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My test: Borderline IgG deficient, plus low HNK1 - What does it mean?

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by Antares in NYC, Aug 15, 2013.

  1. Antares in NYC

    Antares in NYC Senior Member

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    Hi everyone,

    I just needed a bit of help interpreting the meaning of some of my recent blood tests. I'm particularly intrigued about the number for immunoglobulin, which seem at the edge of being deficient, in light of my recent diagnosis for ME/CFS. Here's what I got:
    While my overall IgG numbers are low, notice how my IgG 1 and IgG 3 are just slightly above of the marker for deficiency. Basically borderline deficient on those two.

    I did a quick search online that explained some of the IgG subclasses, and IgG 1 is related to protein/polypeptide antigens, and that IgG 3 is associated to ME/CFS, fibro, and lung infections.
    What does this all mean in the context of my recent diagnosis?

    Also, my HNK1 lymph levels were alarmingly low: CD8-CD57: 1.8%, abs 40 /uL

    For the record, my titers for EBV VCA and Nuclear were very high (>8.0), and also high for HHV6.

    I would appreciate it if someone can decipher the IgG numbers for me, and what can be done, if anything. Thanks!
  2. roxie60

    roxie60 Senior Member

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    Wow your EBV was high. Sorry cant help with IgG tests results. I'm just starting down this path bt I will follow your thread/posts with interest.

  3. Symptomatic

    Symptomatic Senior Member

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    I'm in the same boat with IgG, my HNK numbers were nowhere near yours though:

    IgG1: 422 (422 - 1292)
    IgG2: 433 (117 - 747)
    IgG3: 30 (41 - 129)
    IgG4: 11 (1 - 291)

    HNK1, CD8-/CD57+ at 8.7%, absolute at 78 / uL

    I also have low complement C3a to go along with this: 43.8 (54 - 202)

    My immune system is not happy! Our goal is to kill bugs and support the immune system. I take Benicar, Mino, Zith, LDN, and Homeo-KMAF (homeopathic Gc-MAF). May need/want to add more to the mix later.
  4. roxie60

    roxie60 Senior Member

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    Will be getting HNK1 Monday, will add my results for comparison and education when I get them.
  5. roxie60

    roxie60 Senior Member

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    Symptomatic was your HNK1 in range?
  6. Symptomatic

    Symptomatic Senior Member

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    Yes. 8.7% (range 2-17), and 78 / uL (range 60 - 360).
  7. Antares in NYC

    Antares in NYC Senior Member

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    I think it's remarkable that so many of us have similar numbers when it comes to our immune system:

    - very low or deficient HNK1 cells
    - very low or deficient IgG-1 and IgG-3

    What is happening? What does it mean? Is this another indication that ME/CFS is auto-immune?
  8. roxie60

    roxie60 Senior Member

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    got test results back today. to tired to list all but really the significant one I think is

    CD8-/CD57 (HNK1) + Lymphs = 1.9% LOW
    Abs. CD8-CD57 + Lymphs = 55 LOW

    needto lay down, just preping & going to Dr apmt wore me out.

    FYI I had a Lyme antibody ? ELISA test last Nov and it came back negative (I'm sure I did not get Lyme since last Nov.). Could these HNK1 results be indicative of anything other than Lyme? If I have had lyme for long time is it typical to get worse overtime w/o treatment? Can I be 100% healed from Lyme? Heard it involves alot of drugs which I'm not thrilled about.

    To confirm diagnosis Dr wants me to take IGeneX Lyme Panel (IFA, IgM, IgG Western Blot and PCRs for Borrelia). Anyone take this test and be able to tell me what to expect.
  9. Ema

    Ema Senior Member

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    My IgG numbers looked similar to yours, Symptomatic.

    My doctor put me on Hizentra, which is subcutaneous immune globulin replacement. I started it last Christmas and I definitely think it has made a difference though unfortunately still not a cure.

    That subclass 3 is a puzzler. It won't seem to come up for anything for me after treatment. So either it is immediately complexing with an antigen and is no longer "free" to be measured or something else is going on. But my subclass 3 is still under range after all this time treating while the other subclasses and my total have increased dramatically.

    Ema
  10. Ema

    Ema Senior Member

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    The Lyme ELISA test is worthless unfortunately and the results are no better than chance unfortunately.

