Mononucleosis in Adults: What You Need to Know

Holli (Lapes) Ryan RD, LD/N

Mononucleosis in Adults: What You Need to Know

Mononucleosis, commonly referred to as “mono” for short, is often referred to as “the kissing disease” because it can be transmitted via saliva. Although mono is a common viral infection among children and teenagers, adults can get it, too. So, if you’re an adult and find yourself with symptoms of mono (extreme fatigue, sore throat, fever, swollen lymph nodes, headache and body aches, swollen spleen and/or liver), here is some helpful information for you to know.

Know the Cause

Epstein Barr Virus (EBV) is typically the cause of a mononucleosis infection, but it could also be caused by Cytomegalovirus (CMV). 1 As with all health conditions, proper diagnosis is key. If your doctor suspects mono, you may be given a mononucleosis spot (or Monospot) test, which rapidly looks for EBV antibodies. A blood test is the best way to confirm the diagnosis and to find out what type of virus caused the infection.

Lab Tests for Diagnosis

Your doctor may order the following tests to diagnose your condition:

  • Monospot test
  • Epstein Barr viral capsid antigen (VCA) immunoglobulins G or M (IgG or IgM) antibodies
  • CMV IgG or IgM antibodies
  • Liver enzymes alanine transaminase (ALT) and aspartate transaminase (AST)
  • Ultrasound of spleen
IgM and IgG antibodies are proteins produced by your immune system to fight an infection. IgMs are the first ones to appear and do not persist in the blood for more than a few weeks. A high level of IgMs indicates a current or recent (acute) infection. IgGs appear later and will persist for the rest of your life to protect you against future infections.

Because enlarged organs may occur with mono, your doctor may order an ultrasound of the spleen to check its size.1 Elevated liver enzymes (ALT and AST) showing up on your blood test can also be a sign of mono infection.

Treatment for Adults with Mono

Proper diagnosis is key so you can receive proper treatment. Importantly, mono is not caused by bacteria, but by a virus. As you may know, antibiotic overuse and misuse is widespread, and antibiotics may be wrongly prescribed to someone with a mono infection. Plus, because you are an adult, your doctor may not suspect mono simply because of your age. Also, antibiotics such as amoxicillin and azithromycin are contraindicated for someone who has mono because they could cause a severe rash.2

So, what IS the treatment for mono? Treatment involves rest, fluids, and over-the-counter pain and fever-reducing medicines to ease symptoms. Some doctors may prescribe steroids for excessive swelling. You could also consider adding some nutrients to combat the virus. Help your immune system fight the virus with reishi mushroom3, vitamin C4, and quercetin5.

Nutrient Depletion and Side Effects from Medications

If you were given steroids such as prednisone to help with the inflammation in your body caused by the infection, your body may have become depleted of important minerals such as chromium and calcium.6

The adaptogenic herb ashwagandha can be helpful to promote mental energy and concentration.7 If appropriate for the individual (based on factors such as their medical history and age) a short-term, low dose of the hormone dehydroepiandrosterone (DHEA) can be beneficial as well.8

If you were given antibiotics for this viral infection, you’ll want to restore the good bacteria in your body by taking probiotics. Vitamin K, which has a lot of health benefits, is another good supplement to add in if you were recently on antibiotics because the good bacteria in your gut that were just killed off, produce some vitamin K.9

If you were given antibiotics and developed a rash because of it, you can soothe it with topical applications of witch hazel, aloe, and oatmeal baths. Don’t shower with hot water as it will irritate the rash. Although vitamin C is one’s best friend during this time, avoid citrus fruits and strawberries as these may also irritate the rash. Instead, choose other sources of vitamin C, such as broccoli, or take a vitamin C supplement. You can also consider intravenous therapy with high-dose vitamin C.10

Nutrition and Wellness

The fatigue you’re experiencing could get even worse without adequate hydration. Choose a coconut water with no added sugars as a source of both hydration and minerals (which also serve as electrolytes for heart function and more). Caffeine is never really a good idea when you are sick, but you should especially avoid it while you have mono because of your elevated heart rate due to the illness. Instead of caffeinated tea or coffee, choose decaffeinated tea or plain hot water with lemon and honey. No alcohol either since it may delay the recovery of the immune system and would further elevate liver enzymes.

To soothe your inflamed tonsils, hot liquids are key. Sip on hot bone broth for the protein content, soothing temperature, and minerals. Since your appetite may not be existent, bone broth can help you meet your protein needs. Don’t forget about good old chicken soup for the soul as well. You could also gargle with salt water.

Exclude dairy products and refined grains during this time, especially if you are taking antibiotics, because the simple carb sugars and refined grains can feed the bad bacteria, and dairy tends to contribute to congestion and mucus production. I also suggest having plenty of fresh produce on deck to make nutritious meals.



Refined Grains and Sugar Soup and/or Bone Broth

Water and/or Coconut Water


Fruits and Vegetables

Hot Liquids

About the author: Holli (Lapes) Ryan RD, LD/N is a Social Media Content Specialist at Life Extension. She is a Registered and Licensed Dietitian Nutritionist residing in the South Florida area. Holli believes that quality dietary supplements are an essential tool that have a variety of applications from maintaining good health to managing chronic disease.



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