Neurosyphilis is a serious complication of syphilis where the infection spreads to the brain and nervous system. It is caused by the bacterium Treponema pallidum that invades the central nervous system after untreated or inadequately treated syphilis infection. The RPR (Diagnosis) with Reflex to Titer and Treponema pallidum Antibody test is the most important screening test for identifying syphilis infection and assessing neurosyphilis risk through antibody detection and titer levels.
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Neurosyphilis is caused by the bacterium Treponema pallidum invading the central nervous system after untreated or inadequately treated syphilis infection. This bacteria spreads from the initial infection site through the bloodstream and eventually crosses the blood-brain barrier to infect the brain, spinal cord, and surrounding tissues. Neurosyphilis typically develops years after the initial syphilis infection if left untreated, though early forms can occur within months in some cases.
The RPR (Diagnosis) with Reflex to Titer and Treponema pallidum Antibody test is the most important screening test for neurosyphilis because it detects both non-specific antibodies (RPR) and specific Treponema pallidum antibodies in your blood. High titers in the RPR component suggest active infection and potential disease progression toward nervous system involvement. The Syphilis Antibody Cascading Reflex test provides additional systematic screening for T. pallidum infection. While blood tests cannot definitively diagnose neurosyphilis, they are essential for identifying syphilis infection and determining who needs further evaluation with cerebrospinal fluid (CSF) analysis through lumbar puncture, which provides the definitive diagnosis.
You should get tested if you have been diagnosed with syphilis at any stage and are experiencing neurological symptoms such as severe headaches, vision changes, confusion, personality changes, or difficulty coordinating movements. Testing is also critical if you have untreated syphilis for more than a year, are HIV-positive with syphilis, have high RPR titers that are not decreasing with treatment, or are experiencing unexplained neurological problems with a history of syphilis exposure. Early detection through blood screening can identify those who need CSF analysis to confirm neurosyphilis before permanent nerve damage occurs.
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What this means
Your testosterone levels are slightly below the optimal range. While this is not necessarily cause for concern, it may contribute to occasional fatigue, reduced motivation, or lower muscle mass over time.
Recommended actions
Increase resistance or strength training
Prioritize 7–8 hours of quality sleep per night, try to reduce stress
Include more zinc- and magnesium-rich foods (like shellfish, beef, pumpkin seeds, spinach)
Consider retesting in 3–6 months
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