    Yes, low NK cells can be indicative of immune issues in general but there is some question as to whether or not they should be used as a marker for treatment. Many people who are ill have low NK cells but some (like me!) do not. And sometimes they come up with treatment, but sometimes not. Doctors seem to be moving away from using this test as much these days.

    You can be in remission from Lyme if your immune system can hold it in check. I suspect that many people are exposed to the Bb bacteria but it is only those of us with problematic immune systems that end up with symptoms. That's why I think it is important to support the immune system as well as kill the bugs.

    Have you found anyone else to go over your stim test results? I'm still very worried about you roxie60! That would be my first step, long before starting down the Lyme road. Your immune system may not be functioning at it's best because you have hardly any cortisol. Cortisol is required for proper immune function and is vital to life.

    Ema
  11. roxie60

    roxie60 Senior Member

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    Cortisol was back up and ACTH (I still think whatever flare up in Jul Aug that made me so sick affected my cortisol/ACTH, I could be wrong). I had been taking that Adrenogen (I stopped it about 5 days before recent test due to negative reactions) and doctor thinks it may have boosted Cortisol/ACTH (also it was a different Lab, different results?, I would hope not but????). Cortisol AM was 11.5 (big improvement) and ACTH was 14.9 (some improvement and back in range at the low end (7.2-63.3).

    Estridiol still very low. uMMA in range (6.5 (range 1.6 - 29.7) and normailized to Crt at 0.6 (range 0.4-2.5). Liver enzymes high but improved over last test (again in line with me reporting my flare up ended about the beginning of Sept).
  12. Ema

    Ema Senior Member

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    I really wish you would follow up on this with an endo that specializes in secondary AI. Your results are still pretty bad and you failed an (improperly done) stim.

    Why is your ACTH still so low with that low of a cortisol result? A normal AM cortisol would need to be at least 18. But that's the last I'll say of it. I know you know my opinion!


    It's really hard to fix any of these other things, especially the immune system, if this arm is still out/weak.

    Ema
    roxie60 likes this.
  13. knackers323

    knackers323 Senior Member

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    Hi can I ask what the benicar does? Thanks
  14. roxie60

    roxie60 Senior Member

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    I guess I dont know how to find someone who can help. I called an Endo 50 miles away. It seems no Endos are held in high regard in these parts. I just never seem to get better no matter if I follow protocol so I am getting weary of Dr hoping. If I knew there was an Endo that with out a doubt had 2ndary AI experience I would sign up but when I call them and ask they all say they have experience treating it, even the Endo I went to for the STIM test.
  15. August59

    August59 Daughters High School Graduation

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    If they are taking an opiate pain killer it will lower your ACTH plus blunt the cortisol response to it. As well, they can have low cortisol. Just an FYI

    I'm not sure if a low dose would do it, but chronic pain patients have this problem.
  16. Symptomatic

    Symptomatic Senior Member

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    Ema, was the Hizentra covered by your insurance? If not, I'd be interested in knowing how much it's costing (if you don't mind sharing). How often do you have to do it? I'm needle-phobic, and am also unsure that I trust the IVIG-type products. I know "they" say they're safe, but I wonder what they don't know about and can't yet test for that might be in there and be worse for me than my current issues...
  17. Symptomatic

    Symptomatic Senior Member

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    For me, it decreased my ultra-high 1,25 Vitamin D, which in turn resolved my hypercalcemia and all the symptoms I had from it.

    My doctor also believes it is responsible for my CRP coming down.

    There is a school of thought that believes it helps activate the innate immune system.
  18. knackers323

    knackers323 Senior Member

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    Thanks. High 1,25 can be a sign of autoimmune disease can't it? Has the benicar helped in other was apart from the hypercalcemia symptoms?
  19. Symptomatic

    Symptomatic Senior Member

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    My CRP is now in-range (not as low as I'd like, but in-range nonetheless). High CRP is a sign of inflammation.

    High 1,25D if frequently present in sarcoidosis (my chest x-ray was negative), and is presumed to also be caused by chronic infection (which we're assuming is the case for me; but per 23andMe I also have a fairly whacked Vitamin D receptor; and issues with Vitamin D binding protein (as per high nagalase)). Not sure about autoimmunity per se, but for several years my ANA was positive.

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