Ulta Lab Tests

Lyme Disease

Lyme disease is a tick-borne infection caused by Borrelia burgdorferi that can affect the skin, joints, nerves, and heart. Because early symptoms—fatigue, fever, headache, and body aches—mimic many illnesses, lab testing helps clarify when Lyme is likely and when another cause fits better.

A proactive approach follows recommended algorithms: start with an enzyme immunoassay (EIA/ELISA) and, if reactive/equivocal, confirm with either an immunoblot (“Western blot/line blot”) or a second EIA (the modified two-tier method). Antibodies may take 2–4 weeks to appear, so very early tests can be negative; repeating serology later can be useful if suspicion remains. PCR is reserved for certain situations (e.g., synovial fluid in suspected Lyme arthritis), while CSF antibody index can support neuroborreliosis when lumbar puncture is clinically indicated.
These tests support screening of compatible illness, diagnostic work-ups, and monitoring for alternative causes; they do not replace a clinician’s exam, imaging, or urgent evaluation for severe symptoms.

Signs, Symptoms & Related Situations

  • Early localized (days–weeks): expanding erythema migrans (EM) rash, fever, chills, fatigue, headache, muscle/joint aches

  • Early disseminated (weeks–months): multiple EM lesions, facial nerve palsy, meningitis-like symptoms, shooting pains/paresthesias, Lyme carditis (palpitations, lightheadedness)

  • Late disease (months+): arthritis (often knee swelling), intermittent or persistent joint pain, neuropathy

  • Exposure clues: tick bite in wooded/brushy areas (Northeast/Upper Midwest/West Coast), outdoor work or recreation, pet exposures

  • Co-infections to consider: Anaplasma, Babesia, Ehrlichia, Bartonella—especially with high fever, cytopenias, hemolysis, or sweats

  • Seek urgent care now: chest pain, fainting, shortness of breath (possible carditis), severe headache with neck stiffness, new facial droop, confusion, or signs of sepsis/dehydration
    Symptoms always require clinician evaluation.

Why These Tests Matter

What testing can do

  • Differentiate Lyme from look-alikes by applying stepwise two-tier algorithms

  • Detect seroconversion when repeated after the window period if early tests are negative

  • Support targeted decisions (e.g., joint fluid PCR for suspected Lyme arthritis)

What testing cannot do

  • Diagnose from a single early negative test—antibodies can be delayed

  • Prove “cure” or track treatment success—IgG can remain positive for years

  • Replace clinical judgment, imaging, ECG, or CSF studies when indicated

What These Tests Measure (at a glance)

  • First-tier EIA/ELISA (including VlsE/pepC10 or C6 peptide assays): screening for anti-Borrelia antibodies; more sensitive as illness progresses.

  • Second-tier confirmation:

    • Standard two-tier testing (STTT): IgM/IgG immunoblot after a positive/equivocal EIA.

    • Modified two-tier testing (MTTT): a second, different EIA replaces the immunoblot.

    • Key caveat: IgM results are most reliable within the first 30 days of symptoms; beyond that, isolated IgM positivity is often false positive.

  • PCR (NAAT): highest yield in synovial fluid for Lyme arthritis; low sensitivity in blood/serum.

  • CSF antibody index: compares CSF and serum antibodies when neuroborreliosis is suspected; requires paired samples and clinician oversight.

  • Context labs: CBC, ESR/CRP, and liver enzymes (to assess inflammation or coinfections).

  • Coinfection panels (as directed): Anaplasma/Babesia/Ehrlichia testing when fever, cytopenias, or hemolysis suggest mixed infections.

Quick Build Guide

Clinical goal Start with Add if needed
Typical EM rash present Clinical diagnosis is primary Baseline serology optional; repeat in 2–4 weeks if documentation needed
Early symptoms, no EM (≤2–3 weeks) Lyme EIA/ELISA If negative but suspicion persists → repeat in 2–4 weeks; consider coinfection tests if high fever/cytopenias
Neurologic signs (facial palsy, meningitis-like) Two-tier serology CSF studies (cell count, protein, CSF/serum Lyme antibody index) per clinician
Arthritis (swollen knee) Two-tier serology Synovial fluid PCR if diagnosis uncertain
Carditis suspected (palpitations, syncope) Two-tier serology + ECG (clinical) Further cardiac evaluation per clinician
Prior early negative, ongoing symptoms Repeat two-tier serology Expand work-up for alternative diagnoses or coinfections

How the Testing Process Works

  1. Choose the pathway: order EIA/ELISA first; reactive/equivocal results reflex to immunoblot or a second EIA.

  2. Time it right: if testing within the first 2–4 weeks of illness, a negative result can be too early—plan a repeat if suspicion remains.

