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Only 2 positive IgG bands but still debilitating symptoms

Hello all,

I had many of the symptoms of lyme (as explained after this paragraph) so an integrative medicine doctor did an immunoblot test on me. Only 2 of the 10 IgG bands came back positive so he told me I didn't have it. But my symptoms go on, unexplainable to anyone including the 10 doctors I've seen. Please read on...

My entire body - my arms, elbow joints, knee joints, upper back, lower back, ribs, lower stomach, skin, legs, neck - all burn and tingle. It doesnt burn to the touch, but feels like badd internal sunburn. I am on 2400 mg neurontin, 25 mg amitryptaline, 200 mg tegretol, and 750 mg chlorzoxazone and it barely makes it livable. Without these meds I am bed ridden and want to die. I am in college and cannot sit at all. I stand in the back of the class and watch the lecture, but even standing hurts and burns my legs. Sitting makes it worse, not only in the short term, but in the long term. Every time I sit for a long time or over exert my back (as in having sex or working out) my body pain gets permanently worse and I have to increase my meds. The doctors have found 5 herniated discs and I've had 2 EMGS - that show nothing. They can't find a source for this pain. They tell me its in my head and I need to see a psychiatrist.

Before the pain was this bad, it was just lower back pain from the herniated disc. Before the burning and just the back pain, I had an epidural injection under fluoroscopy but it didnt help. Whenever I sat for too long and played sports each time I did that the pain spread to another area permanently. I even had a thoracic nerve ablation and THE VERY NEXT DAY the pain spread to my neck and ribs and arms and got EVEN WORSE.

Could this be lyme???
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Avatar universal
Thanks for your post -- we're glad you're here, and it's good that you're in contact with ILADS.  Remember that Lyme is (sadly enough) on the cutting edge of medicine, so we and our docs are pioneers -- whether we like it or not -- but at least the company is good here, and we look forward to hearing how things go.  Hurrah!

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Avatar universal
Thanks for your help. I went to ILADS.org and asked for a patient referral and they sent a few doctors to me. I will be setting up an appointment with one soon! I will keep you updated.
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Avatar universal
The difference in the report may be which lab ran it.  I have had other Quest tests in the past (I think) but don't remember the format.  Labs do vary, and if the test is 'owned' by the lab, it would surely have some aspects that other test companies do not.  More important than the lab is the doc:  a good doc will send you to a good lab.
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Avatar universal
Quest Diagnostics ran the lab. By the way, I forgot to mention that there were no pluses or anything next to the tests. Next to each number (41, 23, etc.) it said either "reactive" or "non-reactive". Nothing on the tests say IND. I do not have detailed summaries of the lab, only which bands were reactive or not.
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Avatar universal
Very interesting!  I'm glad your docs are still on the trail to figure things out.  
Also keep in mind that there can be more than one cause for a particular symptom -- and interactions among multiple causes.  For example, is it possible that Lyme bacteria (who like areas of low blood flow) are hiding in the cartilage that constitute the discs in your spine, thus causing or contributing to your pain?  Just a thought.  Keep us posted!
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Avatar universal
Thank you SO much for your descriptive replies. It means a LOT when I'm getting this information from people who know what they're talking about vs doctors who don't care enough to do the research.

As I've stated before, the lyme makes sense in many ways but what DOESN'T make sense is why my pain is being aggravated when I sit or exert my back.

Either way, I am pursuing avenues in both the Lyme disease direction and in the direction of a few spinal cord disorders I am suspecting (arachnoiditis and myelomalacia).

The doctors DO know that I have 4 or 5 herniated discs and that I have some spinal cord compression, but it is very mild. They think they know for a fact that the spinal cord is not responsible for my widespread pain (especially since thoracic and lumbar herniations would not affect my arms and face).

I will keep you updated. Thanks again.
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Avatar universal
Sorry about that.  It's been a long day.

Do you have detailed copies of the test results, or just a summary?  Sometimes summaries leave things out that in the view of others could be useful.  

