Lyme disease and other tick-borne diseases come with a lot of unknowns. Before starting to treat symptoms, you must first get a proper diagnosis. Unfortunately, diagnosing Lyme disease can be complicated and unclear.
Not all Lyme disease tests are created equal. The accuracy of Lyme disease tests can vary widely between testing methods, leaving many people without a reliable diagnosis.
This begs the question – is Lyme disease testing really that bad? In many cases, yes. This is largely thanks to current testing recommendations from the U.S. Centers for Disease Control and Prevention (CDC), and applies to readily available commercial testing that is generally covered by insurance. The good news is, private laboratories, such as IGeneX offer hope.
Current CDC Recommendations
When diagnosing a patient with Lyme disease, the CDC recommends that providers consider the likelihood of someone being exposed to an infected tick, any signs and symptoms they are displaying, and the possibility of other illnesses that may cause similar symptoms.
After considering these variables, the CDC recommends a two-tier testing system using the ELISA and Western Blot. The two tier antibody testing system is intended to detect Lyme disease through the use of two different enzyme immunoassays. The first step is a whole-cell sonicate enzyme, which is then followed by a VlsE C6 peptide enzyme – hence the ‘two tier’ name. Usually, this will be administered through two rounds of tests.
How accurate are Lyme disease tests?
Lyme Disease Test Accuracy Varies
You would think that whatever the CDC recommends is probably the most accurate testing option. That’s not the case with Lyme disease.
Thankfully, more and more testing options are emerging to detect Lyme and other tick-borne diseases more accurately. If you or a loved one is experiencing symptoms of Lyme disease, knowing the different options can help you make a more informed decision, one that is the best for your health.
What is the most comprehensive test for Lyme disease? We’re here to help clarify by ranking Lyme disease test options from best to worst.
1) ImmunoBlots
The most reliable Lyme disease tests available are the Lyme ImmunoBlot IgM and IgG from IGeneX. These tests can detect exposure to early infection, as well as re-activation later on, and long-term chronic exposure.
The IGeneX ImmunoBlots are immunoassay tests, meaning they test for specific antibodies, in this case, ones that develop in response to B. burgdorferi, and the borrelia that cause Lyme disease.
One of the most significant benefits of the IGeneX Lyme ImmunoBlot is that it can detect antibodies even when they are very low, like in the early or late stages of the disease. It is more specific and sensitive than standardized tests and can show a positive when others may give a false negative.
The test has improved sensitivity by detecting multiple strains and species of Lyme-causing bacteria. It is more sensitive, specific, and easier to read than other standard Lyme disease tests.
2) Lyme PCR and cePCR
PCR, polymerase chain reaction, testing has become more widely known during the COVID-19 pandemic. This technology, however, can be used to detect a wide range of diseases, including Lyme disease.
Regular PCR for Lyme disease is a good test, but if often lacks sensitivity because pathogens can hide in tissues and aren’t easily detected in the blood. Culture enhanced PCR (cePCR) involves taking a sample or “culture” of a pathogen and allowing it to grow over time. A clinical sample from the body, usually blood, is incubated so that microorganisms in the sample grow and multiply. PCR technology is then used to identify any potential pathogens. Until recent developments, this technology was too expensive and difficult to use for the clinical diagnosis of Lyme and other tick-borne diseases.
A culture-enhanced PCR test is more sensitive than the standard PCR testing and is the only 100% specific method for identifying tick-borne diseases. It can be used at any stage of the disease.
3) Lyme Broad Coverage Ab Assay
The Lyme Broad Coverage Antibody (BCA) Assay is a simple and cost-effective test that can give you a straightforward positive or negative result. This test detects specific antibodies that the body produces in response to a Lyme infection. It has a 90% sensitivity rate with a specificity of 97%.
This test should be used in conjunction with a patient’s clinical history, symptoms, knowledge of the stage of disease, and further testing results. It can be used during the early stage of disease or later re-activation/ chronic.
The BCA is helpful to give a yes or no test result but does not provide specific protein or band information. Further information and speciation can be done with an ImmunoBlot IgM or IgG.
4) Western Blot
If someone receives a positive result from the ELISA, the second stage is a Western blot to confirm the initial positive result. The traditional Western blot can detect Lyme disease when an antibody from a sample reacts with an antigen on a test strip.
Much like the ELISA, the Western blot also lacks accuracy. One internal study from IGeneX found that 29 of 43 patients with Lyme disease tested negative on the Western blot, meaning the test completely missed their infection.
Both the ELISA and Western blot only detect one strain of one species of Borrelia, meaning they both miss infections caused by other strains and species.
5) ELISA
The ELISA test is typically the first test in the two-tier testing system recommended by the CDC. The ELISA, or “enzyme-linked immunosorbent assay” test, checks for antibodies produced in response to a Lyme disease infection.
Although it is recommended by the CDC, ELISA gives false negatives about 50% of the time. If someone receives a negative test result, it is likely their providers will not proceed with further testing, preventing them from receiving proper treatment. This can be especially harmful in the case of Lyme disease, where long-term complications can often be prevented with the early use of antibiotics.
Lyme Disease Test Accuracy and Diagnosis
We understand how nerve-wracking and frustrating it can be to navigate a potential case of Lyme disease. In order to advocate for yourself, you have to know what your options are, which are offered through reading this article.
Not all medical providers understand the complexities of Lyme disease, so finding a Lyme-literate medical doctor (LLMD) can make a world of difference. Lyme disease is the most frequently misdiagnosed tick-borne disease. Going to a doctor that knows what symptoms to look for at different stages and what your testing options are can help you get an accurate diagnosis and suitable treatment.
IGeneX has the most accurate and comprehensive tick-borne disease tests available, including the ones at the top of this list. Now that you have a better idea of your options, you can start on the path to restoring your health.
