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Igenex results???
Hello All. Last month my LLMD ordered a western blot and urine test (challenged with Amoxicillin) through Igenex. The results are in and the office called today. Urine test=Negative Western Blot=Negative with some positive bands
I have an appt later this week but didn't know if any of you could help me understand. If the test is negative are the positive bands nothing to worry about? Can you have positive bands and NOT have Lyme disease? I truly thought he was going to tell me that all my tests were negative so I am not sure what to think!!
I have an appt later this week but didn't know if any of you could help me understand. If the test is negative are the positive bands nothing to worry about? Can you have positive bands and NOT have Lyme disease? I truly thought he was going to tell me that all my tests were negative so I am not sure what to think!!
I can't add much to Jackie's thorough reply. :) I will just offer to say that you have multiple Lyme specific bands showing. You have more evidence of Lyme than I did, and I have Lyme and a couple coinfections, too.
What does your doctor say about it? These look like IeneX results, so hopefully your doctor is at least Lyme-aware.
If s/he says you don't have Lyme because you don't have 5 IgG positive bands, then you need to find a different doctor who knows more about Lyme, ideally an LLMD.
What does your doctor say about it? These look like IeneX results, so hopefully your doctor is at least Lyme-aware.
If s/he says you don't have Lyme because you don't have 5 IgG positive bands, then you need to find a different doctor who knows more about Lyme, ideally an LLMD.
Welcome -- no one here is medically trained, but we're happy to respond with what we've each learned ourselves from having Lyme.
This test looks for the reaction of your immune system to the presence of Lyme bacteria. It is far from a perfect test, because there are different varieties (strains) of Lyme that don't always show up on this test, and also after you've been infected for a while, your immune system figures it's killed all the bacteria and so stops making antibodies .... but Lyme bacteria are tricky and can sometimes outsmart your immune system, so that your immune system can stop making antibodies against Lyme even though you are still infected.
Also, different docs read the test results differently, according to different schools of thought about how many bands show up positive, and which one. (Each of the numbers below is a 'band', and the more bands there are that are positive (+), the more likely you have Lyme. Also, some bands are more specific to Lyme, meaning those bands indicate Lyme and nothing else, while some bands could be Lyme but could also be something else.)
To make it more complicated, different docs read the bands different ways, and some require more bands with more +++ positives to make a positive diagnosis for Lyme. There is a real art to interpreting these tests, because they are meant to be a clue, not the final answer --- but too many docs use these tests as the final answer.
If you do not already have a copy of the test results (tho I'm guessing you do), always get and keep your own set of copies of test results, because if you change docs along the way, it could be helpful to the new doc to know what results you've had before, and also good for your own records going forward.
Others will chime in here, but here's my quick take on the meaning of your bands, based on something I found a while back on a website called truthaboutlymedisease.com.
Notice there are two sets of bands: IgM and IgG, meaning immunoglobulin M and immunoglobulin G. Soon after a Lyme infection, you body usually begins to make IgM antibodies to the Lyme bacteria, with the goal of killing the bacteria. After a while, your immune system changes over to making IgG, so a doc can sometimes figure out where you are in the course of a Lyme infection (recent infection vs older infection) by the relative strengths of the IgM to IgG.
Confusing, eh? Here are the band details:
=======================================
IgG antibodies (which your immune system makes a while after getting a Lyme infection)
18 - ===>> minus signs I assume mean no reaction from you
23-25 IND ===>>> IND means 'indeterminate', or 'maybe yes, maybe no'; this is an important band, because it is highly specific to Lyme, meaning that no infection other than Lyme will cause this band to light up. Your reaction is weak (indeterminate), but Lyme docs don't just disregard it. That this band shows any reaction is useful information.
