Lab Contact Information Below

Standard Lab Tests 
Are Missing
74.9% 




PATIENTS
To order a test kit from IGeneX Lab

PHYSICIANS
To order Physician Specimen Collection Kits

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What Test Should I Get?
We often don't know where to start when ordering tests after being exposed to ticks. Below is a basic list that can help provide you with an overall picture. Links to where and how to order tests are provided for each tick borne disease. Symptoms and treating information are also at the links provided for each disease.

TBD Related Testing

Bartonella- insurance usually covers Quest Diagnostic Lab.  
Quest Diagnostics: Bartonella Species Antibody (IGG, IGM) with Reflex to Titers- Code 34251x 
More Bartonella Info
Lyme- Borrelia burgdorferi
IGeneX, Inc.
795 San Antonio Rd
Palo Alto, CA 94303
Phone: 1-800-832-3200 Toll free
Fax: 1-650-424-1196 
PHYSICIANS- IGeneX
To order Physician Specimen Collection Kits
Lyme- Borrelia miymaotoi
IGeneX Lab 
Tests for Borrelia miyamotoi
Other Labs That Test For Borrelia miyamotoi
Quest- YES PCR- CPT Code- 87798
More lab test information HERE.

~ ~ ~

The following tick borne disease tests can be ordered as needed (codes and lab names included).  Information about the specific disease, including its symptoms, is at the link provided.
Babesiosis
It is recommended doctors run multiple tests to improve the chance of detecting a Babesia infection. Antibody tests from Quest Lab (includes two strains) and PCR tests from IGeneX Lab in CA for Babesiosis are useful if positive, but a negative result does not rule out the disease. 
Tip- Try to have blood drawn for testing early in the week so it is not delayed in transport and does not sit over the weekend.  
Some advanced experts use indirect laboratory testing such as VEGF, TNF-a, IL-6, IL-1B, ECP, and sudden drops in MSH (LabCorp) or natural killer cell numbers such as CD57, CD56, CD3 and CD4 in response to a malaria or Babesia medication. 
Some feel increased symptoms caused by patients being given low doses of pure Babesia medications is highly suspicious for Babesia.  If someone has an "out-of-range" RDW reading (red-cell distribution width) on a standard CBC blood test, Babesiosis should be suspected.   
More information on Babesiosis
Leptospirosis- suggested for someone exposed to animals
Epstein Barr Virus- often will alert hesitant physicians to a physical problem in the works when they are doubting any actual disease conditions as the source of the problems
Quest
Hepatitis- has unexpectedly been detected in Lyme patients
Quest
Mycoplasma- common infection detected in coinfected patients
Quest
Spotted fevers- increased number of spotted fevers are discovered on a regular basis
Quest
Parvo B19- aka "slapped cheek syndrome" or "fifth's disease"
Quest
Q-Fever- living in rural areas or having animals around can increase the risk of exposure to Q-fever
Quest
Anaplasmosis- symptoms similar to spotted fevers, usually without the rash
Quest
Ehrlichiosis- symptoms similar to spotted fevers, usually without the rash
Quest
Tularemia- aka Rabbit Fever
Quest
Brucelliosis- living in rural areas or having animals around can increase the risk
Quest
Trichinosis-  rural areas, farms, ranches and meat packing plants can increase likelihood of exposure
Quest
Salmonella-  rural areas, farms and ranches can put people at a higher risk for exposure
Histoplasmosis- hunters, barns, livestock and bird sanctuaries can increase risk of exposure
Quest

The Lyme Test Access Program (Lyme-TAP) is a nationwide patient assistance program offered by Ferndale Foundation in coordination with the Lyme Patients Assistance Group to provide assistance for initial Lyme-related lab tests to patients who demonstrate true financial need.

***

IGeneX Lab 
Tests for 
Borrelia miyamotoi
*
New Lab Tests For 
*
Other Labs That Test For 
Borrelia miyamotoi

Igenex Lab- YES

Imugen Lab- YES

Quest- YES 

PCR- CPT Code- 87798

Labcorp- NO
***

According to a 2005 study from Johns HopkinsLyme tests miss approximately 75% of the patients who have Lyme disease.  Other sources have determined the percentage of people missed could be as high as 90%. 

Remember, a negative test does not exclude 
The diagnosis of Lyme disease!

***
Attention Doctors!
Treat the Patient
NOT The Tests!
***

The CDC states.... It is possible for someone who was infected with Lyme disease to test negative because: Some people who receive antibiotics (e.g., doxycycline) early in disease (within the first few weeks after tick bite) may not develop antibodies or may only develop them at levels too low to be detected by the test.  Source

  ***

Western Blot Bands Explained

List of Western Blot bands and explanations from various sources

9  cross-reactive for Borrellia

12  specific for Bb (Lyme)

18  flagellin fragment (Lyme)

20 may be cross-reactive for Borrellia

21  unknown

22  specific for Bb, probably really the 23/25 band

23-25 outer surface protein C (OspC), specific for Bb.  Can be an early band. 

