My Child Had Lyme Disease Got Treated And Is Now Depressed Could This Be A Sign Of A Relapse
Depression is a word that encompasses physical, cognitive, and emotional components. The physical would be poor sleep, fatigue, low energy, lack of sex drive. The cognitive would include poor concentration and trouble making decisions. The emotional would include feeling guilty, hopeless, suicidal, and being unable to enjoy life in any aspect. Chronic symptoms triggered by Lyme disease are most often associated with insomnia or hypersomnia, fatigue, headaches, pain, and, not uncommonly, problems with cognition as well. In other words, chronic Lyme symptoms are most often associated with the physical and cognitive parts of the depressive picture and less often with the emotionally despairing part. When a person presents with the emotional part that is sustained for at least 2 weeks, it may be that a full syndrome depression has emerged related to the Lyme disease or that it is a concurrent but unrelated illness. The emotional aspects of depression might occur secondarily to being sick with a physical illness or directly from an infection affecting the brain or from chemicals affecting the brain that were released by infection outside of the brain. When a person has Lyme encephalitis , the emotional part of depression can be very dramatic. The person might be suddenly tearful for no apparent reason, have very poor frustration tolerance, become paranoid or angered at the least provocation, and appear to have a personality change.
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What Does A Positive Lyme Igm Mean
The IgM antibodies are the first antibodies to be produced in the body in response to an infection. IgM antibodies are larger than IgG antibodies and when present in high numbers, may indicate a recent or new active infection. In short, a positive IgM may be a sign of a current, or very recent, infection.
Antibodies And Lyme Disease Testing
Remember that IgM antibodies appear early on as a response to an infection, but levels typically decline over time. Because of this, tests that rely on the detection of IgM antibodies, like the Lyme IgM Antibody Serology, may only be positive for two to six weeks after exposure.
Other tests like the Lyme Broad Coverage Ab Assay, Lyme ImmunoBlot, and Lyme Western Blot detect multiple types of antibodies and may able to detect Lyme disease in the case of later re-activation of infection.
Tests that depend on the detection of antibodies, specifically IgM antibodies, are time sensitive, and typically only have a small window which they can be used after exposure to a tick. Luckily there are other tests available for people who are in the late stages or have Chronic Lyme disease. These tests include the Lyme Multiplex PCR, Lyme Western Blot IgM, and the Lyme Dot-Blot Assay .
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Can You Test Negative For Lyme But Still Have It
It can occasionally provide erroneous “positive” findings. However, if you get it done too soon after being sick, your body may not have produced enough antibodies for the test to detect. Even if you have Lyme disease, this will give you a “negative” result. Testing too early is just as important as testing too late.
In fact, some doctors now recommend that everyone who experiences symptoms consistent with Lyme disease be given a blood test before they start treatment just in case it turns out they do have the infection after all. This is especially true for people who live in or travel to areas where the disease is found frequently. The sooner you seek treatment, the better your chances of recovery.
Lyme disease is a complex illness that requires expert care from physicians who know how to diagnose and treat it effectively. If you are struggling with symptoms that could be related to this condition, see your doctor as soon as possible so he or she can conduct an examination and order appropriate tests.
What Is A Lyme Disease Blood Test
A Lyme disease blood test is used to determine if you have contracted Borrelia burgdorferi , the bacterium that causes Lyme disease. Lyme disease tests are conducted with a routine blood draw.
While there are other species of Borrelia that cause Lyme disease, B. burgdorferi is the most common cause in the United States. Most antibody tests in the United States only test for B. burgdorferi, but other species-specific tests are available depending on a persons travel history.
Lyme disease is transmitted to humans through ticks that are infected with Borrelia.
- shortness of breath
Lyme disease can be difficult to diagnose. Ticks are very small, and the bites are not always noticeable. Symptoms of the disease can vary from person to person. Not everyone experiences the classic bulls-eye rash pattern around a tick bite.
It should be noted that testing is not always required to make a diagnosis. For people with a classic bulls-eye rash living in a high risk area, testing is not recommended for diagnosis.
Your doctor will use the results of a Lyme disease antibody test, along with the report of your symptoms, to confirm a diagnosis.
Antibodies are proteins your body makes in response to foreign or harmful substances called antigens. Common antigens include:
Your body produces antibodies if you have contracted B. burgdorferi. These Lyme disease-specific antibodies will be present in your blood, and your test will be positive if you have the bacterial infection.
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Common Antibody Tests And How They Work
ELISA
The Enzyme-Linked Immunosorbent Assay is the first-tier test, or screening test, recommended by the CDCs two-tier testing strategy. This plate-based test works by taking a sample of the patients blood and then placing it in a petri dish containing a specific Lyme antigen. If the patients sample contains Lyme antibodies, they will bind to the antigens in the petri dish. This process is revealed when the lab technician adds an enzyme to the dish and observes the reaction.
