The Elisa And Western Blot Are Not Sensitive Enough
Another major limiting factor of the traditional ELISA and Western blot is the quality. These tests tend to use lysed BB cultures, and therefore, depending on the culture conditions, some antigens are over-expressed, and some are under-expressed. This, in turn, can affect the ability to detect antibodies from patients blood.
Whats more, if a patient tests too early after a tick bite, his or her body may not have produced enough antibodies to show up on a test with suboptimal sensitivity.
Are Lyme Disease Tests Accurate
Yes and no.
The key to an accurate Lyme disease test and any other serological test is timing. To get accurate results, the body must have time to develop antibodies.
It might seem as if this would be easy. A tick bites someone, shortly after they develop symptoms, doctors administer a test, and they know if they have Lyme disease. But it isnt that simple.
Sometimes the body hasnt produced antibodies even if symptoms are present. Sometimes patients dont even develop typical Lyme disease symptoms, so its difficult to know when or if to administer the test. If a patient does not develop migraines, testing wont be able to confirm an infection for at least four weeks after becoming ill. The delay of diagnosis means there will likely be an increased chance of persistent symptoms.
Another issue that arises with Lyme disease testing is its inability to confirm a cure. Even after someone heals, antibodies persist and youll get a positive test result. This is a possibility for months or years after treatment. This can result in two issues:
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Her ordeal is a common one every year, some 300,000 people in the United States are diagnosed with Lyme disease, according to the Centers for Disease Control and Prevention, and that number is on the rise. Some people wait months or years to get a correct Lyme diagnosis. And their cases highlight a problem: Tests for Lyme in the first month of infection are frequently wrong. When diagnosed and treated early the infection is a simple one to get rid of, but left untreated it can cause a myriad of lingering symptoms, from severe arthritis to short-term memory problems.
Now, a number of research groups are working to improve Lyme tests to catch infections in the early stages. One avenue being studied by the CDC aims to create a Lyme signature of small molecules in the blood an approach that, in early testing, catches a dramatically higher share of early infections.
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Investigation Of Suspected Neurological Lyme Disease
The diagnosis of neurological Lyme disease can only be confirmed by examination of the CSF and a paired serum. A definite diagnosis is based on the presence of a pleocytosis in the CSF, demonstration of intrathecal synthesis of specific antibodies to Borrelia species in CSF by comparison to serum and the presence of neurological symptoms. It is not possible to confirm intrathecal synthesis and hence definite neurological Lyme disease without a paired serum .
In 2018 RIPL is introducing a service for the detection of intrathecal synthesis of Borrelia-specific antibodies which is summarised in this flow diagram.
Clinicians may ask for guidance on laboratory testing of CSF from RIPL if required.
Everlywell Lyme Disease Test
Everlywells Lyme Disease Test checks for a persons exposure to any of the three strains of Borrelia bacteria. The test is suitable for those experiencing fatigue, headaches, or joint pain. The test offers a fingerprick sample collection.
Once people receive their kits, they can register them online, collect their sample, and return it to the labs using the prepaid shipping labels. They can access their results through their online dashboards.
The kit costs $109.
There are some advantages that Everlywell services offer:
- It works with CLIA-certified labs.
- Independent board-certified physicians review and approve peoples tests.
- It offers free shipping.
QuestDirects Lyme Disease Test is available in person. People purchase their test and book an appointment with a nearby Quest Patient Service Center, where a medical professional collects the sample.
They then receive their results through their MyQuest accounts.
The cost for the test is $89, with an additional $6 fee that covers the physicians visit.
Pros and cons
QuestDirect has some advantages. Firstly, the MyQuest portal allows individuals to view their results online. Additionally, the companys health team can contact the customer if their results require prompt attention.
However, disadvantages include the fact that there is an additional physician fee. The service is also unable to provide a receipt for health plan reimbursement.
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Testing And Diagnosing For Lyme Disease
The most common testing used for diagnosing Lyme disease is the two-tiered CDC recommended tests. These include the ELISA and the Western Blot. Both are indirect tests in that they merely measure the immune systems response to an infectious agent instead of looking for evidence or components of the agent itself. Many physicians falsely yield to the CDC definition case of Lyme disease to make a diagnosis. However, these tests were originally designed for surveillance of one single species of Borrelia. The tests were never intended to be used in making clinical diagnosis. These standard Lyme tests can give false negatives between 50% and 80% of the time, depending on which study you are looking at. Even on the CDC website, they state, Lyme disease is diagnosed based on symptoms, physical findings and the possibility of exposure to ticks. Yet, despite this information, doctors are still relying on laboratory tests to definitively determine whether a patient has the disease or not. This current method of diagnosing has serious and sometimes deadly consequences for patients who indeed have Lyme disease and/or co-infections, but do not receive treatment due to a negative lab result.
