How Lyme Disease Is Diagnosed: Types of Tests and What They Mean

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You’re feeling unusually tired. Maybe your joints ache, or you’re having trouble focusing—and there’s that memory of a tick bite weeks ago.
Could it be Lyme disease? You’re not alone in wondering, and getting clarity often starts with the right tests.

Lyme disease can be tricky to diagnose, especially in its early stages. Symptoms vary, and not all tests are created equal. Some people get false negatives. Others are misdiagnosed entirely.

In this post, we’ll walk you through the main types of Lyme disease tests, how they work, what they do (and don’t) tell you, and what to expect at each stage of the diagnostic process.

How Doctors Diagnose Lyme Disease

Lyme disease is primarily caused by the bacterium Borrelia burgdorferi, spread through black-legged tick bites. Diagnosing it often involves a combination of:

  • Medical history and symptoms
  • Known or possible exposure to ticks
  • Physical signs (like the bullseye rash)
  • Laboratory testing

Because early Lyme symptoms can resemble other illnesses—and not everyone gets the telltale rash—testing plays a crucial role in confirming diagnosis.

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🧪 Types of Lyme Disease Tests

  • Most doctors follow a two-step blood testing process recommended by the CDC:

    ➤ Step 1: Enzyme Immunoassay (EIA) or Immunofluorescence Assay (IFA)

    • This test checks for antibodies to Borrelia burgdorferi.

    • If negative: usually no further testing (unless symptoms are very recent).

    • If positive or borderline: move to Step 2.

    ➤ Step 2: Western Blot Test

    • Confirms the presence of specific antibodies.

    • Looks for IgM (early infection) and IgG (later-stage infection) bands.

    • At least 2 of 3 IgM bands or 5 of 10 IgG bands are needed for a positive result.

    🧠 Note: Antibodies take time to develop, so tests may be negative in the first 1–2 weeks after infection.

2. PCR Testing (Polymerase Chain Reaction)
  • Detects bacterial DNA, not antibodies.

  • Most useful for testing joint fluid (synovial fluid) in patients with Lyme arthritis.

  • Less reliable for blood or spinal fluid.

  • Can provide faster results, but false negatives are common.

 

3. ELISA Test (Enzyme-Linked Immunosorbent Assay)
  • Often used as part of the first step in two-tier testing.

  • Detects antibodies to Borrelia burgdorferi.

  • Highly sensitive but not specific—may produce false positives.

 

4. C6 Peptide Test
  • A newer generation ELISA test that detects a unique part of the Lyme bacteria.

  • Can be more accurate in early stages of Lyme disease.

  • Sometimes used as an alternative to traditional two-tiered testing
5. Spinal Tap (Lumbar Puncture)
  • Used when neurological Lyme (neuroborreliosis) is suspected.

  • Tests cerebrospinal fluid for Lyme antibodies.

  • Usually performed if symptoms include facial paralysis, meningitis, or cognitive issues.

When Should A Test Be Taken?

  • 3–30 days after a tick bite if symptoms (fatigue, fever, rash, joint pain) develop.
  • Immediately after noticing a bullseye rash — this alone is diagnostic.
  • After persistent, unexplained symptoms and a history of tick exposure.

What Do Lyme Test Results Mean?

Result What It Might Mean
Negative (early)
Possibility of Lyme exists—test may be too soon. Retest necessary in 2–3 weeks.
Negative (later)
Likely not Lyme, but further evaluation may be needed.
Positive IgM only
May indicate early Lyme or a false positive. Needs clinical context.
Positive IgG
Suggests past or ongoing infection.
Equivocal or borderline
Repeat testing or additional evaluation recommended.

Why False Negatives and Positives Happen

    • Antibodies may not show up early in the infection.
    • Some people never mount a strong immune response.
    • Cross-reactivity with other infections can produce false positives.
    • Tests vary in accuracy depending on the stage of the disease.

Want to learn more about HBOT for Lyme support?

Some people turn to complementary approaches to manage symptoms during or after antibiotic treatment.

One such option is Hyperbaric Oxygen Therapy (HBOT):

HBOT may support healing by:

  • Reducing inflammation
  • Enhancing oxygen delivery to tissues
  • Potentially targeting bacteria in low-oxygen environments

Why Choose Les Cours Hyperbaric Centre?

Les Cours Hyperbaric Centre is a reputable and professional facility that offers top-notch hyperbaric oxygen therapy. Our experienced team is well-equipped to guide you through the treatment process and ensure your safety and comfort throughout the sessions. With state-of-the-art hyperbaric chambers and a commitment to providing the best care possible, Les Cours Hyperbaric Centre is an excellent option for individuals seeking relief from Lyme Disease symptoms through HBOT.

Key Takeaways

  • Lyme disease diagnosis involves a combination of symptoms, history, and lab testing.
  • The most common tests include the two-tier antibody system and PCR.
  • No test is 100% accurate—timing and interpretation are key.
  • Always consult a Lyme-aware practitioner if symptoms persist.