Kit if you'd like to add yours, much appreciated.
www.co-cure.org/drt9.htm
1 -- Complete blood count (CBC). This common and inexpensive test gives us a wealth of information. If the WBC (White blood cell count) is high (over 9000) it leaves me more suspicious of an antibiotic sensitive infection. If it is low with a high lymphocyte count, especially if atypical lymphocytes are present, this is more suggestive of a viral infection. An elevated eosinophil count suggests allergies or parasite infections. The tests also look for anemia and evidence of iron, folate, or B12 deficiencies. It also screens for blood cell cancers and can give evidence of many other problems.
2 -- Sedimentation rate (ESR) -- this test is only considered significant medically if it is elevated (i.e. -- over 20). It screens for inflammation. In most people with CFS/ FMS it actually is lower than normal. If it is modestly elevated I look for inflammatory processes more aggressively and will routinely use low-dose Cortef treatment. If it is over 50 in a patient who is over 50 years old, that patient needs to be evaluated for polymyalgia rheumatica, a very treatable inflammatory condition which mimics FMS but is a very different process.
3 -- A general chemistry -- although there are many panels it should include at least a blood sugar (glucose), BUN and creatinine (checks for kidney function and dehydration), SGOT and SGPT (also called alt and ast), bilirubin and alkaline phosphatase (to check for liver and bone diseases), albumin (protein), calcium, magnesium, sodium, potassium, and uric acid levels.
4 -- Iron, TIBC (total iron binding capacity), percent saturation and ferritin levels. These tests check for iron deficiency and excess. Both of these are critical to detect. If the iron is high, it is very easy to treat (donate blood) but can cripple and kill you if it is missed. Iron deficiency will often be present even if the blood tests are technically normal. This is because the blood test's normal range is based on preventing anemia from severe iron deficiency. More moderate levels of iron deficiency, however, can cause fatigue, brain fog, cold intolerance, restless leg syndrome, immune dysfunction, and infertility. Because of this, I usually recommend treating with iron if the percent saturation is less than 22 percent OR the ferritin level is less than 40. I recheck each four months until the blood tests come above these levels.
5 -- Vitamin B12 level. Although normal is anything under 209, evidence suggests that significant B12 deficiency occurs at much higher levels even in healthy people. Other evidence suggests that very high levels may be needed to maintain optimum health in CFS/FMS patients. I recommend that anybody with a level under 540 be treated with B12 shots. A good argument can be made for treating everybody with CFS/FMS with B12 shots regardless of the blood level.
6 -- Thyroid testing. Many doctors will only check a TSH blood test to evaluate thyroid function. Unfortunately, this test is very unreliable in the presence of hypothalamic dysfunction. If the TSH is over three, it strongly suggests that you should be treated with thyroid hormone. I would also check a free T4 level. This checks the level of the active hormone. The interpretation of other T4 hormone tests is difficult because protein binding is altered in CFS. In the experience of many physicians, and this has been supported now by several studies, thyroid blood tests will miss the large majority of people who need thyroid hormone therapy. If you have symptoms of low thyroid (to be discussed in a future newsletter) you should be treated with thyroid hormone regardless of the blood test results.
7 -- A cortisol and DHEA-sulfate (DHEA -S) level. These should be drawn before 9 AM and before eating or drinking anything besides water that morning. If the cortisol is under 14 mcg/dl or if the patient has symptoms of a low adrenal, I would treat with very low-dose Cortef (usually 5-15 milligrams daily which is about equal to 1- 3 mg prednisone). If the DHEA- S is less than 120 mcg/DL in a female or 350 mcg/DL in a male I will usually treat with DHEA. Do not use the DHEA in the presence of hormone sensitive cancers (e.g. breast, ovarian and prostate) unless approved by your physician.
