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Date of last update: 10/12/2017.

Forum Name: Viral Infections

Question: Mononucleosis and mitochondrial damage?

 urania - Fri Aug 29, 2008 8:19 pm

I am a 27y female, was diagnosed with mononucleosis in Nov. 2006--I had severe fatigue, malaise, swollen axillary lymph nodes, fever and joint pain. Everything seemed to resolve in about two months and I went back to normal work and activity schedule (before getting sick I was running 3miles 3 times a week). By May 2007 I had gradually worked my way up to running a mile 2-3 times a week and thought it was all over, until one day I collapsed after running.

My energy level got worse over the next 2 months and I had a complete mono relapse in June 2007, with the same symptoms like the first time, and also headaches, insomnia, anhedonia, and irregular periods. Both times I was tested for mono, Lyme, CMV, thyroid and autoimmune disorders, also electrolytes, liver enzymes, CBC. Both times I was only positive for mono, everything else was normal. I slowly got better over several months, with all symptoms resolving except that I still have low stamina a year later. It's not that I'm tired all the time, in fact I feel completely back to normal--as long as I don't do any activity that requires sustained effort. Even just walking I can only last about 15min or so before I get very tired, and less on a hot day. Several doctors have told me I don't have CFS, and I also think I don't match the list of recognized CFS symptoms. Once I get tired, it doesn't take hours or days to recover, but the transition from feeling perfectly fine walking to feeling completely drained and having to sit down is very abrupt. I feel like I've completely run out of energy, even though I don't feel I've exerted myself in the sense that my heart isn't pounding and I'm not short of breath, which is what I would expect if this was due to simply being out of shape. The low stamina has been consistent over the past year and doesn't seem to have got better even though all other symptoms are gone.

My question is: could mono cause mitochondrial damage or otherwise disrupt the biochemical processes in the body responsible for making energy? It literally feels like I have a finite store of energy which normally would be replenished at a rate close to the rate of being used up with a moderate activity, but in my case it's not getting replenished at the normal rate and so every time I hit a wall when it gets used up. I've spent this past year trying to get in shape and being prevented by this consistent pattern of getting tired after only 15min or so of even a low-intensity activity. What kind of tests can I have done to determine whether I have mitochondrial damage? Is mitochondrial damage reversible? What kind of specialist should I see?

Other background: History of occasional tachycardia and PVCs since 1996, diagnosed with a form of dysautonomia (mitral valve prolapse syndrome, except that my valve isn't prolapsing). In fact I first started running at the advice of my cardiologist who said cardio exercise would help--and did it ever!, to the point where all palpitations and PVCs completely disappeared once I started running regularly. Now that I haven't been able to do it for more than a year, they have come back, so I'd really like to know what I can do to be able to exercise again.
 John Kenyon, CNA - Tue Sep 09, 2008 11:41 pm

User avatar Hello -

Your mono history, unfortunately, sounds rather unremarkable. It's a really abrupt energy drop, almost like someone's pulled a plug. You'll have to be patient and work at it slowly to get back to feeling normal again.

I am aware of one study which might back up your idea about viral damage to mitrochondria, and it is the first, I believe,to yield fairly convincing evidence that this may be the case. There is, however, as yet no universal agreement on it, since most studies have shown no similar results. I also don't know what you might do to ameliorate this effect. Many people suffering from post-viral fatigue syndrome (PVF) claim to have benefitted to varying degrees from mega doses of vitamin C and extra A and E, but this is mostly based upon anecdotal evidence. So long as the C is kept to a reasonable level (to avoid forming kidney stones) and the A is kept within usual and customary doses, it may help some. Good nutrition and lots of rest are both important, but I think most helpful of all is patience, which can be tried very much by this problem.

I'm really not sure what the most appropriate type of specialist would be for this problem -- maybe a nutritionist.

Regarding the mitral valve prolapse syndrome (MVPS) without evident actual prolapse, this is extremely common and people who suffer from it often are prone, as i'm sure you know, to unaccountable fatigue, yet, as you've discovered, tolerate exercise really well and even thrive on a regular exercise program. Do the best you can with that under the current limitations, and with any luck you'll start to feel like yourself again before too terribly long -- although it would be very foolish of me to try and predict a timetable for that happening. Everyone is different in that respect.

Best of luck to you. Hang in there and just do as much as you can. Stay in touch, too, and let us know how things go.

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