We have all experienced a viral infection (such as the flu or common cold) which left us bedridden for a few days, at some point in our lives. Most of the time, our bodies fight off the infection and we don’t have any further issues. But sometimes, an infection may cause lasting harm or may even become chronic. Many different types of viruses have been known to trigger chronic fatigue — Epstein Barr Virus, Cytomegalovirus, Human Herpes Virus, etc. And there have been various theories over the years from various researchers and practitioners about the role of viruses in chronic fatigue — some of them claim that chronic viral infections are the central cause (and devote huge attention to trying to treat the infection), and other experts say that these infections are mostly just symptoms, i.e. opportunistic pathogens that only cause an issue AFTER the person’s health has already deteriorated. Moreover, there are are widely varying opinions about whether treating the viral infections are actually an effective way to fix the chronic fatigue. Some people report great success and others report minimal to no effects from focusing on treating infections.
This week, I am talking to Dr. J. E. Williams, OMD, who is a specialist in viral immunology.. He has spent the last 35 years treating tens of thousands patients (he has done over 150,000 patient visits), many of them suffering from chronic fatigue (CFS). Furthermore, Dr Williams himself, once suffered from chronic fatigue after he was infected with Dengue fever. Listen in, as he shares how he helps his patients recover from chronic fatigue (CFS) that is triggered by viral infections, and how you can treat it.
In this podcast, you’ll learn
- Why you are feeling fatigued when you have a virus infection (and why that is important)
- The most common viruses that trigger chronic fatigue (CFS)
- The top lifestyle strategies to prevent viral infections.
- The most accurate ways to test for viruses (and why it can be difficult)
- Why inflammation is suspected to contribute to viruses becoming chronic
- How antiviral therapies work (and why they don’t)
- The best strategies for overcoming chronic infections
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Common Viruses That Can Trigger Chronic Fatigue (Cfs)/ Myalgic Encephalomyelitis │ And The Best Viral Infection Treatment Approach – Transcript
Ari Whitten: Hey there, everyone. This is Ari Whitten and welcome back to The Energy Blueprint podcast. Today, my guest is Dr. J.E. Williams, who is a highly respected integrative medicine clinician who treats and revitalizes patients with even the most severe stages of illness.
He’s been in practice for about 35 years and has a whopping, I was just remarking on how amazing this is, 150,000 patient visits over those 35 years. He also has been treating chronic fatigue syndrome for much of that time if not all of that time, and he was just telling me actually before I started recording that he’s been treating chronic fatigue syndrome patients since 1983, before they even had the term chronic fatigue syndrome or anyone knew what it was.
His mission is to bridge complementary and alternative therapies with evidence-based clinical science. His specialty is viral immunity. Welcome, Dr. J.E. Williams.
Dr. J.E. Williams, OMD: Thank you, Ari.
Ari Whitten: Yeah. Also, on a personal note, I want to mention that we were connected just a few weeks ago through some mutual friends and colleagues, and we had the chance to get together in San Diego and do lunch and go for a walk and talk about viral immunity and chronic fatigue and all this good stuff.
I just have to say that he is a brilliant guy and I’m very excited to have him on the podcast to be able to talk about a lot of the stuff that we talked about in person and share all of this with you guys. If you could get started by just talking a bit about your background and how you got into this field, and how you started to specialize in viral immunity in particular.
Dr. J.E. Williams, OMD: Well, like all pioneers, you kind of head off into a direction that’s completely unknown. For me, that was in 1967. I left, I grew up in a small New England farm, was a very bright kid who was supposed to go to ivy league schools, and I wanted to study ecology, and there was no field at that time really of ecology, and so I chose wildlife biology and went to the University of Alaska against everybody from my high school, my parents.
I started on this type of pioneering path from that point on and made choices all along the way that were ahead of the curve. I’m one of the very first American acupuncturists for example, starting in the ’70s. At the same time because of my scientific interest, I pursue more the research and the biological end of things, and then when I went into clinical practice in 1983, the first place I worked, it was called California Clinic of Preventive Medicine.
It was in Del Mar, California and I lived in Encinitas, so it was great to be at Swami’s with you for more than 35 years in Leucadia, and we started there, we’re way ahead of our time, there was three of us as owners, there was an allergist, eye, ear, nose and throat surgeon from San Francisco, myself, and a homeopathic doctor from South Africa. We brought in some naturopaths from Hawaii and Oregon, and we worked together on difficult cases.
At the time, allergy or an allergic cause was thought to be the underlying reason why people were having what we call now fibromyalgia or ME or CFS. We focus mainly on allergy. That was before RAST testing, which was blood testing for IgE, before the IgG testing, they were just doing skin and prick testing all across your upper back or your arm. What we wanted to do was something better and different, so we were doing drops under the tongue and we were doing electrodiagnostic testing from Europe, like EAV and other devices.
People came to us from all over the world, from Saudi Arabia, from Brazil, from Europe, all over the United States and Canada, with the most difficult conditions, but not cancer. They already were not easily diagnosed conditions, difficult to diagnose, difficult to understand, and I learned so much, I was humbled every day that I was there.
One of my patients told me that she couldn’t be in the sunlight, she couldn’t drink water. We thought they were all psychosomatic right in those days. Her husband had to drive her, they had a van but no windows, inside it was completely gutted out, and they had a chair bolted down in the center of that, and that’s where she sat while he drove her. Then she came out, even in Southern California, bundled up, sunglasses, scarf, gloves, everything like that.
I watched her coming in like that, and then she looked at me one day and said, “You don’t believe me.” I said, “You’re right, I don’t.” Then she said, “I want to show you something,” and we went outside and her husband said, “No, don’t.” She said, “Come with me.” We went outside, and she pushed back her glove and pulled up her sleeve over her arm and exposed it to the sun for 10 seconds, swelled up like she had hives, right in front of my eyes. I said, “I’m so sorry,” and I worked really, really hard to try to understand these type of cases.
