Episode 95: Chronic Epstein-Barr Virus (EBV) Through a Functional Medicine Lens with Dr. Christoper Bump, DC
Show Summary:
Today we are going to cover the topic of Chronic Epstein-Barr Virus (EBV) with Dr. Christopher Bump.
Dr. Bump is a functional medicine practitioner with over 35 years of experience in clinical nutrition. His practice philosophy includes integrating science-based alternative and integrative therapeutics, applied with a systems biology approach.
Today, we'll uncover the mysteries surrounding chronic EBV infections, discuss the potential long-term effects on health, and explore effective strategies for diagnosis, and treatment using functional and integrative medicine.
So join us for this enlightening conversation that will provide valuable insights for those affected by chronic EBV and give you steps to take to elevate your health and wellness. We hope you enjoy!
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Full Transcript:
Dr. Christopher Bump
Epstein Barr has a gamma herpes virus. There's three classes alpha, beta, gamma. The gamma viruses are primarily you won't hear Kaposi too much. It primarily creates a sarcoma. But Epstein Barr is a gamma herpes virus. And what that means is that it will create a latency within the host, meaning as it infects the body, it's going to stay there. Epstein Barr, this is interesting too, is the Epstein Barr primarily infects immune cells. In the western population, it's primarily B lymphocytes. In the Asian population interesting, it's T lymphocytes, due to some genetic differences, I believe. So, epstein barr, and there's a few little factoids that I think that are really relevant to this and 95% of the world population will test positive for exposure to EBV. In other words, everyone gets this virus, no one is spared. And that's pretty safe. So you're gonna see 95% of your patients to cero positive for IgG viral capsid antigen. We'll discuss that later. So. So with that broad overview of individuals that are exposed to this virus, then how is it that we're even having this discussion? And what is going on with this virus? That would even lead to us having a podcast about chronic epstein barr right.
Dr. Andrew Wong
Welcome to the capital Integrative Health podcast. I'm your host, Dr. Andrew Huang. Today we're going to cover the topic of chronic epstein barr virus, or EBV. With Dr. Christopher bump. Dr. Bump is a functional medicine practitioner with over 35 years of experience in clinical nutrition. His practice philosophy includes integrating science based alternative and integrative therapeutics applied with a systems biology approach. So what happens when viruses enter the body? And how can our bodies more effectively respond to them? Today we'll uncover the mysteries surrounding chronic EBV infections, discuss the potential long term effects on our health, and explore effective strategies for diagnosis and treatment of chronic EBV using functional and integrative medicine. Please join us today for this enlightening conversation that will provide valuable insights for those affected by chronic EBV and give you steps to strengthen your own immune system. Welcome to the capital, integrative health podcast. Dr. Baum. Thanks so much for coming on today.
Dr. Christopher Bump
Well, Andrew, it's it's a pleasure to be here. And I'm excited to have a conversation with you. Yeah.
Dr. Andrew Wong
Yeah. So we're really excited to get into this conversation, Chris, about chronic epstein barr virus. And, you know, we know that there's been a lot of talk about how to treat this virus. You know, there's also different opinions about whether or not chronic EBV is even a thing. So I think we'll want to get into that from the conventional perspective as well. Before we get into that, I always like to ask our guests, and I think our listeners would like to hear this too, a little about your story. And what drew you to become a functional medicine practitioner?
Dr. Christopher Bump
Sure. So you might be able to tell that my hair is a little silvered. And so consequently, I'm literally on the other side of age, which means that I've been practicing a long time. 40 some odd years now, actually. And I it's interesting journey. And I won't go through too much of it. But just know that I went through chiropractic education, to use it as a port of entry in the late 70s. To create this holistic model, which evolved into functional medicine back then in the 70s and 80s. We call it holistic medicine. So I went through chiropractic because I felt that that was a it was a an easier port of entry for me than the indoctrination of traditional medicine. So and so I've grown up with the concept of functional medicine. And still I'm learning and growing as we speak.
Dr. Andrew Wong
Yes, yes. What what chiropractic medicine is inherently holistic and there's there's a lot of interconnections that you have, right. agree
Dr. Christopher Bump
that the philosophical foundation of chiropractic is simple that you know, nerves, the NOR logic supplied to the systems. If it's interrupted, may interrupt function, I took a slightly different philosophical approach and never really subscribed to the traditional chiropractic but more like always looking at human health through a structure function relationship. And, and I suspect we'll have an opportunity to discuss what I mean by that. Because right down to the cellular level, we can address the structure of the cell and hence function of the cell
Dr. Andrew Wong
gas. And I'd love to get into that today. So let's kind of take a deep rabbit hole dive in. Sure. Sure, yeah, we got some rabbits during the pandemic. So this is kind of the things I love to say. Now we started our podcast during the pandemic, so kind of some rabbit hole questions. Let's talk about what Epstein Barr is EBV. You know, a lot of people may know that you know, or not, they may not know that, you know, Epstein Barr can kind of stick around after what's called acute infectious mononucleosis, which is caused by EBV. But let's talk about sort of at first, what is Epstein Barr Virus? What is chronic epstein barr virus? And then how does it differ from say acute EBV
Dr. Christopher Bump
infection? That's a really good springboard for our discussion, Andrew. So Epstein Barr is the gamma herpes virus. There's three classes alpha, beta, gamma, the gamma viruses are primarily you won't hear Kaposi too much. It primarily creates a sarcoma. But Epstein Barr is a gamma herpes virus. And what that means is that it will create a latency within the host, meaning as it infects the body, it's going to stay there. Epstein Barr, this is interesting too, is the Epstein Barr primarily infects immune cells. In the western population, it's primarily B lymphocytes. In the Asian population interesting. It's T lymphocytes, due to some genetic differences, I believe. So, Epstein Barr and there's a few little factoids that I think that are really relevant to this and a 95% of the world population will test positive for exposure to EBV. In other words, everyone gets this virus, no one is spared. And that's pretty safe. So you're gonna see 95% of your patients to zero positive for IgG viral capsid antigen. We'll discuss that later. So. So with that broad overview of individuals that are exposed to this virus, then how is it that we're even having this discussion and what is going on with this virus that would even lead to us having a podcast about chronic epstein barr right. So the acute phase of of EBV infection is, as you know, typically classified as mononucleosis. In that time period, immunity is built up, and the host immunity will shift from acute reaction, and that's where you would measure IgM. And that will last typically two weeks. After that, there are two different markers that continue to remain elevated. One is called viral capsid and the other is called nuclear antigen. I might be getting a little ahead of myself here with this, Andrew, but know that anyone who has been exposed to EBV will show an elevated v ca or viral capsid antigen, typically, but not always, they will also show an elevation of a nuclear antigen. I'll explain that later. So in most individuals, the virus then creates what is called a latent phase, it goes into the cell establishes residents and the way I describe it, Andrew it it sets up shop, it sets up a platform for it to in a sense, regulate the cell that it's living in. And as long as the the cells in a healthy, calm, peaceful place, the theme the virus and the cell remain in an equilibrium balance.
