Aa
Labs
Has anyone had any experience with Medical Diagnostic Labs in Hamilton N.J? I know Igenex is the preferred Lab but my doc sent bloodwork to M.D. L. Any thoughts?
A lab can be great at many things, and still be a poor choice for Lyme testing. I have come to the belief that many doctors (not all) know nothing about the lab they use other than some hearsay they heard from other docs that it's good. Or, because it is the one that takes all the same insurance that the doc does, and so there are no insurance complications.
Many labs use mass produced Western Blot test kits that are based on a single strain, the B31 Shelter Island strain. Some researchers who study Lyme and doctors who treat it believe that genetic variability of Borrelia results in a different mix of antibodies that may or may not line up with the Shelter Island strain used by the lab. And so where you got Lyme might increase or decrease your chances for testing "positive" at most labs.
So if a lab is comparing your blood antibodies to the Shelter Island strain and you got Lyme say, in California or Florida where there is much greater genetic variability than in New England, and then your results are compared to the CDC surveillance criteria, which was developed using statistical analysis of antibodies shown by early, rheumatic Lyme patients in New England, you very well might not show a "positive" even if you have Lyme.
This doesn't even factor in the people who already took insufficient antibiotics, which can interfere with antibody production, or people who have taken steroids, which suppresses the immune system and decreases antibody production.
The CDC surveillance criteria was designed to produce a bare minimum of false positives without regard to the number of false negatives. How it became the diagnostic standard, I cannot comprehend. Because of this criteria, many labs, especially the ones that use these mass produced test kits, don't even look at any bands outside the CDC criteria. You could show multiple Lyme specific antibodies and still test CDC negative. Since the labs usually don't show anything else, you won't know that you did indeed show evidence of Lyme.
This is why IGeneX is so much better. They have a more relaxed interpretation that calls some results positive even if the CDC doesn't. They show all relevant bands. A couple other labs that also show the relevant bands are Clongen and Stoneybrook.
However, the LymeMD blogger has written about sending blood tests for one patient to three different labs and getting three very different results. He also says he sees better overall results from IGeneX. (IGeneX uses their own test kit which combines two different genetic versions of Borrelia which provides for more accurate results. It is not just that this is all they do, or that their lab is clesner than the other lab. They literally do more advanced testing.)
If your result comes back positive, you are good to go. If it comes back negative (as mine did...I didn't even get past the screening test) and you still think you might have Lyme, contact IgeneX to ask for a test kit and try again there.
Many labs use mass produced Western Blot test kits that are based on a single strain, the B31 Shelter Island strain. Some researchers who study Lyme and doctors who treat it believe that genetic variability of Borrelia results in a different mix of antibodies that may or may not line up with the Shelter Island strain used by the lab. And so where you got Lyme might increase or decrease your chances for testing "positive" at most labs.
So if a lab is comparing your blood antibodies to the Shelter Island strain and you got Lyme say, in California or Florida where there is much greater genetic variability than in New England, and then your results are compared to the CDC surveillance criteria, which was developed using statistical analysis of antibodies shown by early, rheumatic Lyme patients in New England, you very well might not show a "positive" even if you have Lyme.
This doesn't even factor in the people who already took insufficient antibiotics, which can interfere with antibody production, or people who have taken steroids, which suppresses the immune system and decreases antibody production.
The CDC surveillance criteria was designed to produce a bare minimum of false positives without regard to the number of false negatives. How it became the diagnostic standard, I cannot comprehend. Because of this criteria, many labs, especially the ones that use these mass produced test kits, don't even look at any bands outside the CDC criteria. You could show multiple Lyme specific antibodies and still test CDC negative. Since the labs usually don't show anything else, you won't know that you did indeed show evidence of Lyme.
This is why IGeneX is so much better. They have a more relaxed interpretation that calls some results positive even if the CDC doesn't. They show all relevant bands. A couple other labs that also show the relevant bands are Clongen and Stoneybrook.
However, the LymeMD blogger has written about sending blood tests for one patient to three different labs and getting three very different results. He also says he sees better overall results from IGeneX. (IGeneX uses their own test kit which combines two different genetic versions of Borrelia which provides for more accurate results. It is not just that this is all they do, or that their lab is clesner than the other lab. They literally do more advanced testing.)
If your result comes back positive, you are good to go. If it comes back negative (as mine did...I didn't even get past the screening test) and you still think you might have Lyme, contact IgeneX to ask for a test kit and try again there.
The medical establishment is not favorable toward IGeneX, which may be what you are seeing in articles etc. The establishment believes the Western blot/ELISA two-tier testing works just fine, thank-you-very-much, and ignores the known problems and limitations of W.blot/ELISA. The higher rate of positive results from IGEneX doesn't fit with the establishment's view that Lyme is rare, hard to get, and easy to cure.
Haven't read anything bad about this lab. Just have been reading about the many more positive results found at Igenex compared to other labs. Different interpretion I guess.
Haven't read anything bad about this lab. Just have been reading about the many more positive results found at Igenex compared to other labs. Different interpretion I guess.
I don't know that MDL is out here on the left coast, so I don't really have an opinion, but I'm usually inclined to let the doc pick the lab but then read up on the lab online and see what people say, just so I'm a bit tuned in. It's also fair to ask the doc why s/he likes Lab A over Lab B and why they don't use Lab C.
The docs are (usually!) more informed than we the patients on why one lab over another, but that for me is a good starting point, not an end point if the lab doesn't seem to be cutting it for some reason, or I read something disturbing about the lab or its testing. That leads to a further convo with the doc about 'What do you take from this news article about Lab A?'
The docs are (usually!) more informed than we the patients on why one lab over another, but that for me is a good starting point, not an end point if the lab doesn't seem to be cutting it for some reason, or I read something disturbing about the lab or its testing. That leads to a further convo with the doc about 'What do you take from this news article about Lab A?'
Have an Answer?
You are reading content posted in the Lyme Disease Community
Fearing autism, many parents aren't vaccinating their kids. Can doctors reverse this dangerous trend?
Can HIV be transmitted through this sexual activity? Dr. Jose Gonzalez-Garcia answers this commonly-asked question.
A breakthrough study discovers how to reduce risk of HIV transmission by 95 percent.
Dr. Jose Gonzalez-Garcia provides insight to the most commonly asked question about the transfer of HIV between partners.
Before your drop a dime at the pharmacy, find out if these popular cold and flu home remedies are a wonder or a waste
Fend off colds and the flu with these disease-fighting foods