I’ve seen many like that. They had an illness for sure, but we didn’t know anything then. We knew that they had some type of fatigue syndrome, we knew that they had some type of allergic syndrome, clinically we knew that there were crossovers between autoimmunity, but we didn’t know what to do with them.
Little by little, year by year, decade by decade we advanced, and I learned more.
Dr. Williams’ own experience with chronic fatigue (CFS)
Ari Whitten: Yeah. You also, you were telling me in person about this, you also have some very personal experience with severe chronic fatigue. Can you talk a bit about that?
Dr. J.E. Williams, OMD: Well, yes, I can. Let me say first is that these cases are often … Up until recently, conventional practicing physicians didn’t want to see these cases. They didn’t believe that it exists, and they wouldn’t see the patients. Fibromyalgia, rheumatologists would refuse to see them if they had already said, “I have fibromyalgia,” they said, “I can’t do anything about that. I don’t know what it is. It’s not a real disease, go away.”
I saw that they, when antidepressants first came out, I was working at the time with the Center for Women’s Medicine in Mission Valley in San Diego. I was the only male provider in the all woman, all managed, business managed and all physician and all nurses and all PAs were women, and it was great. Also, way ahead of our time, and it didn’t last but a few years. We saw all of these types of cases were coming into us, predominantly chronic fatigue as a gender, not gender specific, but gender bias towards female.
They were treated with, and this was in the late 80s, early 90s with all the new SSRIs. They treated hundreds of women. Out of those, and I did my own formal surveys, few of those people got better from chronic fatigue on an antidepressant.
Ari Whitten: About how many roughly as far as a percentage?
Dr. J.E. Williams, OMD: Five percent, a very small amount, maybe no more than 20. If they did get better, they only felt a little bit better. Their mood was better, but their energy was zero improved.
Ari Whitten: Okay. Just to clarify a point, the reason they were prescribing SSRIs at that time, antidepressants was because they largely thought at that time chronic fatigue syndrome was mostly psychogenic or that these people were hypochondriacs, it was just all in their head, or that they were just depressed. Is that what was going on?
Dr. J.E. Williams, OMD: Yes, that’s true, but also I think because they had nothing to give them. All of a sudden they had a medication that affected serotonin, not just for depression but for feel good, feel better, a little more energy type of, got your neurotransmitters regulated or balanced, and because it was not just the easy and quick thing to do, but yes that too, but also from what you’ve just said is that it was a pat on the shoulder, “Yes, dear. You’ll be okay. I know life is stressful. Try this pill.”
I didn’t believe that. I believe that these, most of them had a real problem. I had already been working with this by the time approximately 10 years or 12 years. Some of them did improve, so depression or neurotransmitter dysregulation was part of that, and some of them did, but most of them didn’t. I still was not sure. I was male, the CFS patients were mostly women. I didn’t relate. I could treat, I could examine. We didn’t have still in the ’90s a lot to do for them. I wasn’t sure. I wasn’t sure, real or not real, and how could they be that tired, how could they be that weak, the things that they complain about. It wasn’t just tiredness like you would take a nap and you recover from it. They also were weak. Weak meaning difficulty picking up things or lifting or vacuuming and getting tired of vacuuming.
I’ve also conducted fieldwork with indigenous people, part of what I do is ethnomedicine. I study the last traditional people on the planet, I’ve lived with the Yupik people in the St. Lawrence Island in the Bering Sea, just below the Arctic Circle. I’ve lived with the Q’ero people in the Andes and others. What we find from this is that people have a lot of energy, and that simple ways of life work, and that their energy status is based on mostly what they eat and how well they sleep, and that modern people are exposed to a lot of chemicals, and so they probably have some type of problem like that.
In my work in the upper Amazon, I was with the Shipibo people, and I got sick, I always got sick, but I got really sick. I came back, and I wasn’t sick then, I came back from Peru, within three weeks of coming back and I was having dinner with a colleague, an MD-PhD, well-known researcher, and I didn’t feel good. I started to feel, I just wasn’t feeling good at all. I excused myself and I went to the restroom, and I was almost passed out. I came back and I said, “I’m going to have to go home. I think I’m coming down with something, maybe from the food, I’m not sure, but I feel really, really bad.”
I was with a journalist friend, and he offered to drive me home, and off I went. That was a Friday. I developed a super high fever that night. I was so sick and so weak I couldn’t even pick up the phone to call anybody. I could see the phone on the floor where I had next to my low bed in California style, and I couldn’t reach over and pick up the phone. I couldn’t get water. It was terrible.
Finally, I was able to crawl to the phone, knock the phone off the hook, somehow I dialed my friend and she came over almost immediately, brought me fluids and everything. Over the next few days I lost my color vision, which came back thankfully, 100% and it wasn’t like everything was a black and white movie, it was shades of grays and dark colors, and it was almost a different terrain. You could see the shadows stood out more, very, very strange and disconcerting.
Then about day five, I started to recover. Over the next few weeks my vision came back, but I was very sick. After that, my energy never came back. I couldn’t, I was so weak, I couldn’t hold a pencil. It literally would tip out of my hand like that. I would be at my desk like this, and I would watch the pencil just go like that, fall down on my desk. I was weak and tired. I couldn’t wash my dog. I’d be in bed for the rest of the afternoon. My god, this is how chronic fatigue people feel.
Then I got an autoimmune condition. My joints swelled up, which was secondary to the first infection. I went to all the top doctors in infectious disease, everybody I knew, all my colleagues, everybody that I didn’t know that I got referred to, nobody had a single idea of what I had. They thought I had malaria, but it turned out that I didn’t. We went down the list of things that I didn’t have. It turned out that I had, the Peruvian doctors finally solved it, that I had an atypical dengue fever with a delayed onset.
Now, this is really important, because not every single case, most ME/CFS cases do not have an acute illness like I had, but some do. Even if you don’t, as I talk about in my book, that fatigue replacing fever as an evolutionary change in the model of how we’re responding to microbial infections is, then it shows up later, it surfaces later.
