I’m looking for insights into rapamycin-caused EBV (Epstein-Barr Virus) reactivation. I’m particularly eager to hear from folks who have experience with this or who are knowledgeable about how these two things interact.

If you’re thinking, wait, doesn’t rapa suppress EBV lytic replication? Yes indeed, there’s research that indicates rapamycin can suppress the active phase of EBV by inhibiting lytic replication and thus reducing viral load.

At the same time, rapa can suppress (at least some) immune system functioning, and thus reduce the body’s ability to control (at least some) viral infections, allowing latent viruses like EBV to reactivate.

Which is what is happening for me. After over two years of intermittent/pulsed rapa, it is clear to me that rapa is at least a primary cause of EBV reactivating in my system.

Almost everyone has EBV – some 90% of the world’s population was infected in early adulthood. But for most, the EBV is asymptomatic and latent and stays that way – doesn’t reactivate. (Though I suspect many people don’t realize what’s going on if it’s mild; reactivated EBV can be connected to CFS.)

Reactivated EBV can feel like a flu, mild or severe. Symptoms can include malaise, fatigue, brainfog, headache, sweats, and more. Definitely something to avoid.

I don’t get EBV-reactivation (EBV-ra) every time I take rapa, but it happens often. While rapa dose might be relevant, I’ve had EBV-ra at doses as low as 2mg. I don’t plan to stop doing pulsed rapa, and I’d like to go back up to a dose of 3 or 4mg (every 7-14 days) but to do that, I need to be able to more reliably avoid EBV-ra.

I assume my reaction is atypical, because I don’t see anyone else here talking about rapa-caused reactivated EBV. For the first six months or so on rapa, I didn’t get EBV-ra, then it happened more and more often.

I’m experimenting with meds and supplements (under the supervision of docs) to provide immune system support, keep EBV latent, and inhibit lytic replication. This includes various supplements and potent anti-virals. (Ask if you want the list.)

I’d really like prevent EBV from going lytic in the first place. Must be something different about me from most of you who do not get reactivated EBV with rapamycin. Wish I knew what.

I’d love to hear from anyone with experience on this topic. Failing that, have you got an interesting theory that I might put to the test? Thanks.

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I also wonder if senescent cell load might be an upstream cause as well, perhaps keeping my system at a tipping point where virus(es) can get a better hold following a rapamycin peak. Anyone think that’s likely?

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Somewhat related thread:

Please do share, would love to see what ideas you’ve had. Is valacyclovir one of them (or would also help with other viruses)?

Are you getting more sick with other things - colds, flue and Covid and also trigger EBV and other dormant virus flare-ups

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Have you had blood tests to show reactivation?

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Current antivirals include: valacyclovir, lomatium isolate extract, andrographis.

No, I am not getting sick with other things. Other than EBVra, I’ve been quite healthy.

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Have you had blood tests to show reactivation?

Yes, but not repeatedly. My understanding is that the tests are good at identifying that you have reactivating EBV, but not necessarily at asserting that that is what is happening right now. I’ve had enough occurances to know the symptoms, so I can catch it earlier. Also have ongoing blood panels to look for other explanations; none have been indicated.

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Some 4o summary:

Here’s a concise summary of how Lomatium isolate extract and Andrographis are used in relation to viral infections, along with their potential benefits and known risks/side effects.

  1. Lomatium Isolate Extract (Lomatium dissectum)

Traditional Use:
• Native American and herbal medicine for respiratory infections, influenza, and viral illnesses.
• Thought to have antiviral, immune-stimulating, and anti-inflammatory properties.

Mechanism (proposed):
• May inhibit viral replication (in vitro data, not well-characterized).
• Thought to modulate immune response and mucus membrane integrity.

Evidence:
• Anecdotal and historical use during the 1918 flu pandemic.
• Limited modern scientific studies—mostly in vitro or case-based.
• No large clinical trials to confirm efficacy.

Risks / Side Effects:
• The most common side effect is a rash (“Lomatium rash”)—itchy, full-body, and unpleasant, usually appearing within days of use.
• Photosensitivity, nausea, and GI upset also reported.
• Not recommended for pregnant women or people with liver issues.
• May interact with other immune-active herbs or medications.

  1. Andrographis (Andrographis paniculata)

Traditional Use:
• Widely used in Ayurveda and Traditional Chinese Medicine for fever, colds, flu, and infections.
• Also known as “King of Bitters.”

Mechanism (proposed and studied):
• Contains andrographolide, which has:
• Antiviral activity (e.g., against influenza, dengue, herpes, and even some coronaviruses in lab studies)
• Anti-inflammatory and immunomodulatory effects
• May inhibit viral entry or replication

Evidence:
• More studied than Lomatium.
• Some RCTs and meta-analyses suggest benefit for upper respiratory infections, shortening duration and severity.
• Mechanisms supported by in vitro and animal data for various viruses.

Risks / Side Effects:
• Generally well-tolerated at standard doses.
• GI upset, fatigue, allergic reactions possible.
• High doses or prolonged use can suppress fertility in animals (human relevance unclear).
• May interact with immunosuppressants, blood pressure meds, and anticoagulants.

Summary Table

Herb Antiviral Effects Evidence Level Key Risks
Lomatium Historical use for flu/respiratory viruses Mostly anecdotal, minimal clinical research Skin rash, GI upset, photosensitivity
Andrographis Broad antiviral & immune effects Supported by some clinical trials for cold/flu GI upset, allergies, possible fertility suppression at high doses

Would you like recommendations on formulations, dosing ranges, or how these might complement conventional antivirals or immune therapies?