Updated on April 29, 2018
HLA DR is a simple blood test that is done to determine if you’re one of the 24% of the population that has genes that are susceptible to getting very sick from the super tiny “biotoxins” (bio meaning from living organisms) and inflammagens (agents that cause inflammation) that are naturally made by certain molds, Lyme, blue-green algae, some actinobacteria, a few types of reef fish, and the bite of the brown recluse spider. It’ll also tell you if you’re susceptible to getting Chronic Fatigue, a nasty nasal infection called MARCoNS, or tend toward too low MSH (master control hormone) along with if you should avoid the Lymerix or Gardasil vaccines. I wrote about the significance of this test in the blog “Are You Moldy”.
In that blog, I presented the “Rosetta Stone” (key) for interpreting the lab results. Even though I tried to improve upon the wording of the original Rosetta Stone developed by Dr. Shoemaker, I still felt like I was making it overly complicated – not good for “moldy” people with impaired brain function. In response, I wrote this blog hoping that it might make interpreting test results easier.
Update April 29, 2018
In Parasites & CIRS Update, I mentioned that HLA-DR testing has fallen out of favor. In 2017, Dr. Sonia Rapaport presented at the International Conference on Chronic Pathologies. At 10:30 in that presentation, she discusses the fact that the number of people that have a susceptible haplotype is much higher than the 24% reported by Dr. Shoemaker. Race, country, and ethnicity all play a role. For example, 90% of folks in Belgium have at least one “bad” halplotype. Given this, she seriously questioned the usefulness of HLA-DR testing.
Sean also points out that in the 2016 Irvine Mold Conference that Dr. Shoemaker himself commented that HLA-DR testing is questionable. I don’t have those videos, but I do have notes that others took of the conference. At that time, Dr. Rapaport was already looking into HLA-DR.
There are three basic steps. First, you find the first two numbers listed in each of the five sections of the lab results and convert them using a simple set of rules. The five sections are labeled DRB1, DQ, DRB3, DRB4, and DRB5. Second, you place these numbers into groups (buckets) and try to mix-and-match these numbers to see if you can create at least one of the known combinations that are problematic. Third, if you have at least one susceptible gene combination, then you are susceptible and should read over the “Are You Moldy” blog to get a sense for if something more should be done. That’s it. Hope this helps.
Step 1: Rules to Convert Lab Numbers
- Change 03 to 17
- All others leave as is
- If only one present, write twice
- Leave as is
- If only one present, write twice
- Change 01 to 52A
- Change 02 to 52B
- Change 03 to 52C
- If blank, write nothing
- If only one present, may need to write twice*
- If present, write 53
- If blank, write nothing
- If only one present, may need to write twice*
- If present, write 51
- If blank, write nothing
- If only one present, may need to write twice*
*If there is only one allele listed in all three categories (DRB3, DRB4, DRB5) then you may need to write it twice – you have to look at DRB1 and DQ alleles along with all the known haplotypes.
Step 2: Rules to Combine Alleles
- Put DRB1 numbers into first bucket. You will always have two.
- Put DQ numbers into second bucket. You will always have two.
- Put DRB3, DRB4, and DRB5 numbers-letters into third bucket. You may have none, one, or two.
- Take numbers-letters from each bucket and place into matching slots.
- DRB1 numbers go into first slots
- DQ numbers go into second slots
- DRB3, DRB4, DRB5 numbers go into third slots (may be empty)
Step 3: Interpret Results
- Test One
- 11-3-52B: susceptible to various Biotoxins and avoid Gardasil
- 7-4-53: no known susceptibility – benign
- It only takes one bad combination (haplotype) to be susceptible
- Test Two
- 7-2-53: mold only susceptibility
- 17-2-52A: mold only susceptibility
HLA DR Calculator
You can double check your results using this nifty HLA DR Calculator.
Note: I have not tested this calculator for accuracy.
Susceptible HLA DR Haplotypes
- Multiple Susceptibility (dreaded): 11-3-52B, 12-3-52B, 4-3-53, 14-5-52B
- Mold: 7-2-53, 7-3-53, 13-6-52A, 13-6-52B, 13-6-52C, 17-2-52A, 18-4-52A
- Chronic Lyme: 15-6-51, 16-5-51
- Dinoflagellates (fish): 4-7-53, 4-8-53
- MARCoNS: 11-7-52B
- Low MSH: 1-5
- MS: 15-6-51
- Chronic Fatigue: 4-3-53, 11-3-52B
- Chronic Fatigue from Lyme vaccine Lymerix: 4-3-53 (Subtypes 0401, 0402, and 0404 for DRB1 are worst.)
