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Dr. David
Dr. David, Board Certified MD
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Experience:  Board Certified Physician
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Please can someone give me some advice (not Dr Thomas). I

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Please can someone give me some advice (not Dr Thomas).
I have had two bouts of giardia this year and have now undergone an IGG subclass blood tests. The results show a borderline low level of IGG1. I can provide the full results.
There is some debate going on between the doctors about the clinical significance of this finding. One side is saying it could be indicative of CVID or similar. The other side appear to be wishing to do a re-test and believe that the Giardia is just bad luck. I just wondered if an expert Immunologist might have a POV and also what is the likely scenario of treatment (or lack thereof) if I do indeed have a low IGG1 level? Is this serious?
I am not especially ill but have had some regularised (not frequent) infections over the last few years e.g. chest, tonsils and a boil on the skin. However, i have not been "ill" or hospitalised or anything of the sort. The giardia has been in many ways an anomaly.
best wishes
Customer: replied 2 years ago.
I have added the results
This is Dr. David
Giardia infection is one of the most common causes of waterborne disease in the United States and the parasite is found in backcountry streams and the infection comes from you drinking river or lake water which has not been properly treated.
usually gardia infection causes watery diarrhea until you get treated with anti-parasitic agents like flagyl (metronidazole) or others.
I am not too worried about slightly low IgG1 subtype
usually the Adult serum level range 4.9-11.4 (g/l)
and the mean level is 6.98 g/l
these IgG and IgM and IgA levels all vary up and down normally and is often due to your body's immune system
occational infections such as chest, tonsil, skin infections are very common and don't point to a clinical history of someone who has Common Variable Immune Deficiency
one case of giardia doesn't make me start to worry about CVID
let me know if you have questions.
Customer: replied 2 years ago.
i have had two bouts of giardia as per above.
one in may and one in november.
interestingly my son caught it so possibly may have re-infected me. there has been some debate about whether i had resistance or reinfection. the second time i was treated with a sandwich treatment of tinizadole + albendazole +tinizadole. This was due to a recent paper (worth reading) published by the london school of tropical medicine showing massive increase in resistance to metronizadole.
anyway, it is interesting you also take a more "cautious" pov on IGG1 deficiency. i am being re-tested next week along with a pcr test of my stool to see if the giardia has gone.
In the worst case that there is some potential minor deficiency what is the likely course of action? healthy lifestyle blah?
kind regards ***** *****
Customer: replied 2 years ago.
did you get the results?
Customer: replied 2 years ago.
yes, I got your blood test results
sorry about the delay
interesting about that article.
is that it?
I don't think you have to worry about potential minor immunodeficiency.
best thing to keep yourself healthy is to wash your hands frequently with soap and water
I know that sounds boring, but it has been shown to be the one best thing to prevent spread of infections.
let me know if you have other questions.
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Customer: replied 2 years ago., this is the article - see above. I am being treated by dr ***** ***** from uclh (google him). He is a world authority on giardia.i hope you are right re immunodeficiency. I am just hoping that the symptoms i have from taking the antibiotic sandwich therapy are post infectious IBS/Lactose intolerance rather than a re-emergence of this bloody parasite. I will keep you posted if thats OK!thanks