Dr. Andrew Wong
Chris you're talking about in the nucleus was where it sets up shop are
Dr. Christopher Bump
so good for your listening audience that I like to describe the size of the virus if I may, to kind of just and I know I'm going off track here a little bit for your question, but If, if you if I am a a b lymphocyte sitting here, and I'm holding a basketball or soccer ball, that would be the relative size of a bacteria, it's going to maybe damage the outside membrane, but it's not going to get inside the cell. Now, if I'm holding a tiny little vitamin D capsule, that would be the relative size of a virus to me a white blood cell. So it can get anywhere in the cell that it needs to. And of course, it needs to get in the nucleus, why it needs to borrow our DNA machinery, or our chromosomal DNA. So and this is what's interesting about viruses, Andrew, is that, you know, there's some virologist don't even list viruses as life forms, because they're dependent on us for replication or other mammals or for replication. So yeah, the EBV is living inside the nucleus. So all of this process that I'm describing, will take place primarily within the nucleus, right? So in the latency, it sets up a nice quiet little place. Would you like me to go on into like, what happens with chronic?
Dr. Andrew Wong
Yes, please.
Dr. Christopher Bump
Okay, so So, so when, when the virus is in its latent state? It will, I mentioned that it kind of sets up shop, it sets up a little factory to keep itself in its latent state, but really what it's doing, it's using nine to 10 genes on a regular basis to regulate the internal of the cells. And this is absolutely mind boggling. fascinating to me, Andrew, because what the virus does in that process, it turns off something called toll like receptors, toll like receptors are these transmembrane proteins that listen to cell signaling that alert the cell that there's danger, infection injury, and right,
Dr. Andrew Wong
it turns off the alarm system?
Dr. Christopher Bump
It turns off the alarm system, like, oh, my god, is that a good thing? Absolutely. It's a good thing, because it allows the cell to immortalize I mean, it really allows the cell to continue to replicate and be in place because of the toll like receptors will create autophagy and apoptosis if they're highly triggered. So the virus is enlightened state, it's always there, kind of working this low grade regulation of cell function. It all sorry,
Dr. Andrew Wong
Chris can Sorry to interrupt. I just want to clarify a point before we get further into that. So if the Layton virus or the viruses turning off in the latent state, the toll like receptors, and at some more like in cell, you're saying that's a good thing for the cell, because there's more longevity of the cell, or there's also a double edged sword to that as well. Okay,
Dr. Christopher Bump
okay, you Yeah. And that double edge is that it allows the virus to remain replicating or in control. So the way I like to explain this relation, Andrew, is that in a healthy individual or healthy cell, assuming that no one is going to escape the infection of this virus, but in a healthy environment, there's a mutually respectful relation that can be established between the virus and the host. That's what the latency place is, it's good for both of them. It's more self serving I, in my opinion for the virus than us. But hey, we've grown up over 100 million years with this dude. So it's about getting rid of it. So we have to accept it. And that's really the theme for me in terms of clinician, we have to find a way to establish that mutual relation and balance within the cell. Now, what happens in the lytic phase, and this is what links into chronic active EBV is, if the virus becomes threatened, if it senses danger to its survival, instinctively, it's going to go mad here. So we'll go into replication phase, which is called its lytic phase. So it will go from a regulation of nine genes up to 122 genes. So that's like a 12 All fold increase in cellular metabolic activity. And that's where the problems will arise as we get into this discussion. So in the lytic phase, the virus up regulates, then starts making all these excessive Well, viral replication proteins for making viral babies so that it's surviving. And then they're, they're secreted out of the cell, either through the membrane or lysosomes, not lysosomes. Endoplasmic and, and they keep replicating then go infect other cells, etc, etc.
Dr. Andrew Wong
I just have one question to go back for the acute EBV infection, you mentioned that there's different things that that could be, you know, seemed symptom wise, like fever or cervical lymphadenopathy, which is sort of a inflammation of some of the lymph nodes in the in the the front part of the neck, you know, throat issues, you know, maybe a sore throat, you know, different things like that upper respiratory type symptoms. What if our listeners, listeners might be saying, hey, you know, Dr. Bum? You know, my epstein barr, antibody tests are positive, but I don't remember having acute mono, is it possible to have asymptomatic infection of mono? I'm giving you the softball here. But yeah.
Dr. Christopher Bump
So Oh, my God, it's such a perfect question, because I have patients in all the time. So you know, the lead question they asked clinically, is, how are you doing with fatigue, how's your energy, and there's usually concomitant association with decreased energy, that many patients just as soon as they're normal, or they're just assuming that they're decreasing in energy, because they're aging. Brain fog is another associated kind of broader clinical symptom, skin rashes, some GI distress, basically, and any sign or symptom that could relate to an increase in oxidative damage on a cellular level, can be attributable to this lytic phase, because of what happens in the cell. So, so yeah, there's a whole but getting back to your, your question. Individuals very often patients very often don't remember having infectious mono. And, but they're usually individuals who are either their young mothers or their mothers who started with symptoms as young mothers, so they may have teenagers now, but that, you know, things changed since I was a young mother and I just attributed to the stresses of being a mom. Young overachievers Absolutely. Young high school kids, adolescents who are playing two and three sports, they're, they're straight A's in their studies, and they're always pushing that high level of adrenergic drive those individuals Oh, yeah, I remember having a cold or a kind of a fluid thing for a week or two, it knocked me down, but I kept going those kinds of things. But that was never diagnosed for mono, right. The other problem with that is the the rapid mono test is so unreliable, that even if a child is taken to the pediatrician, and they run that rapid test, it's it's not efficacious for a good diagnosis. Okay, so
Dr. Andrew Wong
everyone at least 95% or more people have that very, not everyone is symptomatic and an acute phase and then you mentioned a few things that can be associated with chronic epstein barr it sounds like more in the lytic phase like fatigue, brain fog, gut issues, skin rash, any other symptoms that would be you know something you see clinically in your practice and stuff.
