Testing and Labs

This page outlines diagnostic tools that help reveal underlying biological dysfunctions commonly observed in Post-Acute COVID-19 Vaccine Syndrome (PACVS). It includes advanced laboratory testing and functional panels used by clinicians and researchers to assess immune activity, mitochondrial health, vascular status, gut integrity, and biomolecular persistence. These tests provide objective markers that guide clinical management and support ongoing research into the mechanisms of PACVS.

Testing and diagnostics list last updated on December 12, 2025

1. Spike Protein and Plasmid DNA Detection

Inmodia Spike Protein and Plasmid DNA Testing (Germany) – https://inmodia.de/en

Inmodia performs ultra-sensitive testing for:

  • Vaccine mRNA from the original mRNA sequence (e.g., Wuhan spike)
  • Spike protein in plasma, exosomes, and immune cells (PBMCs)
  • Plasmid DNA fragments, including SV40 enhancer and ORI region

These components are assessed across compartments (blood, immune cells, extracellular vesicles), offering insight into immune persistence, impaired clearance, or unintended cellular uptake following vaccination.

What to look for:

  • Spike protein in exosomes, PBMCs, or plasma
  • Vaccine mRNA in PBMCs or exosomes
  • Plasmid DNA sequences months or years post-vaccine

2. Autoantibodies and Immune Dysregulation

CellTrend Autoantibody Panel (Germany) – www.celltrend.de

CellTrend performs highly specialized ELISA-based testing for autoantibodies implicated in PACVS, Long COVID, and ME/CFS. These include:

  • G-Protein Coupled Receptor (GPCR) Autoantibodies
    • β1-adrenergic, β2-adrenergic
    • M2 and M4 muscarinic acetylcholine receptors
    • AT1R (Angiotensin II receptor)
    • Endothelin-1 type A receptor
    • MAS, CXCR3, and others
  • ACE2 Autoantibodies
  • Neurological and vascular signaling markers

These antibodies may contribute to:

  • Dysautonomia (e.g., POTS, orthostatic intolerance)
  • Vascular inflammation and blood pressure dysregulation
  • Chronic fatigue and cognitive dysfunction
  • Cardiac or gastrointestinal symptoms linked to autonomic imbalance

What to look for:

  • Elevated β1, β2, M2, M4, AT1R, ACE2, ET-A, MAS, or CXCR3 receptor autoantibodies
  • At least 5–7 elevated autoantibodies are commonly observed in PACVS and ME/CFS research cohorts (e.g., Mantovani et al., Wallukat et al.)
  • Immune dysregulation driving PACVS syndrome, particularly affecting autonomic, vascular, and cardiac regulation

3. Mitochondrial and Metabolic Dysfunction

Organic Acids Test (OAT) – Mosaic Diagnostics (USA) – https://mosaicdx.com – Nutripath (Australia) – https://nutripath.com.au

Detects metabolites indicating energy metabolism blockages:

  • Elevated succinic acid (suggests Complex II dysfunction in the Krebs cycle, impeding mitochondrial ATP production)
  • High lactate with low pyruvate (indicates anaerobic shift and inefficient energy generation)
  • Increased oxidative stress markers (e.g., oxalates, HVA)
  • Reduced branched-chain and essential amino acids, seen in parallel amino acid testing, may reflect systemic catabolism
  • Also includes bacterial and fungal metabolites such as arabinose, tartaric acid, HPHPA, and others — offering insight into microbial overgrowth and gut-brain axis involvement

DUTCH Hormone and Cortisol Panel – Precision Analytical (USA) – https://dutchtest.com

Identifies HPA axis dysfunction:

  • Flattened cortisol curve and low DHEA suggest chronic stress or burnout
  • May show low melatonin or impaired hormone conversion affecting sleep and circadian rhythm

What to look for:

  • Abnormal mitochondrial markers (e.g., elevated succinate, lactate shift)
  • Signs of energy deficit, oxidative stress, or amino acid depletion
  • Hormonal exhaustion profiles
  • Neuroinflammatory signatures (e.g., quinolinic acid, from tryptophan metabolism)
  • Microbial overgrowth indicators that complement stool or gut-specific testing

4. Gut Microbiome and Permeability

Disruption of the gut microbiome is a recurring finding in PACVS. Functional stool and microbiota testing can uncover overgrowth of opportunistic bacteria, low beneficial flora, and signs of gut barrier breakdown — all of which may contribute to immune dysregulation, chronic fatigue, food sensitivities, and systemic inflammation.

