My lab results from Dr. Bieger

[eric_s]

Hi

This evening i got back my lab results from Dr. Bieger. It's the first time i've had serious testing and so i'm curious what you think about it, if it matches what many other people also have, etc.

Unfortunately, i don't have all the results yet. It might be that tomorrow i will hear about the results of the XMRV test and testing for reactivated herpes virus infection, because he will contact that lab.

So this is what i have that is not normal:


Name..........................................Value......................Normal

MCHC........................................31,3 g/dl...................33 - 36

T-Cells absolute...........................732 /?l................920 - 2580
CD4 helper cells absolute...............443 /?l................550 - 1660
CD8 cells absolute........................265 /?l.................280 - 930
NK cells (absolute).........................44 /?l.................100 - 600

COX-2......................................2,996 Qu..................< 2,932
NFkB (IkB).................................49,05 Qu.................< 18,368

Also vitamin D, selenium and homocysteine were not normal. And he wrote "no immature t cells (CD4/CD8+)!!", so i don't seem to have them or at least not at this moment...

It's not very important, there are hundreds of people on here with their results and i will talk with Dr. Bieger about the results anyway, but if anyone is interested in these things and has some spare time, feel free to comment or ask, if you're interested in other values or anything.

 

[heapsreal]

interesting results, some cfsers immune systems are mostly active, yours looks like it is quite suppressed. besides nk function all my cd lymphocytes are in the high range. Have u been tested for infections as well? u could also be a good candidate for immunoglobulin therapy as this can help stimulate your immune system so your cd4, cd8 and nk numbers improve and help fight what ever infections are going on, also finding what type of infections and treating them with either antivirals or antibiotics can also help. keep us posted on what happens next, thanks.

cheers!!!

 

[eric_s]

Thanks, i will keep you posted. I think he also tested for reactivated herpes virus infections, but those results are not in yet. I hope if it looked like some serious infection he would have told me in the letter . He proposed some antivirals, but i will discuss that with him first, i'm rather reluctant to take a lot of medications.

 

[heapsreal]

Thanks, i will keep you posted. I think he also tested for reactivated herpes virus infections, but those results are not in yet. I hope if it looked like some serious infection he would have told me in the letter . He proposed some antivirals, but i will discuss that with him first, i'm rather reluctant to take a lot of medications.

all i can say was that i was reluctant to use medications but after awhile i new i couldnt positively think my way out of it and wanted to feel better, no miracles but i know i would be alot worse if i didnt use meds, but its a personal thing to weigh up with your doc. The test help validate the way u feel which is a good thing, u know its not just burn out or depression now.

good luck.

 

[eric_s]

I've known that since the start, so that's nothing new for me (no offense meant ) . I know a lot about ME/CFS, it's just that we don't have any doctors in Switzerland that do serious lab testing or treatments (for ME/CFS, for everything else they're very good). At least not that i know of. Personally, i'm not convinced that treatments generally make people better. I know they work in some people, but there are also many cases where they don't work or even make people worse. And you have to consider the effects of the medications on your body and health. Of course an untreated illness also is bad for the body. So you have to weigh things against each other. I still think the way forward for us is more research to find better treatments, not so much the existing ones.

Sh... i wonder now if i should get a HIV test ? With regards to a suppressed immune system, the interesting thing is that i hardly ever get a cold or something like that since i have ME/CFS. In Spain i caught one two or three times within the last year, probably because i'm not used to these bugs and it was quite heavy every time, took me a week or longer to get rid of it and once i had around 39.5 degrees. But in Switzerland i never get anything.

 

[heapsreal]

I've known that since the start, so that's nothing new for me (no offense meant ) . I know a lot about ME/CFS, it's just that we don't have any doctors in Switzerland that do serious lab testing or treatments (for ME/CFS, for everything else they're very good). At least not that i know of. Personally, i'm not convinced that treatments generally make people better. I know they work in some people, but there are also many cases where they don't work or even make people worse. And you have to consider the effects of the medications on your body and health. Of course an untreated illness also is bad for the body. So you have to weigh things against each other. I still think the way forward for us is more research to find better treatments, not so much the existing ones.

Sh... i wonder now if i should get a HIV test ? With regards to a suppressed immune system, the interesting thing is that i hardly ever get a cold or something like that since i have ME/CFS. In Spain i caught one two or three times within the last year, probably because i'm not used to these bugs and it was quite heavy every time, took me a week or longer to get rid of it and once i had around 39.5 degrees. But in Switzerland i never get anything.

i understand where your coming from but i had to try something or else i would be on some type of disability pension which i cant afford, plus i also look at the long term risk of cfs with increased risk of cancers etc, even though treating with antivirals hasnt proven to reduce these risks, it hasnt been disproven and its got to take a load of the immune system which then is free'd up to hopefully fight cancers etc, plus i also think cfs is a progressive illnesses and just gets worse and possibly quicker without treatments. But there are know cures just treatments which most have to stay on to prevent going backwards. With myself, my lymphocytes were all quite high and indicated some chronic viral infection, taking antivirals helped lower these to closer to normal while improving how i feel. for me there is definately a correlation to how i feel and my lymphocyte levels which can be controlled by antivirals to some degree.

