(For Lyme, a bulls eye rash is definitive. But only a few patients really ever get that classic rash. If a person has EVER has such a rash, that detail remains important for their lifetime.)
Lyme is supposed to be determined by a clinical diagnosis, from symptoms, history, physical and dialogue exam by an expert lyme literate doctor (LLMD). This explains why the testing is so tricky:
"With most infections, your immune system first forms IgM antibodies, then in about 2 to 4 weeks, you see IgG antibodies. In some infections, IgG antibodies may be detectable for years.
Because Borrelia burgdorferi is a chronic persistent infection that may last for decades, you would think patients with chronic symptoms would have positive IgG Western blots.
But actually, more IgM blots are positive in chronic borreliosis than IgG. Every time Borrelia burgdorferi reproduces itself, it may stimulate the immune system to form new IgM antibodies.
Some patients have both IgG and IgM blots positive. But if either the IgG or IgM blot is positive, overall it is a positive result.
Response to antibiotics is the same if either is positive, or both. Some antibodies against the borrelia are given more significance if they are IgG versus IgM, or vice versa.
Since this is a chronic persistent infection, this does not make a lot of sense to me. A newly formed Borrelia burgdorferi should have the same antigen parts as the previous bacteria that produced it.
But anyway, from my clinical experience, these borrelia associated bands usually predict a clinical change in symptoms with antibiotics, regardless of whether they are IgG or IgM."
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Lyme may or may not be the underlying infection for some chronic illnesses. But, if there is Lyme there are often other tick-borne infections to consider.
And, if whether it is Lyme (or not), there are also even other chronic "stealth" infections that evade detection that can cause similar health problems.
In addition to the usual coinfections from ticks (such as babesia, bartonella, ehrlichia, RMSF, etc.), there are some other chronic stealth infections that an excellent LLMD should know about: ----------
I would encourage EVERY person who has received a Lyme diagnosis to get the following tests.
- at link.
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There are many reasons to go ONLY to an ILADS-minded LLMD for diagnostics. However, if for some reason you find yourself with a doctor who is not LL, and they suggest either of the two things below, you need to know this:
* AVOID LUMBAR PUNCTURE (also called spinal tap). Many doctors want this done but it is NOT a good test for lyme and other tick-borne and stealth infections also have less invasive testing methods).
* AVOID STEROIDS as they can make lyme (and other stealth infections) much worse and much harder to treat. -
--thank you to Keebler for her collection of links--
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