Lyme tests now vs. 6 years ago

I don't know that there have been any major advances in testing in the past six years, but PCR testing is becoming more popular and accessible. People also seem to be testing more for mold illness, food sensitivities, autoimmune markers, and mast cell issues.

How are your symptoms? Have you tried any sort of treatment? Were you tested for all the very common co-infections?

Antibody tests rely on your immune system to make antibodies to a pathogen, but because Lyme disables parts of our immune systems, there are a lot of false negatives. This is why Lyme is a clinical diagnosis, meaning based on signs and symptoms, not just on lab work. Many of us never have clear answers, especially given how many co-infections and other conditions tend to compound Lyme. Did your LLMD question whether you had Lyme because your symptoms are not typical of Lyme, or just because of the test results? That is not how LLMDs tend to operate, so I'd recommend consulting someone else. It's possible that doctor claimed to be Lyme-literate but in actuality was following IDSA guidelines instead of ILADS.

there is the Lyme MSIDS questionnaire from Horowitz - helps differentiate Lyme from other things - on the one hand - if you are on here I would guess you would likely score highly on that - but its free and quick so i think worth doing and it may be a useful sanity check and help you feel better about spending more on testing.

then there are some of the newer antigen/serology tests - but ones that use whole cell lysate of Lyme spirochetes and wild type strains - ( eg Tick plex test from Finland ) not laboratory strains and so people who are negative on traditional older serology tests often show up positive on this. ( i did )
years ago there were concerns about false positives in whole-cell lysate tests - but these may have been partly due to marketing campaigns by the various test companies.

i spent some time on the subject and even had a dialogue with the study authors who published the tickplex test validation and was satisfied that the false positive rate was v small indeed for this test

then there are some even newer tests that are a combination of phage technology and PCR - developed as a way of increasing sensitivity - since there are many more phages vs Lyme spirochetes. Pheonix phage test - this has been discussed on here recently.

this looks promising to me - but as with all private testing labs - they rarely have their testing validated by independent 3rd parties and so it's very hard to tell what their real-world performance is. so just go in with your eyes open.