- Gardasil Vaccine for cervical cancers should be avoided: 11-3-52B
- Low Mold Risk: 7-9-83, 9-9-53, 12-7-52B
- No Known Susceptibility: 8-3, 8-4, 8-6
- Low Risk Mold: 7-9-53, 12-7-52B, 9-3-53, 9-9-53
- Note: People with 11-3-52B haplotypes that have very high TGF-beta 1 often have connective tissue issues, dysautonomia, and mast cell activation. Connective tissue issues range from those similar to Ehlers-Danlos syndrome, to Chiari Malformations in the brain, to pelvic floor dysfunction, to chiropractic adjustments not holding – need constant re-adjustments. Dysautonomia involves the autonomic nervous system resulting in symptoms such as fainting, cardiovascular issues, and breathing problems. Dysautonomia is linked to conditions such as Parkinson’s disease and diabetes. The 11-3-52B haplotype tends to have more pain and somatic dysfunction (musculoskeletal, nervous, or lymphatic). This group of people tend to be very hard to treat.
- Note: In his book “Surviving Mold“, Dr. Shoemaker listed 1-5 as low MSH. However, it is not listed on the Surviving Mold Website. This does not mean that 1-5 doesn’t have significance. In his FAQ’s, Dr. Shoemaker says, “In assessment of the DRB-1 1-5 over the years (together with its related haplotypes of 10-5 and 103-5, and 1-3 and 1-4) the only variable that reaches statistical significance we have seen is a reduced level of MSH in cases compared to other cases and then to controls.”
- Note: Up to 5% with a no known susceptibility haplotypes may still get CIRS from mold but will recovery more easily. There are a total of 54 known haplotypes – see page 716 in the book “Surviving Mold”. Alternatively, upon completion of the Biotoxin Test, you’ll be shown the 54 haplotypes 😉
- Dr. Shoemaker’s HLA DR Chart
Thank you Greg for this post. It made it simple! Questions please. Is it possible to tell which parent these come from? Mom or Dad, or both? And, can I mix the 3 numbers in row one with the three in the other? Don’t necessarily need to, both give me a positive. And last question, please, when you say Low MSH 1-5, what exactly is that? Mine is very low. Those two in combination? Or the first 5 examples? Thank you for your time and your entire blog! It’s all helpful!
Everybody has two haplotypes – gene combinations. You inherit one from Mom and one from Dad. There’s no way of knowing who gave you what haplotype – although I had the same question as you because if parents re-marry, then it helps to determine the odds that children are susceptible to Biotoxin Illness.
Yes, you can mix numbers between the two rows representing your two haplotypes. Although, you cannot move numbers/letters amongst the various “slots”. In other words, DRB1 numbers must always be placed in the first slot, DQ numbers in the second slot, and all others in the third slot.
If you compare my list of known problematic haplotypes with Dr. Shoemakers list, you’ll see that I have a couple of extra ones. These were either mentioned in Dr. Shoemaker’s DVDs or I read it somewhere else – didn’t keep notes on the source. However, 1-5 is a known haplotype listed by Dr. Shoemaker. It’s one of those with only two numbers – no DRB3, DRB4, or DRB5.
I don’t remember reading anything specifically about the low MSH haplotype 1-5. I assume it means that MSH is being driven low for some reason while other Biotoxin Illness markers with no known association with MSH like MMP9, C3a, C4a, VEGF and so on are OK – whereas the bulk of these would be out of range for someone with Biotoxin Illness.
However, we do know from Dr. Shoemaker’s work that when MSH is low, MARCoNS often take up residence. Assuming the same adverse health effects hold for someone with low MSH only and those with Biotoxin Illness and low MSH, then looking at my blog What Is Biotoxin Illness we see that when MSH is low, then the thyroid, ACTH, sex hormones, cortisol, ADH, and VIP are all adversely effected. Also, MSH, ADH, and VIP tend to move in unison so when one is low, the others tend to be low too.
Initially, I incorrectly was thinking having low MSH was no big deal. However, Dr. Shoemaker has commented that MSH is a “master controlling hormone”. He has often pined about the fact that no pharmaceutical company currently produces this hormone as he feels it would benefit those with CIRS greatly. Given the known impact of low MSH, folks with low MSH will no doubt be quite symptomatic.
Furthermore, given that you don’t have a moldy haplotype, I’m assuming this must mean you’re able to clear biotoxins and their related inflammagens. However, there must be a reason MSH is low, and I’m wondering if it isn’t inflammation based just like in Biotoxin Illness wherein cytokines block Leptin receptor sites – but with a trigger other than biotoxins. Given that Leptin is the signal for MSH production, this perhaps is because you’re Leptin resistant like folks with Biotoxin Illness – see the work of Dr. Jack Kruse regarding his Leptin Reset Easy Start Guide.
