Hi Everyone,
I had a lot of blood work done. Some of them I know I have seen on here that you should not always go by what the lab states are the Reference ranges. Could you let me know what you think about the following levels?

My Thyroid Panel: T3 uptake 30, T4 8.5, Free T4 2.6. I looked it up and it appears labs can use different reference ranges. Why is that?

My Total Vitamin D, 25 OH, was 41, D, 25 OH, D3 was 41 and D, 25 OH, D2 was <4.

My Epstein Barr Virus EBNA (IGG) was high at >5. My Epstein Barr Virus VCA IGG was high at 3.60. Do I remember correctly that there is a type of Chronic Epstein Barr Virus? I've tested positive for this several years back and I know the levels can stay with you for life once your have the disease. They did not test the IGM.

My symptoms have been continually getting worse since the summer. I feel exhausted all the time, possibly from Thyroid? I also have joint and muscle pain. My neuropathy has flared up several times since the summer.

Please let me know what you think.

Hi Hopeful,

There may be more than one. I have a distant cousin with Chronic Fatigue Syndrome (CFS) who says it is EBV, and Chronic EBV is one of the alternative names for CFS.

OTOH, other sources draw a distinction (that I haven't figured out yet).

chronic epstein barr virus

Numbers vary, but there seems to be a concensus that most of us have the virus, albeit dormant.

I can speak from personal experience that it can reactivate in a number of ways; HOWEVER, I wouldn't jump to any conclusions because of lab numbers. At least some of the sites I read said that Chronic EBV cannot be DX'd by lab tests—ostensibly because most of us test positive for the virus anyway. A few of the sites also mentioned that CEBV is rare in the West and more common in Asia.

An archive search for "chronic epstein-barr" turned up a half dozen or so hits; oddly none of them in the Fibromyalgia and Chronic Fatigue forum.

Doc

--as it was one of the things investigated during the most acute phases of neuropathy.

Without getting ridiculously complicated--the subject is very complex, as there are a number of different titres that need to be tested--your EBV results are very typical of most of the adult population in the Western world. The Epstein Barr Virus (technically, human herpes virus 4) infects at least 95% of us by age 30. The large majority of us get infected by it in childhood when the symptoms resemble a bad cold--it is not always associated with mononucleosis. After infection the virus is immortalized in the pharynx, lying dormant in most people, unless some trigger or compromised immune condition allows it to reactivate and spread.

Because of this, almost all of us will show a positive response to an assay of the EBV IgG EBNA (Epstein Barr nuclear titre) and the Epstein Barr VCC IgG (virus capsule antigen). These just mean that the body was once infected with Epstein Barr. The more interesting results are the IgM and IgA titres for what is called the early antigen--these may indicate a reactivation. But these are not tests that most labs do automatically unless asked--I had mine done through a specialty lab.

This may be the simplest explanation I've seen (and it's not that simple), but look particularly at the chart:

http://labtestsonline.org/understand...s/ebv/tab/test

If I remember correctly, you receive IVIG. This can (and will) alter some lab results. Keep in mind that each dose of this product comes from about 2000 donors, so you might show positive results that didn't derive from you.

Talk to your doctor about what results can be effected by the IVIG. But I would suspect that EBV is one of them.

Hi,
You are right I do get IVIG. However, I tested positive once before for EBV well before getting IVIG that's why I was concerned about it being chronic.

That is a good point you made though. I don't know why but I never thought about IVIG being able to change lab results. I was only thinking it could change my antibody levels. I will talk to my doctor about that.

Hi Glenntaj,
Thank you for the information the article is interesting. I'm going to ask my doctor if he thinks I should have more testing.
Thanks again!

Hi Dr. Smith,
Thank you for the information. I followed the link and read some of the articles. Sounds like you had a reactivation of EBV. Did you find out about through lab testing?
At my next appt. I'm going to ask my doctor about it.
After reading all of this I have a feeling he'll say no.
Do you know if most people with neuropathy see an infectious disease doctor?

I found out in kind of a strange roundabout way. I've had (what used to be chronic) migraines since ~10 years ago. I got a cold/virus that included a headache. The cold went away, but the headache didn't. Several years, doctors/neurologists, and medications/treatments later, the ortho that I saw for my spine asked me if I had seen "the headache guy" (a neurologist whose practice is limited solely to headaches/migraine).

After examining me and listening to my story, this neuro asked me three questions. After hearing the answers, he turned around to his file cabinet, pulled out a sheet and handed it to me, and dx'ed my headaches: chronic tension-type headache/migraine complex—sudden onset. He (and the sheet) explained (among other things) that this type of headache is brought about by re-activation of the EBV by another virus—in this case, human rhinovirus. Who'da thunk?

Everything that followed confirmed his dx. No tests were done; like some conditions, this one is determined more by symptoms/empirical evidence.

My guess would be no, because except in a possibly very few rare instances, peripheral neuropathy isn't contagious, unless it's a result/symptom of some disease that is far more overt/serious.

Doc

[QUOTE=Dr. Smith;1034744]I found out in kind of a strange roundabout way. I've had (what used to be chronic) migraines since ~10 years ago. I got a cold/virus that included a headache. The cold went away, but the headache didn't. Several years, doctors/neurologists, and medications/treatments later, the ortho that I saw for my spine asked me if I had seen "the headache guy" (a neurologist whose practice is limited solely to headaches/migraine).

After examining me and listening to my story, this neuro asked me three questions. After hearing the answers, he turned around to his file cabinet, pulled out a sheet and handed it to me, and dx'ed my headaches: chronic tension-type headache/migraine complex—sudden onset. He (and the sheet) explained (among other things) that this type of headache is brought about by re-activation of the EBV by another virus—in this case, human rhinovirus. Who'da thunk?

Everything that followed confirmed his dx. No tests were done; like some conditions, this one is determined more by symptoms/empirical evidence.



My guess would be no, because except in a possibly very few rare instances, peripheral neuropathy isn't contagious, unless it's a result/symptom of some disease that is far more overt/serious.

Doc[/QUOT
I have always wondered if I had acquired an infection that caused this. I was in China and Mexico the year this started.

That would certainly fall under that last case I mentioned. Something tells me (and I could be wrong) that an ID specialist would be interested in treating the infection, but if you're over it, or something arose from it, s/he may hand you off to a different, more knowledgable specialist—in this case, a neurologist. Feel free to disagree and follow this up; a quick question or two to your PCP should get you an answer.

Doc