Reviewed by Veena Angle, MBBS, MD and Physician Brandon Yew

Infectious Mononucleosis: How to Reduce Symptoms and Improve Immunity

Published September 13, 2022| 8 min read

Infectious mononucleosis is a common disease usually caused by the Epstein-Barr virus. Learn more about how to treat it and prevent future infections.

The word “mononucleosis” is printed on a green pad placed on the table next to medical gloves, stethoscope, surgical mask, pills, and test tube rack.

Mono, or infectious mononucleosis, is a contagious disease usually caused by the Epstein-Barr herpes virus. It spreads primarily through contact with bodily fluids. For this reason, it is considered a young person’s disease, sometimes also called “the kissing disease”, as it can spread through the exchange of saliva during kissing.

Treatment involves addressing symptoms until the infection subsides on its own. Fortunately, infectious mononucleosis responds well to symptom management, especially when combined with Traditional Chinese Medicine (TCM).

What Is Infectious Mononucleosis?

The term “mononucleosis” was first used in the 1920s when infected individuals showed an increase in an atypical type of white blood cell described as “mononuclear”. About 95% of the world population would have carried the virus at some point by the time they reach adulthood, although infectious mononucleosis that presents with symptoms peaks primarily among 15 to 24-year-olds.

The illness is spread through contact with bodily fluids, such as sneezing, coughing, kissing, or sharing drinks, food, and utensils. Occasionally, an infection may also occur due to sexual contact. Less common modes of transmission include organ transplants and blood transfusions.

In TCM, infectious mononucleosis is considered a disease of pathogenic Dampness, phlegm, and blood clots brought on by external pathogenic Wind and Fire. “If the infection is prolonged, damage to qi (vital life energy) and yin (cooling energy and body fluids) will ensue, resulting in their deficiencies,” Real Health Medical Senior TCM Physician Brandon Yew explains.

Causes and Symptoms

Teenage girl holding the neck in pain due to sore throat — A painful sore throat is a common symptom of infectious mononucleosis.

90% of mononucleosis cases are caused by the Epstein-Barr Virus, with the remaining cases attributed to the Cytomegalovirus (CMV), Human Immunodeficiency Virus (HIV), Adenovirus, Hepatitis A Virus (HAV), Herpes Simplex Virus (HSV), Rubella virus, as well as the Toxoplasma parasite.

Incubation could take four to six weeks after encountering the virus. A symptomatic patient gradually presents with fever, swollen lymph nodes, a sore throat, and extreme fatigue lasting several weeks. Other symptoms may include body aches and weakness, rashes, headaches, loss of appetite, and enlarged Spleen or Liver.

While there is no cure or vaccine, most cases are not a serious medical concern, requiring only symptom management. However, severe mononucleosis symptoms can interfere with everyday life, especially for teenagers in secondary school or young adults recently entering the workforce.

In some cases, the fatigue could linger for several months. Also, remember that asymptomatic individuals can still infect others, and immune-compromised individuals may develop serious complications from the infection.

Diagnosis and Treatment for Infectious Mononucleosis

Your healthcare professional will be able to diagnose infectious mononucleosis from your symptoms. A blood test can confirm the diagnosis. Treatment focuses on symptom management of symptoms as follows:

Avoid physical exertion: Mononucleosis can make you very fatigued, so physical exertion could over-tax your body. Moreover, one of the symptoms of mono is an enlarged spleen, which can rupture and cause serious complications if you over-exert yourself physically.
Keep hydrated: Drink plenty of fluids to avoid dehydration, further compromising your condition.

Reduce fever and pain: Use nonsteroidal anti-inflammatory drugs (NSAIDs) to keep fever symptoms and body aches manageable.
Get quality rest: Mononucleosis is a very draining infection. Make sure to get good rest and sleep to enable your body to fight the infection.
Soothe the sore throat: A severe sore throat can be very painful. Gargle warm water mixed with salt and suck on throat lozenges.

TCM Approaches to Treatment and Immunity

Dried honeysuckle flower petals on a plate on a wooden table. — Honeysuckle flower (*jin yin hua*, 金银花) is a common ingredient in Chinese herbal formulas like *Yin Qiao San* and *Qing Ying Tang*. It’s used to help dispel Heat in infectious diseases like mononucleosis.

“TCM helps your body fight the infection through herbal medication, acupuncture, cupping, gua sha (scraping), and bloodletting. All are formulated carefully by a TCM physician to address a patient’s unique body constitution, hence, it’s best to consult a TCM physician for a proper assessment,” advises Physician Yew.

Herbal formulas to address pathogenic Dampness, phlegm, and blood clots

TCM herbal decoctions have been used for centuries to treat viral infections. A 2014 study of 81 children in China showed those treated with TCM decoctions had a shorter duration of symptoms than the control group, which received the conventional antiviral Ganciclovir and immunostimulant Pidotimod.

A recent 2021 study published in the Pharmaceutical Biology journal showed, through animal models, that the Si Miao Qing Wen Bai Du (四妙清瘟败毒) decoction inhibits replication of the Epstein-Barr virus.

Physician Yew shares a list of herbal remedies your TCM healthcare practitioner may choose.