There are several private labs that offer Lyme disease and other vector borne testing.
We are not medical professionals and cannot recommend any specific testing. Please consult your doctor to find the right test for you and your family.
How Is Lyme Disease Diagnosed
Though several types of tests do exist for the diagnosis of Lyme disease, the best tests for a Lyme disease diagnosis are blood tests, also known as serological tests. These tests are indirect, meaning they dont detect the infecting bacteria or its antigens but rather the antibodies an infected persons body produces in response to these antigens.
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Common Types Of Testing For Microbes
Testing is getting better, and there are a variety of different ways to test, but none of them are anywhere near 100% accurate. Testing is mostly useful for diagnosing acute illness. This is especially true when symptoms of illness suggest infection with a higher virulence microbe that might respond to acute treatment with antibiotics. New innovations may gradually improve testing for chronic illness associated with stealth microbes.
Pcr Antigen Detection And Culture Testing
Other types of tests for Lyme disease include PCR , antigen detection, and culture testing. These tests look for the bacteria as opposed to the antigens created by your body in response to the bacteria.
A PCR test uses a portion of DNA from the borrelia bacteria to help with detection. Antigen testing looks for a specific protein of the Lyme bacteria to help diagnose Lyme disease and can identify infection in people who have had negative results using the ELISA and Western blot tests.
The final option is culture testing, which is highly regarded as the gold standard for diagnosis. Blood is taken from a person suspected of having Lyme disease, and the lab attempts to grow Lyme bacteria using the blood culture. This test is new, however, and the CDC has exercised caution against using it since there is only one commercially available culture test for Lyme disease.
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The Role Of Lyme Disease Tests
The purpose of the most common type of Lyme disease testing is to determine whether you have developed antibodies as a result of past exposure to the Borrelia bacteria that cause Lyme disease. Antibodies are proteins created by the immune system that target specific threats like bacteria and viruses.
Blood testing alone cannot determine whether you have Lyme disease. Instead, testing can provide helpful information that your doctor can consider along with other factors, such as any symptoms youve had and whether youve been exposed to ticks that can carry Borrelia, to determine if a diagnosis of Lyme disease is appropriate.
Beyond blood testing, it is possible to analyze fluid from the central nervous system for signs of the Borrelia bacteria.
So When Do You Need Blood Tests For Lyme Disease
In some cases, you can have Lyme disease without the rash. Or you may not see the rash before it goes away on its own.
In these cases, your doctor should ask you about your medical history and do a thorough physical exam. Your doctor should look for these signs that you might have Lyme disease:
- You were in an area with ticks and Lyme disease.
- You also have fever or redness, warmth, and swelling in one or a few joints at a time usually the knees, shoulders, or wrists.
Other symptoms can occur later on. Talk to your doctor about testing and treatment choices.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
04/2013
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An Introduction To Lab Testing
Lyme disease tests can serve as valuable resources for the diagnosis and treatment of tick-borne disease. But its important not to get too hung up on the results.
The problem of chronic Lyme disease, cant be solved exclusively by looking at lab results, which is something I know from personal experience. In fact, becoming overly obsessed with lab results can hinder the recovery process.
Lab work provides a snapshot of whats going on inside your body. But multiple other factors including your symptoms, the length of time youve had them, and clinical presentation, as well as the environments in which you live, work, and travel all factor into making an accurate diagnosis.
Furthermore, the human body is an immensely complex biological machine, with millions of different biochemical functions happening simultaneously. Lab tests provide an ever-so-small glimpse at certain key functions of different systems in the body. From those indicators, determinations can be made about how well the body is functioning and whether illness is present.
Laboratory assessment, however, is far from absolute. Because the human body is so complex, the ability of lab testing to predict a specific chronic illness, such as one from a tick-borne disease, is often limited. All labs are subject to variability and different interpretations.
Completion Of Lyme Disease Test Request Form
Diagnostic samples must be submitted with a completed RIPLLyme disease test request form . Please use a single request form for each patient even when sending several samples.
Please provide details of the sample type, patients symptoms and onset date, tick bite or exposure history and, if relevant, travel and treatment history. Symptom onset date is particularly important for interpretation of laboratory results.
When sending CSF, please provide the cell count and total albumin, IgG and IgM levels for the CSF and serum pair, if available.
Ideally the clinician who sees the patient should print out and complete the appropriate request form . Send the request to the local laboratory with the clinical sample along with a local laboratory request form, whether this is paper or electronic.