Update: In his book “Surviving Mold“, Dr. Shoemaker listed 1-5 as low MSH. However, it is not listed on the Surviving Mold Website. This does not mean that 1-5 doesn’t have significance. In his FAQ’s, Dr. Shoemaker says, “In assessment of the DRB-1 1-5 over the years (together with its related haplotypes of 10-5 and 103-5, and 1-3 and 1-4) the only variable that reaches statistical significance we have seen is a reduced level of MSH in cases compared to other cases and then to controls.”
Great insight on low MSH. I’ll def. look into that.
My Lyme Dr. has come back and says looking on the Rosetta Stone I have a DQ result of 5 which he says is in the multi-sus range on the chart. This is so important that I want to make sure he is wrong and misinterpreting my test results posted above. This could save me a world of time and trouble! Thank you !!
Well, I don’t know that I have much more to offer. I totally understand that it’s important to get a definitive answer. There is a 14-5-52B genotype that is multi-susceptible and this has a DQ of 5. However, all the alleles need to match up. Just because you’ve got a 1-5 and a 10-5, both of which have a DQ of 5, doesn’t mean you’re multi-susceptible. It sounds like maybe your Lyme Doctor is using a different Rosetta Stone (key) that says that regardless of what the other alleles (letters and numbers) are doesn’t matter – so long as the DQ is 5 then you’re multi-susceptible? From everything I’ve read and having seen Dr. Shoemaker’s interpretation of mine and two other family member’s HLA DR results, this is not how Dr. Shoemaker interprets results.
I’ve added a Youtube video of Dr. Neil Nathan describing how to interpret HLA DR to the Deciphering HLA DR blog post.
By the way, in his book “Surviving Mold“, Dr. Shoemaker listed 1-5 as low MSH. However, it is not listed on the Surviving Mold Website. This does not mean that 1-5 doesn’t have significance. In his FAQ’s, Dr. Shoemaker says, “In assessment of the DRB-1 1-5 over the years (together with its related haplotypes of 10-5 and 103-5, and 1-3 and 1-4) the only variable that reaches statistical significance we have seen is a reduced level of MSH in cases compared to other cases and then to controls.”
I think you confirmed what I was thinking- that my Lyme Dr. thinks you only have to have one or more numbers or letter and not all three for it to be positive.
I think between you and LABCORP Dr. this is most likely.
Again, thank you for your time and help!
Hi, I was hoping you might be able to help me. I just got my LABCORP HLA test results and can’t understand it. My Lyme Dr. says I’m multisusceptable and low MSH but I want to double check as he might not be experienced in interpreting the results.
After getting off the phone with the Dr. at LABCORP, he simplified the test result by telling me on one chromosome DRB DQ? I have a 1, 5, -(blank), and on the other chromosome I have a 10, 5, – (blank).
Appreciate if you had any input! 🙂
There are definitely 1-5 and 10-5 haplotypes. As you mentioned, 1-5 is associated with low MSH while 10-5 has no known susceptibility. As it stands, you’ve got some conflicting interpretations. If you can pick off the first numbers for DRB1, DQ, DRB3, DRB4, and DRB5 from your report, we may be able to get this figured out.
Hi Greg, thank you so much for your reply! Why don’t I give you the info on the LABCORP test result in full and maybe that can help…forgive me, I can’t make heads or tails.
DQB1 Allele 1 DQB1*05:ACGXX
DQB1 Allele 2 DQB1*-
Again my Dr. said this represents multisuscepatability according to Shoemaker, and double low MSH. I just want to see if thats accurate. What do you think?
The LapCorp Doctor is correct. You’ve got a 10-5, and a 1-5 haplotype. You’re not “muti-susceptible”. See my recent Reply to a Comment from Persistent about the low MSH haplotype 1-5.
Thank you again Greg for that info. I have been exposed to a lot of indoor mold and I do have Lyme disease which is not responding well to treatment. Can you tell me if I have any susceptability to mold or Lyme? I just want to make sure before I go back to my Lyme Dr.
Thanks also for the info on low MSH, I think I should just have it tested.
You do not have a “susceptability” to either mold or Lyme. In other words, based upon your haplotypes and Dr. Shoemaker’s work, you should be able to clear the toxins from both of these. My understanding is that folks without a “susceptability” to Lyme typically respond well to a short course of antibiotics with no further treatment needed. Although, I’m sure there are plenty of exceptions – like yourself. Given that low MSH can cause all sorts of trouble and you’re not doing better treating Lyme alone, looking into MSH sounds like a good idea to me. If MSH is low, I’d test for MARCoNS.
Thank you so much for writing this! It comes at a great time for me as I’m trying to make sense of the results I just received today.
I just need to clarify something with my results…
DRB1 is 13/14
DRB3 02 –> 52B
DRB4 & 5 are blank.
So could those combine as 13-6-52B making me mold sensitive? Or since 13 is the first listed for DRB1 and 06 is the second listed for DQ are those not combineable? Am I making any make sense?