The ELISA has been heavily criticized in the Lyme community for its limitations as a screening test. In two-tier testing, screening tests should be as sensitive as possible. If the test isnt sensitive enough, it can fail to detect infections. Since the CDC only recommends performing a Western Blot if the first test was positive, someone who has Lyme that was not detected in their screening test can be left with an infection that will worsen and become much harder to treat.
Finding The Right Lyme Disease Test
Symptoms of Lyme disease can mimic a wide range of illnesses, which can cause tick-borne infections to go misdiagnosed for long periods of time. Laboratory testing is vital for confirming a diagnosis so that people can get the treatment that they need.
However, it can be difficult to find the testing and care you need after potential infection of Lyme disease. Not all Lyme testing is created equal. For example, the CDC-recommended two-tiered testing is notoriously unreliable, as many commercially available tests are not always sensitive enough to detect active infections.
IGeneX tests, on the other hand, provide higher sensitivity testing to detect the bacteria that causes Lyme and other tick-borne diseases. IGeneX test panels contain tests designed to detect IgM or IgG antibodies, meaning they can detect disease at multiple stages.
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Can You See Lyme Disease In The Blood
The primary diagnostic for Lyme disease diagnosis is a blood test for antibodies to the bacterium. If a person develops central nervous system symptoms, such as meningitis, IgM, IgG, and western blot tests on cerebrospinal fluid may be conducted . The antibody tests may not show up until after infection has been cleared. Thus, they are not useful for making a diagnosis at first visit.
You can see Lyme disease in your blood by using a blood smear technique. A lab technician will take a sample of your blood, make an actual slide with this sample, then stain it with special chemicals that reveal bacteria under the microscope. People who have Lyme disease have large numbers of bacteria in their blood. These bacteria cause certain immune cells called phagocytes to swallow them whole and destroy them. This process leaves behind “bull’s-eye” marks where the bacteria once were. A doctor can examine these “Bull’s-Eye” signs under a microscope and confirm the diagnosis of Lyme disease.
People who have recently been infected but have not yet produced antibodies will also have visible bacteria in their blood. In fact, you can usually see many more bacteria per cell under the microscope.
Antibiotics kill off most bacteria, even those that play a necessary role in health. For this reason, doctors do not recommend treating patients with only antibodies against Lyme disease with antibiotics.
What Are Igm And Igg And Why Is The Igm Often Positive In Chronic Lyme Shouldnt That Be The Igg
IgM and IgG antibodies
IgM antibody is generally felt to be the first responder to an infection. In essence when present we usually interpret this as representative of an acute infection. This level usually falls off as the IgG antibody develops for often long term presence/protection. HOWEVER, in the setting of chronic Lyme disease the IgM antibody is found more often than is the IgG. This runs counter to the standard perspective, expecting that IgG should be present in the setting of a chronic infection.
One plausible explanation for this counterintuitive phenomenon is that the organism has the capacity to hide from the immune system and thus our immune system intermittently senses the presence of this organism, which subsequently becomes immune neutral. As a result of this interaction, our immune system is being fooled into perceiving a recurrent new infection and thus responding to this new infection by generating IgM.
Bburgdorferi the organism responsible for Lyme disease, has evolved multiple mechanisms to elude the immune system
- Change in outer protein coat 1
- Relatively immune inert cyst form 2,3
- Immune dysfunction-eg. CD57 4
- Production of chemicals to disable antibodies 5
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How Long Do Lyme Igm Antibodies Last
As mentioned above, IgM antibodies are not long-lasting. They are typically only produced at the beginning of an infection and slowly decrease in the few weeks that follow. They act as short-term protection, jump-starting the bodys defences against Lyme disease. This is why using IgM as a base when testing for Lyme disease will only help if the person has an active infection.
Although both IgM and IgG antibodies are needed to respond to certain infection-driven illnesses, they do so in their own ways that benefit the health of the body in both the short term and long term.
Featured image by Kelly Sikkema on Unsplash
What Are The Roles Of Igm And Igg
The main role of all antibodies is to seek out and mark pathogens to be killed or destroyed, but each antibody has its own division within the body that it needs to focus on. IgG and IgM antibodies are the types the circulate throughout the bloodstream and make their way into organs.
IgM antibodies are on the frontlines in the sense that they are produced first to provide fast but short-lived protection against illness. These types of antibodies are also an important part of immune regulation, as well as immunological tolerance. They can elicit different responses within the body by binding to antigens, setting in motion the attempts at fighting off invaders.
IgG antibodies are the types with memory on their side. IgGs have the ability to recognize certain pathogens. They are retained within the body and can be reproduced quickly if the body is ever invaded by the same pathogen again. They are tasked with the long-term protection of your health.
