Need Help Interpreting Igenex Lyme Results

[RyanInTexas]

igm/igg below:
IGM:

IGENEX NEGATIVE

CDC/NYS NEGATIVE

18+

31 IND

39 IND

41 +++

IGG:

IGENEX POSITIVE

CDC/NYS NEGATIVE

28+

39+

41+++

58+

IFA RESULT BURGDORFERI: 40 [EQUIVOCAL]

BARTONELLA FISH RNA: NEGATIVE

BABESIA FISH RNA: POSITIVE

E. CHAFEENSIS IGM: <20

E. CHAFEENSIS IGG: 160

B. MICROTI IGG: <40

B. MICROTI IGM: 40

BERGDORFERI PCR: NEGATIVE

Ok guys hopefully you can help me make sense of this. We did have a tick infection in our home in August 2013 and I got flu like symptoms 2 weeks later after we treated the house. I don't remember a bite or rash though.

Around that time I also started waking up after 1-2 hrs of sleep, which has never happened before. I am asthmatic and take an inhaled corticosteroid, but my asthma is very mild. When I stopped taking Advair, I always had sleep disturbance, and when I went back on the Advair, no more sleep disturbance.

In the summer of 2014 I went off Advair again and got the mid-night awakeneings again followed by H Pylori and Gut Dysbiosis after treating the H Pylori with antibiotics. I'm a mess ever since.

In November 2014, after taking Tetracycline and Metronidazole for H Pylori, I developed a nonstop muscle twitch in my bicep. That lasted for 3 days then went away. In January 2015, after going back on Advair to help me sleep again, I developed muscle twitches in my legs and arms that come and go every 10-20 seconds when the muscle is at rest.

I also got the Spectracell Micronutrient Test at the White Blood Cell level and I am low in B12, B5, Folate and Choline. All else is normal.

Help! Do I need to be treated for Lyme and Babesia?? My only symptoms at this point are the sleep disturbance and muscle twitches. I suspect I was infected back in August 2013 but cant be sure. What treatments do people suggest if indeed you think I have Bergdorferi or Babesia?

[JackieCalifornia]

You're quite welcome ... I didn't want to run off at the mouth too much, but often do.  Glad you took it well.

Steroids (and that includes OTC steroids) do their work by suppressing the immune system, which then are unable to attack invaders like bacterial infections (including Lyme).  So yes, that could have been a problem when you were treated.

Also, 8 days of antibiotics could very well have been insufficient to kill any Lyme bacteria that were lurking.  Lyme bacteria have a very long reproductive cycle (7-10 days), far longer than the usual ~20-30 minutes of other bacteria.  It is when splitting to reproduce that bacteria are susceptible to antibiotics, so the armor-plated Lyme bugs aren't much affected by the 'usual' antibiotics for a week or so.  Lyme treatment using antibiotics usually go on for months and may need additional treatment with different antibiotics depending on which co-infections are present.

NonLyme docs aren't bad people, and they are just following what the bigwigs in the Infectious Disease Society of America (IDSA) say -- and those are the docs who decree what appropriate treatment is in that field.  

Which all brings us back to finding a Lyme doc, for all the reasons above.

If you have a strong immune system, you may not have many symptoms except reasonably tolerable ones like twitching and not sleeping well.  I just felt tired a lot and like I had a mild, permanent hangover (and I don't drink).  There are many ways to find reasons for the way one feels with Lyme (like working too hard, having a long case of the flu, whatever), because the symptoms are often very subtle -- but over time, you'll begin to adjust to feeling lousy all the time and just slog along.  

I would find a Lyme specialist for a work up.  It's money well spent.  TXLDA:  Texas Lyme Disease Assn.  Check them out.  :)

[RyanInTexas]

Thank very much for the detailed reply Jackie. You mention it being over one year so Doxy might not be effective.

In November 2014 I took 8 days of Flagyl and Tetracycline to kill what was left of my H Pylori. I was also off of my corticosteroid, Advair, which I had been taking for a while. 3 weeks later my muscle twitches started. Is that a coincidence? Did I release what my immune system was containing? I'm still trying to figure out if the corticosteroid I was on either helped my immune system contain the infections or has made everything worse.

My only symptoms to date are twitches and sleep disturbance. On nights that I sleep 6-8 hours straight, which are rare, I do not feel fatigued.