Dr. Christopher Bump
Those are the primary I will see on occasion or throw Algis as well my Algis as well, especially in the upper body, again, associating any any increase oxidative damage to the downstream consequences. What that what that might look like in organs and tissues. So the other part of this Andrew is the potential for EBV and, and the brother it's brothers cytomegalovirus, human herpes virus six to damage or effect other glands and tissues, so and fibroid is probably the best studied. Multiple Sclerosis. autoimmunity is another one very well studied. But what so whenever I see anyone, any patient who has signs symptoms of thyroiditis, hypothyroid Hashimoto thyroiditis I immediately am thinking, Oh, I wonder if there's a viral Interplay here, as well? Yes.
Dr. Andrew Wong
Yes, I agree. I think you know, Hashimotos multiple sclerosis. We know there's a big there's a big study that came out a couple years ago, that that there's Association, I think, even concluded there is a potential causation with, with Epstein Barr being a potential root cause for Ms. Correct? Absolutely.
Dr. Christopher Bump
In fact, I just read in review of our discussion to see if there's any newer literature and there's absolutely a very robust study of looking at. I think it was, like 10 million military recruits over a period of time and a very definitive, causative relation between EBV and Ms. Yes.
Dr. Andrew Wong
And I think this is a $64,000 question, I'll that I may bump it up to 128. With the inflation now. The function of medicine practice, you know, we know we're always evaluating not only one, but multiple root causes of things and everything kind of acts, you know, synergistically? How do we know as clinicians? And how do we know as patients, you know, people are listening or anyone that's listening? If these things like fatigue, brain fog, skin rashes, GI issues are from, you know, gut dysbiosis, or from toxins or, you know, versus a chronic infection like Epstein Barr or some other infection, like how do we, we get a bunch of lab tests back? If you get a bunch of data back? How do we how do we sort out all those different possible threads? Who
Dr. Christopher Bump
distills down to treating the patient rather than the test? Right? Exactly. And, and, really, it's so so my, my clinical approach in working with a very complex individual who has multiple imbalances in multiple systems, is to work from the obvious and distill down. And, and I will say that there are two primary therapeutic drives for me in that process. One is to work on the cellular process. And I think we'll want to talk about that in detail. So that's, that's a primary. And then second, or it's, it's not that they make a distinction between cellular damage and cellular function, and the gastrointestinal tract, but they are a one on one level. And then I start more with the detoxification and cellular work than the gut work for For this reason, it's easier for me to get patients to go through a, a noticeable positive change, when I can help them change their lifestyle, and have them sense an improvement in their overall energy and sense of vitality. Gut rehab takes a while, and it's it's a slow moving process. So I UK, second.
Dr. Andrew Wong
So that's great. I want to I want to make sure we get to that for this session. I think that, that Thank you. Thank you so much. Chris wanted to get for a couple of the the intro kind of set up questions a bit in terms of, you know, why do some people you know, 95% of the population has epstein barr, they may or may not remember keep mana, like we said, how do we what are some of the underlying factors that contribute to the development and persistence of chronic epstein barr and some individuals whereas other people may be walking around with, you know, amazing energy they're walking around like Olympians are running and you know, different things like that, how do we how do you how do you kind of kind of parse that out there. So,
Dr. Christopher Bump
I tease that apart. This way, Andrew, I think about what are the what are the potential antecedents and triggers using functional medicine parlons that may lead to imbalances or compromises in an individual. Ultimately, it see if I if I use the word stress, it does not get it at all, because stress can come from multifactorial places. So it can be spiritual stress, emotional stress, mental stress, it can be structural stress, it can be environmental stress, it can be intracellular stresses. So but anything that causes an increased burden on the cellular function is going to potentially cause the virus to feel threatened. And so consequently, going up into the lytic phase,
Dr. Andrew Wong
it's going to want to jump off the ship essentially. Oh, yeah, a virus is gonna
Dr. Christopher Bump
jump out of this. Yeah. Yeah, so yes, exactly. And so, so. So there are and so This is where you can tie gastrointestinal disorders like dysbiosis, or an inflamed gut or heightened immune response in the gut, or increased permeability to an upstream trigger for increased cellular burden from the endotoxin buildup of say LPS or protein fragments, whatever it may be, that causes an increase on a cellular reaction, all of these kinds of things will lead to the virus being threatened hence, going up in sounds like
Dr. Andrew Wong
the terrain matters, right? If the train is inflamed, then then that's going to cause people to have more likely to have Epstein Barr that's chronic immune system imbalance.
Dr. Christopher Bump
Yeah, and so I am careful about using the word inflamed or inflammation because it like stress is a it's kind of too broad of a stroke, for us to use without defining what we mean by that. Yeah. And, and, and so yes, to your point, Andrew, is any we could say it this way. So, so toll like receptors, one of their jobs, is to trigger a whole host of inflammatory cytokines. And so, tumor necrosis factor will do that NF kappa B, anything that triggers these transmembrane signaling molecules that are listening in and doing a surveillance on our balance will lead to a potential immune and inflammatory response. Yeah. And that's what you know, the the variety of triggers is like, Oh, my God, it's, it can be huge. Yes. And
Dr. Andrew Wong
before we get into thank you so much before we get into the, the cellular process that you're talking about, I wanted to just touch on how we test for chronic epstein barr. I know that clinically is really the main thing is, you know, how's the person presenting, treating the person? But are there specific tests or markers that are used to identify the presence of Epstein Barr Virus?