28 - ===>>> no reaction from you
30 - ===>>> no reaction from you
31 ++ ===>>> this lights up positive only in the presence of Lyme bacteria, indicate outer surface protein A (OspA), which is a bit of protein the Lyme bacteria has on its outside
34 IND ===>>> this is indeterminate, but that is usually interpreted as a weak positive, therefore Lyme. It indicate OspB, which lights up only in the presence of Lyme
39 IND ===>>> this one is also specific to Lyme, indicating the presence of protein found on the Lyme bacterium's little whiplike tail
41 ++ ===>>> this could be Lyme, or could be another spiral-shaped bacterium, so it's a 'maybe'
45 + ===>>> ditto band 41 above
58 + ===>>> unknown, but may be a bit of Lyme bacteria
66 - ==>> no reaction from you
83-93 IND ===>>> this is specific to Lyme also
==============================================
IgM antibodies (which your immune system makes soon after getting a Lyme infection)
18 + ===>>> indicates the presence of Lyme, not a strong indication, but still positive, so it counts
23-25 - ===>>> no reaction
28 - ===>>> no reaction
30 + ===>>> a weak positive (but still positive), could be Lyme or something else
31 - ===>>> no reaction
34 - ===>>> no reaction
39 IND ===>>> this one is also specific to Lyme, indicating the presence of protein found on the Lyme bacterium's little whiplike tail
41 ++ ===>>> this could be Lyme, or could be another spiral-shaped bacterium, so it's a 'maybe'
45 - ===>>> no reaction
58 ++ ===>>> exact meaning unknown, but may be a bit of Lyme bacteria
66 + ===>>> indicates presence of bacteria, could be Lyme but could be another bacterium
83-93 IND ===>>> this is specific to Lyme also, read as a weak positive
=================================================
See what your doc says as to interpretation. There are different standards that these tests are read by, and some docs require more + signs on more bands than other docs do.
If your doc blows this off and says you don't have enough + marks on the right bands, I would find another doc (definitely a Lyme specialist) for a second opinion.
If your doc says yes, you should take antibiotics but only gives you meds for a few weeks, I'd also find Lyme specialist, because Lyme needs longer treatment than most bacterial infections for reasons I won't detail here. We're talking months, not weeks. Docs who are not Lyme specialists do not believe in this approach, and if need be we can get into the reasons with you for your information and decision-making.
Lyme does not go away by itself, and the longer you're infected, the more miserable you can feel and the harder it might be to cure.
Also, a Lyme specialist would question you closely about your symptoms, because the ticks that carry Lyme also (about half the time) carry one or more other diseases (co-infections) that need separate diagnostic tests and different antibiotics from Lyme. If your current docs has not given consideration to this possibility, I would definitely see a Lyme specialist for a second opinion.
You'll see the term LLMD, which is patient shorthand for 'Lyme-literate MD', meaning a doc who things more progressive and advanced thoughts about Lyme and its co-infections. It's not a formal title or degree, but instead is just what we call the docs to make it easy to identify a Lyme-knowledgeable doc (LLMD) from a doc who's not so up-to-date. A nonLLMD may refuse to work with you if s/he knows you are also seeing an LLMD, because the two camps don't much trust or respect each other. It's a scientific war, and we the patients are caught in the middle. An LLMD can be any specialty or a general practitioner; what counts is their world view. We can possibly help you find an LLMD if you need some pointers.
You don't indicate which state you are in, but some states are stricter with the docs than other states are, and restrict the manner in which treatment is conducted.
So that's the big story. Sorry to overwhelm you, but hang on. Let us know how we can help. Best wishes to you -- J.
This test looks for the reaction of your immune system to the presence of Lyme bacteria. It is far from a perfect test, because there are different varieties (strains) of Lyme that don't always show up on this test, and also after you've been infected for a while, your immune system figures it's killed all the bacteria and so stops making antibodies .... but Lyme bacteria are tricky and can sometimes outsmart your immune system, so that your immune system can stop making antibodies against Lyme even though you are still infected.
Also, different docs read the test results differently, according to different schools of thought about how many bands show up positive, and which one. (Each of the numbers below is a 'band', and the more bands there are that are positive (+), the more likely you have Lyme. Also, some bands are more specific to Lyme, meaning those bands indicate Lyme and nothing else, while some bands could be Lyme but could also be something else.)
