Should you get tested for Lyme disease?
The current laboratory diagnostic tests for Lyme disease are blood tests to detect the antibodies created by your body to fight and kill the bacteria that causes Lyme. This bacteria is called Borrelia burgdorferi, or Bb.
However, with early-stage Lyme your antibodies may not have had time to develop in your body. Therefore a blood test at this time will often appear negative. It can take your body up to two months to develop enough antibodies to be detected by these tests. In other words you could have Lyme but the test results will still come up negative.
What does this mean for you? By all means, if your doctor recommends a test, get the test. But don’t rely on it completely. Trust your body and trust your homework. Monitor your symptoms. Ask questions.
How do doctors test for Lyme disease?
Lyme disease is typically assessed based on clinical diagnosis, in combination with laboratory tests. There is much debate over the accuracy and reliability of the laboratory tests and the likelihood of false positives and false negatives. The following tests are FDA-approved for diagnosis:
- The Enzyme-linked immunosorbent assay or ELISA is the first step. This test detects antibodies to B. burgdorferi and, if positive, is followed up by the Western Blot test.
- The western blot is usually run as a second-stage to confirm the diagnosis following a positive ELISA result. The Western blot detects antibodies to several proteins of B. burgdorferi. Together these tests are known as the ELISA/Western Blot.
- Alternatively, the polymerase chain reaction (PCR) is a highly sensitive test that detects DNA from the Borrelia bacteria in fluid drawn from an infected joint (typically synovial or cerebrospinal fluid). It is much less commonly used as the bacteria are most likely to bind to joint and nerve tissues and more difficult to detect.
For more on the Lyme testing process as defined by the CDC, check out this flow chart.
Testing for late-stage Lyme disease
If you suspect you are experiencing symptoms of late-stage Lyme disease, it makes sense to talk to your doctor about getting tested. The test is the same regardless of the stage of Lyme disease. Again, don’t rely on it completely. Trust your body and do your homework. Ask questions.