At a recent conference the medical director the Igenex medical director recommends doing "primed PCR urine tests if western blot tests are inconclusive. Antibiotics drive the Borrelia into the bladder where they can be detected in the urine. It is also a good clinical trial as you will see if there is any herxing or symptoms while on or immediately after the antibiotics. Be sure to keep a good diary of symptoms- headache, brain fog, fatigue, aches during these days. Your doctor should call Igenex (1-800-832-3200) so you have the correct forms and containers. There are many protocols used some recommend 3 days of collections or 5 days with 3 specimens sent. Here is a typical protocol:
Take Ceftin 500 mg twice daily with Zithromax 250 mg twice daily and collect urine for 5 days. Collect and send 3 separate urine samples during these days to Igenex for PCR tesing.
Igenex actually recommends repeat testing if initial test are inconclusive ie only one specific band is poistive. If you retest be sure to ask your doctor to check for 31kDa box as this will increase specificity. Your doctor must check this off on the back of the requisition paper or it will not be done ( I didn't know about this for 3 years and I'm a doc). 31kDa is highly specific for Lyme and can help clinch the diagnosis in "iffy" cases. If money is an issue and insurance won't cover repeating western blots- just do the urine PCR with antibiotics as it give both a clinical and lab diagnosis.