Image by on IgM antibodies search the body through the bloodstream to hunt down threatening pathogens.
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Independent Studies Show Testing Accuracy In Late Stage
A 2016 systematic review that included 8 studies of CDC-recommended two tier test performance in Late Lyme showed Lyme antibody testing to be 99.4% sensitive and 99.3% specific** in North America.
In other words, out of 100 people with Late Lyme disease, 99-100 of them will test positive. Out of 100 people who may believe they have Late Lyme disease but do not, 99-100 of them will test negative.
Misinformation can convince patients to ignore or misinterpret negative tests to justify a false Chronic Lyme diagnosis.
Is There Anything Else I Need To Know About Lyme Disease Tests
At-home test kits for Lyme disease are available. To do these tests, you usually collect a drop of blood from your finger and send it to a lab for testing. If you want to do an at-home test, it’s important to talk with your provider first. Some at-home tests may use lab methods that aren’t proven to work, so your results may not be accurate.
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Lyme Disease Antibody Test Procedure
The Lyme disease antibody test requires no advance preparation. A lab technician will swab the inside of your elbow with an antiseptic before drawing your blood. Your blood will be drawn from a vein in your arm using a small needle.
The blood draw should not be painful, though you might feel a slight prick when the needle is inserted into your vein.
The blood sample will be collected in a vial. The puncture site will be bandaged, if needed, after the needle is removed. After the blood draw, you are free to go home.
There are very few risks associated with the Lyme disease antibody test. Excessive bleeding is possible, but there may be an increased risk if you take blood thinning medications or certain anti-inflammatory drugs like:
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What Is Immunoglobulin M
Antibodies are large proteins of the immune system that neutralize intruders, such as bacteria, viruses, fungi, and parasites. There are five main types of antibodies: IgA, IgD, IgE, IgG, and IgM.
IgM are the largest antibodies. They are the first-line defense of our immune system. They provide general but short-term protection against new infections. IgM levels decline as the body starts producing more IgG antibodies, which are responsible for long-term protection against pathogens .
Apart from immune IgM antibodies, which are produced in response to infections, we also have natural IgM antibodies that circulate in the blood without exposure to any intruders . These are responsible for removing damaged and pre-cancerous cells, thereby also decreasing inflammation and protecting us from autoimmunity .
Severity Of Lyme Disease
Misconception: B. burgdorferi infection is potentially lethal.
Science: Although Lyme disease can cause heart or brain abnormalities, there have been remarkably fewif anydeaths attributable to this infection.
LymeScience note: After this paper was published, CDC three case studies of deaths associated with Lyme carditis, though two patients had preexisting heart conditions. While its not entirely clear if the infection caused the deaths, CDC still reiterates, Prompt recognition and early, appropriate therapy for Lyme disease is essential.
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At What Stages Of Lyme Disease Are The Igg And Igm Antibodies Elevated
Since IgM antibodies are created quickly after a pathogen enters the body, the numbers of IgM bodies during an active Lyme disease infection would be highest within the first few weeks of infection. During this time, which is referred to as early localized Lyme disease, IgM antibodies will begin to build up and hunt down the bacteria causing the infection. An early localized Lyme disease infection typically lasts anywhere from one to four weeks, with IgM antibodies being highest during the first several weeks before declining.
IgG antibodies begin production as IgM declines. These antibodies can still appear during the early localized state of Lyme disease, rising a few weeks following the onset of the infection. They then decrease, the same way that IgM antibodies do. However, they end up stabilizing during the course of the infection. This can happen during early localized Lyme disease, but the number of IgG antibodies will still be high enough to detect in a Lyme disease test during the second stage of Lyme disease, known as early disseminated infection, which can last up to four months.
Image by on IgM and IgG antibodies are found in the blood however, IgM antibodies can only be found during a certain period of time following an infection.
Coinfection With Other Tick
Ixodes ticks have a broad host range, therefore increasing the chance of acquiring multiple pathogens from reservoir hosts. This suggests that patients with one documented tick-transmitted disease may be at increased risk for infection with other tick-transmitted microorganisms. In Wisconsin, a study of 96 patients with a primary diagnosis of LD demonstrated immunoserologic evidence of coinfection with Babesia microti and/or Ehrlichia phagocytophila in 9.4% . In addition to ehrlichiosis and babesiosis, coinfection with tick-borne encephalitis virus is a possible consideration for LD patients in Europe. Infection with multiple agents could explain, at least in part, the variable manifestations and clinical responses reported in some patients with LD and may have confounded our understanding of the true clinical spectrum of the disease. As a practical consideration, laboratory testing for coinfection should be considered in some clinical situations to ensure that appropriate antimicrobial therapy is prescribed.
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