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Test Results Confusion - Western Blot

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Posted 9/15/2017 2:47 PM (GMT 0)
Good Morning! I'm new here. I'm hopeful someone can shed some light on my recent experiences. I've been sick for about a year. My doctor ordered a Lyme test recently and all bands were absent on the western blot test except for IgG P41 and IgM P23. My doctor said the results were positive and put me on doxycycline for 30 days. Once I finished the antibiotics, I had slight improvement in my symptoms but not much. My doctor referred me to infectious disease who told me my Lyme test was not positive. My doctor considered it positive because 2 of 3 bands (23, 39 or 41) were present, but infectious disease was looking for 5 of 10 bands.

At this point, would you pursue the Lyme disease diagnosis or would you think it's something else?

My main symptoms are chronic low grade fever, chills, swollen neck and chest lymph nodes, numbness in right arm/hand and joint pain.

Thank you in advance for any advice! This has been a frustrating year.

Post Edited (Rachel Hope) : 9/15/2017 8:58:19 AM (GMT-6)

Posted 9/15/2017 3:18 PM (GMT 0)
Hi Rachel Hope and welcome to our forum. First off, testing for lyme disease is very unreliable. I had the Elisa test done by Quest labs and I was negative. There is a blurb on that test that states:

The screening test and/or blot for B. burgdorferi antibodies may be falsely negative in early stages of Lyme disease, including the period when erythema migrans is apparent.

I had the Igenex Western Blot and was CDC Negative for both the IgG and IgM. At the bottom of my Igenex lyme test it states:

Diagnosis should not be based on laboratory tests alone. Results should be interpreted in conjunction with clinical symptoms and patient history.

I believe in this statement and do not put much credence in the CDC's criteria for a positive. But, just so you know this is how your doctors got their diagnosis.

For IgM WB, the CDC says you are positive if you have 2 of the following bands present, 23-25, 39 and 41.

For IgG WB, the CDC says you are positive if you have 5 of the following bands present, 18, 23-25, 28, 30, 39, 41, 45, 58, 66, 83-93.

I think your first doctor got the IgG mixed up with the IgM.

But, this would not matter to me. The fact that you have bands appearing positive or even IND, I still would rely on the above statement in blue. If you have symptoms and even 1 positive band or none, I think it is lyme.

Hope this helps.
Posted 9/15/2017 4:29 PM (GMT 0)
Band 23 is Osp C, completely specific to Borrelia Burgdorferi. No other organism could elicit the body to create an immune response that would show up as band 23. Band 41 is a response to a tail of a spirochete. So band 41 is not Lyme-specific, but if it's not Lyme, you have (or have had in the past) some spirochetal disease, and there aren't a ton of them.

The CDC's guidelines of 5 bands was created for epidemiology studies: to study the spread of the disease throughout the population, not to diagnose specific cases. It's grossly mis-used now, and has a very high false-negative rate.

Post Edited (Mustard Seed) : 9/15/2017 10:32:20 AM (GMT-6)

Posted 9/15/2017 4:44 PM (GMT 0)
Thank you so much for your responses. I really appreciate you taking the time!
Posted 9/15/2017 4:47 PM (GMT 0)

Rachel Hope said...
Thank you so much for your responses. I really appreciate you taking the time!

No problem, welcome!
Posted 9/15/2017 4:53 PM (GMT 0)
Hi and welcome to our forum,

Glad you found us but sorry that you have Lyme.

We encourage all new members to read our "New to Lyme" start here thread at the top of the page. It has all kinds of good and important information on Lyme, co infections, testing, symptoms, detoxing and much more.

Its crucial if you are still experiencing symptoms to keep treating and to treat properly.

We can help you find an llmd(Lyme literate Md) here by enabling your email so you can receive response from members.
Then you would have to start a new post asking "seeking and llmd in your area" or you can go to ilads.org and send a request fro llmd's also.

Most infectious disease md's are not Lyme literate unfortunately.

You should also consider changing your user name, if it is your real name just for safety/privacy reasons.


I wish you the best of healing, take care, Jo
Posted 9/15/2017 5:33 PM (GMT 0)
Hi Hope, welcome!


As Mustard Seed stated - Band 23 is specific to Lyme disease. Only LD will produce that positive band.


I encourage you to seek out a LLMD - as goshawk said.
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