chronic high temps could indicate a bacterial infection, but that could also be a secondary infection from your immune defiencies. Also usually cold symptoms etc are from the immune system fighting the infection, so maybe not get any colds or cold symptoms means that your immune system isnt fighting it but letting these infections spread. coughs, runny noses etc are the way your immune system deals with infections. I would still be very concerned about not treating infections, especially if they are chronic and ongoing. like i have already mentioned, a poor run down immune system can lead to many other medical problems down the track, cancer being one of them. If u get a chance to read Oslers web, they found higher percentage of rare cancers in patients from the cfs outbreak in lake tahoe, these didnt eventuate till a few years after the initial onset.

But like already mentioned its something u have to talk over with your doc and its your option with what to do. i chose to try and treat it while i have the chance. i wish i started treating cfs even earlier as i think i would be alot better at this present time, but at the end of the day i think its slowing the progression of this illness down.

cheers!!!

 

[eric_s]

Thanks for the input. Yes, i will discuss it all with Dr. Bieger and i also want to go and see Dr. De Meirleir. Unless it would be too costly, i don't know yet.

Would you mind telling me your NK cell values?

Also i would be interested in TNF Alpha, IL 8 (S), COX-2 and NFkB. It seems Dr. Bieger didn't test many cytokines, i think that would be interesting too, but probably he only gave me the basic tests there so it wouldn't cost too much.

 

[ukxmrv]

They may be "only" his basic tests, Eric, but he does seem to have guessed the ones that you would show abnormalities in. Maybe all his CFS patients are showing as abnormal in these. I've not been able to find my sheet of test results for a while but will compare when I do. Mine were from a USA lab but tested the same sorts of things - plus TNF-a which for me was raised.

Dr Beiger seemed interested in the herpes family when he was talking at the Invest in ME conference this year.

I had to look up the MCHC test to see what it is. Obviously it something he thinks is important to test for in his patients. Don't know anything about that one.

Glad you got to see him! Be interested to hear any treatment plan.

 

[eric_s]

What he did in the area of the immune system is called "small immune status", so i guess in the other package there are more tests.

He tested TNF alpha as well, but i didn't mention it, because it wasn't marked as abnormal. I have TNF alpha <0,1 and it says normal is <1. There's some sort of a diagram for each value that shows the normal range and where your value is, and mine for TNF alpha is at the end of the bar, but the normal range goes until the end of the bar as well.

Yes, he seems to know very well where to look. I think he is a good doctor.

He suggested treatments in the letter he sent me. But also some results are still out, so the treatments he suggested are not definitive yet.

 

[heapsreal]

He seems like a switched on doctor just by going by the tests he has ordered and a good find too.

cheers!!!

 

[Nielk]

Good luck Eric with whatever you decide to do.
In either case, it's good to have a better picture of what's going on in your body even if you decide not to treat it.
Knowledge is always good because it gives you the power whether you want to act on it or just watch it or try some appropriate supplements.
Good luck,
Nielk

 

[eric_s]

Thanks, Neil. Yes, it was so crazy to get gested many times and every time they said everything is alright. I've even heard "i hardly ever see someone with better values" . Dr. Bieger told me they have a very good immunological institute in Basel, Switzerland, one of the best in Europe, if i remember correctly, so i might also want to ask there. But now i will first wait for all the results and then see if he thinks it would make sense to do some even more detailed testing, for example the more extensive immunological panel.

I think XMRV will also make a big difference for me. Because if it plays a role in ME/CFS then i think we need to develop treatments that take this into account.

 

[Francelle]

Thanks for posting these results Eric - they are very interesting. Keep us posted on anything else which is out of the usual range.

I have a question about ranges for these types of tests. Have they been doing these immune panels for very long? If not, I wonder whether they have enough statistics of people's levels to know what is a normal parameter or not or whether they are still feeling their way?

 

[eric_s]

I have no idea, but i did a quick check and saw that for the non-immune values, like MCHC, homocysteine and selenium, he is using a rather tight normal range.

For MCHC he uses a normal range from 33-36, while here http://www.dr-balzer-luehr.de/diagnostik/diagnostik_laborbefund.htm it says 30-36, here http://www.aok.de/bundesweit/91254.php?id=15 31-37, 32-36 here http://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobin_concentration and 33-36 here http://www.laborwerte-verzeichnis.de/laborwerte/MCHC.htm. I had 31.3, so i'm not out of the normal range according to some references.

For homocyteine he says i should have <8, here http://www.medicinenet.com/homocysteine/article.htm it says <10, here 4-17. I have 12.1.

My selenium is at 88, so inside the normal range found in the population, but lower than what's recommended.