Which lab ran the tests?  Some labs are better than others.

When you say bands 23 and 41 are positive, do the overall test results show one or more plus (+) signs next to the band numbers?  The more plus signs, the stronger the evidence, but even just one plus sign should be counted as yes.  Specifically:

     -- Band 23 indicates the presence of outer surface protein C (OspC), which is present ONLY when you have Lyme disease.

     -- Band 41 indicates the presence of the little whip-like tail common to all spiral-shaped bacteria, which includes Lyme as well as other related bacteria.  So Band 41 is a 'maybe' for Lyme.  But when you add Band 23 to the list (see the preceding sentence beginning 'Band 23 ...'), then Band 41 is more likely to be evidence of Lyme.  

Are there any bands that say 'IND'?  That is shorthand for 'indeterminate', meaning 'maybe.'  Many Lyme docs will count IND as a weak positive, but a positive nevertheless.  In other words, it ain't nothing, so it is likely something to count as positive.
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Here is another aspect to consider:  when a Lyme infection is new, the human immune system produces IgM antibodies against the Lyme bacteria, and then after a while, production of IgM antibodies will trail off, and the immune system will begin to product IgG antibodies.  There is some overlap in production, so it is possible to have IgG and IgM antibodies at the same time.  Both are significant markers of Lyme bacteria being present.

Note that your own two positive bands are both IgG, meaning Immunoglobulin G.  IgG is produced not when a Lyme infection is new, but later on, when the body's shock troops (IgM, short for Immunglobulin M) are tapering off and the IgG reinforcements come on to the scene.  This is a helpful timing mechanism for docs, to estimate how long you have been infected.  At the same time, the body's immune system may be having some success at killing off the Lyme bacteria themselves, so the other markers of Lyme (such as bands 23 and 41) may taper off as the immune system either kills the bacteria or allows them to hide and wait for the coast to clear before emerging again.  

I am not medically trained, so you should check all this with a real doc (not one who plays at this online like I do), but to my understanding, it sounds like you may have had Lyme for a while, and your body is doing a reasonably good job at killing the Lyme off and/or the Lyme are hiding in biofilms, just waiting to come out to play again, so that the immune system is slowing down its production of IgG but is not done.  This can go on for years and years.  'Biofilms' are like the 'cloak of invisibility' from an old science fiction movie or comic book, where the bad guy can't be seen, but is still there waiting to do more mischief.

This does not mean the Western blot and ELISA tests are worthless; to the contrary, they are helpful, but not perfect.  If they show positive, the test is considered reliable and accurate, but if the tests show negative, it is possible that your immune system just can't 'see' the Lyme because it is cloaked.  This is called a 'false negative' test result.

These older tests can be useful, but there is another kind of test that works differently, and many Lyme specialists use not only Western blot and ELISA tests, but also IGeneX Labs' more recent polymerase chain reaction (PCR) test.  

While the W.blot and ELISA tests are looking for your immune system's reaction to the presence of Lyme bacteria (which may be cloaked and invisible in the protective biofilms mentioned above), the PCR tests look not for antibodies again Lyme, but instead looks for Lyme DNA in the patient's bloodstream.  A direct test!  

IGeneX's PCR test is relatively new, and many docs hold to the older and less precise W.blot and ELISA tests as simply good enough ... but why I do not know.  My Lyme doc used both PCR *and* W.blot/ELISA tests, to get as many data points as possible, but to my understanding, a positive PCR is usually enough.  

If I were in your situation, I would find an ILADS-type MD for a consultation and possible testing.  Being an ILADS member doesn't mean the doc is a genius or has a total grip on the whole Lyme situation, and if you find yourself with a doc like that, go to another one.  Always get full copies (not just summary pages) of test results, and give copies to the next doc, if you need to go that direction.  Keep a whole set of all this stuff in your possession; you never know when you might need it for a new doc down the line to look through.