[JackieCalifornia]

Here's the short version:

You say:  "Help! Do I need to be treated for Lyme and Babesia??"  

     Yes.  They will not go away without treatment.  Lyme is related to syphilis, and if you are not familiar with the results of untreated syphilis, you should go read them.

You say:  "My only symptoms at this point are the sleep disturbance and muscle twitches."  

     Those are common symptoms of Lyme, but the disease will not go away without treatment, and will very likely get worse.

You say:  "I suspect I was infected back in August 2013 but cant be sure."  

     It doesn't matter if you know when you were infected.  Focus on today and what to do to protect yourself.

You say:  "What treatments do people suggest if indeed you think I have Bergdorferi or Babesia?"  

    Antibiotics.  You have been infected long enough (over a year) that doxcycline is almost certain to be ineffective.  The Lyme bacteria hide in the body where doxy cannot reach.  Other antibiotics are required.

The longer you wait, the harder it is to cure Lyme and whatever other infections the ticks brought.  We're not talking the sniffles here.  Lyme is a serious disease.  

[JackieCalifornia]

Part 2 of 2:

     You say:  "Around that time I also started waking up after 1-2 hrs of sleep, which has never happened before. I am asthmatic and take an inhaled corticosteroid, but my asthma is very mild.  When I stopped taking Advair, I always had sleep disturbance, and when I went back on the Advair, no more sleep disturbance.In the summer of 2014 I went off Advair again and got the mid-night awakeneings again followed by H Pylori and Gut Dysbiosis after treating the H Pylori with antibiotics. I'm a mess ever since."

Be sure to tell your doc all this -- I don't know how strongly your asthma treatments suppress your immune system, but it helps the Lyme bacteria if your immune system is not up and fighting.  Whether it relates, the doc will know and take it into account.
===========================================
     You say:  "In November 2014, after taking Tetracycline and Metronidazole for H Pylori, I developed a nonstop muscle twitch in my bicep. That lasted for 3 days then went away. In January 2015, after going back on Advair to help me sleep again, I developed muscle twitches in my legs and arms that come and go every 10-20 seconds when the muscle is at rest."  

Could be related, maybe not.  Lyme bacteria use up magnesium in the body, and that can lead to twitching and cramps.  Again, be sure to tell the doc.  Every data point can be helpful in the mind of a good doc.
=====================================================

You say:  "Help! Do I need to be treated for Lyme and Babesia??"  If you have either or both of those infections, they will not go away by themselves, and can do significant damage to your body.  Treatment is very much in order, and what treatment depends on what infections.

You say:  "My only symptoms at this point are the sleep disturbance and muscle twitches."  Sometimes that's all that shows up.  

You say:  "What treatments do people suggest if indeed you think I have Bergdorferi or Babesia?"  Having a good, experienced MD who specializes in Lyme and other tickborne infections is key to getting well.  Other docs mean well, but there is a huge split in the medical community that leaves many Lyme and/or other tickborne infections undiagnosed and undertreated.  You do not want to be one of those people.  Lyme disease is in the same family as syphilis, and if you are familiar with the damage done by untreated syphilis, you'll understand why.  Treatment is with antibiotics of various kinds, depending on which infection(s) you have.

Texas Lyme Disease Assn (TXLDA) can help you find a Lyme specialist near you. Go for it!

[JackieCalifornia]

Welcome to MedHelp -- sorry you have reason to be here, but it's good you are following up.  I have read in various places that it's hard to get a Lyme diagnosis in TX, because the medical chieftains are disinclined to believe it's there or (if it's there) that it's serious.  So, big points to you and your doc for exploring the possibilities.

Your doc is testing you through IGeneX, a lab in Palo Alto CA which has a particularly good set of tests, more accurate than the old standard Western blot and ELISA tests.  Wblot/ELISA are not useless, but IGeneX is more precise because it looks for DNA of the Lyme bacteria, which is direct evidence of Lyme infection:  IGeneX is a good step by your doc.

IgM are the antibodies your immune system makes shortly after a Lyme infection, and after a while that trails off and your body starts make IgG antibodies.  Both are reliable, but both are needed to be sure both phases of the infection are looked for so the docs know better how to treat.  If either IgG or IgM shows positive, it simply indicates generally how long ago since the bite, not whether there is an infection.

