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List of recommended Viral/Bacterial Tests.

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by curry, Oct 23, 2010.

  1. curry

    curry Senior Member

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    I am a bit overwhelmed about the information, which tests for viral & bacterial infections are advised to get done.

    So I've been compiling a list about the tests available, and would greatly appreciate your input if there's a test missing on it, and also would be interested to hear your thoughts on which tests should be given priority.


    My sources for this list are Dr. A. Martin Lerner and Dr S. Myhill.


    TESTS:
    • Human herpes virus 6 (HHV6).
    • Human cytomegalovirus (CMV or HCMV).
    • Borrelia antibodies (Lyme's disease) & Co-infections.
    • Epstein-Barr virus screen.
    • Amoebic antibodies.
    • Brucella antibodies.
    • Chlamydia antibodies .
    • Psittacosis (from parrots) and ornithosis (from birds) - rare
    • Echinococcus (tapeworm) antibody.
    • Enteroviral antibody screen (coxsackie virus, adenovirus, polio virus and echo virus).
    • Helicobacter antibody.
    • Hepatitis A antibodies (Total)- HAV.
    • Hepatitis B core antibody HBcAB.
    • Hepatitis B e antibody HbeAb.
    • Hepatitis B surface antibody (post vaccination check).
    • Hepatitis C antibody HCV.
    • Hepatitis D (Delta).
    • Hepatitis E antibody (IgG).
    • Herpes I and II combined IgG antibody test.
    • HIV antibodies HIV1 and 2. T
    • Leishmania antibody.
    • Leptospira antibody.
    • Malaria antibodies.
    • Measles antibodies.
    • Mumps antibodies.
    • Mycoplasma antibodies.
    • Mycoplasma incognito.
    • Parvovirus antibodies.
    • Rubella IgG.
    • Salmonella antibodies.
    • Schistosoma antibodies.
    • Toxoplasma antibodies Total.
    • TPHA & VDRL.

    Quote:

    'Over the last 2 decades, Dr. Lerner has treated and tested scores of ME/CFS patients.
    He says he's discovered that 3 main viruses are associated with the condition: Epstein-Barr (EBV), human herpes virus 6 (HHV6) and human cytomegalovirus (CMV or HCMV). In his experience, people can have either one of these viruses or a combination of them. On top of that, he says he's identified a subgroup of people who have Lyme disease on top of these viruses, and that this is the harder group to treat.'
  2. rlc

    rlc Senior Member

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    hi curry to be honest if you can find a doctor who will run tests for you i would advise getting as many as possible done, however if you havn,t been tested for the likes of hep C, HIV and Lyme by your doctor i would be seriously concerned about what their doing, in the canadian criteria for CFS there is a list of diseases that should be excluded before giving the diagnosis of CFS make sure that your doctor has ruled them out first before worrying about other possibilities link to the Canadian Criteria here http://myalgic-encephalomyelitis.com/ME-CFS-canada-protocol.html this criteria however dosn't include Vitamin D deficiency make sure you get that tested if you have any symptoms that are not in this criteria make sure that you get them properly investigated they may point to somethig else going on hope this helps all the best
  3. Cloud

    Cloud Guest

    Agreed that the exclusionary diseases need to be ruled out first because a person may have a treatable condition such as Addisons, Pernicious Anemia, or Celiac disease. The list of exclusionary diagnosis' are diseases that can look a lot like ME/CFS. But I would also add that a person can have any of those exclusionary diseases and also have ME/CFS. Not a lot of docs out there able to differentiate those diseases, but still need to get it done.
  4. curry

    curry Senior Member

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    You tell me... :(
    (All I've got from my national healthcare GP so far was a 'regular' blood test in 2007 and the same test in 2009 - and I was told he is not willing to investigate any further as the test result was more or less normal.)

    For this reason I am trying to figure out what tests I should do in private labs, and what I can afford to test.
    I assume other people are in the same way let down by their health care system, so I thought this list may help.