28 OspD.  Specific for Bb (Lyme).

[23-28] Potential for Central Nervous System (CNS) involvement. 

30 OspA- substrate binding protein- common in European and 
one California strain.  Check for mycoplasma.

31 OspA, specific for Bb (Lyme). 

34 outer surface protein B (OspB); specific for Bb (Lyme).

35 specific for Bb

37 FlaA gene product- specific for Bb (Lyme).

38 cross-reactive for Bb

39 BmpA- a major protein of Bb flagellin; specific for Bb-  Sometimes found in those with joint involvement.  
It is the most specific antibody for borreliosis of all bands.

41 flagellin protein of all spirochetes.  This is usually the first to appear after a Bb infection and is specific for all Borrellia.  Can be positive due to relapsing fever, oral spirochetes and syphilis.  
Flagella or tail protein.  Flagella is used to move Borrelia burgdorferi from point to point.  Many bacteria have flagella.  This is the most common borreliosis antibody.  

45 cross-reactive for all Borellia (sometimes people with Lyme who have 
this band positive also have the co-infection Ehrlichiosis).  
Heat shock protein. This helps the bacteria survive fever. The only bacteria that does not have heat shock proteins is Treponema pallidum, the cause of syphilis.

50 cross-reactive for all Borrellia

55 cross-reactive for all Borrellia

57 cross-reactive for all Borrellia

58 unknown but may be a heat-shock Bb protein- Check for viral infections

60 cross reactive for all Borrellia

66 Oms66- cross-reactive for all Borrelia, common in all bacteria- Check for E-coli
 
83 high molecular mass protein.  Specific antigen for the Lyme bacterium.  
This is the DNA or genetic material of Borrelia burgdorferi. It is the same as 93, based on medical literature. Laboratories vary in assigning significance to the 83 versus the 93 band.

93 
an immunodominant protoplasmic cylinder antigen, associated with the flagellum. Possibly the same protein as in band 83, just migrates differently in some patients.

NOTES:

When reporting bands, the reporting laboratory marks bands with the following indicators of intensity:

-Not present
+Low
++Medium
+++High
+/-Equivocal = indeterminate (present, but not as intense as the "Low" reading)

Other bacteria besides Borrelia burgdorferi may produce the 45, 58, 66, and 73 kDa bands.

Some patients might have an IgM response at the time of the EM rash.  The IgG response tends to start several weeks after infection and peak months to years later.  In some patients, the IgM response can remain elevated- in others it might decline, regardless of whether or not treatment is successful.

Many Lyme disease experts believe it is a mistake to exclude 31 and 34 kDa antibody proteins from the list of significant bands. 

Lyme disease patients may not test positive for exposure to B. burgdorferi because their antibodies to the organism are bound up in immune complexes.

An indeterminate number of patients with late or chronic Lyme disease are simply seronegative for unknown reasons.

Article- Testing for Borreliosis- by Dr. Charles Crist



Some of The Reasons Why Someone Could 

Have A False-Negative Lyme Test

Dr. Robert Bransfield


1. Recent infection- before immune response has had time to produce antibodies

2. Antibodies are bound 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 for any condition

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 and is not a diagnostic criteria

20. Lack of standardized control

21. Most controls use only a few strains as a reference point

22. Few organisms are 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 Western Blot criteria fails to include most significant bands

Source

 

***

A false-negative Lyme disease test is a disadvantage in several ways. 
1.  Your health care professional may not realize you have Lyme disease and not treat you as a result.  
2.  False negative tests may cause a delay in obtaining a proper diagnosis.  Not receiving proper treatment in the early stages allows a complex infectious organism(s) to spread throughout your body, making your condition worse and allowing the disease to advance to later stages.  
3.  You may be improperly diagnosed with fibromyalgia, CFS, MS, Parkinson's, ALS, ADD, depression and other disorders when in fact Lyme disease is the underlying culprit.  Treatment for those conditions will not reach the source of the problem.  
4.  A negative test provides the insurer another reason to deny your medications and any further testing or treatment for Lyme and tick borne diseases.
***    
Johns Hopkins 2005 Lyme Test Study 
Approximately 75% of people with Lyme are missed with standard testing methods
Study Here

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Lyme Disease Diagnosis
***
IGeneX Lab
Over the years many informed health care professionals have stopped using the standard "insurance approved" Lyme tests and will send blood samples to labs that specialize in tick borne disease testing.   If you would like to use a specialty lab to aid in the diagnostic process, you (or your doctor) can have a test kit sent to you upon request.  For more information please contact:    

IGeneX, Inc.
795 San Antonio Rd
Palo Alto, CA 94303
Phone: 1-800-832-3200 Toll free
Fax: 1-650-424-1196 


Difficulty Affording Lyme Testing?
The Lyme Test Access Program (Lyme-TAP) is a nationwide patient assistance program offered by Ferndale Foundation in coordination with the Lyme Patients Assistance Group to provide assistance for initial Lyme-related lab tests to patients who demonstrate true financial need.


