POLYMERASE CHAIN REACTION FOR LYME

[lemons]

Hi could someone tell me what a POLYMERASE CHAIN REACTION for Lyme is please. Is it more reliable than the western blot or is it the same thing? I got this printout from my doctors yesterday and it reads like this: “LYME DISEASE SEROLOGY” “SAMPLE REFERRED TO” WILL BE FILED AS: 43h..00 POLYMERASE CHAIN REACTION OBSERVATION, SPECIAL PATHOGENS UNIT, PORTON DOWN. “BORRELLIA 1GG/1GM (C6EIA)” WILL BE FILED AS ;43e0.00 BORRELIA BURGDORFERI IgG LEVEL NEGATIVE “COMMENTS” WILL BE FILED AS 46…00 URINE EXAMINATION NO SEROLIGICAL EVIDENCE FOR B. BURGDORFERI INFECTION. What I really don’t understand is the reference to a urine exam as I didn’t do a urine sample?? Thanks for reading, Lemons x

[lynnie_sydney]

Hi Lemons

http://www.ilads.org/lyme_research/lyme_articles6.html

You will find some good information in this ILADS article which details the different tests run for Lyme – those which are good, those which are not and what the shortcomings are for all of them (there is no perfect test but there are some which are all but useless, particularly the ELISA). My understanding is that PCR is very sensitive and is good for people who have early disease and have not yet been treated with antibiotics – but think it is usually run after the Western Blot on people who test negative but whose symptoms still clinically indicate Lyme.

Be well! Lynnie

Palindromic RA 30 yrs (Chronic Lyme?)
Mino 2003-2008 100mg MWF - can no longer tolerate any tetracyclines
rotating abx protocol now. From Sep 2018 MWF - a.m. Augmentin Duo 440mg + 150mg Biaxsig (roxithromycin). p.m. Cefaclor (375mg) + Klacid 125mg + LDN 3mg + Annual Clindy IV's
Diet: no gluten, dairy, sulphites, low salicylates
Supps: 600mg N-AC BID, 1000mg Vit C, P5P 40mg, zinc picolinate 60mg, Lithium orotate 20mg, Magnesium Oil, Bio-identical hormones (DHEA + Prog + Estrog)

[lemons]

Thankyou for the advice Lynnie. Im still confused about the reference to a urine test though. Im starting to think if there could be a mix up with my results ? So fed up, having a bad day today, shoulders are agony, neck is stiff and I am so tired I am in bed looking out of my window, a meadow with a line of oak trees in the distance. I can hear people in their gardens laughing and enjoying the warm day. I am now starting to look ill, I have lost so much weight and I have dark circles under my eyes. Havent worn makeup for over two months as I cant be bothered.I realy want and need to have a good long cry, with sobbing and lots of dramatic pillow beating but I cant as its the weekend and everyone is at home.

[Maz]

Hi Lemons,

You can trust the ILADs website that Lynnie posted as offering legit info.

From a lay perspective, The Better Health Guy (Scott Forgenson) offers his take on the different testing methods for Lyme disease. Here’s what he says about PCR testing:

http://www.betterhealthguy.com/lyme/testing

“3) PCR (polymerase chain reaction) – a sensitive method of testing where minute amounts of DNA are looked for. Though many consider this method of testing to be useful, I have not found that to be the case. In a presentation that I attended by Dr. Aristo Vojdani (head of Immunosciences Lab), it was noted that PCR tests are positive somewhere between 6% and 15% of the time. Thus, it was stated that this is not generally a useful test for the evaluation of Lyme Disease. For PCR to be useful, it should be expected that it may take repeated tests in order to get a positive result.“

While my limited understanding is that PCR testing is very specific in terms of looking for and finding borrelia DNA in the blood, it is not reliable in terms of sensitivity (as Scott says above – it’s only positive 6 to 15% of the time). This is because borrelia is a corkscrew-like organism that quickly drills out of the bloodstream and into the lymphatic system and other bodily tissues as a survival mechanism to avoid immune detection. Therefore, if there is no borrelia in the small blood sample drawn, how can they possible find its DNA unless it is actually resident in the actual sample being examined?

http://www.news.ucdavis.edu/search/news_detail.lasso?id=9922

4) Lyme DOT-BLOT is an assay for the direct detection of Lyme antigen in the urine. The Reverse Western Blot is an antigen detection test in urine where the urine is exposed to rabbit antibodies for Borrelia Burgdorferi.

As for the urine test and not having done one, you should definitely ask your doctor about this! It may be that the lab usually does both at the same time and your doc didn’t realize – not sure what they do in UK in this regard – and it is just printed on the results form as negative when not run. That is highly confusing, if that is the case, because for someone who isn’t as inquisitive as you, they might overlook that and have it in the file for life, always being told their result was negative when run! You may also be right that somehow your results were mixed up with someone else’s. Worth a check.

