From what I read, IgM antibodies are made by the immune system early in the infection, and then they trail off and IgG antibodies ramp up. How accurate that 'change-up' analysis is, I don't know, but they both mean Lyme bacteria are present.
I have a list of the bands printed out a couple of years ago from truthaboutlymedisease [dot] com, and it says:
31: outer surface protein A (Osp A), specific for Borrelia burgdorferi (Bb), meaning no other bacteria would cause this to show positive on the test
41: flagellin protein of all spirochetes, so could be Lyme or another bacterium in the same family
58: unknown but could be a heat-shock protein of Bb
Thanks! So just that one band specific for Borrelia is probably not very significant then?
Yes I too have heard that IgM indicates early infection. This certainly does not match up with my symptoms being much more indicative of chronic infection. I suppose it matches up with most of my labs being normal though. Just so weird!
You could have been bitten again and not known it, and that could ramp up your immune system to produce more IgM antibodies. I think I had an initial Lyme infection that just made me tired and run down, and then when I must have been bitten again (still seeing no tick and no rash), I got much sicker. There are so many unknowns about how we each are infected that relying only on the few pieces of hard data like your IgM levels is leaving out potentially signficant data that you just don't have evidence for. The tests are helpful but should not be the last word.
As to whether having one specific band for Borrelia is not signficant, I strongly disagree. If that band does not mean Lyme, then what does it mean? Everyone reacts differently to an infection, and the very high standards set in the medical community for diagnosing Lyme were done years ago for **clinical research purposes**, not for diagnosing people ill with Lyme. The research data has to be terribly pure so that the resulting scientific conclusions are without doubt. In the real world, it just doesn't work that way.
It would be like saying 'the tornado only blew down part of my house, so that means it really wasn't a REAL tornado.'
Lyme is a clinical diagnosis, based on symptoms and history and aided by tests -- the judgment of a wise MD is what is needed, not a test devised for research and not clinical medicine.
A single Lyme-specific band on a test means LYME.
I would, in your situation, continue to pursue Lyme and any coinfections you may have, to get them treated, and see how you do. If you do not follow that path, you could stay ill permanently. Don't do that!
I've never had any Lyme specific bands positive. I was only band 41 positive and my Lyme doc has been treating me for it for months now and I'm feeling (somewhat) better. I never thought it could be Lyme but it is. We are now looking at co-infections too. I would definitely pursue Lyme.
I know that Lyme is a clinical diagnoses. I just hear about everyone feeling better on antibiotics as you Ellon, and I don't :( I have been on various oral antibiotics now for six months, and I still only feel a little worse than I would if I was to stop them. That and given my extremely complex history on top of completely normal labs, I was having doubts. I just got lucky to get the proof I wanted. My LLMD did not insist on the test. I just wanted some solid evidence for myself. Now I have to worry about co infections too. Anyone know if LabCorps co infection test are more accurate? At least insurance will pay for those.
I don't want you to get the wrong impression. I still feel AWFUL on the antibiotics. It's just that some symptoms that I've had for months (it took them 5 months to figure out it was Lyme) have disappeared while many new ones have taken their place. I think I can honestly say I feel WORSE on doxy than I did without it. My major symptom was dizziness though and thankfully that is about 70% better which is why I say I feel somewhat better on the doxy. And I used to have sharp burning sensations all over and that has completely disappeared. But the doxy has brought out fatigue that I've never had before I started it, muscle aches, muscle twitching, heart palps, headaches and more.
I just posted on your other thread, but I'll add a little bit here, too.
I had bands 18, 31, & 41 on the IgM. Band 18 is Lyme specific but the CDC ignores it on the IgM. I believe they look at it in the IgG, but I didn't show it there.
Band 41 indicates a spirochete flagella, but it could be from a non-Lyme spirochete, such as dental spirochetes, which are really common. Band 41 is usually the first antibody to show up in a Lyme infection and is almost universal in Lyme patients. The body recognizes that protein as foreign very quickly.
Band 58 is quite common with Lyme, but usually shows up a bit later. The CDC only looks at it in the IgG.
The CDC test interpretation ignores bands 31 and 34 because these were being used to develop a vaccine back in the 90's. These are two very Lyme specific and common antibodies early in infection. The CDC wanted a test criteria that wouldn't show a false positive for a vaccinated patient, who could show positives on 31 & 34 without being infected.
After the vaccine failed, they didn't revisit the test interpretation. Allen Steere, the one who came up with the test interpretation, said that it didn't matter because patients would still show the other antibodies and infected patients would still show "positive" on his criteria. A stunning bit of hubris, if you ask me. It makes no medical or scientific sense to ignore these bands. Most labs don't even look at or report them because they're not in the test criteria.
