OpenHealth Q&A

Understanding Lyme Disease Test Results

A 28-year-old female, currently on Prozac and Lamictal (with normal lab results for Lamictal levels), reported negative results on a pregnancy test. She has a history of anxiety and mood disorders but with no additional complications. For nearly three weeks, she has dealt with ongoing nausea without any episodes of vomiting. Headaches have been a recurring issue, accompanied by periods of lightheadedness and dizziness. There have been three instances of intense nausea that did not lead to vomiting, all while experiencing continuous mild nausea in between these episodes. Her medical visits include one at urgent care and two trips to the emergency room (ER). During the initial ER visit, she was diagnosed with gastroenteritis and was prescribed oral Zofran, with lab results within normal limits (WNL). The subsequent visit at urgent care indicated that it likely was not a gastrointestinal infection, but the medical team could not determine the cause of her symptoms. Again, her lab tests came back WNL, with no indications of liver or pancreatic issues, and she received more Zofran. Following up with a physician assistant virtually, the provider suggested that her symptoms were improving, possibly indicating a GI bug. However, the next day, she encountered severe nausea again, which lasted several days, prompting another ER visit. Fortunately, there were no immediate concerns, and she was treated with a GI cocktail and prescribed Compazine. During her second ER visit, a Lyme disease screening was performed, yielding the following results: - Lyme Disease Serology for IgM: Positive - Lyme Disease Serology for IgG: No value present (due to the positive result for IgM) - B. burgdorferi IgG Immunoblot: Negative, showing no bands - B. burgdorferi Antibody IgM Immunoblot: Negative, no significant bands detected (notably, a positive result is indicated when 2 or more of the bands - 23, 39, 41 dKa - are present). While her white blood cell (WBC) count was normal, there was a slight increase noted in her neutrophils at 77.5%, and a slight decrease in lymphocytes at 15.1%, with absolute neutrophils reported at 7.6. The attending physician noted the possibility of an infection but did not elaborate further. With the IgM serology showing positive results but other immunoblot tests returning negative findings, there is some confusion as to whether this implies the overall Lyme disease screen is negative. She was informed she would receive a call if any of the results were abnormal, leading her to assume that the screen might be considered negative despite the initial positive IgM result, leaving her uncertain about its implications.

Answers (1)

7/13/2025, 6:40:42 PM

OpenHealth AI

Summary: The positive IgM serology for Lyme disease, alongside negative IgG and immunoblot tests, suggests that while you may have been exposed to the Lyme bacteria, it does not necessarily confirm a current infection. Given your ongoing symptoms, it’s essential to address both potential Lyme disease implications and your gastrointestinal concerns.

Explanation: Lyme disease testing is often complex. The presence of IgM antibodies indicates recent exposure, but they can remain positive for a considerable time after an initial infection and may not mean active disease, especially when other tests (IgG and immunoblot) do not support a diagnosis. The normal lab results for your white blood cells and mild neutrophil changes do not depict an acute severe infection, reinforcing that a clear-cut infection isn't likely.

Your ongoing symptoms, such as nausea, lightheadedness, and headaches, might be due to a gastrointestinal issue, medication side effects, or anxiety rather than Lyme disease itself. It’s important to observe how symptoms evolve while considering all possible symptoms.

Next Steps:

1. Monitor Symptoms: Keep a daily log of your nausea, headaches, and any other symptoms, including when they occur and their severity. This can provide valuable information for healthcare providers.

2. Hydration and Diet: Focus on staying hydrated. Eat small, bland meals that are easier on your stomach to help manage nausea.

3. Follow Up: Consider scheduling an appointment with your primary care provider or an infectious disease specialist to discuss the Lyme test results in detail and explore other potential causes for your symptoms. Make sure to bring your symptom diary.

4. Medication Review: Discuss with your healthcare provider how your current medications (Prozac and Lamictal) could be influencing your symptoms, including the role of Compazine for nausea management.

5. Anxiety Management: Consider strategies to manage anxiety, which may be complicating your symptom experience. Techniques like deep breathing, mindfulness, or talking with a mental health professional could be helpful.

6. Further Testing if Needed: If symptoms persist or worsen, inquire about additional tests that could rule out other gastrointestinal issues or underlying conditions.

Remember, it’s important to stay proactive in your health care, and maintaining open communication with your healthcare team will help you find the answers and relief you need.