  3. Provide the specimen: blood draw for serology; synovial fluid or CSF is collected only when clinically indicated.

  4. Get results securely: most serology posts within a few days; confirmatory steps are reported with an overall interpretation.

  5. Review in context: your clinician will align labs with exposure, exam, and—when needed—ECG, imaging, or lumbar puncture.

Interpreting Results (General Guidance)

  • EIA positive/equivocal → confirmatory positive: consistent with Lyme infection in the right clinical setting.

  • EIA positive/equivocal → confirmatory negative: overall negative (screen likely false positive).

  • Early negative EIA: does not exclude Lyme; retest in 2–4 weeks if suspicion remains.

  • Isolated IgM positive (>30 days of symptoms): often false positive—interpret cautiously with your clinician.

  • IgG persistently positive: indicates past exposure; not proof of active disease or treatment failure.

  • PCR positive in synovial fluid: supports Lyme arthritis; negative PCR does not rule out disease.
    Always interpret results with a qualified healthcare professional; patterns, timing, and exposure history matter most.

Choosing Panels vs. Individual Tests

  • Most adults: use two-tier serology (EIA → immunoblot or EIA → EIA).

  • Arthritis focus: serology first; add synovial fluid PCR if the diagnosis is unclear.

  • Neurologic focus: serology plus clinician-directed CSF evaluation (antibody index).

  • Broad tick-borne work-up: add Anaplasma/Babesia/Ehrlichia tests when fever, low counts, hemolysis, or severe illness suggest coinfection.

FAQs

How soon after a tick bite should I test?
If you have no symptoms, routine testing is not usually helpful. If symptoms develop, test using two-tier serology, keeping in mind the 2–4 week antibody window.

Do I need testing if I have the EM rash?
An expanding erythema migrans rash is often diagnosed clinically. Serology may be negative very early and is not required to start clinical decision-making.

What if my test is negative but I still feel unwell?
You may have tested too early or another condition may be present. Discuss repeat testing and evaluation for alternative diagnoses with your clinician.

Why is my IgG still positive months later?
IgG antibodies can persist for years and do not prove ongoing infection or treatment failure.

Is PCR better than antibody testing?
PCR is targeted (best in joint fluid for arthritis). Serology remains the mainstay for most cases.

Will these tests detect other tick infections?
No. Lyme tests are Borrelia-specific. Your clinician may add Anaplasma/Babesia/Ehrlichia testing based on symptoms and blood counts.

Can I test my tick instead?
Tick testing does not diagnose human infection and does not replace monitoring for symptoms and clinical testing.

Related Categories & Key Tests

  • Infectious Disease Tests Hub

  • Tick-Borne Disease Panels • Arthritis Tests • Neurologic Evaluation • Cardiac Tests (ECG/Markers) • Immunity & Titer Tests

  • Key Tests Lyme EIA/ELISA (incl. C6/VlsE assays) • IgM/IgG Immunoblot or Second EIA (MTTT) • Lyme PCR (synovial fluid/CSF, select) • CSF Lyme Antibody Index • CBC • ESR/CRP • Liver Enzymes • Anaplasma/Babesia/Ehrlichia panels

References

  • Centers for Disease Control and Prevention — Lyme disease testing and two-tier/modified two-tier algorithms.
  • Infectious Diseases Society of America, American Academy of Neurology, American College of Rheumatology — 2020 guideline on Lyme disease diagnosis and testing.
  • Association of Public Health Laboratories — Considerations for modified two-tier testing for Lyme disease.
  • Clinical Microbiology Reviews — Serologic testing for Lyme borreliosis and interpretation pitfalls.
  • American College of Rheumatology — Evaluation of Lyme arthritis and role of synovial fluid PCR.

Available Tests & Panels

Your Lyme Disease Tests menu is pre-populated in the Ulta Lab Tests system. Select a two-tier serology pathway (EIA → immunoblot or EIA → EIA), add synovial fluid PCR for uncertain arthritis cases, and consider CSF antibody indexonly when your clinician directs a lumbar puncture. Use filters to include coinfection testing when symptoms or blood counts suggest it. Review timing and results with your clinician to plan next steps and follow-up.

