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
PLEASE REMEMBER
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!
Instead
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The three most common tick borne infections:
Lyme, Babesia and Bartonella
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Labs That Test For Borrelia miyamotoi
Igenex Lab- YES
Imugen Lab- YES
Quest- YES PCR- CPT Code- 87798
LYME
IGeneX Lab Choices
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
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
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.
HELPFUL HINTS
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!
SPOTTED FEVERS
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
ADDITIONAL TICK & VECTOR BORNE DISEASES
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
STANDARD TESTS
(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
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
Hormones – estradiol, progesterone, testosterone free and total
IgG food sensitivity testing
Genova Diagnostics, Great Plains Lab, US Biotek
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.
DIFFICULTY AFFORDING 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