You may want to consider taking a leave from school while you are in treatment, but I found I was no worse off for continuing to work.  I wasn't as productive, but some paycheck or school time may be better than no paycheck or school time.  It's up to you, and if you try one approach and it doesn't work, then try a leave of absence or a lighter course load.

Good for you for pursuing this situation -- gotta be persistent when Lyme is involved.  Let us know how we can help, and let us know how you do, okay?  Go for it!
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Avatar universal
Jackie, I am not a woman nor am I a breastfeeding mother lol. I am a 28 year old male in college trying my best to hang in there and not dropout. It makes studying close to, but not quite yet, impossible.

The 2 bands I tested positive for are 23 KD (IGG) and 41 KD (IGG). Does this help?
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Avatar universal
A few more thoughts ...

You say:  "Only 2 of the 10 IgG bands came back positive so he told me I didn't have it."  Looked at the other way, you have 2 positive bands that may or may not be significant.  It also matters which bands they are, I think.

I went back and did a little reading last night, and there is a point of view that Lyme can be trasmitted through breast feeding.  I have not researched it further than that, but I would definitely tell your Lyme doc that you are or have breastfed so the doc can decide whether to test you and potentially your baby.

I am not medically trained, so don't think I am telling you there is a problem:  I am saying instead that I would definitely talk with my Lyme doc at the next opportunity about whether there is risk of transmission to your baby.  It's what I would do.
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1763947 tn?1334055319
Minocycline is used for the co-infection of bartonella but doesn't not help Lyme. Also the dosages given to that Lyme and co-infections are usually at least double of mainstream dosages.

Listening to Dr Horowitz the other days was very eye opening. He is treating some infections with maybe triple or more than the regular doses.

He is lucky that the medical boards leave him alone to do his trials. We are lucky to have someone like him working for us.
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Avatar universal
You're quite welcome -- you've been through a lot already, and you're tough enough to keep plowing ahead -- this is good.  

You're right, your symptoms don't seem to match up exactly with Lyme, but it's possible you've got Lyme *and* something else.  Which bands on the Lyme test were you positive on?

You say, "The only reason I have to suspect it MAY not be lyme is that I don't have fatigue or flu-like symptoms, just the pain I described."  Everyone's presentation of symptoms in Lyme is different ... these are not hard-and-fast lists.  Lyme is often accompanied by other infections, and when those get all mixed up in the body, many docs don't understand why the symptom array is not clear-cut and does not point to a single set of symptoms for Infection X.   A Lyme doc knows this, and as a group, I think they are probably pretty good diagnosticians, simple because Lyme requires that.

You say, "Also, the pain gets PERMANENTLY worse if I sit for too long upright or exert my back - leading  me to believe it may be a spinal cord injury, but the doctors have run 2 MRIs and 2 EMGs and tell me its not."  Lyme likes to hide in areas of low blood flow, including cartilage [think: spinal column], because the immune system doesn't generally go such areas.  That's also why the older blood tests for Lyme may come up negative, because the Lyme bacteria migrate to cartilage (with very little blood flow), while the older blood tests (ELISA and Western blot) are looking for bacteria *in your blood*.  Lyme bacteria also create slimy areas in the body called 'biofilms', which shield the bacteria from the human immune system.  So you have several possible reasons your treatments may not be effective if you have Lyme.

You say, "I've been on Minocycline (a tetrecycline) for years for acne. Wouldn't this have killed the lyme?"  Not necessarily.  Not all bacteria are susceptible to tetracycline.  

Lyme is a tricky witch, and docs who are not specialists in that field are using a different rule book when it comes to diagnosis and treatment.  

I just searched online for                  ----   gainesville fl llmd    ----
and got some potentially helpful links.

In your situation, I would look around on the 'net to see which Lyme docs are nearby and have a good reputation among patients (from comment boards like this one) and also look for organizations like the Florida Lyme Disease Association to put you in touch with docs and others.  Lyme truly is everywhere.