In this case, I had both. I had the acute, I had the chronic, and then I had the latent. It took several years of slowly recovering, taking natural therapies, and I never, I’m still not 100% back to me, but I’m not fatigued with exercise. I just have to be careful, I have to pace myself. I learned that my patients were suffering from a real disease and I knew how they felt. Matter of fact, I was sicker than most of them.
Ari Whitten: Mm-hmm. Wow. This kind of prompted a special interest it sounds like in pursuing this link between viruses and chronic fatigue syndrome.
Dr. J.E. Williams, OMD: Yeah.
Why fatigue replaces fever
Ari Whitten: Okay. I’d love for you to talk about this thing that you just mentioned in passing, the fever and fatigue thing. In an evolutionary context, fatigue is replacing fever. Can you explain a little bit more about what you mean by that?
Dr. J.E. Williams, OMD: Sure. With an acute illness, acute infection from a microbial organism like a bacteria or a virus or a parasite, you mount a fever as a response to that organism. We also know that there’s lots of cellular activity going on and crosstalk between so-called messenger molecules, cytokines and chemokines.
For thousands of years, doctors have known that fever is the first sign of illness. In my nature pure training, you would promote and/or support the fever, and you would want the patient to sweat. This is how Hippocrates did it, this is how Chinese medicine does it, this is how my mentor Bernard Jensen did it. Then you manage that fever with cool compresses, so you don’t want it to go too high, but you actually want to support it, and then that heats the body up, makes things more fluid, activates certain chemicals that are temperature sensitive and knocks down those microbes and you respond and get better.
Now, you also feel tired. When you have the flu, you don’t just sneezing and coughing and have a stomach ache, you have a fever and you go to bed because you feel tired, so you have both. You have a fever and you have fatigue. What if you have no fever, or the febrile response is blunted, and you just have the fatigue? I see a shift happening, either that modern people do not have the capability of mounting a febrile response, or we’re so overly exposed with microbes now, not the super infectious ones like polio for example, but many others from disrupted environment, from cutting down a rainforest and living with pets and animals all over the place, and we have exposure that’s unprecedented. Many of those are subliminal or not necessarily will drive a febrile response, but they do show up as a fatigue response. That’s the gist of it.
Ari Whitten: Got you. Is it possible that fevers are more of a short-term response, and the body limits them to a certain length of time, whereas fatigue can be sort of an indefinite response in a way?
Dr. J.E. Williams, OMD: That’s true. A high fever in a healthy younger person is the general response to virus or bacterial infection. That lasts for 12 hours to three days, 72 hours or so. A sustained high fever will cause damage to your brain and nervous system and other tissues, so evolutionarily we don’t want that going on for too long.
However, there are other types of fevers. There’s tidal fever, there are low-grade fevers, and there are subjective fevers. What you see in some chronic fatigue patients, and I believe there are subsets of chronic fatigue that have subjective fevers, in other words they feel like fevers, but when I take their temperature, they’re not, they don’t have a temperature. Or sometimes they feel chilled when not in air-conditioned, even in the summer, and that’s a sign of fever, and when I take their temperature, when they say, they say they feel their forehead and they don’t feel hot, I said, “If you have chills, that means your body has a low-grade fever, let’s take your temperature,” and then they have 99, 99.5, usually not over 100.
There are variations of the febrile response, and then there are tidal fevers, so they might report that they have fever in the evening. I ask them to take their temperature when they have that, and sure enough in the morning and in the office they’re normal, and in the evening they have this little spike come up.
Ari Whitten: Interesting.
Dr. J.E. Williams, OMD: Mm-hmm.
Why infections commonly trigger chronic fatigue syndrome (CFS)/ myalgic encephalomyelitis
Ari Whitten: Can you give me a broad overview of your perspective on the role of viruses or infections in general and ME, chronic fatigue syndrome? Are there any predictable patterns? How common of a trigger are infections in the context of chronic fatigue syndrome?
Dr. J.E. Williams, OMD: I believe infections are very common or concurrent, and sometimes causative like in my case. Because microorganisms are, over our lifetime we’ll be exposed to hundreds and hundreds, if not thousands of different types of viruses. Which is first, the immune deficiency or the virus in those type of cases that are not acute like mine was? There are five hallmarks that I use or identified in ME/CFS, and one of those is that one of the most common triggers is viral, but there also other co-activating events or triggers like allergies, like autoimmunity, like exposure to yeast and mold, like stress, like a chemical sensitivity, hormone imbalances.
What I find is clinically, a lot of inexperienced practitioners chase the wrong thing. They go after the adrenal, adrenal fatigue, or they go after allergies when there’s none there. Identifying viruses is important in my opinion. Every chronic fatigue patient that comes in with ME/CFS, IBS, fibromyalgia, I assume that they may have a viral base or viral trigger, and I look for that. I look at the symptoms. We know very well what acute infection symptoms are, fever, fatigue, and symptoms associated like headaches, severe headache, or associated with that particular infectious organism, but then there’s chronic, and then there are latent symptoms of viral infection.
I look at what those symptoms are, do they have recurrent or tidal fevers, do they have allergies and start separating things out, how severe is their chronic fatigue, have they taken antidepressants, and have they worked or not work. If they have a fever, do they use Tylenol? Do they suppress it or not suppress it? Do they have swollen lymph glands in their throat? Again, subjective or objective. They say, “Yes, I feel,” when I check them, they don’t. They feel something there, and sometimes when they come in repeatedly, I check, and I say, “Today you have a little, is it tender,” “No,” or, “Yes.” Following these different clinical signs and having the patient follow them is important to me.
