processed foods with any kind of regularity. It is not enough to “only eat a little” of these “foods.” If they’re a daily or weekly part of your life, you’re eating far too much of them.

The bottom line is that refined sugar and processed foods promote inflammation, weaken your immune system, and feed opportunistic pathogens in your gut – which leads to all of the problems discussed on this page, and more. For every thing you swallow, I admonish you to read the full ingredients list and be familiar with all of the ingredients. I know it’s hard, exhausting, disheartening, and sometimes so upsetting that you just want to collapse in the grocery aisle and cry on the floor (yes, I’ve been there, literally), but your health is you. Your brain, heart, liver, and kidneys are you. Take care of your you. It’s the best gift you can give to yourself and your loved ones.

In addition to the obvious additives on the ingredients list, it’s also advisable to avoid meat that isn’t certified organic or from a local, small operation. And, as you’ve heard hundreds of times, avoid alcohol and tobacco. Alcohol can suppress immune function and increase inflammation and if you’re sensitive to histamines it can be particularly explosive in its damage. Smoking cigarettes can also weaken immune function and promote chronic inflammation. 

Why do some people smoke and drink into old age with obvious consequences to their health?

Those individuals likely had few to no antibiotic treatments in their life and an unbroken chain of inherited healthy microbiome. They also likely had a healthier upbringing that led them to have a better regulated nervous system, which is shown to be one of the biggest factors in who becomes chronically ill versus those who don’t. For more on that, I highly recommend reading Childhood Disrupted.

I’m Raederle, thanks for reading

I’m Raederle – a nutrition expert who has moved largely into neuropsychology. I was born with an impaired microbiome which was further imploded through infantile antibiotic administration (as my inadequate immune system / microbiome meant I became sick easily in the first place), and due to antibiotics, this condition could only be expected to get worse. This issue was further compounded when I bit a glass thermometer at the age of three, getting mercury poisoning for which my stomach had to be pumped. (I can still recall the glass being picked out of my teeth.)

Because of the total ineptitude of the allopathic medical system found in the States, my parents were not even briefed in the most basic way about mercury toxicity (even though it was well-researched enough by the nineties when this occurred). Also, despite the growing awareness of the microbiome’s role, nothing was said about what the repeated antibiotics (and mercury!) would be doing to my gut.

My childhood was filled with endless doctor’s notes, and repeated illnesses. My root problems were not diagnosed and my symptoms were often misdiagnosed. Because I was a child, my own perceptions and assertions were repeatedly invalidated and ignored – even though I was later able to confirm through testing that many of my theories were correct.

My case was a forerunner for what is now affecting the entire younger generation. Microbiome collapse in one’s teens was extremely rare in my generation (I was born in 1989), but now, for those born ten or fifteen years later, my lifelong struggles are becoming mainstream teen and early twenties problems. And still, allopathic medicine in the States sits back and twiddles its thumbs despite the overwhelming amount of research being done around the world about effective ways to treat and prevent this array of problems.

Please don’t give up on yourself. If the medications aren’t helping and/or you’re being misdiagnosed, then take matters into your own hands. Many amazing great books saved my life after a stream of doctors failed me. I wish you fruitful research and relief.

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