My Favorite Lab for Lyme TestingApr 18, 2023
Testing for chronic Lyme disease is tricky. Standard tests ordered through big commercial labs like Labcorp and Quest are sadly lacking in sensitivity. In fact, the basic ELISA test, which is the first test ordered, was never designed to be a diagnostic test - it was supposed to be "surveillance criteria", in other words, used to classify and count cases - NOT to diagnose disease. And if a Western blot test is even run (which is typically isn't unless the ELISA is positive), it still doesn't test for all the significant bands, giving an even more limited view.
Thus Lyme-literate practitioners generally test through specialty Lyme labs. The one I use, which is still my favorite, is IGeneX labs.
In my opinion, IGeneX is always working to improve their lab methodologies. Where historically only the Borrelia burgdorferi used to be tested by Western blot, now they can test Borrelia burgdorferi, tick-borne relapsing fever, Babesia and Bartonella via Immunoblot, which is a slightly more advanced version of the Western blot.
IGeneX also have clear diagnostic criteria and clear reports.
There is no Lyme test that is 100% reliable, and to be clear, chronic Lyme is still a clinical diagnosis (based on a person's history and symptoms), backed up with lab work. But in my opinion, IGeneX is the best we have.
The hard part is the cost, and I realize that IGeneX is more expensive than some other Lyme labs, and not covered by insurance other than Medicare. However, since many people have been unwell for years, and spent multiple thousands of dollars on treatment, I do think it is important to gather the best information possible on what could be a life-changing diagnosis.
Another lab that has gained popularity recently is Vibrant Labs. But I won't lie, I don't love it. Granted, it is significantly less expensive than IGeneX, but I do have some concerns about the information it provides and the lack of clarity in its reports. IMO, there is a LOT of interpretation that is required by the practitioner to evaluate the results, and unless the practitioner knows their Lyme stuff really well Vibrant can have everyone looking like they have Lyme and co-infections.
I'm all for sensitive testing and minimizing false negatives, but I am also for having sensible criteria for what is deemed positive.
I wish that IGeneX testing was accessible to everyone that needed it. I understand that sometimes it is cost prohibitive, and in that case is Vibrant Wellness is what the patient can afford, then that's what we do.
But in terms of the quality of testing, I still view IGeneX as the best, and I still order their tests whenever possible (and no, I'm not affiliated with them in any way, just a Lyme doc that wants the best results for my patients!).
The moral of the story is this - don't trust standard labs such as Labcorp and Quest to do a great job with Lyme testing. They do thousands of tests really well, Lyme just isn't one of them. Vibrant is affordable, but kinda confusing in their results; IGeneX is top of the line but more expensive.
Each person has to make the decision that's right for them to progress along their own path to health.