Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Sep 25, 2017
Last Modified Date: Sep 25, 2017
Published Date: Jul 29, 2017
Lyme Disease Tests and Diagnosis
Lyme disease is an illness that is primarily spread by the bite of a black-legged tick, also known as a deer tick. These ticks are found in wooded or grassy areas throughout the United States. It is a very common ailment, with about 300,000 people diagnosed with Lyme disease in the US every year, according to CDC estimates. Left untreated, Lyme disease can have serious health consequences, so if you think you might have been exposed, getting a Lyme disease test is wise, as is seeing a healthcare professional for diagnosis and treatment upon receiving a positive test result.
About Lyme disease
Lyme disease is caused by bacteria, called Borrelia burgdorferi. People become infected with this bacteria when they are bitten by a tick that carries the bacteria. According to the Centers for Disease Control and Prevention (CDC), early symptoms of Lyme disease typically appear within 3 to 30 days after being bitten by an infected tick and may include:
- Swollen lymph nodes
- Muscle aches
- Joint pain
- A characteristic “bullseye” rash – a pale center surrounded by a reddened area – near the site of the tick bite
- A more general, diffuse rash that may appear near the bite or in other areas of the body
Detects antibodies to Borrelia burgdorferi, the bacteria that causes Lyme disease
Left untreated, Lyme disease can spread in the body, leading to more serious symptoms. Later-stage symptoms typically appear weeks or months after infection with the Lyme disease bacteria and may include:
- Severe headaches and neck stiffness
- Additional Lyme rashes on the body
- Severe joint pain and swelling, typically at large joints
- Facial palsy (paralysis/drooping)
- Pain in muscles, tendons, joints and/or bones
- Heart palpitations or irregular heartbeat
- Shortness of breath
- Numbness, tingling or shooting pains in the hands or feet
- Inflammation of the brain or spinal cord
- Short-term memory problems
How Lyme disease is diagnosed
Lyme disease can be difficult to diagnose, since symptoms are often non-specific, making them easily attributed to other diseases and health conditions. For this reason, when Lyme disease is suspected, whether that suspicion stems from the appearance of symptoms consistent with the disease, a known bite from a black-legged tick, or known exposure to tick-infested areas, lab tests are typically used to confirm a diagnosis. The CDC recommends that medical testing labs use a two-step process to assess patients who are being tested for Lyme disease infections.
The first step of the process is to use a Lyme disease blood test to evaluate whether or not a patient has developed antibodies to the Borrelia burgdorferi bacteria. Antibodies are proteins, produced when it is invaded by bacteria or viruses that target those invaders specifically to aid in their destruction. The presence of antibodies that target Borrelia burgdorferi bacteria shows that the patient has been exposed to the bacteria, indicating Lyme disease infection.
If the Lyme disease antibody test results are negative, finding no indication of Lyme disease, no further testing is necessary. If results are positive, indicating Lyme infection, the CDC recommends that a second test, called the Western Blot, is done to confirm the presence of Lyme-specific antibodies. The CDC states that testing for Lyme disease should only be considered positive if both steps of testing yield positive results for Lyme-related antibodies.
The CDC recommends that both steps are completed in cases where the initial step detects antibodies to Lyme disease bacteria. The agency also recommends against skipping the first step and completing just the Western Blot test, as this creates an increased risk for faulty testing results, which has the potential to lead to misdiagnosis and improper treatment. It is important to note that it takes some time for antibodies to Lyme disease to build up to detectable levels in the body, so running these blood tests too soon can lead to false negative test results. According to WebMd, it may take as long as 2 months for your body to make enough antibodies to be detectable in blood tests. Therefore, if you had testing done within 2 months of getting bitten by a tick and/or noticing symptoms and received a negative result, it may be worthwhile to be tested again to ensure you have not been infected with Lyme disease.
What to expect when being tested for Lyme Disease
To have this two-step testing process done, you will need to have a blood sample taken, which will be done via a simple blood draw. Your sample will then be analyzed by a medical testing laboratory to determine whether Lyme disease antibodies are present in your blood, and if so, measure their concentration in the bloodstream. If results of the first lab test are positive, a Western Blot test will be done, typically using the same blood sample. Once both tests are completed, your results will be compiled into a lab report. If testing was ordered through your doctor's office, your report will be sent to them, and results relayed to you by that office. If you have purchased your tests directly from Health Testing Centers, your results report will be sent directly to you, generally within one to three days of your testing appointment.
How Lyme disease is treated
Lyme disease is treated with oral or intravenous (IV) antibiotics. Oral antibiotics are typically used in early-stage Lyme disease, usually for a period of 14 to 21 days. IV antibiotics may be administered in later-stage Lyme disease treatment, particularly when infection has spread to involve the central nervous system. Treatment with IV antibiotics may be prescribed for a period of 14 to 28 days.
How many people get Lyme disease?:
Signs and Symptoms of Untreated Lyme Disease:
Two-step Laboratory Testing Process:
Lyme Disease Test: