interpret lyme test results please

My husband received his Western Blot test results. Could you help us understand?
IgG CDC negative
IgG: 66, 41, 34,18

Band 66 Intensity: 96 Cut Off Ratio: 3.7
Band 41 Intensity: 115 Cut Off Ratio: 4.4
Band 34 Intensity: 44 Cut Off Ratio: 1.7
Band 18 Intensity: 88 Cut Off Ratio: 3.4

Positive for Mycoplasma pneumoniae IgG Pos (Index = 2.44)

TIA

to clarify the "CDC positive/negative" situation - years ago when the CDC first decided Lyme was a possible issue in the USA - it decided to do what is called disease surveillance - that is to try and track its incidence across the country and especially if that incidence is increasing over time.

This is tricky in lyme as diagnosis has always been a problem - with known issues with all serological tests.
but since its a national program - they cant just use dr's clinical diagnosis as a national measure - as each doctor will vary dramatically in how they diagnose - so they need a repeatable consistent data point to track.
it doesn't actually matter for their purposes if this data point misses 90% of cases - as long as its consistent - so that if national cases rise, this number also rises proportionally - by setting the criteria to be super strict and to exclude all but the most absolutely unquestionably positive cases that light up all the bands - they minimise false signals in their disease tracking data.
They then made it clear that this criteria should not be used for clinical purposes - ie diagnosing patients.

Alas - presumably because doctors want simple black and white tests "the CDC criteria" became commonly used as pass fail criteria for clinical use in many conventional medicine practices and still is today - despite the above being common knowledge and still printed on the CDC website.

see first paragraph here
https://ndc.services.cdc.gov/case-definitions/lyme-disease-2017/

RobWireGuy said...
How was your IgM results for bands?

Just curious........

Rob

Good question!

one of the main problems with serology based tests for lyme - is that you are measuring a secondary effect - ie "how is the patients immune system behaving"

not a direct test "can we see the bacteria"

in lyme - there are countless studies showing that the very thing you are measuring ( how the patients immune system is responding) is itself disrupted by the lyme infection - and as a result it no longer functions the way its expected to - and does not produce the pattern of IgG or IgM antibodies that are expected in most* other infections.

in all other disciplines this would be classed as crazy logic and thrown out the window
in lyme testing there are few alternatives - and so we are kinda stuck with it - even though it is flawed.

for example - there are papers finding that around 20% of patients with confirmed lyme infection by culture ( gold standard test method but rarely used) NEVER produce ANY detectable anti-lyme antibodies at all. so this makes it clear that lyme interferes with normal expected antibody production.

more often with lyme disease - and what you will often see if you read other peoples accounts here
- is there is general poor sensitivity of basic C6 ELISA tests ( this is the general first line test used in many countries - and looks for only one antibody) - so often just a negative result
- and on western blots - some kind of random selection of a few IgG and IgM antibodies or a few indeterminate - rarely the full suite.

the main reason for this is the immune disruption mentioned above

however, borrelia also have a key feature v few other microbes have - in that they change the proteins expressed on their outer surface regularly - it is these outer surface proteins that the immune system reacts to and makes antibodies to - so this means the immune system has to keep relearning how to recognise them and then make new antibodies to the latest outer surface protein - this is the explanation for reoccurring IgM antibodies in chronic lyme infection

there is ongoing confusion where people, including doctors, apply general rules of thumb learned from testing other simpler organisms to borrelia - which have altogether different biology and so those explanations do not fit borrelial infections well at all.

*I say most - as in many chronic bacterial infections - especially those in the co-infection group - expected antibodies are often not present after 6 months - the mechanisms for this are also not clear but likely due to some immune evasion or immune suppressive effects the organisms have developed over the millennia to aid their chronic infection survival strategy - ie killing the host is no good for survival - and getting mopped up by the host immune system is no good either - so they have to find something in between. That in between way involves some manipulation of the immune system by the microbe.

I just learned from a medical PA that IgM (supposedly) indicates current infection & IgG (supposedly) indicates past infection. Is that the correct???
Based on what Garzie wrote above, it seems almost irrelevant.

So since my husband has IgG bands showing in his test results, but not IgM, yet is presenting with some symptoms, should we still consider that it is possible that he is dealing with an active infection?

