Quick Facts
- Sample: Blood (venous draw)
- Fasting: Not required
- Turnaround Time: 7–10 business days. May take longer based on weather, holiday, or lab delays.
Benefits
- Early detection saves treatment costs — catch infection early and reduce costs from $1,380 to $464 (Yale School of Public Health 2024)
- No physician visit required — order online 24/7 and access 2,000+ testing locations nationwide
- Two-tier accuracy — FDA-cleared testing achieves 99.5% specificity when positive results undergo confirmatory Western blot (CDC 2024)
- Confidential results — Result delivered directly to secure online account within days
Who Is This Test For?
- Outdoor enthusiasts in endemic regions who hike, camp, or garden regularly
- Recent tick bite victims — especially if tick attached over 24 hours
- Individuals with characteristic symptoms — unexplained fever, headache, fatigue, joint pain, or expanding rash
- Residents of high-incidence states — Northeast, mid-Atlantic, upper Midwest during May-August peak season
- Those experiencing neurological symptoms — facial paralysis, meningitis, or cardiac irregularities after outdoor exposure
- Follow-up monitoring cases — repeat testing 2-4 weeks after initial negative results when suspicion remains
How It Works – Just 3 Steps
- Order online — Purchase your test and schedule a blood draw at a convenient lab location near you
- Get tested — Visit any lab location for a quick blood draw
- Review results — Access secure, HIPAA-compliant results within 7-10 business days
FAQ
Can I get tested immediately after a tick bite? Wait 2-4 weeks after tick bite or rash appearance for optimal accuracy, as antibodies take time to develop (Harvard Lyme Disease Research Center).
Will a positive test mean I currently have Lyme disease? Not necessarily—IgG antibodies persist 10-20 years after treatment and don't indicate active infection (National Institutes of Health). Results require clinical correlation with symptoms and exposure history.
What happens if my first test is positive? Your sample automatically undergoes confirmatory Western blot testing at additional cost ($60-80) to verify results and minimize false positives.
How accurate is this test for early Lyme disease? Sensitivity ranges 29-74% in the first 4 weeks but improves to 95-100% for late-stage disease (Cleveland Clinic Journal of Medicine 2019).
Should I stop antibiotics before testing? No—continue all medications as prescribed. Early antibiotic treatment may reduce antibody development but doesn't invalidate testing (Mayo Clinic Laboratories).
More Details
What is the purpose of this test?
This test detects IgM and IgG antibodies your immune system produces against Borrelia burgdorferi, the bacterium causing Lyme disease. IgM antibodies appear 2-4 weeks after tick bite and indicate recent infection, while IgG antibodies develop at 4-6 weeks and persist long-term. The CDC-recommended two-tier approach uses enzyme immunoassay (EIA) screening followed by Western blot confirmation, maximizing accuracy while minimizing false positives that could lead to unnecessary antibiotic treatment (CDC Clinical Testing Guidelines 2024).
Who would benefit from this test?
You should consider testing if you've spent time in wooded or grassy areas in high-incidence states (Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, Wisconsin) and experience erythema migrans rash, unexplained fever, severe headache, stiff neck, muscle aches, or joint pain within 3-30 days of exposure. Testing benefits individuals who removed an attached tick, develop facial nerve palsy or heart irregularities, or have persistent symptoms despite initial negative results. With 476,000 Americans diagnosed annually—8-10 times more than officially reported—proactive screening enables early treatment when outcomes are best (CDC Surveillance Data 2024).
When should I order this test?
Schedule testing 2-4 weeks after tick bite or when erythema migrans rash appears. Testing performed within the first 7-14 days yields significantly reduced sensitivity and may produce false negatives requiring repeat testing. If your initial test is negative but symptoms persist or clinical suspicion remains high, order repeat testing 2-4 weeks later to allow antibody levels to rise above detection thresholds. Peak testing accuracy occurs 4-6 weeks post-infection when antibody responses are fully established.
