Diagnostic Excellence

Diagnosis of Chronic Lyme Disease

Accurate diagnosis is the foundation of effective treatment. Our comprehensive diagnostic approach uses advanced laboratory testing and thorough clinical evaluation to uncover what standard tests miss.

When to Seek Testing

Symptoms That Warrant Advanced Lyme Diagnostics

Many patients who come to us have been symptomatic for months or years without a clear diagnosis. If you experience a combination of the following symptoms, especially if they began after a known or possible tick exposure, advanced Lyme testing should be considered:

Persistent fatigue unresponsive to standard treatment
Migratory joint or muscle pain without clear orthopedic cause
Cognitive impairment, brain fog, or memory difficulties
Neurological symptoms: tingling, numbness, nerve pain
Cardiac symptoms: palpitations, chest tightness
Psychiatric symptoms that appeared suddenly or worsened
Symptoms that wax and wane on a cyclical pattern
Multiple diagnoses without clear resolution (fibromyalgia, CFS, MS, etc.)

The Diagnostic Gap

Why Standard Testing Fails

The conventional two-tier testing approach has significant limitations that leave the majority of chronic Lyme patients without a proper diagnosis.

The Two-Tier Problem

The standard diagnostic protocol requires a positive ELISA screening test before a Western Blot confirmation is performed. This two-tier system was designed for epidemiological surveillance, not individual patient diagnosis. Its sensitivity for chronic or late-stage Lyme disease is estimated at only 50-60%, meaning nearly half of infected patients receive false-negative results.

Several factors contribute to this failure:

ELISA measures antibody levels that may decline in chronic infection
Western Blot requires a specific number of reactive bands, excluding patients with partial responses
Immune suppression from chronic Borrelia infection reduces antibody production
Some Borrelia strains produce antibodies not detected by standard test kits
Early antibiotic treatment can prevent full seroconversion

Clinical Consequences

The consequences of relying solely on standard testing are severe. Patients with active chronic infections are told they do not have Lyme disease. They are given alternative diagnoses, prescribed symptom-management medications, and often told their symptoms are psychological.

This diagnostic failure leads to:

Years of undiagnosed infection allowing further tissue damage
Inappropriate treatments for misdiagnosed conditions
Progressive neurological, cardiac, and joint involvement
Psychological distress from being dismissed by physicians
Accumulation of co-infections that go undetected

At St. George Hospital, we believe that no patient should be dismissed because of a test limitation. Clinical evaluation must always accompany laboratory results.

Our Diagnostic Protocol

How We Diagnose Chronic Lyme Disease

Our diagnostic approach combines comprehensive clinical evaluation with advanced laboratory testing to build a complete picture of each patient’s infection status, immune function, and systemic involvement.

1

Comprehensive Medical History

Detailed review of symptom onset, progression, tick exposure history, prior testing results, previous treatments, and response to antibiotics. We assess the full timeline and pattern of illness to identify characteristic Lyme disease features.

2

Physical and Neurological Examination

Thorough physical examination with specific attention to neurological function, joint involvement, cardiac assessment, and signs of autonomic dysfunction. We evaluate for clinical markers of active infection and systemic inflammation.

3

Advanced Borrelia Testing

We utilize multiple testing methodologies beyond standard ELISA and Western Blot, including Borrelia ELISpot (cellular immune response), specialized Western Blot with expanded band analysis, and when indicated, direct detection methods. These tests measure the cellular immune response to Borrelia, which remains active even when antibody levels decline.

4

CD57 Natural Killer Cell Analysis

CD57+ NK cell levels are characteristically low in chronic Lyme disease and serve as both a diagnostic marker and a treatment response indicator. Serial CD57 measurements help us track treatment progress over time.

5

Co-Infection Panel

Comprehensive testing for common tick-borne co-infections including Bartonella, Babesia, Ehrlichia, Anaplasma, Rickettsia, Chlamydia pneumoniae, Mycoplasma pneumoniae, and Yersinia. Co-infections are present in an estimated 50-80% of chronic Lyme patients and require specific, targeted treatment.

6

Immune Function Assessment

Evaluation of immune system markers including lymphocyte subsets, cytokine profiles, complement levels, and immunoglobulin levels to assess the degree of immune dysregulation and guide immunomodulatory treatment decisions.

7

Systemic Assessment

Additional testing as clinically indicated, including inflammatory markers (CRP, ESR, cytokines), thyroid function, adrenal function, hormonal panels, micronutrient levels, liver and kidney function, and heavy metal screening to evaluate the full systemic impact of chronic infection.

Our Philosophy

Clinical Judgment Guides Our Diagnosis

Lyme disease remains a clinical diagnosis supported by laboratory testing, not a laboratory diagnosis alone. No single test can definitively confirm or rule out chronic Borrelia infection. Our physicians integrate the full clinical picture, patient history, symptom pattern, physical examination findings, and results from multiple laboratory tests, to arrive at a diagnosis and treatment plan.

We take every patient’s symptoms seriously. If you have been told that your tests are negative but your symptoms persist, we encourage you to seek a comprehensive evaluation. Many of our most successful treatment outcomes begin with patients who were previously told they did not have Lyme disease.

Testing Methods Compared

Standard vs. Advanced Diagnostics

Standard Testing

Commonly used in conventional medical settings:

ELISA screening (antibody-based)
Standard Western Blot (limited bands)
Sensitivity: approximately 50-60% for chronic Lyme
Does not detect cellular immune response
No co-infection screening included
No immune function assessment

Our Advanced Protocol

Comprehensive approach used at St. George Hospital:

Borrelia ELISpot (T-cell immune response)
Expanded Western Blot analysis
CD57 NK cell quantification
Full co-infection panel (8+ pathogens)
Immune system profiling
Inflammatory and metabolic markers
Clinical correlation with experienced physicians

Evidence & Outcomes

The Case for Comprehensive Testing

Published research consistently demonstrates the inadequacy of standard Lyme testing for chronic disease. Key findings include:

Two-tier testing misses up to 50% of culture-confirmed late Lyme cases (Dressler et al., 1993)
T-cell based assays (ELISpot) detect cellular immune responses absent in serological tests (von Baehr et al., 2012)
CD57+ NK cells are significantly reduced in chronic Lyme patients (Stricker & Winger, 2001)
Co-infections alter the clinical presentation and reduce diagnostic accuracy for Borrelia (Swanson et al., 2006)
Clinical diagnosis combined with advanced testing improves detection rates for chronic Lyme disease

Our diagnostic approach reflects the current understanding of Borrelia biology and the well-documented limitations of standard serological testing.

What Patients Can Expect

A typical diagnostic evaluation at St. George Hospital includes:

90-minute initial physician consultation
Comprehensive blood panel (10+ tests)
Physical and neurological examination
Results reviewed within 5-10 working days
Personalized treatment plan based on findings
Full written report for your records

RELATED THERAPIES

Treatments Informed by Our Diagnostics

H.E.L.P. Apheresis

When diagnostics reveal elevated inflammatory markers and microclots, apheresis directly filters these from the bloodstream.

Whole-Body Hyperthermia

Diagnostic identification of persistent Borrelia and co-infections guides hyperthermia protocols targeting heat-sensitive organisms.

Ozone Therapy

Immune panel results inform ozone therapy protocols that enhance immune function and provide antimicrobial support.

Immune Therapy

NK cell activity and lymphocyte subset results guide targeted immune restoration therapy for Lyme patients.

Get Tested Properly

If standard tests have left you without answers, our advanced diagnostic evaluation can provide the clarity you need to begin effective treatment.