Lyme Testing

This is very difficult to understand. I apologize for that. I still don't understand it all. Try to get through it and read down to the bottom of the post. This is very important and sort of explains the complexities of Lyme Tests. Testing for Lyme Disease is very controversial because of the inaccuracies of the test results.

First, the most common testing that Primary Care Physicians order to test for Lyme Disease is called the ELISA which stands for Enzyme-Linked Immunosorbant Serum Assay. The office will draw a blood sample. Then the blood is tested for antibodies that our bodies produce in response to being introduced to the Borrelia burgdorferi (Bb) (aka the Lyme Bacteria). In one study that I found, they tested 516 labs. In those 516 labs, 55 percent of the results were inaccurate. How would you feel if pregnancy tests were only 45 percent accurate? Those aren't exactly a reliable results.

How do they run the ELISA test? Well, they take different parts of the Lyme bacteria and break it down into segments and then add the patient's blood. Any antibodies that are in the blood will bind to the different segments of the Lyme bacteria. The segments will change color and it will be diluted until there is no color. At this point, they will give a dilution ratio. One Part Serum to how many parts of water they had to use to make it have no color. 1:256 (would be 1 part serum to 256 parts water). When you receive your results, it will give one of three options. Your results will be either positive, negative or indeterminate. Indeterminate means that your blood hadto be diluted too much to be called a negative, but not enough to be called a positive.

For more information on the ELISA test and other tests:

Lyme Literate Medical Doctors (LLMD) generally order a second kind of Lyme test called the Western Blot. There are several labs that can run the Western Blot, but a true LLMD typically uses IgeneX from California. The controversy in this is that IgeneX test uses more "bands" than a regular lab would use. When you receive your test results from IgeneX, you will receive two kinds of results. One is called the IgG and the other is called IgM.

You will note a bunch of different "numbers" with kDa next to it. Some of the numbers will even show a double star (**) next to it and kDa stands for Kilo Daltons.

When the labs are determining your test results, they see something like that this:
Photo Courtesy of IgeneX



As you can see, some areas (called bands) are dark and some are very light and others aren't there. Some of the bands are Lyme specific and others aren't. Out of a possible 25 bands, only 10 are reportable. So 15 bands are automatically thrown out. Out of the 10 bands that are reportable, 5 must be positive on the IgG to be considered positive in the CDC (Centers for Disease Control).

For the IgM to be considered positive, 2 out of 3 specific bands must be positive. It wouldn't matter if 8 of the 10 bands were positive, if two of those bands weren't specifically 23, 39, 41 then the CDC would say you had a negative Western Blot test. 23, 39, 41. Obviously, this is highly controversial in the medical community.

For the IgeneX IgM results, you would have to have 2 of the double star numbers with a plus in order to be positive. For the CDC results to be positive, you'd have to have 2 of the BOLDED NUMBERS to be positive. Your actual results would be not bolded, I'm just bolding them here for you to see.

The test results you see from IgeneX may look like this:

IGENEX IGM RESULT: POSITIVE
CDC/NYS RESULT: POSITIVE

18kDa: ++
22kDa: -
**23-25 kDa: +
28kDa: -
30 kDa: +
** 31kDa: -
** 34kDa:-
** 39 kDa: IND
** 41 kDa: +
45kDa:-
58kDa:-
66kDa:-
73kDa:-
** 83-93 kDa: IND


When looking at the IgG results, it's even more controversial. For the Igenex test results to be positive, two or more ** (there are six of them) numbers have to be positive. For the CDC test results to be positive, FIVE of the bolded numbers (there are ten of them) have to be positive.
In the following sample, if one of the IND had been + instead, the results would have been IgeneX IgG Positive and CDC IgG negative.

IGENEX IGG RESULTS: NEGATIVE
CDC/NYS RESULTS: NEGATIVE


18kDa: -
22kDa: -
**23-25 kDa: -
28kDa: -
30 kDa: -
** 31kDa: IND
** 34kDa:-
** 39 kDa: IND
** 41 kDa: ++
45kDa:-
58kDa:-
66kDa:-
73kDa:-
** 83-93 kDa: -

I hope this helps clear up questions regarding Western Blots & ELISA's.