Test Results

[ChelsBells]

Original Post 'Inability to sleep, chest pain, please help' Inability to sleep, chest pain, please help

I am hoping that the smarties on this forum can help me figure out what is going on with my health. I believe it is Neuro Lyme Disease, my doctor does not. What are your thoughts?

I know it's a lot but any help, advice, or knowledge would be greatly appreciated. Some of these test results are very hard to understand, as I have recieved very little clarification from the neurologist & rheumatologist that ordered them.

I am fighting hard to get my life back. Thank you so much<3

Symptoms: Started abruptly on 4/21/21

Tremors when lying down (have to wear neck brace to sleep, cannot use a regular pillow, have to use a 45 degree angle pillow)

Sometimes I will wake up shaking with tremors and nausea.

I cannot lay on my side - back and neck feels like pinching pain - get extremely dizzy - will have a plethora of symptoms after doing this. I've been a side sleeper for as long as I can remember but haven't been able to sleep on my side since this started.

If I look to my sides, down or up, I see stars, get dizzy, lightheaded, like passing out - sometimes with this throat feels numb and then harder to take a breath.

Burning, tingling, numbness in between shoulders that radiates down spine up between ears.

In certain positions, different parts of my face spasm & go numb.

Cannot hold my torso up without it getting extremely fatigued/weak - then I get numb down my spine.

Laying on my back in certain positions will cause my heart to race, blood pressure goes up, dizziness and nauseous. This generally only happens when lying down.

My throat goes numb in certain positions making it hard to breath and swallow.

Voice changes. Sometimes I have no voice in the morning.

Aspirate on saliva & while drinking.

Both arms start to feel extremely weak, heavy, and like I can't raise them. Feeling like I was being paralyzed. Had boyfriend move me to a different position and usually that would work.

Sternum pain.

When I have tremors, i start almost losing feeling in my hands/arms, I get weakness in my arms, starting at my shoulders.

Will wake up and my stomach feels like I'm dropping from the top of a roller coaster, then my blood pressure goes wacky



Test Results:

DNA AB, DOUBLE STRANDED

Component	Your Value	Standard Range
DNA Ab, Double Stranded	10 IU	0 - 30 IU
Anti-dsDNA Antibodies Interpretive Guidelines: 0-30 IU Negative 31-60 IU Low Positive 61-200 IU Positive >200 IU Strong Positive New EIA reagent kit in use on 2/15/2021. Please note this reagent kit has a different reference range than the previous kit.

ENA AB
Component Results

Component	Your Value	Standard Range
SSA Ab	Negative	Negative
SSB Ab	4 Units	0 - 19 Units
Anti-SSB Ab Interpretation <20 Units Negative 20-39 Units Borderline 40-80 Units Moderate Positive >80 Units Strong Positive
Smith Ab	Negative	Negative
Sm/RNP Ab	3 Units	0 - 19 Units
Anti-Sm/RNP Ab Interpretation <20 Units Negative 20-39 Units Weak Positive 40-80 Units Moderate Positive >80 Units Strong Positive

LYME AB, IGG/IGM, IMMUNOBLOT

Component	Your Value	Standard Range
Lyme Ab, IgG, Immunoblot	Negative	Negative
Band(s) present: 93 kDa (Insufficient number of bands for positive result) INTERPRETIVE INFORMATION: B. burgdorferi IgG Immunoblot For this assay, a positive result is reported when any 5 or more of the following 10 bands are present: 18, 23, 28, 30, 39, 41, 45, 58, 66, or 93 kDa. All other banding patterns are reported as negative.
Lyme Ab, IgM, Immunoblot	Negative	Negative
Band(s) present: 41 kDa (Insufficient number of bands for positive result) INTERPRETIVE INFORMATION: B. burgdorferi Antibody IgM Immunoblot For this assay, a positive result is reported when any 2 or more of the following bands are present: 23, 39, or 41 kDa. All other banding patterns are reported as negative. Performed By: ARUP Laboratories 500 Chipeta Way Salt Lake City, UT 84108 Laboratory Director: Tracy I. George, MD

B12

Component	Your Value	Standard Range
Vitamin B12	550 pg/mL	213 - 816 pg/mL
Intrinsic Factor blocking antibodies may interfere with this test method. If test results are in conflict with the clinical diagnosis, it is recommended that the patient be tested for Intrinsic Factor blocking antibodies to rule out this possibility.