    Thank you very much for the link. :)
  5. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    do all the herpes tests eg ebv, cmv, hhv6 as well as mycoplasma and chlamydia pn. Then get a general immune system check like a lymphocyte subset test and also if u can a natural killer function test(not numbers) which might be hard to get. These infection can atleast be treated with antivirals and antibiotics.

    cheers!!!
  6. Cloud

    Cloud Guest

    Completelt agree Curry. These are the ones commonly found in ME/CFS. I'm sorry to hear of your all too common story of a doctor not wanting to test you beyond the basics because they come back ok. That ignorance is epidemic in the medical community, and we have all dealt with it on some level....and usually a lot. Go for finding a good doc who will at least have an open mind and is willing to test you further. Better yet, get a good ME/CFS doc.
  7. rlc

    rlc Senior Member

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    hi curry if it at all possible find a way to get a better doctor, you could spend a fortune paying for tests that might not have anything to do with your problems, any half way decent doctor should be running more tests then this doctor, find out what your rights as a patient are and use them, this doctor sounds totaly neglegent, find out what those tests actually said! more or less normal sounds like there might be something wrong with them, which might help you figure out whats going on. keep posting people will try and help, dont let anyone diagnose you with CFS with out properly investigating it, it could be something else causing your problems! all the best
  8. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

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    I am very happy with my insurance, but I am sure that will change for the worst in the very near future!

    Thanks for nothing Congress!!
  9. curry

    curry Senior Member

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    Thank you all for the nice and supportive posts. You are a great bunch. :)

    Regarding patients rights, frankly speaking, there aren't any which could overrule the decision making of the GP. I can also not so easily change the GP, due patients are assigned to certain GPs in the catchment area where they live - my GP was the only one available who was able to take on new patients. If I make a big fuss I could change to one of his colleagues in the same health centre, but I doubt they would overrule his decision.

    So my plan is to pay for the lab testing myself, and when some results come back as positive I will consult him for treatment, which he will have to provide by law.

    Obviously I have to make careful decisions what tests to run, as my funds are limited...

    If I understand correctly then the following should be tested:
    • Human herpes virus 6 (HHV6).
    • Human cytomegalovirus (CMV or HCMV).
    • Borrelia antibodies (Lyme's disease) & Co-infections.
    • Epstein-Barr virus screen.
    • Mycoplasma antibodies.
    • Hepatitis C antibody HCV.
    • 'General immune system check (like a lymphocyte subset test)'
    • Natural killer function test

    I am thankful for any further advice. :Retro smile:
  10. Timaca

    Timaca Senior Member

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    I get most of my infectious pathogens run at Focus Diagnostics Lab in CA. http://www.focusdx.com/focus/1-reference_laboratory/index.asp
    You can then compare your antibody titers more easily with what is posted on the HHV-6 website as what might be considered a "high" result: http://www.hhv-6foundation.org/testing.htm

    For EBV, make sure you include the Early Antigen (EA) in your testing: http://www.vicd.info/testing.html Here is an article that may interest you: http://www3.interscience.wiley.com/cgi-bin/fulltext/111088889/PDFSTART

    For enterovirus testing, it is important to use ARUP lab: http://www.enterovirusfoundation.org/chronicinfections.shtml (Scroll down until you see the info about ARUP). Coxsackie B is a problem in a friend and in me, so I would definitely suggest testing for it too.

    Quest owns Focus lab, so if you discuss your test needs with your local lab director, you might be able to get them to send to Focus for you. And if you're really lucky they may also be able to send out to ARUP lab.

    Best, Timaca
  11. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    that looks good curry, that covers most of the common causes, i hope u find some answers.

