So You Think You Have MS? Queue the Bloodwork Circus
When doctors think you might have Multiple Sclerosis (MS), they don't just roll you into an MRI and call it a day.
Nah, first you get tossed headfirst into bloodwork game — because, surprise, your symptoms could be caused by fifty other things that need to be ruled out first.
Welcome to medical gaslighting, but make it protocol.
Here's a breakdown of what they usually test for — and why you're about to get billed more than your car is worth:
Complete Blood Count (CBC)
Spoiler: this one's cheap in more ways than one. You'll barely feel it in your wallet. And if they do find something abnormal, celebrate — your immune system might just need a juice box and a nap, not a lifetime subscription to chaos.
Comprehensive Metabolic Panel (CMP)
The Comprehensive Metabolic Panel (CMP) is basically a vibe check for your organs.
They're making sure your liver isn't waving a white flag, your kidneys aren't quietly quitting, and your blood sugar isn't staging a coup.
If anything's off, it could explain your symptoms without needing to drop the MS bomb.
Good news: this test is relatively cheap.
Bad news: the results usually just lead to more tests, because the U.S. healthcare system loves a sequel.
Vitamin D Levels
Low vitamin D is suspiciously common in MS.
If you live north of Florida and don't worship the sun daily, odds are you're already a little fungus. Congrats — you now have something in common with half the MS community.
When I moved to Seattle and had and appointment with the new doctor, he pulled up my labs, looked me dead in the face, and said,
"You have the lowest vitamin D levels I've ever seen in a human."
He legit asked if he should prescribe me a few UV lamps.
I laughed, passed on the tanning bed starter kit, and agreed some high dose vitamin D pills.
Vitamin B12 and Folate
Thyroid Panel (TSH, T3, T4)
Since a wonky thyroid can cosplay MS almost perfectly (and is way more common), they need to rule it out before tossing the MS label around and billing your insurance company into an early grave.
Quick fix if it's the thyroid: pills.
Quick fix if it's MS: LOL good luck.
Inflammatory Markers (ESR, CRP)
"Are you inflamed enough to roast a turkey on your forehead?"
They'll run tests like ESR and CRP to see if your body is quietly simmering like a busted crockpot.
If these numbers are high, it could mean another inflammatory disease is throwing a tantrum — like lupus, RA, or some other autoimmune disaster.
It's not super specific (basically just tells them something is pissed off), but hey, it's cheap drama for your chart and gives them another excuse to order even more expensive tests later.
Bonus points if you get the "we're not sure what it means yet" speech.
ANA (Antinuclear Antibody Test)
"Do you have Lupus, or did you just roll snake eyes in genetics?"
The ANA test checks if your immune system is attacking you just for fun — which could mean Lupus or one of the other autoimmune dumpster fires that love to cosplay as MS.
If it comes back positive, congrats: you might have a completely different lifelong battle ahead.
If it's negative?
Congratulations again — you're still in the running for MS, and no one's any closer to explaining why your body feels like it's buffering in real life.
Either way, buckle up. ANA tests are just the beginning of the "let's see what other misery we can find" phase.
Infectious Panels (aka 'Fun with Viruses')
"Did a bacteria break you before your immune system could?"
Before doctors start blaming your immune system for going rogue, they have to make sure it wasn't an infection that wrecked you first.
Cue the infectious disease panel — testing for HIV, syphilis, and a few other delightful surprises that can trash your nervous system long before MS gets a chance.
(And yes, there's no way to casually tell your family, "I'm being tested for syphilis" without getting at least one raised eyebrow.)
Good news: if they catch an infection, it might be treatable.
Bad news: if they don't find anything, congratulations — you're back in the MS Hunger Games.
Lyme Disease Test
"You ever been bitten by the wrong tick?"
Lyme disease can mimic MS almost perfectly — weak legs, brain fog, nerve pain, the whole funhouse ride.
So of course they have to test for it, even if you've never so much as looked at a forest.
The catch? The crazy cost of the test. And just to add insult to injury, even the good Lyme tests can miss the infection far more that you would think — so sometimes they'll order it twice.
Double the drama. Double the financial trauma.
The Bottom Line
It's about making sure they don't miss something easier (and cheaper) to fix first.
You don't get a "Congratulations, it's MS!" email because your CBC looked funky.
You get it after they've poked your blood, scanned your brain, stabbed your spine, and peered into your very soul — and then guessed based on whatever's left standing.
And no, it won't be an email.
There's no billing code for that.
It'll be an in-person visit with a neurologist who delivers the news with all the warmth of a DMV clerk handing you a speeding ticket.
Something like, "Buckle up — you're in for a ride," minus the courtesy of an actual seatbelt.
Medical mysteries, baby.
And you get to foot the bill.
Oh, and speaking of bills:
Congrats — your cost of living is about to spike too.
Once you figure out your old diet was basically that of a feral raccoon you'll get the joy of learning that eating healthier costs double.
Then tack on the supplements they tell you to take ($), the prescriptions to manage your new collection of symptoms ($$), and the DMTs (disease-modifying therapies) that clock in at upwards of $300,000 a year ($$$$).
Nobody warns you about this part:
MS isn't just disabling. It's expensive as hell.
But sure — tell me again how it's all in my head.
