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.
The Clinical Diagnosis Of Lyme Disease
Misconception: Lyme disease is a clinical diagnosis that should be made based on a list of symptoms.
Science: No clinical features, except erythema migrans or possibly bilateral facial nerve palsyin the appropriate contextprovide sufficient specificity or positive predictive value. Laboratory confirmation is essential except with erythema migrans.
What Do Testing Kits Typically Include
Depending on the method of collection, testing kits may include:
- a device to collect the blood, urine, or saliva sample
- instructions
- a container to ship the sample back to the lab
- a shipping label
Some kits come with a bandage, wipes, and a biohazard bag. Kits may contain extras such as Styrofoam holders, labels, or tubes with varying solutions inside.
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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.
How Much Do At
Generally, at-home Lyme disease tests cost around $100, while others may cost closer to $500. The difference comes down to how many pathogens you are hoping to test for. On average, the test will look for two or three, but more expensive tests may screen for 10 to 15.
Depending on your insurance and which test you select, it may be covered. Another option is to pay for the Lyme disease test with your HSA/FSA, since some companies will accept that as a payment form.
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Pcr For B Burgdorferi
Short for Polymerase Chain Reaction, a PCR tests directly for borrelia DNA in the hosts blood, tissues, or urine. Historically, PCR has had limited accuracy, but improvements in technique are allowing PCR for microbial DNA to be the future of testing. At some point, it may be possible to define a persons entire microbiome.
For now, testing is available for the most common species of borrelia and many common species of coinfections with other stealth microbes. Testing is most accurate during acute infection, and much less accurate during chronic infection.
Again, the bottom line is that if you have many or most symptoms of chronic Lyme disease, then you are likely harboring at least one species of borrelia and several other species of stealth microbes no matter what the testing shows.
Many companies are offering microbial DNA testing, but a few are taking the lead. DNA Connexions tests DNA in either blood or urine specimens for three species of borrelia and several of the most common coinfections. Testing kits are available online.
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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You Do Not Usually Need Tests To Show That You Have Lyme Disease
In most cases, theres a clear sign of Lyme diseasea painless, spreading rash that often grows to look like a bulls eye. If you have this rash, and you recently had a tick bite or were in an area known for Lyme disease, you dont need a test. Instead, your doctor can just start treating you with antibiotics, as appropriate.
What Abnormal Results Mean
A positive ELISA result is abnormal. This means antibodies were seen in your blood sample. But, this does not confirm a diagnosis of Lyme disease. A positive ELISA result must be followed up with a Western blot test. Only a positive Western blot test can confirm the diagnosis of Lyme disease.
For many people, the ELISA test remains positive, even after they have been treated for Lyme disease and no longer have symptoms.
A positive ELISA test may also occur with certain diseases not related to Lyme disease, such as rheumatoid arthritis.
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The Test Isnt Designed To Detect The Exact Disease
A number of Lyme disease lab tests are designed to identify only a few species of the Borrelia bacteria that can cause Lyme disease. In the United States, for example, many tests are only designed to detect Borrelia burgdorferi, leaving out many other species that are less common yet still known to cause the disease in humans, including the recently discovered B. mayonii.
In fact, a recent internal study showed exactly how easily tests could miss infections from species other than B. burgdorferi. IGeneX researchers tested 43 samples all positive on IGeneX Lyme ImmunoBlot tests using the more limited Western blots prepared from the following species of Borrelia:
- burgdorferi B31
- spielmanii
- valensiana
When only a B. burgdorferi B31 Western Blot was performed, only 14 of the 43 Lyme ImmunoBlot-positive samples were Western-Blot-positive. In other words, the B. burgdoferi Western Blot missed 29 of the 43 infections. However, when all eight Western Blots were performed, the remaining twenty-nine samples were detected.
This inability of many lab tests to cast a wide enough net of detection could result in false-negative results for patients infected with different strains of disease-causing Borrelia.
Lyme Testing: Accurate When Used Appropriately
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.
