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 and Other TBD 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!


Treat The Bite


The three most common tick borne infections:

Lyme, Babesia and Bartonella


Labs That Test For Borrelia miyamotoi

Igenex Lab- YES

Imugen Lab- YES

Quest- YES PCR- CPT Code- 87798


IGeneX Lab Choices

Lyme ImmunoBlotIgM and IgG

Lyme ImmunoBlotIgM and IgGTBRF ImmunoBlot IgM and IgG

Lyme ImmunoBlotIgM and IgGTBRF ImmunoBlot IgM and IgGLyme IGX Spot

Lyme ImmunoBlotIgM and IgGTBRF ImmunoBlot IgM and IgGLyme IGX Spot

More ImmunoBlot Test Information Here


Bartonella- speciality lab that tests blood, tissues, etc. for Bartonella and other tick borne diseases. Galaxy Lab: See test request form

Quest Diagnostics: Bartonella Species Antibody (IGG, IGM) with Reflex to Titers- Code 34251x. (Tests for Bartonella henselae and Bartonella quintana.)

IGeneX Lab: See test request forms and prices IGeneX Bartonella- order test kits first


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 Lab- Galaxy 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.


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 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!


Quest or IGeneX or Galaxy

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

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


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

Tularemia- Francisella tularensis, aka Rabbit Fever Quest

Mycoplasma- common infection detected in coinfected patients. Quest

Brucella- living in rural areas or having animals around can increase the risk. Quest

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

Histoplasma- hunters, people working in barns, working with livestock and at bird sanctuaries can increase risk of exposure. Quest

Leptospira- suggested for someone exposed to animals. Quest

Hepatitis- has (unexpectedly) been detected in Lyme patients. Quest

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. Quest

Parvo B19 Virus- aka "slapped cheek syndrome" or "fifth's disease". Quest

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

Additional Viruses & Opportunistic Infections

Human Herpes virus 6 Quest

Human Simplex virus I and II Quest

Cytomegalovirus Quest


(Add More Testing As Indicated)

Red blood cell count, hemoglobin, hematocrit Quest

White blood cell count Quest

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

B12 and folate Quest

C3a & C4a Quest

Sed rate (ESR)

CRP Quest

CD-57 Quest

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

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

Vitamin D- often low in TBD patients Quest

Liver Panel– baseline, then monthly during antibiotic therapy Quest

Kidney Panel- baseline, then monthly during antibiotic therapy Quest

Iron and ferritin Quest

Additional Testing

As Determined Necessary

Adrenal testing plus DHEA

Canary Club


Hormones – estradiol, progesterone, testosterone free and total

Canary Club


IgG food sensitivity testing

Genova Diagnostics, Great Plains Lab, US Biotek

Gluten Intolerance Panel

Testing Information

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.


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.

Last Updated- April 2019

Lucy Barnes