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What Tests Should I Get?

What Tests Should I Get?

We often don't know where to start when ordering tests after being exposed to ticks. Below is a basic list of standard and tick bone disease tests that can help provide you with an overall picture.  There are some lower cost tests for those on a tight budget and/or those who must rely on insurers to cover the costs of the tests. 

Links to where/how to order tests are provided for each tick borne disease. Symptoms and treating information are also at the links provided for each disease. Additional information on labs and tests is located here.

TBD Related Testing

Lyme Tests Won't Detect Antibodies To The Infection 
For 3-6 weeks after you are exposed (tick bite),
So save your money and don't order them!

The three most common tick borne infections:
Lyme, Babesia and Bartonella

Lyme- Borrelia burgdorferi
Domestic & International Patient Testing
IGeneX, Inc.
795 San Antonio Rd
Palo Alto, CA 94303
Phone: 1-800-832-3200 Toll free
Fax: 1-650-424-1196 

To order a test kit 

To order Physician Specimen Collection Kits 
Lyme- Borrelia miymaotoi
IGeneX Lab 
Tests for Borrelia miyamotoi

Other Labs That Test For Borrelia miyamotoi
Bartonella- standard testing 
Quest Diagnostics: Bartonella Species Antibody (IGG, IGM) with Reflex to Titers- Code 34251x.  (Tests for Bartonella henselae and Bartonella quintana.) 

Bartonella- speciality lab that tests blood, tissues, etc. for Bartonella and other tick borne diseases.
Babesiosis- Antibody tests from Quest Lab and PCR tests from IGeneX Lab in CA for Babesiosis are useful if positive, but as with any tick borne disease test- a negative result does not rule out the disease. 

Galaxy LabGalaxy Lab tests for Lyme, Bartonella, Ehrlichia, Rickettsia (spotted fevers) and Babesia. Test information here.  

Tip-  If a patient has an "out-of-range" RDW reading (red-cell distribution width) on a standard CBC blood test, Babesiosis should be considered.   

More information on Babesiosis


Tip- It is recommended doctors run multiple tests to improve the chance of detecting a tick borne infection.

Tip- Have blood drawn for testing early in the week so it is not delayed in transport and does not sit over the weekend. 

Additional Testing for Tick Borne Diseases
And Opportunistic Infections

The tests below are often ordered to check for some additional tick borne coinfections: Rickettsia rickettsii (spotted fever), Ehrlichia chafeensis (HME), Anaplasma phagocytophila (HGA).

IMPORTANT-  If any of the three following tick borne diseases are suspected, don't wait for test results- START TREATING IMMEDIATELY WITH DOXYCYCLINE! 

Spotted fevers- IMPORTANT-  Never wait for test results if any spotted fever is suspected!  Treat IMMEDIATELY!  

Anaplasma- symptoms similar to spotted fevers, often without the rash.  IMPORTANT-  Never wait for test results if Anaplasmosis is suspected!  Treat IMMEDIATELY! 
More information on Anaplasmosis

Ehrlichia- symptoms similar to spotted fevers, usually without the rash. IMPORTANT-  Never wait for test results if Ehrlichiosisis suspected!  Treat IMMEDIATELY! 
More information on Ehrlichiosis


Q-Fever- living in rural areas or having animals around can increase the risk of exposure to Q-fever.
More information on Q-fever

Tularemia- Francisella tularensis, aka Rabbit Fever
More information on Tularemia

Mycoplasma- common infection detected in coinfected patients.
More information on Mycoplasma

Brucella- living in rural areas or having animals around can increase the risk.
More information on Brucelliosis

Trichinella- rural areas, farms, ranches and meat packing plants can increase likelihood of exposure.
More information on Trichinella

Histoplasma- hunters, working in barns, working with livestock and at bird sanctuaries can increase risk of exposure.
More information on Histoplasmosis

Leptospira- suggested for someone exposed to animals.
More information on Leptospirosis

Hepatitis- has (unexpectedly) been detected in Lyme patients.
More information on Hepatitis

Epstein Barr Virus- often will alert hesitant physicians to a physical problem in the works when they are doubting any actual disease conditions are the source of the problems.
More information on Epstein Barr Virus

Parvo B19 Virus- aka "slapped cheek syndrome" or "fifth's disease".
More information on Parvo B19

Salmonella- living or working in rural areas, on farms and ranches can put people at a higher risk for exposure.
More information on Salmonella

Additional Viruses & Opportunistic Infections

(Add More Testing As Indicated)



HLA-DR4 and HLA-DR2 (indicates genetic susceptibility)


C3a & C4a



Thyroid– TSH, free T3, free T4, reverse T3, anti-TPO and anti-thyroglobulin 

Autoimmune markers (systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), scleroderma, myositis, and mixed connective tissue disorder) 

Vitamin D- often low in TBD patients

Liver Panel– baseline, then monthly during antibiotic therapy

Kidney Panel- baseline, then monthly during antibiotic therapy


Additional Testing  
As Determined Necessary

Adrenal testing plus DHEA

Hormones – estradiol, progesterone, testosterone free and total 

IgG food sensitivity testing 

Gluten Intolerance Panel

Candida antibodies – IgG, IgM, IgA 

Methylation- Test for A1298C and C677T 

Testing Notes

Run as many different types of tests as possible to obtain the most diagnostic clues.  Consider treating, especially in those who may have chronic Lyme and tick borne infections, with some doxycycline prior to blood collection for urine antigen and Western blot tests.

Reasons Why A Lyme Western Blot May Be False Negative
See A List of 27 Reasons Why Here


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.

DIY Tick Testing Kits are much less expensive and can give you some idea of the infections that the tick that bit you was carrying. Do not discount negative results if you are ill.

DIY Human Tick Borne Disease Testing allows you to order your own tests online without a local doctor's signature.  The costs are often quite a bit less than using traditional labs. Do not discount negative results if you are ill.       

DIY Standard Testing allows you to order many regular blood tests online at lower costs than traditional labs.  Do not discount negative results if you are ill.

Lucy Barnes
Last Updated- August 2018
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