Table of ContentsView AllTable of ContentsTypes of TestsPurpose of TestsRisks and ContraindicationsBefore the TestDuring the TestAfter the TestInterpreting ResultsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Types of Tests
Purpose of Tests
Risks and Contraindications
Before the Test
During the Test
After the Test
Interpreting Results
Frequently Asked Questions
Alongside evaluation of symptoms, several tests may be needed. Blood tests include enzyme-linked immunoassay (ELISA) and the Western blot blood test. Assessment ofcerebrospinal fluid (CSF)usingspinal tapand other specimens may be done if symptoms warrant.
Verywell / Jessica Olah
When Lyme disease is suspected, the first steps are an assessment of symptoms and the likelihood of tick bite. If a person displays characteristic symptoms (especially the bullseye rash), lives in an area where there are bacteria-spreading black-legged ticks and there’s a risk of exposure, testing will be called for.
Tests for Lyme disease involve assessment of either blood samples or CSF, which is the fluid that surrounds the brain and spine. These include:
Thepolymerase chain reaction (PCR) testcan be used on CSF if antibodies against the organism causing Lyme disease were detected. This test looks for bacterial DNA. It is done only to determine if a symptom is related to Lyme disease. It may be used on CSF if meningitis/encephalitis is suspected, on other specimens, or on synovial fluid, but generally not on blood or urine.
What Is a Lyme Disease Test?
Given the range of tests that can potentially be used to detect Lyme disease, it’s important to understand their differences, and what each can and can’t do. While all can be helpful for diagnosis of this condition, each has its own specific advantages and disadvantages.
Whatsymptomsprompt a healthcare provider to call for diagnostic testing in the first place? The early symptoms—beginning three to 30 days after tick exposure—include:
In addition, severalother factorsare taken into account, and can prompt tests even in absence of symptoms:
Generally speaking, tests of antibody levels, most often ELISA and Western blot, are considered the “gold standard” of diagnosis. Other tests, including PCR, look for DNA evidence of the bacteria, so they may also prove useful.
Notably, the accuracy of these tests varies based on disease progression; what works during an earlier stage may not be as effective down the line, and vice versa. Here’s a quick breakdown:
Despite their broad application, there are a couple of things to keep in mind when it comes to antibody tests like ELISA:
For blood tests, the primary complications are bruising and discomfort at the site of needle entry.More invasive and impactful are CSF tests, which require lumbar puncture. Though the overall risk of the procedure is minimal, there are some occasional complications, including:
It’s unsafe to have a lumbar puncture if there is inflammation at the intended site of injection, an increased risk of uncontrolled bleeding, or if pressure within the skull (intracranial pressure) is too high.
Preparing for both blood tests and lumbar puncture means understanding timing, what to wear, and what else you might need to have along. Here’s a quick rundown of what you need to know:
Pre-Test
Blood tests are very easily tolerated and require little in the way of preparation; however, much more is involved when getting ready for a CSF test. What happens before the lumbar puncture procedure? Several important steps:
Throughout the Test
Collecting a specimen for a blood test takes about five minutes.Basically, a healthcare professional will find an appropriate vein, usually in the upper arm. While making a fist, you’ll feel a pinch as a needle is inserted and blood is drawn into a test tube.
CSF tests are a little more involved. Preparation and recovery in the hospital or clinic are more extensive. Here’s what typically happens:
Post-Test
Those who have blood samples taken are able to go home as soon as they’re ready afterward. For CSF tests, however, a little more recovery is involved, as patients need between one and four hours of recovery time in the clinic or hospital.You can go only when the healthcare provider is sure it’s safe for you to leave.
Managing Side Effects
If you have CSF testing using lumbar puncture, you should expect to feel fatigued and seek rest for about 24 hours afterward. In addition, many experience a collection of symptoms called “post-lumbar puncture headache,” which lead to:
While this typically resolves within a couple of hours of the procedure, it may take up to five days. If the symptoms persist longer than that—or if there’s any sign of infection in the puncture site—make sure to call your healthcare provider.
It can take up to two weeks to get the results of Lyme disease tests. Much depends on where you’re having the work done. Each test measures specific attributes. Here’s a quick primer on the kinds of results you might encounter:
Typically, you’ll have an appointment or phone conversation with your healthcare provider to discuss your results. In these consultations, it’s essential that you’re open with your practitioner and that you learn as much as you can about your condition from them.
