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Lyme Results: Band 23 and 41 IGM POSITIVE
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Lyme Results: Band 23 and 41 IGM POSITIVE


Thank you for offering a platform for discussion.

I tested negative on the Lyme WB at Labcorp on June 12, but positive on two bands IGM: IGM 23 AND IGM 41. All IGG were NEGATIVE.

I have got tested for HIV, Hep C, HSV2, Clymadia, Gonorrehea and Syphillis (syphilis) (using RPR) and tested negative.

I have these symptions ON AND OFF from last 4 months: Abdominal Pain (mostly in Upper Abdomen), Fatigue, Non-Specific Urethritis, Headache, Leg pains and Loose and Foamy/Scattered Stools.

Coming back to tests, please comment on the following:

1. Band 41 (Flagellum) in Lyme WB is common for many diseases - Can it be related to other Flagellum like H.pylori and E.coli?
2. Is Band 23 specific to Lyme? Are there any other diseases that can be related to a Positive Band 23?
3. Would you recommend any other Lab Tests OR Any possible diseases i can relate to these tests, as, only IGM is positive and i have symptoms from last 3-4 months.


Thank you,
Scott
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Avatar_f_tn
this is similar to the results of mine....41 is present in both and 23 is present in IgM band. My doctor seems to think this is Lyme...I have no recollection of a tick bite or rash and I am not outside often... but she says it still happens and isn't uncommon that they will bite you and fall off, without a rash. I haven't been feeling myself for the past month so I understand. The tests I believe cost a lot of money. Talk to your doctor about antibiotics (thats what I am doing) taking Doxycycline 100mg twice a day and I am going to go 4 another test after that and see what happens. The medicine won't hurt you and treats other bacterias as well it is also good for acne I have heard.
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I'm far from an expert on understanding the test results.  Here is a link to a post by another member, SOONERMOM, and her doctor's explanation of some details of the Western blot:

http://www.medhelp.org/posts/Lyme-Disease/If-I-really-do-have-Lymes-Disease/show/973861?personal_page_id=5046&post_id=post_4559109

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428506_tn?1296560999
Thought I would add:

I was tested for everything under the sun, twice.  My ELISA was negative on a couple of occasions.  My Igenex results were IgG 39+ 41+++, IgM 41+.  I went over 1.5 years with obvious symptoms before getting diagnosed.  I've been on antibiotics 6+ months and am starting to get better after being practically disabled.

I was never a CDC positive case.
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Avatar_f_tn
Welcome.  Band 23 is a significant band.  41 is non-specific as you stated.  The link that wonko posted explains the western blot very well.

Considering you live in a lyme endemic state you may want to see a lyme literate MD and get a western blot done through Igenex labs.
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Avatar_m_tn
Friends,

This is very tricky and i noticed that a very experienced doctor is also surprised and confused with the lab results. Please share your experiences and please answer my questions, if possible:

1. Band 41 (Flagellum) in Lyme WB is commonCommon cold for many diseases - Can it be related to other Flagellum like H.pylori and E.coli?
2. Is Band 23 specific to Lyme? Are there any other diseases that can be related to a Positive Band 23?
3. Would you recommend any other Lab Tests OR Any possible diseases i can relate to these tests, as, only IGM is positive and i have symptoms from last 3-4 months.

Any information/suggesstions will be appreciated by many sufferers.

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Avatar_m_tn
Its quite possible that its some other disease, or a band closely related to some other disease. Please help and share your experiences.
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Avatar_f_tn
what has your doctor said? did he or she put u on a medicine to clear or try and clear up the Lyme if you have it? Talk to your doctor about medicines...I am scared about my results too so I totally understand. My doctor took action and put me on Doxycycline for a month and I am going to get re-tested on July 10th. Talk to him or her about medicines and what they think...whats their opinion? maybe you should try it? for a month or so? If you are very worried get a few opinions...goodluck.
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I would like to see what everyone else has to say since my results seem veryyyyy similar to yours....
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see mine were band 23 was positive IgM and band 41 was positive in both IgM and IgG. and this too was through the Western Blot. I am very scared/worried too... I hope this is right and that this test is reliable and the results are reliable... I would also like to ask that same question can 23 be something else? is any way shape or for? or is it strictly Lyme? I am so confused too. I understand...
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Avatar_f_tn
You say 23 is significant band...even if its only an IgM band? what is the difference between the IgM and IgG bands?
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428506_tn?1296560999

