Positive Lyme Test, No Symptoms, Don't Treat

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Don't treat Lyme disease positive test without any Lyme disease symptoms by Marty Ross MD image.

A Positive Test And No Lyme Symptoms

Many wonder what to do if a person has a positive Lyme test but no symptoms. With the exception of an acute tick bite within last 6 months, it is not a good idea to treat with herbal or prescription antibiotics in these situations. However, consider taking steps to support the immune system. But if symptoms of Lyme disease develop, then a person should begin herbal or prescription antibiotics.

1.  It Is Not Clear How Long to Use Antibiotics or If They Work to Eradicate Lyme

Unfortunately, there is no way to tell if a treatment is complete when someone does not have symptoms of Lyme. There is no research that tells us how long to treat to get rid of all Lyme germs or if antibiotics even can get rid of Lyme. In chronic Lyme treatment there is not a "done" test. A test can remain positive even when treatment is complete because we likely do not get rid of every Lyme germ.

For more information on what it means for someone with chronic Lyme disease to be done with treatment see Finished? And How to Prevent Relapse.

Marty Ross MD Discusses Positive Lyme Testing Without Symptoms.

The recording is a Lyme Byte recorded during Conversations with Marty Ross MD on March  19, 2014, when Dr. Ross practiced in Seattle, Washington.

2.  Testing Does Not Show Who Will Get Lyme Disease

A positive Lyme test may indicate a person either has a Lyme infection, or is a false positive result.

Not everyone with Lyme infection develops Lyme disease. Lyme disease is the mess of symptoms and medical problems that exist when an infection and other factors like detoxification or immune system problems combine to cause "dis-ease". Studies show that 50 percent of people who have a positive Lyme antibody test (a western blot) do not show symptoms of Lyme disease. However there are no long term studies that show how many of these people eventually develop the disease. My experience in a busy Lyme disease practice in Seattle suggest that most with the infection do not develop the disease over time. This means many have immune systems that control the infection.

A false positive result means that a test says a person has a medical problem even when he or she does not. This means the test is wrong. The chances that a test is correct when it is positive is called the predictive value. The predictive value of any test increases when there are symptoms of the illness or a person lives in an area where a large number of people have the disease.

So without any symptoms of an illness there is a greater chance that a positive test is wrong.

For more information about what is needed to make a Lyme disease diagnosis see my video article How to Diagnose Chronic Lyme Disease. For information about the accuracy of Lyme infections tests see A Review of Lyme Infection Tests. Pass or Fail.

3.  Do No Harm

At many medical school graduations physicians take an oath to "do no harm". There are both risks and benefits from using herbal or prescription antibiotics. When someone has a full blown Lyme disease, then the benefits far outweigh the risk of using antibiotics. In recommending antibiotics in these situations there is a greater chance that health care providers help rather than harm.

One major risk of using herbal or prescription antibiotics is the creation of treatment resistant Lyme. When Lyme germs are under stress from antibiotics they change into microscopic cyst forms and/or move into biofilm communities. Some germs develop persister forms which are very difficult to treat. It is also possible the Lyme could develop antibiotic resistance as all types of infection can through genetic and metabolic processes inside of the germ. Treating someone who is healthy with antibiotics may do harm by making it very difficult to treat Lyme infection if he or she does develop the the disease.

Steps to Boost the Immune System

Here are some lifestyle steps to boost the immune system to keep an inactive Lyme infection under control.

  • regular sleep of seven or more hours a night,
  • regular exercise.whole and organic foods to limit toxins that can suppress the immune system,
  • a good multi-vitamin that provides all of the essential nutrients the immune system requires, and
  • ongoing emotional detoxification (emotional stress is a very strong immune system suppressor).


The ideas and recommendations on this website and in this article are for informational purposes only. For more information about this, see the sitewide Terms & Conditions.

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About The Author

Marty Ross, MD is a passionate Lyme disease educator and clinical expert. He helps Lyme sufferers and their physicians see what really works based on his review of the science and extensive real-world experience. Dr. Ross is licensed to practice medicine in Washington State (License: MD00033296) where he has treated thousands of Lyme disease patients in his Seattle practice.

Marty Ross, MD is a graduate of Indiana University School of Medicine and Georgetown University Family Medicine Residency. He is a member of the International Lyme and Associated Disease Society (ILADS), The Institute for Functional Medicine, and The American Academy of Anti-Aging Medicine (A4M).

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