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How Do I Check For Lyme Disease
Lyme disease is most common in Northern America or Northern Europe. People who spend time in wooded or grassy areas and have exposed skin are most at risk of tick bites. If you are bitten and successfully remove the tick within two days, your risk of contracting Lyme disease is low. Still, its always important to err on the side of caution and take a Lyme disease test if you have been exposed to Lyme disease-carrying ticks.
A blood test is used to identify the antibodies of the bacteria in your blood . As it can take your body some time to develop antibodies, these tests are the most reliable a few weeks after initial exposure.
If you would like to test from home, LetsGetCheckeds at-home Lyme Disease Test works by identifying Borrelia antibodies in the blood which can indicate exposure to Lyme disease. It involves a simple finger prick sample and online results will be available within 2-5 days.
The test will arrive in discreet packaging with a return envelope and clear instructions inside. Should you have any questions, our dedicated medical team is available throughout the process to offer a helping hand. If you need further information about the collection process, you can find out more here.
Your Test Was Not Sensitive Enough
Many doctors and labs adhere diligently to the two-step tests for Lyme disease approved by the FDA and recommended by the CDC, which involves an initial enzyme-linked immunosorbent assay followed by a Western blot test. Both tests are designed to detect antibodies in the patients blood to the B. burgdorferi bacteria. According to the CDC, both must be positive for a patient to be diagnosed with Lyme disease.
However, recent studies have raised concerns about the Lyme disease test accuracy, particularly the ELISA, which has been found to have a poor sensitivity rate, or ability to detect antibodies in the blood. Recent studies, in fact, report that the ELISA and Western blot can miss up to 60 percent of well-defined Lyme disease cases.
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How Lyme Antibody Testing Works
Antibody testing for Lyme disease requires two different tests to establish a positive result. If either the first tier test or the second tier test is negative, the test result is negative overall.
But in the event of a negative result, Dr. Adriana Marques of the NIH states:
For patients with signs or symptoms consistent with Lyme disease for less than or equal to 30 days, the provider may treat the patient and follow up with testing of convalescent-phase serum.
The first tier of the two-tiered testing system is an Enzyme Immunoassay .
The second tier of the well-established Standard Two-Tiered Testing involves a Western Blot test, which can be complicated to understand. The Western Blot is also called an immunoblot or a line blot.
The Western Blot test typically reports two types of antibodies that may be indicative of a Lyme infection: IgM and IgG.
According to the CDC, Positive IgM results should be disregarded if the patient has been ill for more than 30 days.
According to a consensus of experts, including representatives of the American Academy of Pediatrics, American Academy of Neurology, American College of Rheumatology, and Infectious Diseases Society of America:
Immunoglobulin G seronegativity in an untreated patient with months to years of symptoms essentially rules out the diagnosis of Lyme disease, barring laboratory error or a rare humoral immunodeficiency state.
Testing For Lyme Disease Years Later
When a person doesnt know that theyve had Lyme for years and begins presenting with symptoms of a chronic Lyme disease infection, they will likely be tested to look for antibodies. This is because antibodies continue to build up within the system while the infection runs rampant.
Image by on How accurate are the results when testing for Lyme disease years later?
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Can A Dog Contract Lyme Disease
Yes. Talk to a Veterinarian about giving the Lyme diseasevaccine to your dog as a preventive measure, there are some whobelieve it may be effective and others who do not. It is notnecessary except in certain areas of the US, so speak to a Vetabout its use.Symptoms of Lyme disease in dogs include: # High fever # Swollenlymph nodes # Lameness # Loss of appetite # Inflamed joints #Lethargy Dogs get Lyme disease from very small deer ticks thatcarry the bacteria that causes Lyme Disease. Preventive tickrepellents and systemic medicines that provide protection againstticks should be used for dogs in areas where these ticks carryingthe bacteria are found such as dogs along the Atlantic coast, thosein New England states, in Oregon and California, and someMidwestern states. Treatment for infected dogs is usuallyantibiotics or antimicrobial agents.
