About the Test
Purpose of the test
Lyme disease is caused by an infection with a group of bacteria known as Borrelia. The purpose of Lyme disease testing is to see whether your immune system has developed antibodies to Borrelia, which helps determine whether you have previously been infected with this bacteria.
It is important to remember that while this is informally called Lyme disease testing, tests alone cannot diagnose Lyme disease. It is possible to have antibodies to Borrelia without having active Lyme disease; this can occur if you were infected with Borrelia at some point in the past.
What does the test measure?
Lyme disease testing measures the levels of antibodies in the blood. In particular, it looks for forms of antibodies known as immunoglobulin M (IgM) and immunoglobulin G (IgG) that are specific to Borrelia bacteria. The immune system produces these antibodies as part of its response to infection.
IgM levels are usually highest a few weeks after infection. IgG levels can take longer to build up, peaking within a few months after infection. While elevated IgM can reflect a current infection, both IgM and IgG antibodies can be present for months or even years after infection, and, as a result, may be found in people who do not have a current or active Borrelia infection.
To improve accuracy, the Centers for Disease Control and Prevention (CDC) advises laboratories to conduct two stages of blood testing for these antibodies. If the first test is positive, a second test is conducted, usually with a different type of laboratory method.
Some products marketed as at-home Lyme disease test kits measure substances other than antibodies and use test samples other than blood. These alternative tests have not been shown to accurately or reliably determine if a person has Lyme disease or Borrelia infection. The CDC recommends against the use of any such unvalidated tests.
When should I get a Lyme disease test?
Lyme disease testing is only recommended under certain circumstances. In general, antibody tests are conducted when you have symptoms of Lyme disease and a confirmed or likely exposure to ticks that are known to carry Borrelia. In these cases, the timing of testing is important. Because antibodies may not form for a few weeks, testing soon after a tick bite or development of a skin rash may cause misleading results.
Antibody testing is not advised if you do not have symptoms of Lyme disease, including for people who live in areas that are confirmed to have the types of ticks that can transmit Borrelia. Testing is also not recommended if you have general symptoms, such as joint pain, but no likely exposure to Borrelia-carrying ticks.
If you have had a tick bite and/or symptoms of Lyme disease, you should talk with your doctor who can address whether Lyme disease antibody testing is appropriate in your situation.
Benefits and Downsides of At-Home Lyme Disease Tests
When considering at-home Lyme disease testing, it’s important to consider its distinct benefits and downsides.
Some of the primary benefits of at-home testing include:
- Testing on your schedule: With an at-home test, you can take the test at a time that’s convenient for you and without the need to make an appointment or go to a medical office.
- Simple process: Most test kits are designed to streamline the process of preparing your test sample so that it’s quick and efficient.
- Fingerstick blood draw: For people who are uncomfortable with having their blood taken from their vein with a needle, a fingerstick blood draw may be preferable.
- Direct pricing: Although you will have to pay out-of-pocket, the total cost of an at-home test is usually transparent before making a purchase.
Some of the potential downsides of at-home Lyme disease testing include:
- Use of unvalidated tests or test methods: Some at-home test products use unproven types of testing, such as urine testing. Others may use laboratory methods that do not follow the CDC’s two-step method criteria or have not been evaluated for accuracy. Following proven testing methods is important to reduce the risk of inaccurate results.
- Lack of physician consultation: Many at-home test brands provide results without review or consultation by a trained doctor, which makes it more difficult to understand the significance of your test results.
- Out-of-pocket cost: Health insurance very rarely covers at-home tests, so you will normally have to pay for the test yourself.
- Repeat testing is usually required: If your test result comes back positive, your doctor may want to prescribe repeat testing before evaluating your situation and determining whether you have Lyme disease.
Types of At-Home Tests
There are a range of products that are advertised as at-home Lyme disease tests. However, many options use unvalidated test methods. To avoid these unvalidated tests, you should look only for antibody blood tests that use reputable laboratories. Your doctor may be able to help you determine whether a test uses validated methods.
The following sections outline our picks for the best at-home Lyme disease tests available:
Best Overall
Everlywell Lyme Disease Test
Price: $109
Type: Self-collection
Sample: Blood (fingerstick)
Results timeline: Within several days
Everlywell’s straightforward Lyme Disease Test kit is our choice for best overall at-home Lyme disease test.
To take the test, prick your disinfected fingertip using a tiny needle, called a lancet, that is included in the kit. After applying a few drops of blood to the test strip, use a prepaid shipping label to mail your sample to the lab.