BORRELIA BURGDORFERI AB, TOTAL WITH REFLEX TO IMMUNOBLOT

Component	Your Value	Standard Range
Borrelia Burgdorferi AB, Total	Positive	Negative
Presence of detectable Borrelia burgdorferi antibodies. Current testing guidelines recommend that all positive results be supplemented by further testing in a standardized Western blot assay. Potential assay interference due to circulating antibodies against Human Ehrlichiosis (HGE) and Tick Borne Relapsing Fever (TBRF) has been found; interpret results from these patients with caution. There currently is no test of cure for Lyme disease, and this test should not be ordered for that purpose.

CK Total
Component Results

Component	Your Value	Standard Range
CK	83 U/L	29 - 168 U/L

Protein Electrophoresis , Reflex to IFIX
Component Results

Component	Your Value	Standard Range
Protein, Total	7.7 g/dL	6.4 - 8.3 g/dL
Albumin	4.67 g/dL	3.86 - 6.04 g/dL
Alpha 1	0.19 g/dL	0.06 - 0.22 g/dL
Alpha 2	0.79 g/dL	0.46 - 0.98 g/dL
Beta	0.82 g/dL	0.50 - 1.23 g/dL
Gamma	1.23 g/dL	0.40 - 1.28 g/dL
A:G Ratio	1.54	1.62 - 2.72
Protein Electrophoresis Interpretation	No monoclonal seen	No monoclonal seen, See scan or report

Copper

Component	Your Value	Standard Range
Copper	127.1 ug/dL	80.0 - 155.0 ug/dL
INTERPRETIVE INFORMATION: Copper, Serum or Plasma Elevated results may be due to skin or collection-related contamination, including the use of a noncertified metal-free collection/transport tube. If contamination concerns exist due to elevated levels of serum/plasma copper, confirmation with a second specimen collected in a certified metal-free tube is recommended. Serum copper may be elevated with infection, inflammation, stress, and copper supplementation. In females, elevated copper may also be caused by oral contraceptives and pregnancy (concentrations may be elevated up to 3 times normal during the third trimester). This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes. Performed By: ARUP Laboratories 500 Chipeta Way Salt Lake City, UT 84108 Laboratory Director: Tracy I. George, MD

ANA Screen with Titer if positive

Component	Your Value	Standard Range
ANA by IFA	See Titer/Pattern
ANA Titer and Pattern	1:160 Homogenous	1:40 Homogenous, 1:80 Homogenous, 1:40 Speckled, 1:80 Speckled
This is a borderline significant ANA titer.

ESR

Component	Your Value	Standard Range
ESR	27 mm/hr	0 - 20 mm/hr

C Reactive Protein

Component	Your Value	Standard Range
C-Reactive Protein	0.4 mg/dL	0.0 - 1.0 mg/dL

CBC With Differential
Component Results

Component	Your Value	Standard Range
White Cell Count	6.5 K/uL	3.8 - 10.5 K/uL
Red Cell Count	4.7 M/uL	3.8 - 5.2 M/uL
Hemoglobin	10.2 g/dL	11.6 - 15.6 g/dL
Hematocrit	35 %	34 - 46 %
MCV	74 fL	80 - 97 fL
MCHC	29 g/dL	32 - 36 g/dL
RDW CV	15.9 %	11.7 - 14.7 %
RDW SD	41.9 fL	36.0 - 46.0 fL
Platelet Count	408 K/uL	160 - 370 K/uL
Nucleated RBCs	0 /100 WBC	0 /100 WBC
% Neutrophils	56 %	%
% Immature Granulocytes	1 %	%
% Lymphocytes	34 %	%
% Monocytes	7 %	%
% Eosinophils	1 %	%
% Basophils	1 %	%
Absolute Neutrophils	3,680 /uL	1,700-7,500 /uL
Absolute Immature Granulocytes	30 /uL	0 - 50 /uL
Absolute Lymphocytes	2,170 /uL	1,000-3,500 /uL
Absolute Monocytes	450 /uL	200 - 900 /uL
Absolute Eosinophils	70 /uL	0 - 500 /uL
Absolute Basophils	50 /uL	0 - 200 /uL

