Understanding Opportunistic Infections

  📍 Welcome to the Made to Heal Show. I'm Dr.  Kasey  Holland, the host of Made To Heal. On this show, we discuss complex chronic illness, complex medical conditions, mystery symptoms, and their root causes. And ultimately your body's innate ability to overcome them. In this episode, we are going to be talking about opportunistic infections and diving into what exactly that means.

In my medical background, I also spent a lot of time in research, and so one thing that I do a lot with patients is talk about their labs and understanding their. Blood work, and I still constantly get a lot of questions in this area. So in this episode, I wanna talk about immunology and what it means when we have opportunistic infections.

If you know me at all, you know that a lot of my work has had to do with Epstein Barr virus and Epstein Barr virus reactivation, and that is considered an opportunistic infection. So I wanna unpack this, help you understand what's going on in your immune system, what it means when there's an opportunistic infection, what the labs are actually saying, what we have to decide based on your symptoms and presentation and what it looks like to overcome opportunistic infections.

Okay? Opportunistic infection. What does that mean? An opportunistic infection means that. If your immune system is operating properly and all things are good that you really should not have a problem with that infection. Common opportunistic infections that we see are herpes family viruses, so think HSV one where you get the sore HSV two in the genital area.

Epstein bar virus is also an opportunistic infection. The thing about opportunistic infections is that they are very common. So greater than 95% of people will have been exposed to Epstein-Barr virus by the time they are an adult. And I can say the same thing with HSV one and HSV two. Most everybody comes into contact with these viruses and then what happens when some people still have problems with them now?

I just talked a lot about viruses. There's also opportunistic infections that are fungal, like candida and bacteria like mycoplasma, pneumonia, and this family of infections. A lot of times if you have an opportunistic viral infection, you might also be carrying a fungal or a bacterial, and it makes sense, right?

Because. If you're susceptible to an opportunistic viral infection, whatever is going on in your body means that you might also be more susceptible to a bacterial or fungal. So let's talk about the labs and the testing for these opportunistic infections and what that looks like, because I think that labs.

Are so easy to understand when it's the first time that you've had an infection and it's a, yes, it's positive. No it's not. But when we get into this realm of opportunistic infections and you have chronic fatigue for years, or these symptoms that just aren't going away, or maybe you have a herpes flare up multiple times per month, and it's, it's like, how do standard labs help with that?

Here's the problem, so. In a conventional setting and that acute setting where it's the first time that you've been exposed to that virus, it's pretty simple. You're going to have a blood draw and the labs come back. And typically what you'll see if it's in that acute setting and the first time that you have had that infection, is your IGM antibodies will be positive.

So M think of them as the mama antibodies. They're the first antibodies that respond to an infection. They typically stay positive acutely, and then they go negative. And your IgG antibodies are gonna pop up. And these antibodies can be confusing for labs because they can stay positive for a really long time.

But that is part of how your. Immune system creates memory of what it's seen so that when it gets exposed to a virus, it can respond very quickly. You don't get sick, right? Um, or maybe you have, you know, a very, very short illness, but this memory is what makes our immune system strong. And so when. We look at this on the labs, it becomes really difficult when we have these opportunistic infections because typically when you test for opportunistic infections, you look at IGM and IgG.

Now, a lot of times that IgG will stay elevated a little bit throughout life because again, it's that memory response. So what happens when. You have, let's use a herpes flare for an example. What happens when you are getting acute herpes flares once a month, twice a month, and you go to test the IGM is negative because, okay, you know, you've had this infection before, but the IgG is positive.

But then what does that tell you? Because, well. Obviously it's positive because you've had it before, but you know that your body is still responding to this infection because you have the lesions and the symptoms to prove it. Typically, and a lot of times in these instances, the IGG will be really, really high normal, not just a mild elevation for memory, but a very, very, very high normal.

Sometimes it really depends on what lab company you're using, but it can be 10 times to a hundred times the upper limit of normal. And then you also have the symptoms, and that means, okay, your body is having difficulty handling this opportunistic infection and needs. Support, and that's in my clinical practice when we treat it.

I think that the herpes example is a good example because it's a really obvious symptom that yes, you, you have the herpes lesions, one common infection, the Epstein bar virus. It's not, it's, it's not that straightforward because fatigue is more of a vague. Symptom that could be caused by a lot of things.

And so oftentimes doctors will say, well, that doesn't mean that you have a reactivation. Uh, there's other labs as well, like the early antigen that can be helpful. But again, that only stays positive typically for a certain amount of time. So that can be negative. And in my clinical practice, you can still be dealing with that reactivation.