To make it more complicated, different docs read the bands different ways, and some require more bands with more +++ positives to make a positive diagnosis for Lyme. There is a real art to interpreting these tests, because they are meant to be a clue, not the final answer --- but too many docs use these tests as the final answer.
If you do not already have a copy of the test results (tho I'm guessing you do), always get and keep your own set of copies of test results, because if you change docs along the way, it could be helpful to the new doc to know what results you've had before, and also good for your own records going forward.
Others will chime in here, but here's my quick take on the meaning of your bands, based on something I found a while back on a website called truthaboutlymedisease.com.
Notice there are two sets of bands: IgM and IgG, meaning immunoglobulin M and immunoglobulin G. Soon after a Lyme infection, you body usually begins to make IgM antibodies to the Lyme bacteria, with the goal of killing the bacteria. After a while, your immune system changes over to making IgG, so a doc can sometimes figure out where you are in the course of a Lyme infection (recent infection vs older infection) by the relative strengths of the IgM to IgG.
Confusing, eh? Here are the band details:
=======================================
IgG antibodies (which your immune system makes a while after getting a Lyme infection)
18 - ===>> minus signs I assume mean no reaction from you
23-25 IND ===>>> IND means 'indeterminate', or 'maybe yes, maybe no'; this is an important band, because it is highly specific to Lyme, meaning that no infection other than Lyme will cause this band to light up. Your reaction is weak (indeterminate), but Lyme docs don't just disregard it. That this band shows any reaction is useful information.
28 - ===>>> no reaction from you
30 - ===>>> no reaction from you
31 ++ ===>>> this lights up positive only in the presence of Lyme bacteria, indicate outer surface protein A (OspA), which is a bit of protein the Lyme bacteria has on its outside
34 IND ===>>> this is indeterminate, but that is usually interpreted as a weak positive, therefore Lyme. It indicate OspB, which lights up only in the presence of Lyme
39 IND ===>>> this one is also specific to Lyme, indicating the presence of protein found on the Lyme bacterium's little whiplike tail
41 ++ ===>>> this could be Lyme, or could be another spiral-shaped bacterium, so it's a 'maybe'
45 + ===>>> ditto band 41 above
58 + ===>>> unknown, but may be a bit of Lyme bacteria
66 - ==>> no reaction from you
83-93 IND ===>>> this is specific to Lyme also
==============================================
IgM antibodies (which your immune system makes soon after getting a Lyme infection)
18 + ===>>> indicates the presence of Lyme, not a strong indication, but still positive, so it counts
23-25 - ===>>> no reaction
28 - ===>>> no reaction
30 + ===>>> a weak positive (but still positive), could be Lyme or something else
31 - ===>>> no reaction
34 - ===>>> no reaction
39 IND ===>>> this one is also specific to Lyme, indicating the presence of protein found on the Lyme bacterium's little whiplike tail
41 ++ ===>>> this could be Lyme, or could be another spiral-shaped bacterium, so it's a 'maybe'
45 - ===>>> no reaction
58 ++ ===>>> exact meaning unknown, but may be a bit of Lyme bacteria
66 + ===>>> indicates presence of bacteria, could be Lyme but could be another bacterium
83-93 IND ===>>> this is specific to Lyme also, read as a weak positive
=================================================
See what your doc says as to interpretation. There are different standards that these tests are read by, and some docs require more + signs on more bands than other docs do.
If your doc blows this off and says you don't have enough + marks on the right bands, I would find another doc (definitely a Lyme specialist) for a second opinion.
If your doc says yes, you should take antibiotics but only gives you meds for a few weeks, I'd also find Lyme specialist, because Lyme needs longer treatment than most bacterial infections for reasons I won't detail here. We're talking months, not weeks. Docs who are not Lyme specialists do not believe in this approach, and if need be we can get into the reasons with you for your information and decision-making.
Lyme does not go away by itself, and the longer you're infected, the more miserable you can feel and the harder it might be to cure.
Also, a Lyme specialist would question you closely about your symptoms, because the ticks that carry Lyme also (about half the time) carry one or more other diseases (co-infections) that need separate diagnostic tests and different antibiotics from Lyme. If your current docs has not given consideration to this possibility, I would definitely see a Lyme specialist for a second opinion.
