With spring coming up in the northern hemisphere I thought it would be good to have a post about the different testing options.

For clarification: this post is for everyone that reads this forum. I personally I am in no need of a test right now (and it’s still cold and snowing here).

I personally don’t know about the newest latest greatest ones, so please add what you know.

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1)I just read about Lyme urine antigen here on another post. I googled it, sounds pretty good. I see galaxy and I-genix offer variations of this . I didn’t know they could test for protein particles from lyme in urine. So far is this proven better than blood test?

2)I also googled lyme tests on my phone so naturally ads popped up. There are now home lyme test kits, CVS apparently stocks these for less than 50 bucks. I didn’t read into them so if they’re just your typical western blot or something else, I don’t know. There are several of these. I don’t know if you need to send all of them into their lab or if some actually tell you results at home.

Post Edited (astroman) : 3/12/2023 9:57:25 AM (GMT-8)

i spoke to some people in the tick born infections testing industry on the urine antigen test - the CEO of one of the testing companies

they didn't seem to think the Lyme antigen test was going to work out as very effective

there was a previous urine antigen test attempt a few years ago - it was on the market briefly i think - as i recall, the developers canned it a few years ago as it didnt seem to work with many of the strains of spirochetes

like PCR - getting enough of the stuff you are looking for in the sample is the difficulty - i think they were using some kind of microbead technology to try to do that with the urine. i think it might be useful in the context of doing 2 or 3 other tests for lyme at the same time - each using different approaches and then you can take a view of all the results in the round - rather than rely on 1 test
this about the best approach we have at the moment - because each test on its own is pretty poor - unless you get lucky

what we really need is a single simple test that is sensitive enough to detect it 99% of the time - if it is there - without a high false positive rate

the only test technology that i think has the potential to be a big step forward like this is the RED labs phage based test
here the idea is that each borrelia has 50 or more phage's( viruses that live off the borrelia population - yeah, i know, it sounds like science fiction - but it is a real thing - and the technology has been used to test for other disease before) - and so they have developed a test using PCR to look for those phage's, which, because there are 50x as many is 50x easier ( PCR for borrelia in blood is found to be only around 50% sensitive - i.e. misses infection 50% of the time - mainly because the borrelia spend their time mainly in tissues - with normally v v low levels in the blood)

so if anyone can duplicate what RED labs has done and thereby validate it - then we have a game changer

everything else so far i have read about is playing around the edges - no great advantage over what we have

however, with the RED labs test they are finding spirochetes in 50% of "healthy controls"......

this may not be a wild or erroneous as it might seem

serological surveys in some countries have found antibodies to lyme in 20% of older adults - eg in Germany (a European country that believes it has a low incidence) so if you really did develop a very sensitive test 50% of the population might not be as crazy a it sounds

clearly 50% of the population are not sick with Lyme - so if true - it may be we need a paradigm shift from:

exposed = infected = sick

to

something of a more nuanced understanding - where high % of the population is naturally exposed and infected - but only a subset are actually ill at any one time.

if the RED labs findings are borne out by other groups - then this may indeed be the reason serological testing has turned out to be so poor - as the pass/ fail criteria will have been messed up by the infected so called "healthy controls"