A doctor should use clinical diagnoses as well as Western immunoblot and Elisa tests for borrelia antibodies.
If you have a cfs/me-like illness, were bitten by a tick, and the above tests come up positive it would be quite odd to assume you didn't have Lyme.
Positive test results from combined Immunoblot and Elisa seem quite accurate, if wiki can be trusted below.
Though i'm not a scientist and I have no expertise in these areas. ( Or any areas really ).
'The serological laboratory tests most widely available and employed are the
Western blot and
ELISA. A two-tiered protocol is recommended by the
Centers for Disease Control and Prevention (CDC): the
sensitive ELISA test is performed first, and if it is positive or equivocal, then the more
specific Western blot is run.
[88] The reliability of testing in diagnosis remains controversial.
[2] Studies show the Western blot
IgM has a specificity of 94–96% for patients with clinical symptoms of early Lyme disease.
[89][90] The initial ELISA test has a sensitivity of about 70%, and in two-tiered testing, the overall sensitivity is only 64%, although this rises to 100% in the subset of people with disseminated symptoms, such as arthritis.
[91]
Erroneous test results have been widely reported in both early and late stages of the disease, and can be caused by several factors, including antibody cross-reactions from other infections, including
Epstein-Barr virus and
cytomegalovirus,
[92] as well as
herpes simplex virus.
[93] The overall rate of false positives is low, only about 1 to 3%, in comparison to a false negative rate of up to 36% using two-tiered testing.
[91]'
The only other issue is- who is doing the testing? Once again, you are trusting your doctor to find a reputable lab. I can only hope there's a fair degree of consistency and rigour in the borrelia testing sequences across laboratories, because I don't really know.
Infectolabs of Germany run these tests for me.
Laboratory Tests Stage III (chronic Lyme disease):
- Borrelia IgG- and IgM-EIA incl. VlsE
- Borrelia IgG- and IgM-Immunoblot incl. VlsE
- Borrelia Elispot-LTT
- CD3-/CD57+Cells
I had three positive bands come up for an Immunnoblot test and a positive for the Elisa. Considering my illness and tick bite history what could I do but consider that Lyme is at least a factor, if not the full problem of my illness?