You'll see the term LLMD, which is patient shorthand for 'Lyme-literate MD', meaning a doc who things more progressive and advanced thoughts about Lyme and its co-infections. It's not a formal title or degree, but instead is just what we call the docs to make it easy to identify a Lyme-knowledgeable doc (LLMD) from a doc who's not so up-to-date. A nonLLMD may refuse to work with you if s/he knows you are also seeing an LLMD, because the two camps don't much trust or respect each other. It's a scientific war, and we the patients are caught in the middle. An LLMD can be any specialty or a general practitioner; what counts is their world view. We can possibly help you find an LLMD if you need some pointers.
You don't indicate which state you are in, but some states are stricter with the docs than other states are, and restrict the manner in which treatment is conducted.
So that's the big story. Sorry to overwhelm you, but hang on. Let us know how we can help. Best wishes to you -- J.
can someone help me i dont understant my lab results
igg
18 -
23-25 IND
28 -
30 -
31 ++
34 IND
39 IND
41 ++
45 +
58 +
66 -
83-93 IND
IGM
18 +
23-25 -
28 -
30 +
31 -
34 -
39 IND
41 ++
45 -
58 ++
66 +
83-93 IND
please help
igg
18 -
23-25 IND
28 -
30 -
31 ++
34 IND
39 IND
41 ++
45 +
58 +
66 -
83-93 IND
IGM
18 +
23-25 -
28 -
30 +
31 -
34 -
39 IND
41 ++
45 -
58 ++
66 +
83-93 IND
please help
Sorry, I really don't know! There are others here who know much more about the 'bands' than I -- what I posted was a quote from an earlier post by someone else.
Thank you all for the feedback!! The information is VERY helpful! I am just starting to get an understanding of Lyme though I still have a LONG way to go!!
Jackie-My LLMD did not repeat the IgG...just the IgM. He says he is concerned about what is currently going on. Does that make any sense??
Wonko-My neuro diagnosed me with Partial Transverse Myelitis (at risk for MS) in January. I then looked into the causes of TM, remembered that I was bitten by a tick and here I am. Now, I have ringing in the ears, bouts of vertigo, floaters in the eyes and constant muscle twitching. The numbness in right arm has much improved over the course of the past few months though. Mainstream medicine says "let's watch you" :( No fun! I feel stuck between a rock and hard spot as I am sure many of you do!
Jackie-My LLMD did not repeat the IgG...just the IgM. He says he is concerned about what is currently going on. Does that make any sense??
Wonko-My neuro diagnosed me with Partial Transverse Myelitis (at risk for MS) in January. I then looked into the causes of TM, remembered that I was bitten by a tick and here I am. Now, I have ringing in the ears, bouts of vertigo, floaters in the eyes and constant muscle twitching. The numbness in right arm has much improved over the course of the past few months though. Mainstream medicine says "let's watch you" :( No fun! I feel stuck between a rock and hard spot as I am sure many of you do!
JJJ77,
Did you get your IgG results, too, or just the IgM you list above?
I had a weak Western blot through Igenex: IgM 41+, IgG 39+ 41+++ and that's it. Negative ELISAs, negative CSF.
With Lyme, you need to keep in mind the possibility of co-infections also transmitted by the tick. The co's can cause symptoms and require treatment, but would not show up in Lyme testing.
The testing overall fails to help many patients. My LLMD's approach is to rely mainly on a clinical diagnosis, and use the test results to guide treatment.
If you have any positive bands, many Lyme symptoms, and have gone through a thorough differential diagnosis through mainstream medicine, then I would keep Lyme high on the lists of suspects.
Did you get your IgG results, too, or just the IgM you list above?
I had a weak Western blot through Igenex: IgM 41+, IgG 39+ 41+++ and that's it. Negative ELISAs, negative CSF.
With Lyme, you need to keep in mind the possibility of co-infections also transmitted by the tick. The co's can cause symptoms and require treatment, but would not show up in Lyme testing.
