Chronic Fatigue Panel - NBI
Chronic Fatigue Panel - NBI

Chronic Fatigue Panel

Regular price $143.00

Chronic fatigue is common, particularly in women. People struggling with chronic fatigue may experience more than simply feeling tired. People often complain of a number of symptoms including headache, joint pain, gastrointestinal (GI) disturbance, cognitive dysfunction (brain fog, difficulty learning new information, recalling information or finding the right words), visual disturbance and numbness and tingling. 

From the person’s perspective who’s struggling with this, their experiences can best be described as just generally off―things simply aren’t working right. They’re tired all the time, and yet some suffer from insomnia. They experience brain fog and yet some are overburdened by thoughts. They’ll get unexplained temporary relief for a few days or weeks and then the symptoms return. They might not be able to sweat when they exercise and afterwards feel like they’ve been run over by a truck. They might suffer from multiple chemical sensitivity and become sickened by the smell of cigarette smoke, perfumes, and other scents. They may be constipated. Their fingers and toes may frequently get cold and they might suffer from migraine headaches. Frequently they feel frustrated, angry and sad. Who wouldn’t?

The Chronic Fatigue Panel helps identify important potential contributors to how people might be feeling so they can be informed and take steps to improve their health.

What’s Reported

Epstein-Barr Virus (EBV) Infection Panel

  • Epstein-Barr Virus VCA Antibody (IgM)
  • Epstein-Barr Virus VCA Antibody (IgG)
  • Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG) 

Iron Status Indicator

  • Ferritin

Red Blood Cells and Indices

  • Red Blood Cells (RBC) 
  • Hemoglobin
  • Hematocrit
  • Mean Corpuscular Volume (MCV)
  • Mean Corpuscular Hemoglobin
  • Mean Corpuscular Hemoglobin Concentration
  • Red-cell Distribution Width

White Blood Cells

  • White blood cells (WBC)
  • Absolute and Percent Neutrophils
  • Absolute and Percent Lymphocytes
  • Absolute and Percent Monocytes
  • Absolute and Percent Eosinophils
  • Absolute and Percent Basophils 


  • Platelet Count
  • Mean Platelet Volume 

Manual Differential

  • If abnormal cells are noted on a manual review of the peripheral blood smear or if the automated differential information meets specific criteria, a full manual differential will be performed.

Vitamin B12 Status

  • Vitamin B12 (Cobalamin)
How to prepare

Fasting: No.
Water: Drink plenty of water to stay well hydrated.
Medications: Take all medications as prescribed.
Dietary supplements: Avoid taking dietary supplements containing vitamin B12 for two days prior to the test.

How long until you get the results

3-5 Business Days
Result turnaround times are estimates and not guaranteed. Due to factors outside of our control, such as weather, holidays, confirmation/repeat testing or equipment maintenance, our lab may require additional time to complete tests.

More about this test

Complete Blood Count (CBC)

The complete blood count (CBC) with differential and platelets panel is a standard test routinely run during annual exams. The CBC test evaluates three categories of blood cells—red blood cells, white blood cells and platelets. These cells can help provide important information about immune function, whether there may be an infection, blood disorders, nutritional deficiencies, your body's ability to form blood clots, bone marrow health and more.

Epstein-Barr Virus (EBV)

EBV can affect nearly all systems in the body. Symptoms of EBV infection can include:

  • Arthritis
  • Cough
  • Ataxia (poor balance)
  • Hepatomegaly (enlarged liver)
  • Splenomegaly (enlarged spleen)
  • Fatigue
  • Fever 
  • Arrhythmia (irregular heart beat)
  • Irritability
  • Jaundice
  • Lethargy
  • Nausea
  • Neck stiffness
  • Rashes
  • Sore throat
  • Swollen lymph nodes 

EBV is transmitted most commonly through body fluids, mostly saliva. EBV can also be transmitted through blood and semen in sexual contact. 

EBV can also be a risk for some cancers, such as Burkitt’s Lymphoma. 


Ferritin is the storage form of iron in the body, storing up to 80% of the total amount of iron. Since iron is stored in the body as ferritin, a serum ferritin test is the most reliable screening test for iron status. Iron deficiency causes lots of symptoms, including fatigue, shortness of breath, rapid heart rate, dizziness, depression, difficulty processing information (brain fog), decreased memory (forgetfulness) and feeling cold.

Vitamin B12

Vitamin B12, cobalamin, is part of the B complex family of vitamins. Vitamin B12 is necessary for converting the inactive form of folate to its active form, playing an important role in the production and function of red blood cells (RBCs) and breakdown down the blood toxin homocysteine. Among other things, vitamin B12 deficiency can cause anemia, elevated homocysteine and fatigue.


Akkoc G, Kadayifci EK, Karaaslan A, et al. Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis. Case Rep Infect Dis. 2016;2016:7549252. 

Center for Disease Control and Prevention (CDC). Chronic Fatigue Possibly Related to Epstein-Barr Virus -- Nevada. 1986;35(21);350-2. Accessed October 10, 2019. 

Diaz-Mitoma F, Vanast WJ, Tyrrell DL. Increased frequency of Epstein-Barr virus excretion in patients with new daily persistent headaches. Lancet. 1987;1(8530):411-415. 

Lachner C., Steinle N.I., Regenold W.T. The neuropsychiatry of vitamin B12 deficiency in elderly patients. J. Neuropsychiatry Clin. Neurosci. 2012;24:5–15. 

Li ZY, Lou JG, Chen J. [Analysis of primary symptoms and disease spectrum in Epstein-Barr virus infected children]. Zhonghua Er Ke Za Zhi. 2004;42(1):20-22.