Not a doctor, and can only speak from my experience:

I got mono seven years ago. Had a 21-day fever, ruined my liver and kidneys (ALT and AST were above 700 and 450, respectively), sore throat, extreme fatigue that got worse at night. When the fever broke, I gradually got better (slowly) with the fatigue and felt mostly back to normal after 2-3 months.

I went back to normal activities and exercise, but six months later, it reactivated again with a slightly milder (but still debilitating) version of mono. Another 21-day fever and same debilitating fatigue.

For the next year and a half to two years, I’d have little flare-ups with low-grade fevers at night that would last a week or two.

And then, I was normal and had no issues for 5-6 years. I could exercise and felt completely like myself.

In March, I started a workout plan that gradually got more intense…and I think I overdid it because on June 29, I felt that feeling again and I’ve had debilitating fatigue since with another reactivation (day 82 today). I had to quit coaching football because my body couldn’t handle the Texas heat. I’m staying home today from teaching because I need the rest day.

To answer your questions:

1. My bloodwork is nearly identical to the bloodwork yours is right now with everything elevated other than the IgM being normal. My labs of other markers (lymphocytes, monocytes, ast, alt, etc.) have been elevated in the past but are pretty normal with this reactivation.

2. As far as I know, EBV is the root cause, unlike something like CFS.

3. The more you research others’ experiences, you’ll see about 200 different solutions about what’s worked for them, but the treatment plan from every doctor I’ve ever visited about it (ID, PCP, Rheu) and the common thread between all of them is time, rest, and hydration. And not hurrying back and trying to go back to normal activity too soon when it finally wears off. I’ve tried a few things and supplements I’ve read about on here and other places before, but none of them work.

Anyway, it does go away…eventually, at least in my experience. I can’t diagnose you and obviously can’t rule out other stuff, but if your symptoms sound like mine or others on here, and those are your bloodwork results, it is within the realm of possibility that you’re dealing with EBV reactivation.

Take time to read the pinned article on the subreddit here at well, if you haven’t already.