The testing overall fails to help many patients. My LLMD's approach is to rely mainly on a clinical diagnosis, and use the test results to guide treatment.
If you have any positive bands, many Lyme symptoms, and have gone through a thorough differential diagnosis through mainstream medicine, then I would keep Lyme high on the lists of suspects.
I had Reactive bands on Quest on 30 and 41 IGG. Does this make lyme likely or unlikely? I saw that 30 says European strains... I lived in Europe (spain) for 3 years and was exposed to TONS of ticks. Maybe this is why? I didn't have any IGM, but am definately having symptoms. What could this mean? I'm going to retest with Igenex but am still waiting for it in the mail!!
Hope, is this what you posted? I saved it, but not the name of who posted it. JJJ77's bands look to be indicative of Lyme, if I'm reading this correctly -- but I'm no doctor.
JJJ77, what about the IgG results on your tests?
And remember, Lyme is a *clinical* diagnosis, meaning symptoms trump test results, but test results assist the diagnosis.
=============================================
from www [dot] truthaboutlymedisease [dot] com :
"IGeneX also now offers a new 30-31kDa Confirmation IgG and IgM test. If results from the initial Western Blot are positive for bands 30 or 31, it is possible that these could be due to cross-reactivity with several different types of viruses. In this confirmatory test, highly specific recombinant antigens are used to validate that the positive result is not due to cross-reaction with viruses.
"There are nine known Borrelia burgdorferi genus specie specific KDA Western Blot antibodies (bands): 18 23 30 31 34 37 39 83 and 93.
"Only one of these Borrelia burgdorferi genus specie specific bands is needed to confirm that there is serological evidence of exposure to the Borrelia burgdorferi spirochete and can confirm a clinical diagnosis of Lyme disease. (More info pages 12 & 13 "Western Blot Made Easy": http://www.publichealthalert.org/PHA%20JUNE%2007.pdf )
"Igenex Western Blot Break Down by band:
"9: cross-reactive for Borrelia
"12: specific for Bb
"18: highly specific to Lyme (Many LLMD's say if this band alone is positive, you have lyme - see link above)
"20: cross-reactive for Borrellia
"21: unknown
"22: specific for Bb, probably really the 23/25 band
"23-25: outer surface protein C (OspC), specific for Bb
"28: unknown
"30: unknown; probably an outer surface protein; common in European and one California strain - Has cross-reactivity with several different types of viruses
"31: outer surface protein A (OspA), specific for Bb - Has cross-reactivity with several different types of viruses
"34: outer surface protein B (OspB; specific for Bb)
"35: specific for Bb
"37: specific for Bb
"38: cross-reactive for Bb
"39: is a major protein of Bb flagellin; specific for Bb
"41: flagellin protein of all spirochetes; this is usually the first to appear after a spirochete infection but is NOT specific to Lyme (i.e, other spirochete diseases have flagellas - see link above "Western Blot Made Easy" for more info)
"45: cross-reactive for all Borellia
"50: cross-reactive for all Borrellia
"55: cross-reactive for all Borrellia
"57: cross-reactive for all Borrellia
"58: unknown but may be a heat-shock Bb protein
"60: cross reactive for all Borrellia
"66: cross-reactive for all Borrelia, common in all bacteria
"83: specific antigen for the Lyme bacterium, probably a cytoplasmic membrane
"93: unknown, probably the same protein in band 83, just migrates differently in some patients[/b]
"An IgM positive test result means more recent & likely currently active infection. IgG positive means previous exposure to the bacteria or older infection of Lyme. If no symptoms are present with IgG positive, it may mean an 'inactive' LD infection. No matter the results, please remember LD is a clinical diagnosis, you can have a negative test and still have Lyme Disease and the co-infections, even through the best labs. If you have symptoms, you need treatment."
===
JJJ77, what about the IgG results on your tests?
And remember, Lyme is a *clinical* diagnosis, meaning symptoms trump test results, but test results assist the diagnosis.
