Training with Mononucleosis

Medical Q&A [Moderated]
1

Hello,

I’m 27 male and was just diagnosed with Mono, did the IgG and IgM tests and IgM is 9x while IGg is negative which signals that it is ongoing from what I’ve gathered.

I felt weird random pretty intense fatigue for 1 hour some 14 days ago and then everything was normal after but I’ve gotten swollen tonsils 3 days later and it has been ongoing since then with white spots and everything. Other than the sore throat I didn’t even feel I was sick since I’ve trained a few times since then, doing zone 5 cardio, cardio, deadlifts etc but went to check it out anyway since the white spots weren’t going away even with antibiotics. Bloodwork was mostly normal with lymphocytes 46% out of the normal 45% by the test standards, liver enzymes were 1.6x more than normal. However I did stop working out completely had 37.1 C one day and I’ve been on full rest.

It has gotten significantly better some 10 days after first symptoms, no longer using Nsaids, highest temperature was 36.9 and some minor fatigue during the day for a few hours and I’m functioning mainly normally with slight discomfort in the throat. What would be a reasonable time to start working out?

I’ve been thinking of total rest for a few more days and maybe getting an ultrasound of the spleen to see if it is enlarged and then doing really light weight training. I’ve got a heart rate monitor so was thinking of trying to stay in zone 2-3. I also do Muay Thai and I was just about to start BJJ so I was thinking of delaying that for a few weeks at least to not spread it to people or making it worse.

2

Doron,

Thanks for the post and sorry to hear you’re not feeling well. As you know, we cannot give you medical advice via the forum. For further evaluation and discussion on your specific case, a consultation may be worthwhile.

In any case, it is currently recommended that ALL athletes with infectious mononucleousis should refrain from sport for ~ 3 to 4 weeks, as the window for splenic rupture has been estimated to be 2 to 21 days after diagnosis. Unfortunately, this is mostly consensus rather than being based on rock-solid evidence. It would be reasonable to avoid non contact activity for 2-3-weeks and 4 weeks for contact activities.

We discuss this on case #3 in episode 283.

3

Thank you very much for the reply and linking the podcast as well will listen to it.

That was about the plan I’ve had. Today is exactly 2 weeks almost no symptoms so was planning on taking at least 1 more week of rest before doing lightweight activities and about 2-3 more weeks before anything contact related, plus to do an ultrasound of the spleen to see what is going on.