- You were recently infected and tested before your body produced Lyme antibodies.
- You took antibiotics before testing, which co-opted the antibody response.
- You were already on long-term antibiotics for another illness.
- Not enough “free” Lyme antibodies were detectable in your blood because they were all doing their job binding to the Lyme bacteria
- Lyme spirochetes were protected and hiding inside a biofilm colony.
- Spirochetes were burrowed deep inside your body (i.e., cartilage, fibroblasts, neurons, etc.)
- Only small blebs were in your body. No whole bacteria are needed for the PCR (polymerase chain reaction) based tests.
- No free spirochetes in body fluid on the day of the test.
- Genetic heterogeneity as there are at least 300 strains of Lyme, 100 in the U.S. You might be infected by a strain of Borrelia that the test doesn’t recognize.
- Antigen variability as Borrelia can change its outer surface protein to suit its environment so that the test will detect a “non-Lyme specific” antibody.
- Spirochetes are in the dormancy phase (L-form) with no cell walls, so there is nothing for the immune system to attack with antibodies.
- Lyme’s surface antigens can change body temperature
- You have an immune deficiency, and the body isn’t producing antibodies.
- You have had a recent anti-inflammatory treatment that suppresses the immune system. (i.e., steroids, arthritis meds)
- Co-infections with Babesia (protozoa) cause immune suppression.
- Down-regulation of your immune system by your body’s own cytokines.
- Lab error or poor technical capability or training to detect Lyme.
- You might have late-stage Lyme. Lab tests are not standardized for detecting late-stage Lyme.
- The lab tests might only have been approved for investigational use.
- Lack of adequate reference points for the test. Most tests only use a few genetic strains as reference.
- The revised Western Blot criteria fail to include important antibody bands (i.e., 31,34).
- CDC testing criteria are designed for epidemiological study, not clinical diagnostics.