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Need Help Interpreting Lyme Disease Western Blot Results
I just got my lab results back for the Western Blot, and I was wondering if anyone could give me some insight into what they mean. I go back to my doctor in a few weeks, but in the meantime I figured I'd try to find out some more about this. The notes are pretty straight forward, but as far as the medical diagnosis I am unsure. These are my results:
[+1115] Lyme Disease AB W/RFX
H2.10, reference range: 0.00 to 0.90
Interpretation: Positive
B. Burgdorferi 18 KD (IgG)- Nonreactive
B. Burgdorferi 23 KD (IgG)- Nonreactive
B. Burgdorferi 28 KD (IgG)- Nonreactive
B. Burgdorferi 30 KD (IgG)- Nonreactive
B. Burgdorferi 39 KD (IgG)- Nonreactive
B. Burgdorferi 41 KD (IgG)- Reactive
B. Burgdorferi 45 KD (IgG)- Nonreactive
B. Burgdorferi 58 KD (IgG)- Nonreactive
B. Burgdorferi 66 KD (IgG)- Nonreactive
B. Burgdorferi 93 KD (IgG)- Nonreactive
Note: IgG Western Blots which have 5 or more of the 10 significant bands are considered positive for specific antibody to B. burgdorferi.
-----
Lyme IgG WB Interpretation: Negative
Reference range: Negative
B. Burgdorferi 23 KD (IgM)- Nonreactive
B. Burgdorferi 39 KD (IgM)- Nonreactive
B. Burgdorferi 41 KD (IgM)- Reactive
Note: IgM Western Blots which have 2 or more of the 3 significant bands are considered positive for specific antibody to B. burgdorferi.
-----
Lyme Disease AB W/RFX
B. Burgdorferi Interpretation (IgM): Negative
Reference range: Negative
[+1115] Lyme Disease AB W/RFX
H2.10, reference range: 0.00 to 0.90
Interpretation: Positive
B. Burgdorferi 18 KD (IgG)- Nonreactive
B. Burgdorferi 23 KD (IgG)- Nonreactive
B. Burgdorferi 28 KD (IgG)- Nonreactive
B. Burgdorferi 30 KD (IgG)- Nonreactive
B. Burgdorferi 39 KD (IgG)- Nonreactive
B. Burgdorferi 41 KD (IgG)- Reactive
B. Burgdorferi 45 KD (IgG)- Nonreactive
B. Burgdorferi 58 KD (IgG)- Nonreactive
B. Burgdorferi 66 KD (IgG)- Nonreactive
B. Burgdorferi 93 KD (IgG)- Nonreactive
Note: IgG Western Blots which have 5 or more of the 10 significant bands are considered positive for specific antibody to B. burgdorferi.
-----
Lyme IgG WB Interpretation: Negative
Reference range: Negative
B. Burgdorferi 23 KD (IgM)- Nonreactive
B. Burgdorferi 39 KD (IgM)- Nonreactive
B. Burgdorferi 41 KD (IgM)- Reactive
Note: IgM Western Blots which have 2 or more of the 3 significant bands are considered positive for specific antibody to B. burgdorferi.
-----
Lyme Disease AB W/RFX
B. Burgdorferi Interpretation (IgM): Negative
Reference range: Negative
No same results the doctor based her decision off of. I just finally got a chance to get back to her after the results from months ago. They didn't order a follow up for after the medication is complete. I guess they figure it doesn't matter, since they don't think I really have it. I found a Lyme specialist in my area who is supposed to be really good. As soon as I can get to her I am definitely going to. And you're welcome, I am glad to offer as much advice as I can about it =]
Sorry, were these the same test results you posted about above, or new ones? I was assuming you have new ones.
Do you have a copy of the test results?
I'm not medically trained, but I would take the doxycycline as instructed, but at the same time find a Lyme specialist for a second opinion ... but I also wouldn't necessarily tell my current doc I was doing that. (They can get SO offended, and that poisons the relationship with that doc, whom you might well need in the future.)
Best wishes -- let us know how you do -- thanks for letting us know about this development!
I'm not medically trained, but I would take the doxycycline as instructed, but at the same time find a Lyme specialist for a second opinion ... but I also wouldn't necessarily tell my current doc I was doing that. (They can get SO offended, and that poisons the relationship with that doc, whom you might well need in the future.)
Best wishes -- let us know how you do -- thanks for letting us know about this development!