Thank you for your help!
Yes, you can mix and match to come up with 13-6-52B – mold susceptible. The 14-3-52B is the other known genotype but has no known significance.
Thank you so much! I’m so happy to have found your blog!
Hi Greg, I read your post on low MSH and just got my nasal staph swab test back and it came back Staph Coag Neg in large amounts.I have the 1-5 low MSH halotype but no other susceptible halotypes . I do have Lyme disease. I’ve yet to get my MSH tested as it is hard to find a lab . Do you think, or has Shoemaker said, that Lyme disease without Biotoxin illness can cause a lowered MSH? I don’t have any pain or reduced pain tolerance but this high MARCoNS result might be a low MSH indication.
Given you don’t have a Lyme susceptible haplotype, you should be able to knock out Lyme relatively easily. Dr. Shoemaker says usually 3 weeks of Amoxicillin for men and Doxycycline for women (sometimes Biaxin or Ceftin). According to Dr. Kruse, Lyme toxins trigger the same cytokine storm seen in Biotoxin Illness resulting in Leptin resistance and a wide range of dysregulation. I’d start by reading his blog called Hey Lyme Disease, Meet Leptin. Given that Lyme toxins trigger the same gut issues as Biotoxin Illness, it’s not surprising to see Dr. Kruse recommends the first four steps in Dr. Shoemaker’s protocol for folks without susceptible genes that don’t bounce back from Lyme.
Related to MSH, if you get a Doctor to write a script, you should be able to take it to your nearest Lab Corp blood draw center – see Are You Moldy. Check out the Physician’s Order Sheet 6-20-2014 for details. Make sure to call ahead so they’re not “shooting from the hip” when you show up. MARCoNS are definitely indicative of low MSH.
Related to labs and Lyme, you might want to consider getting C3a and C4a drawn. When C3a and C4a are high, it’s indicative of active Lyme. When C4a only is high, it’s indicative of mold exposure. By the way, if you’ve been dosed up pretty good with antibiotics, then it’s quite likely that the spirochetes are dead and what you’re dealing with is their toxins. If you use Dr. Shoemaker’s protocol to bring down C3a and C4a and either one spikes up a month after going off the protocol, then you’ll know you need more antibiotics or you’re in a moldy environment depending if it’s C3a and C4a, or just C4a respectively.
I just want to remind people that read these comments that I’m a former General Contractor and High School math teacher. I’ve taken extensive notes as I studied Biotoxin Illness. When someone writes in with questions for very difficult to treat chronic illnesses, I look through my notes to jog my memory, dig up a few links, and speak a bit about the topic. Although I enjoy trying to help out, please always check with your Doctor, do your own research, and so on. Of course, this is just common sense and this is what people do but it makes me feel better to throw in this disclaimer now and then. For anyone that has the money, I HIGHLY RECOMMEND signing up for a SurvivingMold Membership or a Reversing Disease for Optimal Health Membership or both.
Hi Greg, thanks for that useful reply!
I’ve been doused with tons of antibiotics for 3 years and have had some significant improvement but still quite ill. I do believe the bugs are still alive as I herx and symptoms wax and wane and time of day differences. The bugs I have left are either drug resistant or recovery is blocked by exposure to mold, metal levels, enviromental pollutants, parasite infection, or maybe now involvement with large staph coag neg infection. I will get the C3a and C4a tests done as you said.
MSH testing at Labcorp requires the specific lab you are going to having a special additive, something I’m having a very hard time getting Labcorp to confirm, so people be aware:)
I read in an article that low MSH could be from being sick like this for more than 6 months, but I was wondering about 2 questions:
1. If you have heard or have heard Dr. Shoemaker mention anything about having low MSH from Lyme disease without having actual biotoxin illness?
2. Also, without MSH replacement treatment, do you know if MSH comes back to normal with the clearing of Lyme disease alone?
Thanks for the tip on MSH testing. That must be the trasylol. MSH Draw Procedure
I don’t have anything on Dr. Shoemaker making specific comments on Lyme always lowering MSH or something to that effect. However, Dr. Kruse says in Hey Lyme Disease, Meet Leptin, When leptin increases as the result of a biotoxin exposure, there is a simultaneous decrease in alpha MSH secretion from the hypothalamus. Lyme toxins are biotoxins. Dr. Shoemaker has shown that it’s not just MSH that gets taken for a ride but a whole host of biological markers when some folks are exposed to biotoxins from Lyme, mold, and so on. So in effect, Dr. Shoemaker has clearly said the Lyme toxins can lower MSH.
My Mom, bless her soul, has been going to see Doctors for over half a century. She loves antibiotics. She loves Mayo and they load her up with them. When she takes them, she feels better for a while. It’s a never-ending cycle. Through my efforts, we now have labs documenting she has Biotoxin Illness. So the antibiotics help because they’re anti-inflammatory and Biotoxin Illness is all about massive inflammation but they’ll never get her better. Mayo doesn’t get it.
