| Diagnosing Lyme Disease |
| NOTE: THIS IS MEANT AS AN INFORMATIVE GUIDE AS TO HOW TO DIAGNOSE LYME DISEASE, AS ALWAYS CONSULT A PHYSICIAN |
| Before a diagnosis of CFS or FMS, a doctor should include a routine laboratory panel with a CBC; a T3, T4, and thyroid-stimulating hormone test; an ESR for evidence of any inflammatory conditions; blood chemistries for indications of diabetes, mellitus, or kidney, gallbladder, or liver problems, and a urinalysis. A chest x-ray is also appropriate and, if you are aged 40 or older, an EKG. Many experts also recommend, in endemic geographic areas of the country, a Lyme Disease test and, in the presence of risk factors, a test, for HIV infection. Additional tests depend on the findings of the history and physical examination. If, for example, there are reports of any joint symptoms, consider ordering tests for rheumatoid factor and antinuclear antibodies. Similarly, muscular symptoms warrant a test for creatine kinase levels. Check for focal neurological deficits in a fatigued person who complains of having cognitive problems. A brain MRI may be required to rule out early-onset multiple sclerosis. To meet the CDC criteria for having Lyme Disease, they have you do the ELISA and the Western Blot. To be thorough, both assays should be used, even though the Western Blot is more sensitive. The increased sensitivity of the Western Blot is analogous to a mountain where the base is a Western Blot and the summit is an ELISA. The Western blot has considerably more sensitivity because it provides detection before the peak of the response. The Western Blot is a qualitative assay based upon the individual visualization of a patient's unique antibody response against the various Borrelia antigens. This type of assay is not restricted by the sensitivity and specificity concerns as the ELISA. An ELISA assay with a quantitative cut-off, and which is not necessarily specific to only the most unique antigens of B. burgdorferi, needs to consider population aspects of false positives (specificity) and false negatives (Sensitivity.) A positive or equivocal ELISA must always be followed with the corresponding (IgM and IgG) Western Blot. "http://www.igenex.com/lymeset1.htm" The right test to screen for borreliosis is the Western Blot. Other screening tests, such as the IFA, EIA, ELISA, and PCR DNA probe are often negative when the Western blot is positive! Doctors who diagnose and treat borrelisis patients, go straight to the Western blot as their screening test. Therefore, regardless of what IFA, EIA, ELISA, and PCR DNA probe test show, you should all ways follow with a Western blot. But the Western blot needs to be done at the "right laboratory" one that specializes in borreliosis testing. IgeneX is one that specializes in borreliosis testing and typically found borrelia-associated antibodies that the regular laboratories miss. The right way to process the Western blot specimen is for the blood to be drawn and express mailed early in the week. Research shows the borrelia antibodies have the potential to clump together, resulting in false negative test results. So far unclumping has not been practical for laboratories to do. The fresher the specimen, the more accurate the test results. This way, express shipping will assure that the specimen does not spend the weekend sitting at the post office. This is the right way to test and ship borreliosis specimens. Western blots look for antibodies. These antibodies are made by your immune system. In this case, the antibodies are made to fight against different parts of Lyme bacteria, which is called Borrelia burgdorferi, and other Borrelia species. In other words, your immune system does not make one big antibody against the whole bacteria. Some times when the Western Blot shows negative, antibiotics can help convert the test to a positive. What may happen when people are given two weeks of tetracycline (or other antibiotics) is that some of the bacteria die. When Borrelia burgdorferi dies, it is less efficient at avoiding the immune system. That's when antibodies may be formed against Borrelia burgdorferi, converting the negative or equivocal Western blot to positive, in about 36% of cases. When the Lyme borrelia are alive, they are geniuses at avoiding the immune system. They may do things like go inside white blood cells, and come out enclosed by the cell membrane of your own white blood cells! This may partly explain why antibodies against Borrelia burgdorferi are often not found when patients are tested. On our first visit with the new doctor, they drew blood to test for Lyme Disease and babesioses, then he had told us about the antibiotics and how some of them can make you sick. As the antibiotic begins killing the bacteria, they release toxins into the body causing adverse reactions to the treatment. While we were there, he gave my wife a prescription for an antibiotic called Tetracycline, after 5 days on this she became much worse. At this point we knew she had Lyme disease before her blood test came back positive, this reaction to the antibiotics is called a Herxheimer Reaction, known to Lyme patients as a "HERX." Remember, not all antibiotics will have the same effect, some may make you feel a little better when you are taking them. But then when you stop, they may make the symptoms worse or you may have more of them. And trying to explain that to our doctor, and getting him to listen to us, was like pulling teeth. CONTINUE <<Back HOME |