8 -- A urinalysis -- this screens for infections, bleeding, diabetes, and dehydration
+and I'd like to add recommending an MRI for any people who have had car accidents or injuries in the past on the neck area. Xrays also are not qualified to show that type of injury, which shows up alot here at Friends.
www.co-cure.org/drt9.htm
1 -- Complete blood count (CBC). This common and inexpensive test gives us a wealth of information. If the WBC (White blood cell count) is high (over 9000) it leaves me more suspicious of an antibiotic sensitive infection. If it is low with a high lymphocyte count, especially if atypical lymphocytes are present, this is more suggestive of a viral infection. An elevated eosinophil count suggests allergies or parasite infections. The tests also look for anemia and evidence of iron, folate, or B12 deficiencies. It also screens for blood cell cancers and can give evidence of many other problems.
2 -- Sedimentation rate (ESR) -- this test is only considered significant medically if it is elevated (i.e. -- over 20). It screens for inflammation. In most people with CFS/ FMS it actually is lower than normal. If it is modestly elevated I look for inflammatory processes more aggressively and will routinely use low-dose Cortef treatment. If it is over 50 in a patient who is over 50 years old, that patient needs to be evaluated for polymyalgia rheumatica, a very treatable inflammatory condition which mimics FMS but is a very different process.
3 -- A general chemistry -- although there are many panels it should include at least a blood sugar (glucose), BUN and creatinine (checks for kidney function and dehydration), SGOT and SGPT (also called alt and ast), bilirubin and alkaline phosphatase (to check for liver and bone diseases), albumin (protein), calcium, magnesium, sodium, potassium, and uric acid levels.
4 -- Iron, TIBC (total iron binding capacity), percent saturation and ferritin levels. These tests check for iron deficiency and excess. Both of these are critical to detect. If the iron is high, it is very easy to treat (donate blood) but can cripple and kill you if it is missed. Iron deficiency will often be present even if the blood tests are technically normal. This is because the blood test's normal range is based on preventing anemia from severe iron deficiency. More moderate levels of iron deficiency, however, can cause fatigue, brain fog, cold intolerance, restless leg syndrome, immune dysfunction, and infertility. Because of this, I usually recommend treating with iron if the percent saturation is less than 22 percent OR the ferritin level is less than 40. I recheck each four months until the blood tests come above these levels.
5 -- Vitamin B12 level. Although normal is anything under 209, evidence suggests that significant B12 deficiency occurs at much higher levels even in healthy people. Other evidence suggests that very high levels may be needed to maintain optimum health in CFS/FMS patients. I recommend that anybody with a level under 540 be treated with B12 shots. A good argument can be made for treating everybody with CFS/FMS with B12 shots regardless of the blood level.
6 -- Thyroid testing. Many doctors will only check a TSH blood test to evaluate thyroid function. Unfortunately, this test is very unreliable in the presence of hypothalamic dysfunction. If the TSH is over three, it strongly suggests that you should be treated with thyroid hormone. I would also check a free T4 level. This checks the level of the active hormone. The interpretation of other T4 hormone tests is difficult because protein binding is altered in CFS. In the experience of many physicians, and this has been supported now by several studies, thyroid blood tests will miss the large majority of people who need thyroid hormone therapy. If you have symptoms of low thyroid (to be discussed in a future newsletter) you should be treated with thyroid hormone regardless of the blood test results.
7 -- A cortisol and DHEA-sulfate (DHEA -S) level. These should be drawn before 9 AM and before eating or drinking anything besides water that morning. If the cortisol is under 14 mcg/dl or if the patient has symptoms of a low adrenal, I would treat with very low-dose Cortef (usually 5-15 milligrams daily which is about equal to 1- 3 mg prednisone). If the DHEA- S is less than 120 mcg/DL in a female or 350 mcg/DL in a male I will usually treat with DHEA. Do not use the DHEA in the presence of hormone sensitive cancers (e.g. breast, ovarian and prostate) unless approved by your physician.
8 -- A urinalysis -- this screens for infections, bleeding, diabetes, and dehydration
+and I'd like to add recommending an MRI for any people who have had car accidents or injuries in the past on the neck area. Xrays also are not qualified to show that type of injury, which shows up alot here at Friends.
USA
He just
expect's it..
