N.B. As things currently stand, tests cannot prove the absence of Lyme disease. It’s always best to seek the advice of a medical practitioner with experience of Lyme disease as sometimes a clinical diagnosis is necessary.
If you have further questions on testing for Lyme disease, don’t hesitate to email us at email@example.com or join our friendly discussion group on Facebook and post your questions there.
Testing for Lyme disease is a controversial and highly debated area of medicine. LDUK does not endorse any particular type of Lyme disease testing but instead strives to highlight all available, known options.
Four publications analyse independent studies of test accuracy. A short summary can be found here.
“In comparison to the methods used for HIV, Lyme disease testing can generate between 170 and 560 times as many false negative results”
The initial testing method for Lyme disease offered by the NHS is an ELISA test which is usually performed at a local hospital laboratory and takes a few days or possibly a week to come back. Although there have been no specific studies to find out the percentage of false negatives in the UK, the reliability of the ELISA test appears to be questionable and it’s important to be aware that a negative result cannot rule out Lyme disease, especially as it can take up to 6-8 weeks after being infected for it to show up in blood tests, if at all.
If the ELISA test is positive or equivocal, the blood sample is usually sent to the Rare and Imported Pathogens Laboratory (RIPL) at Porton Down in England or the NHS Highland National Lyme Borreliosis Testing Laboratory at Raigmore Hospital in Scotland. The next round of testing for Lyme disease is then carried out which involves a Western blot (sometimes called an Immunoblot) test.
You can request printouts of both of these tests and it’s advisable to do so for your own records.
The NHS sometimes use a cerebrospinal fluid (CSF) test to look for antibodies. Samples are obtained by carrying out a lumbar puncture. An EIA is then used to confirm the presence of antibodies to Borrelia. It is possible for this test to produce a positive result for Lyme disease before blood tests turn positive but it also has a high rate of false negatives.
Private UK Labs
In the UK, it is possible to pay for private Western Blot testing for Lyme disease using the same test kit as the NHS uses, without producing a positive ELISA result first. This may be useful if your GP cannot order a Western Blot directly for some reason. Both laboratories use the same testing facilities as the NHS located at RIPL, Porton Down and therefore the result should be accepted by NHS doctors. It is important to be aware that these tests have the same issues as the NHS tests when it comes to low sensitivity and false negative results.
- County Pathology Limited
You either need your GP to authorise a Western Blot test or a doctor at this private laboratory can authorise it for you for a fee of £25.
- The Doctors Laboratory
Your GP needs to write a letter to request this Western Blot test.
Private Overseas Labs
There are private laboratories abroad which offer testing for Lyme disease that some Lyme disease doctors prefer to use. These laboratories also offer testing for a wide range of co-infections. These laboratories include ArminLabs and BCA Lab in Germany as well as IGeneX and Immunosciences Lab and in the USA. There is also Innatoss laboratory in the Netherlands. It is important to remember that the NHS don’t tend to accept results from these independent laboratories and that LDUK does not endorse any private laboratory. As these test results aren’t generally accepted by the NHS, this leaves many patients seeking private treatment for Lyme disease and associated conditions.
- ArminLabs offer an Immunoblot test (called a SeraSpot), an LTT EliSpot as well as a PCR test. They also test for a variety of co-infections with both EliSpot and antibody testing. The laboratory has DAkkS accreditation. The Academy of Nutritional Medicine is the official UK representative for ArminLabs and all Lyme disease testing enquiries in this country should be submitted to this organisation. You can send your blood samples by courier and so you do not have to go to the laboratory in person.
- BCA Lab offers a similar range of testing as ArminLabs using test kits and the laboratory has DAkkS accreditation.
- IGeneX offers a Western Blot test that includes more bands than the NHS test. They also provide antibody testing for co-infections and a PCR test.
- Immunosciences Lab offers a multi-peptide ELISA test for Lyme disease, Babesia, Bartonella and Ehrlichia. Also on offer is Immunoserology of Lyme disease by MPE and Western Blot. It is possible to order this test through the London Clinic of Nutrition by emailing firstname.lastname@example.org or calling 02033320030. If you can find someone to do your blood draw locally, you can send your sample in the post to the London Clinic of Nutrition and they will forward it on to Immunosciences Lab. If you are local to the clinic, they offer a phlebotomy service for £35.
- Innatoss Laboratories is based in the Netherlands and it is an accredited laboratory which offers CE approved testing. The following 5 tests are on offer for Lyme disease:
- ELISA IgG (Euroimmun)
- ELISA IgM (Euroimmun)
- C6 ELISA
- Western blot 1 (usually Euroimmun IgG/IgM/Mikrogen recomLine)
- Western blot 2 (usually Euroimmun IgG/IgM/Mikrogen recomLine)
The Western blot selected depends on the result of the ELISA test and Mikrogen is the same test kit manufacturer as the one used by the National Lyme Borreliosis Testing Laboratory (NLBTL) in Scotland. The difference is, Innatoss includes both the IgG and IgM test, whereas the NTBTL only uses the IgG test. Evidence and recommendations from the test kit manufacturers suggests that using both IgG and IgM in Western blot testing improves sensitivity.
Innatoss are corporate supporters of Caudwell LymeCo charity and will donate 5% of all sales of Lyme disease tests ordered from the UK to the charity. Read more here.
Alternative Medicine Testing
Some alternative practitioners use bioresonance machines and other energetic techniques to test patients for infections and illnesses. This form of testing for Lyme disease is highly controversial and isn’t scientifically validated but some practitioners and patients feel it may be useful. You can find alternative pracititoners here who may use energetic testing methods.
For further information on Lyme disease diagnosis, please click here
N.B. We are not medical professionals