My vitamin D seems to be really low (4.8), i wonder how long it has been like this. It's been some time since i last had a check up, i guess 2 years or so, but no doctor has ever told me i have low vitamin D before. But i would actually not be extremely surprised if they just hadn't tested for it. Here http://www.easy-immune-health.com/Normal-Vitamin-D-level.html it says it should at least be higher than 20, here http://www.nlm.nih.gov/medlineplus/ency/article/003569.htm it says 30-74 is normal.

For the immune values, which are the ones that i'm more interested in, i guess they know pretty well what is normal, because those tests i had are probably standard tests and have been done for many years. Especially because of HIV. It's actually a bit scary to see all those HIV pages popping up when i do a search for CD4 count or CD8 count as well.

My CD4, CD8 and NK cell counts are below normal according to anything i've found, but i think they are not exremely low, it can get much lower.

It seems that at least some people are of the opinion that low NK cell counts are found in chronic lyme, maybe i should look into that as well.

 

[SpecialK82]

Eric, here's an article about immune markers and what is typically increased and decreased:

http://chronicfatigue.about.com/b/2...mune-dysfunction-chronic-fatigue-syndrome.htm

 

[eric_s]

Thanks, Special K. I don't seem to have this pattern, because my TNF alpha is low. But i also think different studies have found different such patterns, the one the WPI has described is different, as far as i know. Or at least i read this before, that Nancy Klimas's pattern is not the same as the WPI's. It's quite wierd. Maybe there isn't one pattern, but the pattern is rather that the immune system is abnormal compared to healthy people. Maybe there are subgroups that can be identified, i don't know. I'm curious what Dr. Bieger and other immunologists will say to my values, what they could mean and how it compares to healthy people and other people with ME/CFS.

 

[eric_s]

I wonder why after so many years they don't know yet if there is a distinct such immunological pattern for ME/CFS or not. So many people see ME/CFS specialists like the Drs. Bell, Komaroff, Lerner, Montoya, Peterson, Klimas, De Meirleir, Bieger, etc. There should be thousands and thousands of such data sets from patients around. How can you then not have an answer to that question? It's kind of hard to believe...

 

[Daffodil]

hi eric. your results look like typical CFS to me....it doesnt look like it is THAT bad yet...but definitely some immune suppression! i will be curious to see what dr. beiger wants you to take.

so wonderful that someone else in europe is on our side. please keep us posted!

sue
xoxo

 

[heapsreal]

Thanks for the input. Yes, i will discuss it all with Dr. Bieger and i also want to go and see Dr. De Meirleir. Unless it would be too costly, i don't know yet.

Would you mind telling me your NK cell values?

Also i would be interested in TNF Alpha, IL 8 (S), COX-2 and NFkB. It seems Dr. Bieger didn't test many cytokines, i think that would be interesting too, but probably he only gave me the basic tests there so it wouldn't cost too much.

hi eric my nk reading are from a research study and the reference ranges are from a healthy control group.
nk cell activity 51.91 (13.8-34.8) this number has improved with cycloferron, previous readings were very low 6
nk dim cells 73 (60-88)
nk bright cells 1.95 (5-10) this is the reading they are finding abnormal in cfs patients and what i think they are looking at using for a cfs diagnosis.

Also my total lymphocytes have been elevated but came down to normal with antivirals but my cd8 and cd3 have always been elevated but did come down with antivirals although still high. my nk numbers cd56 have always been within normal limits but obviously dont work very well as my nk function test has shown.

lymphocyte subset pre antivirals 2008
total 4.7H (1.1-4) march 2011 3.7
cd3 3.71H (.8-2.4) march 2011 2.91H
cd4 1.96 H(.5-1.6) march 2011 1.56
cd8 1.57 H(.2-1) march 2011 1.21H
cd56 .33 (.07-.6) march 2011 .31

I have 11 seperate sub set tests since 2007 and they seem to correspond with how i feel and also have improved with antivirals and immune modulators, the pattern is up and down but is gradually improving. The nk function test though over the last 18 months have gradually gotten worse so i think it is a better indicator of how i feel, i think the lymphocyte test is more of an indicator of my viral load to cmv which is improving but because im not 100% i think its more of a co-infection. cd8 lymph i was told by my doc is an indicator of ebv and cmv, so treating them helps but isnt the whole storey at this stage.

At the end of the day i still feel unwell but these tests show my body is trying to fight something.

cheers!!!

 

[eric_s]

hi eric. your results look like typical CFS to me....it doesnt look like it is THAT bad yet...but definitely some immune suppression! i will be curious to see what dr. beiger wants you to take.

so wonderful that someone else in europe is on our side. please keep us posted!

sue
xoxo

Hi Sue

I tried to compare my values to yours, but it seems that many of the tests you had i haven't had. Probably i would like to get a more extensive set of immunological tests, but of coures only if Dr. Bieger thinks that makes sense. Yes, i will keep you posted. The other test results are not in yet.

Eric