Microbiome and Stool Testing (Global)

Common lab providers include:

These tests can assess:

  • Overgrowth of Streptococcus spp., Enterococcus spp., or other lactic-acid–producing species
  • Low Lactobacillus and Bifidobacterium populations
  • Yeasts, parasites, and digestive inflammation markers (e.g., calprotectin, secretory IgA)
  • Zonulin and beta-glucuronidase, which indicate intestinal permeability and detox capacity
  • Short-chain fatty acid (SCFA) production, which is key for mucosal health
  • Gut Health and Function

    Food IgG and Histamine Testing – ImuPro (Germany) – https://imupro.com
  • Measures IgG sensitivities to over 260 foods (e.g., gluten, dairy, egg, soy)
  • Includes Diamine Oxidase (DAO) testing for histamine intolerance
  • Often reveals heightened reactivity to histamine-liberating or cross-reactive foods

What to look for:

  • Gut barrier disruption (e.g., elevated zonulin, low sIgA)
  • Dysbiotic or inflammatory flora, such as elevated Streptococcus with low protective species
  • Elevated IgG antibodies to food antigens or low DAO activity
  • Post-vaccine immune dysregulation affecting gut health, including impaired mucosal immunity, microbiota imbalance, and gut-brain axis dysfunction — often without overt systemic inflammation


5. Nutrient, Mineral, and Heavy Metal Testing

OligoScan (France) – Practitioner-Operated Spectrophotometry

OligoScan is a portable, non-invasive device used by licensed practitioners to assess intracellular nutrient status, oxidative stress, and toxic metal accumulation. It uses real-time spectrophotometry to evaluate levels at the tissue and cellular level, offering insights beyond what standard blood or urine tests can reveal.

Assesses:

  • Intracellular minerals (e.g., magnesium, iodine, selenium, zinc, phosphorus)
  • Heavy metals (e.g., aluminum, mercury, cadmium, lead)
  • Oxidative stress and sulfur metabolism
  • Tissue acidity (e.g., low phosphorus may reflect acid stress)
  • Intracellular vitamin saturation, including Vitamin C, Vitamin D, and B-complex levels

This form of testing can help identify functional nutrient deficits, toxic burden, and metabolic stress that may underlie persistent immune dysfunction, fatigue, or impaired recovery in PACVS.

Additional Insight:

OligoScan is especially useful in cases of immune dysregulation where tissue-level depletion is suspected. It can highlight deficiencies in key recovery nutrients such as:

  • Magnesium – for ATP synthesis and cellular resilience
  • Zinc and selenium – antiviral and antioxidant roles
  • Iodine and phosphorus – linked to thyroid metabolism and acid-base buffering
  • Vitamin C and D – for immune modulation, repair, and redox balance
  • Copper, manganese – support for superoxide dismutase (SOD) and mitochondrial enzymes
  • Sulfur metabolism markers – associated with glutathione detox and inflammatory regulation

OligoScan may also reveal tissue acidity, particularly in bacterial overgrowth states (e.g., Streptococcus), where chronic lactic acid buildup contributes to acid stress, low phosphorus buffering, and reduced mitochondrial energy efficiency.

By evaluating nutrient uptake at the tissue level, OligoScan provides insight into why patients with PACVS may remain symptomatic despite normal bloodwork — enabling more personalized support strategies.

What to look for:

  • Heavy metal accumulation interfering with neurological, immune, or mitochondrial function
  • Oxidative stress or impaired sulfur-based detox pathways
  • Tissue-level deficiencies of magnesium, zinc, iodine, selenium, or B vitamins
  • Low intracellular saturation of key vitamins (C, D, B-complex)
  • Tissue acidity or poor buffering, especially in bacterial overgrowth (e.g., low phosphorus)
  • Mineral ratio imbalances reflecting adrenal stress, inflammation, or poor absorption


6. General Blood Markers and Immune Trends

Routine pathology testing remains an important foundation for assessing systemic inflammation, clotting trends, and immune cell status in PACVS. While standard panels may not always reflect the full extent of dysfunction, subtle multi-marker shifts can indicate underlying immune or vascular stress.

Routine Haematology and Biochemistry

  • Full Blood Count (FBC):May reveal low-normal white blood cells (WBC), lymphopenia, or neutropenia, consistent with post-viral immune exhaustion
  • Coagulation markers:May show mildly elevated D-dimer, fibrinogen, or changes in prothrombin time
  • Inflammatory markers:ESR, CRP, and ferritin can be mildly elevated, low-normal, or fluctuate
  • Platelets: Can be in the low-normal range, and combined with other clotting markers, may suggest early-stage hypercoagulability or microclotting

Combined subtle changes — such as slightly elevated D-dimer, altered fibrinogen, or low-normal platelets — may reflect microvascular inflammation or fibrinaloid microclots, which are proposed in PACVS-related fatigue and circulation issues.

