GETTING A DIAGNOSIS
"As any doctor can tell you, the most crucial step toward healing is having the right diagnosis. If the disease is precisely identified, a good resolution is far more likely. Conversely, a bad diagnosis usually means a bad outcome, no matter how skilled the physician." -- Dr. Andrew Weil
WHAT IS A CLINICAL DIAGNOSIS?
Medical textbooks and the CDC (Center for Disease Control) emphasize that Lyme disease is a clinical diagnosis.
The diagnosis of Lyme disease should be made after evaluation of a patient's symptoms and the risk of exposure to infected ticks. Blood tests may be administered in conjunction with clinical diagnosis to demonstrate the presence of antibodies to the bacteria. It should be stressed that the results of blood tests cannot be interpreted in the absence of appropriate clinical information (i.e., symptoms of infection).
Therefore the doctor should examine the patient for typical Lyme disease signs, listen to the patient's history and description of his or her symptoms and use this information to make a determination. Blood tests are usually done at the same time, but cannot be relied upon. According to ILADS (the International Lyme and Associated Diseases Society), if a doctor suspects Lyme disease and sees little reason to believe the patient has some other disease, he or she should begin treatment without delay! As per Public Health Notifiable Disease Management Guidelines, the two-tier confirmation of Lyme disease for surveillance stats purposes, fails to detect up to 90% of cases and does not distinguish between acute, chronic, or resolved infection. Blood tests for Lyme disease is not what determines Lyme disease.
WHO CAN GIVE A CLINICAL DIAGNOSIS?
Both Naturopathic or Medical doctors who are experienced or have studied Lyme and tick bourne diseases can give you a clinical diagnoses so treatment can be started without delay.
They may give you an eradication agent such as an antibiotic to challenge the infections. If you get flu like symptoms, it is an indication you have some infection in you that does not belong there and longer treatment will follow. If your doctor is uninformed about Lyme or refuses to run the necessary testing, you should seek out a Lyme Literate Medical Doctor ("LLMD").
WHAT IS A LYME LITERATE MEDICAL DOCTOR (LLMD)?
Lyme knowledgeable, Lyme friendly, Lyme educated, or Lyme literate are doctors who have learned about Lyme disease, the nature of the specific bacteria and the co-infections, its effect on the body, and how best to treat this serious complex multi-system inflammatory disease.
These rare doctors bring relief and hope for a better life to thousands of people infected with Lyme and co infections.
IS THERE A TEST TO PROVE LYME?
There are no completely reliable tests for Lyme disease.
Your doctor must base his or her diagnosis on your symptoms, and medical history. Doctors cannot rely solely on blood tests for Lyme disease, most especially because of the nature of the spirochete bacteria. The spirochetes do not linger in the blood stream, as they burrow into the cells (such as the leukocytes) and when they do exit from the cell the cellular membrane remains covering it, thus shielding its identity from the immune system. It is not often found in blood during a blood test. At present there are a few lab blood tests available, but all have problems.
WHAT IS THE ELISA (LYME TITER) TEST?
The blood test used to screen for Lyme that is typically used by most family doctors is called the ELISA Test (or the "Lyme Titer" test.
An ELISA test means nothing if it is negative, and it rarely indicates infection if it is performed too early after the tick bite.
Patients in later stages of Lyme disease seldom have a positive ELISA test, possibly because they have ceased to produce the antibodies the test looks for. Many working with Lyme infected persons believe that the ELISA test is only about 30-60% accurate. The ELISA test is not based on the specific Lyme bacteria strain that is most useful for accurate diagnosis.
While a positive ELISA test is a reasonably reliable indication of infection, a negative test is useless. (Positive indicates it happened to be in the blood at the moment the blood was drawn and as well tests have returned false positives for whatever reason.) A screening test should have at least 95% sensitivity and the ELISA misses 35% of culture proven Lyme disease, therefore as a first step of the screening it has been and still is unreliable. As of 2013, this testing protocol is still being used by many medical doctors as the sole diagnosis for Lyme disease. The western blot (may be more accurate) but, in Canada it is not given unless the Elisa was positive.
WHAT IS THE WESTERN BLOT TEST?
The Western blot test for Lyme disease often shows infection when an ELISA test does not.
Even if the test results are not positive by these present standards, any positive Lyme-specific bands are useful indicators of infection, but often if ELISA is negative then the Western Blot is not performed.
WHAT ARE THE CDC GUIDELINES?
Unfortunately, the Centers for Disease Control have set a criteria for considering a Western blot test as positive for Lyme disease.
This criteria is very strict and misses many people in Lyme disease surveillance and thus the provincial statistics are unbelievably low. These guidelines also leave many infected patients without a diagnosis and thus the medical treatment that would stop the progression of this disease.
WHAT ARE FALSE NEGATIVE TEST RESULTS?
Even if the test results are not positive, any positive Lyme-specific bands may be an indicator of infection.
WHAT OTHER TESTING MAY BE USEFUL?
Live Cell Analysis Using Dark Field Microscopy may show the presence of spirochetes, or Protozoa, or Bartonella, or fungus and other infections. These are found in offices of some MD or ND's or Health practitioners. There are other types of testing used by Natural Practitioners; Bioresonance informational machines. Muscle testing and similar. Lyme RIFE frequencies. You may also want to challenge the infections with known Lyme eradicators.