Comprehensive Metabolic Panel
Component Results

Component	Your Value	Standard Range
Sodium	140 mmol/L	136 - 145 mmol/L
Potassium	4.4 mmol/L	3.5 - 5.1 mmol/L
Chloride	103 mmol/L	98 - 107 mmol/L
Carbon Dioxide	28 mmol/L	22 - 29 mmol/L
Anion Gap	9 mmol/L	7 - 14 mmol/L
BUN	9 mg/dL	7 - 19 mg/dL
Creatinine	0.65 mg/dL	0.55 - 1.02 mg/dL
Glucose	84 mg/dL	70 - 99 mg/dL
Calcium	9.5 mg/dL	8.4 - 10.2 mg/dL
Bilirubin, Total	0.3 mg/dL	0.0 - 1.4 mg/dL
Alkaline Phosphatase	67 U/L	40 - 150 U/L
AST/SGOT	14 U/L	5 - 34 U/L
ALT/SGPT	8 U/L	0 - 55 U/L
Albumin	4.0 g/dL	3.5 - 5.0 g/dL
Protein, Total	8.0 g/dL	6.4 - 8.3 g/dL
e-GFR	120 mL/min/1.73 sqm	60 - 120 mL/min/1.73 sqm
e-GFR Interpretive Statement: Chronic kidney disease, e-GFR <60 mL/min/1.73sqm Kidney failure, e-GFR < 15 mL/min/1.73sqm

C3

Component	Your Value	Standard Range
Complement C3	127 mg/dL	83 - 193 mg/dL
C4 Component	Your Value	Standard Range
Complement C4	31 mg/dL	15 - 57 mg/dL

Urinalysis with Microscopy
Component Results

Component	Your Value	Standard Range
Color	Light Yellow	Yellow, Light Yellow, Amber, Colorless
Clarity	Clear	Clear
Specific Gravity	1.020	1.005 - 1.035
pH	6.5	5.0 - 8.0
Leukocyte Esterase	Negative	Negative
Nitrite	Negative	Negative
Protein	Negative mg/dL	Negative mg/dL
Glucose	Negative mg/dL	Negative mg/dL
Ketones	Negative mg/dL	Negative mg/dL
Urobilinogen	0.2 mg/dL	<2.0 mg/dL
Bilirubin	Negative	Negative
Hemoglobin	2+	Negative
WBC	0-2 /hpf	<=5 /hpf
RBC	3-5 /hpf	<=2 /hpf
Bacteria	Negative	Negative
Squamous Epithelial Cell	None Seen /hpf	<=2 /hpf
Renal Tubular Epithelial Cell	None Seen /hpf	<1 /hpf

Protein/Creatinine Ratio, Urine

Component	Your Value	Standard Range
Creatinine, Urine	38 mg/dL	mg/dL
Protein, Urine	<6.8 mg/dL	mg/dL
Protein/Creat Ratio, Ur
Unable to calculate.