How do I interpret the results?
Results report initial screening as an index value with automatic reflex to Western blot confirmation when positive or equivocal:
- Negative (<0.90): No antibodies detected → Repeat in 2–4 weeks if symptoms persist
- Equivocal (0.90–1.09): Uncertain result → Automatic Western blot confirmation
- Positive (≥1.10): Antibodies detected → Automatic Western blot confirmation
Disclaimer: Reference ranges may vary by laboratory. Listed ranges are general guidelines and may differ from those used by the performing lab. Always consult your healthcare provider for interpretation.
The CDC does not recommend using the Western Blot test as an initial screening for Lyme disease. It should only be performed to confirm positive or equivocal results from the first-tier screening test, since other medical conditions may cause false-positive results.
Western Blot Confirmation Criteria:
- IgM Positive: 2+ bands (23, 39, 41 kDa) — only interpret within first 30 days of symptoms
- IgG Positive: 5+ bands (18, 23, 28, 30, 39, 41, 45, 58, 66, 93 kDa) — indicates established infection
- Critical: Negative results during the first 2-4 weeks don't rule out Lyme disease. Always correlate laboratory findings with symptoms, exposure history, and timing (Mayo Clinic Laboratories).
Pre-test preparation
No fasting or dietary restrictions are required. Maintain normal eating and drinking habits but stay well-hydrated before your appointment to facilitate blood draw. Continue all current medications—you don't need to discontinue antibiotics before testing. Wear clothing with sleeves that roll up easily. Bring insurance information if applicable or prepare for out-of-pocket payment ($89-$109). If you have a history of fainting during blood draws, inform the phlebotomist beforehand. Note the date of tick exposure or rash appearance to help determine optimal testing timing.
How often should I get tested?
After known tick bite with no symptoms: Single test at 2–4 weeks post-exposure
- Initial negative result with persistent symptoms: Repeat in 2–4 weeks to allow antibody development
- After successful antibiotic treatment: No routine retesting — antibodies persist long-term
- New tick exposure after previous infection: Test only if new exposure occurs 6–12+ months later
- Regular outdoor activity in endemic areas: Test when symptoms develop, not as routine screening
Once treated, don't use serology for treatment monitoring—antibody levels remain elevated long after infection clears. Monitor clinical symptom resolution instead (Infectious Diseases Society of America Guidelines 2021).
Why early detection matters
Lyme disease imposes nearly $1 billion in annual U.S. healthcare costs, with average per-patient expenses reaching $2,000. Early-stage patients who receive prompt antibiotic treatment (10-21 days of doxycycline, amoxicillin, or cefuroxime) experience significantly better outcomes and 68% lower costs compared to late-stage disease requiring intravenous therapy. Despite appropriate treatment, 10-25% of patients develop Post-Treatment Lyme Disease Syndrome (PTLDS) with persistent fatigue, joint pain, and cognitive difficulties. Recent research shows that 14% of early-diagnosed patients still develop PTLDS, with bacterial remnants driving ongoing inflammation weeks after treatment. Early detection during the 3-30 day window following tick bite enables intervention before dissemination to joints, heart, or nervous system occurs (Northwestern University 2025; Yale School of Public Health).
Related tests you may consider
Lyme Disease DNA Blood Test, Qualitative, Real-Time PCR — Detects the genetic material (DNA) of Borrelia burgdorferi, the bacteria that causes Lyme disease. This test helps confirm active infection, even before antibodies develop.
Borrelia Miyamotoi Antibodies Blood Test, IgG and IgM — Screens for antibodies against Borrelia miyamotoi, a tick-borne bacterium related to Lyme disease. It helps identify current or past infection in individuals with Lyme-like symptoms.
HNK1 (CD57) Profile Blood Test — Measures CD57 natural killer (NK) cells, which may be low in people with chronic infections such as Lyme disease. It helps evaluate immune function and monitor recovery in long-term illness.