I just wanted to update everyone on what the doctor told me about my blood results. She said that the first part of the test was positive, because it shows that I was bit by a tick before. But then the other parts of the test are negative (with only a few reactive strands here and there) because it shows my immune system fought it off. She told me that she only treats the disease when it's like that based on symptoms. Typically they wouldn't give me anything for it, but she said that if I wanted to take the medication I could and there wouldn't be any negative side effects. So I agreed and I am going to start it as soon as I can. I was given doxycycline hyclate 100mg two times a day for 21 days.
Oh, I believe you! I'm just not familiar with the Quest lab reports, and I can see from the way they reported it why Lyme docs often/usually use LabCorp. The tests are complex in the way they are structured -- and I'm not familiar with the interpretation of Quest Lyme tests since my doc used LabCorp.
I can tell you that, from what I have read, your immune system produces antibodies against a recent Lyme infection, and those antibodies are called Immunoglobulin M, or "IgM". Then after a while (weeks or months?), your quick-response immune system trails off, and a later reaction begins, with the immune system manufacturing Immunoglobulin G, or "IgG". By testing for both IgM and IgG, a doc can guesstimate (because there are no hard and fast cutoff dates) whether and how long you have been infected. Sometimes people don't know they have been infected and aren't obviously ill enough for a doc to think of running a Lyme test, and eventually the immune system just gets bored and stops reacting, as I understand it. That's why at some point, in some people, there is very little or no reaction on the standard Lyme tests, so regular docs will say No, You Don't Have Lyme.
Lyme specialists view it differently and understand that Lyme is not like 'regular' infections, so they will often test for Lyme with a PCR test, which (I believe, but I'm not medically trained) looks not for the immune system's reaction to Lyme bacteria, but instead for bits and pieces of Lyme DNA, in other words: direct evidence of Lyme infection, instead of indirect evidence created by the immune system.
Some docs will, if your tests come back negative, give a short course of antibiotics and then re-test, to see if your immune system has been stirred up to react against the Lyme. That gives the docs another piece of data to make a diagnosis.
Unfortunately, docs who are NOT Lyme specialists rely on the tests and believe they are entitled to do so. That leaves them unable however to account for a patient's symptoms, and that is why we patients are left to shift for ourselves in this matter. Fortunately there are docs who think more broadly and progressively, sometimes called by patients 'LLMDs', or 'Lyme Literate MDs' to identify those who understand the trickiness that is Lyme.
In your situation, I would certainly go back and visit with the doc, get the test results (and be sure to get a hard copy of the test for your own files at home), and then decide what to do next, as in whether to go see another doc, preferably an LLMD, for a second opinion. You don't mention whether your doc is a specialist or a GP, and oddly enough, the docs who should understand best about Lyme (neurologists and infectious disease docs) are too often the ones with the least understanding.
Given that I don't understand the Quest labs reports, I'll nevertheless venture to say that I am surprised that it gives you a 'positive' in one place, because the only numbered 'band' that you show positive on (number 41) is one that is not specific to Lyme. 'Specific' in this context means that no other bacteria would show positive except Lyme, so that a positive band 41 could mean Lyme, but could also mean other ailments also caused by spiral-shaped bacteria, of which Lyme is only one. This positive result may make sense on the Quest test, but it wouldn't on the LabCorp tests, so this just shows I don't understand the Quest tests.
I am sorry you're feeling ill enough to need to track all this down, but you are doing the right thing. If you do have Lyme, it won't go away by itself.
Oh, and did the doc test you for other diseases that the same ticks carry? In about half the cases of Lyme, the patients also have another 'bonus' disease such as bartonella, babesiosis, or a couple others.
NonLLMDs believe strongly in the accuracy and sensitivity of the tests they use, but the tests are simply not all that accurate, so if they tell you you don't have Lyme or co-infections, but you know that you are sick with something, then following up with another doc may be your only reasonable option, imho.
Come back and tell us what you find out, okay? Take care --
I can tell you that, from what I have read, your immune system produces antibodies against a recent Lyme infection, and those antibodies are called Immunoglobulin M, or "IgM". Then after a while (weeks or months?), your quick-response immune system trails off, and a later reaction begins, with the immune system manufacturing Immunoglobulin G, or "IgG". By testing for both IgM and IgG, a doc can guesstimate (because there are no hard and fast cutoff dates) whether and how long you have been infected. Sometimes people don't know they have been infected and aren't obviously ill enough for a doc to think of running a Lyme test, and eventually the immune system just gets bored and stops reacting, as I understand it. That's why at some point, in some people, there is very little or no reaction on the standard Lyme tests, so regular docs will say No, You Don't Have Lyme.
Lyme specialists view it differently and understand that Lyme is not like 'regular' infections, so they will often test for Lyme with a PCR test, which (I believe, but I'm not medically trained) looks not for the immune system's reaction to Lyme bacteria, but instead for bits and pieces of Lyme DNA, in other words: direct evidence of Lyme infection, instead of indirect evidence created by the immune system.