Dr. Christopher Bump
Yeah, I should probably make a distinction for your audience at this point. Before I talk about testing. I am not referring or speaking to a very small percentage of individuals with chronic EBV who go into develop different carcinomas. And it's good point. Yeah, I'm not speaking to that. And though that category of patient in the medical arena is considered chronic active EBV that's not what I'm seeing. That's not what we're speaking about. We're talking about the walking wounded, the the the, the, the gray areas, for individuals that are poorly defined, poorly diagnosed, that are chronic, that can then be associated with this process, kind
Dr. Andrew Wong
of like the tip of the iceberg, what what we see in the conventional medicine world is that epstein barr, it may contribute to maybe more extreme imbalances that might lead to the development of, of cancers, is that is that sort of accurate, but then there's a bunch of things underneath that water, that that it could still affect that maybe is not accepted by the conventional medical world in terms of how that would be affecting.
Dr. Christopher Bump
Yeah, that's well said, Andrew. Yeah, the the cancers and there's a number of different specific cancers that are clearly related to EBV, the fraction their percentage of individuals contracting those, and it's thought in the medical research that there's, you know, everything always gets distilled down to a genetic predisposition. I kind of try to refrain from that thinking, because it's too reductionistic. I suspect that there's there is a predisposition in certain individuals who are chronically stressed, who then may lead to say lymphoma, as an example. But that's, that's not what we're speaking to today. Yeah,
Dr. Andrew Wong
it's good. Really good point. Really good distinction. So So yeah, testing, where are you missing there?
Dr. Christopher Bump
So the testing is, it's interesting. Andrew EBV specifically has some fairly robust and what I think are reliable markers for the clinician to make a pretty good assessment of where this virus is. Now just as a little tangential side, Saito, Megalo virus and human herpes virus six, which are the Epstein Barr viruses brothers, they do not have the type of testing that I'm going to speak to they only show IgA, I mean IgG IgG and related immune response. Okay, with that said, so, so what I find the most reliable useful testing are the traditional Cyril immunoglobulin testings that reflect immune reactivity to three different proteins in the virus. Those three proteins are first viral capsid antigen, the second is nuclear antigen, and the third is early antigen. The viral capsid antigen will show a positive IgM. For acute in the first two weeks post acute infection, the IgM diminishes, and the immune the B cells produce IgG mediated so that within two to four weeks after initial infection, the the patient will show an increase in VCA IgG. That simply in my explanation, Andrew just tells you as the clinician that the patient has been exposed to the virus, it doesn't give an idea of its action or activity, just how much but there's an interesting correlate that I can make for you. And that is this, the higher the VCA IgG G. Hens to indicate how robust that virus may have been in the initial infection. Or it's certainly a measurement of how robust the lymphocytes have gone to respond to it. So, so there isn't any research that connects that that's clinical experience and insight. So when I look at someone who comes in with a greater than 600, VCA, IgG, I know that they've been slammed with virus, okay, but not as all last there. So the other two markers, nuclear antigen. Again, I'm mostly interested in IgG, because it's going to give me an idea of chronic surveillance, immune surveillance, if you will, the nuclear antigen relates to the latent phase. So that's a marker that's going to tell the clinician that the virus is in this kind of equilibrium status. But again, the level of that nuclear antigen will kind of give you a sense of how robust the infection is. So even though a virus may be in latent stage, remember, I said that it's still activating nine different genes to keep that cell regulated, the more the more robust. So so. So if a clinician sees the nuclear antigen elevated IgG, it's going to indicate late in phase. However, if the third protein early antigen shows an elevation, and I don't, in this one, I don't. To me, it doesn't matter if the E early antigen is just a little bit elevated or severely elevated. It tells me that the virus is up in its lytic phase.
Dr. Andrew Wong
I was gonna ask you about that the amplitude of that it sounds like yeah, it varies for different people. But yeah,
Dr. Christopher Bump
it does vary Andrew, and but with the early Imogen, I don't make a distinction so much with that, though, I can. But it because I've done this for so long. I've been I started looking at Epstein Barr Virus in chronic fatigue back in the early 80s. So you know, we've been 40 years of watching this virus and so clinically, well, yeah, I can make a clinical Association easily that the increase numbers of those EA of the early antigen do correlate with signs and symptoms. Do you
Dr. Andrew Wong
see that program Do you see the early antigen IgG which is indicating like you said the lytic phase or the or the nuclear antigen, which has antibody, which is indicated late in phase? Do you see those fluctuate and respond to, to treatments like up and down? Or is it not predictable there?
Dr. Christopher Bump
Thank you. Thank you. Thank you. Yeah, very rarely, well, I see the viral capsid antigen come down. But I will often see the nuclear antigen come down or go up? Depending? So, yes. And certainly the early antigen does the same, it can come up and down. So I will see fluctuations in immune, immune response to those Yeah,
Dr. Andrew Wong
great, great. I like when I get into the year process there about, you know, how you use the process of detoxification and cellular health, maybe we'll get into that, and we can kind of integrate some of the things that that you would how you would how you would, uh, you know, I guess the dress or treat this?
Dr. Christopher Bump
Sure, I would like to do it. Before I do that, Andrew, I think it's, it's worth hearing this. Since COVID, I've seen a very unique shift in Epstein Barr Virus presentations. And not only am I seen an increase in reactivations, in the early emergence, that's like, I mean, it's like, oh, my gosh. But also, I have seen in a handful of patients, which is bizarre, new infections, actual IgM, elevations indicating acute new infections, and, and I haven't been able to find anything that correlates explains that process so much, or if it's a false reading, because of the COVID. But it's just something thank
Dr. Andrew Wong
you for bringing that up. And I think I'd love to hear your thoughts, actually, since we're on top of COVID, about how is there an association that you've seen in your practice or research at all, in terms of long COVID or kind of post viral inflammation? And then And then, you know, reactivating, Epstein Barr as well, absolutely.
