Lab test

Lyme Disease IgG/IgM Immunoblot

Used as the confirmatory second step after a positive or equivocal Lyme ELISA screen. Recommended for people with a tick bite history, unexplained joint pain, fatigue, or neurological symptoms in a Lyme-endemic area. No fasting required. Results reviewed by a General Medicine clinician.

Receive actionable insights and deep analysis—not just lab values– in as little as 48 hours

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What is a Lyme Disease IgG/IgM Immunoblot?

The Lyme Disease IgG/IgM Immunoblot is the confirmatory second-step test for Lyme disease, used after a positive or equivocal ELISA screen. By identifying antibodies to specific proteins on the Borrelia burgdorferi bacterium, it distinguishes true Lyme infection from false-positive ELISA results — providing a much higher level of diagnostic specificity.

IgM antibodies — early infection signal

IgM antibodies are the first to develop after Lyme exposure, typically appearing 2–4 weeks after infection. A positive IgM result suggests recent or early-stage infection and helps guide prompt treatment decisions.

IgG antibodies — established or past infection

IgG antibodies develop later — usually 4–6 weeks after infection — and can remain elevated for months to years. Positive IgG confirms exposure to Lyme bacteria and may indicate ongoing or previously treated infection.

Confirmatory specificity

Unlike the ELISA screen, the immunoblot identifies reactivity to specific Borrelia proteins — significantly reducing false positives and providing the clinical confidence needed to guide treatment in diagnostically uncertain cases.

Complete insights in as little as 48 hours

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Instantly schedule at 2,000+ labs nationwide, at a time that works for you. Most visits take 15 minutes or less, with both walk-ins and appointments available.

Get results in 48 hours

Your results are delivered quickly—and reviewed by medical professionals. You’ll get clear explanations, robust health insights, and recommended next steps tailored to your health needs.

Take action with physician guidance

Choose to review your results and manage your plan with a General Medicine physician—or simply use the insights on your own.

Track progress over time

Repeat annually to see trends, improvements, and new emerging risks or book individual tests that focus on your set goals

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We help you understand your options, connect you to the right clinicians, manage prescriptions, coordinate any needed evaluations, and keep an eye on your overall health along the way. It’s comprehensive care that looks at the full picture — your goals, your history, your lifestyle — and makes it simple to move forward with confidence.

What's included

Test type

Blood sample

Collection method

Venipuncture

Fasting

Not required

Results processing time

1 to 2 days

IgG Lyme Antibodies

These are antibodies that often appear later in the infection and can remain for a long time, indicating exposure or ongoing infection.

IgM Lyme Antibodies

These are the first antibodies your body produces in response to a recent Lyme infection.

Ongoing support, always available.

You’ll be supported by experienced clinicians who care for a wide range of health needs, from everyday concerns to more complex conditions.

Our clinicians track your progress over time and adjust your care as needed. If medication is prescribed, we’ll manage dosing and monitor for side effects. If lab testing is recommended, we review results and refine your plan accordingly. You’re never left to navigate care on your own.

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Frequently asked questions

What is the Lyme Disease IgG/IgM Immunoblot?

The immunoblot (Western blot) is the second-step confirmatory test for Lyme disease. It's used after a positive or equivocal ELISA screen to confirm the result. IgM antibodies suggest early or recent infection; IgG antibodies indicate more established or past infection.

Why is this test used as a second step rather than first?

CDC guidelines recommend a two-tier testing approach — ELISA first, immunoblot second. The immunoblot alone has high specificity but lower sensitivity and is most informative when done after a reactive ELISA. Using it first increases the risk of false negatives.

How long after a tick bite should I wait to test?

IgM antibodies typically appear 2–4 weeks after infection; IgG may take 4–6 weeks or longer to develop. Testing too soon after a bite often produces false negatives. If exposure was recent, a clinician may recommend retesting at 4–6 weeks for a more reliable result.

Can I have Lyme disease with a negative test?

Yes, in early infection before antibodies have developed. Additionally, antibody levels can decline over time in treated cases. Lyme diagnosis should always incorporate clinical presentation and exposure history alongside lab results — not lab results alone.