Lyme Disease Antibodies
$119.00
LAB CORP 164226 CPT 86618
Description
This Lyme Disease Antibody Profile is designed as a first-line blood test when Lyme disease is suspected.
The laboratory first measures total antibodies against selected Borrelia burgdorferi proteins. If that initial result is reactive, the specimen automatically undergoes additional separate IgG and IgM antibody testing against other Borrelia proteins.
This is called modified two-tier testing and allows both stages of Lyme serology to be completed within one laboratory profile when reflex testing is required.
Labcorp Test 164226 – Lyme Antibodies, Modified 2-Tier Testing Profile, Serum/Plasma
Total Lyme Antibodies
The first immunoassay looks broadly for an antibody response to selected Borrelia burgdorferi proteins.
IgG & IgM Reflex
Reactive specimens are automatically tested with separate IgG and IgM immunoassays targeting additional Borrelia proteins.
Modified Two-Tier Testing
The initial screen and second-tier antibody evaluation are integrated into one testing sequence.
What Is Lyme Disease?
Lyme disease is a tick-borne infection caused primarily in the United States by Borrelia burgdorferi.
The infection is transmitted through the bite of infected Ixodes ticks. Not everyone remembers being bitten because immature ticks can be very small and the bite itself may go unnoticed.
Lyme disease can affect several systems, including:
- Skin
- Joints
- Nervous system
- Heart
- General energy and systemic function
How the Lyme Antibody Test Works
Lyme blood testing does not usually look directly for the bacterium. Instead, serologic testing evaluates the immune response your body develops against Borrelia burgdorferi.
Total Antibody Screen
The laboratory begins with a sensitive immunoassay measuring total antibodies against selected Borrelia proteins.
Reactive Result
If the first test is reactive, the same specimen proceeds automatically to second-tier testing.
IgG & IgM Testing
Separate IgG and IgM immunoassays evaluate antibodies against additional Borrelia antigens.
Is This an ELISA or Western Blot Test?
Older Lyme testing commonly used an EIA or ELISA as the first step followed by a Western blot or immunoblot as the second step.
Labcorp Test 164226 now uses a modified two-tier testing algorithm. The current methodology is chemiluminescent immunoassay rather than the older ELISA-plus-Western-Blot sequence.
The principle is similar: an initial antibody test is followed by a more specific second antibody assessment when the first result is reactive.
How Is This Different From the Lyme Disease Line Blot?
Second Opinion Physician offers two different Lyme antibody testing options because they serve different purposes.
| Test | When to Choose It | What It Does |
|---|---|---|
|
Lyme Antibodies, Modified Two-Tier Profile Labcorp 164226 |
Best starting option when you have symptoms or possible tick exposure but have not already completed appropriate Lyme antibody testing. | Begins with total antibody testing and automatically reflexes to separate IgG and IgM immunoassays when reactive. |
|
Lyme Disease Line Blot Labcorp 163600 |
Best when another laboratory has already produced a positive or equivocal first-tier Lyme screen and you specifically need second-tier Line Blot testing. | Measures IgG and IgM responses to specific Borrelia burgdorferi proteins as a standalone second-tier test. |
Already Have a Positive or Equivocal Lyme Screen?
If you already had an EIA, ELISA or IFA elsewhere and only need second-tier confirmation, you may not need to repeat the entire screening process.
View the Lyme Disease Line Blot Confirmation TestWhat Do Lyme IgM and IgG Antibodies Mean?
Earlier Antibody Response
IgM antibodies tend to appear earlier after infection. Their diagnostic value is greatest during the first several weeks of symptoms.
Established Antibody Response
IgG develops later and may remain detectable for many years, including after successfully treated infection.
IgM and IgG should not simply be interpreted as “active” versus “old” Lyme disease. The timing of symptoms is critical.
Why the 30-Day Rule Matters
IgM May Be Informative
During the first several weeks of illness, IgM can provide useful evidence of a recent immune response.
IgG Carries More Weight
After approximately 30 days of symptoms, isolated IgM positivity becomes less reliable and is more likely to produce false-positive interpretation.
When Should Lyme Disease Testing Be Considered?
Lyme antibody testing is most useful when symptoms and exposure history create a reasonable clinical suspicion of Lyme disease.
Testing may be considered with:
- Known or possible tick exposure
- Outdoor exposure in areas where Lyme disease occurs
- Unexplained febrile illness after tick exposure
- Facial nerve palsy
- Neurologic symptoms compatible with Lyme disease
- New large-joint swelling or Lyme-type arthritis
- Possible Lyme carditis
- Persistent symptoms following a compatible untreated illness
Early Lyme Disease Symptoms
Erythema Migrans Rash
The characteristic Lyme rash typically expands gradually from the site of the tick bite. It may develop a target-like appearance, but many erythema migrans rashes do not look like a classic bull's-eye.
Flu-Like Illness
- Fatigue
- Fever or chills
- Headache
- Muscle aches
- Joint discomfort
- Swollen lymph nodes
A Classic Erythema Migrans Rash May Not Require Blood Testing
Antibody tests can be negative during the earliest stage of Lyme disease because the immune system has not yet produced enough antibodies to be detected.
For this reason, a characteristic expanding erythema migrans rash in a person with appropriate exposure can be diagnosed clinically without waiting for serology to become positive.
