How is Lyme Disease diagnosed?

See how Lyme Disease is diagnosed. Which specialists are essential to meet, what tests are needed and other useful information for the diagnosis of Lyme Disease

Lyme Disease Diagnosis

Lyme disease is a tick-borne illness caused by the bacterium Borrelia burgdorferi. It can lead to a wide range of symptoms, including fever, fatigue, headache, muscle and joint aches, and swollen lymph nodes. If left untreated, it can progress to more severe complications affecting the heart, nervous system, and joints. Early diagnosis is crucial for effective treatment and prevention of long-term complications.

Clinical Evaluation:

Diagnosing Lyme disease begins with a thorough clinical evaluation. The healthcare provider will review the patient's medical history, including recent exposure to tick-infested areas and any symptoms experienced. They will also perform a physical examination to check for characteristic signs such as a rash, specifically the erythema migrans (EM) rash.

Testing for Lyme Disease:

If Lyme disease is suspected based on the clinical evaluation, laboratory testing is typically recommended to confirm the diagnosis. The two primary types of tests used are:

Enzyme Immunoassay (EIA) or Immunofluorescence Assay (IFA): These tests detect the presence of antibodies produced by the immune system in response to the Borrelia burgdorferi bacteria. A blood sample is taken, and the antibodies are measured. However, these tests have limitations, especially in the early stages of the disease, as it takes time for the body to produce detectable levels of antibodies.

Western Blot Test: If the EIA or IFA test is positive or equivocal, a Western blot test is performed to confirm the diagnosis. This test detects specific antibodies against various proteins of the Borrelia burgdorferi bacteria. It provides more detailed information and helps differentiate between recent and past infections.

Interpreting Test Results:

Interpreting the results of Lyme disease tests can be complex. False negatives can occur, especially in the early stages of the infection when antibody levels may be low. Additionally, false positives can happen due to cross-reactivity with antibodies from other infections. Therefore, test results should always be considered in conjunction with the patient's clinical presentation and exposure history.

Other Diagnostic Methods:

In certain cases, additional diagnostic methods may be used to support the diagnosis of Lyme disease:

PCR (Polymerase Chain Reaction): This molecular technique detects the genetic material of the Borrelia burgdorferi bacteria in blood, joint fluid, or tissue samples. PCR is particularly useful in the early stages of the disease when antibody levels may still be low.

Lymphocyte Transformation Test (LTT): LTT measures the patient's immune response to Borrelia burgdorferi by analyzing the activation of lymphocytes. It can be helpful in cases where antibody tests yield inconclusive results.

Imaging Studies: In some instances, imaging studies such as MRI or ultrasound may be performed to evaluate specific complications associated with Lyme disease, such as neurological or joint abnormalities.

Consultation:

In complex or challenging cases, healthcare providers may seek consultation from infectious disease specialists or other experts experienced in diagnosing and managing Lyme disease. Their expertise can help ensure accurate diagnosis and appropriate treatment.

Conclusion:

Diagnosing Lyme disease involves a combination of clinical evaluation, laboratory testing, and sometimes additional diagnostic methods. It is important to consider the limitations of each test and interpret the results in the context of the patient's symptoms, exposure history, and other clinical findings. Early diagnosis and prompt treatment are essential for preventing complications and promoting a successful recovery.

Diseasemaps

There are blood tests, but there are many false negatives, so often people should be retested if the clinition thinks it's a false negative

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ILADS physicians are key to proper diagnosis and to order spacific tests that can confirm thier clinical diagnosis. I would highly suggest to NOT go to an IDSA physician at this time in history because they write the treatment guidelines and believe in very limited and closed minded views about the severity of Lyme and associated tick born diseases. Also, the standard blood test that IDSA recommends is highly inaccurate and flawed as to give false negative results to people who are very ill because this is an illness that suppresses the immune system so can go undetected by the normal means of testing.

Posted Feb 26, 2017 by Suzy 850

I got my blood test done privately, as the NHS are rubbish at diagnosis of Lyme

Posted May 9, 2017 by Lynn 1000

Since it is known that there is no test out there available that tells you you Don't have Lyme disease then diagnostics is really the only way to know. I had the bulls eye rash which is hitting the Lyme lottery since that is a positive for Lyme. Yet, conventional testing has never been positive.

Igenex would be my choice to send someone for testing but still not accurate many times.

Lyme needs to come out of the closet. The CDC needs to acknowledge that it is a Pandemic. That it is everwhere, even in our blood supply. That it is sexually transmitted and that you can contract it not only from many types of ticks but from misquitos, biting flies, fleas, sand fleas....Doctors need to be properly educated and not say that there is no chronic Lyme. The whole system is in shambles. Lyme literate doctors that cost thousands to just to see you once, then putting you on years of antibiotics costing more thousands of dollars. Only to have you relapse years down the line. There is no cure for Lyme so research dollars need to be given so we can find a way to fight this along with other dangerous tick borne illnesses.

Posted May 11, 2017 by Susan 1270

Lyme literate Doctor should be able to diagnose with symptoms. For tests the Elisa is unreliable. Igenex or Armin labs in Germany are better labs.

Posted May 12, 2017 by Lorraine 1001

A red circle (EM) is 100% contamination, then no test is required. A diagnosis through complaints is a priority because blood tests are not reliable. If someone has a positive antibody test, that one has Lyme. But if the test is negative, it says nothing. Many Lyme patients are tested by means of the LTT test. This is so far the most reliable test. Other patients choose an alternative test as bioresonance or a combination of.

Posted Jul 19, 2017 by A 800

Lyme disease is based on subjective data. It is a clinical diagnosis. If the symptoms fit, then it is rightly diagnosed. The blood tests are more than 40 years old and are notorious for false-negative results. It is a two-tiered testing system including the ELISA with reflex to Western blot. The ELISA has to be positive in order for them to reflexively run a Western blot. More often than not, the ELISA is falsely negative.

