Obviously, many other illnesses must be ruled out prior to a CFIDS, Fibro, Lyme or Mold diagnosis. If you have had a thorough work-up and have a Fatiguing diagnosis you will need to do some more work to discover what is causing your dysfunction. There are so many things to look into and so many different tests that it really can be confusing.  I have spent well over $75,000 on testing over the past 4 years and I will share what I have learned along with the order I would do them if I had it all to do over again.  Then I will go into a bit of detail about each test.

1. Biotoxin Screening Test. This is quick and easy and can be done via the new on-line test with a VCS test and biotoxin risk score (and a lot of cool tracking features) soon. I actaully saw Dr. Shoemaker in person and tested in his office.  I tested positive for the presence of biotoxins and didn’t start to feel better without CSM treatment to remove them. I used to fail the test all of the time, and once I began making progress with treatment, I started to pass the test during parts of the month and then fail during other parts of the month. Eventually, I will pass the test all of the time.  The cyclical nature of the pass/fail of the test is consistent with a Lyme infection since Bb cycles in a 3 to 4 week cycle and can be a big clue. That said, I was so sick I felt poorly all the time and only when I started to recover did the cycle become apparent.
2. CD57 Stricker Panel represents a breakthrough in helping to rule-in or rule-out Lyme. The symptoms of Lyme, CFIDS, and Fibro overlap and it is very difficult to distinguish what you are really dealing with. I was misdiagnosed with CFIDS for 4 wasted years but really had Lyme. If you have low CD-57’s (counts between 20 and 60 are common for Chronic Lyme, and <180 is less than normal), then you are dealing with Lyme. Nothing else is known to suppress the CD-57 NK subset. Here’s another good summary of the CD57 test and it’s import.
3. The Shoemaker Panel of tests can help you understand if Mold is a causal agent. C4a is a very useful measure and is monitored as part of treatment. If the patient improves on CSM and get’s worse with a concommitant rise in C4a with 48 hours, on-going mold exposure is implicated. If the patient graudally feels worse over the course of 2 weeks, with a concommitant rise in C4a during that time period, a persistant Lyme infection is indicated. Both mold and Lyme are very hard to test for with conventional testing.
4. The ION Test by Metametrix is a fairly new test that most mainstream MD’s won’t have a clue about. It tests your red blood cells (RBC’s) for levels of good minerals (I was very, very deficient), heavy metals, levels of amino acids and vitamins, along with levels of quinolinic acid (a potent neurotoxin) and lipid peroxides (a good measure of fat oxidation). The latter is very important since the cell wall of every single cell in the body is composed of lipids (fats). If those are overly oxidized, the cell won’t function properly and illness results. Levels of good minerals are also very critical. Simply put, you won’t heal if you don’t balance them.
5. Thyroid Panel to include T3, T4, TSH and reverse T3. If you have low body temperature hypothyroidism must be suspected. Unfortunately, levels of thyroid hormone often test within normal range, even with hypothryoidism is present. Given that, a trial of compounded T3 may be indicated. Some practicioners use compounded T3 to displace toxins that may be binding the active sites. The Wilson Protocol is useful for some.
6. Comprehensive Stool and Digestive Panel. Doctors Data and Diagnostech both offer very useful profiles.
7. Fry’s Clinical Laboratory does blood smear analysis for Babesia and Ehrlichia co-infections. I know of no other lab that does blood smears and this one came highly recommended.