I know there are all kinds of discussions about how tenacious Lyme is. Furthermore, I believe that all the toxins in our bodies contribute to an impaired immune system that leads to getting sick and then having a hard time getting better. However, I can attest to the wide and cyclical symptoms that a person who is loaded up with biotoxins goes through. As it sounds like you know, its one hell of a never-ending roller coaster ride. Why not at least seriously follow the first 4 or more steps of Dr. Shoemaker’s protocol and see if like me, the roller coaster begins to dissolve away? Go after the toxins.
Anyway, my guess is you’re going to find that it’s more than MSH that’s out of range. I have not read anything about low MSH correcting with arresting Lyme alone. Certainly there are people that have gotten better with long-term antibiotics for Lyme but I don’t think the Lyme group tracks MSH – except recently with the advent of Dr. Shoemaker’s findings. On the other hand, I’ve read a ton about how low MSH corrects with the clearing of Lyme toxins. So even though you don’t have Lyme susceptible genes and should be able to clear Lyme toxins without extra help, roughly 5% of people with good genes still have trouble and need a little help. My advice is that 3 years of antibiotics is more than enough down that road especially given the mountains of data showing that ignoring the toxins is a huge mistake.
After reading Shoemakers work and latest book Surviving Mold, and several other sources I put together a collection of articles of why the all important MSH is lowered so dramatically in the case of all bio toxin illnesses, including lyme, especially in HLA-DR susceptible types. In short, any time the immune system can”t properly identify the biotoxin antigen(s), it spirals out of control. The inflammatory cytokines pound on the hypothalamus leptin receptors until they are fully occupied, and I have heard some say even destroyed, in severe long term undiagnosed cases. There’s a flow whereby leptin will activate a pre hormone called POMC. Below are some great diagrams and discussions of this neuro hormone flow.
Effects of Peptides
Melanocortins: Anti-Inflammatory and Neuroprotective Peptides
MSH Deficiency – Why The Hypothalamus And Pituitary Shut Down
MSH or alpha Melanocyte Stimulating Hormone
Mold Exposure, Lyme, Biotoxins, MARCoNS, Sinuses
If the receptors are occupied or destroyed by these proinflamatory cytokines to a great extent, there is little opportunity for leptin to properly activate the receptors on the hypothalamus to create POMC. From POMC, PC1 cleaves pro-ACTH and beta LPH. PC1 further cleaves Pro-ACTH to N-POC and the all important ACTH. Beta-LPH is cleaved by PC2 to create gamma LPH and the important beta endorphins. ACTH is cleaved by PC2 to create the important Alpha MSH, which is what the discussion is about. CLIP is also created from the cleave. Note also that from N-POC PC2 cleaves to gamma MSH and from gamma LPH PC2 cleaves to beta MSH. But alpha MSH is the one the has receptors throughout the body. As we know it controls tons of important processes.
So any biotoxin that creates an overly stimulated immune reaction that persists chronically, can mess up those leptin receptors. In doing so MSH production is starved or downregulated. ACTH is also dysregulated. Beta endorphin production drops. All because the production of POMC is downregulated. Note Marcons can directly cleave and destroy alpha MSH
As a lyme and mold with 11 3 52B. I have encountered both of these. The Kruse article does not delve into this topic deep enough as to why this occurs in the context of a dysregulated imminent system and bad antigen receptor recognition (HLA-DR) genetics.
I just had my hla genes and c4a tested and the results are:
Allele 1: 12, 3, 52A
Allele 2: 14, 3, 52 C
Would this be considered multisuseptible? My doc says its closest to multisuseptible, but i am not sure what that means.
My C4a came out at 13,500.
My 1,25 vit d was also very elevated.
Tested negative wb igenex, but had IFA IGG to borrelia, anaplasmosis, and bartonella.
He thinks i need to move into new house and have both mold illness and lyme per my hx and results.
From page 716 in Dr. Shoemaker’s book, “Surviving Mold”, the only 12-3 haplotype is a 12-3-52B. Similarly, the only 14-3 haplotype is a 14-3-52B. As such, something seems out of place. Maybe DBR3/4/5 was transcribed incorrectly? You can check this yourself with my post Deciphering HLA DR Labs.
Interestingly, I recently had a discussion with a person with Bartonella. This person was quite adamant that based upon studies of Dr. Breitschwerdt, that Bartonella was a hidden epidemic and that the best way to test was with Galaxy that does ePCR (polymerase chain reaction) – as opposed to the IFA IGG (indirect fluorescent-antibody technique) you had done. I don’t have an opinion one way or another, just mentioning it in case it’s helpful.