    cheers!!!
  12. rlc

    rlc Senior Member

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    Hi curry my recomendation for tests is this, do what ever you can to see a different doctor at the practice you go to, there are a few reasons why i would recomend this, the doctor you've seen sounds at best neglegent, i know a couple of medical receptionist, so i know that in most practices the patient's always try and book with one doctor because there so much better, and that the good doctor is very well aware of how bad the other doctor's are! so there is a chance you found the worst doctor in the practice and the other's will be better. Also if you look at the list of conditions on the canadian criteria there are alot of different diseases that can have the same symptoms as CFS, so the odds on you having it are quite long, however if you add up just the number's of how many people have diabeties, hypothyroidism and B12 deficiency your going to find that it comes to around a billion, the numbers for CFS are thought to be about 17 million. So statisticly the odds of you having CFS are very small, and the other more common conditions should be ruled out first. The problem with this is that's going to involve alot of tests and alot of money so if you can get another doctor to do that for you, one there's more chance that they'll find something else thats not CFS and be able to treat it, also your going to save alot of money and time. The problems with ordering lab test yourself are numerous, alot of them are amazingly complicated to interperate and can only be worked out by some one with years of training, alot even if positive have to be compered to other tests and symptoms before a diagnosis can be made, some can come back normal but still don't rule out the condition, and in a list as big as your original one there's a high chance of a lab error, so you can end up spending a fortune only to be none the wiser our at worst think you have something you don't. If your problems are caused by somthing as simple as B12 deficiency which any competant doctor should be able to diagnose and treat, it's going to be a real shame to spend all that money for nothing. If you can ge to see another doctor if possible take someone with you, doctors behave very differently if there's another witness in the room, if CFS isn't writen on your file don't mention it, you want to get everything else ruled out first, alot of Doctor's think CFS means your mad, instead of saying things like fatigue say weakness etc, and stand up to them to the best of your abilities if they aren't being helpfull all the best hope this helps
  13. rlc

    rlc Senior Member

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    hi curry me again, if you decide to try another doctor, if you haven't already check your self for things like the whites of your eyes being yellow, rashes, strange marks on your skin, if yor skin is getting darker or lighter, etc if you have any of these things it can sometimes help a doctor work out whats going on. You say you don't think you have any rights as a patient, i don't know what country your in, but most counties in the world do, if you want to, let me know what county your in, i'll see if i can find it for you on the net, heres a link to the one we have in new zealand, there is probably something similar in your country, http://www.newzealandnow.govt.nz/patient-rights~288.html because we have this, when a doctors doing something like talking over the top of you, you can say something like i have the right to be listened to and they'll immediatly remember that you can report them for breaching your rights, Most countries in the world do have some often severe punishment for doctors who behave badly. So knowing your right can be very helpful. If all else fails there's a trick that's often used here by a lot of people to get tests done, because are health system is terrible! which sometimes works well, so i'll be keeping an eye on this tread and if you can't get a doctor to help i'll explain it to you. If at any stage your feeling like things are getting really bad go strait to a hospital, all the best i hope things start working out for you soon
  14. curry

    curry Senior Member

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    Hi rlc,

    Thank you a lot for your concern and advices.

    I paid for a B12 and D test at a private lab, and the test came back saying I'm seriously B12 deficient - when I asked my GP for advice, I was told 'to buy B12 tabs at the local drugstore, and I would be fine'. :rolleyes:
    This was 12 months ago...
  15. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    if u were b12 deficient i would take the test again after using b12 tablets(for a few weeks), make sure there the type that dissolve inder your tongue. IF your still b12 deficient, take the results to another doctor and ask for b12 injections. This could be the cause of your cfs, if not then fixing b12 can improve your symptoms, LOw b12 is a medical condition called pernicious anemia, lack of intrinsic factor that help u to absorb b12 in the gut and treatment for this is regular b12 injections.

    cheers!!!
  16. rlc

    rlc Senior Member

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    hi curry, i think we may have solved your problem, well apart from the one that your doctor is showing signs of Dementia! if you have failed a B12 test the correct course of treatment is a course of injections to lift your levels very quickly back to what they should be because the consiquences of B12 deficiency can be very serious. If it is decided that the level of deficiency is at a level that isn't that low it can be treated with oral supplements, but these are suposed to be perscribed by a doctor, and follow up testing is required to make sure that the treatment is working! The symtoms of B12 deficiency can be found here http://vitamins.lovetoknow.com/Vitamin_B12_Deficiency_Symptoms and here http://www.essortment.com/all/vitaminbdefi_rndj.htm i think you might find you have some of these symtoms. Because you have failed this test and your doctor failed to make sure you got correct treatment, you have a Medically proven reason to demand to see another doctor so go for it!!! most labs say that b12 below 160 shows deficiency, the new research says it should be above 300pg/ml (221pmol/L) so make sure they get it to the right levels, and you'll probably find your cured. dispite what a lot of people think b12 can have side effects so be careful if taking it link here http://ezinearticles.com/?The-Side-Effects-Of-Vitamin-B12&id=816035 referance ranges for vit d are also being questioned old ones and treatment here http://www.ncbi.nlm.nih.gov/pubmed/19835345 new research here http://www.vitamindcouncil.org/ so you might want to check your tests result against these. all the best doctors, argggg
  17. justy