For treating symptoms of the infection:

Yin Qiao San (银翘散): Dispels Wind and Fire
Bai Hu Tang (白虎汤): Dispels Fire
Qing Ying Tang (清营汤): Dispels Fire and dissipates blood clots, nourishes yin
Er Chen Tang (二陈汤): Dispels Dampness and phlegm

Xiao Luo Wan (消瘰丸): Dissipates phlegm, clears Fire, and replenishes yin
Yin Chen Hao Tang (茵陈蒿汤): Purges Fire and dispels Dampness

For restoring health after recovery:

Sheng Mai San (生脉散): Replenishes qi and yin

Qing Hao Bie Jia Tang (青蒿鳖甲汤): Dispels residual Fire and blood clots, replenishes yin
Qing Gu San (清骨散): Dispels residual Fire and replenishes yin
Dang Gui Liu Huang Tang (当归六黄汤): Dispels residual Fire and Dampness, replenishes yin
Gan Lu Yin (甘露饮): Dispels residual Fire and Dampness, replenishes yin

Self-help remedy using acupoints

Physician Yew also shares you can perform acupressure on yourself by massaging the following acupoints using fingers or a blunt object like a massage stick.

Apply the appropriate amount of pressure to elicit a tolerable sensation of soreness or tenderness. At the same time, massage in both the clockwise and anticlockwise directions using a circular motion, 20 times each way. Repeat for at least three minutes per acupoint.

For treating symptoms of the infection:

When the elbow is flexed, qu chi is in the depression at the lateral end of the transverse cubital crease, midway between chi ze (LU5) and the lateral epicondyle of the humerus.

An illustration of a left hand, showing he gu (LI4) acupressure point — He gu is located on the back of the hand, between the 1st and 2nd metacarpal bones. It helps dispel pathogens and restores and enhances qi and blood circulation within the meridians.

On the radial aspect of the 1st metacarpal at the midpoint of the bone at the junction of the red and white skin.

On the dorsal aspect of the forearm, on the line connecting yang chi (SJ4) and the tip of the elbow, two finger-breadths above the transverse crease of the wrist between the ulna and radius bones.

Qu chi (LI11, 曲池): Dispels Wind, Fire, and Dampness
He gu (LI4, 合谷): Dispels Wind, Fire, Dampness, and blood clots
Yu ji (LU10, 鱼际): Dispels Fire and Wind

Wai guan (SJ5, 外关): Dispels Wind and Fire

For restoring health after recovery:

Nei guan is ocated on the front of the forearm, 3-fingers breadth above the transverse crease of the wrist. It restores and enhances the heart’s function for improved qi and blood circulation within the meridians.

Located along the midline of the lower abdomen, 4 fingers-breadth below the navel. It dispels pathogens for improved qi and blood circulation within the lower abdominal cavity and revitalises Kidneys’ yang energy.

Located along the midline of the lower abdomen, 2 fingers-breadth below the navel. It dispels pathogens for improved qi and blood circulation within the lower abdominal cavity and revitalises kidneys’ yang energy.

To locate Xue Hai (SP10), flex the knee and press the spot 2 fingers-breadth above the superior medial border of the patella on the bulge of the medial portion of quadriceps femoris.

Located on the medial side of the shank, at the depression posterior and inferior to the medial condyle of the tibia.

3D illustration of the zu san li acupoint — Located on the shin bone, four fingers-breadth below the depression of the knee joint, one finger-breadth (middle finger) from the anterior crest of the shin. It dispels pathogens to improve qi and fluid circulation within the meridians and revitalises the Spleen and stomach.

Located on the shin, eight fingers-breadth below the depression of the knee joint, two fingers-breadth from the anterior crest of the shin. It dispels pathogens to improve qi and fluid circulation within the meridians and strengthens the stomach’s function.

An acupoint like San Yin Jiao can be used to manage symptoms of social anxiety.

3D illustration of the Taichong (LV3) acupressure point — Located on top of the foot, in the depression closest to the first metatarsal space. It revitalises the Liver.

Qu chi (LI11, 曲池): Dispels residual Wind, Fire, and Dampness
He gu (LI4, 合谷): Dispels residual Wind, Fire, Dampness, and blood clots

Yu ji (LU10, 鱼际): Dispels residual Fire and Wind
Nei guan (PC6, 内关): Dispels residual Fire and blood clots
Guan yuan (RN4, 关元): Regenerates qi
Qi hai (RN6, 气海): Regenerates qi
Xue hai (SP10, 血海): Dispels residual Fire within the blood, dissipates blood clots and Dampness

Yin ling quan (SP9, 阴陵泉): Dispels residual Dampness
Zu san li (ST36, 足三里): Dissipates residual Dampness, regenerates qi
Feng long (ST40, 丰隆): Dispels residual Dampness and phlegm
San yin jiao (SP6, 三阴交): Dispels Dampness and regenerates yin
Tai chong (LR3, 太冲): Dispels residual Wind, Fire, and blood clots

Physician Yew strongly advises against self-diagnosis and self-medicating with TCM regimens without consulting a certified TCM professional first. A qualified TCM physician will assess your unique body constitution and current medical state before advising you.

If symptoms worsen or become severe, speak to your doctor immediately. Fortunately, most cases of infectious mononucleosis reach recovery on their own using proper symptom management, rest, and immunity building.