Advanced Expert Reading of Lyme Disease Western Blots
How can doctors ignore it if someone has a Western Blot test result that shows even a single "band" — a fingerprint band — that is specific to Lyme?
The interpretation of the Lyme Western Blot test is very serious. A positive Lyme patient should never be missed. Perhaps one Chinese view would miss very few. In one recent Asian study, they take the position that one band or antibody against the Lyme bacteria shows the infection is present. They even consider a non-specific spirochete antibody to be useful if you prove it is not caused by other major spirochetes. In other words, a person who had neither syphilis nor leptospira whose Western Blot showed a 41 kDa band, should be assumed to have Lyme disease.
Let us talk about how to interpret a Western Blot test. Some reports do not even list the result numbers. They just report it as almost always negative on the G or M class of antibodies. The doctor has no chance to think and reflect on the results when a laboratory simply says your Western Blot is either "negative" or "positive." This is a laboratory playing clinical physician. Medicine is never merely a laboratory result.
Next, it is important to understand some Western Blot results offer more than a simple positive or negative. They offer a result that is an "indeterminate" or "+/-". My appeal is that an indeterminate result should always be viewed as positive. If you can see it with the eye, that means the patient's blood has antibodies against that particular surface Lyme bacteria chemical. People and healers do not realize that indeterminate or +/- bands often are very clear to the human eye.
If a person's test shows one "fingerprint band," some people feel that this is proof of Lyme disease. These highly specific bands, generally accepted in the world literature, are 13, 14, 17, 21, 23, 24, 25, 28, 31, 34, 35, 37, 39, 83, 84, 93 and 94 kDa. Some feel that herpes can give a false 31 kDa band, but I feel that is rare.
The laboratory who does the testing can be a poor one that invests nothing to optimize their testing kit.. Very few major laboratories in the United States, Canada and Europe are routinely useful at Western blot testing for Lyme disease. But what if a poor laboratory shows a result with a 23, 39 or 93 kDa band? Some would say that a positive on any of the sixteen Lyme surface chemicals above means the patient has Lyme. In contrast to general laboratories like those mentioned above, who do other lab tests very well, IGeneX is peerless when it comes to Western Blots. In the last eleven years IGeneX has had an exceptional record on their Western Blot testing. Amazingly, they are sent five blind samples every four months from New York State and have been correct 98% of the time for over a decade. What other laboratory is that correct on negative and positive blind controls?
Your clinician is taking a gamble if he or she wants to use an ELISA test first. To put it bluntly, many patients and physicians report that the ELISA test as a screening tool is useless, because it misses obviously positive patients. For example, an ELISA is much less sensitive and specific than the Western Blot and misses even the most obvious PCR-positive patients with clear past histories of massive Bull's Eye rashes (while they are not the norm, they provide evidence of spirochetes). The best testing is the use of the best laboratory Western Blot read by the approach listed above.
Want to improve on the Western Blot for Lyme disease? The most cost effective way, if the tests are covered by insurance, is to use indirect testing. Lyme, Babesia and Bartonellachange the results of many lab tests that are not simply antibody or PCR (DNA) tests for each. But that is material in other books. For example, the topics are introduced in books written by James Schaller, MD and researcher Kimberly Mountjoy, such as Checklists forBartonella, Babesia and Lyme Disease and Babesia Update 2009: A Cause of Excess Weight, Migraines and Fatigue?, A Common Reason for Failed Lyme Disease Treatment. Dr. Schaller has written 13 books on tick infections and also offers many free new teachings on his face book page "James Schaller" or "James Schaller MD," and on this website.