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

18 KD (IGG) Band

Optimal range: 0 - 0.001 Units

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 relatively recent infection. 

IgM antibodies usually disappear after eight weeks post-exposure. 
IgG remains in the serum for a very long time. 

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23 KD (IGG) Band

Optimal range: 0 - 0.001 Units

Two 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 relatively recent infection. 

IgM antibodies usually disappear after eight weeks post-exposure. 
IgG remains in the serum for a very long time. 

LEARN MORE

23 KD (IGM) Band

Optimal range: 0 - 0.001 Units

Two 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 of an older infection.

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28 KD (IGG) Band

Optimal range: 0 - 0.001 Units

Two 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 relatively recent infection. 

IgM antibodies usually disappear after eight weeks post-exposure. 
IgG remains in the serum for a very long time. 

LEARN MORE

30 KD (IGG) Band

Optimal range: 0 - 0.001 Units

Two 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 relatively recent infection. 

IgM antibodies usually disappear after eight weeks post-exposure. 
IgG remains in the serum for a very long time. 

LEARN MORE

39 KD (IGG) Band

Optimal range: 0 - 0.001 Units

Two 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 relatively recent infection. 

IgM antibodies usually disappear after eight weeks post-exposure. 
IgG remains in the serum for a very long time. 

LEARN MORE

39 KD (IGM) Band

Optimal range: 0 - 0.001 Units

Two 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 of an older infection.

LEARN MORE

41 KD (IGG) Band

Optimal range: 0 - 0.001 Units

The 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 large percentage of the healthy controls tested positive on the 41kd band.

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41 KD (IGM) Band

Optimal range: 0 - 0.001 Units

Two 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 of an older infection.

LEARN MORE

45 KD (IGG) Band

Optimal range: 0 - 0.001 Units

Two 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 relatively recent infection. 

IgM antibodies usually disappear after eight weeks post-exposure. 
IgG remains in the serum for a very long time. 

LEARN MORE

58 KD (IGG) Band

Optimal range: 0 - 0.001 Units

Two 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 relatively recent infection. 

IgM antibodies usually disappear after eight weeks post-exposure. 
IgG remains in the serum for a very long time. 

LEARN MORE

66 KD (IGG) Band

Optimal range: 0 - 0.001 Units

Two 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 relatively recent infection. 

IgM antibodies usually disappear after eight weeks post-exposure. 
IgG remains in the serum for a very long time. 

LEARN MORE

93 KD (IGG) Band

Optimal range: 0 - 0.001 Units

Two 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 relatively recent infection. 

IgM antibodies usually disappear after eight weeks post-exposure. 
IgG remains in the serum for a very long time. 

LEARN MORE

Bartonella Henselae Ab, Igg

Optimal range: 0 - 0.003125 Units

Bartonella Henselae Ab, Igm

Optimal range: 0 - 0.01 Units

Bartonella Quintana Ab, IgG

Optimal range: 0 - 0.003125 Units

Bartonella Quintana Ab, IgM

Optimal range: 0 - 0.01 Units

C6 Qual Result

Optimal range: 0 - 0.001 Units

CD8-CD57 + Lymphs (Percent)

Optimal range: 2 - 17 %

The 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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CMV-IgG Antibody

Optimal range: 0 - 0.001 Units

Cytomegalovirus is a common virus that usually causes no or only mild symptoms. Cytomegalovirus testing detects antibodies in the blood that the body produces in response to the infection or detects CMV directly.

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EBV-VCA, IgG

Optimal range: 0 - 0.001 Units

EBV-VCA, IgG is an antibody (protein) that is produced by the body in an immune response to an Epstein-Barr virus antigen.

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Lyme Disease AB (IGG), Blot

Optimal range: 0 - 0.001 index

Two 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.

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Lyme Disease AB (IGM), Blot

Optimal range: 0 - 0.001 index

Two 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 MORE

Lyme Disease Ab, Quant, IgM

Optimal range: 0 - 0.8 index

Lyme Disease Screen

Optimal range: 0 - 0.9 index

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. This marker is part of the ELISA assay.

LEARN MORE

Lyme IgG/IgM Ab

Optimal range: 0 - 0.91 ISR

Lyme Index (C6 ELISA)

Optimal range: 0 - 0.91 index

Lyme WB IgM

Optimal range: 0 - 0.001 Units