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Do I Have to Have a Blood Test for Lyme Disease?

blood tests for lyme diseaseGetting tested for any disease can be incredibly overwhelming. Lyme disease is a bacterial infection that you get from a tick bite and this infection can be very serious if not treated successfully. Knowing if you should get a blood test for Lyme disease depends on whether you have been bitten by a tick as well as your symptoms.

If you have been bitten by a tick and removed that tick within twenty-four hours of being bitten then you are unlikely to have been infected. If you feel fine and no symptoms arise then over the next few days or weeks then there is probably little cause for alarm. However, if the tick was attached for some time and you begin to develop any strange flu-like symptoms, you may need to consider getting a blood test.

One of the first symptoms that occur in 60 to 80 percent of Lyme disease cases is a rash that resembles a bull’s eye. This rash is also known as an erythema migrans. The rash usually surrounds the tick bite and expands outwards, although the Lyme disease rash may reappear at locations far from the original bite site at a later date. Other symptoms include chills, unexplained fever, stiff neck, headaches, fatigue, joint pain, muscle aches, and swollen lymph nodes. As the disease progresses, you may experience arthritis in the knees or larger joints, heart and nerve problems, and even cognitive symptoms such as confusion and poor concentration.

When you have these symptoms after a tick bite, your doctor may wish to test you for Lyme disease, especially if you live in an area endemic for the infection. Lyme disease diagnoses can be tricky since there are many ways to test for the disease and the tests often result in false negatives. For your first step towards diagnosis, you must have a blood test. There are a few different blood tests that are typically used.


The enzyme-linked immunosorbent assay blood test, better known as the ELISA test, is usually the first test that is performed. This test works by finding antibodies to Borrelia burgdorferi, the Lyme disease bacteria. The accuracy of the ELISA test has been, and continues to be, the subject of some debate, but the US Centers for Disease Control maintain its usefulness as part of a two-tier testing protocol for Lyme disease. A positive ELISA will usually need to be confirmed by a Western Blot test, whereas a negative result may lead physicians to rule out Lyme disease.

Western Blot

If you have a positive or borderline result with the ELISA test, you will usually be given the Western Blot test. This blood test detects the antibodies of the Borrelia burgdorferi. If the blood test shows a high titer of antibodies, it is likely that you have the bacteria that cause Lyme, although there have been many concerns raised over the accuracy of Western Blots for Lyme disease.


If both the ELISA and Western Blot test are inconclusive, your doctor may also perform an indirect fluorescent antibody test, or IFA. This also tests for Lyme disease bacteria antibodies in your blood.

If you do not want to have your blood tested, your doctor may agree to give you a different type of (unorthodox) test, such as a spinal tap. This is not recommended as the first step of a diagnosis, however. The spinal tap is not recommended in most cases because although it is very effective, the antibodies can be hard to find in the spinal fluid. This test is much more painful than a simple blood test and runs the risk of accidental damage to the spinal cord and/or nerves.

If you are experiencing any symptoms of this disease, it is important to see a doctor. A Lyme Literate Medical Doctor, also known as an LLMD is your best option when seeking a Lyme disease diagnosis. Your doctor will decide if a blood test to detect Lyme disease is right for you.

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