So that's where it gets all gray and where it can be really helpful to work with somebody that specializes in opportunistic infections and looking at really what's important to look at is your symptoms and, and your history and what's working treatment wise and what's not and what's going on. But what I wanna talk about, now that we understand that.

Foundation of op opportunistic infections and, and what's going on with the immunology there and why that is confusing in that IGM versus IgG. I wanna talk about what do you do about opportunistic infections, because I oftentimes have patients that have the fungal load, the viral load, and bacterial load opportunistic infections.

Oftentimes the. When patients have fatigue, especially since COVID-19, the Epstein Bar virus is tested more regularly now, and that's positive. And then doctors will kind of just stop and be like, okay, that's the problem. It's the Epstein Bar virus. But for me, when I find one opportunistic infection positive, I think there's probably more because that is a sign that your body's immune system and your body's state.

Is not, is not handling an opportunistic infection, which the definition literally is typically there in immunocompromised or a weakened immune system. So if you just take the medication, whether it's a pharmaceutical or a natural antiviral, whatever, it's if you just take that and don't do anything else.

The state of your immune function in biochemistry isn't necessarily going to change, and you're probably still gonna be dealing with that infection. Now. It doesn't mean that you shouldn't take the, maybe it's an antiviral or an antimicrobial or antifungal. It doesn't mean you don't need that, and you probably do need that to, uh, to help your body overcome that, but.

You need to do more. We need to ask why this opportunistic infection is there. And the other thing is that we need to set you up for success. So these herpes family viruses that are really common with opportunistic infections, once they're in the body, the way that they integrate with the body cellularly, they're going to be there.

So as you go throughout your life, there might be times where that viral load goes up and down and up and down, and people will say, I have a flare up. I don't feel good. Things like that. And that's because that opportunistic infection is still there and your symptoms are telling us that, oh, now it's not handling it well again, so we need.

To address that we need to not just look at this infection, we need to look at what's around it so that your body can overcome it. And this is what is oftentimes missing in patient care and treatment plans that leaves you sick for a long time. And in upcoming episodes, we're going to talk about all sorts of things that can impact.

Your immune response, your oxidative stress levels. Oxidative stress levels are a sign of how your body is processing reactive oxygenation species. We come into toxins, stress all, all throughout our environment and our body has to be able to respond and clear out that any damage that happens, and it uses antioxidants to do that when there's more.

Reactive oxygenation species activity, more toxicity, more stress than there is antioxidants in the body to be able to handle it. We see elevated oxidative stress levels in the body. It's also what causes aging. So think of, you know, rest on a nail aging, things like that. But when we reach that point and those oxidative stress levels are really high, that can also set you up for opportunistic infections.

A lot of times in conventional medicine it's like, oh, only in the elderly or immunocompromised people that have had, uh, maybe cancer treatment, things like that. That's kind of what is thought of with immunocompromised, but there's such a spectrum of how well immune systems are functioning today, and in order to really hone in and prevent these opportunistic infections.

Which we are learning is becoming increasingly important as we see more and more research coming out, linking Epstein Barr virus to multiple autoimmune conditions. Uh, a very close link with multiple sclerosis, which we'll talk about that in an upcoming episode as well. Uh, but it's important to regulate these opportunistic infections because when they are active, they turn on inflammatory pathways that promote disease.

So we have to address the bugs, but we also have to address why the bug is active, and that is the key to resilient health and making it so that. The opportunistic infection can be there, but you still feel good and you aren't having symptoms. So that is a lot of what we are going to spend time doing on the Made Teel Show is looking at things that leave you vulnerable and the traditional thought of immunocompromised versus healthy.

There's a whole spectrum in between where you can be not operating. Really in a healthy way and have a weakened immune system. Maybe. Maybe your white blood cell count hangs out at four, and that doesn't flag red on the lab, but it's always that low normal, that's a sign that your immune system is burdened.

And so as we look at this, I, we have to shift our focus of not just immune compromised versus. Good immune, but the whole spectrum in between. And look at it on an individual basis of what you have been exposed to, how your body is handling it, what, what your genetics are, what your family history is, what your daily life is, what your stress is like, what infections, what toxins you've been exposed to.

What's going on in your gut are your adrenals and your thyroid working. All of that plays hugely into opportunistic infections and so. We have to address all of those to fully overcome these pesky opportunistic infections. Thank you for joining me in this short solo episode on Opportunistic Infections on the Made to Heal Show.

