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I have a 44 year old aunt with recurrent HSV1 and a high IgM/IgG currently, as well as a very high VZV IgG and previous EBV.
She complains of fatigue and a lot of other symptoms and she started treatment for subclinical hypothyroidism with markers and TPO levels changing constantly. She had a recent herpetic outbreak and now again higher TPO. While she was getting treatment her regular menses stopped suddenly but are now back on track. She also has cortisol on the low side which she is managing.Her are some of her labs results:
There is a slightly raised CD4+/T helper cells with slightly high CD8+/ cytotoxic T cells
she has low CD19+/ B lymphocytes and a low percent alsoshe has slightly high CD3+/T lymphocytes and the %NK cells (CD56/CD16) is on the high side
Is there a range you aim for with the CD4/CD8 ratio?
Her CBC is ok but the monocytes go up at times. Neutrophils have been slightly low in the past.
I am thinking she should start Th2 support (to elevate Th2 response) to support t cell function and elevate B lymphocytes? (would I use the th2 modulator or something else to elevate this)?
Also thinking to start Th1 support to help with the autoimmune process?
Should these be started together or one after the other to assess response?Would appreciate some feedback to ensure I’m on the right path here!
Her lab Results:
CD4+ lymph 51.2 (31-59)
absolute CD4+ 802 (359-1519)%CD8+ 25.4 (12-35)
Absolute CD8+ 397 (109-897)%CD19+ 8.7 (3.3-26) seems LOW
absolute CD19+ 136 (12-645) seems LOW%CD3+ 76 (58-87)
absolute CD3+ 1190 (622-2400)%NK cells 15.1 (1.4-19.4)
absolute Nk cells 237 (24-406)CD4/CD8 ratio 2.02 (0.92-2.02)
The high viral loads suggest that she’s not fighting viral burdens effectively. Anti-viral surveillance depends upon Th1 and NK cell responses.
When looking at labs, keep in mind what the body should be doing. So, it’s good to see NK cell numbers tipped up when there is so much viral burden, especially with IgM elevation that suggests a new or reactivated infection.
Th2 response should not be pushed higher here, as it will further inhibit Th1 response.
Thyroid labs will bounce around when there’s active autoimmune process going on.
CD4/CD8 ratio may change with time. have her repeat once to see if she gets info on trend.
Main thing is to support anti-viral immune capacity and reduce inflammation. Identify other sources of inflammation.
Also, be sure patient isn’t hypoglycemic, as low blood sugar will disable M1 macs, which are a key cell type for fighting infection.
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