240 – The Lyme Test

Video on Lyme Testing Difficulties: http://www.kake.com/news/headlines/95079714.html

From Dr. Burrascano:

DIAGNOSING LYME . Is a clinical diagnosis- look for multisystem involvement . 17% recall a bite; 36% recall a rash . 55% with chronic Lyme are sero-negative . Spinal tap- Only 7% have + CSF antibodies! . ELISAs are of little value- do Western Blots . PCRs- 30 % sensitivity at best- requires multiple samples, multiple sources

CD-57 COUNT (Natural Killer Cells) . Low counts seen in active Lyme . Reflects degree of infection . Can be a screening test . Can be used to track treatment response . Can predict relapse . Commercially available and covered by insurance!

WESTERN BLOT IN LYME . Reflects antibody response to specific Bb antigens- they are reported as numbers called “bands” . Some bands are seen in many different bacteria- “nonspecific bands” . Some bands are specific to spirochetes . Some bands are specific to Bb . Positive blot contains bands specific for Lyme . Specific: 18, 21-24, 31, 34, 37, 39, 83 & 93 . Spirochetes in general: 41 . Nonspecific: All others! . The more specific bands that are present, the more sure the diagnosis

NOW THE BAD NEWS! PITFALLS OF THE WESTERN BLOT . Very difficult to produce and interpret a western blot . Bands do not easily line up . Appearance affected by subtle changes in temperature and chemistry of the test system . The specific strain of Bb used to produce the antigens may not match the strain the patient has!

HOW DO YOU MAKE THE DIAGNOSIS? . Lyme is a clinical diagnosis . Even the best Lyme tests are only an adjunct . Use the ILADS point system

Test Details

Excerpted from PRWeb  ( Posted: 2/16/2010 )

The ELISA and Western Blot tests are the most common tests currently used to confirm the presence of Borrelia burgdorferi (Bb) antibodies. The first step calls for a test such as the ELISA to be conducted. If positive, a Western Blot test is done in hopes of confirming that Lyme antibodies exist. However, even if Lyme antibodies exist, it does not mean that the patient has Lyme disease.

Further complicating matters is the fact that antibody tests can confuse Lyme antibodies with antibodies created by other complications in the body, including antibodies created in reaction to bacteria other than the Bb organism. This means the majority of the results of the ELISA and Western Blot tests are not completely accurate. It also means that it is common to receive false positive and false negative results when using the ELISA or Western Blot tests. In other words, a negative test result cannot guarantee that Lyme antibodies do not exist. Conversely, a positive test result cannot guarantee that a patient actually has Lyme antibodies in his/her system. In both cases, accurate positive antibody test results does not mean that a patient has active Lyme bacteria in their system.

However, then it starts to get complicated. That’s because Lyme is a very evasive bacteria and unlike other bacteria, getting an ‘accurate positive’ test is complicated, even controversial. There are various tests for various stages, the laboratory work has to be very precise, and there are many roads that lead to false conclusions. Other infections that are present can also alter the effectiveness of test results.

The fact is there is no Lyme disease test available today that is 100 percent accurate to rule out or confirm the infection. False positive results and false negative results are very common. Dr. Braccia uses the following tests in his practices and encourages all Lyme patients become more familiar with them.

The Lyme PCR Test is the gold standard for Lyme disease testing accuracy
The PCR test is not well known but very accurate. The Polymerase Chain Reaction (PCR) test confirms that Lyme bacteria are present in the body. The PCR test is relatively new. It is designed to confirm that Lyme bacteria DNA are present. A positive PCR test almost always guarantees that a patient has Lyme disease, if the laboratory work has bee performed properly. Dr. Braccia observes, “A negative PCR doesn’t prove a patient doesn’t’ have Lyme however there are PCR strategies that assist in the test confirmation. Another factor that must be taken into consideration is do the fact that PCR test results often vary depending upon which lab performs the test. Therefore it’s important for the physician to use a lab that is accurate in their analysis.

The Lyme C6- Peptide ELISA Test is the newest entry in Lyme disease testing accuracy. The Lyme C6 Peptide ELISA is very different that the earlier Lyme ELISA test. It was developed at Tulane University and available since 2000. It can confirm exposure in more that 60% of patients. The chance of a false positive result in under 1%. While this new test when positive can confirm that an individual is infected with Lyme disease, unfortunately there is still no test clinically available that when negative proves that an individual does NOT have Lyme disease.

One last thought on more testing confusion is Lyme disease Co-infections.
Testing for Babesia, Anaplasma, Ehrlichia and Bartonella (other tick-transmitted organisms) should be performed. The presence of co-infection with these organisms points to probable infection with the Lyme spirochete as well. If these co-infections are left untreated, their continued presence increases morbidity and prevents successful treatment of Lyme disease.

According to the Centers for Disease Control and Prevention, 27,444 cases of Lyme disease were reported in 2007. It is spread by black-legged ticks, also known as deer ticks, and is most common in Connecticut, Massachusetts, Maryland, Minnesota, New Hampshire, New Jersey, Delaware, Pennsylvania, New York and Wisconsin, according to the CDC.

