best way to test for lyme disease

i was bit by a tick years ago, but don't remember if i ever got sick back then.   i've dealt with depression and anxiety for years--and now i hava fibromyalgia and some arthritis--one knee needed orthoscopic surgery to stop pain.  now i have secondary adrenal insufficiency with no apparent reason as to why my pituitary won't make ACTH anymore.  i also have thyroid nodules and low thyroid.  i've wanted to be tested for lyme disease for quite awhile---but i hear the testing is not particularly accurate----especially in a long term case.  there is a chiropracter that tests for it near our area by actually looking at the blood itself.   i'm always alittle skeptical about alternative doctors--although i think they have their place---i just get my back up when people try and push them on me.  what is your opinion on this type of testing----and could my problems be related to lyme.    i am also DQ2 positive and have 3 children with celiac disease.  i am starting to show antibodies to gliadin, but my Ttg is normal.  it also looks like i could have developed eosinophilic esophagitis in the last year---between scopes to dilate my esophagus.

[Garth L Nicolson, PhD]

Your problems could certainly be related to chronic Lyme Disease.  In our studies we found that a rather high percentage of Fibromyalgia Syndrome patients were also Lyme patients, with the percentage much higher in Lyme regions than non-Lyme regions.  

Although some alternative practitioners claim to be able to diagnose Lyme by the presence of spirochetes in a blood smear, most physicians depend on Western blot determination of Borrelia burgdorferi proteins in the blood plasma.  One of the best laboratories for this is IgeneX (www.igenex.com).

It is certainly true that testing for chronic Lyme (and associated infections) is not full-proof.  Depending on the type of test used, it can come up false-negative, and often repeat testing is required.   Most ILADS physicians use lab testing as an adjunct to clinical analysis of chronic Lyme.

In additon to Borrelia, most chronic Lyme patients also have Mycoplasma, especially M. fermentans, a particularly nasty infection, Bartonella, Babesia, among other possibilites.  It would be a good idea to have these tested as well as it does change the treatment strategy.

Prof. Garth Nicolson