Dr. Christopher Bump
There's, there's a very strong correlation. In fact, in the IFM, at the Institute for Functional Medicine, they have a long COVID protocol. And they've done some research in looking at this correlation, and have seen a very definitive correlate with an increase in activation of EBV. You almost
Dr. Andrew Wong
have to wonder if some of the long COVID symptoms are not only from the persistence of the virus or immune system activation, but also the rear reemergence of Epstein Barr. Yeah,
Dr. Christopher Bump
good point, a good point. And when we talk about the therapies or my approach to interventions, it will make sense. And so again, as I said, we're not treating the bug. We're not treating the virus as much as the human. That's a huge
Dr. Andrew Wong
point because the bugs gonna be in the system no matter what exact that's a really key point for Epstein Barr for Lyme disease often unless you get it right away. I think a lot of times these persistent viruses or stealth infections that act like viruses, like because Lyme is a bacteria but it's kind of acts like a virus to sure mycoplasma, mycoplasma, and and the cousins, like you said, are brothers brothers or sisters? I don't know. Are they brothers?
Dr. Christopher Bump
Yeah, really? They're beta viruses. So they have a little bit of a difference to them. Okay.
Dr. Andrew Wong
Okay. Okay. But
Dr. Christopher Bump
I think something that I'd like to share with you that it's kind of a more of a clinical observation for me, because I've been so interested in these viruses over a long period of time. There is definitely an increase in over the past 20 some odd years in the elevations of these viruses that I see in patients. And and I can't help and of course, I haven't seen any studies that verified this. I'm just making a clinical Association towards stress response. And what has happened in our culture, the Western cultures. I don't see much Asian population but but in Western culture, there's just been such an extraordinary amount of stress since 2001, in patients reactivity to life, but from news to environment to so much politics, and
Dr. Andrew Wong
then the EMFs right, the electromagnetic fields and yeah, the oxidative stress from the environment.
Dr. Christopher Bump
Yes. And so So I think that we could draw a pretty clear The line of increase associated as stress increases the
Dr. Andrew Wong
activity. Maybe we shouldn't watch the news as much, then I don't know if that's Oh,
Dr. Christopher Bump
my gosh, Andrew, I strongly advocate I actually, I don't mandate it. But I recommend all patients to stop. Turn the television on. Just no news.
Dr. Andrew Wong
in any form. digital detox. Yeah.
Dr. Christopher Bump
Well, it is. And I asked the question, when you're when you're engaged with a screen, and you're listening to or watching, how do you feel from that? Do you feel positive and engaged and charged in a, in a life giving loving way? Or are you feel fear and angry? And if it's negative? Why would you do that? You know, it's like, why would you subject yourself to that?
Dr. Andrew Wong
It's a good plan. Yeah, that's great, great advice. So,
Dr. Christopher Bump
so you want to hear about the cellular stuff. And but what I think yes, I think that sounds great. So so what I will say about epstein barr, Andrew really applies in my clinical experience across the board that anything that increases cellular reactivity, will affect its function. So, so if we, so without going into too much nuance and details here, when I described the virus going up into its lytic phase, it's in this nice quiet mutual nine gene kind of mutual relation to 122 genes. Well, that would be like this, that would be like, you're working in an office building with 100 people. And the office building is set up perfectly for all of you in your business, all your supplies are needed all your exit, certainly that all your communication is nicely met. And then one day you come in and you say management up above says we have to share space with 1000 people, like oh my god, it would create such a burden such a mess. So that's that's kind of like a pictorial I like to use of what happens on a cellular level, when the virus goes up into its lytic phase, you're getting a 12 fold increase in metabolic activity. So what does that look like a 12 fold increase in reactive species, whether they're oxygen or nitrogen or sulfur. So, those reactive species then have to be neutralized or they have to be dealt with with that natural anti oxidation process. Associated with that, because of the oxidative potential damage from all of these reactive species, you will, the patient or the cell suffers in two primary ways. One is a loss of energy because of electron stealing, I guess you called swiping or borrowing. So these free radicals can easily be neutralized, or stabilized is a better word with the electrons from the ATP from mitochondrial respiratory chain. So that's one source. So that's where energy comes into play. The other has to do with signaling proteins in the end the actual cell membrane itself, so that, again, cell membrane, the phospholipid membrane, and the trans membranes, signaling proteins, whether they're through the the, the the cell membrane itself, or the organelle membranes, they're, they're offering free lunch for better stability to these. So they're offering electrons to stabilize, consequently, then the downstream of that is loss of function. So then our cell membranes, and our organelles can't communicate with each other and the outer environment so well.
Dr. Andrew Wong
Being sure, yeah, that makes sense. So,
Dr. Christopher Bump
if you ramp that up 12 fold, it puts an incredible burden on our antioxidant systems, and eventually our detoxification enzymes. And, and this is one of the areas for me that gets overlooked in the functional medicine community that we speak about. detoxification, bio transformation. We don't often enough related right down into The cellular process, because we're always thinking about these exogenous insults like heavy metals in environmental pollutants, etc. But we forget that cellular components, and endogenous Lee produced waste, like from viruses also need to be detoxified. In fact, Humans inherently evolved these Cytochrome P 450. Enzymes, in response primarily to microbes, and plant phenols, you know, that were toxic to bugs and potentially toxic to us. So, our isoenzymes p 450s. kind of developed out of that, so, but in this picture I'm trying to create for you, Andrew, so if there's excessive burden, then there's going to be also increased autophagy and apoptosis, but it's more that I believe, the autophagy and the viral breakdown, than the cellular waste that needs to be detoxified
Dr. Andrew Wong
for the audience. I'm sorry, can you can you just kind of describe what a toughie G is just, yeah,
Dr. Christopher Bump
so So autophagy is the breakdown and clearing out of used cellular parts. That's how I like to describe it. So when parts of the cell need replacing and repair, we have this kind of auto destruct. So the kind of dissolve, and the membranes and the internal proteins of these organelles need to be cleaned up and neutralized. And remember that, that the cells say that the the detoxification enzymes, and the reason I harp on this a little bit, Andrew, is it they are phospho lipids, right? So so if you have a membrane from a virus or bacteria, or your own inherent endogenously produced, they need to be broken down and cleaned out, they need to be hydrolyzed by the cytochrome P 450. Enzymes. That's really how we evolved them. So for me, therapeutically, I know I'm rambling and going on here. That's great. That's why it's it's so important for me to support the detoxification pathways. And anti oxidation pathways are really one in the same in. What
Dr. Andrew Wong
about cellular mitochondria membrane support? Are you thinking also things like giving someone phosphatidylcholine and other their fatty acids and things? Yeah,
Dr. Christopher Bump
my favorite is actually the CDB city. Choline. It's a precursor for the fossil lipids. Yeah. So interesting. little sidebar, I had patients on city choline, prior to, because I've used it for years to support cellular membrane structure. And, and it was uncanny. They just did not contract the COVID virus. It's like, eventually some of the mutations Yes, but yeah, I love the city calling for it. But to answer your question, yes. The fossil to call liens are so critically important for regeneration of the phospholipid membranes. Yeah, yeah.
