For RA or other autoimmune disease patients, The Institute for Molecular Medicine suggests the following lab tests (codes are IMD or CPT codes). Please note that patients should be off all antibiotics and immune enhancement products for 4 weeks prior to testing to insure that the test will not be a false-negative due to the antibiotic suppression of a blood infection.

1. Test Panel 1007 (CPT: 87798x3, 87581)—Mycoplasma species panel of 4 pathogenic mycoplasmas (M. fermentans, M. penumoniae, M. hominis, M. penetrans) by PCR. Justification: Almost 60% of Chronic Fatigue Syndrome (CFS) and Fibromyalgia Syndrome (FMS) and 50% of Rheumatoid Arthritis (RA) and other autoimmune patients have one or more intracellular, systemic mycoplasmal infections similar to those found in a variety of chronic illnesses [Nicolson et al. Mycoplasmal infections in chronic illnesses: Fibromyalgia and Chronic Fatigue Syndromes, Gulf War Illness, HIV-AIDS and Rheumatoid Arthritis. Medical Sentinel 1999; 5:172-176].

Ultrasensitive and ultraspecific mycoplasma tests can only be done by a small number of labs, most university or government labs that have been trained by us under a U.S. government contract. Specimen Requirements: one (1) 5 cc Lavender top Plastic Tube (EDTA). The blood is collected, immediately mixed and placed on ice, then shipped on wet ice (overnight domestic air courier) or immediately flash frozen and shipped with dry ice by air courier (foreign shipments) to IMD to arrive within 24-36 hours.

2. Test 1006 (CPT: 87486)—Chlamydia pneumoniae by PCR. Justification: Many CFS, FMS,MS, RA and other autoimmune patients have this systemic infection along with viral infection(s). We were among the few labs that developed the molecular tests that are now done for this type of infection. The other labs that use these procedures are university labs. Requirements: one (1) 5 cc Lavender top Plastic Tube (EDTA). Specimen Requirements: one (1) 5 cc Lavender top Plastic Tube (EDTA). The blood is collected, immediately mixed and placed on ice, then shipped on wet ice (overnight domestic air courier) or immediately flash frozen and shipped with dry ice by air courier (foreign shipments) to IMD to arrive within 24-36 hours.

3. Test 07056 (CPT: 87486)—Brucella species by PCR. Justification: We previously found that some GWI and autoimmune patients have this chronic infection which causes Brucellosis, an airborne infection causing system-wide chronic signs and symptoms. We are the only lab that has a molecular test for this infection. Requirements: . Requirements: one (1) 5 cc Lavender top Plastic Tube (EDTA). Specimen Requirements: one (1) 5 cc Lavender top Plastic Tube (EDTA). The blood is collected, immediately mixed and placed on ice, then shipped on wet ice (overnight domestic air courier) or immediately flash frozen and shipped with dry ice by air courier (foreign shipments) to IMD to arrive within 24-36 hours.

4. Test 07047 (CPT: 87476)—Borrelia burgdorferi (Lyme Disease) by PCR. Justification: Many CFS, FMS and RA and other autoimmune patients have this systemic infection (diagnosed as Lyme Disease) along with other infection(s). Requirements: one (1) 5 cc Lavender top Plastic Tube (EDTA). Specimen Requirements: one (1) 5 cc Lavender top Plastic Tube (EDTA). The blood is collected, immediately mixed and placed on ice, then shipped on wet ice (overnight domestic air courier) or immediately flash frozen and shipped with dry ice by air courier (foreign shipments) to IMD to arrive within 24-36 hours.

5. Test 07039 (CPT: 87532)—Human herpes virus 6 (HHV-6) test by PCR. Justification: Many chronic illness and autoimmune patients have this systemic viral infection, and it should be tested for in any autoimmune illness. Specimen Requirements: Collect blood in one (1) 5 cc Lavender Top Plasma Tubes (EDTA), mixed and separate blood plasma by centrifugation. The plasma is collected, placed on ice, then shipped on wet ice (overnight domestic air courier) or immediately flash frozen and shipped with dry ice by air courier (foreign shipments) to IMD to arrive within 24-36 hours.

6. Test 07034 (CPT: 87496)—Cytomegalovirus (CMV) test by PCR. Justification: Many CFS and FMS and autoimmune patients have this systemic viral infection, and it should be tested for in any autoimmune illness. Specimen Requirements: Collect blood in one (1) 5 cc Lavender Top Plasma Tubes (EDTA), mixed and separate blood plasma by centrifugation. The plasma is collected, placed on ice, then shipped on wet ice (overnight domestic air courier) or immediately flash frozen and shipped with dry ice by air courier (foreign shipments) to IMD to arrive within 24-36 hours.

7. Test 04651 (CPT: 85610)—Prothrombin Time (PT) by photo-optical method. Justification: Many CFS/FMS and autoimmune patients have coagulation problems that must be documented. Requirements: one (1) 5cc Blue top (citrated) Plastic tube. Spin for 15 min, pipet plasma into plastic vial and freeze. Send as frozen sample with dry ice by courier to IMD to arrive within 24-36 hours.

8. Test 03140 (CPT: 85730)—Activated Partial Thromboplastin Time (PTT) by photo-optical method. Justification: Many CFS/FMS and autoimmune patients have coagulation problems that must be documented. Requirements: one (1) 5cc Blue top (citrated) Plastic tube. Spin for 15 min, pipet plasma into plastic vial and freeze. Send as frozen sample with dry ice by courier to IMD to arrive within 24-36 hours.

9. Test 07073 (CPT: 85384)—Fibrinogen by nephelometry method. Justification: Many CFS/FMS and autoimmune patients have coagulation problems that must be documented. Requirements: one (1) 5cc Blue top (citrated) Plastic tube. Spin for 15 min, pipet plasma into plastic vial and freeze. Send as frozen sample with dry ice by courier to IMD to arrive within 24-36 hours.

For best price and highest quality I suggest that the above PCR specialty tests for CFS/FMS patients be ordered through International Molecular Diagnostics, Inc., 15162 Triton Lane, Huntington Beach, CA 92649 USA. Tel: 714-799-7177, ext. 202 (Client Services) or ext. 204 (Brant Blasingame).

Order forms and additional information are available upon request. Tests must be ordered by a physician. The IMD website is www.imd-lab.com. On this site you will find additional information about testing and disease. The Institute for Molecular Medicine website is www.immed.org. On this site you will find publications and documents on CFS/ME, FMS, autoimmune diseases and other chronic illnesses. Immediate Fax-back information is available 24 hours per day by calling our telephone number 714-903-2900.

Prof. Garth Nicolson

President & Chief Scientific Officer,

The Institute for Molecular Medicine (www.immed.org)

Professor of Internal Medicine

(c) 2002 Garth Nicolson. All Rights Reserved.