Why You Can Have Lyme Even if You Test Negative

A negative Lyme disease test does not necessarily mean that you don't have Lyme disease.

Here are some reasons that your test might come back negative even if you have Lyme disease. 

Why You Might Have Lyme Even if You Test Negative

First, understand that the ELISA and Western blot tests measure the levels and types of antibodies that your immune system makes against Lyme disease (see my hub on Lyme testing).

1) If you take the Lyme test too early in the course of the disease, you might not be making enough antibodies yet. The rate of positive results among people with Lyme disease rises from about 20-30% in the first 2-4 weeks to up to 80% by the fourth week. (NYT Health Guide). http://health.nytimes.com/health/guides/disease/lyme-disease/diagnosis.html

2) If you have taken or are currently taking antibiotics, your Lyme antibody levels might be too low to meet the criteria for a positive test result (NYT Health Guide). If you plan to start antibiotic therapy for something that might be Lyme disease, get a Lyme test first. http://health.nytimes.com/health/guides/disease/lyme-disease/diagnosis.html

3) Ironically, having a high bacterial load of Lyme bacteria might cause you to test negative. The more bacteria you have, the more of your antibodies will be stuck to bacteria, leaving fewer antibodies floating around to show up in a test.

4) If you are immunosuppressed, whether from immune-suppressing drugs or a disease, you might not be making enough antibodies for a positive result.

5) The cut-off level for the lab you are using might be high. You might have Lyme antibodies, but not enough to meet the criteria set by the lab that performs your test.

6) You might be producing Lyme antibodies, but not the "right" bands (or types of antibodies) for a positive result. Ask to see all the band results of your Western blot (see my upcoming hub about Lyme bands and CDC criteria).

And Vice Versa

On the other hand, you might not have Lyme disease even if you test negative.

You might test positive due to a previous, resolved case of Lyme disease or from similar infections such as relapsing fever or syphilis. 


If you have tested negative even though you think you have Lyme disease:

1) Consider getting tested again in a few weeks.

2) Think about finding a Lyme-literate doctor.

3) Try other, more sensitive tests, such as the IGeneX or PCR tests (see my hub on Lyme testing).

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Comments 6 comments

Lisa Hilton 4 years ago

I will link to this article on my squidoo articles about this same subject, hope it helps! Thanks for spreading awareness!

emil 3 years ago

5 positive bands( 3 specific) no antibodies. First symptoms of Lyme diseas over 10 years ago. No rash. Fever, severe jt pain ankles/feet. Headach. Couldn't lift head off of pillow without using both arms. I think fever also.

Now has peripheral neuropathy legs. No diabetes. Neurologist has no dx for this symptom. Has fatigue, memory loss. Off balance at times also. What should be next step? Urine test?

Thank you

Jean 2 years ago

Emil, find a Lyme literate dr.

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RockyMountainMom 2 years ago from Montana

Thank you for this article! It helps off set some new hubs with errors, one of which states that Lyme is OVER diagnosed, unfortunately!

RockyMountainMom profile image

RockyMountainMom 2 years ago from Montana

Sharing this in multiple Lyme communities today!

Patti 9 months ago

I want to tell you I have had Lyme isease 25 years I am from New Jersye,oved to NC they think its a joke. had stroke mri showed disseminated encephalomyelitis related to Lyme disease.. have seizures lie o Xanx have lesions biopsied with sprichetes found in them.email dovegirlone @gmail.com

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