Dr. Andrew Wong
Yeah. So what other things are you thinking in terms of how to support the cellular process? You mentioned? Things like antioxidants? Talking about phospholipids any other any other thoughts? Especially I think, I think we should also touch on ideally, the role of nutrition and, and lifestyle, are there other things like that that would affect maybe other nutraceuticals or herbs that would affect the cellular and brain health?
Dr. Christopher Bump
Yeah. Perfectly then. So. So if you if we consider the whole human, the whole patient and and not get reduced down to the specific imbalances? We go, Well, what's dietarily? What is the thing that you want to orient towards? Well, you want to orient towards any dietary change that reduces immunological burden or cellular metabolic burden? So what's that look like? Clean organic, non chemicalized, non processed foods and an elimination of the most renowned antigens. So they're most renowned that you know are the gluten thing gliadins In the casings and corn, soy and we can peanuts and we can go right down the list. So I will always put patients on a strict elimination diet as I have them jump into therapeutic protocol, increasing, increasing their clean protein sources, and organic vegetables went possible and if they can tolerate fruits, some, especially the high
Dr. Andrew Wong
nutrient value, and it sounds like no alcohol, either alcohol would be part of the elimination diet. I know a lot of people are on this elimination diet like but I have two drinks at night.
Dr. Christopher Bump
Oh my god. So So I'm currently doing research and hope to present and write up a book about a functional medicine approach to alcohol.
Dr. Andrew Wong
Oh, nice. That is well needed. i Oh my god, so excited about that.
Dr. Christopher Bump
So alcohol and you actually dissolves and phospholipid membranes, it is so friggin destructive. But you know, and here's the caveat in alcohol is, I can almost say that there's no positive thing about alcohol, except this. It is one of the few drugs chemicals that humans have access to, that literally quiets and calms themselves, which, when you consider the pain and suffering of the human journey, it's okay to take a break. It's okay to disconnect. Alcohol is absolutely wonderful for that as his marijuana, those two in particular. The other hallucinogens and other that's a whole different discussion from a psycho spiritual perspective. But when I've been thinking about so it's it's relaxing, it's wonderful. But the question is, what are the damages? And what is your tolerance and how far you didn't? So the risk
Dr. Andrew Wong
reward like Yeah, yeah, what's what's kind of going on there? Yeah. Yeah,
Dr. Christopher Bump
yeah. As you can see, we could go with them. And
Dr. Andrew Wong
that's a whole nother that's another rabbit hole. Right? Yeah. It's hard. It's hard to argue against the social benefits and the relaxation benefits. Like you said, I think maybe for someone with chronic epstein barr or oxidative stress, you know, it's so clearly alcohol is not doing them any favors from a cellular membrane perspective. If you're if it's dissolving, be the phospholipids. That's yeah. It's
Dr. Christopher Bump
a definite no. definite no. Yeah. So But getting back to to like the dietary nutritional thing. So So in a nutshell, really what we want to do is help the patient reduce their stress burdens. And that can be metabolic stress burdens. So someone who is insulin resistant and are trending towards, will do really well with intermittent fasting. The stress management from emotional and mental, something that I didn't say that I think is relevant here, Andrew, is that so I'm speaking about how house how the virus will upregulate 220 genes, if it's threatened, well, when when we are in a stress response, when we are in that simpatico adrenal reactivity that fight or flight sympathetic nervous systems up ticking are adrenaline's up ticking out what happens when the cellular level there is we're also increasing metabolic rate. So in stress response, some researchers say it will increase metabolic activity 100 fold, but most can concur that it's at least a 10 fold increase. So, so you can have the double whammy of viral upregulation stress up regulating. And so yeah, so anything we do to help quiet and calm the patient's metabolic burden?
Dr. Andrew Wong
I think I remember you saying, Chris, that might have been one of the conferences that chronic stress or acute stress or chronic, you know, unmitigated stress, especially will will activate the lytic phase of the virus, like kind of like more replication is that is that accurate?
Dr. Christopher Bump
Yeah, so So what I when I speaking a little earlier about the toll like receptors, what I should have made a distinction about is that there's, there's, there's transmembrane toll like receptors on the outside of the cell. And then there's endogenous or intracellular toll like receptors, the EBV in its in its latent phase turns off the internal ones. Okay, so the, the intracellular toll like receptor there's two of them five and nine, I believe them but the, the transmembrane ones, the outer ones do not get turned off. Okay. That's it. So yeah, so that's where the trigger of stress, because that's what what toll like receptors are doing.
Dr. Andrew Wong
I'm sorry, I'm sorry, it's stressful trigger the transmembrane or the intracellular both for trans member transmembrane. It's different mechanism than not.
Dr. Christopher Bump
Yeah, it's the first stage and alerting the cell. Yeah, the internal ones would have established as the internal ones have turned off, and that's allows the cells to immortalize. Yeah. But the external the transmembrane. One, that that's will still respond to a stress response, and that indeed, is what will trigger the virus up into its lytic phase.
Dr. Andrew Wong
Now, in terms of, I know, this is a little getting into the science of this, but I just want to ask you, if if the cells are immortalized because the intracellular TLR toll like receptors are turned off, does that mean these cells will eventually become cancerous or they they just eventually die because of other you know, oxidative stress, etc.