Some docs will, if your tests come back negative, give a short course of antibiotics and then re-test, to see if your immune system has been stirred up to react against the Lyme. That gives the docs another piece of data to make a diagnosis.
Unfortunately, docs who are NOT Lyme specialists rely on the tests and believe they are entitled to do so. That leaves them unable however to account for a patient's symptoms, and that is why we patients are left to shift for ourselves in this matter. Fortunately there are docs who think more broadly and progressively, sometimes called by patients 'LLMDs', or 'Lyme Literate MDs' to identify those who understand the trickiness that is Lyme.
In your situation, I would certainly go back and visit with the doc, get the test results (and be sure to get a hard copy of the test for your own files at home), and then decide what to do next, as in whether to go see another doc, preferably an LLMD, for a second opinion. You don't mention whether your doc is a specialist or a GP, and oddly enough, the docs who should understand best about Lyme (neurologists and infectious disease docs) are too often the ones with the least understanding.
Given that I don't understand the Quest labs reports, I'll nevertheless venture to say that I am surprised that it gives you a 'positive' in one place, because the only numbered 'band' that you show positive on (number 41) is one that is not specific to Lyme. 'Specific' in this context means that no other bacteria would show positive except Lyme, so that a positive band 41 could mean Lyme, but could also mean other ailments also caused by spiral-shaped bacteria, of which Lyme is only one. This positive result may make sense on the Quest test, but it wouldn't on the LabCorp tests, so this just shows I don't understand the Quest tests.
I am sorry you're feeling ill enough to need to track all this down, but you are doing the right thing. If you do have Lyme, it won't go away by itself.
Oh, and did the doc test you for other diseases that the same ticks carry? In about half the cases of Lyme, the patients also have another 'bonus' disease such as bartonella, babesiosis, or a couple others.
NonLLMDs believe strongly in the accuracy and sensitivity of the tests they use, but the tests are simply not all that accurate, so if they tell you you don't have Lyme or co-infections, but you know that you are sick with something, then following up with another doc may be your only reasonable option, imho.
Come back and tell us what you find out, okay? Take care --
It says Test Performed at: Quest Diagnostics, which must be the same place. I didn't leave anything out of the lab, I posted everything as accurately as possible. This is the Interpretation for the Positive:
Due to recommendation by the Food and Drug Administration (FDA), all positive or equivocal Borrelia burgdorferi antibody EIA (screening) tests will be followed by the Western Blot. The screening test for B.burgdorferi has a low predictive value for a negative result when used to detect early infection and low predictive value for a positive result when exposure history, symptoms, and clinical findings are not consistent with Lyme disease. Positive or equivocal second-step testing of the specimen is done using a method that is more specific for antibodies to B.burgorderi (e.g. Western Blot).
That's honestly all the information on this lab. I will definitely keep posting when I find out what is going on here. Thanks for trying to help.
Due to recommendation by the Food and Drug Administration (FDA), all positive or equivocal Borrelia burgdorferi antibody EIA (screening) tests will be followed by the Western Blot. The screening test for B.burgdorferi has a low predictive value for a negative result when used to detect early infection and low predictive value for a positive result when exposure history, symptoms, and clinical findings are not consistent with Lyme disease. Positive or equivocal second-step testing of the specimen is done using a method that is more specific for antibodies to B.burgorderi (e.g. Western Blot).
That's honestly all the information on this lab. I will definitely keep posting when I find out what is going on here. Thanks for trying to help.
Greetings --
Sorry to hear you have been ill, but good for you for working to figure out what's up.
I'm not medically trained, so what I say here is just derived (perhaps incorrectly) from what I have read in various places.
These appear to have (perhaps) been run by Quest Labs, not one that my Lyme doc used.
I am unclear as to why the third line says 'positive', while the specific bands below it have only one positive. Were there other lists of bands that you did not paste here?
That the lab says you are positive at all would be a red flag for a Lyme specialist.
Sorry not to be more helpful. After you see your doc, would you post back and tell us what s/he said?
Sorry to hear you have been ill, but good for you for working to figure out what's up.
I'm not medically trained, so what I say here is just derived (perhaps incorrectly) from what I have read in various places.
These appear to have (perhaps) been run by Quest Labs, not one that my Lyme doc used.
I am unclear as to why the third line says 'positive', while the specific bands below it have only one positive. Were there other lists of bands that you did not paste here?
That the lab says you are positive at all would be a red flag for a Lyme specialist.
Sorry not to be more helpful. After you see your doc, would you post back and tell us what s/he said?
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