therefore miss or delay their treatment and continue to suffer unnecessarily. Another downside is that this testing method unfor- tunately cannot be utilized immediately af- ter a bite or tick attachment because it takes time for antibodies to develop a response to the offending organism. This test could only appear positive if the immune system has had time to respond to the infection, approx. 6-8 weeks. Recommendation - Get this test first! As long as it is performed 6-8 weeks after you think you have been infected.
The gold standard testing for detection and confirmation of Lyme is a Bb culture. This test examines whether or not it is possible to grow the Bb organism from the blood, tissue, or spinal fluid sample over a 4, 8 or 16 week cycle. This test is also limited because Bb is a slow growing organ- ism and this test is infrequently positive after the organism has traveled outside of the blood stream and inside of the tissue. This test however does show that you have Lyme because the sample taken from your body was able to grow the Bb organism. Recommendation – This test can be
completed if you suspect an infection and have current exacerbation of symptoms. It can be completed anytime after infection. DNA or PCR (Polymerase Chain Reaction) testing is also available. This test determines if fragments of the Bb DNA are present within the blood. This test does not indicate an active infection or immune re- action; it only indicates whether fragments
of the bacteria are present in the sample taken. A limitation of this testing is that it is often found to be negative. Thoughts are this is because the Bb organism is only present in blood for a short period of time or that the genetic load needed to test positive is not present within the blood. Either way this test is often conducted to assist in the diagnosis of Lyme. Recommendation – I believe that this test can be an add-on to the tests listed above or it can be utilized if the tests above are negative and you still suspect Lyme.
One of the well-known labs that many
Lyme literate physicians utilize is IgeneX laboratory out of California. The testing can be expensive but their labs seem to be much more successful at picking up a Lyme and co-infection diagnosis than conven- tional
labs-www.igenex.com. Personally, I think if you can afford this testing, which can cost approximately $1,000, this is the best option.
Recommendation –If you are found
negative with the CDC guidelines, ELISA and Western Blot, I believe following up with this test is the best option if you still suspect Lyme as the cause to your symp- toms.
Ticks are very much like a dirty needle and can carry much more than just the Bb bacteria. Other infections referred to as co-infections, can also be present. These co-
infections, Babesia, Bartonella, Anaplasma, Ehrlichia, Mycoplasma, among others are an important piece to the puzzle but echo the same problems with testing, as Lyme. Testing can examine the immune response to the specific co-infection (IgG and IgM) along with PCR testing to detect DNA frag- ments within the blood. Once again it is important to keep in mind that these are a clinical diagnosis supported by laboratory data.
There is much to be desired for a
sensitive and specific test that accurately diagnoses Lyme disease. That being said, I support the use of the testing options and recommendations described above, as they are the most current ways we have to detect this evasive disease and support a clinical diagnosis. Personally, I am glad I was tested. I was fortunate enough to find that I met the criteria for a positive diagnosis of Lyme from CDC guidelines. Having this confirmation is helpful, but if you are struggling to find answers, do not take a negative test as the “be all and end all” and forego pursuing treatment. Often one of the best options is to pursue a treatment trial while monitoring your symptoms.
As I mentioned in Part 1: If you pres- ent with signs and symptoms, specifically an EM rash after a known bite, treatment should be started immediately and not de- layed for a confirmatory test. It can even be argued that if you present with an EM rash without a known bite but live in a Lyme en- demic area then treatment should be started immediately.
Part III…Sneak Peek
In the next part, I will specifically be speaking about treatment options, both natural and pharmaceutical. There are many options out there and I hope to be able to shed some light on their effectiveness and importance.
Until next time…Your Health Detective
Dr. Rudy Mueller DC IFMCP. See ad this page.
Suggested Resources: -“Healing Lyme” and “Healing Lyme Dis- ease Coinfections” by Stephen H. Buhner -“Why Can’t I get Better? Solving the Mystery of Lyme and Chronic Disease” by Richard I. Horowitz, MD -“Lyme Disease and Modern Chinese Medi- cine” by Qingcai Zhang and Yale Zhang -International Lyme and Associated Diseases Society 2013 Annual Conference
18 Essential Living Maine ~ August 2014
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