Lab Contact Information

(Human Testing)


IGeneX, Inc.
Tick Borne Disease Testing

795 San Antonio Rd

Palo Alto, CA 94303

Phone: 1-800-832-3200 Toll free
Fax: 1-650-424-1196 

BioHealth Diagnostics

Adrenal Testing

Phone 619-223-7074

Genova Diagnostics

Detox Profile, Hair Testing  

Phone 800-522-4762

Meridian Valley 

Allergy, Hormone Testing         

Phone 425-271-8689

Metametrix

Ion, Urine Testing                       

Phone 800-221-4640

Fry Laboratories, L.L.C.  

Tick Borne Diseases

Phone 866-927-8075

Advanced Laboratory Services

Lyme Culture Tests

855-238-4949

Genelex Lab

Liver Enzymes, MTHFR, etc.

3101 Western Ave., Ste. 100, Seattle, WA 98121

800-TEST-DNA (800-837-8362) or 800-523-3080

Medical Diagnostic Lab, LLC

Tick Borne Diseases

2439 Kuser Road 

Hamilton, NJ 0869 

877-269-0090

Galaxy Diagnostics

Bartonella & Other TBD's

7020 Kit Creek Road

Suite 130

Morrisville, NC  27560

919-313-9672


Laboratories Testing Ticks 

FREE Tick Testing


Additional Options

IGeneX, Inc.
795 San Antonio Rd
Palo Alto, CA 94303
(800) 832-3200

Up to 20 ticks per batch
Multiple Tests- Each Test You Order Is $68.00

Lyme Disease (B. burgdorferi) 
Babesiosis (B microti and/or B duncani) 
Ehrlichiosis (Ehrlichia)
Bartonella henselae
Rickettsia
Relapsing Fever 

More Information & Form
http://www.igenex.com


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Connecticut Veterinary Medical Diagnostic Laboratory

61 North Eagleville Road

Unit 3203 Storrs, CT 06269-3203 

Phone: 860-486-3738 

Fax: 860-486-2737


Deer Tick: 1-Panel PCR- Borrelia burgdorferi - $50.00

4-Panel PCR (Human Host) - Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti, Borrelia miyamotoi - $120.00

3-Panel PCR (Non-Human Host) - Borrelia burgdorferi, Anaplasma phagocytophilum, Borrelia miyamotoi - $100.00

Dog Tick: 3-Panel PCR (Any Host) - Francisella tularensis, Rickettsia rickettsii, Ehrlichia species - $100.00

Lonestar Tick: 3-Panel PCR (Any Host) - Francisella tularensis, Ehrlichia species, Borrelia lonestari - $100.00

Brown Dog Tick: (Non-Canine Host) - Rickettsia rickettsii - $50.00

2-Panel PCR (Canine Host) - Rickettsia rickettsii, Ehrlichia species - $80.00


More Information & Forms

http://cvmdl.uconn.edu/forms/ACCDOC007%20Tick%20Submission%20Form%20fillable%2012716.pdf


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Analytical Services, Inc.

Tick Testing 

130 Allen Brook Lane

Williston, VT 05495

(800) 723-4432

Lyme Disease (Borrelia burgdorferiONLY-  $65 per tick

More Information & Forms  http://www.analyticalservices.com/tick-testing.html 

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Connecticut Pathology Laboratories

1320 Main St., Ste 24

Willimantic, CT 06226

(860) 450-1823            

Individual Test (Borrelia, Anaplasma, or Babesia): $50.00 

2-Test Panel (Borrelia and Anaplasma, Anaplasma and Babesia, Borrelia and Babesia): $80.00 

3-Test Panel (Borrelia, Anaplasma, and Babesia): $100.00

Call number above for forms and instructions

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Imugen

315 Norwood Park South

Norwood, MA 02062

(800) 246-8436

DEER TICKS ONLY

$75.00 for B. burgdorferi (Lyme Disease spirochete)

$75.00 for B. microti (Babesia parasite)

$98.00 for both B. burgdorferi and B. microti

More Information & Forms

http://www.imugen.com/tick_testing.html

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Clongen Laboratories 

211 Perry Pkwy #6

Gaithersburg, MD 20877

(301) 916-0173

Multiple Organisms

Individual test (see list at website) – $75 two or more tests – $65 each except viruses.  ColtiVirus: $195, Heartland Virus: $195, Powassan Virus: $195.  All three viruses: $500

More Information & Forms

https://www.clongen.com/clinical-diagnostics-services/tick-testing-information/

***

Tick Chek- Tick Testing Services

1-866-713-Tick

East Stroudsburg, PA

Multiple Organisms- Check List Here



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