Dr. Christopher Bump
So we'd like to think that they go through apoptosis eventually because of long term overuse of developing into cancer is a really good question. I don't have a really clear answer for that. And it may be one of the triggers for the development for say, lymphoma.
Dr. Andrew Wong
Oh, got it. Okay. So so so having having something where where you know, intermittent fasting may may promote or you know, apoptosis and that cleanup of the junkyard so it doesn't keep on getting immortalized you know, we don't want immortalized junkyard essentially what happens with the cancer Okay, thank you. That's very helpful. Any I know a lot of people are trying different things like Laura Seaton or you know, just to name a couple of things. Olive Leaf Extract me what are your thoughts on nutraceuticals? Vitamins, good things like that.
Dr. Christopher Bump
There's two that are really well studied. That reduce the the the dampened down the lytic phase. Okay. So that's real valuable. The one that has the most robust study is artemisinin, or, or good old fashioned mugwort. Yeah. So artemisinin, it's the biosynthetic of that is called artesunate. That's a step removed, but the Artemis and it is amazing. It's powerful, too. So that's number one. Number two is Berberine and Berberine. Like curcumin, it's kind of like one of these fundamental broadspectrum beneficial herbs that touches everything. But it has a significant body of literature, showing it to being able to damp in the lytic phase didn't know
Dr. Andrew Wong
that one. That's good. That's good. And especially because you can use it for metabolic syndrome also.
Dr. Christopher Bump
Absolutely. Yeah. And interesting. There's studies that show that it has a associated synergistic benefit with curcumin as an anti cancer therapy.
Dr. Andrew Wong
Nice. deburring thank you for mentioning that. And then so we talked about detox and a lot of things here. But I love I love how it's it's all about really treating the terrain, you know, more than the bug. I mean, there's certain specific things. I guess I just want to ask about vitamin D, you know, Vitamin D is all we always know is, that's got a lot of press recently with COVID. Um, what is the role of say, you know, vitamin, vitamin D, maybe serum levels? If that's if that's a thing with epstein barr, you know, where do people? Where should people kind of keep the vitamin DS, so
Dr. Christopher Bump
so I don't have a real good answer about vitamin D. I check it, I put patients on it. But I'm not clearly versed in saying there's a direct correlation. What I can say that I do is I test both the Qlc trial or the 125 dihydroxy, vitamin D and the 25 hydroxy. The difference being that the 25. hydroxy is more of a reservoir form. And the 125 is a more active form. So I'd like to look at that ratio. I like to see the active form up in the 5060 range. And what's interesting is you can see with vitamin D, as long as that active formula 125 dihydroxy is up in that 60 range, even though the 25 di 25 hydroxy might be seeing the 30 range and somebody's more inclined to supplement for that. It tells you that they're using it well and converting it well and that for me is is the important thing. Really,
Dr. Andrew Wong
that's a really good point. Any thoughts about the GI tract on you mentioned? That's that's a whole another deep dive there really?
Dr. Christopher Bump
Yeah, so, so how I interpret the GI tract, especially with patients who are chronically compromised with this syndrome, if we want to call it a syndrome, chronic epstein barr virus, inevitably, I don't think that I've ever not seen some type of gastrointestinal distress. And that can be as simple as indigestion and low hydrochloric acid to full blown dysbiosis, leaky gut and Lippo polysaccharide increases. So there's a whole gamut because of the influence of the gastrointestinal tract on every single system of the body, it has to be considered, for me as part of a therapeutic drive. Now, how I go about doing that might be different, I do some specialized testing. But sometimes history alone and clinical signs and symptoms are plenty adequate to help to arrive. Thank
Dr. Andrew Wong
you. I just had a chicken or egg question on that. So can Epstein Barr cause leaky gut and intestinal permeability and cause GI issues are more the GI issues are then kind of leading it from a little late until lytic phase on the EP? Oh,
Dr. Christopher Bump
that's a loaded one. I believe in can go both ways. There's interesting that you asked that question, Andrew, because there's a recently over the past year or two, there's an increase investigation and interest in the GI effects of EBV, especially around poorly defined irritable bowel. colitis is any chronic inflamed. Irritation, may have an etiology associated with EBV. Okay,
Dr. Andrew Wong
thank you. And then one more vitamin question I have because, you know, we use a lot of zinc and ascorbic acid as possible. I just wanted to ask you about zinc. And also, there was a study that you you know about from the Riordan clinic, Dr. Nick arroba, did a study in 2014 on intravenous ascorbic acid, intravenous vitamin C, and it did show a reduction I believe, and and I think a 40% reduction and some of the Epstein Barr antibodies with like, say 10 treatments or so of IVC. What are your thoughts on on zinc and then in the vitamin C?
