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Lyme Disease Testing

A variety of tests are available for Lyme disease assessment, however, test results are sometimes ambiguous and therefore diagnosis must be made based on history and symptom picture as well as test results.

Many doctors who are unfamiliar with Lyme disease just use the Lyme test available in their local laboratory. This is usually the Lyme ELISA. This tests measure a patient’s antibody, IgM and/or IgG, in response to exposure to the Lyme bacteria. By today’s standards, these tests are not very sensitive, and are not the preferred testing method.

Dr. McFadzean uses IGeneX Laboratory in Palo Alto, CA for Lyme and co-infection testing. They are specialists and the leaders in the field.

Immunoblot tests (IgG and/or IgM) can visualize the exact antibodies you are making to the Lyme bacteria. They are more sensitive than the ELISA tests and are often the preliminary tests run. There are different “bands” that indicate infection with Borrelia burgdorferi, and so the more bands that are visible (positive), the stronger the indication that Lyme disease is present.

30/31 kDA Confirmation Test (IgM or IgG) – when these particular bands are positive or indeterminate on the Immunoblot, this test, run as a follow up, can further assess if the positive bands are actually caused by the Lyme bacteria.

Lyme IFA (performed as part of a Lyme Panel) detects IgG, IgM and IgA antibodies against 
B. burgdorferi. IgM-specific titers usually persist in the presence of disease. Antibody levels tend to rise above background levels about 2-3 weeks after infection and may remain elevated in case of prolonged disease.

PCR (Polymerase Chain Reaction) test detects the presence of the DNA of the Lyme bacteria and can be performed on whole blood, serum, urine, CSF and miscellaneous fluids/ tissues. Because it looks for actual DNA, the test has high specificity; however, because Lyme bacteria like to “hide” in the body, the PCR can often be negative.

Lyme Dot Blot Assay (LDA) looks for the presence of pieces of the Lyme bacteria in urine. The assay specificity is between 89-90%. This test is most effective when provoked by an intensive regimen of antibiotics.

In addition to Lyme Disease, Dr. Nicola often tests for co-infections such as Babesiosis, Ehrlichiosis, Bartonella or Mycoplasma.

Babesia Tests
B. microti IgG/IgM Antibody
B duncani IgG/IgM Antibody (west coast strain, formerly WA-1)
Babesia PCR Screen
Babesia FISH (RNA)

Ehrlichiosis Tests
Anaplasma phagocytophila (HGE) IgG/IgM Ab
Anaplasma phagocytophila (HGE) PCR
Human Monocytic Ehrlichia (HME) IgG/IgM Ab
Human Monocytic Ehrlichia (HME) PCR

Bartonella Tests
Bartonella henselae IgG/IgM Antibody
Bartonella henselae PCR for Whole Blood, Serum*, or CSF

Rickettsia Tests
Rickettsia PCR for Whole Blood, Serum or CSF

Mycoplasma Tests
PCR for various strains of mycoplasma such as fermentans, pneumonia

Other testing will be recommended as needed. Please see the Diagnostic Testing page for full descriptions of tests. The following tests are frequently recommended to assess other underlying stressors on the immune, digestive and detoxification systems.

– Functional Adrenal Stress Profile
– Expanded Chemistry Profile Plus
– Gluten Intolerance Screen and Food Sensitivity Profile
– Gastrointestinal Pathogen Screen
– H. pylori Stool Antigen
– Candida DNA and Candida Antibodies
– Mold Antibodies Profile
– Heavy Metal Provoked Urine Test