Homocysteine and Methylation

  • Elevated homocysteine may result from genetic variants (e.g., MTHFR) or systemic stress
  • May contribute to vascular irritation, mitochondrial strain, or coagulation risk
  • Consider MTHFR genetic testing, and discuss methylated B vitamin support (e.g., methylfolate, methylcobalamin) with a practitioner


T-Cell Subsets and Lymphocyte Profiling

T-cell panels via flow cytometry help evaluate adaptive immune balance.

What to look for:

  • Low total lymphocytes (lymphopenia) or reduced CD4/CD8 counts
  • Elevated NK cells (CD16+56+) may appear in persistent immune activation
  • Abnormal CD4:CD8 ratio or atypical B/T cell distributions may also suggest immune dysregulation


Immunoglobulin G (IgG) Subclass Testing

Assessment of total IgG and subclasses can identify immune imbalances.

What to look for:

  • Low IgG1 or IgG3 – may suggest reduced defense against viral infections
  • Elevated IgG2 or IgG4 – may occur in chronic immune activation or desensitization
  • IgG subclass patterns can support understanding of recurrent infections or autoimmunity


Cytokines – IL-6 & IL-8 and Inflammatory Profiles

Cytokine panels can reveal immune signaling dysfunction. IL-6 and IL-8 are particularly relevant to PACVS.

What to look for:

  • Elevated IL-8 – associated with neutrophil activation, vascular inflammation, and microclotting
  • Elevated IL-6 – common in chronic inflammation and autoimmune activation


Cardiac Monitoring and Cardiovascular Markers

Cardiac workup is essential in PACVS cases involving chest pain, palpitations, or a history of myocarditis/pericarditis.

Recommended assessments:

  • High-sensitivity Troponin – detects myocardial injury
  • CK, CK-MB – muscle and cardiac inflammation
  • NT-proBNP / BNP – heart strain or early heart failure
  • ECG / Holter monitor – arrhythmia and rate variability
  • Echocardiogram – evaluates ejection fraction, effusion
  • Cardiac MRI – detects myocarditis, fibrosis, pericardial thickening
  • Tilt Table Test – assesses orthostatic intolerance (POTS)
  • CRP / ESR – for systemic inflammation
  • ANA / Autoimmune panels – for vasculitic or cardiac autoimmunity
  • TSH, Free T4 – thyroid influence on heart rhythm
  • Iron studies / Ferritin – to rule out overload or anemia

Vitamin D Status

  • Vitamin D plays a crucial role in immune modulation and inflammation control
  • Levels should ideally be above 100 nmol/L (40 ng/mL) for optimal immune and mitochondrial support in post-viral or vaccine-related syndromes
  • Low or borderline Vitamin D may exacerbate fatigue, immune suppression, or prolonged recovery

Vitamin B12 Status

  • Vitamin B12 is essential for mitochondrial energy production, neurological function, and immune system regulation.
  • Maintaining serum vitamin B12 levels in the higher-normal range, preferably above 1000 pmol/L, may help optimise mitochondrial energy production, support red blood cell synthesis, and promote nervous system repair and resilience.
  • Borderline or low-normal B12 levels may contribute to fatigue, neurological symptoms (such as paresthesia or cognitive impairment), immune suppression, or delayed recovery after viral or vaccine-related injury.

7. COVID-19 Serology – Spike vs. Nucleocapsid Antibodies

COVID-19 antibody testing can help differentiate vaccine-induced immune responses from those caused by natural SARS-CoV-2 infection. This distinction is useful when evaluating the underlying immune landscape in PACVS.

What to look for:

  • A serological profile characterized by high Spike-specific IgG with low or absent Nucleocapsid-specific IgG (NCP) is indicative of an immune response driven primarily by vaccination rather than natural infection.
  • Persistently elevated Spike-specific IgG levels may reflect ongoing antigenic stimulation or immune system recognition of spike protein, particularly in individuals exhibiting prolonged post-vaccination symptomatology.

While antibody tests do not detect spike protein directly, a high Spike IgG profile may warrant further investigation through molecular-level testing.

Inmodia (Germany) offers ultrasensitive assays capable of detecting residual spike protein, vaccine mRNA, and plasmid DNA fragments (e.g., SV40, ori region, spike gene template) in plasma, PBMCs, and exosomes. This type of analysis may provide direct evidence of spike protein persistence or intracellular uptake, especially when serology indicates ongoing immune activation.

For further confirmation of spike protein persistence beyond serological profiling, advanced molecular testing may be warranted.