This person also thought that Bartonella may be the underlying driver behind CIRS. Who knows? Still, when I get a chance I want to do some reading about Bart. Currently, what causes the immune system in CIRS to fail is unknown. However, this person had been treating for years with antibiotics with less than stellar results so my suggestion was to examine the possibility that the issue may be with clearing the toxins left over from Bart. A simple HLA DR test is a great place to start with answering this question. Anyway, these are just a couple of thoughts in case they’re helpful.
907 Ticks, Fleas & Mystery Disease
Looking back on my hladr genes i think the interpretation is correct. Would you mind helping me to check if i interpreted them incorrectly?
DQB1 ALLELE 1
DBQ1 ALLELE 2
Something seems amiss.
DRB1 is 12 and 14.
DQ is 3 and 3.
DRB3 is 52A and 52C.
These combine to 12-3-X, and 14-3-X.
The trouble is that there are only two 12-X-X haplotypes along with three 14-X-X haplotypes and they all end in 52B. I would think it very unusual that you have a pair of undiscovered haplotypes given the thousands of patients from whom data was collected.
Known 12-X-X and 14-X-X Haplotypes
thanks for your help.
If the patient data was collected from thousands of patients i would assume there could be some other hla genes. Im half korean and chinese by the way. Dont know if that makes a difference .
I wonder if labcorp could have made an error and if i shoUld retest?
But according to my lyme /mold doc he says my c4a of 13500 is already telling of mold issues and possible lyme/intracellular bacterial and or viral infections
According to Dr. Shoemaker’s Physician’s Order Sheet 6-20-2014, LabCorp 167120 is the correct HLA DR test for determining CIRS haplotypes. I’d double check your paperwork to make sure it was LabCorp and this lab. This lab is hard to mess up for the phlebotomist (room temperature draw with no special processing) so it would seem to be less prone to error although who knows what happens at the lab itself. I can’t say more about if other haplotypes exist but will try to look into this time permitting.
On the other hand, C4a is prone to error. It has to be spun down immediately and frozen. Failure to do so can dramatically change the results. The bottom line is you need to look at a bunch of labs, symptoms, and exposure to come up with a proper diagnosis. An inconclusive HLA DR test and a single high C4a isn’t enough information. Take a look at Diagnosing Biotoxin Illness Using Labwork. My “two-cents” worth is to really figure out if you’ve got CIRS and treat this
first. Please read the Binder section for help diagnosing Lyme. It’s pretty much guaranteed you’ll have one or more opportunistic infections but addressing them will not clear up CIRS. It can help strengthen your body, but the elephant in the room is CIRS.
From reading my results I have
12 3 52A
13 6 52B
Are 52A & 52B interchangeable? If not then I only have a mold susceptible gene but if yes I have multi & mold.
Ah, this is a nice example. I’m assuming you’ve transcribed your test results wherein you got these results.
DRB1: 12 & 13
DQ: 3 & 6
DRB3: 52A & 52B
The last step is to combine them into known haplotypes. You can look on page 716 of Surviving Mold or take the Biotoxin Illness Test. When you do, you’ll see there is no 12-3-52A haplotype. As such, you must have 12-3-52B and 13-6-52A. These are both known haplotypes.
We then look up these haplotypes and see, as you’ve stated, that you’ve got a “dreaded” and mold haplotype.
That’s what I thought but was hoping I was wrong. Thank you for clearing that up. I know I have Lyme already. And I’m guessing a dreaded gene means I can’t detox Lyme toxins on my own. But do these hla results mean I for sure have a problem with mold or just that I’m suceptable to having a problem with mold?
For me, it was bad news and good news when I learned I had a pair of dreaded genes. Bad that it meant having to be forever vigilant about mold but good that I finally knew what was wrong. Yes, it only means you’re susceptible. Lab work confirms the matter. You can get a NeuroQuant study done and brain features will tell if you whether Lyme or mold or both are issues.
If you’ve got Lyme and mold issues, make sure to study up. For example, C3a and C4a are very telling for you. In particular, C3a and C4a will remain high in spite of treatment for biotoxins if Lyme hasn’t been addressed. Also, Lymies definitely need to get fish oil and a no-amylose diet in place in advance of CSM. I talk a bit about this in the Are You Moldy article.
Wow!! Thanks for that info. Just ordered nordic naturals ultimate omega. I will work up to 2.4 g of EPA. I did fail the VCS too. My llmd put me on CSM but didn’t mention the fish oil so glad you did. The C3 & C4 how are they ordered? Labcorp? Quest?
See Physician’s Order Sheet (Updated 06/20/2014).
Also read about getting labs right.
Hi Greg, we’ve chatted on my case a bit here and you had suggested I take some further tests. I was wondering if you had any thoughts on these results as I’m still quite ill. I’ve been on antibiotics for 3 years with some improvement. I’ve been exposed for sure to indoor mold:
DQB1 allele1*05 ACGXX
DQB1 allele2 1*-
( no susceptibility?)