Your symptoms and test results are different than mine, but since Lyme has so many ways of presenting and so much variation from person to person, that doesn't mean very much.  Here are a few thought and questions:

IgM antibodies for Lyme diseaes appear in the blood earlier than IgG antibodies.  I'm not sure on the quantitative times for each, but that could be why you show only IgM bands at ~4 months into symptoms.  You may have stated it and I just missed it, but did you also have an ELISA test?  The ELISA usually is done before the Western blot.

What lab did your Western blot?  Quest and LapCorp are the most common labs associated with insurance companies.  There are also specialty labs dedicated to testing for Lyme and tick-borne infection (TBI).  A major such lab is Igenex.  Many doctors who specialize in Lyme disease use Igenex.

No matter what lab is used, the blood tests are not reliable enough to clearly diagnose all patients.  Many rely on clinical diagnosis based on symptoms, history, and the ruling out of all other conditions.  Have you had other tests to look for other possible causes of your illness?  Has your doctor discussed with you what else s/he is considering?  

Do you recall a tick bite, or did you have a bull's eye rash?  I had neither, and have read that up to 40% of patients don't recall the bite.  But of course if you do, it's an important clue.

The medical community is strongly polarized on Lyme disease, from the testing, diagnosis, to treatment.  You must be aware of this, and how it may influence your ability to get a diagnosis and proper treatment.  That is why patsy10 mentioned an LLMD or "Lyme literate" physician.  This is a patient descriptor, not an accreditation.  If you seek out an LLMD, I'd suggest looking for one that has ILADS affiliation.  

We're here to try and help answer questions, as it is very murky to navigate this.  Other resources that may help you at this stage are the ILADS website, the book "Cure Unknown" by P. Weintraub, and the documentary (currently in select theaters) "Under Our Skin."  All have informative websites that you can easily find.

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I know your response was to scottmurphy but that helped...could or would you be able to also answer my question about band 23 being significant?
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428506_tn?1296560999
My response is for anyone who finds it helpful in anyway.

Did you read the post I linked above, in my 1st response on this thread?  It talks about the Western blot bands.  I personally know very little about the bands.  

The tests failed me as my screening test was negative twice, and that lead to a significant delay in my diagnosis/treatment.  I personally relied mainly on a good clinical diagnosis by a doctor familiar with Lyme, made after everything else under the sun was ruled out.  My response to treatment also solidified my diagnosis.
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Avatar_f_tn
yes that thread was from me lol. but yes thank you for your help! I really appreciate it. I guess I will just wait and see what happens when I take the tests over again on July 10th.
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Ooops!  I forgot who the original poster was on that thread!

I know it's very confusing that there are such distinct and non-overlapping views on Lyme.  At  this stage, it's good for you to be aware of that, you don't need to pick sides or become an expert overnight.  I went through a lot of confusion before getting diagnosed, and really thought that Lyme had been properly ruled out.

If you haven't yet, you may want to find the trailer to "Under Our Skin" online.  It's only about 2.5 miutes, and will give you a glimpse into how different doctors take different stances, and how patients are left in the middle.  

I had not only my physician, but many other specialists tell me I didn't have this disease, and it took a lot of time and help from kind strangers to help me sort out what was happening to my health.  And it's an ongoing process!
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thank you for your kind advice and opinions, you have been really helpful...I really hope this is what it is and that it gets cleared up. My doctor seemed very shocked and so did I but when she had gotten the results back she had take immediate action... Hopefully it really is Lyme and hopefully we solved this problem... I will keep everyone posted next time I go in and with the results...
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I watched this 5 min 30 ish sec. documentary on it. It is very very upsetting and I feel so bad for those cases I wish everyone on this site the best. and I hope we all get treated consistantly and correctly.  
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Avatar_f_tn
To try and answer your questions:

1.  Yes.  From what I have read 41 is the most common but can be positive with other things like H. Pylori.
2.  ?
3. Igenex labs for testing

IgM-Current or chronic infection
IgG-Past infection

However from what I have read either can indicate a current lyme infection.

