Friday, March 13, 2009


There are many reasons for testing negative for Lyme disease when a patient is really infected. Some of the reasons for this are listed below and are from Dr. Robert Bransfield's website. One obvious reason for seronegativity is that there are over 300 strains of Borrelia burgdorferi (the spirochete that causes Lyme disease) and the testing only tests for 1 or 2 strains. It is also thought that the sickest patients with the heaviest spirochetal load are the ones who most often test negative. This is thought to be due the antigens being bound up together in immune complexes with the spirochete. The theory is that because the antigens which we are measuring for are bound in a complex with the bacteria...that there are none left over that are free be measured.

In my own experience, I first tested negative but was put on antibiotics anyway because the CDC says that Lyme is a clinical diagnosis. This means that the doctor should base treatment on symptoms and history, using the testing only as an adjunct to diagnosis. After 4 months on antibiotics, I was tested again and this time I tested positive. Some doctors and researchers feel that when some of the lyme bacteria is killed off, this then frees up some of the antigens and they are now floating free and can be measured. I have been on periodic long term antibiotics and finally have my life back.


1. Recent infection before immune response

2. Antibodies are in immune complexes

3. Spirochete encapsulated by host tissue (i.e.: lymphocytic cell walls)

4. Spirochete is deep in host tissue (i.e.: fibroblasts, neurons, etc.)

5. Blebs in body fluid, no whole organisms needed for PCR

6 No spirochetes in body fluid on day of test

7. Genetic heterogeneity (300 strains, 100 in U.S.)

8. Antigenic variability

9. Surface antigens change with temperature

10.Utilization of host protease instead of microbial protease

11. Spirochete in dormancy phase (L-form) with no cell walls

12 Recent antibiotic treatment

13 Recent anti-inflammatory treatment

14 Concomitant infection with babesia may cause immunosuppression

15 Other causes of immunosuppression

16 Lab with poor technical capability for Lyme disease

17 Lab tests not standardized for late stage disease

18 Lab tests labeled "for investigational use only"

19 CDC criteria is epidemiological not a diagnostic criteria

20 Lack of standardized control

21 Most controls use only a few strains as reference point

22 Few organisms are sometimes present

23 Encapsulated by glycoprotein "S-layer" which impairs immune recognition

24 "S"- layer binds to IgM

25 Immune deficiency

26 Possible down regulation of immune system by cytokines

27 Revised W.B. criteria fails to include most significant antigens


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