( all 3 normal?)
-Had staph/MARCoNS- after treatment= no growth.
-Strange no low MSH given HLA results and large previous staph infection?
-No KPU issue
-Low- normal functioning Methylation pathway.
You had said previously I’m not susceptible either Lyme or Mold.
Any additional thoughts?
I remember chatting with you. You’ve got 1-5 and 10-5 haplotypes. That 1-5 is associated with low MSH. Low MSH is no trifling matter in and of itself as we’ve discussed a bit.
I’m assuming you used Lab Corp for the MSH draw code number 010421. This is according to Dr. Shoemaker’s Physician’s Order Sheet 6-20-2014. If so, then your MSH is low. The range for MSH is 35-81 pg/mL. This is the range that Dr. Shoemaker used when he collected data. Do not use the current range of 0-40 pg/mL. The range has changed because labs frequently re-norm their ranges based upon test results. Is it any wonder that the range of a test will fall lower as it used more and more to diagnose CIRS? Really, it’s OK to not have any of the very critical hormone MSH? Total nonsense. By the way, don’t use aromatase inhibitors or supplement with DHEA or testosterone when MSH is less than 35 as it will likely make you much sicker.
Given the range of your C3a and C4a, it looks like those labs were done at Lab Corp. They need to be done at Quest to get any useable data as this is the test that Dr. Shoemaker used. The normal ranges from Quest are C4a: 0-2830 ng/ml, C3a: <940 pg/ml. As such, we don't know anything about your C3a and C4a levels. You can read more about this test in Are You Moldy.
So you’ve got low MSH, had MARCoNS, are symptomatic, were exposed to mold, and have low MSH. Even though you should be able to clear mold and Lyme toxins, about 5% of people with good genes still have trouble. If it’s at all possible, I’d consider more testing along the lines mentioned in Diagnosing Biotoxin Illness Using Labwork. If not, then perhaps reading up on the Biotoxin Protocol and implementing the first few steps for many months to see what impact it has might be informative. This is a harder way to go because if you don’t see improvement you won’t know why – was it an unknown mold exposure, was it gut issues, etc.
Finally, gut health is huge. Unfortunately, those with CIRS have terrible gut health in part due to low MSH. Lots of veggies and high quality meat. You can read up on Dave Asprey’s Bulletproof Diet or Doug Kaufmann’s Phase One Diet.
Thanks for that Greg……I understand this could be important in my symptoms overall. You are right my C4a, C3a was done by Labcorp.
Apparantly Quest does not draw for the C4a, C3a test anymore. I was wondering if you:
1. Knew of a current source that draws and send to Jewish Hospital ( I think it might have to be sent there?)
2. Any way to extrapolate the results from Labcorp into some idea of what it compares to in Quests’s results?
3. Where I can find the protocol, if any, for treating low MSH ?
4. Could share any info or knowledge that you have about low MSH treatment and outcomes?
I really appreciate any info as per above- I will ask my Lyme Dr. of course but your info has been really helpful also.
1. I have not heard anything about Quest no longer doing C3a and C4a – see links to their website. You can read the C4a section in Are You Moldy. It talks about how to go through Lab Corp if Quest, for some reason, just isn’t possible.
Test Code 42003
CPT Code 86160
Test Code 42658
CPT Code 86160
2. That would be cool but I don’t know of any.
3-4. The protocol would be the same as for Biotoxin Illness. That is, test the inflammatory markers in the protocol and then systematically bring them back into range culminating with VIP therapy. Since you’re not susceptible, chances are you won’t have to go through the whole protocol and will be able to jump past steps.
It’ll be good to educate your Lyme doc a bit about mold. It sounds like he/she is interested.
Thanks for that Greg.
I wanted to post a reply to report what I just found out regarding Quest testing C4a, C3a. First time they said they no longer do it as I posted above, today they say the info on the links you posted above ( and probably what the first person I talked to misunderstood) the info is out of date and the name and codes have changed. Now this person says the names and codes are:
Test Code: 19956 (K94824)
CPT Code : 86160
Test Code: (K94825)
I’d caution anyone to check for themselves or ask their Dr. to clarify as I’m not sure what to make of the murky Quest info. I’ll actually test this when I go to a clinic next week and try to use these names and codes. The thing is these tests go to National Jewish Hospital which I believe is the special requirement that Shoemaker wants.
Regarding low MSH, thanks for the direction, I will look into it. My Lyme Dr. just related that Klinghardt says MSH can be increased by inhaling MYRRH oil using a diffuser not a nebulizer, and low MSH is related to anti-gluten antibodies and if you have this tested positive you must avoid all gluten.
Just wanted to pass on the info for anyone to check out.