Dr. Christopher Bump
So our answer the vitamin C was the study was using IV vitamin C. And yes, it's absolutely but it was one study in a group of patients. I'd like to see more of that. But you know, when when we think about glutathione and vitamin C, and some of these kind of ubiquitous antioxidants that are, it makes perfect sense. To work to increase them however we do it whether we use a liposomal glutathione or an oral vitamin C, loading and loading vitamin C to tolerance. It makes perfect sense for cellular support. And I haven't seen any follow ups on that particular study that you're citing. But it's it's certainly hopeful. Yeah. And
Dr. Andrew Wong
then because sorry, to before the zinc. This is kind of a evolving to a super advanced episode now, but just had a question because we were chatting with an expert on oxalates recently, and basically this idea that ascorbic acid can can lead to more oxalate production, which could be inflammatory in and of itself. So any any thoughts about sort of oxalates Does that have any role in any of this with EBV? And
Dr. Christopher Bump
so So oxalates are tricky for me, because whenever I see increases in oxalate, say in an organic acid test, I'm thinking more yeast, more, more than anything. So I'm thinking dysbiosis, especially with Candida or Saccharomyces driving that process. So that's where my head goes clinically, rather than getting real myopic into oh my god, now we have to remove all oxalates from the diet which comes really? That's
Dr. Andrew Wong
tough. That's tough. Yeah. Okay. I'm sorry to interrupt. So then zinc, D D zinc in your practice that offer so zinc
Dr. Christopher Bump
is one of the fundamentals. Yeah, but we can make an assumption that most people are going to be deficient in zinc. Its efficacy and so the thing for me has two primary functions protein synthesis. is an immunological differentiation. So it's really important in both of those. And so both of those roles are implicated in this whole burden of oxidative damage and cellular function. Right. So, so yeah, yes, zinc all the time. Absolutely. But here's the problem, or the challenge that we need to look at, we have to look at in relation to copper, and even iron because the metallic proteins that regulate those are doing this triad dance. And so, so you can potentially put someone on zinc and have them bind it, because their copper might be out of balance to the zinc. So So and that would look like, possibly, let's see, how would that work? I'd have to think that out. And Andrew, but, but I will always look at the relation between the copper and zinc particular
Dr. Andrew Wong
same? Yeah, yeah. That makes sense. Um, well, I wanted to thank you so much, Dr. Bump for coming on. today. We have a couple of closing questions. It's really fascinating. And I think we took a deep dive down a couple of rabbit holes today. So thank you. Thank you. I'd love to ask you, Chris, what is one thing you wish everyone knew about treating chronic epstein barr
Dr. Christopher Bump
Epstein Barr Virus, the one thing that I would suggest, based on what you're hearing in our conversation, Andrew, is to learn to love the virus, learn to accept it, learn to be at peace with a virus. And the only way we can do that is to nurture and love ourselves, and be at peace with ourselves, inherently what I'm saying and that is that we have to reduce our stress burdens ever. So that's by far the most important to me
Dr. Andrew Wong
making peace with the bugs making peace with ourselves. Yep, absolutely very similar.
Dr. Christopher Bump
They intertwine they intertwine, right.
Dr. Andrew Wong
And then part of our mission at capita Integrative Health here is making integrative health care more accessible, focusing on the small steps we can do to prove our health. So Chris, we'd love to hear from you. This is a very fun question. Usually just one personal thing under $20 That you feel has transformed your own health.
Dr. Christopher Bump
So I love this question, Andrew. So for your listening audience, they need to know that you sent that to me, so I could think about it. And I did. And I had so much fun with that question. And I went through all kinds of different gyrations. And mind you, I'm 70 years of age. And so my health journey in terms of not only as a physician, but personally goes back almost 55 years. And I will tell you that there are two single things that were easily Well, the book I would recommend is easily under $20. But the process that I went through I so I will say it this way, there was a book that changed my relation to health. And it was a biography of Edgar Casey. Edgar Casey was a was also known as the sleeping prophet. He's very much akin to how Abraham works through Esther Hicks. He, he, in a sense, channeled this voice that gave answers to individuals who were unwell. And all of his answers were based on an he called it the escape records. It was beyond him. But they were all remedies that were natural, non pharmaceutical, non surgical. And when I read there is a river. There's two biographies that I like about it changed my life, it actually is what caused me to explore what I'm doing now. It's set up that model for me. So we opened up this window of awareness for me. Okay, so that was number one. Number two was Hasee recommended an apple diet, a three to five day Apple diet. And it was the very first thing I did, I was probably 17 or 18 years of age, and took myself through this five day, Apple diet. That and that was I mean, it probably cost me $10 to do back in 1977 or five or whenever it was, but it was certainly well under 20 bucks. And it was life changing for me. Because of this reason. In choosing not to eat food, and only orient towards Apple, it it caused me to be very mindful and thoughtful about my release. issue with food and my relation with myself. And so it became more of a spiritual exercise for me rather than just so I wouldn't necessarily recommend most individuals to do an apple diet at this point in time. But it's it's kind of like the foundation. Yeah,
Dr. Andrew Wong
that's so interesting. I've read about an apple diet with some other different books and you know, it has structured water in it and different things, but it really sounds like a spiritual journey to like you said, it's like, either fasting or some something where it's a mono diet where you're just really focusing inward, which is amazing. Yeah,
Dr. Christopher Bump
yeah. No, Andrew, I didn't get to talk to you much about and I'll say this, because it ties into what I just said about the Apple diet. I took that concept and, and apply that to the detoxification program I take patients through currently. So I take patients through a 28. They detoxification using a medicinal food powder that supports these pathways. But in in the middle of that program, I take them through five days of just drinking this medicinal food shake. For the same reasons, it's valuable. Yeah, it's
Dr. Andrew Wong
that type of, you know, similar to the Apple die, where they're kind of going through, I think I have I have definitely noticed that too. When I go through like a TLC detox or you know, something like that, it starts to get really deep into the into not just the body, but the mind, emotions and spirit for sure. Thank you for sharing that. And Dr. Bump. Thank you so much for coming on today. And this has been a really great conversation. I love the by the way, I love your screen. I'm not sure if the screensaver, it's like a, a Jackson Pollock thing behind you. I'm not sure what that is.
Dr. Christopher Bump
So I'll tell you about that. That's I did that painting. Okay. Okay, so the niran COVID. going, Wow, those are so boring. But yeah, I gotta do something to spice this up. So I did that. It's beautiful.
Dr. Andrew Wong
Beautiful. Thank you. Well, Dr. Brown, we just want to ask you, Chris, how listeners can learn more about you and work with you if they want to kind of go to your clinic or different things? Sure.
Dr. Christopher Bump
So So I have a website at Dr. bump.com. That's easy. And that's probably the easiest way for anyone to get in touch with me but I'm not adverse to sharing my email. That's Dr. CJ bu MP, Dr. CJ bump at Gmail.
Dr. Andrew Wong
Okay, easy enough. Yeah. Thank you so much.
Dr. Christopher Bump
It was really a pleasure.
Dr. Andrew Wong
Thank you so much for joining us today for this episode of Capitol Integrative Health podcast. A quick reminder that the information we share on this podcast is meant for educational and informational purposes only. It's not a substitute for professional medical advice, diagnosis or treatment. We highly recommend that you speak to a qualified health care provider before making any medical or healthcare decisions. If you enjoyed this episode, please take a few moments to subscribe and leave us a review. Your reviews help us reach more people and continue to offer innovative insights and information to better optimize your health and wellness.