Report Questions about C 4 Complement Serum test in PANS / PANDAS (Lyme included) Posted June 24, 2014 Here's an article on C3a and C4a as they relate to lyme and mold. http://www.jacemedical.com/articles/C4a%20C3a%20testing%20for%20Lyme%20disease.pdf High C3a indicates lyme, high C4a can indicate mold. But according to Shoemaker and my LLMD, you need to run the test thru Jewish Laboratories - now a division of Quest. Only this lab provides measurements Shoemaker considers meaningful. Other labs, even those within the Quest family, don't give you comparable measurements. We went to Quest in Dec and they sent it to the wrong lab. Had to re-run in Jan and go thru hoops to get it done right. As for the pain - is there joint swelling? Swollen lymph nodes? My son's pain was lyme related. But other issues including mold can also cause pain.