David, I remember in your talk on adaptogens at Medicines from the Earth you mentioned that EBV is usually rears its head as an opportunist when HPA depletion and chronic fatigue is present since the immune surveillance is generally not very good in those people (like chickenpox later manifesting as zoster or HSV recurring). When would be a time when you would treat EBV in a person along with strengthening the HPA axis? E.g. if someone has muscle aches, flu-like symptoms etc., so the typical symptoms of mono that are recurring along with the chronic fatigue, plus higher IgG titers, would you treat the infection, too? Also, trying to find a good resource for interpreting EBV- IgG titers. A friend of mine has way high IgG titers against EBV (10-20 times higher than the "normal range") and I'm wondering if someone who has gone through mono and has just sustained immunity would have high titers like this or if that's a sign of the virus reactivating because he has adrenal fatigue. thanks for your time

If someone is highly symptomatic like your friend, you are going to work on enhancing the immune and endocrine functions, as well as trying to inhibit the virus. I cannot say for certain, but based on symptoms, it seems like an active infection.