TSH

TSH

1.220 uIU/mL

0.465 - 4.680 uIU/mL

T3 Free

T3, FREE

3.76 pg/mL

2.77 - 5.27 pg/mL

THYROID PEROXIDASE AND THYROGLOBULIN ANTIBODIES - Details

Component	Your Value	Standard Range
THYROGLOBULIN ANTIBODIES	<1 IU/mL	< or = 1 IU/mL
TEST PERFORMED AT: QUEST DIAGNOSTICS WOOD DALE 1355 MITTEL BOULEVARD WOOD DALE, IL 60191-1024 Laboratory Director: ANTHONY V. THOMAS, MD
THYROID PEROXIDASE ANTIBODIES	1 IU/mL	<9 IU/mL

Thyroxine Free

THYROXINE, FREE

1.28 ng/dL

0.78 - 2.19 ng/dL

Vitamin D

Component	Your Value	Standard Range
VITAMIN D 25-OH, TOTAL	41.6 ng/mL	30.0 - 100.0 ng/mL
Expected values (Recommendation for 25-OH Vitamin D levels): Level Range (ng/mL) Deficient <20 Insufficient: 20 - <30 Sufficient: 30 - 100 Potential Toxicity: >100

METANEPHRINES, FREE
Component Results

Component	Your Value	Standard Range
Metanephrine	0.23 nmol/L	0.00 - 0.49 nmol/L
Normetanephrine	0.38 nmol/L	0.00 - 0.89 nmol/L

Catecholamines

Component	Your Value	Standard Range
Epinephrine by HPLC	67 pg/mL	10 - 200 pg/mL
Norepinephrine	273 pg/mL	80 - 520 pg/mL
Dopamine	<20 pg/mL	0 - 20 pg/mL

Tryptase

Component	Your Value	Standard Range
Tryptase	4.1 ug/L	<=10.9 ug/L
Performed By: ARUP Laboratories 500 Chipeta Way Salt Lake City, UT 84108 Laboratory Director: Tracy I. George, MD

Methylmalonic Acid

Component	Your Value	Standard Range
Methylmalonic Acid	0.18 µmol/L	<0.40 µmol/L
Interpretation
Methylmalonic acid is within the normal range.

 

[youngsinatra]

In regards to neurological symptoms, I‘ve seen multiple cases in my family, where getting the vitamin D closer to 80-100 ng/ml was truely miraculous, even when they were sufficient before and had symptoms with 30-40 ng/ml.

How much vitamin D are you currently taking?

Another thing I‘d look into is HDT. (High Dose Thiamin Therapy by Dr. Constantini)
HDT Therapy

Both vitamin D and B1 have very profound effects on the brain and nervous system, but also on chronic stealth infections.

 

[S-VV]

The high heart rate, high blood pressure and nausea when lying is SNS activation, aka supine hypertension. Its common in autonomic failure and POTS. The pain in the shoulders is the classic “coathanger pain” associated with POTS. The dizziness and inability to support an upright torso again point to standing hypotension.

The intermittent bilateral arm weakness, facial tremors and lack of feeling suggest some kind of peripheral nerve sensorymotor impairment, including the cranial nerves. This needs to be investigated with an electromyographic and nerve conduction study.

The aggravation of symptoms when turning the head, if vertigo is ruled out may point to some anatomic problem in the cervical structures. Appropriate imaging needs to be done here (MRI, computed tomography etc...).

Finally, the blood tests point to a slight inflammatory state (high ESR, borderline ANA) that is not uncommon in EDS.

More investigations need to be done. The supine hypertension, intermittent bilateral sensorymotor abnormalities and the cervical aggravation may or may not be related to eachother, and need to be evaluated separately by a competent neurologist and rheumatologist/neurosurgeon.

 

[S-VV]

All in all, its a very frustrating and obtuse case. I recommend management of symptoms. A nonselective beta blocker will be helpful both for supine hypertension and tremors and for standing hypotension.

 

[Chad_Catholic]

Are there any updates?

 

[ChelsBells]

Are there any updates?

Hi Chad! I know this is a super late response, turns out I have Lyme Disease. I have been feeling so much better though. Definitely not 100% myself, but drastically better than even a year ago. From being nearly bed bound + so many other wild symptoms - to being able to work full time and partake in some of my old hobbies. Feel so lucky to be alive.