If your read wonko's first post there is a link which explains the western blot very well or go to drcharlescrist.com
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Below is something I found that might explain the significance of the band 23-25(OspC)..and other bands as well and how the CDC came to accept certain bands as criteria.

http://www.lymenet.de/labtests/brenner.htm

"   1. the first band to show up on a Lyme disease patient's IgM blot is usually the one at 41 kDa,
   2. followed by the OspC band and/or the one at 39.

It also goes on to say how if you are IgM positive after being sick for more than 6 weeks (of course who was tested that soon???) that it doesn't apply because it should be more  of a IgG response in their opinion.  This is why no one around here considers me  positive I guess.  This is also how the LLMD differ, the consider it an "ongoing" infection where the bacteria is constantly changing and our immune system is changing antibodies to adapt to the bacteria.



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thank you for your responses again...is there anyway I can have your input on mine and someone elses other post on is Lyme disease transmitted through sex? I would really appreciate this. thank you.
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what does it mean when he says 5 out of those bands have to be considered positive? isn't this a lot? do you think with mine and scotts results we do have Lyme? sorry I have really been freaking out as to what I have and I am  sooo confused...
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Avatar_n_tn
Hi. Just read a little of your "story." My son too had pain in his upper stomach and loose stoole. Before he had that he complained about a few normal lyme symptoms, but not too bad that we took him to get checked. (Never knew he was bit.) When I finally took him to the doctor for his stomach, our dr. told us that 8 out of 10 children with unexplained stomach problems were tested for lymes with a positive result. He had lymes alright. Five positive bars and antibodies ar 2.32. He was tested for H.plyori and that was negative. I would have another lyme test done. As you know, lymes is tricky and gives false negatives and other screwy results. Good luck.
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thank you for your comments hopefully scottmurphy reads it too! I am being treated for mine already and will go and test again july 10th to see if the medication helped. I hope that this is it and its the answer to my problems...
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oops.....Lol I meant to send my comment to scottmurphy. I'm pretty new to this site,sorry...: )
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Avatar_n_tn
Hello all.
I was diagnosed 15 months ago when I ended up in the hospital with RMSF and subsequent Bell's palsy.  The lyme titer at that time was negative but came positive in f/u bloodwork.  Today, I received my most recent blood work and I am still very positive, IgM bands 23, 39, and 41 all positive with a positive high of 212.  15 MONTHS.  Freakin' ridiculous.  I am guessing I will never be the same.  Certainly functional but not my old self.   Does this ever go away? I am becoming weary of all this baloney.  
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Welcome to MedHelp --

Sorry to hear of your situation.  Would you share with us what treatment you have had (probably antibiotics -- which ones and for about how long)?

We might be able to give you some ideas from our own experiences.
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My mom was diagnosed with the same three bands.  This was through a Western Blot.  Her symptoms vary from memory loss, confusion, aching, arthritis, atrial fibulation, dizziness, etc.  We are in the process of attempting to find out what is causing this.  In the report, it states that is could be:  periodontal disease, leptospitosis, yaws and pintal, conective autoimmune  (rheumatoid arthritis and systemic Lupus Erythematosus and also individuals with antineclear antibody), Rocky Mtn. Spotted Fever, Epstein-Barr Virus and cytomegalovirus.  This is quite a range of diseases and conditions.  We are just beginning to investigate what is could be.  Good luck.
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Do I take correctly from your comment that the drs are saying it is NOT Lyme?  And if so, on what basis?
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Avatar_m_tn
I also have 23 and 41 IgM only.  How do they know it is for sure lyme?  I see a LLMD next week for the first time.  Been on doxy for about 3 weeks now.
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The LLMD will take a careful history of your symptoms, and based on that, with additional data from your test results, the doc will make a diagnosis.  Much about Lyme is in shades of grey, rather than black or white.  That's just the way it is, not to worry.  Having a wise doc makes up for iffy tests.
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Avatar_m_tn
Yeah, I just didn't know if it means I def. have the lyme bacteria, or if there are other types of bacteria/illnesses that could make certain bands positive?  This is all so confusing!!
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Band 41 could be Lyme, but could also be something else.