IGeneX and supposedly some other labs have indicated that people with late stage Lyme and neuro symptoms are more likely to show band 31. IGeneX also says on their test results that an active Epstein Barr virus can show a Band 31. (Don't remember the exact wording.) I don't fully understand this as I thought band 31 was unique to Lyme. Even with this potential cross reaction, unless you have an active case of Mononucleosis (Glandular Fever), then it could only be Lyme. In a nutshell, Band 31 is highly indicative of Lyme, and should be considered (in my opinion) a confirmation in someone with Lyme symptoms.
The only reason I can think that they ignore the IgM after the first month of infection is because of assumptions that Lyme behaves like other infections. Late stage Lyme patients weren't included in the study to create the test interpretation because it's very difficult to prove late stage Lyme patients actually have Lyme disease. The spirochetes are extremely difficult to culture reliably, especially in late stage patients. As a result, they used early stage patients with a bulls eye rash and verified exposure to infected ticks, and then they cultured the skin at the edge of the rash. But in late stage patients, the bugs have moved out of the blood into tissues, so it's tough to culture from the blood. As the population of bugs in the blood drops, so does antibody production.
The scientific need for absolute proof of infection has left many of the unfortunate late stage patients in the dust, as we just don't show the same antibodies as early stage patients. I truly hope the new culture test from Advanced Laboratories will be the beginning of change in testing and diagnosing patients, especially the late stage patients.
And so, don't worry that you don't have a positive IgG. I didn't either and I clearly have Lyme Disease, Bartonella, and Babesia. LLMDs just say that your body is still treating the infection as a new/current infection and never got to the point of creating "protective" IgG antibodies. You have Lyme specific antibodies and plenty of symptoms. While uninformed or misinformed doctors may doubt a Lyme diagnosis, you don't need to. You probably just need a different treatment protocol to start feeling better. I've heard people with Morgellon's frequently start feeling better on Rocephin.
Have you been tested for other coinfections yet, such as Babesia or Mycoplasma? They could be holding you back, too, as my Babesia did.
No, I have not been tested for coinfections. I think my Dr likes to treat on a clinical basis. And that is good, I am just not a huge fan of guessing games. I am undergoing a Bartonella treatment now. And as with Borrelia treatment, I feel no better at all! Maybe I'll ask my Dr about Rocephin.
Yeah I want to get tested for coinfections. I am just not sure if I can afford much IGenex testing. Then I have kids to worry about too. Maybe I'll request some LabCorp coinfection labs. Not sure how accurate they are, but at least they would be paid for.
Here are my IgM results in case anyone is interested:
IGenex result POSITIVE
CDC result POSITIVE
And my current CD57 is 8! I know some people don't think it holds any weight. But I don't know if it could have meaning, as in like how many coinfections are involved and such. The rest of my immune system test are awesome, even my CD56! So I cannot help but think it must have some sort of meaning.
I was hoping I could slide that comment in there without you noticing cave. LOL! I just knew you'd have to comment on that one. I didn't say it had anything to do with a person's progress or non progress.
18 kDa +
**23-25 kDa IND
** 31 kDa IND
** 34 kDa +
** 39 kDa +
** 41 kDa ++
According to a post from a couple of years ago (meaning it's not new information) on the website truthaboutlymedisease [dot] com, these bands mean:
18: "highly specific to Lyme; many Lyme specialists say if this band alone is positive, you have Lyme"
23-25: "outer surface protein C (OspC), specific for Bb" [meaning that only Borrelia burgdorferi ("Bb"), which is the bacteria that causes Lyme, will cause band 23-25 to show positive"
31: "outer surface protein A (OspA), specific for Bb --has cross-reactivity with several different types of viruses" -- but given how many just-Lyme bands you are positive on, it's likely Lyme
34: "outer surface protein B (OspB), specific for Bb"
39: "is a major protein of Bb flagellin [the little whiplike tail the bacteria have]; specific for Bb
41: "flagellin protein of all spirochetes [meaning spiral-shaped bacteria, which includes Lyme]; this is usually the first to appear after a spirochete infection but is NOT specific to Lyme" -- meaning that it could be Lyme or it could be something else
Even to me, who is not medically trained, this is a very strong positive for having Lyme disease. The first step to getting well is knowing what you've got -- and it looks like you're there on the Western blot. Co-infections are also possible.
Good for you for pursuing this -- best wishes to you!!
Your doc may take a broadminded view of which bands popped up positive ...
There's a saying around here that a 'not negative' is a positive. An IND [indeterminate] really means something, or there would nothing/zip/zero on that line. All data should be read together, and not just line by separate line, and a good Lyme doc will know that.
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