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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.
 

 
 

Test for Lyme Disease can help with the following:
 
 
Infections  Lyme Disease
 From the website for THE LYME DISEASE SOLUTION by Ken Singleton, M.D..

"One of the most crucial elements in the successful treatment of Lyme disease is an accurate diagnosis of Lyme and of its potential co-infections. The sooner the diagnosis can be made from the time of the initial infection with Lyme or its co-infections the better." This is the website..

Dr. Klinghardt exclusively uses the IGeneX Lab in Palo Alto for his blood tests, and Fry Labs in Arizona for direct microscopy testing.

"I don't have a financial investment in it, but it's the gold standard in our field," he says. "They use two different antigens. The commercial labs and hospitals and so forth, they use one antigen and are notorious in under-diagnosing Lyme disease. We recommend to rather not test it than get a false negative, which will sometimes lead the patient 20 years on the wrong track. With the other co-infections, the detection rate drops way down.

… We do the FISH test [for Borrelia] at IGeneX Lab. It's a direct microscopy test which has more false negatives than the western blot.

… The leading test for Bartonella that we use is Fry Labs in Arizona. Steven Fry, who does a wonderful direct microscopy test, often comes back positive with the diagnosis of hemobartonella. Hemo means simply blood – Bartonella in the blood. Remember, he's testing the blood where the Bartonella typically does not live. It lives in the nervous system. So if you find it in the blood in small amounts it generally is an indicator that there is a high amount in other tissues in the body."

An indirect test is the CD57 test. "CD-57" is a specific group of natural killer cells that are particularly damaged by the Lyme spirochetes. Therefore, if your numbers drop to a certain level, it is an indirect indicator that you may have Lyme disease, because the only known infection to suppress CD57 is that of Borrelia burgdorferi.

Normally, your CD57 value should be over 100. If it's lower than that, you're infected with Borrelia. If it's below 60, you probably have both Borrelia and Mycoplasma, and, most likely, some other co-infections.


2013. New Lyme-like agent - Borrelia miyamotoi.

It probably sickens more than 4,000 Americans every year, and until now, no one knew exactly what it was.

Thanks in part to a very sick Hunterdon County woman, researchers have identified a new tick-transmitted illness, which is similar to Lyme Disease.

Although the discovery is new, researchers say they do not expect more people to get sick from infected ticks. Instead people, who in the past may have been misdiagnosed, will now know the correct cause of their disease.

“It’s an important discovery because it is not exactly like Lyme, and any time you find a new disease, it is significant,” said Peter Krause, a senior research scientist at Yale, who authored a paper showing 18 people in the northeast have contracted the bacteria that causes the disease.

Krause said he believes the bacteria has probably been around for years but was misdiagnosed as Lyme Disease, because the symptoms and treatment are so similar.

The disease — too new to have a name — is spread by deer tick, which transmit a bacteria called Borrelia miyamotoi.

Like Lyme Disease, symptoms include headache, fever and muscle aches, and it can be treated with the same antibiotics used to treat Lyme.

“Some patients have both this and Lyme.” Krause said. “We don’t have enough data to know how much sicker you get if you get both.”

There are two factors that distinguish this bacteria from Lyme Disease, Krause said. The first is a relapsing fever that can recur every few days or even over a period of weeks. The other factor is that the rash usually associated with Lyme Disease only appears in 10 percent of those patients who have this new kind of bacteria.

Like Lyme disease, this bacteria can have far more serious consequences for those patients who already have compromised immune systems.

Anna Felix, a Hunterdon County woman, holds the dubious distinction of being the first patient in North America to have a confirmed case. The 81-year old first began feeling ill in the fall of 2011, shortly after being treated for Lymphoma.

She lost 30 pounds, had cognitive problems and could barely leave her Kingwood Township home.

Her doctor suspected the cancer had returned but an oncologist found nothing. Felix was then seen by Joseph Gugliotta, a physician affiliated with Robert Wood Johnson Medical School, who thought Lyme Disease might be the culprit. When he performed a spinal tap, he found corkscrew-shaped bacteria.

“Her spinal fluid was filled with them,” said Gugliotta who works at Hunterdon Medical Center.

It was Borrelia miyamotoi, which was first discovered nearly 20 years ago in Japan, but it wasn’t until 2011 that Russian doctors confirmed the bacteria could infect humans. Felix's case confirmed what Russian doctors had been seeing.

"Everything was very exciting to me," he said.

A strong dose of penicillin was all Felix needed to recover. [By Dan Goldberg/The Star-Ledger on January 22, 2013]
 
 


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GLOSSARY

Antibody:  A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.

Antigen:  A substance, usually protein or protein-sugar complex in nature, which, being foreign to the bloodstream or tissues of an animal, stimulates the formation of specific blood serum antibodies and white blood cell activity. Re-exposure to similar antigen will reactivate the white blood cells and antibody programmed against this specific antigen.

Anti-inflammatory:  Reducing inflammation by acting on body mechanisms, without directly acting on the cause of inflammation, e.g., glucocorticoids, aspirin.

Bacteria:  Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.

Cysts:  A closed pocket or pouch of tissue; a cyst may form within any tissue in the body and can be filled with air, fluid, pus, or other material. Cysts within the lung generally are air filled, while cysts involving the lymph system or kidneys are fluid filled. Cysts under the skin are benign, extremely common, movable lumps. These may develop as a result of infection, clogging of sebaceous glands, developmental abnormalities or around foreign bodies.

ELISA:  (Enzyme-Linked Immunosorbent Assay): A test that detects the presence of the AIDS virus or Lyme Disease antibodies.

Hepatitis:  Inflammation of the liver usually resulting in jaundice (yellowing of the skin), loss of appetite, stomach discomfort, abnormal liver function, clay-colored stools, and dark urine. May be caused by a bacterial or viral infection, parasitic infestation, alcohol, drugs, toxins or transfusion of incompatible blood. Can be life-threatening. Severe hepatitis may lead to cirrhosis and chronic liver dysfunction.

Immune System:  A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.

Metabolism:  The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Oncology:  The study of cancer.

Parasite:  An organism living in or on another organism.

Red Blood Cell:  Any of the hemoglobin-containing cells that carry oxygen to the tissues and are responsible for the red color of blood.

Rheumatoid Arthritis:  A long-term, destructive connective tissue disease that results from the body rejecting its own tissue cells (autoimmune reaction).

White Blood Cell:  (WBC): A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. Also known as a leukocyte.