Repeat Lyme & Coinfection Testing to Check Treatment Status Is Not Valid

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Repeat Lyme and coinfection testing to check status is not valid Image by Marty Ross MD

Updated: 7/2/2024

Don’t Be Fooled by The Repeat Test or The Done Test

People with Lyme want to know if treatment is working—especially if they are not feeling better.

  • The truth is, there are no immune system tests or direct tests that acurately show if you have recovered or are recovering from Lyme and coinfections.
  • Going one step further, there are no tests that show you are cured. 

Simply put, retesting or testing for a cure is not scientifically valid.

Marty Ross MD Discusses Repeat Lyme, Bartonella, and Babesia Testing

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The Repeat Lyme & Tick-borne Infections Testing False Claim

Immune Reaction Tests

There is a current trend among some Lyme literate practioners to retest patients.

  • The elispot tests through Armin Labs, Infectolab, and even IGenex measure if a type of white blood cell called a T Cell has reacted to Lyme or one of the coinfections. 
  • The other type of immune reactivity test detects antibodies. Antibody tests are called immunoblots and westernblots. These tests see if your immune system is making antibodies against Lyme or one of the coinfections.

Read more about the various ways to test for Lyme, Bartonella, and Babesia in The Best Lab & Test for Borrelia, Bartonella, & Babesia.

Some physicians wrongly believe that a more reactive elispot, western blot, or immunoblot means the germs are more active or that a person has a higher germ load. The opposite of this is the belief that a non-reactive immune system test means the germs must be under control or out of the body.

A Different Take on Immune Reactivity 

Keep in mind, Lyme and coinfections can suppress the immune system. So a negative or less reactive elispot, immunoblot, or western blot could be due to large numbers of germs suppressing the immune system.

Another issue is that Lyme and Bartonella live in persister forms and biofilms where the immune system cannot see them. Additionally, Lyme can hide in tissues with poor blood flow. So these germs can hide from immune cells, creating a falsely low immune response test. Also, the elispot test offered by Armin and others will not find Lyme or other germs when present up to fifteen percent of the time.

Another way to look at a very reactive immune test is that treatment is done or has worked. Once treatment is over, without any immune suppression, the immune system could become super-charged and much more reactive to battle even the smallest amount of remaining germs or germ proteins. So increased reactivity could mean your immune system has it all under control.

Direct Germ Detection Tests

Direct germ detection tests see if the DNA of Borrelia, Babesia, or Bartonella are present in you.

  • One direct test method is called a FISH test where a flourescent marker is attached to germs to make them visible on the microscope.
  • Another direct test method is called a PCR test where DNA of the germ is detected from a blood sample. There is also a newer ecPCR test where the blood sample is placed on a growth promoting medium to grown germs and their DNA to enhance the amount of a PCR reaction. 

Positive direct tests do mean you still have the infection. But negative tests do not mean the germ is gone. The problem with direct tests, like FISH and PCR methods, is germs do not always swim by the needle at the time your blood is drawn. As an example, PCR of Lyme is shown in testing to only find Lyme 30% of the time it is present. 

How to Determine Where You Are

In my clinical experience, the best predictor of when treatment is done, or where you are in your treatment for Lyme or the coinfections is to follow the symptoms. If testing is negative, but you still have a lot of symptoms, then there is a good possibility the germs are still active and require further treatment. For more information about how to determine to stop treatment see Finished? And How to Prevent Relapse.


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.


View Citations

1. Harris et al. An Understanding of Laboratory Testing for Lyme Disease. Journal of Spirochetal and Tick­borne Diseases—Volume 5, Spring/Summer 1998.

2. iSpot LymeTM: A New Generation of Lyme Disease Testing. Chenggang Jin, PhD, MDa,b, Deanna J. Fall, BAc, Diana Roen BS, and Gottfried Kellermann, PhD c. ©NeuroScience, Inc. April 2013.

3. Fallon, Brian A., et al. Conquering Lyme Disease: Science Bridges the Great Divide. NEW YORK, Columbia University Press, 2018. JSTOR,

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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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