Lyme Disease Test UK

How do you know if you have Lymes disease?

Lyme disease is caused by the spirochete bacterium Borrelia burgdorferi (Bb), which is transmitted to humans through a tick bite. As the infection spreads it can infiltrate multiple tissues and systems throughout the body creating debilitating and often mysterious symptoms.

Lyme disease symptoms

Once an infected tick bites a human, it begins to transmit microbes, among which Bb may be included. If the immune system responds immediately to the influx of Bb, acute Lyme symptoms occur. 

Symptoms of acute Lyme disease include:

• Flu-like symptoms such as headache, night sweats and chills
• Skin rash (like a bullseye) around the bite
• Chronic fatigue
• Migratory numbness and tingling, tinnitus
• Muscle and joint pain
• Sleep issues

If the immune system does not quickly detect the bacteria, or if treatments during the acute phase fail, Lyme disease may produce chronic symptoms. Chronic Lyme disease can cause more serious dysfunctions in diverse body systems. Due to the complexity of the disease, symptoms can also overlap with other conditions making its diagnosis very challenging: 

• ME, fibromyalgia and Chronic Fatigue Syndrome are the most recognised sub-conditions of Lyme disease. 
• Alzheimer’s disease, shown by a well-documented relationship between Lyme and neurodegenerative diseases [1].
• Cardiovascular symptoms [2] are often present in Lyme patients. 
• MS and other autoimmune conditions such as lupus, Rheumatoid arthritis and Hashimoto’s.
• Neuropsychiatric problems, like depression, anxiety, headaches, brain fog, mood swings, emotional lability, suicidal thoughts, and cognitive dysfunction [3]. Often exacerbated by not knowing what is causing the illness.
• Neuropathy, or nerve malfunction, which can be caused by nervous system inflammation in various parts of the body.

Lyme disease rash

Two of the most well-recognized events that point towards a Lyme disease diagnosis are a recent tick bite and erythema migrans lesion, also known as a “bull’s-eye” rash. As it’s unique to Lyme; people with it can receive a diagnosis without clinical testing. However, few people with Lyme disease recall a tick bite and in up to 50% of cases, the rash typical to Lyme, doesn’t appear, severely limiting the clinical utility of these diagnostic features [4].

3 stages of Lyme Disease

Lyme disease can occur in three stages:

Stage 1 - Early localised disease: Symptoms of Lyme disease usually start 1 to 2 weeks after the tick bite. One of the earliest signs of Lyme disease is a bull’s-eye rash. The rash occurs at the site of the tick bite, usually, but not always, as a central red spot surrounded by a clear spot with an area of redness at the edge. It may be warm to the touch, but it isn’t painful and doesn’t itch. However, as mentioned above many people don’t have this symptom. The rash can occur with or without systemic viral or flu-like symptoms.

Stage 2 - Early disseminated Lyme disease: It occurs several weeks to months after the tick bite. Characterised by a general feeling of being unwell and a rash that may appear on other areas of the body other than the location of the tick bite. During this stage there is evidence of systemic infections that may have spread to other organs. 

Stage 3 - Late disseminated Lyme disease: occurs months or even years after the tick bite. This stage is characterised by the chronic Lyme disease symptoms, mentioned above.

What is the most accurate test for Lyme disease?

At the London Clinic of Nutrition we use clinical diagnosis based on your medical history, symptoms and exposure to ticks. We also use results from the Richard Horowitz questionnaire to help us decide if further testing is necessary.  This questionnaire has been scientifically validated in its ability to differentiate Lyme disease from healthy individuals.

For an accurate diagnosis of Lyme, if indicated, we consider a combination of the three markers listed below. 

• Elispot detects the presence of the actual bacteria (rather than an immune response to it). It is a highly sensitive test and can detect even one single Borrelia burgdorferi-reactive T-cell. It’s thought to be between 20 and 200 times more sensitive than a conventional ELISA test. The test becomes negative when B. burgdorferi is no longer active, making it useful for monitoring treatment. It should become negative about 4 to 8 weeks after the completion of an effective therapy.

• Seraspot tests for the presence of antibodies. It is similar to the ELISA test but is more specific and sensitive in detecting Borrelia antibodies.

• CD57+ cell count: While acute Borrelia burgdorferi infections and other diseases show normal CD57+ parameters, chronic Lyme patients often have less than 100 CD57+ cells/μl. Testing for this marker can give us an indication if Lyme is present.

We run these specific markers through ArminLabs – founded by Dr. Armin Schwarzbach who has been at the forefront of tick-borne research for more than 20 years. We prefer to use the combination of 3 markers as the bacteria have the ability to ‘hide’. However, it is also possible to just run 2 markers (Elispot & CD57+) and still have an accurate result.

How do doctors test for Lyme disease?

Lyme disease often either goes undiagnosed for many years with the patient not knowing what is wrong with them or sometimes it gets misdiagnosed as fibromyalgia, chronic fatigue and MS. Diagnosis of MS is often given as the lesions on an MRI appear the same for both diseases. 

The current standard diagnostic tools may not detect Lyme due to the lack of clear and precise diagnostic guidelines:  

1. If the patient doesn’t recall being bitten by a tick or there is no presence of the bull’s eye rash, then doctors don’t consider testing for Lyme. However, approximately 50% of patients don’t recall the tick bite and don't experience the bull’s eye rash, making diagnosis of Lyme rather challenging.  

2. Standard methods use a two tier-ed blood testing strategy for Lyme. The first tier is an ELISA (enzyme-linked immunosorbent assay) blood test, which measures levels of antibodies against Borrelia burgdorferi. Once tested, ELISA then may or may not be followed by the Western blot which also tests for antibodies to B. burgdorferi but goes a step further by reporting reactivity to 10 different proteins found in the bacterium.  Both tests produce a high incidence of false negatives as they only measure antibodies to the infection. Antibodies may not be present for a number of reasons: 

• There may not have been enough time for Lyme symptoms to develop, therefore it is possible for these tests to be negative despite active infection.
• The immune system may be suppressed, a key characteristic of Lyme.
• Bb is able to shift into different forms (bleb, cystic and cell wall deficient) allowing it to ‘hide’ undetected.

Can Lyme disease be detected by a blood test?

As many people don’t recall a tick bite nor do they develop the typical bull’s eye rash, these Lyme disease testing guidelines can often lead to missed diagnosis or a misdiagnosis.

In the UK, and in the rest of Europe, the usual method of blood tests is through a 2 tier system. Both blood tests measure antibodies and very often produce false negatives for the reasons mentioned above.

Here at the London Clinic of Nutrition, we specialise in ‘untreatable’ conditions such as Lyme's disease and combine industry-leading nutrition and functional medicine expertise, alongside the latest in-house testing, so we can attend to all your health needs in one trip. 

As a functional medicine clinic, we always take an individualised approach. During our diagnostic and treatment phase, we would pay particular attention to gastrointestinal function, detoxification and immunity.

Find out more about our functional medicine approach to Lyme’s disease here.