Remember, these bands reflect the reaction of your immune system to Lyme. Some people have stronger immune systems than others, some are weaker, and over time, the positive response tends to fade -- the longer you have been infected, the weaker the response on this test overall.
This is the IgM part of my results. Remember, an IgM positive test result means more recent & likely currently active infection.
On my IgG Results I am negative - negative even though I have 2 positives on bands 41 and 58 and 2 IND's on bands 31 and 39. Remember IgG means previous exposure to the bacteria or older infection of Lyme.
I also 'scored' a 40 on my IgG, IgM, IgA (GMA) which is equivocal.
How To Decipher Lyme Bands
The following is a breakdown of the Western blot only. As co-infections will show their own titers.
IgM is a sign of a current infection.
IgG can be a sign of a current infection if symptomatic, or of a past exposure to or past infection by the organism.There are nine known Borrelia burgdorferi genus specie specific KDA Western Blot antibodies (bands):
18 23 30 31 34 37 39 83 and 93.
Only one of these Borrelia burgdorferi genus specie specific bands is needed to confirm that there is serological evidence of exposure to the Borrelia burgdorferi spirochete and can confirm a clinical diagnosis of Lyme disease.Igenex Western Blot Break Down by band
9 cross-reactive for Borrellia
12 specific for Bb
18 highly specific to Lyme (Many LLMD's say if this band alone is positive, you have lyme )
20 cross-reactive for Borrellia
22 specific for Bb, probably really the 23/25 band
23-25 outer surface protein C (OspC), specific for Bb
30 unknown; probably an outer surface protein; common in European and one California strain - Has cross-reactivity with several different types of viruses
31 outer surface protein A (OspA), specific for Bb - Has cross-reactivity with several different types of viruses
34 outer surface protein B (Osp; specific for Bb
35 specific for Bb
37 specific for Bb
38 cross-reactive for Bb
39 is a major protein of Bb flagellin; specific for Bb
41 flagellin protein of all spirochetes; this is usually the first to appear after a spirochete infection but is NOT specific to Lyme (i.e, other spirochete diseases have flagellas)
45 cross-reactive for all Borellia
50 cross-reactive for all Borrellia
55 cross-reactive for all Borrellia
57 cross-reactive for all Borrellia
58 unknown but may be a heat-shock Bb protein
60 cross reactive for all Borrellia
66 cross-reactive for all Borrelia, common in all bacteria
83 specific antigen for the Lyme bacterium, probably a cytoplasmic membrane
93 unknown, probably the same protein in band 83, just migrates differently in some patients
An IgM positive test result means more recent & likely currently active infection.
IgG positive means previous exposure to the bacteria or older infection of Lyme.
If no symptoms are present with IgG positive, it may mean an "inactive" LD infection.
PLEASE BE AWARE MANY LLMD'S CONSIDER A BAND THAT IS 'IND' AS POSITIVE, IGENEX TEST READS 'IND's' ARE SIGNIFICANT AND DOES NOT INDICATE A NEGATIVE.
Bb Borrelia burgdorferi
Bmp Bacterial membrane protein
HGE Human granulocytic ehrlichiosis
kDa kilodalton = molecular weight
Oms Outer membrane-spanning
Osp Outer surface proteins
Positive (+ or +/-) IgG results on Bands 31 or 34 kDa may occur after vaccination in otherwise uninfected people.
IGeneX considers the IgM equivocal if only one of the @ bands are present.
When reporting bands, the reporting laboratory marks each band with the following indicators of intensity:
- Not present
+/- Equivocal = indeterminate (there, but not as intense as Low)
There are nine known [Lyme] Borrelia burgdorferi species specific Western Blot antibodies (bands): 18, 23, 31, 34, 37, 39, 83 and 93.
Only one of these Borrelia burgdorferi genus specific bands is needed to confirm that there is lab evidence of exposure to the Borrelia burgdorferi spirochete and can confirm a clinical diagnosis of Lyme disease.
CDC Criteria are Confusing in Real Clinical Settings
CDC Western Blot IgM surveillance criteria includes only two burgdorferi genus species specific antibodies for IgM 23 and 39 and excludes the other seven Borrelia burgdorferi antibodies.
CDC Western Blot IgG surveillance criteria include 18, 23, 30, 37, 39 and 93 and exclude bands 31, 34 and 83.
It does not make sense to exclude any Borrelia burgdorferi genus species-specific antibodies in a Lyme Western Blot, and to include only two of these antibodies in IgM because all the antibodies in IgG were once IgM.
The CDC wrongfully includes five non-specific cross-reacting antibodies in its Western Blot surveillance criteria: 28, 41, 45, 58 and 66. This leads to the possibility of false positive Lyme Western Blots. There can be no false positives if only Borrelia burgdorferi genus species-specific antibodies are considered. One can have a CDC surveillance positive IgG Lyme Western Blot with the five non-specific antibodies without having any Borrelia burgdorferi genus species specific antibodies.
This does not make sense.
The CDC recommends that the Lyme Western Blot be performed only if there is a positive or equivocal Lyme ELISA. In my practice of over 10, 000 children with Lyme disease, 30% with a CDC positive Lyme Western Blot have negative ELISA's. The Lyme ELISA is a poor screening test. An adequate screening test should have false positives, not false negatives.