Chronic Lyme Disease..

Thank you for joining us again, Dr!
   I was diagnosed with late stage chronic lyme disease in July.  I'm currently living in the UK on military orders, but became sick in US.  
  I was hoping you could help interpret my Igenex results.  I'm currently seeing a LLMD here in the UK, but unfortunately doesn't offer much info to me.

  My Igenex was IGG POS  30+ 31++++ 41++    IGM NEG  30+ 31+++ 34IND 41IND 83-93IND.  
My CD57 from a speciality lab in Germany was 13.  Western blot from Quest had IGG 30 and 41 Reactive.

  My symptoms are dizziness (rocking in boat), brainfog, weakness, fatigue, joint pain (mostly ankles, hands, and knees), muscle pain, eye and ear pain, neck and shoulder pain, burning sensations in feet/shins,irritable, mood swings, occasional anxiety, tingling/numbness in feet and hands and painful/burning swollen tongue.  I'd say my most debilitating symptoms are the dizziness, brainfog, and weakness in arms.  The pain is tolerable.  All my symptoms come and go..
  
I've had two sets of MRI's 18 months apart that are totally normal.  My neuro exams are always normal as well, so they say it's not MS.  I've also been seen by two Rhem. who have ruled out auto immune.   Everything has come back normal except for my lyme test.  

My LLMD started me on 1000 mg daily Ceftin.  I was on it for 3 months with little improvement, and have just began taking Amox, Zithromax, and Flagyl Pulsed.

With the information I've provided, does lyme disease seem like the correct diagnosis? Do you believe I can safely rule out MS? Also what do my lab results mean?  I am so worried I may have something else and am treating the wrong thing.  

I appreciate your help!
Thank you!

[Garth L Nicolson, PhD]

I personally consider Lyme Disease Borrelia-positive when three or more of the following bands are positive in Western blots: 18K, 23K, 30K, 31K, 34K, 37K, 39K, 83K and 93K. Since you had three bands positive, you likely have Lyme.  Not every patient is positive on Western blot, and some Lyme patients are diagnosed on signs/symptoms alone.

In addition, the co-infections with Lyme Borrelia, Mycoplasma species, Bartonella species, Babesia species, Ehrlichia species, etc. also cause symptoms, and different combinations of antibiotics are used, depending on the types of co-infections (see our website, www.immed.org for more information on co-infections).

[skarey]

Thank you Dr. Nicolson for your reply.
   What is your opinion on IND bands?  

[Garth L Nicolson, PhD]

Are you referring to “indeterminate” bands on Western blots?  This could be a function of the technique—such bands could be positive at different antibody concentrations, longer incubations at higher temperatures, etc. or they could be negative when conditions are changed.  Testing labs use a standard set of conditions when performing Lyme Western blots, and these conditions, which may be unique to that particular lab, are generally a compromise so that most Borrelia bands will show up positive if they are truly positive and negative if they are truly negative.  However, some bands may not be tested under optimal conditions, resulting in an indeterminate result that cannot be scored as positive or negative.