=============================================
from www [dot] truthaboutlymedisease [dot] com :
"IGeneX also now offers a new 30-31kDa Confirmation IgG and IgM test. If results from the initial Western Blot are positive for bands 30 or 31, it is possible that these could be due to cross-reactivity with several different types of viruses. In this confirmatory test, highly specific recombinant antigens are used to validate that the positive result is not due to cross-reaction with viruses.
"There are nine known Borrelia burgdorferi genus specie specific KDA Western Blot antibodies (bands): 18 23 30 31 34 37 39 83 and 93.
"Only one of these Borrelia burgdorferi genus specie specific bands is needed to confirm that there is serological evidence of exposure to the Borrelia burgdorferi spirochete and can confirm a clinical diagnosis of Lyme disease. (More info pages 12 & 13 "Western Blot Made Easy": http://www.publichealthalert.org/PHA%20JUNE%2007.pdf )
"Igenex Western Blot Break Down by band:
"9: cross-reactive for Borrelia
"12: specific for Bb
"18: highly specific to Lyme (Many LLMD's say if this band alone is positive, you have lyme - see link above)
"20: cross-reactive for Borrellia
"21: unknown
"22: specific for Bb, probably really the 23/25 band
"23-25: outer surface protein C (OspC), specific for Bb
"28: unknown
"30: unknown; probably an outer surface protein; common in European and one California strain - Has cross-reactivity with several different types of viruses
"31: outer surface protein A (OspA), specific for Bb - Has cross-reactivity with several different types of viruses
"34: outer surface protein B (OspB; specific for Bb)
"35: specific for Bb
"37: specific for Bb
"38: cross-reactive for Bb
"39: is a major protein of Bb flagellin; specific for Bb
"41: flagellin protein of all spirochetes; this is usually the first to appear after a spirochete infection but is NOT specific to Lyme (i.e, other spirochete diseases have flagellas - see link above "Western Blot Made Easy" for more info)
"45: cross-reactive for all Borellia
"50: cross-reactive for all Borrellia
"55: cross-reactive for all Borrellia
"57: cross-reactive for all Borrellia
"58: unknown but may be a heat-shock Bb protein
"60: cross reactive for all Borrellia
"66: cross-reactive for all Borrelia, common in all bacteria
"83: specific antigen for the Lyme bacterium, probably a cytoplasmic membrane
"93: unknown, probably the same protein in band 83, just migrates differently in some patients[/b]
"An IgM positive test result means more recent & likely currently active infection. IgG positive means previous exposure to the bacteria or older infection of Lyme. If no symptoms are present with IgG positive, it may mean an 'inactive' LD infection. No matter the results, please remember LD is a clinical diagnosis, you can have a negative test and still have Lyme Disease and the co-infections, even through the best labs. If you have symptoms, you need treatment."
===
Went to the doctor today and I think Hope75 is right...I am more confused now then I was before :( My IgM Western Blot was all negative with the following exceptions:
23-25 IND
31 IND
39 IND
41++
Dr started Omnicef for a month and then I go back to see him. He is very nice and asked if I have any questions but I still don't understand enough to know what the heck to ask!! He said that I was about as close to a positive result as one person could be and still fall short. He then added that there is defintely "something" going on. Any feedback you all can offer would be great!!!
23-25 IND
31 IND
39 IND
41++
Dr started Omnicef for a month and then I go back to see him. He is very nice and asked if I have any questions but I still don't understand enough to know what the heck to ask!! He said that I was about as close to a positive result as one person could be and still fall short. He then added that there is defintely "something" going on. Any feedback you all can offer would be great!!!
I'm sorry your confused, I understand. I believe I posted on here the criteria according to Igenex somewhere, but don't remember where (brain fog?:). My understanding is there are certain bands that are stronger indicators of Lyme. I had some that were "Indeterminate", so they were neither positive NOR negative. In sum, be prepared to be confused and just as JackieCalifornia said, get yourself a copy (or two for good measure). I'm sure your LLMD will clarify. I am told I now have to get tested for co-infections, so you're probably not done with the diagnostics yet. Take care and keep us posted, as I am learning right along with you.
I'd get photocopies of the test results at your appointment -- so you can see exactly what was positive. Then let us know? Hang in there.
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