Thanks again, cheers,
Definitely write back when you find out about those new Quest codes. As you mentioned, the key is having the lab work done through National Jewish Medical & Research Center in Denver, CO. By using the right Quest code, this is automatically specified. If you go through Lab Corp, you have to explicitly specify this as discussed in the C4a section in Are You Moldy.
Dr. Shoemaker’s protocol is proven. Dr. Klinghardt uses lots and lots of therapies that are constantly being changed. I was treated by a Klinghardt practitioner for two years so I got to see first hand how at least once a year whole groups of therapies were discarded to make room for new ones. I’m not saying it doesn’t make sense to experiment but only after implementing on a solid protocol and using labs when possible to confirm efficacy of treatment. I’m concerned that if you jump past the most basic of steps like making sure you’re living and working in clean spaces and taking binders to clear toxins, that trying to raise MSH alone isn’t going to help that much. It sounds like you get this as you’re pursuing more lab work and then will be able to see if it’s just MSH or if you’re suffering from Biotoxin Illness – that you’re one of the 5% with OK genes that still can’t clear toxins all that well.
Hi Greg, I posted with you back and forth a few months ago regarding C4a and C3a testing through Quest Lab and National Jewish Center. I’ve not done the tests yet but was getting ready to do them again in the next week when I contacted Quest again today to make sure.. and got further confusion from them ( again).
I’m no where near Baltimore and would be coming from Toronto to Buffalo/Niagara Falls to a Quest center but they have no such test codes in their central system, and central customer service says only the Baltimore branch must have the codes and sends to NJC, not the regular Quest draw centers. So they tell me all other draw centers cannot send the test to NJC- only to their main company Labs, and that leaves me having to travel to Baltimore MD to have these tests done. Which is not possible.
Baltimore draw center tells me directly that hey have the codes and any draw center should be able to send it to the NJC.
I’d be interested if anyone has had their blood drawn from any other Quest locations other than Baltimore for this test sent to NJC?
Balimore’s test codes are : NJC-C4a, NJC-C3a
The last C3a/C4a testing I had done was in 2012 through the local Quest draw center here in Wisconsin with paperwork that listed Test Name: NJC – C4a/C3a and Order Code: 42658/42003. My brother, also in Wisconsin, had a C4a Quest draw in his area early 2015. “Central Customer Service” sounds confused. Maybe just call the closet Quest draw center, give them the NJC – C4a/C3a name and 42658/42003 codes, and ask that they look into how to do this test properly and confirm that the samples will be sent to National Jewish Hospital.
I just received my gene tests back from the lab. I have been sick for 17 years. Went through 2 lawsuits with a school where I was teaching. I think I have a 43-53 and a 43-52B. The results of my scores are:
To me it seems like I end up a 43 52B or a 43 53
for extra information email me.
Yep, many schools are very unhealthy. It’s a tragedy for kids and teachers.
The link you sent requires a login. All we need is the first series of numbers as shown in the “Test 1” and “Test 2” examples above.
There certainly is a 4-3-53 but not a 4-3-52B so seems like something is a bit off.
Thank your for your quick reply. Here are the numbers as I see them.
I don’t really see any DQ alone.
I also don’t know how to log in. Or am I now logged in?
It is wonderful to have this service. Amazing actually.
Thanks Mary from Michigan
Oops. What I meant was that the login was related to the link you sent to your HLA DR lab. When I clicked the link to see your results, I was presented with a login screen.
I just happen to be adding a tweak to an article when you posted your comment so the timing was just right. Most times it takes me a couple of days to get back to people.
DRB1: The 4 and 11 stay as they are.
DQB1: Since there is only one DQ of 3, this means you have two DQ’s both of which are 3.
DRB3: The 02 converts to 52B.
DRB4: The 01 converts to 53.
These combine into 4-3-53 and 11-3-52B.
Now that you know that you’ve been exposed, are symptomatic, and have susceptible genes, the next step is lab testing to see what markers are out of range and then start systematically addressing them.
All the best.
Thank you so much for your help. Not good news, but so glad I understand now. Thank you, Mary from Michigan.
My daughter and her son were tested for the HLA-DR by PCR Physician Order Sheet and only got HLA-DR1 and not the other numbers. I called the telephone number at the top of the order sheet and they said the Code # 012542 had been changed for that test.
The office manager gave me the new number for the HLA DR by PCR under the code # as 167120. We have not tried that number yet. Could you tell me the website where the number is correct?
The office manager said that number was changed in June. I am confused. Thank you for your help.
Mary from Brighton, MI
LabCorp 167120 is the correct test for determining CIRS haplotypes. Not only is it important to designate the correct test but it’s also important to use the correct lab. In the case of HLA DR, LabCorp is the correct lab. You can look up Dr. Shoemaker’s Physician’s Order Sheet 6-20-2014 for this information.