Lyme Testing
Let’s look at the two different ways to test for Lyme disease first:
The two most common diagnostic tests for Lyme are the enzyme-linked immunosorbent assay (ELISA) and the Western blot. Both of these blood tests measure the presence of antibodies that form in your body if you are infected with Borrelia burgdorferi, the bacterium that causes Lyme.
According to the International Lyme and Associated Diseases Society (ILADS), the tests are not always reliable to make a definitive diagnosis of Lyme. Both the ELISA and Western Blot are indirect tests, since they measure an antibody’s response to the infection, not the infection itself. However, it can take weeks to generate enough antibodies to be detected by these tests. As a result, a blood test may give false negative results even if you are infected with Lyme.
ELISA – This is the screening test used when Lyme disease is first suspected. It measures the levels of antibodies against Lyme bacteria. According to the Centers of Disease Control and Prevention, if the test proves negative for the antibodies, no further test is recommended. If the ELISA is positive or unclear, a second test is recommended to confirm the disease. However, the ELISA is falsely negative nearly 50% of the time. Sadly, many people are never tested beyond this point and are told they do not have Lyme disease when in fact they may be infected.
WESTERN BLOT – This test is run as a second-stage to confirm a positive ELISA result. It also tests for antibodies, however it reports reactivity against a panel of 10 different proteins found on the Lyme bacteria. According to the CDC, 5 of the bands must be positive for an overall positive, reportable Western blot test result.
This is generally considered the most reliable test currently available (although it is estimated to be only 80% accurate even at the best labs). Many doctors will not consider using this test unless the ELISA is positive, thus missing an important diagnostic tool.
Some Lyme specialists and scientists believe that there are five very specific bands on the Western blot test that are highly indicative of Lyme disease, band numbers 23, 31, 34, 39 and 93.
If any of these bands are positive and the patient is experiencing symptoms of Lyme disease, they may feel treatment is warranted.
What are the symptoms of Lyme disease?
Lyme disease symptoms are wide-ranging, with more than a hundred different symptoms recorded. Symptoms can also change over time, as the bacteria spreads throughout the body. To make things more confusing, Lyme disease symptoms will also vary from patient-to-patient. Lyme disease can mimic hundreds of other conditions since its symptoms mirror many medical problems such as multiple sclerosis, arthritis, chronic fatigue syndrome or lupus, and is sometimes known as “The Great Imitator” because of this.
Symptoms can play a key role in diagnosing Lyme disease. Due to the lack of an accurate diagnostic test, many patients are diagnosed based on a combination symptoms and diagnostic testing. This makes it extremely important for patients to keep track of all the symptoms they experience, to share with their healthcare provider. Lyme disease symptoms can vary based on stage of the disease (early, late, post-treatment, or chronic) and if other tick-borne infections are present and can change over time.
Symptoms in acute Lyme disease:
Acute Lyme disease (aka: early localized LD) occurs days to weeks after the initial tick bite and infection, in which the bacteria have not yet spread from the site of infection in the skin.
The most common symptoms in acute (aka: early localized) Lyme disease are the ones people are most familiar with. Because they are symptoms often shared with other illnesses, however, it’s important to recognize that they could mean Lyme and you should see a Lyme-treating physician right away.
- Erythema migrans rash or EM rash. This rash begins at the site of the tick bite about a week after the bite, and gradually expands.
Note: The center of the rash may clear, giving the rash the appearance of a “bulls-eye.” Rashes may take on many different shapes and not all rashes will have a bulls-eye appearance. There can be multiple rashes on the body. While a rash is characteristic of Lyme disease, many people will not develop a rash at all.
- Fever
- Fatigue
- Aches
- Chills
- Swollen lymph nodes
- Other flu-like symptoms
Symptoms in early disseminated Lyme disease:
Early disseminated Lyme disease occurs days to months after infection, in which the bacteria have begun to spread. There is a wide range of possible symptoms at this stage, including:
- Severe headaches and neck stiffness
- Arthritis, especially in the knees or other large joints
- Muscle aches and pains
- Heart palpitations or shortness of breath (Lyme carditis)
- Facial paralysis on one or both sides (also known as Bell’s palsy)
- Numbness or tingling in the hands or feet
- Extreme fatigue
Symptoms in late stage Lyme disease:
Late stage Lyme disease, which can include post-treatment, chronic, and neurological, occurs months to years after infection, in which the bacteria have spread throughout the body.
The symptoms of late disseminated disease are similar to those of early disseminated disease, but may be more extensive, more severe, and longer lasting. Late symptoms may also include:
- neurologic features including vertigo or dizziness,
- difficulty sleeping
- mental fogginess
- difficulty following conversations
- difficulty processing information
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Biomarkers included in this panel:
Two types of antibodies are detected in the Western blot test. This particular marker is called 18 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a r
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 23 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a r
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 23 KD (IGM) and hence is a IgM antibody marker. IgM antibodies reflect a relatively recent infection. IgG antibodies in contrast are a sign o
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 28 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a r
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 30 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a r
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 39 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a r
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 39 KD (IGM) and hence is a IgM antibody marker. IgM antibodies reflect a relatively recent infection. IgG antibodies in contrast are a sign o
Learn moreThe 41 KD band is often found on the Western blot. A recent study looked at the banding patterns of patients with chronic Lyme disease and healthy controls from the inner city of New York who have never had Lyme disease. They found that a l
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 41 KD (IGM) and hence is a IgM antibody marker. IgM antibodies reflect a relatively recent infection. IgG antibodies in contrast are a sign o
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 45 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a r
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 58 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a r
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 66 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a r
Learn moreTwo types of antibodies are detected in the Western blot test. This particular marker is called 93 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a r
Learn moreBorrelia burgdorferi is spirochete class bacterium. B. burgdorferi sensu stricto, B. burgdorferi sensu lato, B. burgdorferi afzelii and B. burgdorferi garinii spirochetes enter the human body through tick bites. Mixed with tick saliva, Borrelia tr
Learn moreThe CD57 test is offered in some clinical laboratories and is being used by some health practitioners to evaluate and follow patients diagnosed with chronic Lyme disease.
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Learn moreEBV-VCA, IgG is an antibody (protein) that is produced by the body in an immune response to an Epstein-Barr virus antigen.
Learn moreTwo types of antibodies are detected in the Western blot test. IgG antibodies are a sign of an older infection. IgM antibodies in contrast reflect a relatively recent infection.
Learn moreTwo types of antibodies are detected in the Western blot test. IgM antibodies reflect a relatively recent infection. IgG antibodies in contrast are a sign of an older infection.
Learn moreThe two most common diagnostic tests for Lyme are the enzyme-linked immunosorbent assay (ELISA) and the Western blot. Both of these blood tests measure the presence of antibodies that form in your body if you are infected with Borrelia burgdorferi, t
Learn more