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western blot vs. igenex
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western blot vs. igenex

What test do you think is more accurate, Western Blot or Igenex?

I am going to ask my neurologist to test me for lyme soon. Should I tell him what test I want or should I just let him order a test he thinks is best? I'm going to start there and if he refuses to test me (which I doubt because he is a great neurologist) then I will see a LLMD.

Thanks

-Sarah
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Avatar_f_tn
Igenex is a laboratory that runs various tests on blood drawn from you.  LabCorp and Quest Diagnostics are other well known labs, but their Lyme test results are not as detailed as the tests run by Igenex, so I understand.

'Western blot' is a kind of test, just like an ELISA is a kind of test, both used in Lyme diagnosis and treatment/tracking.  

Igenex is preferred by a number of LLMDs because they are thought of as superior in the way the do their work, so I have heard.

Your neuro may want to start with an ELISA test, and only if it is positive to do the Western blot.  I don't understand why anyone does the ELISA test at all, since it is often wrong and gives a false negative.  The CDC standards for testing do a two step of ELISA first and if positive then a Western blot.

Neurologists are not very Lyme-savvy as a group, so it's good you have a good feeling about your neuro.  It would be fair to ask the neuro what tests he/she suggests and what lab is used; then if there are additional tests you want done, certainly ask for them.  If the dr laughs at you (as one did to me), then it's time to consider a new dr, but your approach of going with the program until proven otherwise is a good one.  It's wonder to have a dr you trust, and that is the most important first step.  Perhaps he/she is willing to learn about Lyme too.

Good luck, tell us what happens.  Others may also have some advice here on a good approach to your dr.  Glad to hear you're taking charge!!
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Avatar_f_tn
2 weeks into my sick time from work in dec 2006 I had a positive elisa and a neg western.  Then 5 weeks into my sick time from work (never took a sick day in my 15 years of work, that is how sick I was) another neg western blot so I waited 2 years and then asked my new md after my normal heart monitor, echo and mri if I could be tested by Igenex.  I am so thankful for that test, as It was what started dr's to stand up and take notice that I was truely sick physically.  I would recomend Igenex just for the reason that it will tell if your body has or is making antibodies against the lyme bugs.  If some bands come back positive and you have been tested for ms and lupus etc... I would definently see what a course of antibiotics does to your situation.
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Avatar_f_tn
This is good to know. I was wondering about this myself. After what I read about the ELISA it sounds disappointing. I think when I see an LLMD I will ask about Igenex.
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Avatar_m_tn
ELISA is slightly more sensitive, but less specific, which is presumably why more false positives may occur for ELISA. The P/F criteria are not agreed upon by Lyme community. Usually, one ends up doing Western Blot which sort of makes the ELISA unnecessary. However, since the Western Blot is also unreliable, one can argue that it's not a bad idea to both, except for cost.
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The standard IDSA testing for Lyme is to first do an ELISA test.  Then, if and only if it is positive, a Western blot is performed.  As JackieCalifornia posted, "ELISA" and "Western Blot" are test names.

"IGeneX," "LapCorp," and "Quest" are the names of laboratories that can perform these tests.  If you are in the US and have medical insurance, you are probably covered to get testing done by LapCorp or Quest.  Igenex is a private lab in Palo Alto, CA.  They don't bill your insurance, you need to pay for the testing.  You can read more about the lab at their website:

http://igenex.com/Website/#

So doctors operating under IDSA guidelines will only order a Western blot if the patient has a positive ELISA.  If a W. blot is ordered, most doctors will order through whichever lab works with their insurance (again, the big ones in the US are Quest and LabCorp).  However, many "lyme literate" physicians prefer IGeneX since they are a specialty lab devoted to Lyme testing.  
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