@Wanja, How was your experience with DEDIMED? I'm an American living in Berlin looking for Lyme testing, and I couldn't find much else by way of English-speaking labs around here.
I just visited Cape Cod, got bitten by ticks, tested negative for Lyme once and positive once, started antibiotic treatment, and want to test afterwards to make sure they worked. (Or whether the positive result, just days after the bite, was potentially a false positive.) DEDIMED is willing to test me but they seem trigger-happy with diagnosis, not to mention expensive (120 EUR *not* including tests, private pay only). I've wasted a lot of money on useless treatments for mysterious illness (I'm in the fibromyalgia realm) and I'd rather my remaining assets not go the way of Martin's car!
i have been studying Lyme and other tick born infections in depth for a number of years - the topic is complex and only some of the answers exist at this point in time - however there is a good deal we do know - but there is also a huge issue with misinformation and out of date information.
making sense of thsi is a mine field to the newly initiated / diagnosed
i can tell you:
1, serological tests are highly insensitive in the first 4-6 weeks after tick bite. this results in many false negatives as the body need around 4 weeks to start to make the antibodies the test looks for. for this reason most authoritative sources advocate for treatment based on clinical signs rather than based on testing.
2, there is, so far no test, that can tell you you are no longer infected. people are working on this type of test but so far nothing concrete has emerged. be aware that it is common for people with confirmed lyme disease to test and have a series of different results on western blot tests - sometimes these bands - sometimes some other bands - sometimes only IgG bands - sometimes only IgM - sometimes no bands. the borelia burgdorferi s.l. spirochete is known ( multiple papers on this) to repeatedly change the outer surface proteins expressed in its outer membrane - this are the proteins that the human immune system recognises and makes antibodies to - so the types and amounts of antibodies inside the host vary over time in response to these changes.
3, all serologic testing is flawed and unreliable - even after 6 weeks - many, many studies find sensitivity of anywhere between 20 to 70% at best ( manufacturers all claim much higher - but independent studies repeatedly find a big difference between the manuf claims and reality)
4, alternate test technologies are of as yet limited value - eg -
*PCR - so few spirochetes are in the blood at any one time that PCR of blood has proven to be only around *50% sensitive ( misses half of true cases)
*LTT - may be better than serology - but also flawed - / sensitivity issues - especially if immune function compromised or CD57+ counts low
*CD57+ tests - often low in Lyme - but sometimes actually high in lyme - and can be low in other diseases
*various nanotrap antigen / metabolite tests - so far none have proven universally effective
*phage based testing - finds much higher positive rate than any other method so far - interpretation difficult
regarding the lack of or slow / partial response to treatment as evidence for chronic Lyme being a non existent disease - a short study of the immune evasion techniques the spirochete is armed with gives ample explanation for the poor or incomplete response to conventional antibiotic treatment
-intracellular infection - organism can reside inside cells - a protected environment vs outside / between cells - much lower abx concentrations exist inside cells -
-biofilm formation - the Lyme spirochete lives mostly in micro biofilm colonies sequestered inside tissues - biofilms forms are up to 1500x more tolerant of abx vs free swimming forms
- host immune disruption - borrelia quickly colonise and damage germinal centres of the immune system, they also dysregulate the immune system, making it harder for the host immune system to function properly to eradicate it.
-antigenic variation - as described above - the organism is able to change the proteins it expresses in its outer surface to fool the immune system - hence its able to go about its business unhindered - until the immune system tries to catch up - by which time its changed its outer surface again
-co-infection - many studies show a high degree of co-infection exists in human lyme patients - in particular bartonella, babesia - but also anaplasma, erhlichia, rocky mountain spotted fever or other Rickettsia's, relapsing fever and many others - all of which may be transmitted by the same tick or picked up by the now immune-compromised patient elsewhere. co-infection typically causes a more severe symptom picture and more difficult treatment path.
people who have been sick for years with lyme often take years of systematic consistent treatment ( 1-2 years is perhaps typical) to fully recover but it is possible.
i struggled with diagnosis for 6 years - and was given diagnosis of post viral fatigue, fibromyalgia, CFS etc before finding lyme and bartonella - and am now 60% recovered - can workout 3-4 times per week and go hill walking, and i'm improving gradually month by month. in my case treating bartonella was key to moving forward.
i'm not suggesting everyone with a CFS diagnosis has lyme - but given the way the medical profession steer away form chronic Lyme, due to the controversy around it - and label people with just about any other diagnosis they cannot be pulled up in front of a board for - its safe to say that a fair number of them are.
in surveys of patients in the UK by Lyme advocacy groups - the majority of patients later diagnosed with Lyme - were first given a CFS diagnosis by UK GP's - i wonder how many stop there and just accept it. if i had my life would have been just about over.
for those interested in lyme support, info on diagnostics and treatments - i can recommend a knowledgeable and helpful group here
https://www.healingwell.com/community/default.aspx?f=30