Lyme Evidence Sheet

Reviewed 2026-07-24

What happens after my first Lyme test?

Lyme antibody testing is usually interpreted as a two-step process. A positive or equivocal first test is followed by a second test, and the sequence is considered together.

What the evidence says

  • CDC describes a two-step antibody testing process for Lyme disease.
  • Reporting guidance explains that the first and second test results are interpreted as a sequence.

What this can tell you

  • Whether the report describes a complete testing sequence.
  • What final interpretation to ask the laboratory or clinician to explain.

What this cannot tell you

  • Whether a laboratory result alone explains every symptom.
  • Whether one screening line alone is a final diagnosis.

A useful question for your clinician

Was the complete recommended two-step sequence performed, and what is the final interpretation?
Sources (2)
  1. 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 ↗
  2. 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 ↗