human
Do labs ever actually determine EBV reactivation? TL;DR I'm tired of being tired.My OBGYN doesn't know what to do with these results but refer me to an MD who is also a Naturopath.I've had daily fatigue and elevated lymphocytes for nearly 3 years. Initially, my PCP sent me to Hematology and now over to my OBGYN. Hematology increased my iron but when fatigue continued for months after, my OB ordered hormone, thyroid, and EBV panels..Hormone and Thyroid resulted in normal values. CBC done in late January: lymphocytes % =50.6, Neutrophils % =37. EBV panel (February): EBV Ab IgM to Capsid U/mL Value <36.00, EBV Ab IgG to Capsid U/mL Value 393.00, EBV Ab IgG to Nuclear Antigen U/mL Value <18.00. NOTE: Suggestive of a recent Epstein-Barr virus infection.No illness between mid 2019 and these results. Not even a cold. Definitely not mono (had that aged 15)Am I wasting my time going to see a naturopathy-focused MD?
gpt
EBV DNA would be the test that would detect EBV reactivation (that term is probably not a great one, but at the moment Im at a loss for a better one). Its ironically the one doctors check the least often, probably because they dont understand what they are checking for. EBV IgM, if positive, is certainly compatible with recent infection. The IgGs are all variably positive in different patients, to the extent that I place zero value in them. Transplant physicians have a legitimate use for them, but otherwise in my humble opinion they are checked inappropriately > 95% of the time, including in your case.The pretest probability that fatigue in a previously infected patient is due to EBV reactivation is extremely low.Hope that helps. Maybe an ID doc can weigh in better.Regarding seeing a naturopath, I would say if insurance covers the services/treatments they recommend thats a hint they are legit. If its out of pocket to a large extent, Id personally steer clear, but thats an individual decision. Its not medicine, so I really have no authority to judge there.Whats your absolute lymphocyte count?
Reasons why OB wouldnt follow MFM or HEM recommendations?Trying to wrap my head around what is going on with my provider.Had two uncomplicated pregnancies (shoulder distocia in first, scheduled c section second). I am currently 17W and this pregnancy is going well thanks to some info/changed approach.Unfortunately, my husband and I suffered 5 consecutive losses after these pregnancies before this one. OB was not supportive when I kept asking and saying I was concerned. Went to specialist after not getting answers/support.It was discovered I have Factor V Leiden clotting disorder and 2 other borderline clothing disorders. Met with hematology who had me start lovenox in current pregnancy. Lab reults showing clotting disorder as well as notes CC to OB.OB is not supportive of me staying on lovenox (despite being currently managed by HEM)Additionally, she is arguing about my due date. Despite myself, MFM and other radiology imaging aligning (actually even measuring ahead of my calculations) whereas the uktrasounds she has performed are substantially off. Like over a week behind. I brought this up to my MFM and said its either user or equipment issue. And that they would speak with OB about correcting due date.This is important because I need to stop lovenox and transition to heparin before I go into spontaneous delivery.Again, she is refusing to acknowledge the MFM and change my due date to the correct due date.I dont even know what to say - I know people change physicians all the time but I have built what h thought was a good relationship with this provider and Im literally bothered by the contentious nature of this.Why short of ego would this provider not want to listen to MFM and HEM?I am in the northeast fyi
I cant say what the provider is thinking, but honestly this is causing you enough stress that it would be worth considering a change in provider.Agree with above comment. Switch OBs. This is unacceptable.