Initial and Following Blood Tests in CAP's Treatment

Initial and following blood work is not just a matter of Cpni [1] related indicators, but also relevant to your particular history and case, as determined by your doctor. Suggestions drawn from experts treating Cpn in a variety of conditions include the following.

Initial blood work can be obtained for the following tests:

1. CBC & Differential
2. Liver function tests
3. Uric acid
4. Serum iron studies (typically depleted by Cpn: low iron levels are more diagnostic, and are not necessariy indicators to supplement, which may actually increase Cpn infection-- see references below).
5. Red blood cell ALA dehydratase
6. Red blood cell PBG deaminase
7. Vitamin B-12 level
8. Homocysteinei [2] levels
9. Serum methymalonate level.
10. Vitamin Di [3] levels
11. Thyroid panels (standard plus free T4, free T3, revers T3) [Endocrine disturbances common in Cpn and associated diseasesi [4]]
12. Creatinine
13. AST
14. ALT
15. 24-hour urine and 24-hour stool specimens for porphyrins

Dr Stratton has noted relative to porphyrins:

Homocystine levels are elevated with B12 and folatei [5] deficiency, but can be reduced by folate alone. On the other hand, serum methyl malonate levels are elevated in B12 deficiency and are not changed by folate. Therefore, serum methyl malonate levels are the best indicator of B12 deficiency.

Another indicator, according to Dr. Stratton, is high hemoglobin and high hematocrit.

Dr. Powell notes:

I also tst DHEAi [6]-S and free testosteron in perimenopausal females. Both increase nitric oxide levels, which kills Cpn.  No point heading into treatment with low androgens.

Regular Followup Tests

1. CBC & Differential
2. Liver function tests (especially important when using medications such as INHi [7] or Rifamcini [8] which can have liver toxicity, and because die-off of liver cells infected with Cpn can affect liver function)
3. Vitamin D levels (if supplementing deficiency)
4. Thyroid panels (standard plus free T4, free T3, reverse T3) (if supplementing deficiency)
5. AST
6. ALT
7. Others as determined by doctor relevant to your particular condition.

Some References-

Iron and the Role of Chlamydia pneumoniae in Heart Diseasei [9], http://www.cdc.gov/ncidod/eid/vol5no5/letters.htm [10]

Weinberg ED. Patho-ecologic implications of microbial acquisition of host iron. Reviews in Medical Microbiology 1998;9:171-8.

Freidank HM, Billing H. Influence of iron restriction on the growth of Chlamydia pneumoniae TWAR and Chlamydia trachomatis. Clinical Microbiology and Infection 1997;3 Suppl 2:193.

Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int. 1997;7(5):439-43.  http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dop... [11]

Lips P, Chapuy MC, Dawson-Hughes B, Pols HA, Holick MF. An international comparison of serum 25-hydroxyvitamin D measurements.Osteoporos Int. 1999;9(5):394-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dop... [12]

Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004 Mar; 79(3):362-71.

Heaney RP. Functional indices of vitamin D status and ramifications of vitamin D deficiency. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1706S-9S.

May E, Asadullah K, Zugel U. Immunoregulation through 1,25-dihydroxyvitamin D3 and its analogs. Curr Drug Targets Inflamm Allergy. 2004 Dec;3(4):377-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dop... [13]