Band 23 is ONLY Lyme.and nothing else.

Non LLMDs usually require more positive bands than LLMDs do to make the call of a Lyme diagnosis.  LLMDs take into account your history and symptoms, partly because the positive test results tend to fade after time passes, so if you've been infected for a long time, you're less likely to get a positive result even if you are still infected.    That's why seeing an LLMD is important, because they take these factors into account.

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Avatar_m_tn
So it is highly likely it's lyme with 41 AND 23.  

All of my symptoms started out of nowhere in August and I haven't felt myself since August, so it is probably lyme.  It's just so strange that I never remembered any tick and didn't have a rash etc...  

I am SO glad I came to msg boards and learned more abt lyme and demanded my dr. to run tests.  I feel lucky that I was positive with both tests too.  I cannot imagine the people that show negative and then go on not knowing what is wrong with them.

Adrenaline got me through my last weekend with graduation, engagement etc...  I've been laying down most of this week and now tonight starts a busy holiday weekend.  I just want to feel back to normal.  I've been doing the 'why me' thing and been feeling depressed this week.  I need to be able to start my job and take boards in Feb.  Looking fwd to my LLMD appt next week.
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I hope your doc is truly an LLMD, and not a regular doc.  It makes all the difference.

A nonLLMD will require several positive bands to diagnose Lyme, but an LLMD willl view it all differently.  There is much not yet known (and much being discovered every day) about Lyme -- and the tests are just not accurate enough to be the last word.

One thing an LLMD will not require is a rash or a tick -- many of us, including me, never saw either one.  

An LLMD may also, after quizzing you about your symptoms, test for other diseases the same ticks carry.  The symptom assortment is all over the place for Lyme and these co-infections, so everyone presents differently, and the docs need to be subtle in their assessment.

Feeling depressed is often part of Lyme, because of not being understood or diagnosed, but also because the the biochemical effects of the infection.  It really really really does affect your emotions, biochemically.  It's not something you can just snap out of anymore than you can snap out of a broken leg.  But it will get better with treatment.  Been there.

Take heart!  Let us know how you do!
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Avatar_m_tn
Yeah, he is a LLMD, I'm not travelling 8 hours each way for nothing! :)

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Avatar_m_tn
Wow, an active post.  I was bit by a tick the end of October.  Have not felt the same since.  Weird feeling.  Hospital once for uncontrollable shaking and sweating.  A couple more minor incidences since then.  Still get chills and my butt and back of thighs hurt.  Not pain, just soreness and a warm acking sensation.

Positive on 23 and 41 band, negative on 39.  I had to fight with my dr. today to put me back on Doxycycline.  Was on for 3 weeks.  This is a wild disease.  You do not feel like YOU.  There are times I have no motivation.  I could care less about anything. I do not like at all.

Does anyone else experience same symptoms?  Also,, my blood work (liver enzymes) make me look like a raging alcoholic.  White blood cells down, ALT and AST way high (33 & 49).  Other liver tests show my liver is distressed.  Yes I drink, same for 30 years.  All of a sudden my tests are terrible compared to last year.

any input you may have would be appreciated.  I see an infection control dr. in 3 weeks.  Do not know what his experience is with Lyme, but it is in MA, so I am guessing he has seen it before.

Brian
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Avatar_m_tn
Wow, an active post.  I was bit by a tick the end of October.  Have not felt the same since.  Weird feeling.  Hospital once for uncontrollable shaking and sweating.  A couple more minor incidences since then.  Still get chills and my butt and back of thighs hurt.  Not pain, just soreness and a warm acking sensation.

Positive on 23 and 41 band, negative on 39.  I had to fight with my dr. today to put me back on Doxycycline.  Was on for 3 weeks.  This is a wild disease.  You do not feel like YOU.  There are times I have no motivation.  I could care less about anything. I do not like at all.

Does anyone else experience same symptoms?  Also,, my blood work (liver enzymes) make me look like a raging alcoholic.  White blood cells down, ALT and AST way high (33 & 49).  Other liver tests show my liver is distressed.  Yes I drink, same for 30 years.  All of a sudden my tests are terrible compared to last year.

any input you may have would be appreciated.  I see an infection control dr. in 3 weeks.  Do not know what his experience is with Lyme, but it is in MA, so I am guessing he has seen it before.

