hi, if you mean "how did I get tested for Lyme disease"
I think it best to start by stating what the research shows regarding testing.
This is a deep subject in itself - but there are some fundamentals that I believe are now established beyond useful debate namely that:
there are many tests that can detect Lyme disease.
however, none are 100% sensitive (or even above around 80% sensitivity in the real world)
many factors impact on the ability of the test to detect the disease in infected patients
there are many strains and species of Lyme causing borrelia - and not all produce the antigens that the tests look for evidence of (mosts tests were developed using lab strains like B31 or only some species)
the organism also adjusts which proteins it presents on its outer surface over time to fool the immune system -
and people's immune systems are also different - meaning that its a bit of a crapshoot as to whether any one patient is producing the antibodies the tests look for at any given point in time.
it has also been demonstrated that around 20% of patients never produce recognisable antibodies at all
the basic tests offered by most primary care physicians are demonstrated to be somewhere around 50% sensitivity (+/-20% depending on which study you read)
as a result, diagnosis is supposed to be achieved by clinical symptom picture according to all international guidelines I have read.
however, in practice, primary care physicians will very very rarely do this without a black and white test result(which, per above, does not exist) - or more recently - a stereotypical bulls-eye rash
there are more specialist tests, although none of these are really fully proven to be much better in terms of sensitivity (and insurance companies and state health systems seldom recognise these).
this is therefore clearly a complex disease which is challenging to diagnose.
however, a panel of tests including a range of different tests using different technologies together with the history and symptom picture can be used to give high % confidence of diagnosis.
I was tested by Armin labs in Germany, and tested positive for Mycoplasma as well as Lyme disease, and also had a very low cell count of a specific white blood cell count "CD57+ cell count" (very low, or occasionally CD57+ counts, are often found in chronic Lyme disease).Together with the history of how my partner and I became ill, the symptom picture we both developed, including many supporting test results for biomarkers etc were also consistent with Lyme disease - this gave me sufficient confidence to move forward in this direction.
For anyone reading this, however, it is important to state that there is no black and white diagnosis in such complex diseases, unless perhaps you happen to be in the few who light up all the tests positive, for the majority it is likely to be a careful consideration of all the possible differential diagnoses, reasoning your way through based on evidence, and all the while guarding as best you can from confirmation bias.
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