PLEASE Help Me Understand EBV Dx

[lazyace]

Hello all, I am a 41 year old male and have been on a long journey in search of a cause for my fatigue and periodic lightheadedness.  It began about 7 months ago with a sinus infection.  I have had a long history of allergies and sinus infections.  I felt like I had a typical sinus infection and went to see my ENT.  He put me on Abx which didn't help with the fatigue and lightheadedness.  After several follow-ups and rounds of Abx, he ordered a CT scan and suggested that although I didn't have a raging infection, that sinus surgery might be the answer.  Thus, in April I had sinus surgery to open up narrow passages and cavities.  However, much to my disappointment, it didn't cure the fatigue or lightheadedness.  The ENT then ordered extensive balance and hearing tests, along with a brain MRI with contrast.  Results of those tests were fine.  

He told me at that point that my sinuses were clear and my problems were not sinus related.  Although I was frustrated to be without an answer, I began to realize he was probably right.  This lead me to an allergist that ordered RAST and blood tests for both environmental and food allergens.  The results reaffirmed that my allergies were still significant, and I began receiving shots in July.  However, I still wasn't convinced that my fatigue and lightheadedness were allergy related.  After all, I've had allergies my whole life, and know how it makes me feel.

I visited with my PCP (internist) and described my ongoing saga.  He ordered a CBC, thyroid, blood sugar test.  All were normal.  He suggested having a sleep study done.  Given that I was overweight and tired, he thought I could be a victim of sleep apnea.  After the sleep study, it was clear he was right.  I was Dxd with moderate/several sleep apnea and placed on a CPAP machine.  After 3 weeks, I visited with the sleep doctor and indicated that I wasn't feeling any improvement, and maybe felt a little worse.  He stated that I should be seeing some benefit after 3 weeks, and suggested that my symptoms may be due to something else.

I did extensive research on the internet and assembled a spreadsheet with every plausible cause for my symptoms, and returned to my PCP and asked that I be tested for every one of them.  I had also taken the full length online evaluation by Dr. Jcaob Teitelbaum on his website endfatigue.com.  The result of the evaluation suggested that I was probably not suffering from CFS.  Then some of my blood tests taken by my PCP came back.

To my surprise (and his), my EBV Igg was elevated at 8.0 and my EBV Igm was elevated at 1.2.  He asked if I had ever had mono, and I couldn't recall ever having it.  He indicated that I must have had a very recent EBV infection, but would need a PCR test to tell whether it was still active.  I was stunned because I didn't have a sore throat or fever, just severe fatigue.

I am confused about what to do, what questions to ask and what tests to request.  I have tried to absorb as much info here as possible, by reviewing the stories of others like me.  Is it bad luck that I would acquire a recent EBV infection while in the midst of struggling with sleep apnea?  Is it possible that this whole odyssey began 7 months ago and the sleep apnea has nothing to do with it?  Does the elevated Igm number truly indicate the infection is very recent, and if so, how recent?  If EBV is contracted exclusively thru saliva, how could I get it without any exchange of saliva except with my wife of 12 years?

I really need some help and direction, before the depression tears me apart.  I'm useless to my wife and 13 month old son, and DESPERATE for help.

[PlateletGal]

Most patients with CFS usually have 2 or 3 of the following abnormalities:

Elevated IgM/IgG coxsackievirus B titer
Elevated IgM/IgG HHV-6 titer
Elevated IgM/IgG C pneumoniae titer
Decreased NK cells, either the percentage or their activity

http://emedicine.medscape.com/article/235980-diagnosis



Pathogen Testing --- EBV titer, CMV titer, HHV-6 titer (preferred methology & lab):


http://www.immed.org/illness/clinical_testing.html  --- pathogen testing and the preferred labs


http://www.drpodell.org/chronic_fatigue_syndrome_hhv6.shtml


Another link of tests that physicians are ordering to rule out CFS: http://www.name-us.org/MECFSExplainPages/TestAbnormalities.htm#Tests_for_Abnormalities_in_ME/CFS





Other Tests:

http://web.mac.com/carlitos.gonzalez/CFS/Blog/Entries/2008/4/12_Useful_Tests_for_a_better_


For additional information, visit MedHelp's page "Diagnostic and Blood Tests to Help Rule Out Chronic Fatigue Syndrome" :

http://www.medhelp.org/health_pages/Fibromyalgia/Diagnostic--Blood-Tests-to-Help-Diagnose-CFS/show/376?cid=39

[lazyace]

As the resident expert here, can you tell me what tests I should ask about to determine whether this is a current infection or reactivation?  Also, what tests are recommended for Hepatitis and the other HHV's?  I am interested in knowing if I have any other infections that may be related.  How about other tests that can help to either rule in or rule out the possibility of CFS?

Thanks for your help!!!

[PlateletGal]

I applaud you for searching for answers. I can tell you that I read a recent article about how long it is taking teens to recover from mono. These were the researchers findings:

"The researchers monitored 301 adolescents with the infection. Six months after the mononucleosis diagnosis, 70 patients (24 percent) had not made a full recovery.

Thirty-nine of these subjects were diagnosed with chronic fatigue syndrome, reflecting 13 percent of the original group of 301.

Six months later, at a 12-month follow-up visit, 7 percent had chronic fatigue syndrome, and at 24 months, chronic fatigue syndrome persisted in 4 percent. That is about 20 times higher than in the general teenage population."

source: http://www.vancouversun.com/health/Mono+linked+chronic+fatigue+syndrome+teens/1817020/story.html


I would consider possibly seeing a holistic practitioner and/or Naturopathic physician. Through my experiences... I've found that these physicians seem to be the only physicians who can help you with boosting your immune system (naturally).