Brian
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Avatar_f_tn
Welcome.  I'm not medically trained, but from what I have read, band 23 is specific only to Lyme bacteria, meaning that band won't light up unless there are Lyme bacteria present.  Band 41 may or may not indicate the presence of Lyme bacteria.  However, docs who are NOT Lyme specialists usually require more bands and more positive (+) readings on those bands to diagnose Lyme, compared to Lyme specialists.

Unfortunately, infectious disease (ID) docs are often most resistant to diagnosing Lyme, which should not rely entirely on the admittedly poor tests available, but instead should be based on your history and symptoms.

Good luck with the ID doc; I hope you are lucky and s/he is broadminded enough to consider Lyme seriously, and also to consider other diseases carried by the same ticks.  Those diseases require separate testing and treatment from Lyme.

It is difficult to tell the docs who 'believe' in Lyme from those who don't, so going ahead to see the ID doc is probably worth doing, but in the meantime, I'd suggest you do a little research online to see if you can figure out his/her inclinations in that regard ahead of time.  Try searching/googling the ID doc's name and also search:

llmd massachusetts

or

llmd boston [or whatever area you are in]

and see what pops up.  If the appointment doesn't progress satisfactorily from your view, I'd suggest you consider see another doc, this time one who appears to have LLMD leanings.

Let us know how it goes, okay?  Best wishes --
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Thanks, I have been doing research for 4 or 5 weeks now.  I thought band 23 was not good..  What a nightmare.  I see 1993 posts and I think, "it is better now".  HAH, maybe not.  I will have lots of questions with the Infection Control Doc., thanks to posts like this.  I am in an HMO, this is where I have to go for now.

It is really weird how this (if it is Lyme) makes you feel. I have the site bookmarked.  I will keep you posted.

I am amazed that 2 Tuesdays ago, when I had a follow up appointment from my hospital visit, I was shaking and sweating.  I asked Dr Sanjay to put me back on Doxycycline.  I said., "look at me, I am shaking and sweating".  but I had no fever.  She said you already had 3 weeks of treatment, you are fine.  Just a cold or something.  They do not understand.

A little scared, a little messed up, I am.  What is becoming clear to me is that the DRs  are not going to be an ally.  I had to argue today to get back on antibiotics.  I appreciate forums like this.  Thanks,

Brian
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You might be weary of it, but remember, if you stop, it comes back!
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Good for you for being an independent thinker on these matters.  It is normal and necessary to trust one's doc, and it's very difficult to become a skeptic esp when so ill, but in Lyme, self-defense is regrettably necessary.

Many of us end up going 'outside network' for Lyme treatment.  NonHMOs will reimburse to some extent, but HMOs, perhaps not.  HMOs are efficient and effective with known ailments and proven treatments, but when faced with puzzling, cutting edge ailments for which there are no proven, slamdunk approaches and treatment protocols (like Lyme), the efficiency of the HMO approach can translate as rigidity and treatment failure.  Not always, of course, but it's something to be aware of.  As you are finding out, much of medicine believes it understands Lyme fully and has the appropriate treatment nailed, when it fact it doesn't, based on the experience of too many of us here and elsewhere.  Your experience may be better, and I hope it is, but it's something to be aware of.

Getting proper diagnosis and treatment is a challenge, but very well worth it.  Do keep us posted, and best wishes --  
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i had test done 10 years after i may have been infected and it showed up negative,it was in the emergency room,the blood test was sent away,what are the norms for what test are done by er doctors cause i notice 4 possible different test can be done,in anyones opinion what test were done,whats the norm for a er doc if he sends a test like that away,
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i thought i was infected in 1999 but the more i look at the pictures of spider bites the infection i had and the gaping hole left by it look more like a spider bite,i found an engourged tick on my leg in 2009 and went to the emergency room and thats when this happened
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so band 23 is a solid hit on lyme diesese and band 41 is the 2 of 3 to diagnose lyme disease if i read right what is the third cause i see many listed
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Avatar_f_tn
Welcome.  If you aren't already aware, there is a big divide in the medical community about how to diagnose and treat Lyme disease.  The tests are not very accurate, but docs who are not Lyme specialists do not agree with that approach and so are inclined to say someone can't possibly have Lyme.

