Diagnostics

So, you think you may have lyme.  Go get a blood test, easy....right?  Not exactly.  Lyme is the most highly politicized and mishandled disease of our time.  Due to inaccurate testing and outdated treatment guidelines, many many people infected with Lyme and other tick borne illness go undetected or under treated .

Lyme mimics over 350 diseases.   Also called "The Great Imitator", Lyme is often misdiagnosed as Fibromyalgia, Chronic Fatigue Syndrome, M.S., ALS, Lupus, Parkinson's Disease and Dementia.  Because it is a multi-systemic disease and has so many symptoms, many people with Lyme are labeled hypochondriacs or are told they are suffering from depression or anxiety.

Most LLMD's (Lyme Literate M.D's) know that The ELISA test is extremely unreliable, yet that is the test the CDC recommends, so your primary care doctor will follow those guidelines.  It is critical to get a proper diagnosis early on.  If you suspect Lyme, get a Western Blot test from a specialty lab.  IGENEX labs in Palo Alto CA is the best know in the Lyme community:

http://www.igenex.com/Website/

What do the bands mean?

Western Blot Bands description 

18 p18 flagellin fragment
20 cross-reactive for Borrellia
21 unknown
22 specific for Bb, probably really the 23/25 band
23-25 outer surface protein C (OspC), specific for Bb 
28 outer surface protein D (OspD); Oms28; specific for Bb 
30 OspA substrate binding protein; common in European and one California strain
31 outer surface protein A (OspA), specific for Bb
34 outer surface protein B (OspB); specific for Bb
35 specific for Bb
37 specific for Bb
38 cross-reactive for Bb
39 is a major protein of Bb flagellin; specific for Bb
41 flagellin protein of all spirochetes; this is usually the first to appear after a Bb infection
45 cross-reactive for all Borellia (sometimes people with Lyme who have this band positive also have the co-infection Ehrlichiosis)
50 cross-reactive for all Borrellia
55 cross-reactive for all Borrellia
57 cross-reactive for all Borrellia
58 unknown but may be a heat-shock Bb protein
60 cross reactive for all Borrellia
66 cross-reactive for all Borrelia, common in all bacteria 
83 specific antigen for the Lyme bacterium, probably a cytoplasmic membrane
93 unknown, probably the same protein in band 83, just migrates differently in some patients 

The bands highlighted in red are very specific for Bb, the bacterium that gives one Lyme Disease.

IGM-acute stage or newly infected
IGG-chronic infection


IGENEX will consider a test "positive" if 2 or more of these bands are present in your Western Blot, either IGG or IGM:
OspC (23-25), 31,34,39,41, and 83-93.

CDC criterion are much more stringent, causing many false negatives.  Sadly, many are told they are negative for Lyme, when they are actually infected, due to outdated and poor diagnostic guidelines, and IDSA, your insurance company and your doctor adhere to CDC criteria.  This is why it is critical to see an LLMD, who knows how to properly read these test results and diagnose you correctly.  If left undiagnosed and untreated, Lyme Disease can be debilitating and can be fatal.