The next thing I do is I do testing for Epstein-Barr and Herpes simplex viruses, which are very common and sometimes people have them and don’t know they have them, and HSV 1 and 2 can, even the simple cold sore type, if it gets into your nervous system can paralyze you. People are severely ill from that. Most of them are not, but many of them are. We know that this family of herpes virus causes significant disease, many types of cancer, all types of infections. This is a serious disease family, Epstein-Barr being the one that we think is associated with ME, chronic fatigue.
In my experience, what I see is when I do these Epstein-Barr titers of the, I find that of course they don’t have acute infections, so they’re almost always IgM negative, but then there’s a pattern that shows up with the other titers, antibodies to Epstein-Barr, and then we start to see them show up in these cases almost always. What does that mean? The conventional trained old fashion type of medical doctor will say, “It doesn’t mean anything. It just means they’re exposed to, 95% of everybody in the world has been exposed,” but there are certain practitioners like Dr. Dantini on the other coast of Florida, I now live in the Gulf Coast of Florida, found that if the viral titers are four times higher than the upper limit, you may have latent or chronic active infection. Others have found that they’re much higher.
For example, I see this all the time, one of my patients has in her Epstein-Barr virus nuclear antigen, antibody and negative is less than 18 and positive is over 22, and her titer is 549.
Ari Whitten: Right, I saw this in the slides you sent me. There was another one that was over 600.
Dr. J.E. Williams, OMD: Yeah. The other one has over 600, which means that it’s so high, they can’t measure it. It’s gone off the scale. She also has immune deficiency in her immunoglobulin G. These patients now, you start to work with them antiviral plus immune support.
Ari Whitten: Yeah. Real quick, I want to dig into some details on this subject, because this is I think a point of controversy. I know different clinicians who see things differently with regards to viral testing. IgG is generally regarded as past infections. Some people say, “Oh, IgG can’t tell you anything about current infections. It can only tell you about if you’ve been exposed to something at some point in the past, we don’t know when.”
Dr. J.E. Williams, OMD: That’s true.
Ari Whitten: What you’re saying is, there’s this other distinction between, not just positive and negative on the standard test, but how positive are you, meaning, if the cutoff for positive is above 22, are you a 23 or a 42, or are you a 550. What you’re saying, what you told me in person is the people that are extremely high, that tends to correlate with symptom severity and chronic fatigue. Is that accurate?
Dr. J.E. Williams, OMD: 90 to 100% have symptoms.
Ari Whitten: Okay.
Dr. J.E. Williams, OMD: Here’s something else. The basic four antibodies in medical school were taught, IgA, IgG, IgE, and IgM. The two that in terms of viruses that we look at are the, the first, the active infection is mediated by IgM, and the chronic mediated by IgG. You’re right on that part. However, because the Herpes virus family is so insidious and causes so many types of disease that we have a broader profile now, that simple IgG versus IgM, that’s old-fashioned, that’s 10, 20 years old. I always tell my patients, for me personally, I don’t want anybody practicing 1955 medicine on me. I want 21st-century medicine.
Then we’re looking at, we’re looking at not just the total IgG but in Epstein-Barr, we’re looking at the viral capsid antigen, and we’re looking at the nuclear antigen. This is a breakdown of the IgG into another distinction. That’s when you start to see these massively elevated levels, like on the two patients that we just talked about with the one over 600.
This patient, a female, almost all of them are female, meaning seven, eight, nine out of 10 cases, but the men have the same. They have the same profiling. This patient was having almost mini-seizures and passing out and lightheadedness and just not feeling well and low energy, and she was diagnosed as having epilepsy when she has Lyme disease and Epstein-Barr virus. Wrong diagnosis.
As these viruses track in, and it’s well known that Lyme disease affects the central nervous system, but so will Epstein-Barr virus. Now we have the ME portion of the myalgic encephalopathy, chronic fatigue, versus the chronic fatigue fibromyalgia, or versus the chronic fatigue IBS subsets.
The most common viruses that trigger Chronic Fatigue Syndrome
Ari Whitten: Got you. Can you real quick just go through a list of some of the most common viruses that you see in chronic fatigue syndrome? I know you’ve mentioned a few of them already, but can you just list out the top ones?
Dr. J.E. Williams, OMD: Yeah, of course. The Epstein-Barr is the primary one, but I also see Herpes simplex viruses as I mentioned as well. The second most common one is HHV6, human herpesvirus six. That’s been linked to chronic fatigue by a number of researchers, which I almost always see it with the patients with the high EVV titers, also have high HHV6. Sometimes the HHV6 is higher.
Ari Whitten: Mm-hmm (affirmative).
Dr. J.E. Williams, OMD: The third common one is the Herpes simplex virus. Sometimes they have the shingles virus, the zoster virus, and sometimes they have CMV, cytomegalovirus, but not usually, unless they have chronic hepatitis or HIV.
Ari Whitten: Okay. Do you also deal with bacterial infections?
Dr. J.E. Williams, OMD: Yes.
Ari Whitten: Okay. Do you find that those are extremely common as well, or much less common?
Dr. J.E. Williams, OMD: There are lots of different bacteria, and you have to rule out Lyme first, Lyme disease first. It’s one of those co-factors, and then look at co-infections, other bacteria, and kind of rule that out. The thing that’s important about bacteria is that we can treat that with antibiotics and follow-up, piggyback with antimicrobial, antibiotic botanicals. The outcome is better if they have a bacterial infection, but often they have co-infections. It’s not just one infection. It’s always multiple infections.
Ari Whitten: Okay. A couple of specific questions for you. To dig into the testing a little bit more, there seems to be some disagreement among clinicians that I’ve talked to about what the best types of testing are, blood tests, I know there are some people that I’ve talked to that are advocates of urine testing and there are specific types of tests now available that can apparently test for hundreds of different viruses, so I know some practitioners who are a fan of that. There seems to be some disagreement about what’s best. In your opinion, what types of testing do you think are best?
