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I can't find the whole list right now of what LLMD's consider significant, but I know for certain 39 is specific to Bb (my younger Dd has this one test positive recenetly). if memory serves me right 31 means chronic Lyme, shows up after one or two years. Some bands like 41 cross react with other illnesses, while 39 and a few others typically only react with Bb. While Lyme diagnosis is typically made on the clinical presentation and symptoms, the testing can help validate the diagnosis. The WB results can vary , one theory is that it related to the fact that the spirochetes mutate into three different formes making it more difficult to detect. I consider it fortunate that my DD9's test came up +, because we were able to diagnose and treat her. having 39 and 41 IGM positive is both LLMD positive and CDC positive, so it is surprising that your PCP?ID doc questions it. The infectious Disease Society of America typically denies most Lyme and chronic Lyme exist, so you may want to consider the relevance of that opinion. I have completely lost all respect in regards to the infectious disease speciality in regards to Bb/Lyme and tick borne illnesses. ILADS.org is a good resource for information.

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At the top of the forum is a pinned thread of helpful threads for Lyme. In there, I've posted three links on interpreting results. 31 is one of the two bands that are unique to lyme and considered "smoking guns" (I think the other is 34).

 

Unlike 41, which shows only that your body made antibodies to an organism that has a flagella (lyme, h pylori, syphilis), band 31 only shows up when your body is fighting a Bb spirochete. No other organism is going to cause this band of antibodies. It's why band 31 was chosen for the lyme vaccine and why it was dropped from the CDC surveilance criteria, because if you got the (failed) lyme vaccine, you'd always show positive for band 31

 

As Hopeny said, band 31 usually only shows up once you've had lyme for a year - a sign of chronic lyme, so it makes sense it shows as an IgG +. That you also have a + IgM for 39 - another highly lyme specific antibody - indicates it's a current infection and not just past exposure. IMO, an ID who dismisses these specific bands is someone who denies that chronic lyme exists. Not someone I'd be turning to to get me well. I'm with your LLMD.

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