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Infectious Mononucleosis: How to Reduce Symptoms and Improve Immunity

Published | 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: 

  • 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: 

  • 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.


  1. Cleveland Clinic. 2020. Mononucleosis. [online] Available at: <https://my.clevelandclinic.org/health/diseases/13974-mononucleosis> [Accessed 9 August 2022]
  2. National Center for Biotechnology Information. 2014. Treatment of children with EB virus infection by Chinese medicine: a clinical study. [online] Available at: <https://pubmed.ncbi.nlm.nih.gov/24672940/> [Accessed 9 August 2022]
  3. StatPearls. 2022. Mononucleosis. [online] Available at: <https://www.ncbi.nlm.nih.gov/books/NBK470387/> [Accessed 9 August 2022]
  4. Pharmaceutical Biology. 2021. Simiao Qingwen Baidu decoction inhibits Epstein–Barr virus-induced B lymphoproliferative disease and lytic viral replication. [online] Available at: <https://www.tandfonline.com/doi/full/10.1080/13880209.2021.1934038> [Accessed 9 August 2022]
  5. Dietary Chinese Herbs. 2015. Lonicera japonica Thunb 金银花 (Jinyinhua, Honey Suckle). [online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120270/> [Accessed 9 August 2022]
  6. Dictionary.com. Mononucleosis. [online] Available at: <https://www.dictionary.com/browse/mononucleosis> [Accessed 9 August 2022]

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