Dr. J.E. Williams, OMD: I would say a thoughtful physician who knows his territory would understand that we’re advancing testing all the time. When a new test comes out like urine testing for viral titers, then that’s new and it’s not really track proven. The type of testing that I’m talking about is proven, there’s a standard for it that’s FDA sanctioned, and we have, the researchers use it. It’s still wise to use that testing as a base. These other tests are new, and there are different ones, and I’m aware of them and I use some of them, and I keep always growing and moving into that. One you mentioned is urine testing, and that’s worthwhile.
Now, one of my mentors was William Hitt, another MD-PhD, good friend of mine. He was the one where I got sick with. He did urine injections. This was a World Health Organization researcher and professor of immunology from Tulane University, this was a real conventional guy. He used urine injections and ozone. At the time, that was in the ’70s and ’80s and early ’90s when I was spending a lot of time with him. He didn’t know why. He said, “This seems to work with these people, these patients.” They start with the urine injections, and he said, “Something inside the urine, there are some immunological properties, everything is in the urine, huge amounts of substances in there, and when we inject them back in the patient, it stimulates an immunological response and some of them get better.”
He was doing whole body ozone for big, he had a giant machine. He was practicing out of Mexico at the time, retired doctor in the US, but couldn’t get any support here so he had a little clinic in Mexico, and he used a germ machine, like a transfusion. Most of your blood was cycled out and ozonated and came back in, not just a little bit, and put back in the bottle, that does very little.
Others also used the urine injections. That makes a lot of sense, we’re just not quite in my opinion, not quite all there yet, we’re not all in agreement yet. The other is the DNA testing. I’ve signed up within the last few months with a new lab out of Washington D.C. called [Apariomix 00:38:37], and they do DNA testing, and they can do about 1,000 different viruses, the DNA, but everybody has lots of viruses, so we’re going to identify them, but what do they mean.
Then there are another test enzymes-
Ari Whitten: Can I interrupt for just one sec, because I think this is an important point. I think there are some practitioners who interpret results of those tests, and they say, “You have this virus, this virus, this virus. We need to go treat all of these viruses.” What you’re saying is, it sounds like, and correct me if I’m wrong, it sounds like even healthy people without any symptoms may show up on these tests as having lots and lots of different viruses.
Dr. J.E. Williams, OMD: That’s correct.
Ari Whitten: Is there a way to distinguish between maybe amounts of a certain virus, which one is maybe highly active at a particular time and potentially causative of a person’s symptoms?
Dr. J.E. Williams, OMD: It’s very difficult. We have to leave it up to the practitioner’s discretion and their experience and the evidence that’s behind it. When I worked with the specialty labs, I liked to get to know them. I want to be able to call a PhD on staff who’s a specialist in this area, or the founder of the company and to go over tests with them. I want to learn a little bit more and not just rely on the paper.
Ari Whitten: Yeah. Got you. Standard tried and true tests are the foundation and then sometimes you use some of these other tests as well. Do you have a preference over urine, DNA, or is there any particular test that you’ve found most useful?
Dr. J.E. Williams, OMD: Sometimes we do both urine and blood DNA. That’s the best, if you do samples from both.
Ari Whitten: Okay. Having said that there is a link between some of these viral infections and chronic fatigue syndrome and that you can see certain results on blood tests that paralleled with severity of symptoms, what is it, what do you think is really going on there? Let me phrase this a little differently, because when I was in my mid-20s, I got mononucleosis from Epstein-Barr virus, and I was severely chronically fatigued for several months after that, but then I got better over the course of, not instantly, but after six months, a year, I was mostly back to normal, and I haven’t had chronic Epstein-Barr virus since then, or chronic fatigue syndrome since then. Why is it that in some people this becomes chronic?
Dr. J.E. Williams, OMD: We don’t know. However, there are different theories on that. At this point in time, there are many different theories, and some of them are rising up above the others. In general, there’s agreement that there’s low-grade inflammation, so that instead of having fever, the patients have the fatigue plus low-grade inflammation that sometimes feels like fever but they don’t have a temperature. We can measure that. We look at the gross markers of inflammation, the C-reactive protein, the sedimentation rate, and standard lab tests that are done every day. Often in chronic fatigue patients, those are low or normal. In patients with chronic fatigue who have an activation, exacerbation of their condition, you catch it right then, you’ll see that they’re elevated.
Ari Whitten: Mm-hmm.
Dr. J.E. Williams, OMD: But not always. The inflammation that’s causing it is from a group of subcellular chemicals called cytokines. We can measure those, and we have profiles of those, interleukin 6 and tumor necrosis factor, interleukin 17, 13, we can measure those. Even seven years ago, there was just experimental, but now they’re available and not super expensive testing.
Ari Whitten: Mm-hmm. If someone has chronic fatigue, I know you mentioned this a little earlier in passing, but what kinds of symptoms again would indicate that a person may have potentially chronic viral infection as a big cause or trigger of their chronic fatigue? Are there classic clusters of symptoms that would make you say, “Okay, we need to test you for viruses, because it sounds like maybe you would have a viral infection that’s a big part of this.”
Dr. J.E. Williams, OMD: Yes. There are. I have a list, and I don’t believe I’ve sent that to you, but I will. The list that I find with my patients above the standard list, the list for latent viral infection would be feeling like you have fever or a low-grade fever, and a tendency to have sensitivities or allergies, all kinds of different things, not anything specific, not like gluten only. This constant fatigue, but in different levels, they almost never feel well. They always feel unwell, they don’t have a sore throat, but sometimes they do, or enlarged glands, but sometimes they do, but usually never very enlarged or very sore.
They often have severe gastrointestinal distress, abdominal bloating, distension. When I tap on their belly, it’s tympanic or full of gas. If we look at their gut microbial, again, another test that’s valuable for these patients, we see a pattern almost in all cases, they have low diversity for example. Probiotics don’t help. I’ve used lots and lots of advanced probiotics, don’t seem to help them much. Prebiotics seem to be better.
