Condition lab guide

Lyme Disease Blood Test Results Explained: What They Mean

Also known as: lyme disease test, lyme blood test results, ELISA Western blot

Medically reviewed by Antonieta Rueda, MD and Ayham Shneker, MDLast reviewed July 6, 2026

Lyme disease blood tests look for antibodies against the bacteria that cause Lyme, using a two-step process: a screening ELISA test followed by a confirming Western blot if the ELISA is positive or borderline. Because antibodies take a few weeks to develop, testing too early after a tick bite can produce a false negative.

How blood tests are used

The CDC recommends a two-tiered testing approach for Lyme disease. Blood tests detect your immune response to the bacteria, not the bacteria itself, so timing matters — antibodies may not be detectable in the first 1–2 weeks of infection. Results are always interpreted alongside symptoms and possible tick exposure.

Key Lyme disease tests

TestWhat it checks
ELISA (or EIA)First-step screening test that detects Lyme antibodies. Sensitive but can give false positives.
Western blotConfirmatory second step run when the ELISA is positive or equivocal; checks for specific antibody bands.
IgM vs IgG bandsIgM suggests recent infection; IgG suggests longer-standing infection.

What Lyme results mean

  • A positive ELISA followed by a positive Western blot supports a Lyme diagnosis in the right clinical context.
  • A negative ELISA early in infection may be a false negative — retesting in 2–4 weeks may be advised.
  • A positive ELISA with a negative Western blot is generally considered negative for Lyme.
  • Antibodies can persist for months to years after treatment, so tests aren't used to judge cure.

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Frequently asked questions

How soon after a tick bite can Lyme be detected in blood?

Antibody-based Lyme tests usually can't detect infection in the first 1–2 weeks, because your body hasn't produced enough antibodies yet. Testing is most reliable a few weeks after exposure. Early Lyme with the classic bull's-eye rash is often treated based on symptoms without waiting for blood tests.

Why do I need two Lyme tests?

The two-tiered approach improves accuracy. The first ELISA test is sensitive but can produce false positives, so a positive or borderline result is confirmed with a more specific Western blot. Both must be positive (in the right clinical setting) to support a diagnosis.

Can Lyme blood tests stay positive after treatment?

Yes. Antibodies can remain detectable for months or even years after successful treatment, so a positive test doesn't necessarily mean active infection. That's why Lyme tests aren't used to confirm that treatment worked.

Related biomarkers

Medically reviewed by Antonieta Rueda, MD and Ayham Shneker, MD · Last reviewed July 6, 2026

This article is for informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Blood tests are interpreted by a clinician alongside your symptoms and history. Always consult your healthcare provider about your results.