Posted Aug 16, 2017 by Deanna 2150

Only a Lyme literate doctor will run the full panel of tests needed to truly find out what's going on. Diagnosing the co-infections is crucial to the proper treatment.

Posted Aug 29, 2017 by missy 2050

There are two maintests that are commonly used, the ELISA and the Western Blot. Both are notoriously unreliable but the Western Blot is better than the ELISA. Other, more reliable tests are available from specialised labs and there are other markers than can be used to indicate likelihood of a borrelia infection. Coinfections also need to be tested for.

Posted Aug 30, 2017 by Alex 600

A clinical diagnosis (based on symptoms and observation) is the best and most reliable method. The is NO lab test or blood work that can be depended on for definitive, conclusive results false-negatives are very common. Finding a "Lyme-literate" practitioner is ideal.

Posted Aug 30, 2017 by S. Guthrie 2000

I did not get a diagnosis until I went to a Lyme Literate Dr. And had The Igenix test.

Posted Aug 31, 2017 by Susan 800

Blood test (NOT Elisa & western blot - very high false negatives), symptom assessment

Communicable disease specialists should be able to help and treat, however the reality is that Lyme literate doctors are difficult to find.

Posted Sep 12, 2017 by Sheri 1100

Mostly by a bullseye some where on the body and it seems females are more prone to Lyme than males

Posted Sep 28, 2017 by Darren 400

through a llnd trained by ilads .

Posted Sep 29, 2017 by Sarah 2550

Proper testing through a Doctor who has a real understanding of immune system also someone who knows what to look for Lyme is primarily diagnosed by objective observation and complete history of patient.Testing can be un reliable even though Igrnetics and some other test are now more specific.

Posted Sep 29, 2017 by Katrina 2000

Clinically and through supporting labs

Posted Oct 1, 2017 by Sonya 2000

Very, very tough and that is the tricky part of this disease. The general tests dont work (like ELISA, the method is too old and shows only 20% of correct results.) The patient must find a best private laboratory in Europe or USA to do the testing and has to pay out of his pocket for it.

Posted Oct 9, 2017 by Jessie 1600

Blood test sometimes multiple, you can get false negatives. There is also microscopic blood samples that can be diagnosed and looked at. Some lyme specialist go by history of symptoms.

Posted Oct 25, 2017 by Andrea 2120

Lyme disease is properly diagnosed with blood tests. The patient's blood must be sent to one of only a few labs nationwide that is sensitive enough to give accurate results. Many labs do not give accurate results > false positives or false negatives. Lyme-literate physicians (LLMD) know which labs to send the blood to.

Also, my Lyme-literate physician who diagnosed me after spending 7 years without a diagnosis made a "clinical diagnosis" within 15 minutes of me stepping into his office for the first time. Seven years and many, many doctors who had no clue what was wrong with me. A physician at Stanford University Hospital said to me, "Western medicine is not equipped to find all that is wrong in the body and you are one of those who is slipping through the cracks."

The one symptom upon which my LLMD made his clinical diagnosis was based on the fact that my eyes were ultra-sensitive to light and teared up in sunlight (tears running down my face, even with dark sunglasses on). This symptom does not cross over with other diseases.

After diagnosis, find an alternative-oriented MD who has an Integrative Medicine practice. Also, many of us are helped by a variety of treatments for symptoms: Osteopathic treatment, acupuncture, therapeutic massage, homeopathic treatment, etc.

"The most common diagnostic tests for Lyme disease are indirect ones. They measure the patient's antibody response to the infection, not the infection itself. The two most-used antibody tests are the enzyme-linked immunosorbent assay (ELISA) and the Western blot." - source, LymeDisease.org

Posted Nov 4, 2017 by Lisa 500

It’s pathetic. If we follow the CDC they say use their 2 tot test the Elisa and Western Blot. However, on their site it states these were never meant to be used to diagnose Lyme. My question is why such a contradictory statement. I took the western blot and failed 3x it’s a joke since they removed the main definition making us positive. Some get lucky but most wont. I personally prefer Armin Labs out of Germany. Everyone knows they are very intelligent. I took Igenix CDC+ 18,23,24,31,34,39,41, and 83 wasn’t counted though because it was from a mosquito. I still have the scar. DNA Connextions is great too, but Armin Labs found Qfever and nobody else did. However, not many doctors in the USA use it so I’d go Igenix if you have Medicare the basic test is covered then you just need DNA for co-infections. All tests for Lyme, Bartonella, and Babesia are questionable so many do a clinical diagnosis

Posted Mar 9, 2018 by Niki 8100

It’s suppose to be via a 2 tier horrible test that even the CDC says it sent meant to diagnose Lyme disease. Personally, I love Armin Labs out of Germany. They are also the cheapest. Problem is if you are in the USA make sure the doctor you are going to see accepts it. If not you need Igenix and/or DNA Coonxtions

Posted Mar 14, 2018 by Nikolettie 2700

Elisa Test and the Western Blot

Posted May 26, 2018 by Bethany Wing 2100

The gold standard for testing is through IGenex, but still not100% reliable.
If a person gets a bullseye rash following a tick bite, or other insect bite, that is a confirmation of Lyme. No testing required. Absent a rash, known tick bite and positive serology, then Lyme is a clinical diagnosis. A LLMD should be sought out, or Lyme Literate Medical Doctor or other LL practitioner.

Posted Feb 1, 2020 by Lori 2550

With analytics like those of Arminlabs and Redlabs, the analytics of Elisa, Immunoblot etc give many false negatives

Posted Dec 16, 2021 by José 7770