What Do The Test Results Mean
Because there are three tests that are typically conducted for the Lyme disease blood test, then results can vary based on the combination of test results received. When all three tests are positive, then Lyme disease is likely. These other result combinations are usually interpreted in the following ways.
Positive IgM, Negative IgG, Negative Western Blot.This usually indicates that the Lyme disease infection is in its early stages or that the blood test has produced a false positive result.
Negative IgM, Positive IgG, Positive Western Blot.This is usually interpreted as having a late-stage Lyme disease infection. It may also be an indication that someone had a previous infection that has been removed from the body.
All results negative.This is usually interpreted as there not being any infection present and that the symptoms are being caused by another issue. In some specific instances, however, it can also be seen as the antibody levels being too low to detect.
Once Lyme disease is confirmed, there will almost always be detectable levels of the bacteria which causes the disease in the IgG antibodies in their blood. This will mean that their IgG blood test results will have a standard deviation in what is considered as normal because of the presence of the disease, even if it has been effectively cured.
Interpreting Western Blot Test Results
Lyme Disease Is Remarkably Difficult To Diagnose
The problem with Lyme disease is that the bacteria can create a hard shell around themselves when inactive so that the blood tests are unable to detect them. This is especially true when the disease has reached the chronic stage. The timing of the symptoms is often used by a medical provider to establish a time line to a tick bite or exposure to a high-risk region where the disease is commonly transmitted.
Because the ticks that can spread Lyme disease are often the size of a pinhead, the ticks might not even be notice. A bulls-eye rash at the bite location is a trademark symptom of Lyme disease, but only about half of the people who are infected with the bacteria develop the rash. Once the disease reaches the chronic stage, chronic arthritis, joint pain, and neurological symptoms begin to appear, sometimes several months after the infection.
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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:
If you have never been exposed to B. burgdorferi, you will not have any Lyme disease antibodies in your bloodstream. In this case, your test will be negative.
Selection And Quality Assessment
Our initial search in January 2013 retrieved 8026 unique titles and a search update in February 2014 revealed another 418 titles. After careful selection by two authors independently we read the full text of 489 studies, performed data-extraction on 122 studies and finally included 75 unique published articles . Fifty-seven of these had a case-control design, comparing a group of well-defined cases with a group of healthy controls or controls with diseases that could lead to cross-reactivity of the tests . Eighteen had a cross-sectional design in which a more homogeneous sample of patients underwent both the serological assay and the reference standard . Three studies were not used in the meta-analyses, either because they used immunoblot as a reference standard , or included asymptomatic cross-country runners with high IgG titers as controls .
Results of the search and selection process
Methodological quality graph. Review authorsâ judgements about each methodological quality item presented as percentages across all included studies. On the left-hand side the judgements for the included case control studies and on the right-hand side those for the included cross-sectional studies. RoB: Risk of Bias CrA: Concerns regarding applicability P: patient sampling I: Index test RS: Reference Standard TaF: timing and flow
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Getting Tested For Lyme Disease
Lyme disease testing is usually ordered by a doctor and is used when there are signs or symptoms consistent with Lyme disease.
A blood sample can be drawn in a doctors office or other medical setting. If a test of cerebrospinal fluid is needed, an outpatient procedure called a lumbar puncture can be done in a hospital. Samples are then analyzed in a credentialed laboratory.
Key Points To Remember
- Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
- Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
- Antibodies normally persist in the blood for months or even years after the infection is gone therefore, the test cannot be used to determine cure.
- Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
- Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days.
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Lyme Disease Testing: Why It Continues To Fail To Properly Identify Lyme Disease
Darin Ingels, ND, FAEM
When I was working as a microbiologist in the early 1990s, Lyme testing was still pretty new and we didnt know much about Lyme disease and all of the nuances of testing that would soon follow. Now that it is 25 years later, we have learned a great deal about Lyme disease and the pitfalls of Lyme testing have been revealed. Here is a brief excerpt from my upcoming book on Lyme disease, The Lyme Solution: A 5-part Plan to Fight the Inflammatory Auto-Immune Response and Beat Lyme Disease.
The current recommendation by the CDC for someone who is suspicious of having Lyme disease is to run a two-step process. The first step is to run a Lyme antibody blood test, which measure two types of antibodies against Lyme disease . If this test is positive, then a second test called a Lyme Western Blot should be run to confirm the results of the first test. The Lyme Western Blot looks at a series of specific antibodies against the Lyme organism for both IgG and IgM. If someone has at least 5 out of 10 antibodies for IgG or 2 out of 3 antibodies for IgM, then the Lyme Western Blot is considered positive. The CDC does not recommend doing a Lyme Western Blot IgM test on anyone whose illness occurred within the past month.
Cdc Supports The Development Of New Tests
New tests may be developed as alternatives to one or both steps of the two-step process. Before CDC will recommend new tests, they must be cleared by the Food and Drug Administration . For more details, see: Recommendations for Test Performance and Interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease.
