This is topic Which IGeneX test? in forum Medical Questions at LymeNet Flash.


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Posted by SLH516 (Member # 48060) on :
 
I need to finally be tested for Lyme. I had many symptoms of chronic Lyme in the past that seemed to have largely been in remission for several years. I've had renewed symptoms since a possible covid infection in early 2020 and more rapidly progressing symptoms since a July 2021 camping trip. The camping was in an area known to have infected ticks as well as diagnosed Lyme cases.

What's the general consensus on which lab does the better testing now?

If IGeneX is the preferred lab, which tests/panel I should start with? Cost is an issue, so I need to narrow it down to the least expensive option that will provide the info I need as a starting point.

My neurologist ordered a WB through Diagnostic Laboratory Science that came back positive for P41 IgG but negative for the other antibodies tested for.

I don't have a LLMD right now ($), but I'm hoping the same neurologist will be willing to order the test(s) for me. Since he's not a Lyme specialist, he won't know which tests to order, so I want to be able to steer him in the right direction.

Another question: Since it could take a little time to get the testing done, would it be a good idea to see if I can get a doc to start me on antibiotics while I wait? I have some rapidly progressing neuropathy that is freaking me out.

[ 09-30-2021, 05:21 AM: Message edited by: SLH516 ]
 
Posted by Garz (Member # 52095) on :
 
unfortunately, testing is not straightforward for Lyme.

there is no single test that can give you a highly reliable black and white answer.

probably the most useful first round test is the one you have done already - western blot

however, since that did not show much - it may be of limited value doing the same test again - then again another lab might find different results - or if done after a month of so delay its possible other antibodies could be found.
so that is still an option.

but note that there are sensitivity issues( high false negative rates) with all Lyme serological tests - and as a result clinicians use either several different lyme tests - each using a different technology to improve chances that one will detect it - or they diagnose clinically based on symptoms.

igenex themselves seem to recommend the Immunoblot which i believe is an updated version of the western blot - i think if it were me i would try that one.
they write about it here:
https://igenex.com/tick-talk/the-best-test-for-lyme-disease/
 
Posted by SLH516 (Member # 48060) on :
 
I'm aware of how unreliable the testing can be, though I was under the impression that labs such as IGeneX and DNA Connexions tend to produce more accurate results than other labs on the same tests. (I understand that "more" accurate doesn't mean "always" accurate, and that someone can have Lyme even with negative test results.)

Do all WBs for Lyme test for the same list of antibodies, or do some labs test for more than others? I'm curious if the test I received covered all the antibodies that should be tested for. These are the bands included in my report:

IgG: 18/21, 25, 28, 30, 31, 34, 39, 41, 45, 58, 60, 66, 93/83

IgM: 25, 39, 41

I see that IGeneX tests for IgG/IgM band 23, which my test didn't cover. I can't find the list of antibodies covered by the DNA Connexions test. Is 23 significant enough to justify getting the test done again by IGeneX?

Because of past experience with severe Lyme symptoms, I'm more suspicious of my symptoms being a flare of chronic Lyme set off by a covid infection or possibly a re-infection during my recent camping trip than I am of this being strictly a recent first-time infection. For whatever that's worth. ;-)
 
Posted by terv (Member # 29410) on :
 
I just watched a youtube video by Jr. J in DC. While far from perfect, he thought the EliSpot was the best one now.

Minute 51

https://www.youtube.com/watch?v=pJUbooX42Qk


https://www.arminlabs.com/en/tests/elispot
 
Posted by Lymetoo (Member # 743) on :
 
I know Stonybrook and other labs like Quest and Lab Corp DO NOT test for all possible bands.

Western Blot Explanation
http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/42077

If I were getting the Igenex, I would do the basic IgG and IgM. You don't need the PCR, etc.

The 8th thread in Medical Questions contains many valuable links, filled with information:

https://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=1;t=088555;p=0
 
Posted by Garz (Member # 52095) on :
 
to make matters more complex i think it also depends what antigens they use for the test.

some tests including western blot do i think use only antigens from lab strains of borrelia - eg Borrelia Burgdorferi B31 - and these antigens do not necessarily correspond to all wild type that can cause lyme disease.

I was negative by standard western blot and C6 ELISA but positive by tickplex at Armin Labs - when i looked into it i found that the European species/strains like B. Garinii do not express the proteins that the C6 Elisa looks for.

i was also told by the testing company that in cases where CD57 is low the EliSpot is often negative
 
Posted by Bartenderbonnie (Member # 49177) on :
 
Also ask your Neuro or Primary to test your immune system.

Lyme western blots are antibody based tests that your immune system produces when it sees an antigen (enemy germ). Lyme disease is notorious for disrupting the immune system in many people which causes false negatives.

Here’s the tests you need;

Gamma Globulins
Immunoglobulins Panel, serum
IGA, serum
IGM, serum
IGG, serum
IGM, serum
IGA, serum
IGE, serum

IGG subclasses
IGG 1
IGG 2
IGG 3
IGG 4

M.Pneumoniae AB (IGG)
Influenza Type A AB
Influenza Type B AB
 


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