Sometimes they also have yeast problems. Previously when I first started practicing, everybody, it was in the Candida days, everybody had Candida. All of these patients were Candida patients, and no they weren’t. I kept telling my naturopathic colleagues, no, these are patients with something else. Sometimes they have low-grade, and sometimes they have active yeast infections. In other words, there’s a variety of co-infections.
Sometimes they have bacterial infections like you said and sometimes they don’t. Sometimes they have autoimmune, and sometimes they don’t.
Ari Whitten: Okay. If somebody has a set of symptoms that indicate to you, some of those ones that you just mentioned, that indicates a viral infection or another kind of infection may be playing a role here, then you do some of the tests that you mentioned, and you identify let’s say one or two different viruses that may be playing a role in that person’s symptoms. What then, and have you found that doing antiviral therapies to combat that particular infection actually makes people better? Does it make people all the way better? Does it help just a little bit? Does it help reliably? What’s going on there?
Dr. J.E. Williams, OMD: Well, Ari, that’s the difficult part. If it worked so well, we’d have less sick people. What you have is in these cases ambiguous symptoms that as a rule don’t lead to a classical disease diagnosis, right? That’s number one.
Then we start from there, which makes it very difficult to treat from my experience, and others, and the research, I use the evidence and stay away from the conflicts, it doesn’t help my patients. I want a path, and then I want the patient and myself and my staff to do the work, and then I want to monitor them as they move along. Then I do the testing and see, to find out what our path is, do they have Lyme or mold or autoimmune or perhaps a virus.
Then I design a program, so we’re looking at the viral part of it, I design a program, make decisions up front, are we going to use an antiviral drug and what dosage and for how long. I’ll always use additional natural products because the drugs don’t work that well when they do work, they don’t most of the time, and they have side effects over time, although some patients do very well and some patients have no side effects with them.
We have to be prepared for that, and we have to recognize that the viruses can adapt to the drug, and so becomes less effective, even if they don’t have side effects. That’s usually the case, after a few weeks, a few months, a year or so, the virus has adapted to them, and that’s why the botanical adjuvants are so useful. We have to support the immune system, and so I’m evaluating this patient that we were talking about also had the low IVIg, IgG, and we might use intravenous IgG with her and that’s shown to be useful.
The other classical characteristics of ME chronic fatigue is that it’s resistant to therapy. You have ambiguous symptoms on one hand, you have resistance to therapy on the other hand. What I want to do is bring those, some sense to a path so that I can get some benefit for that patient. That’s my model.
Ari Whitten: Mm-hmm. Have you found in a lot of cases that addressing viral infections in this way is a very powerful way to get benefits for the patient?
Dr. J.E. Williams, OMD: I wish I could say a lot of cases, but I could say some. Some it works really well.
Ari Whitten: I have to say just on a personal note, I really appreciate your humility in that regard, because I happen to know a lot of practitioners, a couple things I’ll mention. I know a lot of practitioners who focus really intensely on virus and infections in the context of chronic fatigue and who chase after infections, and I’ve seen personally a lot of these patients that they’re dealing with who kind of feel better for a little while, and then it just comes back, and then they take the stuff again, and they feel better for a little while, and then the symptoms come back. Then they take the stuff again, and then there’s no effect at all, no benefit anymore, and they still have the symptoms and the antiviral stuff that they were taking or anti-infection stuff that they were taking now doesn’t have any more benefits like it used to.
I’ve seen a lot of people just pursue anti-infection treatments that don’t seem to have much benefit. Having said that, I also have seen definitely people who have gotten significant benefit from it. It’s tough, it doesn’t seem like it’s very predictable in that regard.
Dr. J.E. Williams, OMD: There’s no score that I know of that we can give a patient to predict whether they’ll respond favorably or not. A lot of drugs, there are scores like that, but we don’t have any. I would say that it’s the few, it’s the few patients who respond really well, and then to a single drug therapy or to a combination of two or three drugs. It’s not HIV or Hepatitis C, which I also have a lot of experience with, where you can have some predictable outcome, because first of all, there’s no identifiable virus as there is with HIV or with Hepatitis C.
Ari Whitten: Mm-hmm.
Dr. J.E. Williams, OMD: This is important, is that with those illnesses we measure and I measure all the time and follow all the time the so-called viral load or the quantitative number of how many viruses they’re picking up in the blood, up until recently, there had not been a quantitative Epstein-Barr test. Now there is, but we’re still not seeing the accuracy level that I want on it, and it’s hard to see that there’s actually any viruses that are in the blood. They’re somewhere and they’ve tripped inflammatory changes and other immunological changes that are not measurable by quantitative, but you can see that in HIV and HCV. I wish we could see that in these studies.
What I look for is this. I have a patient who’s, both she and her husband are patients of mine, he has a neurological disorder, pretty advanced, and she has some type of chronic fatigue and some chronic pain problems that are from previous surgeries that healed well but left her with some damage in the hip and sacral area that we manage. The fatigue is what really bothered her.
She was diagnosed with depression, but eventually I convinced her to take an antidepressant, which she did, it helped a little bit, it helped her mood a little bit because of the stress of her husband’s neurodegenerative disorder, caretaking him, but it didn’t help her fatigue at all. I said, “Stay on the antidepressant, your mood is a little bit better. Now we’ll work on this.” She had previously been diagnosed with Lyme, and I asked to see the test, she brought the test in, and it was a company that’s no longer, a lab company in Florida who’s no longer in business. They were a sham lab company in the early days of Lyme.
Ari Whitten: Wow.
Dr. J.E. Williams, OMD: It’s in her head that maybe they were right. She had other tests done and we didn’t find any Lyme. Then I did some, and we didn’t find Lyme. Along the line there, she had been treated with lots of antibiotics and all kinds of stuff, it didn’t help, and probably harmed her some.
Next we looked at the viruses. She was one of these high 500 level, and her Epstein-Barr IgG titers, and she had HHV6 really high, and she had many others. I said, “This is probably what it is,” and she had some immune deficiency. There’s changes in the T lymphocytes and the B lymphocytes in these patients. We started a strategy of treatment that included supporting the thymus, which T cells are thymic-derived cells, therefore the T. We started herbal antivirals, and she was a really, she is a really good patient, and little by little, little by little she’s improved.