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Lyme Disease Blood Test Results Fully Explained
The Lyme disease blood test is used to discover if someone who has the symptoms of a Borrelia burgdorferi infection actually has the bacteria in their bloodstream. Recent infections are much easier to detect and an IgM and IgG blood test will often be ordered as complimentary information gathering tools. This blood test does not always detect the presence of the disease, so patients that have persistent symptoms after having the test may be re-tested in a few weeks.
If any of these tests come back as positive, then other samples will be used to track the stage of the disease to determine if it has reached the chronic infection stage. At this point, a medical provider will order a Western blot test to confirm the presence of Lyme disease.
When Is The Lyme Disease Blood Test Ordered
When someone has the signs and symptoms of Lyme disease or they live in a region that has deer ticks or black-legged ticks, then this blood test will be ordered. It will also be ordered when these symptoms occur without improvement over the course of 7-14 days by most medical providers.
- A bulls-eye rash that grows from the bite site.
- Fevers, chills, and a persistent headache that does not go away.
- Unusual and persistent fatigue that does not immediately improve.
The IgM and IgG tests are generally ordered first when Lyme disease is suspected. This is because people who have never been exposed to the bacteria that causes the disease will not have any antibodies present. If these tests are positive and followed up by a positive Western Blot test, then the chances are very good that Lyme disease is present. This is especially true if antibody levels continue to rise over time.
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What You Should Know About Lyme Disease
If the symptoms of Lyme disease persist and there is no known cause for them, then consulting with a Lyme literate doctor may provide treatment progress. Many health insurance plans will not cover these consultations or tests, however, so proceed with caution.
For those who are treated with antibiotics, a condition called PTLD occurs that mimics the symptoms of the disease for up to 6 months.
In regions where Lyme disease is not prevalent, it is usually up to the patient to insist on receiving the Lyme disease blood test. Use this guide to speak with your doctor about your concerns and discuss what the results may mean for your health.
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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Lyme Disease Antibody With Reflex To Immunoassay
CPT Code: 86618Order Code: 39733Includes: If Lyme Disease Antibody is Positive or Equivocal , then Lyme Disease Supplemental Antibodies , Immunoassay will be performed at an additional charge : 86617 ).Alternative Name: MTTT-2, Borrelia VlsE1 pepC10, B. burgdorferi Ab, Lyme Early, Borrelia ELISA, B burgdorferi, Lyme Titer, Modified Two Tiered Test, Lyme, Serum, Borrelia burgdorferi, Lyme ELISA, Lyme SerologyABN Requirement: No
Transport: Store serum at 2°C to 8°C after collection and ship the same day per packaging instructions included with the provided shipping box.
Ambient : 4 daysRefrigerated : 7 daysFrozen : 30 days
Causes for Rejection: Specimens other than serum improper labeling samples not stored properly samples older than stability limits gross hemolysis grossly lipemic grossly icteric
Turn Around Time: 3 to 5 days
|Lyme Antibody||0.90 index|
The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
AWARDS AND RECOGNITION
Getting An Initial Screening
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Appendix 3 Possible Ranges In Post
The Tables A to D show the absolute numbers of true positives, false positives, false negatives and true negatives for a hypothetical cohort of 1000 patients.
These numbers should be taken with caution, as the results were overall very heterogeneous. Furthermore, although the prevalence does not influence estimates of sensitivity and specificity extensively in our calculation, this assumption requires further elaboration.
To take into account variation in results and uncertainty, the calculations are made for different scenarios and presented in Tables A to D.
|TABLE A: specificity=95 %, prevalence=10 %||TABLE B: specificity=80 %, prevalence=10 %|
|TABLE C: sensitivity=80 %, prevalence =10 %||TABLE D: sensitivity=80 %, specificity=80 %/95 %|
Table A: varying sensitivities, at a fixed specificity of 95 % and a fixed prevalence of 10 % Table B: varying sensitivities, at a more realistic fixed specificity of 80 % and a fixed prevalence of 10 % Table C: varying specificities, at a fixed sensitivity of 80 % and a fixed prevalence of 10 % Table D: sensitivity of 80 % and a specificity of 80 % and 95 %, at varying prevalence.
How To Read Lyme Test Results
This article was medically reviewed by Sarah Gehrke, RN, MS. Sarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.There are 11 references cited in this article, which can be found at the bottom of the page. This article has been viewed 14,293 times.
If you’ve been bitten by a tick, it’s normal to feel nervous that you might have contracted Lyme disease. There is a two-step process recommended by the CDC to test for Lyme. The process tests your blood for evidence of antibodies your body produces to resist spirochete bacteria, which causes Lyme disease.XResearch source Your health care provider will first review your symptoms. Depending on your condition, you’ll be given an initial screening. The more detailed “Western blot” test will be done if the initial screening indicates a positive result.XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source
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