    justy Senior Member

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    Hi Curry, i really sympathise with your position as i also live in the UK. Like you i ave had private testing (mitochondrial function test) which my doctor has completely ignored. i have requested he prescribe the supplements that Dr.Myhill advised were prescribable, but my GP reuses to prescribe them.
    I think that it is hard for people form other countries to understand how difficult it is here in the UK. The NICE guidelines actually prohibit our GPs form doing any testing that would show up viruses etc. Also not allowed to be tested or treated for symptoms related to things lke POTS.

    I would also really like tofind out where or who to get further testing for viruses,infections and parasites with in the UK or Europe. So if anyone has any info on this....
  18. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    http://www.b12-shot.com/ sometimes you have to treat yourself, just make sure u do lots of reading up, if u have a friend that is a nurse they can give u b12 injections and maybe show u how to do them yourself like alot of others do.

    cheers!!!!
  19. rlc

    rlc Senior Member

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    hi curry justy mentioned your from the uk, hi justy you might be interested in this uk patients rights are here http://www.adviceguide.org.uk/index/your_family/health/nhs_patients_rights.htm you have the right to change GP with out giving a reason, you also have alot of other rights, and the right to lodge complaints about treatment. My advice regarding treating B12 deficiency is this, self medicating for this is potentialy dangerous, So it would be advisable to, if in any way possible, to get a different doctor, which you have the right to, to treat this properly. The reasons for this are, your B12 twelve needs to be rechecked to see what level it is at, to work out correct treatment, you may also need more tests to see if you have developed anemia. A B12 shot can be given imediatly after the test is done, so this won,t delay treatment, when B12 deficiency is being treated futher tests are needed to make sure the treatment is working, if some one is taking supplements with out these test being done, there is no way of knowing if correct levels have been reach, so you wont know if the problem has been corrected or something else is causing problems as well, and by far the most important reason is this, if you our any one using suppliments has celiacs which is very common, or any other of a large number of conditions that stop B12 from being obsorbed there levels will continue to drop, this will lead to pernicious anemia which if not treated is fatal (if anyone reading this knows anyone who is self medicating for B12 deficiency can you Please make sure there aware of this!) also if it does turn out that all your problems have been caused by B12 deficiency, you will have proof that you had it, proof that treatment cured it, proof that you had to pay for your own test, and proof that you recieved wrong treatment advice. You can get compensation for misdiagnosis in the uk see link http://www.thompsons.law.co.uk/Clinical-Negligence/medical-misdiagnosis-personal-injury-claims.htm So there is a chance you may become both healthy, and wealthy! all the best hope this helps
  20. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    b12 injections are perfectly safe and no known toxic effects. Some cfs drs /specialists sometimes recommend a compounded b12 product with ultra high doses as in 10,000mcg per/ml 3 times a week, even if b12 levels are normal. In saying that, u said u could get or pay for a b12 test that doesnt require a drs authority, this would be good to confirm b12 deficiency, but b12 injections are far from dangerous even in large amounts and are often used by doctors in people who's b12 blood tests are normal as a tonic or energy boost. if u cant find a doc to treat you then it could be dangerous long term not to treat you, nerve damage, fatigue from anemia etc being some of the problems, which u may already have. If someone is self medicating b12 then they dont have to worry about pernicious anemia, several injections increase the storage of this vitamin that would last several years. Its dam hard to find a good doctor these days but keep searching, but u should keep trying to educate yourself on your personal health matters as doctors tend to miss alot about their patients as they push u out the door to get another customer in to keep the money ticking over.

    cheers!!!!!

    cheers!!!

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