Ari Whitten: Mm-hmm.
Dr. J.E. Williams, OMD: Is she back to 100% normal? No. She’s 78 years old, too, and she’s not expecting miracles, but she’s 60% better.
Ari Whitten: Awesome.
Dr. J.E. Williams, OMD: Mm-hmm. To me, that’s reasonable, and that’s success.
Ari Whitten: Yeah.
Dr. J.E. Williams, OMD: It took that patient, it took us a lot of work on getting her on a path, ruling out things and not wasting time on things and keeping going forwards in a curvy straight line.
Ari Whitten: Yeah, excellent. One other question I have for you, you talked a little bit about co-occurring infections, multiple infections happening at the same time. I mentioned also this pattern of sometimes you see people get a little bit better with some of the antiviral stuff and then they go back to getting worse, they get the symptoms back. To me, this is suggestive of maybe the terrain, the host, building up the health of the host, not necessarily just attacking the infection is also really important.
Dr. J.E. Williams, OMD: Right.
Ari Whitten: Do you have any thoughts on that dynamic between how much of the therapy should be directed towards building up the strength of the host, general health and immune function, versus going after the viruses or other infections with botanicals or antiviral drugs and things like that? The other aspect of this is, if, obviously you think there’s a role for going after the viruses, is there a particular context or order in which you think that should be done, meaning do you think there are other steps that a person should work on before trying to attack the virus, or just go straight to trying to treat the virus?
Dr. J.E. Williams, OMD: Well, as a clinician, I see one patient at a time. My practice is personalized medicine. Even though they have the same condition or the same diagnosis, then I will vary that based on that individual’s ability to handle the cost, the time that they have to work with me and how experimental they are and their mindset. It’s hard to answer that.
I had one case, one of my first patients when I moved to Florida. She came from the other side of the state and was completely bedridden and almost crippled, she was in a wheelchair most of the time. They couldn’t find a diagnosis for her of any type of neurological disorder, she was considered severely depressed and maybe had some allergies. They had ruled out autoimmune disorders. When I did her viral testing, there was extremely high everywhere, including Herpes virus.
I asked her if she had ever been treated with an antiviral, and she said yes she had, but she started to take the Acyclovir I think at one point when she was younger, and it didn’t agree with her. It has a lot of GI side effects. I said, “You know, that was a while back. We have more modern drugs, take this one and let’s see what happens.” She agreed to that.
But, we already started with the intravenous therapies for her to improve her nutrition with other supplements and herbal things. Added the Valtrex, just simple standard formula. She improved dramatically within weeks, and she stayed better. Within two months, she was back to work part-time, and then three months, four months she was full-time. She’s completely better.
Ari Whitten: Mm-hmm.
Dr. J.E. Williams, OMD: That’s an unusually successful case. Most of them are slow going. The terrain is always important, always important. Part of the terrain that I also look at is called the EMC, the extracellular matrix. For that, it’s detoxification therapies, saunas, sublingual medications, and I inject special types of medications under the skin that goes into the extracellular matrix that permeates the whole body and the lymphatic system. When you talk about terrain, that’s the real aim of the real terrain.
Ari Whitten: Let me clarify that. The real terrain you’re saying is the extracellular matrix?
Dr. J.E. Williams, OMD: Absolutely, because it connects to everywhere.
Ari Whitten: Okay. I think that’s a nice segue into the last question, it’s a big question, but it’s the last question I have for you, which is, what are your top strategies for … Obviously this varies by person, obviously it varies by specific virus, but what are your top antiviral lifestyle strategies, and I know you go over a number of these in your book Viral Immunity, which is excellent, but can you talk about maybe your top five or six tips for people to help boost their immunity and build up their terrain to help fight off infections?
Dr. J.E. Williams, OMD: In terms of lifestyle, one is learning to pace themselves appropriately. Two is developing an attitude that we’re going to find out what’s wrong with them more or less, almost, and sometimes right on, and I’m going to keep working until we find it. Hope is important, but not a false hope, a real sense of hope. Then the willingness to try therapies and to report. They need to keep a very good, either a log, brain fog and cognitive disability is a hallmark of chronic fatigue, or somebody else to do that for them.
Then I’d like them to move, and if they can’t, if they’re so fatigued they can’t walk or get out of bed, at least, I say, “Listen, you have five fingers on each hand. Can you raise your hand?” “Yes, I can raise my hand.” “Can you move your hand like that?” “Yes, I can do that.” I say, “Okay, then you can exercise.” Let’s go, one, two, three, four, five, six, seven, eight. One, two … Now we’ve got the patient moving. We need to circulate blood.
Ari Whitten: Yeah.
Dr. J.E. Williams, OMD: If I can get them to do a little slant board with their blood flow better to their brain, by the way, brain scans are I think a missing component that all, I’d like to have, and I wish the insurance companies would start paying for them, all of my ME/CFS patients have MRIs and SPECT scans, because that’s where we see the real physical changes there, and plenty of fluids, water, healthy diet, anti-inflammatory diet, and if they have allergies, avoiding the foods that trigger those. Sometimes people do well on a paleo ketogenic diet. Sometimes we have to try a few different things like that.
Ari Whitten: Mm-hmm
Dr. J.E. Williams, OMD: Then support the base, the nutritional base. I like to do tests of coenzyme Q10 levels. When I first started practicing, this was impossible to test. Then some specialty labs came up, but now we can test them from regular labs and they’re very accurate. Selenium, zinc, these are, vitamin D. Then support those nutrient base for them, that’s more or less the lifestyle approach.
I don’t think lifestyle cures chronic fatigue. I think it’s a real illness, therefore it’s not a lifestyle illness, but this is supporting the terrain. If they’re strong enough, I like to have them do short saunas.