The Haverford Wellness Center in Havertown, PA, under the direction of Domenic Braccia D.O. is dedicated to the accurate diagnosis and reasonable treatment of Lyme disease and other tick borne diseases. Dr. Braccia and the staff of the Haverford Wellness Center are fully equipped and capable of managing all aspects of Lyme disease and the other tick borne diseases from prevention and management of early disease to the most complex diagnostic and therapeutic cases especially for patients in PA, NJ and DE. These cases include treatment failures, and late stage Lyme disease patients who have been ill for many years. For more information visit: www.HaverfordWellness.com

Lyme Disease: Rolling the dice with ELISA

http://news.doccheck.com/en/915/lyme-disease-rolling-the-dice-with-elisa/

New DNA Lyme Screening

https://lymehandbook.com/2010/03/29/dna-ld-screening-enables-early-prognosis/

Lyme Disease Test Labs

 
Igenex Labs (see U.S. certifications)
Sao Palto, California
Clongen Labs, Germantown, Maryland
Stony Brook University Medical laboratory, New York
Mt. Laurel, NJ
(Test tick also,
Medical Diagnostic Laboratories (MDL)
Specialty Laboratoriesclick here)
Santa Monica, CA
Laboratory Corporation of America
Burlington, NC

Serologic Tests for Lyme Disease Yield Disparate Results

 http://infectious-diseases.jwatch.org/cgi/content/full/2011/831/1


15 Responses to “240 – The Lyme Test”

  1. In horses they us a test called PCR (polymerase chain reaction). Here they remove synovial tissue from a joint to test. This is an invasive test; but why don’t they use this on humans if the other tests can not be confirmed?

    • Linda,
      Interesting point. Here is a link that explains why PCR has drawbacks wth LD: http://www.canlyme.com/flawedtest.html

      Every living cell has DNA that is unique to that species of organism. This is true from the simplest bacteria to the most complex mammal. The polymerase chain reaction test is a test that can search for a specific sequence of DNA and multiply that sequence a billion times in less than a day. It is often said that the PCR test is the most sensitive and specific diagnostic test available. However, PCR tests are not without their drawbacks.

      Regards,
      Rob

  2. If you list Labcorp , why not Quest?? its as good/poor as the rest and I wonder why you put MDL in brackets? theyre the BEST for Bartonella since they were at the forefront when NJ led the way to insist it piggy backed with Lyme, about 10-15 yrs ago!! and they have excellent quality control for all their tests!

  3. What about the new MELISA My Lyme test from Neuro Science, in WI? I have just been diagnosed with Chronic Lyme, from 20-25 yrs. ago, being told repeatedly I had fibromyalgia or chronic fatigue syndrome.

  4. Rob, It diagnosed my chronic lyme disease… NO metals, no co-infections (thank God). and the Western Blot was NEGATIVE. I was off the charts on most of the tests.

    • That’s a good start. Now, the insurance companies can’t give you a hard time for your claims.

      I hope you have a good LLD.

      You probably already know, but if you are planning on taking IVs, drink plenty of water, take acidophilus (or yoghurt) and apple cider vinegar to protect your gall bladder and intestines. And for most people, exercising (oxygenating the body) is key to fighting LD.

      Best of luck,
      Rob

  5. Insurance company says NO, because the test was sent out of my network…

    Treating this homeopathically… herbs to rebuild immune system, kill off yeast, natural antibiotic tincture adding one drop per day, to keep the spirochetes from sensing it…

    Seems like a good protocol… feeling tired, but that isn’t anything new.
    Taking a probiotic and purified water by the gallon. Gall bladder was removed several years ago…

    Thanks for the tips. Keep ’em coming!

    • Deb,
      Do you happen to live anywhere near Ct?

      If so, I have an ex-Soviet doctor who has a very economical and (so far) near perfect Lyme treatment.
      Well, I am not yet sure if you ever fully recover from LD. But this seems to be the next best thing.

    • Deb,
      Do you happen to live anywhere near Ct?

      If so, I have an ex-Soviet doctor who has a very economical and (so far) near perfect Lyme treatment.
      Well, I am not yet sure if you ever fully recover from LD. But this seems to be the next best thing.

  6. Rob,
    Used to live in RI, where I acquired Lyme, apparently… Have a great doc in DC, but it’s 2 hrs. from our current home. Are you in CT? I have been trying to fund an updated address and news of Dr. Charles Ray Jones (Lyme pediatrician) and NY Doctor Joseph Burrascano. Any ideas?

  7. Rob. It seems as though there are not any good lyme doctors that i can find in los angeles. Do you know of anyone? I was tested by stonybrook 5/2013 .igm positive 23, 41. And igg indeterminate- 45,58. No memory of tick bite. Have lived in los angeles all my life. I visited boston and rhode island, vermont, in 2006 and 2008. I was retested on 9/2014 by rdl labs and igm positive 23, 39 and igg still indeterminate 41,58. I also had lyme c-6 peptide test and that was negative. All the doctors are confused at my test results.

    • Caren,

      With possibly 2mm new LD cases in the US annually, it is being more and more recognized for the debilitating epidemic it is. It is also known to be widely contracted throughout California; though city dwellers are obviously lower risk. Birds, squirrels and other small mammals are big vectors in transmitting infected ticks throughout our cities.

      Stony Brook labs is a highly reputable LD testing lab. I would not challenge their test results.

      If you need a LLD doctor in LA, try these resources.

      http://www.chroniclymedisease.com/llmd-referrals
      best of luck and I hope you feel better,

      Rob

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