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The Lyme Disease IgG IgM Antibodies Immunoblot Test detects antibodies to Borrelia burgdorferi, the bacteria causing Lyme disease. IgM indicates recent infection, while IgG suggests past or ongoing infection. Doctors order this test to confirm exposure after ELISA screening or when symptoms such as rash, fatigue, joint pain, or neurological issues appear. Results provide critical insight for diagnosing and managing Lyme disease with greater accuracy.

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Blood Draw
Also Known As: Borrelia burgdorferi Test, Lyme Disease Antibodies Test
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The Lyme Disease Antibody Test with Reflex to Blot IgG IgM screens for antibodies to Borrelia burgdorferi, the bacteria that cause Lyme disease. If results are positive or equivocal, a Western blot IgG/IgM is reflexively performed for confirmation. Doctors order this test for patients with tick exposure, rash, joint pain, or neurological symptoms. Results help confirm infection, guide treatment decisions, and support early detection to prevent complications.

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Also Known As: Borrelia burgdorferi Test, Lyme Disease Antibodies IgG IgM Immunoblot Test, Lyme Disease Ab Test
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The Lyme Disease DNA Qualitative Blood Test detects genetic material from Borrelia burgdorferi, the bacteria that cause Lyme disease. This test identifies active infection by analyzing bacterial DNA in the blood. Doctors use it to confirm Lyme disease in patients with symptoms such as fever, fatigue, or joint pain, particularly after tick exposure. It supports early diagnosis and guides treatment to prevent long-term complications.

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Also Known As: Borrelia Spp DNA Test, Borrelia burgoferi Test
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The Lyme Disease IgG Antibody Immunoblot Test confirms exposure to Borrelia burgdorferi, the bacteria that cause Lyme disease. It detects IgG antibodies, which usually appear weeks after infection and remain present for months to years. Doctors use this test to confirm a positive screening result, evaluate late-stage Lyme symptoms, and support diagnosis in patients with joint pain, fatigue, or neurological complications from suspected Lyme disease.

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The Babesia duncani IgG Antibody Test detects IgG antibodies produced in response to Babesia duncani, a parasite that infects red blood cells and causes babesiosis. This test helps identify prior or ongoing exposure and supports evaluation of persistent fever, hemolytic anemia, or flu-like symptoms following tick bites. It aids clinicians in distinguishing babesiosis from other tick-borne infections.

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Also Known As: WA1 IgG Antibody Test
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The Babesia microti IgG IgM Antibodies Test detects antibodies to the parasite that causes babesiosis, a tick-borne infection affecting red blood cells. IgM indicates recent or active infection, while IgG suggests past or ongoing exposure. Doctors use this test to diagnose babesiosis in patients with fever, chills, anemia, or fatigue, and to differentiate it from Lyme disease or other tick-borne illnesses for accurate treatment.

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The Bartonella Species IgG IgM Antibodies with Reflex to Titer Test detects antibodies to Bartonella, the bacteria that cause cat scratch disease and other infections. IgM suggests recent infection, while IgG indicates past or ongoing exposure. If positive, titers confirm antibody levels. Doctors use this test to evaluate patients with fever, swollen lymph nodes, or suspected vector-borne illness, helping confirm diagnosis and guide treatment.

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The C3a DesArg Fragment Test measures levels of C3a desarginated, a stable breakdown product of complement activation. Elevated concentrations reflect immune system activation and may indicate autoimmune disease, sepsis, allergic reactions, or inflammatory conditions. This test provides insight into complement pathway activity, helping evaluate immune dysregulation, monitor disease progression, or assess systemic inflammation.

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The Ehrlichia chaffeensis IgG IgM Antibodies Test detects immune response to the bacterium responsible for human monocytic ehrlichiosis (HME). Measuring both IgM and IgG provides information on recent or past infection, helping identify acute illness or prior exposure. This blood test supports evaluation of tick-borne disease in patients with symptoms such as fever, fatigue, or cytopenias, guiding clinical assessment and patient management.

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What Is Lyme Disease? Risk Factors, Causes, Signs and Lab Tests

According to the Centers for Disease Control and Prevention (CDC), approximately 476,000 people in the United States are affected by Lyme disease each year. 

But if you haven't taken a Lyme disease blood test, you might be unknowingly harboring the illness. After all, the bacteria associated with Lyme disease can lie dormant for months or years.