Be well.

 Welcome to the Made to Heal Show. I'm Dr. Kasey Holland, the host of Made To Heal. On this show, we discuss complex chronic illness, complex medical conditions, mystery symptoms, and their root causes. And ultimately your body's innate ability to overcome them. In this episode, we are going to be talking about opportunistic infections and diving into what exactly that means.

In my medical background, I also spent a lot of time in research, and so one thing that I do a lot with patients is talk about their labs and understanding their. Blood work, and I still constantly get a lot of questions in this area. So in this episode, I wanna talk about immunology and what it means when we have opportunistic infections.

If you know me at all, you know that a lot of my work has had to do with Epstein Barr virus and Epstein Barr virus reactivation, and that is considered an opportunistic infection. So I wanna unpack this, help you understand what's going on in your immune system, what it means when there's an opportunistic infection, what the labs are actually saying, what we have to decide based on your symptoms and presentation and what it looks like to overcome opportunistic infections.

Okay? Opportunistic infection. What does that mean? An opportunistic infection means that. If your immune system is operating properly and all things are good that you really should not have a problem with that infection. Common opportunistic infections that we see are herpes family viruses, so think HSV one where you get the sore HSV two in the genital area.

Epstein bar virus is also an opportunistic infection. The thing about opportunistic infections is that they are very common. So greater than 95% of people will have been exposed to Epstein-Barr virus by the time they are an adult. And I can say the same thing with HSV one and HSV two. Most everybody comes into contact with these viruses and then what happens when some people still have problems with them now?

I just talked a lot about viruses. There's also opportunistic infections that are fungal, like candida and bacteria like mycoplasma, pneumonia, and this family of infections. A lot of times if you have an opportunistic viral infection, you might also be carrying a fungal or a bacterial, and it makes sense, right?

Because. If you're susceptible to an opportunistic viral infection, whatever is going on in your body means that you might also be more susceptible to a bacterial or fungal. So let's talk about the labs and the testing for these opportunistic infections and what that looks like, because I think that labs.

Are so easy to understand when it's the first time that you've had an infection and it's a, yes, it's positive. No it's not. But when we get into this realm of opportunistic infections and you have chronic fatigue for years, or these symptoms that just aren't going away, or maybe you have a herpes flare up multiple times per month, and it's, it's like, how do standard labs help with that?

Here's the problem, so. In a conventional setting and that acute setting where it's the first time that you've been exposed to that virus, it's pretty simple. You're going to have a blood draw and the labs come back. And typically what you'll see if it's in that acute setting and the first time that you have had that infection, is your IGM antibodies will be positive.

So M think of them as the mama antibodies. They're the first antibodies that respond to an infection. They typically stay positive acutely, and then they go negative. And your IgG antibodies are gonna pop up. And these antibodies can be confusing for labs because they can stay positive for a really long time.

But that is part of how your. Immune system creates memory of what it's seen so that when it gets exposed to a virus, it can respond very quickly. You don't get sick, right? Um, or maybe you have, you know, a very, very short illness, but this memory is what makes our immune system strong. And so when. We look at this on the labs, it becomes really difficult when we have these opportunistic infections because typically when you test for opportunistic infections, you look at IGM and IgG.

Now, a lot of times that IgG will stay elevated a little bit throughout life because again, it's that memory response. So what happens when. You have, let's use a herpes flare for an example. What happens when you are getting acute herpes flares once a month, twice a month, and you go to test the IGM is negative because, okay, you know, you've had this infection before, but the IgG is positive.

But then what does that tell you? Because, well. Obviously it's positive because you've had it before, but you know that your body is still responding to this infection because you have the lesions and the symptoms to prove it. Typically, and a lot of times in these instances, the IGG will be really, really high normal, not just a mild elevation for memory, but a very, very, very high normal.

Sometimes it really depends on what lab company you're using, but it can be 10 times to a hundred times the upper limit of normal. And then you also have the symptoms, and that means, okay, your body is having difficulty handling this opportunistic infection and needs. Support, and that's in my clinical practice when we treat it.

I think that the herpes example is a good example because it's a really obvious symptom that yes, you, you have the herpes lesions, one common infection, the Epstein bar virus. It's not, it's, it's not that straightforward because fatigue is more of a vague. Symptom that could be caused by a lot of things.

And so oftentimes doctors will say, well, that doesn't mean that you have a reactivation. Uh, there's other labs as well, like the early antigen that can be helpful. But again, that only stays positive typically for a certain amount of time. So that can be negative. And in my clinical practice, you can still be dealing with that reactivation.