The local laboratory should complete the senders information on the request form and then forward the completed form and sample to RIPL. Before sending samples, clinicians are advised to liaise with their local laboratory because local arrangements may vary.
If only immunoblot confirmation is required because the local laboratory has already obtained a positive Lyme screening test result on the serum sample being submitted, tick the Line blot confirmation only box and write the positive screening test result below.
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The Best Test For Lyme Disease
Lyme disease is a tick-borne illness spread by Lyme borreliaebacteria which includes, but is not limited to, Borrelia burgdorferi sensu stricto. The Centers for Disease Control and Prevention estimate that there are 400,000 cases of Lyme disease annually, making Lyme a serious public health concern that only stands to grow as the spread of ticks affects disease endemicity and seasonality.
One of the biggest challenges of fighting Lyme disease is providing patients with accurate diagnostic tests. Without access to the best tests for Lyme disease, its impossible to diagnose this treatable disease in a timely manner. When the disease isnt caught in time, it can spread throughout the body and cause chronic health problems that could otherwise be avoided with earlier detection and treatment.
The Blood Tests Can Have False Positives
The blood tests can trigger false positives, suggesting that you have the disease when you really dont. This can happen in up to one out of four tests.
This can lead to unnecessary treatment with antibiotics. These drugs are usually safe, but they sometimes cause side effects, such as nausea, vomiting, diarrhea, and increased sensitivity of the skin to sunlight. In rare cases, they can even cause dangerous allergic reactions.
Using too many antibiotics can also lead to the growth of drug-resistant bacteria. This means that bacteria in your body may get stronger and more difficult to treat with antibiotics in the future.
A false positive can also lead to more unneeded blood tests, urine tests, X-rays, and doctor visits.
If you have a false positive, you may not get treated for the real cause of your pain. For example, rheumatoid arthritis is a disease that causes joint pain. It can lead to permanent and severe joint damage if you do not start taking the right medicines as early as possible.
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Is There A Blood Test For Lyme Disease
If your doctor suspects that you have Lyme disease, they may order two blood tests. These will look for signs that your body is trying to fight it off. The results are most precise a few weeks after youâve been infected.
These tests are:
ELISA test. This test canât check for the bacteria that causes Lyme disease. It can only look for your immune systemâs response to it.
Once Borrelia burgdorferi gets into your blood, your body begins to make special proteins called antibodies to fight it off. The ELISA test checks for those antibodies.
Although itâs the most common way to check for Lyme disease, the ELISA test isnât perfect. It can sometimes give false âpositiveâ results. On the other hand, if you have it done too soon after youâve been infected, your body may not have developed enough antibodies for the test to detect them. This will give you a ânegativeâ result even though you do have Lyme disease.
Western blot test. Whether your ELISA test comes back positive or negative, your doctor will need to do this blood test, too.
A Western blot uses electricity to split certain proteins in your blood into patterns. This is then compared to the pattern of people known to have Lyme disease.
At least five band matches means that you have Lyme disease. Still, not all labs have the same standards. Thereâs a chance that you could get a âpositiveâ result from one and a ânegativeâ result from another.
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Is Lyme Disease Curable
While there is no vaccine to prevent us from getting Lyme disease, it can be treated with antibiotics, and most people recover within a few weeks. However, some people can get what is known as Post-Treatment Lyme Disease Syndrome, in which symptoms such as pain, fatigue, or difficulty thinking can last for months.
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Lyme Disease Testing: How It Works
Two common lab tests for Lyme disease are the enzyme immunoassay test and the Western blot test. These tests measure the antibodies that form when someone is infected with Borrelia burgdorferi .
Enzyme immunoassay test
The EIA test is whatâs typically used to screen for Lyme disease by detecting antibodies for B. burgdorferi.
According to the Centers for Disease Control and Prevention, if the EIA test shows negative for the antibodies, no further testing is needed. However, if this screening test comes back with results that are positive or unclear, a second round of testingâusing the Western blot methodâis recommended. This second test is referred to as a confirmatory test.
Western blot test
When the EIA test is positive, the Western blot test is usually done next. This two-step approach to Lyme disease testing helps reduce the number of false positives. The Western blot test detects antibodies for several proteins belonging to Lyme bacteria.
Where Is Lyme Disease Found
In the United States, Lyme disease has been reported in every state, but over 95% of cases are from the Northeastern, Mid-Atlantic, and upper Midwestern states, with a small number of cases reported along the West Coast, especially Northern California. In Canada, Lyme-positive dogs are found mostly in southern Ontario and southern Manitoba, with a small number of cases in southern Quebec and the Maritime provinces.
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