But how accurate are Lyme disease blood tests, and how often should you have one done? Let's find out!

What Is Lyme Disease?

Lyme disease is a bacterial infection that's spread via woodland ticks. It's often very mild, though moderate or intense symptoms can develop over time.

This illness gets its name from its discovery location, Lyme, Connecticut. It is most prevalent in areas with expansive woodlands. As you might imagine, the more forests you have, the more ticks you're bound to encounter. 

Though Lyme disease isn't considered one of the most lethal illnesses, it can prove dangerous for those with compromised immune systems. Additionally, untreated Lyme disease can result in symptoms that last for months.

After spending time in the great outdoors, it's vital to check for ticks and tick bites. You may also want to spray yourself with pest repellent before going for a hike or going camping.  

Risk Factors for Lyme Disease

People with Lyme disease might enjoy spending time outdoors more than those who never contract it. They are more likely to come into contact with the woodland ticks that harbor Lyme disease-bearing bacteria.

As such, the most common risk factors for Lyme disease include:

  • Camping in wooded areas
  • Hiking through wooded areas
  • Spending time outdoors near tick habitats
  • Owning animals that often go outdoors

It's doubtful that someone who spends their life in a large urban area would ever contract Lyme disease. However, for those living closer to the countryside, it's a near-daily risk.

You might also accidentally bring ticks into your home if you own pets that often play outdoors. Because of this, researchers often use canine maps to help track the prevalence of Lyme disease.

Causes of Lyme Disease

Protecting yourself from Lyme disease can be challenging if you live in wooded areas throughout the Northeastern or Central United States. This particular strain of bacteria is called Borrelia burgdorferi. Bacteria that cause Lyme disease are found on insects and ticks.

When a black-legged (Deer) tick bites a person, there's a chance that the bacteria, Borrelia burgdorferi, will pass into the person's bloodstream. When this happens, antibodies rush to stop the spread.

Though Lyme disease is caused by a bacterial infection, it is not often grouped with infectious diseases. That's because there are no recorded cases of human-to-human transmission. 

In the United States, ticks are the primary cause of Lyme disease. Protecting yourself from this illness means consistent pest control services around your home and constant vigilance while walking or hiking through wooded areas.

Signs and Symptoms of Lyme Disease

There are quite a few physical signs and symptoms of Lyme disease. But, perhaps the most notable sign is a circular red rash that spreads out from a tick bite.

According to the Centers for Disease Control and Prevention (CDC), about 70-80% of people bitten by an infected tick get this rash. But this rash does go away with time.

Consequently, some infected individuals may believe that they're perfectly healthy after being infected with harmful bacteria. Even worse, this bacteria can remain dormant for several weeks, months, or even years. 

Still, that doesn't mean that Lyme disease is without symptoms. When the bacteria begins to spread throughout the body, it may cause:

  • Fever
  • Fatigue
  • Headache
  • Neck Stiffness
  • Joint Pain
  • Meningitis

If you've noticed any of these symptoms, or an unexplainable rash that keeps appearing, you may want to have yourself tested for Lyme disease. Often, the recommended treatment is a short course of antibiotics.

That's a small price to pay for staying safe from long-term aches, pains, and swelling. Remember, the sooner you get tested, the sooner you can enjoy a healthier body and mind.

How Do You Treat Lyme Disease?

When a case of Lyme disease is confirmed, the standard course of action is two to four weeks of oral antibiotics. In extreme cases, hospitalization may be recommended. Still, most will recover quickly while taking antibiotics.

Remember, a diagnosis of Lyme disease doesn't mean death. Though the long-term effects of this illness can be mildly debilitating, reversing those effects starts with rapid diagnosis and treatment.

Lab Tests for Lyme Disease

There are quite a few different lab tests that physicians can use to test for Lyme disease. Most are blood-based tests. A person's spinal or synovial (joint) fluid can also be used for testing. 

Still, the most comfortable form of testing is often blood testing. If you're concerned that you may have contracted Lyme disease over the past weeks, months, or years, you can order a Lyme disease blood test online.

With several tests available, it might seem challenging to pick the right one. However, any Lyme disease blood test that checks for specific antibodies related to Lyme disease can be effective.

If your test is positive, you'll want to share those results with your primary care provider. Then, they can recommend antibiotics to help fight off infection and kill the invading bacteria. 

