Yes, you can receive a negative blood test and still have Lyme disease. Even with confirmed tick exposure and objective symptoms of a Lyme disease infection, like an EM rash, you can test negative for Lyme disease. This is called a false negative and happens more often than you’d expect.   Lyme disease is difficult to diagnose. The final determination should not be based on laboratory tests alone, which may be falsely negative up to 50% of the time. Standard Lyme disease testing consists of a two-step, indirect test, meaning it tests for the presence of antibodies created by your body after infection, not the bacteria that causes Lyme disease, Borrelia burgdorferi sensu stricto.   The first test is the enzyme-linked immunosorbent assay (ELISA). The second test, a Western Blot, is most often ordered only if the ELISA is positive. For a confirmed Lyme diagnosis, both tests must be positive. The high incidence of false negatives is a likely result of the fact that it may take up to two months for the body to produce enough antibodies for a positive ELISA.   If you have symptoms of Lyme disease or a confirmed tick bite, ask your doctor to order both the ELISA and the Western blot test from two or more independent labs, as an interpretation of blood tests vary depending on the lab and technician. Your insurance might only pay for one test at one lab, but you should consider paying for the others out of pocket. It’s possible and quite common to get a positive from one lab and a negative from another. Brio Medical Center’s Lyme disease physicians use cutting-edge laboratories that specialize in tick-borne illness and offer tests far superior than the standard ELISA and Western Blot. Our Lyme disease treatment team guides you through collecting your samples and interpreting your results, formulating a personalized treatment plan based on your unique biochemistry.