Clinician handoff
EBV
Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.
Why this still fits
I want to evaluate a post-viral pattern that still feels EBV-like. The strongest clues are mono history, relapse-style flares after stress or illness, and exhaustion that feels deeper than ordinary poor sleep.
What would weaken it
- -No post-viral timeline, no lingering fatigue or lymphatic symptoms, and no reason to think EBV is active in the story.
- -Serology doesn't support recent or reactivated EBV when the clinical picture is also weak.
- -Long COVID, sleep, autoimmune disease, or another explanation fits the trajectory more cleanly.
Key points to communicate
- •I want to know whether EBV is actually part of the current picture or just a common background infection showing up on labs.
- •Please separate post-viral fatigue from autoimmune disease, Long COVID, and ordinary sleep or mood drivers.
- •If EBV stays plausible, I want to know which tests and clinical clues matter most.
Bring this to the visit
- •A timeline of when fog started relative to the viral illness.
- •EBV panel results if available: VCA IgG, VCA IgM, EBNA IgG, EA IgG.
- •Any other lab work done during or after the illness: CBC, CRP, liver panel.
- •Current symptoms beyond fog: fatigue, sore throat, swollen nodes, exercise intolerance.
Useful screening structure
- -EBV panel (VCA IgG, VCA IgM, EBNA IgG, EA IgG) to assess reactivation vs past infection.
- -CRP and CBC to check for ongoing inflammation.
- -If post-viral fatigue persists beyond 6 months, evaluate for ME/CFS criteria.
Tests and measurements to discuss
EBV antibody panel
What this helps clarify: Most doctors only order VCA IgG, which is positive in 90% of adults and tells you nothing about current viral activity.
Range context
Serology context
How to use the result
If EA is elevated: discuss immune support (sleep, stress reduction, pacing), potential antiviral therapy, and infectious disease referral.
Rule out long-COVID/ME-CFS overlap
CBC, ferritin, and thyroid review if the story is unclear
What this helps clarify: Iron storage marker that can affect energy, focus, and cognition.
Range context
40-100 ng/mL
How to use the result
Save the result with date and symptoms from the same week.
Rule Out Related Conditions
EBV is implicated in triggering various autoimmune conditions. Check for these if symptoms suggest.
What this helps clarify: EBV is implicated in triggering various autoimmune conditions.
Questions to ask directly
- •Do my EBV titers suggest recent reactivation or just past exposure?
- •How do I distinguish post-EBV fog from developing ME/CFS?
- •Should we check for co-infections or autoimmune activation triggered by EBV?
- •What is a realistic recovery timeline for post-EBV cognitive symptoms?
Functional impact snapshot
- -Rate cognitive function relative to physical exertion - does activity worsen fog the next day?
- -Track whether the fog is improving month over month or has plateaued.
- -Note crash patterns: does overexertion cause delayed cognitive worsening 24-48 hours later?
Escalate instead of self-managing if
- •Hepatosplenomegaly with severe fatigue - avoid contact sports and get imaging.
- •Persistent fever, night sweats, or lymphadenopathy beyond 4-6 weeks of acute infection.
- •Progressive neurological symptoms suggesting post-infectious autoimmune encephalitis.
Peer-reviewed references