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Diagnosis Of Lyme Disease
The diagnosis of Lyme disease can be made clinically or in conjunction with laboratory test results. When the skin rash is typical and when a patient has been exposed to an environment where blacklegged ticks are known to be established, the diagnosis can be made on clinical grounds alone. In parts of Canada where adventitious, unestablished populations of blacklegged or western blacklegged ticks have been noted, a clinical diagnosis is more challenging. When the rash is atypical or occurs in circumstances in which exposure to the appropriate vector tick species was unlikely, diagnosis is based on the demonstration of a serological response to B burgdorferi. Immunoglobulin M antibodies are usually detectable within weeks of the onset of symptoms however, a significant proportion of patients with EM may not have detectable antibody at the time of initial presentation . Furthermore, when patients are treated very early in the course of illness, antibodies may not develop. When an initial antibody determination is negative, it is suggested that a second serum specimen be collected four weeks later.
Current evidence suggests that commercially available enzyme immunoassays used for the purpose of screening are sufficiently sensitive .
Antigen detection has also been used in both spinal fluid and urine. As with NAT, antigen tests cannot be recommended unless their sensitivity and specificity significantly improve .
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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.
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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British Columbia Specific Information
Ticks are tiny bugs which feed on blood. For information on ticks, removing ticks, and how to avoid being bitten, see HealthLinkBC File #01 Tick Bites and Disease. You may also be interested in the HealthLinkBC File #96 Insect Repellent and DEET.
While most tick bites do not result in diseases, some can. Some of the diseases passed on by ticks include relapsing fever, tularemia, Rocky Mountain Spotted Fever , Q Fever and anaplasmosis. The most well-known is Lyme disease. For more information on Lyme Disease, visit BC Centre for Disease Control – Lyme Disease .
What Happens If You Test Positive For Lyme Disease
Most people who test positive for Lyme disease have a momentof relief. Some have had negative symptoms for a long time but have beenmisdiagnosed or not taken seriously.
The relief doesnt last long, however, because they mustquickly work with their doctor to create a treatment plan, which can includeoral or intravenous antibiotics, diet changes, lifestyle changes and more.
Some benefit most from procedures like apheresis or cleaning the blood. This treatment method is extremely beneficial but should only be done by an expert physician.
Along with apheresis, the doctor can provide additional treatments to aid in your recovery. Treatments can include IV vitamin therapies, pain management, supplements and adrenal and immune enhancement.
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How Do They Test For Lyme Disease
Lyme disease is best tested using two different blood testing methods. These are:
- The Enzyme-linked Immunosorbent Assay test: In a nutshell, this test will look for signs that your body is trying to fight off Lyme disease by producing antibodies. However, the ELISA test may come back negative even when a person is infected by the Borrelia burgdorferi bacteria. False-negatives can occur during the early stages of the disease, where the infected persons body has not produced enough antibodies to fight off the B. burgdorferi bacteria. For this reason, reliable diagnosis is not usually based only on the ELISA test results.
- Western Blot test: Heres a simple way to explain the western blot test without getting into all the nitty-gritty details of what it does and how it does it. Put simply, it separates the blood proteins and detects antibodies to the bacteria causing the Lyme disease. Usually, when an ELISA test comes back positive, a western blot test is performed to confirm the diagnosis.
Ideally, the CDC recommends standard two-tier testing to confirm the veracity of the Lyme disease test accuracy. Together, the ELISA and western blot tests are 99.9% accurate.
What The Experts Say
According to the CDC:
- Patients who have had Lyme disease for longer than 4-6 weeks, especially those with later stages of illness involving the brain or the joints, will almost always test positive.
- A patient who has been ill for months or years and has a negative test almost certainly does not have Lyme disease as the cause of their symptoms.
- Serologic testing is generally not useful or recommended for patients with single EM rashes. For this manifestation, a clinical diagnosis is recommended.
Experts around the world agree with the CDC. A 2018 French review of 16 Lyme diagnostic guidelines from 7 countries revealed a global consensus regarding diagnosis at each stage of the infection. The only outlier was the pseudoscience group German Borreliosis Society , a German counterpart to the pseudoscience group ILADS.
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