Coxsackievirus: An Overlooked Cause of Fatigue
By Bryant Rubright
Coxsackievirus is the cause of hand, foot, and mouth disease. Most people acquire this virus
early in life. Once the acute infection is over, the virus remains dormant in the body. During
times of stress, viruses like coxsackievirus can become reactivated. Coxsackie virus in particular
can become problematic when reactivated because it has an affinity for the heart, and is the
typical cause of viral myocarditis. A blood test for coxsackievirus antibodies can help determine
if it is an issue, as well as various heart testing.
Some of the symptoms of myocarditis include:
- Heart palpitations
- Cold hands and feet
- Poor circulation
There are no conventional medical treatments for viral myocarditis, other than supportive
therapies. Pharmaceutical antivirals have either weak, or no effectiveness at all against
coxsackievirus. There are however a handful of herbs that have strong scientific research
showing superiority over prescription antivirals in effectiveness. Many of them have historically
been used effectively in Chinese medicine for a long time, and now have research supporting
Known in Chinese medicine as ku shen, sophora has been traditionally used as an antiviral and
as a treatment for arrhythmia. It is well researched for treating viral myocarditis. In one study
on 76 people, sophora injections eliminated arrhythmia in all patients, and returned
coxsackievirus titers to normal. 1
Astragalus is most known as an immune boosting herb, but it is also strongly cardioprotective.
Astragalus not only is specifically antiviral against cosxackievirus, but also protects the heart
from damage caused by the virus. 2
Most people know of rhodiola as an adaptogen, but it also has antiviral properties against a few
viruses, one of which being coxsackievirus. A combination of rhodiola, astragalus, and sophora
was four times more effective than the antiviral drug ribavirin in treating mice with viral
Korean red ginseng is another adaptogen that supports the heart. Ginsenosoids found in the
herb are antiviral against coxsackievirus. 4 The specific types of ginsenosoids that occur in higher
amounts in American ginseng were not effective against the virus.
Japanese knotweed is widely known in the Lyme world as an anti-spirochetal herb. It is
especially helpful in Lyme myocarditis as it supports the heart and microcirculation. It is also an
angiogenesis modulator, meaning that it stimulates the production of new blood vessels where
needed, and inhibits their production to places not needed (ie. tumors). On top of its cardio-
protective properties, Japanese knotweed is antiviral against coxsackievirus. 5
Other herbs that are broadly antiviral that show activity against coxsackievirus include: Chinese
skullcap, turkey rhubarb, licorice (glycyrrhizic acid), isatis, and osmunda.
While myocarditis can be caused directly from coxsackievirus infection of the heart, it can also
be from an autoimmune reaction from the virus. Immune desensitization therapies such as Low
Dose Immunotherapy (LDI), or other therapies that promote immune tolerance can be helpful
for autoimmune reactions.