Frequently Asked Questions

Below you will find some of the most frequently asked questions regarding Lyme disease and Lyme disease blood tests. If you continue to have questions about this illness, please reach out to your health care provider.

Can Lyme Disease Be Detected by a Blood Test?

A blood test can detect Lyme disease. However, spinal fluid tests are also an option. Still, blood tests are often the preferred testing method.

That's because spinal fluid tests often involve removing fluids from the spine or joints. This process can be painful or uncomfortable for patients. Blood tests tend to be far simpler and are virtually pain-free.

Blood analysts can use a blood sample to test for Lyme disease by searching for specific antibodies created to fight the bacterial infection. Though there are many types of antibodies, two are crucial to Lyme disease blood tests.

The first set is called Immunoglobulin G, or IgG antibodies. These are the most prevalent type of antibodies found throughout the body. They're present during bacterial and viral infections. 

The second major type of bloodborne antibody is IgM antibodies. Your body creates and releases these antibodies immediately after infection. Analysts can look for these biomarkers to determine infection level and duration.

What Is a Western Blot Test?

The Western Blot Test is a type of blood test that focuses on antibodies. It's very similar to other blood tests in terms of patient procedure. You arrive for your blood drawing appointment and wait for your results.

The thing that makes the Western Blot Test somewhat unique is its processing. Analysts separate the proteins and add them to blotter paper to study the antibodies in any given blood sample. They then add special enzymes and observe changes in the paper's color. Certain colors indicate the presence of specific antibodies, helping analysts determine a sample's status.

What Is the Most Accurate Test for Lyme Disease?

The most accurate test for Lyme disease is either a full-panel Lyme disease blood test or a spinal fluid test. Both offer high levels of accuracy.

Repeat testing may also be an excellent way to determine the presence of Lyme disease. After all, the bacteria that causes Lyme disease can remain dormant in a person's tissues for several months or years.

Consequently, blood testing may be preferable to spinal fluid testing. In addition, it's far easier to perform repeat blood tests than it is to have spinal fluid removed regularly.

It's also worthwhile to note that a person's blood is also rich in antibodies. So when performing a Lyme disease blood test, lab technicians look for the presence of specific antibodies that may indicate Lyme disease.

How Long Does It Take for a Lyme Blood Test To Come Back?

It takes about one to four business days for a lab to process Lyme disease blood test results. That said, complex tests that also test for the presence of other bacteria may require more time to process.

Ulta Lab Tests provides a fast turnaround time on lab results processed by Quest and secure online results. That way, you're not waiting several weeks to learn the outcome of your blood tests.

How Long Can You Have Lyme Disease Without Knowing?

A person can carry the bacteria for Lyme disease for several years before symptoms of the disease start exhibiting. But some people, particularly those with compromised immunity, may notice symptoms more quickly.

Still, the maximum amount of time a person can go without exhibiting Lyme disease symptoms is about 36 months or three years. Most will experience early symptoms far sooner.

Benefits of Lyme Disease Lab Testing With Ulta Lab Tests

Lyme disease can be a slow-progressing illness that causes mild to moderate pain. It can be particularly dangerous for individuals with compromised immune systems. As such, it's vital to get tested for Lyme disease.

Ulta Lab Tests provides some of the most diverse and high-quality medical tests in the United States. When you choose to order tests with Ulta Lab Tests, you know you can look forward to several benefits, including:

  • Secure and Confidential Results
  • No Insurance or Referral Needed
  • Affordable Pricing
  • 100% Satisfaction Guarantee

With Ulta Lab Tests, you just purchase your desired test directly and visit your local patient service center.

From there, it's only a short matter of waiting for your confidential results. Most results are available within a few business days, though some tests might take a little more time.

In addition, Ulta Lab Tests offers a 100% Satisfaction Guarantee and can help you select the right test for your needs.

But it's crucial to note that Ulta Lab Tests are currently unavailable in New York, New Jersey, and Rhode Island. As such, residents of those states may need to schedule a visit with their regular physician for testing.

Order a Lyme Disease Blood Test Today

Lyme disease blood tests can help you avoid months or years of joint and nerve pain. Lyme disease is caused by bacteria that are often spread via tick bites. Avoiding these bites can be challenging, especially in wooded areas.

Order your Lyme disease lab test today, and your results will be provided to you confidentially online in two to four days, and one to two days for most other tests. Take charge of your health and track your progress with Ulta Lab Tests!