A 'plus' sign means the test detected this particular chunk of the bacteria examined; the more plus signs, the stronger the presence of that bacteria.
===================================================
IGM:  IGENEX NEGATIVE
         CDC/NYS NEGATIVE
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     18+          

Band 18 -- highly specific to Lyme; some MDs say if you are positive on this band along, you have Lyme
--------------------------------------------------------------------------------------------
     31 IND    

Band 31 -- specific to Lyme; this registers as outer surface protein A (OspA), but can cross-react with some types of viruses
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     39 IND    

Band 39 -- this is a major protein of the Lyme bacteria's whip-like tail; specific to Lyme
-------------------------------------------------------------------------------------------
     41 +++  

Band 41 -- this is common to other spiral-shaped bacteria, of which Lyme is one; so it could be Lyme, or could be another bacterium.
=============================================
=============================================
IGG:  IGENEX POSITIVE
         CDC/NYS NEGATIVE
-----------------------------------------------------------------------------------------
     28+

Band 28 -- unknown significance

-----------------------------------------------------------------------------------------
     39+

Band 39 --  this is a major protein of the Lyme bacteria's whip-like tail; specific to Lyme
----------------------------------------------------------------------------------------
     41+++

Band 41 -- this is common to other spiral-shaped bacteria, of which Lyme is one; so it could be Lyme, or could be another bacterium.
----------------------------------------------------------------------------------------
     58+

Band 58 -- unknown but may be Lyme-related
==========================

"IFA RESULT BURGDORFERI: 40 [EQUIVOCAL]"

Equivocal means there was a positive reaction on the test, but not a strong one.  Lyme docs would likely count this as a weak positive, but a positive nevertheless.

==========================
BARTONELLA FISH RNA: NEGATIVE

Indicates no Bartonella infection -- I'm not familiar with Bartonella, so others should comment, but a negative result is a good thing.

==========================
BABESIA FISH RNA: POSITIVE

Indicates you likely have a babesiosis infection.  (I had it too.)

==========================
E. CHAFEENSIS IGM: <20
E. CHAFEENSIS IGG: 160

Both these tests look for your immune system's reaction to the presence of a particular bacterium, Ehrlichia Chaffeensis, also sometimes carried by the Lyme ticks.  There should be a scale on the test results that show what numerical levels are significant.  IgM indicates an earlier infection, which perhaps has faded now, but the IgG level at 160 may well indicate a continuing presence of the infection.  Another reason to see a 'Lyme' specialist.
==========================
B. MICROTI IGG: <40
B. MICROTI IGM: 40

"B" stands for Babesia, as mentioned above.  This is a different kind of test than the FISH RNA test above, just adding more data points to the analysis.  IgM indicates an earlier (older) infection, and IgG indicate a more recent infection, so it looks like this result is positive and indicates a more recent infection with babesia.
==========================
BERGDORFERI PCR: NEGATIVE

I'm not familiar with the details of this particular test name, but Bergdorferi is the family name for Lyme bacteria.  PCR is short for 'polymerase chain reaction', which is a particular kind of test that is said to be quite accurate, in that it looks for Lyme DNA in your blood.  This may just be another way of identifying an already standard test, and/or provides another data point.  It is not uncommon for different tests to have seemingly conflicting results, because medicine is an art used to interpret science.  The tests all have to be read together, and that's what a good doc is for, so ask your doc how this fits in.  
==========================
That's the end of parsing the test results, but as you can see, it requires an experienced and wise Lyme specialist to figure out how all this fits together.   In my untrained view, you have enough going on that you would seem to have a couple of things going on that your doc needs to look at.
======================================================
     On to another aspect of all this -- how you feel and what you remember:
======================================================
     You say:  "We did have a tick infection in our home in August 2013 and I got flu like symptoms 2 weeks later after we treated the house. I don't remember a bite or rash though."  

That's good data to give the doc, but it's not necessary to remember a tick or a bite:  I never saw a tick on me or had a rash or a bite mark, and I had test-documented Lyme and babesiosis and was pretty sick.

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MESSAGE IS TOO LONG; SEE SECOND PART FOLLOWING BELOW
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[mojogal]

Yes please treat for both. The longer you wait the sicker you get as the bugs do so much damage to your body. I was bit over 25 years ago but didn't start treatment until 3 years ago since I was misdiagnosed. It is very difficult now and much damage done.