- Physical Exam especially for lymph nodes, oral lesions, rashes, joint swelling, muscle weakness or abnormal sensation and muscle pain.
- Testing for Lyme - perhaps repeating Western blot, using Igenex western blot, dot blot and/or Bowen testing.
- Testing for co-infections - Erlichiosis and Babesiosis testing may also be needed, perhaps also Bartonella especially with persistent lymph nodes or fevers. May need EBV titer for fatigue and low-grade fever, and stool yeast culture for fatigue and digestive problems.
- Other lab tests –complete panel if not done, CBC, HIV, Complete thyroid evaluation including free T3, T4, TSH and possibly Basal temperature measurement. Glucose and sometimes 2 hr. glucose tolerance and insulin may be needed if hypoglycemia symptoms.
- Immune function tests for patients with co-infections may be helpful. The digestive system is important in immune function. Testing for yeast overgrowth in the gut and for digestive function may be needed. Food allergy testing is sometimes recommended.
An Initial Workup for Lyme Disease consists of:
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