Common providers:

  • LabCorp, Quest Diagnostics (USA)
  • Sonic Healthcare, SA Pathology, Clinical Labs, PathWest etc (Australia)
  • Euroimmun, Viramed (Europe)

In Summary – What to look for:

Advanced diagnostics help uncover the biological disruptions driving PACVS. While no single test confirms the condition, recurring patterns across systems may include:

Viral Element Persistence
• Spike protein in plasma, exosomes, or immune cells (PBMCs)
• Vaccine-derived mRNA and plasmid DNA fragments (e.g., SV40 enhancer, ORI region) months or years post-vaccination

Autoimmune Signatures
• Elevated GPCR autoantibodies (e.g., β1, β2, M2, AT1R, ACE2)
• 5–7+ elevated markers suggest immune dysregulation and dysautonomia

Mitochondrial and Metabolic Dysfunction
• Elevated succinate, lactate shift, and oxidative stress markers (OAT)
• Low cortisol, DHEA, or melatonin indicating HPA axis fatigue (DUTCH)

Gut Microbiome and Barrier Disruption
• Bacterial overgrowths (e.g., Streptococcus spp., Enterococcus spp.)
• Low beneficial flora (Lactobacillus, Bifidobacterium)
• Elevated zonulin or beta-glucuronidase (intestinal permeability)
• Elevated food IgG sensitivities or low DAO (histamine intolerance)

Intracellular Nutrient Deficiency and Toxic Load
• Depleted magnesium, selenium, iodine, zinc, or phosphorus (OligoScan)
• Elevated heavy metals (e.g., aluminum, mercury, lead)
• Low intracellular Vitamin C, D, or B vitamins
• Indicators of oxidative stress and tissue acidity (e.g., low phosphorus buffering)

Immune and Vascular Trends
• Low-normal WBC, lymphopenia, or neutropenia
• Mild D-dimer, fibrinogen, LDH elevations (microclot risk)
• High IL-6 or IL-8 (inflammatory and vascular activation)
• Abnormal CD4:CD8 ratio or NK cell activation
• IgG subclass imbalance (e.g., low IgG1/3 or high IgG2/4)
• Vitamin D levels should ideally be >100 nmol/L for immune resilience
• Serum Vitamin B12 levels should preferably be >1000 pmol/L to support mitochondrial, neurological, and immune health
• Elevated homocysteine may suggest methylation block or vascular stress

Cardiac and Autonomic Monitoring
• Elevated troponin, NT-proBNP, CK, or abnormal ECG/echo/MRI findings
• POTS assessment via Tilt Table Test
• Consider autoimmune or thyroid panels for cardiac contributors (ANA, TSH)

COVID-19 Serology Interpretation
• High Spike IgG with low/absent Nucleocapsid IgG = vaccine-only immune signature
• Persistent Spike IgG may correlate with spike protein detection on advanced testing (e.g., Inmodia)


How These Tests Support PACVS

While no single test confirms a diagnosis of PACVS, many individuals show abnormalities across multiple biological domains. Common patterns include:

  • Persistent spike protein or plasmid DNA fragments in immune cells
  • Autoantibodies targeting vascular or nervous system receptors
  • Mitochondrial dysfunction and impaired energy metabolism
  • Gut dysbiosis, permeability, and food immune reactivity
  • Endocrine exhaustion and tissue-level nutrient depletion

These patterns offer objective biological evidence for the multi-system nature of PACVS and allow clinicians to tailor integrative or restorative care based on laboratory findings.


The Purpose of Advanced Testing in PACVS

The main aim of advanced diagnostics is to uncover underlying dysfunctions driving symptoms, so they can be addressed through targeted interventions. Based on test insights, treatment approaches may include:

  • Modulating immune dysregulation and reducing systemic inflammation
  • Supporting mitochondrial ATP production and oxidative balance
  • Repairing gut lining and restoring microbial diversity
  • Facilitating detoxification of heavy metals, spike protein, or oxidative waste
  • Rebalancing the autonomic nervous system and hormonal output

By interpreting these results within a functional medicine framework, clinicians can help the body regain balance, build resilience, and support long term healing.


Finding the Right Medical Support

Patients exploring these types of tests are encouraged to consult with professionals experienced in complex, systems-based medicine, including:

  • Integrative or Functional Medicine Doctors
  • Clinical Immunologists familiar with PACVS or immune-mediated syndromes
  • Professors or Researchers in immunology and chronic disease
  • Doctors trained in advanced lab referrals and multi-system diagnostics

These practitioners can assist in test selection, interpretation, and treatment planning based on your unique biological profile.