HzKabod said...
I just learned from a medical PA that IgM (supposedly) indicates current infection & IgG (supposedly) indicates past infection. Is that the correct???
Based on what Garzie wrote above, it seems almost irrelevant.

for some simple infection that rule generally applies - but for lyme - yes its pretty irrelevant

the lyme disease organism has the largest genome of any bacteria so far discovered.

the large majority of this extra genetic material is dedicated to making different outer surface proteins

this enables it to change the proteins it has on its outer membrane - this is important as these are the ones the immune system is in contact with and trying to make antibodies to, which takes time - maybe 1 month and are initially IgM antibodies ( it later learns from these IgM antibodies what to make IgG antibodies to )

by the time the body has figured out what proteins to make antibodies to the organism has changed the proteins in the outer membrane and now looks like a new infection to the immune system - and so off the immune system goes again, trying to make new (IgM) antibodies to that - and so the cycle continues.....

you can see what an effective an immune avoidance mechanism this is - as the body never quite catches up to the microbe with its learned immunity.

you can also see how this would result in IgM antibodies being present on an ongoing basis in chronic infection

it is not always this way however - as the organism also has other immune disrupting strategies and one of these is it interferes with the body’s ability to make antibodies at all - and so we instead tend to see a somewhat randomised picture of: no antibodies, only IgM antibodies or a random mix of IgG and IgM antibodies on western blots.

It may not be a bad idea for him to get a CD57 Test.

It can be a "smoking gun" pointing to an active Bb infection.

Acceptable levels should be over 75........mine was in the 30's.

The CD57 Killer Cell seems to be directly tied to an active Bb infection,
and the body's ability to respond to it.

Rob

Thanks, Rob.

1) Where would one get a CD57 test?

2) For clarity's sake, a Bb infection is lyme, correct?

HzKabod said...
His symptoms are
aches & pains
tight muscles that come & go
uncomfortableness on chest
brain fog
difficulty finding the right word
confusion
lost 15 lbs.
fatigue

I really appreciate the information you're sharing. It helps me understand why it is so complicated to Dx lyme & co.

So what do you think all IgG bands listed above indicate?

Scary.......is this me you are talking about??

The best I could get for a positive diagnosis was IFA & CD57 tests respectively.
Western Blot came close for IgM (one band positive & another indecisive),
but not so much for IgG (+++41 & 28 w/ 39 indecisive) - no CDC positive
by their protocols.

Part of me still wants to "chase that rainbow" and get that CDC affirmative
that I feel I deserve but may never find.......

Rob

I have been self-treating with the Buhner protocol for neurolyme & bart currently. Previously I treated babesia & mycoplasma with his protocol. I also started treating under the guidance of a naturopath registered nurse & she has me on a Byron White protocol for neurolyme & bart.

Since my husband had a tick bite the end of June 2021 that was lab tested positive for babesia, he's been taking some tinctures for that infection. Because he has cognitive issues I suspect he has either/and/or bart & lyme as well. His naturopath is also treating him for an unidentified parasite (as in--she is legally not allowed to say what it is), using a Wormwood blend of herbs.

I guess we'll look at what Buhner recommended herbs he needs to be taking. He was very fatigued last week, but seems to have bounced back fairly quickly. I think that was initial die off Herx reaction.

Thanks for sharing all your knowledge. It's been helpful in making some decisions.

Very interesting. Very concerning.
Isn't there a link between sexual diseases & spirocetes (sp)?
It seems that some of the tick borne diseases act similarly. Could they possibly be related? And spread similarly?

Quite amazing that you both possibly were infected by horse flies. Sorry to hear that. My husband was not only bitten by a tick that lab tested (+) for babesia this summer, but he also had quite a few bites from horse flies at the beach this year. As well as mosquitos. No place to hide!

He is feeling exhausted today & is already taking a nap. I, on the other hand, am revived today & full of hope. A good counter balance!

Well, I must say--I can only spend limited time on the lyme forum, as much as I appreciate everyone's knowledge & willingness to share--& I have been helped tremendously here--

but reading too much about these diseases & how nasty they are can be discouraging & disheartening. One can feel doomed, with no hope of recovery at times. My condition can be up & down symptom-wise, & I have to guard my hope for a better day by limiting my exposure to info at times.

How are you treating? Are you still using the Buhner protocol or have you incorporated another approach?