The most reliable tests are the Western Blot blood test; the antibody assay for Bb by Igenex Labs, the RIBb test (Rapid Identification of Bb) by Dr. Whitaker, and Dr. Mattman's culture test using live cultures done under a fluorescent microscope. It has to be understood though, that these are still not 100% reliable, but are the best currently available. Many doctors are following the diagnostic protocol of doing a Lyme titre or ELISA test, which are not accurate. IGeneX has multiple means of testing for this, as well as for similar tick-borne diseases like Babeosis, Ehrlichia, Bartonella and Rickettsia.

Laboratory testing for Lyme disease is under continuing development, but is still the best method to confirm the diagnosis. The Lyme Disease Foundation (LDF), in their brochure entitled "LDF Frequently Asked Questions About Lyme Disease" (1999), lists nine reasons for false negative Lyme disease tests results. This means that even though tests indicate you don't have the disease, you still could.

Nine reasons for false negative Lyme disease tests results:
A. Antibodies against Borrelia burgdorferi (Bb) are present, but the laboratory is unable to detect them.
B. Antibodies against Bb may not be present in detectable levels in patients with Lyme disease. Reasons for this are listed below.

1. The patient is currently on, or has recently taken, antibiotics. The antibacterial effect of antibiotics can reduce the body's production of antibodies.
2. The patient is currently on or has previously taken anti-inflammatory steroidal drugs (such as those taken to treat
   rheumatoid arthritis) or certain anticancer drugs. These can suppress a person's immune system, thus reducing or preventing an antibody response. It may be necessary to remain anti-inflammatory free for up to 6 weeks.
3. The patient's antibodies may be bound with the bacteria with not enough free antibodies available for testing. This reason is very important and prevalent. Some of the worst cases of Lyme disease test negative - too much bacteria for the immune system to handle.
4. The patient could be immunosuppressed for a number of other reasons and the immune system is not reacting to the bacterium.
5. The bacterium has changed its makeup (antigenic shift) limiting recognition by the patient's immune system.
6. The patient's immune response has not been stimulated to produce antibodies, i.e., the blood test is taken too soon after the tick-bite (2-6 weeks). Please do not interpret this statement as implying that you should wait for a positive test to begin treatment.
7. The laboratory has raised its cutoff so high that a patient's previously positive test is now borderline or negative.
8. The patient is reacting to the Lyme bacterium, but is not producing the "right" bands to be considered positive.

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It is important to understand the nature of the Bb organism. Bb can change its shape from a spiral to a filament, cyst, granule, hooked rod or elbow. These variants are called L-forms, a name given by the Lister Institute where they were first studied. These L-forms are also called cell-wall deficient (CWD) bacteria taking the non-spiral shape when they have lost much of the cell wall. In this form they do not produce an antibody response, as they have no cell wall, making it impossible for the individual’s immune system to respond. Classic L-forms are active metabolism centers for the production of CWD pleomorphic organisms (Bb). In this form they are able to hide within most tissues in the body, thus protecting them from any host response adverse to their well-being. CWD organisms can revert to typical morphology and may revert into adult forms. For this reason most of the diagnostic tests, i.e. ELISA and Western Blot, which depend on the production of antibodies, are inadequate. Much like the hepatitis model, antigen is present early after initial infection. Later, there is an antibody response in about seventy percent of patients. Tests that look for antibody response will not support an early diagnosis, nor reliably confirm presence of the disease.


After finding that there were few accurate tests for Bb, Eleanor Fort, a medical laboratory technologist, with a long history of research involvement in pediatric hematology / oncology and Jo Anne Whittaker, MD developed a Rapid Identification Profile (RIBb©) for the Lyme organism. The method uses a fluorescent antibody technique on whole blood and is noteworthy for sensitivity and for the brief time required to complete the test (less than 60 minutes).

The accuracy of this method was tested in two other laboratories with identical results. In addition, they look at a concentrated suspension of red and white blood cells (rather than a routine blood smear) to identify the co-infections associated with Lyme disease (Ehrlichia in the white blood cell and the parasite Babesia in the red blood cell). Occasionally, they see all three infections in the same individual - Bb, Ehrlichia, and Babesia. All of these patients have definite abnormal peripheral red blood cell morphology. This is noteworthy, as all require different treatment.

The RIBb test has been further refined. They are currently doing Quantitative Rapid Identification of Borrelia burgdorferi (Q-RIBb©). This process provides a quantitative titration (serial dilution) method of detecting the antigen in a fluid sample of a subject. The test is considered positive for Lyme disease upon detection of brightly fluorescent antigen-antibody complexes. Antibiotics do not affect the test so it is effective whether or not the person being tested is on antibiotics. For Q-RIBb test info contact the Bowen Institute at: 727-937-9077; email: JoAnne@bowen.org; or visit their website at: www.bowen.org.