This happens a lot! The standard CDC criteria is to run what’s called an Elisa test, and then if that’s positive, they do a Blot Test, either a Western Blot or an Immuno Blot test. On the Blot test, the goal is to see matching bands. 5 out of 10 bands have to match for you to get diagnosed with Lyme.
(This is where the confusion begins within the medical community on Lyme testing)
Now the CDC says directly on their website that this is not to be used for a clinical diagnosis. It’s not designed for doctors to use it as the criteria and, in fact, the Infectious Diseases Society of America (IDSA, which is one of the societies for Lyme, has a completely different criteria, which is much more based on the clinical presentation of a patient.
So between the CDC and IDSA, we have pretty different criteria on exactly how to diagnose Lyme.
But most people will follow CDC criteria. And there are some big problems with this! This is really set up for epidemiological surveying not for the clinical diagnosis. It’s set way on the side for if it’s positive, it’s absolutely positive! But we are going to have a ton of false negatives. We are not going to have almost any false positives on the CDC criteria. We have a lot of patients that say I’ve been tested and it was negative.
Now what we do is a couple things and I really like what Dr. Richard Horowitz says (he’s got some great Lyme published books and published materials), I just run the Blot; I don’t like to do the ELISA first test, then the second Blot test, I like to run the Blot and there are some bands that I say are very promiscuous, for example Band 41 will test positive a lot. Other bands are extremely specific to Lyme and Dr. Horowitz says if any of the specific Lyme bands [on the test] Like Band #23, #83, and #93 and a few others, which are very specific; if you have the clinical presentation and you’re matching some of those bands he’s going to make the clinical diagnosis of Lyme. So what we do in the office is a mixture of making sure you get some more thorough testing then just the initial screener test. A lot of people just get that initial screener test…you want to try to get the Blot and then you have to realize there is some wiggle room in the interpretation of that Blot, particularly when you have a lot of the symptoms as well.
Need a second opinion on your Lyme test? Please don't hesitate. Request a free consultation!
Need a second opinion? Please don't hesitate. Request a free consultation!
Need a second opinion? Please don't hesitate. Request a free consultation!