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During the early stages of Lyme disease doctors can often diagnose the disease by the "bull's-eye" rash (see: Lyme disease symptoms). The diagnosis is made easier if a patient has recently been in a region where Lyme disease is common. (Lyme disease is most often found in the Northeaster United States).
A doctor may look over a patient's past medical problems and examine the patient so that he or she can exclude certain diseases that have similar findings in the nervous system, the joints, and the heart.
In the early stages of Lyme disease blood testing is not usually necessary nor is it generally helpful. Blood testing can help diagnosis Lyme disease in the later stages. The body will produce antibodies to attack the Lyme disease bacteria. This can be used to expose evidence that the bacteria are in the body. To detect these antibodies a laboratory method called an Elisa assay is used.
The problem with antibodies is that they can be false indicators of disease because the antibodies can remain after the disease is cured for years. False positive tests in patients without specific findings can even lead to confusion. The current test that has been found to be most reliable is the Western Blot assay antibody test. Researchers are working on finding more accurate and reliable tests.
Lyme disease blood testing is most helpful in conjunction with a clinical diagnosis to help a doctor come to the correct findings. If a patient's symptoms and history lead strongly towards a diagnosis of Lyme disease a doctor may begin treatment without performing a blood test.