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Syphilis or hypochondria?

Good day community, hope you're doing well.
About 4 years ago I was treated for primary syphilis with 30 days of doxycycline orally and a double penicillin shot right after. The whole situation, starting from the intercourse and ending with the treatment was extremely stressful.

My test results before treatment were: RPR and VDRL 1:8 and FTA-ABS 1:20.

After 6 months of treatment, VDRL was negative and FTA-ABS was 1:10.
My doctor didn't prescribe an RPR test. I'm aware that this is the primary diagnostic test for treatment success and I'm not sure why he didn't prescribe it.

Anyway, he was worried about the FTA-ABS not decreasing fourfold so I had one more blood test a year after treatment. My results were: Negative IgM, RPR and VDRL and an FTA-ABS of 1:10. My microbiologist said that the FTA-ABS result cannot decrease further as it would get negative and it is supposed to be positive for the rest of my life.

I am currently getting occasional panic attacks regarding symptoms like skin dryness ,migraines with aura and muscle weakness. Would it make sense to investigate further or am I overthinking this, considering my past results? There are some really scary horror stories about syphilis online.

Thanks for reading,
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Avatar universal
Syphilis uses 2 type tests.
Nonspecific (vdrl/rpr) and specific (tpha/ftabs). One of each.

VDRL and RPR are same group of tests (nonspecific) and doctors need either one but not both. No need for RPR when he did VDRL.

VDRL titre is used as a measure of disiease activite and therapy sucess. And it's negative. So it's a sucess.

FTA ABS is a specific test and titres do not corelate . they get and  stay  positive for life, when cured.  You don't get much more information from that test positivity. Positive lab test forever although there is no more actual disease, there is lab measurable some antibodies to it.

VDRL titres are negative (rvrn below low) and that means negative for disease.

You got quuuite a Therapeutic dose initialy xD which is also encouraging.

If you repeated VDRL in some months (3-6 months) follow up, you would most likely get low titres /negativity again.

You could do it according to doctors advice and standard recommendations but don't really expect a rise.

There is not much point in repeating specific (fta-abs)  tests you'll just get lab positivity forever, and they are not a part routine follow up.

You symptoms are not Syphillis, since it's really negative.
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Avatar universal
VDRL has precise decline (like fourfold) that doctors take seriously.

Doctors don't measure FTA-ABS  titres decline precisely. Positivity is important for the first diagnosis. It may decrease a bit but not fourfold like vdrl, your doctor didn't know that precisely.

You got superpowered treatment for late syphilis(tertiary), more than for primary. Like double the dose duration.
Primary is either doksicycline 14 days OR penicilline. You got double and both. :)

That killed the **** out of your Treponema.

Relax. You got mega dose and negative RELEVANT results.
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Many thanks for your elaborate reply :)
Avatar universal
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207091 tn?1337709493
If you need another opinion, I agree with all of it, especially, "That killed the **** out of your Treponema."

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Thank you :)
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