Ari Whitten: As far as treatments that you use in the clinic, that’s going to be botanicals, antiviral drugs potentially, obviously this is all personalized. Some of the things you found to be useful are certain botanicals, antiviral drugs. What about things like supporting oxygenation? You talk a bit about oxygenation in the book. Do you think hyperbaric chambers are useful for, and I’ll list some stuff. Extracellular matrix, do you think acupuncture is a useful therapy in that context, to boost the extracellular matrix or affect it positively in some way? Ozone, any other things that you find particularly effective in the context of treatments?
Dr. J.E. Williams, OMD: First, we just talked about lifestyle and attitude and the approach to this, I want to bring my patients to, not like a cheerleader, but just as a, we can do this together, it’s not going to be easy, here’s the lifestyle and here’s the basic foundational things we correct. Now, the next things are what you’re talking about, these are soft therapies, they don’t cure the problem, but they help a lot. They help to manage symptoms-
Ari Whitten: Which therapies are you referring to?
Dr. J.E. Williams, OMD: Acupuncture, hyperbaric and the extracellular matrix biopuncture injections, sublingual bioregulatory therapy, homeopathic like sublinguals, those all help. That’s the next level. I wouldn’t stop there. I do all of those regularly.
Ari Whitten: Okay. What do you mean you wouldn’t stop there? What else are you going to add on to that?
Dr. J.E. Williams, OMD: The three main areas that then after that I’m going to look at, remember, I’m based on evidence-based, so I’m testing and I’m having targets that I’m going after, so immune support. Usually that’s for the T lymphocytes or the low immunoglobulin IgG. Using therapies that support, T lymphocytes would be supported with thymus extracts for example, and then beta-glucan and other mushroom extracts that support the immune system, adaptogens like Cordyceps, many different ones and individualize those for the patients. It’s very important however if they have, that you don’t treat this as an immune deficiency order alone, and over support their immune system if they have a tendency towards or they have a concurrent autoimmune disorder, it can make them worse.
Ari Whitten: Mm-hmm.
Dr. J.E. Williams, OMD: The second arm of that would be inflammation management. They all have this low-grade cellular subcellular inflammatory changes. Then I use Moducare, which is a plant sterolin, or Neprinol, it’s a compound of proteolytic enzymes. I use different herbal extracts, like psycho-saponins from Bupleurum plant species.
Then this Italian called Guna, G-U-N-A, it works with French researchers and has come up with anti-interleukins and the cytokine mixes that are homeopathic in nature and that help to dampen or theoretically help to dampen, and those are absorbed sublingually. Then I look at the antiviral therapy. If I have a pretty clear path, will look at then Acyclovir, but also olive leaf extract and other botanicals, sometimes concurrently, and sometimes I layer them, and sometimes I stack them.
Ari Whitten: Mm-hmm. Excellent. Dr. Williams, thank you so much. This has been extremely insightful. It’s been an absolute pleasure to do this. Where can people go to find more about your work? Do you recommend they go to your website or go get your book on Amazon? The book is called Viral Immunity by the way, guys, I highly recommend it. We’ll have a link to it on the podcast page for this episode as well. Can people also work with one-on-one? Do you work with people at a distance online, or do they have to come see you in person? How does that work?
Dr. J.E. Williams, OMD: I practice only part-time now. I’m in the clinic two to three days a week. The rest of the time I’m writing, researching and doing my fieldwork. My practice is limited, but I do take new patients. The best way to find out more about my work is to go to my website, It’s Dr, D-R, JEWilliams.com. Everything’s there, it links to Viral Immunity and all my other books, including beating the flu. I’m also an expert on influenza. Sometimes we think that influenza species could be associated with this as well.
I do work long distance, and I do see patients in the clinic, sometimes both. I have patients from all over the country, all over the world. I like to talk to people before they become patients to make sure we’re a good match, and I like to look at all of their records, all of their lab work before, so we’re not chasing things that have already been ruled out or things that they thought they have that they don’t have, so get a clean slate, and then I get some more evidence and testing.
Sometimes they come in with beautiful test data. This doctor did a great job, and they say, “How come I’m not better yet?” “Because you have this condition, which is very difficult to work with.”
Ari Whitten: Excellent. One last thing is, what do you think is your ideal patient? For people listening to this, is there a way for them to maybe know or have an idea if they are the right fit for you, and if you are the right fit for them? What does your ideal patient look like?
Dr. J.E. Williams, OMD: That’s a great question, Ari. Every doctor wants the ideal patient. My nature cure mentor Bernard Jensen had a sign over his office that I used to have in California, now I don’t have it but you might see it on my website somewhere, it says, “You’re looking for a good doctor, I’m looking for a good patient.”
Ari Whitten: I like that. Excellent. Dr. Williams, thank you again so much. Your website is?
Dr. J.E. Williams, OMD: DrJEWilliams.com.
Ari Whitten: DrJEWilliams.com. Wonderful. Thank you so much, Dr. Williams. It’s been an absolute pleasure and an honor to do this, and thank you for sharing your brilliance with my audience, I appreciate it.
Dr. J.E. Williams, OMD: Thank you.
Common Viruses That Can Trigger Chronic Fatigue (CFS)/ Myalgic Encephalomyelitis │ And The Best Viral Infection Treatment Approach – Show Notes
Dr. Williams’ own experience with chronic fatigue (CFS) (7:04)
Why fatigue replaces fever (17:05)
Why infections commonly trigger chronic fatigue syndrome (CFS)/ myalgic encephalomyelitis (22:22)
The most common viruses that trigger Chronic Fatigue Syndrome (33:00)
The best testing methods for viral infections (35:10)
Why viral infections become chronic (40:55)
How antiviral therapies work on recovery (46:53)
The best approach to treating viral infections (58:16)
The top antiviral lifestyle strategies (1:02:32)
Links
To learn more about Dr. Williams’ work, go check out his website.