Recognizing Untreated Lyme Disease and Getting Treatment
As noted, not every test is conclusive, and positive results may not always mean you have Lyme disease. However, negative ELISA results are strong indicators that you don’t have Lyme disease, as the test is very sensitive.
In addition, these tests can lead to false positives or require additional testing for confirmation. Here’s what you need to keep in mind:
So what happens if a case is confirmed? Most often, courses of antibiotics will be prescribed to take on your case. In more advanced cases, of course, more intensive treatment is necessary.
How Lyme Disease Is Treated
Other Considerations
When discussing your results with your healthcare provider, don’t be shy; engage in the dialogue, and try to learn as much as you can about your condition. What should you ask? Some good questions include:
The more you know—and the better you engage with the process of diagnosis and testing—the better off you’ll be. Make sure to use your consultations with the healthcare provider wisely; these professionals are excellent resources of information, and they’re working for you.
A Word From Verywell
Lyme disease can take many forms; if treated quickly, it generally resolves quickly. However, untreated or advanced cases can become quite serious and may become chronic. Multiple rounds of accurate and effective testing, then, are essential in the fight against the condition.
If you’re feeling anxious about your results, remember that Lyme disease, though debilitating, can be effectively managed. The chances are great that you will see a full recovery.
If you’ve been diagnosed, what’s essential is that you carefully follow treatment guidelines. With some effort and good help, you can surely get the best of this disease.
Frequently Asked QuestionsThe blood test for Lyme disease only takes five minutes. The other Lyme disease test, known as lumbar puncture (spinal tap), can take up to two hours. This is because the healthcare provider must collect cerebrospinal fluid (CSF); collecting CSF only takes a few minutes, but you may be asked to lie down for some time afterward to prevent a headache.Yes, it is possible for Lyme disease tests to deliver false positive results. This can happen with tests like the ELISA, PCR test, and Western blot. Some people may need more than one test for this reason.Immunoglobin G (IgG) and immunoglobin M (IgM) are antibodies that are created to fight against harmful bacteria and viruses.When a Western blot test is used for Lyme disease, it checks to see if blood contains any IgG and IgM antibodies. If the test detects IgG antibodies, it can mean there is longer-term infection of Lyme disease, while IgM antibodies signal an early response to the body’s fight against the disease.
The blood test for Lyme disease only takes five minutes. The other Lyme disease test, known as lumbar puncture (spinal tap), can take up to two hours. This is because the healthcare provider must collect cerebrospinal fluid (CSF); collecting CSF only takes a few minutes, but you may be asked to lie down for some time afterward to prevent a headache.
Yes, it is possible for Lyme disease tests to deliver false positive results. This can happen with tests like the ELISA, PCR test, and Western blot. Some people may need more than one test for this reason.
Immunoglobin G (IgG) and immunoglobin M (IgM) are antibodies that are created to fight against harmful bacteria and viruses.When a Western blot test is used for Lyme disease, it checks to see if blood contains any IgG and IgM antibodies. If the test detects IgG antibodies, it can mean there is longer-term infection of Lyme disease, while IgM antibodies signal an early response to the body’s fight against the disease.