Lyme Antibody Serology
ELISA

LYME IgG/IgM ANTIBODY SEROLOGY

The IgG/IgM Antibody Serology test is an ELISA (enzyme linked immunoassay) which indicates the presence of both IgG and IgM antibodies to B. burgdorferi.1,2 The IgG antibody often persists long after symptoms have disappeared. The presence of antibody indicates exposure, not active disease. A positive or equivocal test must be confirmed by both IgG and IgM Western Blots.

Current FDA-approved ELISA tests are not as sensitive as they should be. While the concept of these screening tests is good, lack of sensitivity is a drawback. In spite of this, Medicare and 3rd party payers often require these tests to be ordered first.

Patients with the diagnosis of Lyme disease based on clinical history have positive IgG/IgM serology results within one year of the tick bite approximately 70% of the time. The percentage of patients with a positive serology is reduced in subsequent years.5

Ordering multiple tests, such as the ELISA, Western Blot, Antigen Capture, and PCR, is significantly more efficient in a clinical diagnosis than is any single test.

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Tom Grier's explanation

From http://www.canlyme.com/labtests.html

(This article is a little dated, but still gives good info. This is just an exerpt)

Indirect Tests (serum antibody tests):

ELISA; Western Blot; IFA; Borreliacidal Antibody Assay (Gunderson test);T-cell Activation Test

Elisa Test

The Enzyme-Linked Immunosorbant Serum Assay is the simplest, least expensive, easiest to perform, and most common Lyme test ordered. It is a test based on detecting the antibodies that our bodies make in response to being exposed to Borrelia burgdorferi (Bb).

It is a preferred test by laboratories, not because it is more accurate than other Lyme tests, but because it is automated. Many different patient samples can be performed by a single machine simultaneously. This allows for a faster turnover, less costs, and theoretically, standardized test results that are consistent from lab to lab.

[Paras exerpted]

Since the ELISA test detects only free antibody, a negative test might actually indicate a more serious infection. Many times, I have seen totally asymptotic patients with ELISA titers over 1000 be treated as though they were on death's doorstep simply because they had a high titer, while patients with borderline titers who are practically disabled are ignored, because a low titer is perceived as meaning less infected! These conclusions are erroneous and actually opposite to the truth, which is that a high titer means greater natural immunity.


In my opinion, the ELISA test is worthless as a diagnostic tool in Lyme disease. It is inconsistent and inaccurate, and should be discontinued as a tool to diagnose Lyme. If the NIH and CDC truly believe, as they've stated, that the diagnosis of Lyme disease is to be made on the basis of symptoms, then these tests should be temporarily banned until each manufacturer can prove efficacy using human serum.