Disseminated and Later Lyme Disease Symptoms
Neurologic
- Facial nerve palsy
- Meningitis symptoms
- Nerve pain
- Numbness or tingling
- Radicular pain
Cardiac
- Palpitations
- Lightheadedness
- Fainting
- Shortness of breath
- Heart conduction abnormalities
Joint
- Intermittent joint swelling
- Large-joint inflammation
- Lyme arthritis
- Knee involvement is common
Can Lyme Disease Cause Fatigue and Brain Fog?
Yes. Fatigue can occur during acute Lyme disease and may persist during recovery.
Neurologic involvement and systemic inflammation can also contribute to symptoms such as:
- Reduced stamina
- Poor concentration
- Sleep disturbance
- Headache
- Muscle or joint discomfort
- Slower recovery after exertion
These symptoms are nonspecific, however. Fatigue or brain fog alone does not establish Lyme disease.
Post-Treatment Lyme Disease Syndrome
Some people experience persistent symptoms after completing recommended treatment for Lyme disease. The preferred term is Post-Treatment Lyme Disease Syndrome (PTLDS).
Symptoms may include:
- Fatigue
- Muscle or joint discomfort
- Difficulty concentrating
- Memory complaints
- Reduced physical stamina
Persistent symptoms do not necessarily mean that viable Borrelia bacteria remain in the body.
A broader evaluation may be needed for inflammatory, neurologic, endocrine, nutritional, sleep, mitochondrial or other contributors to ongoing symptoms.
Can Lyme Antibody Testing Determine Whether Treatment Worked?
No.
Lyme IgG antibodies can remain detectable for years after infection. Antibody levels therefore should not be expected to become negative immediately after successful treatment.
Repeat antibody testing is generally not a useful method for determining whether Lyme bacteria have been eradicated.
What Can Cause a False-Positive Lyme Antibody Result?
No antibody test is perfectly specific. Cross-reactive antibodies or other immune conditions can occasionally produce reactive results.
This is one reason Lyme testing uses a multi-step strategy rather than relying on one nonspecific antibody result.
Possible sources of cross-reactivity can include selected:
- Other infections
- Autoimmune conditions
- Polyclonal antibody responses
- Prior Borrelia exposure
What Can Cause a False-Negative Lyme Test?
The most important reason is testing too early.
Antibodies take time to develop, so serology can initially be negative during early infection.
Other factors that may affect interpretation include:
- Timing of the blood draw
- Previous antibiotic treatment
- Individual immune response
- The clinical manifestation being evaluated
Labcorp Lyme Antibodies Modified Two-Tier Profile
- Labcorp test number: 164226
- Current test name: Lyme Antibodies, Modified 2-Tier Testing Profile, Serum/Plasma
- Method: Chemiluminescent immunoassay
- Specimen: Serum or plasma
- Initial test: Total antibodies to selected Borrelia proteins
- If reactive: Separate IgG and IgM immunoassays against additional Borrelia proteins
- Typical turnaround: approximately 1–2 days, with additional time possible when reflex testing is required
- Preparation: No special fasting is generally required
Which Lyme Test Should I Order?
Choose Labcorp 164226
Choose the modified two-tier Lyme antibody profile when you have not yet completed appropriate Lyme antibody testing.
It begins with the first-tier screen and automatically performs additional IgG and IgM testing when the initial result is reactive.
Choose the Line Blot
If you already have a positive or equivocal Lyme EIA, ELISA or IFA from another laboratory but need second-tier confirmation, the standalone Lyme Disease Line Blot may be more appropriate.
View Lyme Line Blot TestFrequently Asked Questions
Is this the standard first Lyme blood test?
Yes. This profile is designed as an initial serologic evaluation for patients with symptoms or exposure suggesting Lyme disease and includes reflex testing when the first result is reactive.
Is Labcorp 164226 an ELISA?
Labcorp currently identifies the methodology as chemiluminescent immunoassay. Older versions of Lyme testing were often described generically as ELISA or EIA testing.
Does this test reflex to a Western blot?
No. The current Labcorp 164226 modified two-tier profile reflexes a reactive total antibody result to separate IgG and IgM immunoassays targeting additional Borrelia proteins. It does not currently reflex to the standalone Line Blot.
When would I order the separate Lyme Line Blot?
The standalone Line Blot is primarily useful when a first-tier Lyme antibody test has already been performed elsewhere and was positive or equivocal but appropriate second-tier testing was not completed.
Can Lyme testing be negative early in infection?
Yes. Antibodies require time to develop, so Lyme serology can be negative during the earliest stage of infection.
Does positive IgM mean active Lyme disease?
Not necessarily. IgM has the greatest diagnostic value during the first 30 days of symptoms. Isolated IgM findings later in the course of illness carry a greater risk of false-positive interpretation.
Does positive IgG mean I still have active Lyme disease?
No. Lyme IgG antibodies may remain detectable for years following infection and treatment. A positive IgG result documents an immune response but does not by itself prove persistent active infection.
Can Lyme antibodies be used to monitor treatment?
Generally no. Antibodies may remain positive long after treatment, so repeat serology does not reliably determine whether treatment was successful.
What if I already have a positive Lyme ELISA from another lab?
If the initial test was positive or equivocal but second-tier testing was not performed, consider the standalone Lyme Disease Line Blot rather than repeating the entire screening profile.