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infections Diseases.Lyme Disease: Diagnosis and Testing.John T, Taege A.Appropriate laboratory testing in Lyme disease. Cleve Clin JMed. 2019;86(11):751-759. doi:10.3949/ccjm.86a.19029MedlinePlus.ELISA Blood Test.John TM, Taege AJ.Appropriate laboratory testing in Lyme disease.CCJM. 2019;86(11):751-759. doi:10.3949/ccjm.86a.19029University of Rochester Medical Center.Borrelia Antibody (Blood).MedlinePlus.Lyme Disease.National Heart, Lung, and Blood Institute.Blood Tests.Institute for Quality and Efficiency in Health Care.What Happens During a Lumbar Puncture (Spinal Tap)?.National Institutes of Health. MedlinePlus.Lyme Disease Tests.MedlinePlus.Lyme disease tests.Lipsett S, Pollock N, Branda J et al.The positive predictive value of Lyme Elisa for the diagnosis of Lyme disease in children.Pediatr Infec Dis J. 2015;34(11):1260-1262. doi:10.1097/inf.0000000000000858University of Iowa Department of Pathology.Laboratory Services Handbook: B. Burgdorferi (Lyme).MedlinePlus.Lyme Disease - What to Ask Your Doctor.Johns Hopkins Medicine.IgG Deficiencies.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infections Diseases.Lyme Disease: Diagnosis and Testing.John T, Taege A.Appropriate laboratory testing in Lyme disease. Cleve Clin JMed. 2019;86(11):751-759. doi:10.3949/ccjm.86a.19029MedlinePlus.ELISA Blood Test.John TM, Taege AJ.Appropriate laboratory testing in Lyme disease.CCJM. 2019;86(11):751-759. doi:10.3949/ccjm.86a.19029University of Rochester Medical Center.Borrelia Antibody (Blood).MedlinePlus.Lyme Disease.National Heart, Lung, and Blood Institute.Blood Tests.Institute for Quality and Efficiency in Health Care.What Happens During a Lumbar Puncture (Spinal Tap)?.National Institutes of Health. MedlinePlus.Lyme Disease Tests.MedlinePlus.Lyme disease tests.Lipsett S, Pollock N, Branda J et al.The positive predictive value of Lyme Elisa for the diagnosis of Lyme disease in children.Pediatr Infec Dis J. 2015;34(11):1260-1262. doi:10.1097/inf.0000000000000858University of Iowa Department of Pathology.Laboratory Services Handbook: B. Burgdorferi (Lyme).MedlinePlus.Lyme Disease - What to Ask Your Doctor.Johns Hopkins Medicine.IgG Deficiencies.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infections Diseases.Lyme Disease: Diagnosis and Testing.John T, Taege A.Appropriate laboratory testing in Lyme disease. Cleve Clin JMed. 2019;86(11):751-759. doi:10.3949/ccjm.86a.19029MedlinePlus.ELISA Blood Test.John TM, Taege AJ.Appropriate laboratory testing in Lyme disease.CCJM. 2019;86(11):751-759. doi:10.3949/ccjm.86a.19029University of Rochester Medical Center.Borrelia Antibody (Blood).MedlinePlus.Lyme Disease.National Heart, Lung, and Blood Institute.Blood Tests.Institute for Quality and Efficiency in Health Care.What Happens During a Lumbar Puncture (Spinal Tap)?.National Institutes of Health. MedlinePlus.Lyme Disease Tests.MedlinePlus.Lyme disease tests.Lipsett S, Pollock N, Branda J et al.The positive predictive value of Lyme Elisa for the diagnosis of Lyme disease in children.Pediatr Infec Dis J. 2015;34(11):1260-1262. doi:10.1097/inf.0000000000000858University of Iowa Department of Pathology.Laboratory Services Handbook: B. Burgdorferi (Lyme).MedlinePlus.Lyme Disease - What to Ask Your Doctor.Johns Hopkins Medicine.IgG Deficiencies.
Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infections Diseases.Lyme Disease: Diagnosis and Testing.
John T, Taege A.Appropriate laboratory testing in Lyme disease. Cleve Clin JMed. 2019;86(11):751-759. doi:10.3949/ccjm.86a.19029
MedlinePlus.ELISA Blood Test.
John TM, Taege AJ.Appropriate laboratory testing in Lyme disease.CCJM. 2019;86(11):751-759. doi:10.3949/ccjm.86a.19029
University of Rochester Medical Center.Borrelia Antibody (Blood).
MedlinePlus.Lyme Disease.
National Heart, Lung, and Blood Institute.Blood Tests.
Institute for Quality and Efficiency in Health Care.What Happens During a Lumbar Puncture (Spinal Tap)?.
National Institutes of Health. MedlinePlus.Lyme Disease Tests.
MedlinePlus.Lyme disease tests.
Lipsett S, Pollock N, Branda J et al.The positive predictive value of Lyme Elisa for the diagnosis of Lyme disease in children.Pediatr Infec Dis J. 2015;34(11):1260-1262. doi:10.1097/inf.0000000000000858
University of Iowa Department of Pathology.Laboratory Services Handbook: B. Burgdorferi (Lyme).
MedlinePlus.Lyme Disease - What to Ask Your Doctor.
Johns Hopkins Medicine.IgG Deficiencies.
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