You will find that Lyme docs' names are often left out of public areas of sites like this one and others, because there is a bitter fight in the medical community about how serious and widespread Lyme is or is not, and there are medical boards in many places who will go to great lengths to get Lyme specialists in trouble with the authorities who have power to revoke a doc's medical license.  There is a big case like that going on currently on the East Coast, and it's a terrible and sad thing.  So please be discreet by *not* posting Lyme docs' names in public -- we need them up and practicing, not defending against troglodytes installed on the medical boards.

Whew.  Hope this is helpful.  Above all:  don't give up!  You are clearly strong and determined, and that will do you well.  Keep us posted!
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Avatar universal
Wow. Thanks for the fast responses guys, The pain is hard to deal with and I appreciate the support. The only reason I have to suspect it MAY not be lyme is that I don't have fatigue or flu-like symptoms, just the pain I described. Also, the pain gets PERMANENTLY worse if I sit for too long upright or exert my back - leading  me to believe it may be a spinal cord injury, but the doctors have run 2 MRIs and 2 EMGs and tell me its not. Im so sick of this.

In addition, I've been on Minocycline (a tetrecycline) for years for acne. Wouldn't this have killed the lyme?
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Avatar universal
.... and PS -- while it would be entirely logical for infectious disease (ID) doctors to know everything worth knowing about Lyme, it seems to be the opposite:  the ID docs are locked in to the idea that Lyme is rare, hard to get, and easy to cure, and the most you're likely to get from an ID doc is a couple weeks of doxycycline antibiotics.  

That is the 'standard' treatment one receives from a nonLLMD, and it actually works ... BUT ONLY IF the doxy is taken right after getting the tick bite.  Many or most of us never saw the tiny Lyme tick or had the spreading, red, circular rash that the tick bite can cause, so we would not know to go to a doc and beg for a course of doxycycline.  I had Lyme and never saw a tick or had a rash, but I was one sick puppy.

Let us know how you do, okay?
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Avatar universal
I agree completely with mojo.  

I am very sorry you are suffering so much ... and it is terrible that the medical community is in such disarray in dealing with Lyme disease.  There is much confusion and denial about Lyme, which was 'discovered' only a couple of decades ago, and the first MDs to focus on it are still on the job -- unfortunately, these same MDs seem to have locked on to their initial impressions of Lyme diagnosis and treatment, and their egos seem to be in the way even as science has continued to learn more about Lyme.

Again, mojogal's suggestions are the way to go.  The International Lyme and Associated Diseases Society (ILADS) is a voluntary organization whose members are MDs that take a broad and more progressive view of how to diagnose and treat Lyme disease.  My own doc was an ILADS member (he still is, it's just that I'm well now and not his patient anymore), and ILADS is the main group focusing on the mess the medical community has made of Lyme diagnosis and treatment.  Check their website and road around there to get a feel for the approach a doc who thinks bigger thoughts about Lyme than many docs (including the ones you have seen already).

You will see the term LLMD ... it's patient slang for 'Lyme-literate medical doctor', meaning a doc who think broader and bigger thoughts about Lyme than many other docs.  There is no test or exam to be an LLMD:  it's a state of mind and an understanding that Lyme is a new and rapidly spreading disease that is not well understood by 'mainstream' medicine.

Above all, don't give up.  If it turns out you don't have Lyme, a Lyme doc will be the first to tell you, and will likely have other ideas of what you may have.  Let us know how you do, okay?  Best wishes to you --
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1763947 tn?1334055319
Yes it could very well be LYME. Mainstream Doctors love to say it's in your head.

I don't know which 2 out of 10 bands are the positive one but if I were you, I would go to an LLMD, Lyme literate Doctor who could treat you appropriately. Take a copy of your test. An LLMD will run the testing at igenex labs which is a better lab and is more sensitive

To find an LLMD in your area you can email,  ILADS.org and ask them or simply Google LLMD in the area where you live..
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