The diagnosis should be based on history and symptoms, and whether the exact number of bands on the tests are 'hits' is less important, for several reasons including that there are many strains of Lyme bacteria, and the tests don't pick up all of them equally well; after you've been infected for a while, the tests tend not to show positive even tho you have a solid infection; and there are other diseases the Lyme ticks carry that the Lyme tests don't pick up.

So the tests are helpful, but not the last word.  I have also read that band 23 is definitely Lyme; band 41 could be several other infections or could also be Lyme; and there are a dozen other bands that are reported on the standard tests.  

Lyme specialists use a different test, called PCR, that is more precise, but nonLyme specialists don't use it and/or don't believe in it.

Also know that over time, your immune system will stop reacting to the presence of Lyme bacteria, and your tests can come back clean or showing a weak infection when really you are quite ill, or if not yet feeling really lousy, you could be in the future if you get infected again and/or your immune system gets busy fighting off some other, unrelated disease and lets down its guard against the Lyme infection you already have.

My best advice is to find a Lyme specialist, who knows how to take your history, will ask specifics about your symptoms, will order appropriate tests, and will know things nonLyme docs simply don't know and/or don't care to know.

If you search online for

LLMD Miami

you will probably find some leads.  Sometimes the first doc isn't a good fit, and it pays to go on to another one, because Lyme is the wild wild west of medicine and there are some wacky docs out there who want to sell you a lot of vitamins and not much else.  (I personally TAKE a lot of vitamins, but I don't trust docs who want to sell me their own vitamins from their office; the incentives for them are lined up all wrong, in my personal opinion.)

If you need help finding an LLMD, let us know --

Good for you for looking into this!  Best wishes --
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1954289_tn?1332606119
Please come up with a proof positive test for Lyme and train all doctors about this devasting disease.Make it a protocol if someone comes to you with a tick bite and bull eyes rash to be put on antibiotics for 1 month and to be seen once a month for a year with all blood test done to make sure the disease is gone.If it still detects the person should be put on antibiotics for as long as it takes to erradicate the disease.I'm sure the the victims of this disease would rather have a raw stomach for a while then the debilitating effects of this disease that can be so easily cured.And doctors listen to your patients,this is their lives that they entrust into your hands.Insurance company's stop being greedy and realize that its not about money,its about people getting to live a long and happy life.Jesus people with diabetes have to wait a full year to be covered on most hmo's if the disease was pre diagnosed under another hmo,do you know what diabetes can do to a person even in 1 years time.this isnt about moiney,its about the most precious gift there is and that' life,and you only get 1 chance
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1954289_tn?1332606119
I am pretty positive i don't have this disease i have had out of control diabtes and sleep apnea for may years.I had sleeping problems when i was a kid waking up chocking for air.I have had circulatory problems from my blood being like syrup from diabetes.i will have myself checked out throughly  for lyme and for ms for my central nervous system cause i am a worry wort ans this could all be anxiety but ill make sure of that.i ignored my health problems for many years but that will never happen again.i fell bad for anyone who may get this disease and i will make it a point in my life to make sure people who i know and those i dont about this disease.I mean really you can make someone a pace maker to regulate heart beat but you cant make a solid test for a blood born disease
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1954289_tn?1332606119
he refused to test me for Lyme he said the Neurologist will take care of that
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Avatar_f_tn
I'd be sure to get hard copy of all the test results, and then decide what to do.  Neurologists are not known to be progressive thinkers when it comes to Lyme.  Let us know what you find out --

Best wishes --
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1954289_tn?1332606119
could i possibly have a vitamin b-12 problem,i od have the white spots on my arms and the symtoms (symptoms) match
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Avatar_f_tn
Sorry, no idea.  That's the kind of thing a doc would have to look at in context with your other symptoms and your history.  You have a complex history and a good doc is the one to help you unravel what's going on.  Best wishes --
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kathloj
Ottawa
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wonko
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nutrinut_bob