Everlywell follows the CDC’s two-tier model for Lyme disease blood testing. Once the lab receives your test materials, it runs an initial test for IgM and IgG antibodies for three types of Borrelia bacteria: Borrelia garinii, Borrelia afzelii, and Borrelia burgdorferi. If this initial test is positive, the lab conducts an immunoblot test to confirm the result.
If your test results are positive, Everlywell contacts you directly and offers a virtual consultation with a physician. The company also provides a personalized test report with detailed results that you can review with your doctor.
Everlywell’s laboratory is CLIA-certified, reflecting a commitment to best practices in testing procedures. Results are usually available within a few business days after your sample arrives at the lab, and the test report can be accessed online using a secure health portal.
Easiest to Use
LetsGetChecked Lyme Disease Test
Price: $119 (Get 25% off with your exclusive Testing.com discount code. Use code TESTING25 at checkout.)
Test Type: Self-collection
Test Sample: Blood (fingerstick)
Results Time Frame: Within 2 to 5 days
The Lyme Disease Test from LetsGetChecked provides an easy-to-use method for detecting both IgG and IgM antibodies to Borrelia bacteria in your blood.
The fingerstick blood testing kit includes all the materials you need to safely and properly prepare your sample. The test involves disinfecting your fingertip, pricking your finger with a small needle (lancet), applying a small amount of blood to the test paper, and then packaging your sample in a medical grade bag for prepaid shipping.
Please contact UPS to arrange a pickup before you collect your sample. You should collect your sample on the same day as the pickup is scheduled for. Visit the UPS pickup scheduling page or call 1-800-742-5877 to schedule a pickup to return your sample. You’ll be asked to provide some information including your tracking number, address, and pickup day and time. Please keep your tracking number to help you monitor your package.
After the sample arrives at the lab, test results are normally available within 2 to 5 business days. Results are accessible through a secure online portal or the LetsGetChecked smartphone app.
The test kit is produced according to ISO 13485 quality control standards, and LetsGetChecked uses labs that meet quality assurance levels for CLIA certification and CAP accreditation.
If you test positive for IgM or IgG antibodies, you will receive a call from the company’s nursing care team. LetsGetChecked does not perform confirmatory testing, but the nurse can review next steps with you.
Interpreting At-Home Test Results
Your results will usually be available in an electronic test report. In most cases, the test report will show whether your blood sample was positive or negative. A positive result means that antibodies to Borrelia bacteria were found in your blood. The test report may list which type of antibodies (IgM or IgG) were found. If two-stage testing was used, the report may list results for the separate test methods.
It is essential to remember that this test cannot diagnose Lyme disease. A positive test result shows that you’ve had a prior infection with Borrelia, but that is not the same as currently having Lyme disease. Diagnosis of Lyme disease requires consideration of your symptoms, which is why test results should always be reviewed with your doctor.
Are test results accurate?
When looking at your test results, it’s important to know that laboratory methods can have a significant impact on the outcome of Lyme disease antibody testing.
Analyzing blood samples for Borrelia antibodies is a technical process. In some cases, cross-reactivity can cause a positive result when you haven’t actually had a Borrelia infection. Cross-reactivity is when antibodies to other infectious organisms are detected by the test as if they were antibodies to Borrelia.
The CDC has created standards for testing in order to reduce the chances of this kind of false positive result. Studies have found that results are most reliable in labs that use these CDC standards.
The timing of blood antibody testing can also affect accuracy because IgM and IgG antibodies develop at different rates. Taking the test too early after Borrelia exposure can lead to a false negative result even if you have an active infection.
Beyond antibody blood testing, many test methods marketed for Lyme disease are not proven to be accurate. The CDC recommends against the use of unvalidated tests, including the following:
- Urine tests such as urine antigen or PCR tests
- Blood testing with PCR or any laboratory method other than an enzyme immunoassay, immunofluorescence assay, or the Western Blot, also called immunoblot, method
- Cell culture, immunofluorescence staining, or cell sorting of Borrelia bacteria
- Lymphocyte transformation tests
- CD57 lymphocyte assays
Do I need follow-up tests?
Follow-up testing is typically necessary after an at-home test. If an at-home test is positive, your doctor may want to do repeat testing to confirm the results.
In addition, because blood testing by itself cannot diagnose Lyme disease, a physical exam and review of your symptoms is required. Sometimes, depending on your symptoms, other tests, such as analysis of the fluid around the brain and spinal cord (cerebrospinal fluid testing), may be necessary.
Questions for your doctor after at-home testing
If you take an at-home test, you can review the results with your doctor and consider asking some of the following questions:
- Is my at-home test result reliable?
- Is repeat blood testing or any other kind of testing appropriate?
- Are my symptoms consistent with possible Lyme disease?
- If I don’t have Lyme disease, what could be causing my symptoms? What tests can help determine this more concretely?