So that's where it gets all gray and where it can be really helpful to work with somebody that specializes in opportunistic infections and looking at really what's important to look at is your symptoms and, and your history and what's working treatment wise and what's not and what's going on. But what I wanna talk about, now that we understand that.

Foundation of op opportunistic infections and, and what's going on with the immunology there and why that is confusing in that IGM versus IgG. I wanna talk about what do you do about opportunistic infections, because I oftentimes have patients that have the fungal load, the viral load, and bacterial load opportunistic infections.

Oftentimes the. When patients have fatigue, especially since COVID-19, the Epstein Bar virus is tested more regularly now, and that's positive. And then doctors will kind of just stop and be like, okay, that's the problem. It's the Epstein Bar virus. But for me, when I find one opportunistic infection positive, I think there's probably more because that is a sign that your body's immune system and your body's state.

Is not, is not handling an opportunistic infection, which the definition literally is typically there in immunocompromised or a weakened immune system. So if you just take the medication, whether it's a pharmaceutical or a natural antiviral, whatever, it's if you just take that and don't do anything else.

The state of your immune function in biochemistry isn't necessarily going to change, and you're probably still gonna be dealing with that infection. Now. It doesn't mean that you shouldn't take the, maybe it's an antiviral or an antimicrobial or antifungal. It doesn't mean you don't need that, and you probably do need that to, uh, to help your body overcome that, but.

You need to do more. We need to ask why this opportunistic infection is there. And the other thing is that we need to set you up for success. So these herpes family viruses that are really common with opportunistic infections, once they're in the body, the way that they integrate with the body cellularly, they're going to be there.

So as you go throughout your life, there might be times where that viral load goes up and down and up and down, and people will say, I have a flare up. I don't feel good. Things like that. And that's because that opportunistic infection is still there and your symptoms are telling us that, oh, now it's not handling it well again, so we need.

To address that we need to not just look at this infection, we need to look at what's around it so that your body can overcome it. And this is what is oftentimes missing in patient care and treatment plans that leaves you sick for a long time. And in upcoming episodes, we're going to talk about all sorts of things that can impact.

Your immune response, your oxidative stress levels. Oxidative stress levels are a sign of how your body is processing reactive oxygenation species. We come into toxins, stress all, all throughout our environment and our body has to be able to respond and clear out that any damage that happens, and it uses antioxidants to do that when there's more.

Reactive oxygenation species activity, more toxicity, more stress than there is antioxidants in the body to be able to handle it. We see elevated oxidative stress levels in the body. It's also what causes aging. So think of, you know, rest on a nail aging, things like that. But when we reach that point and those oxidative stress levels are really high, that can also set you up for opportunistic infections.

A lot of times in conventional medicine it's like, oh, only in the elderly or immunocompromised people that have had, uh, maybe cancer treatment, things like that. That's kind of what is thought of with immunocompromised, but there's such a spectrum of how well immune systems are functioning today, and in order to really hone in and prevent these opportunistic infections.

Which we are learning is becoming increasingly important as we see more and more research coming out, linking Epstein Barr virus to multiple autoimmune conditions. Uh, a very close link with multiple sclerosis, which we'll talk about that in an upcoming episode as well. Uh, but it's important to regulate these opportunistic infections because when they are active, they turn on inflammatory pathways that promote disease.

So we have to address the bugs, but we also have to address why the bug is active, and that is the key to resilient health and making it so that. The opportunistic infection can be there, but you still feel good and you aren't having symptoms. So that is a lot of what we are going to spend time doing on the Made Teel Show is looking at things that leave you vulnerable and the traditional thought of immunocompromised versus healthy.

There's a whole spectrum in between where you can be not operating. Really in a healthy way and have a weakened immune system. Maybe. Maybe your white blood cell count hangs out at four, and that doesn't flag red on the lab, but it's always that low normal, that's a sign that your immune system is burdened.

And so as we look at this, I, we have to shift our focus of not just immune compromised versus. Good immune, but the whole spectrum in between. And look at it on an individual basis of what you have been exposed to, how your body is handling it, what, what your genetics are, what your family history is, what your daily life is, what your stress is like, what infections, what toxins you've been exposed to.

What's going on in your gut are your adrenals and your thyroid working. All of that plays hugely into opportunistic infections and so. We have to address all of those to fully overcome these pesky opportunistic infections. Thank you for joining me in this short solo episode on Opportunistic Infections on the Made to Heal Show.

Be well.