Lyme Evidence Sheet
Reviewed 2026-07-24What is standard two-tier Lyme testing?
Standard two-tier testing uses an initial antibody test followed, when indicated, by an immunoblot. The result is interpreted as a sequence, not as one screening line alone.
What the evidence says
- CDC describes standard two-tier testing as an initial test followed by a second test when the first is positive or equivocal.
- CDC/APHL reporting guidance describes the combined interpretation of the testing sequence.
What this can tell you
- Which method words appear on a report.
- Why both steps matter.
What this cannot tell you
- Whether testing alone diagnoses every individual.
- Whether a partial report is final.
A useful question for your clinician
Does my report show complete standard two-tier testing and its final interpretation?
Sources (2)
- Centers for Disease Control and Prevention. ‘Testing and Diagnosis for Lyme Disease.’ https://www.cdc.gov/lyme/diagnosis-testing/index.html. Accessed July 24, 2026. Open source ↗
- Centers for Disease Control and Prevention and Association of Public Health Laboratories. ‘Suggested Reporting Language, Interpretation and Guidance Regarding Lyme Disease Serologic Test Results.’ 2024. https://www.cdc.gov/lyme/media/pdfs/2024/05/Suggested-Reporting-Language-Interpretation-and-Guidance-Regarding-Lyme-Disease-Serologic-Test-Results.pdf. Open source ↗