Here in the US, the standard test is “two-tiered,” meaning they start with an ELISA and then move on to a western blot, if the ELISA is positive, to confirm the result. You do not appear to have had the western blot test run.

The difference between the western blot and the urine test is that the western blot looks for antibodies produced by the person being tested to specific borrelia proteins (antigens), which are then read on the test and visualized as antibody “bands.” In the Lyme urine antigen test, they aren’t looking for the host response to Lyme, but for any actual bacterial proteins that may be eliminated from the body in the urine…again…not really all that sensitive because it’s one sample and Lyme proteins may or may not be in the one urine sample. Specific if these are found in the sample, though.

Generally speaking, as Scott mentions in his article, LLMDs seem to prefer the IGeneX western blot, which is both more specific and sensitive than the standard western blot.

http://www.IGeneX.com

With western blot testing, there are different proteins produced by spirochetes and some are more specific than others, which will show up as positive on “double-starred antibody bands.” The problem with standard testing is that they removed some of the very specific antibody bands from this test that show up later in the disease when they were creating the LymeRix vaccine (which was later removed from the market as it was causing RA and other autoimmune conditions in folks getting the vaccine!). They never returned those antibody bands to the test, so some of the sickest patients with chronic cases of Lyme never get picked up on standard western blot testing. This is why when standard two-tiered tests (first the ELISA is run and, if positive, the western blot is run to confirm) return negative for Lyme, folks are prepared to dig into their pockets to get a western blot that does contain these antibody bands and is, hence, more sensitive (looks for more strains than the standard test that only looks for one strain out of the 300 worldwide!) to get IGeneX testing run. This test can be ordered from the UK with blood samples sent to IGeneX, if you wanted to do this and run at about $200 for the basic western blot (in two parts for IgM and IgG, present and past infection). As Scott explains, however, the IgM and IgG test need to be read together and not as separate test results, because Lyme is a waxing/waning disease and may look like a new infection when it’s just reactivated…or may appear negative when a person is just going through a latency period or the bug is successfully hiding itself from immune detection (hence, not producing antibodies). Another problem for rheumatics, if they are on immune-suppressive meds, is that they will likely not be producing much antibody to anything for this test, because their immune system is compromised further by the drugs they’re taking.

Another test LLMDs seem to prefer is the CD57 test, which looks at how badly compromised a person’s immune function is if they are infected with Lyme. It’s not looking for the bug or antibodies to the bug that are being produced by the host or even bits of the bug. It is a test that is looking at host immune function and is considered to be quite specific for Lyme.

So, if you’re looking for better testing, probably the more reliable way to go is to get IGeneX western blot testing done and also the CD57 test. The latter test is quite time-sensitive and needs to be run in the lab within hours of the blood drawn. Only some labs do it in the US, like LabCorp and IGeneX, but in the UK this test may be unavailable as yet. There is also a wide variance that may occur with this test, but if CD57 is on the low side in one test, then it’s assumed a person likely has Lyme. If a person has a low CD57, they may not have strong enough immune function for a positive read on any antibody test. You can read about this test on Scott’s link above, but there is more info on this test here:

http://www.researchednutritionals.com/information.cfm?ID=200

Bottom line, Lemons, is that no test is 100% definitive for no Lyme. This is why Lyme must be a clinical diagnosis made by a Lyme Literate MD who can assess if a person has Lyme based upon their history (living in or visiting an endemic area in the present or past, history of tick bites, history of EM rashes which may be typical or atypical, etc), overall assessment of clinically presenting signs and patient -reported symptoms and supporting labs that may show aberrations typical of certain tickborne diseases.

Here is the rub…while everyone is debating Lyme and the controversies surrounding it, there are numerable other tickborne diseases that are just as virulent and sometimes more so! A person may have both undetected Lyme and some strain of babesiosis, too, for instance. Or, they may have a strain of borrelia, like the Japanese strain borrelia miyamotoi, for instance, that wouldn’t show up on standard two-tiered testing anyway. So, regardless of any test, Lyme, if suspected, must be a clinical diagnosis, made by a doctor who knows what they are doing. It can be confirmed by positive tests, but cannot be ruled out, if the tests are negative either.

A big mess? You betcha! No wonder you’re feeling confused, because even the medical community is confused or ignorant of what is going on. Most doctors don’t know anything about the inadequacies of Lyme testing, which makes all this much worse. Additionally, those who do are afraid to get mixed up in the controversy, because they’re being targeted if they do.

[lemons]

Thanks Maz for so much info. Will try and get to the bottom of this next week.

[Author]

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