Okay, time to report on my visit with Dr. Ackerly vis my 21 tubes of blood. First of all some background. Dr. Ackerley's website and background can be seen
here. I heard (not from her) that she's writing a chapter for Dr. Bredesen's book (?). The more I get to know her the more I like her. I was very impressed with what a careful and thoughtful diagnostician she is.
Here are the takeaways:
Still to come: HLA-DR testing and MRI with Neuroquant (if insurance approves)
Nasal culture: coag+ which means no MARcONS, but MRSA+.
> Started one tube of Mupirocin topically to try to address the MRSA without systemic antibiotics. Says to finish, wait a week, then repeat nasal culture. She indicated that the MRSA could still be coving up MARcONS which could make itself known if the MRSA diminishes.
Mold: Due to raised C4a and low MSH that's better than most, while being okay for other mold labs (mentioned MMP9 and TGF), she can't rule in
or out mold toxicity. She indicated that C4a where I live is always higher in people during the summer when I tested. Says MSH makes melatonin. I asked if taking melatonin supplements could down-regulate MSH and she said that's a good question and that she didn't know.
> Retest C4a during the winter
> I'm going to cut my 2 mg to 1 mg for a while. If I do okay at that then I'll try going off melatonin and retest MSH out of curiosity.
Lipase okay.
Hashimoto's nope.
CIRS: Can't rule in or out.
Chronic Fatigue: Yes. This seems to be seen in the multiple viral antibodies that are commonly seen in CF patients. Actually they're common in the wider population, but maybe moreso in CF (?) where there are symptoms to suggest possible current activation.
- Lyme: Can't rule in or out. The Elissa test I took for this isn't sensitive enough and the two positive bars could be false positive. Said 'consider' the better Lyme urine test through DNA Connections at $500. I'm going to wait on this due to cost and see how I do with other interventions.
Coxsackie: Due to the cold I had when I tested
CMV: Positive for antibodies though IgM is negative
HHV-6: Highest she's ever seen though IgM is negative. She pondered whether the shingles vaccine I had might in some way be raising this but didn't know and didn't have anything to rely on to say that it could. She says this affects the hippocampus and suggests I look into a trial being done at Stanford by Dr. Montoya. She also referred me to the HHV-6 Foundation. At the top of their page full of scary articles is an one saying: 'new data [suggests] that HHV-6A may be a key player in the development of multiple sclerosis. The investigators propose that the viral protein U24 may dysregulate myelination'. 
I'm cluelessly on this!
EBV: Positive for antibodies though IgM is negative. She says the elevated 'early antigen' suggests reactivation. Valacyclovir is a safe antiviral that I use 500 per day to help prevent additional shingles outbreaks. She suggests increasing to 3000/day for a couple weeks and then drop back to 1000/day (mg not pills 
).
She seemed to agree with my new primary care doc that there's not a lot you can do about the viral infections. I'm going to run this past her again to see if I got that right as her perspective.
Visual contrast sensitivity: Failed test I took a while back
> Wants me to do visual contrast sensitivity test
through Dr. Shoemaker instead of the one I did
here.
Mercury: Have come down half way but she wants this at 0.
> Limit seafood to once a week and rely on fish oil. Fish oil makes me too lax but I sneak a half tsp in once and a while - probably not enough to help! I'll try the vegan kind but people take DHA for stiff joints, so no wonder it messes up my already too hypermobile joints
> Look into Andy Cutler's chelation protocol.
VEGF: low. This is angiogenic and builds capillaries throughout the body, assisting with circulation, delivery of nutrients etc. She indicated that viruses can lower this and it contributes to chronic fatigue.
> She likes to use VIP for this and says Dr. Bredesen does as well ($165/mo), but says it's not time for me to add that yet. Apparently VIP is very neuroprotective. Wish I could address this right away but I know she has some reason for waiting and I didn't have time to ask what it is.
CRP: High probably because of cold while testing
> Redo
Osmolality and ADH: 'Very low' and 'low'. This means my blood electrolyte/water balance is off. Electrolyte concentration isn't high enough. This contributes to fatigue and low blood pressure, which I always have. She says diastolic should be 70 minimum and mine is often below that with systolic 100-110 or so, usually closer to 100 occasionally going below that. She said this explains why I'm always bloated when I go keto and up my salt. I get frustrated with that and leave ketoland because I hate the swelling. She says it gets worse at first but will get better as osmolality improves. Oh! Hope so.
> Add 1/2 tsp salt to coconut water and add lime juice for taste and absorption. She said the coconut water adds more electrolytes and that I need the sugar to get the salt into my cells.
MRI with NeuroQuant: Dr. Ackerly says this will be very important in my case, probably due to the HHV-6 and long-standing MRSA sinusitis and brain fog.
> This is still on hold waiting for insurance approval but set for a week or two from now.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
, unless there is enough else to point to needing treatment. Self Hacked has done a little 
