Dr. Kyle Warren
Meghan Feir Walker
In today’s article, I (Dr. Warren) am going to try to clear up a few of the common Lyme myths surrounding not only Lyme disease but other chronic infections as well. I’m going to point out a few ways doctors have been misguided in their thinking and practices, and try to answer some questions about chronic Lyme, why doctors get confused, and why testing can lead doctors and patients astray in the case of chronic illnesses. I’m especially going to explain the Lyme IgG vs. IgM “past infection” myth in testing and how false information leads doctors and patients astray. We’ll also cover how the tests work, how to interpret results (IgM/IgG), when to test, and what the limitations are.
To watch the corresponding video to this article, click here.
Key Takeaways
- The CDC now recognizes chronic Lyme as a real condition called PTLDS.
- The idea that IgG only indicates a past infection is an oversimplification.
- An IgM positive result is not a false positive.
- Quantitative analysis of antibodies is vitally important because some patients don’t produce enough antibodies to begin with. Since antibodies don’t appear to be high, this can falsely make the results appear normal, even if they do have an active infection.
- Chronic infections do not follow textbook immune responses, so proper diagnosis requires improved testing and symptom evaluation.
- Standard Lyme tests often miss chronic cases because they are designed to detect only acute infections.
Chronic Lyme IS real
I’m happy to share that the long debate over whether chronic Lyme disease is real can finally end.
After 40 years of saying otherwise, theCDC officially acknowledged chronic Lyme in April 2022, now calling it post-treatment Lyme disease syndrome (PTLDS).
This is great news for both doctors and patients, but change takes time. Many medical professionals were taught for decades that chronic Lyme didn’t exist, so don’t be surprised if you still meet someone who doubts it. When that happens, you can confidently point them to the CDC’s updated stance on chronic Lyme.
Now that recognition is here, we can finally shift our focus away from arguing about its existence and prioritize helping people find effective treatment and recovery options.
What are IgM and IgG, and Why Do They Matter for Lyme?
When most people see the terms “IgM” and “IgG” on their Lyme test report, they aren’t sure what it all means. These antibodies form the backbone of how your body fights infection(s), and understanding them helps make sense of Lyme test results.
Your immune system is a complex defense network, and one of its most important players is the B-cell. When your body senses an invader, such as bacteria from a tick bite, those B-cells get to work producing antibodies. Antibodies act like personalized “wanted posters” that help your immune system recognize and remove whatever doesn’t belong.
If we were to look at IgM and IgG antibody production from a classic textbook point of view, this is what it would tell you: When you first encounter something new, your body quickly releases Immunoglobulin M (IgM) antibodies. These are your first responders. They move fast and are designed to get control of the infection right away. They are large, quick-acting molecules built for speed rather than precision. A little later, your body shifts gears and begins producing Immunoglobulin G (IgG) antibodies. These are smaller and more refined, and they stick around much longer. In fact, IgG antibodies make up about 70 to 89 percent of all the antibodies in your bloodstream, while IgM accounts for around 15 percent.
Doctors will tell you that IgM indicates a recent, active infection, and that IgG indicates a past infection or a vaccination. While this mode of thinking works well for viruses, when it comes to chronic bacterial infections like Lyme, syphilis, leprosy, etc., it’s not as straightforward.
Understanding IgM vs. IgG Testing for Lyme
The IgM vs. IgG testing “past infection” Lyme myth is closely tied to whether people get accurately diagnosed with chronic Lyme or other chronic infections.
Most doctors tend to believe that IgM indicates a current infection and that IgG indicates a past infection, but it’s not as simple as that, particularly when you’re dealing with patients who are chronically ill.
What’s to be said about the patients who got infected and have never felt better after months or years have passed? It may only show up on the IgG, but since getting infected, they’ve never returned to their baseline level of health.
Acute Lyme disease can produce the classic (but often not present) bull's-eye rash and joint pain, which happens within about a week or so of getting a bite from an infected tick. But chronic Lyme can cause long-term, debilitating symptoms that, in the vast majority of cases, do not resolve on their own.
Acute infections can be life-threatening. Chronic infections can be debilitating.
Keep in mind that with chronic conditions, while the chronic Lyme infection itself might not kill you, it can lead to other bodily problems, serious mental health issues, and exacerbate other conditions, which can lead to life-threatening results. Just because it isn’t acute doesn’t mean it’s not just as dangerous in other ways.
Comparing IgM and IgG: A massive oversimplification
To illustrate what doctors are taught about current and past infections, take a look at the chart below.
This chart is supposed to illustrate an acute infection. These lines are the normal immunoglobulin curves illnesses are supposed to take, and doctors have to study and familiarize themselves with this process.
If we start at the upper left, there’s an incubation period. This is when you get exposed to sickness. There’s a period of time when it’s in your body, but it’s probably not causing any symptoms at this point.
Next, we start developing symptoms and realize we’re getting sick. This is when our body first creates immunoglobulin M, which your body can make relatively quickly.
Notice the purple arc of immunoglobulin M. It comes up in about a week before it goes back down. It’s pretty much gone by about the three-to-four-week mark. Most doctors will say an IgM is an active, acute infection.
Now notice the IgG curve. Immunoglobulin G is Y-shaped and comes up later. It spikes at about three to four weeks after the first onset of an infection.
You’ll keep some IgG around long-term. Notice it spikes up and then comes down; it does not stay up at the peak. You will keep a low amount of immunoglobulin present so that if your body ever sees this infection again, you have some immunity toward it in the future. Doctors will also say that if you have an IgG but the IgM is gone, it’s a past infection that no longer can cause symptoms.
Along with the IgM and IgG curves on this chart, it also shows C-reactive proteins (CRP). In the middle of the test, there’s a green bar that indicates the CRP going up during acute infections.
How Lyme Tests Measure IgG and IgM Antibodies
When a Lyme test is run, labs are not measuring the bacteria directly. They are measuring your body’s antibody response, specifically IgM and IgG levels, to determine if your immune system has seen Borrelia burgdorferi, the bacteria that cause Lyme disease.
The most common approach is called two-tiered testing.
- The first test (an enzyme immunoassay or EIA) looks for general antibodies that might suggest Lyme exposure.
- If that test is positive or uncertain, a second test (a Western blot or another EIA) looks more specifically at IgM and IgG antibodies to confirm it.
These tests are designed for acute infections, where IgM is high and IgG develops later. Because two-tier testing is optimized for early immune response patterns, many chronic cases fall outside its detection window or show incomplete antibody signatures. This is one reason chronic or persistent cases can be difficult; if your IgM and C-reactive proteins have normalized, standard Lyme tests may look “negative” even when symptoms remain.
Because acute infections are the focus of most doctors, they completely ignore chronic infections…
For acute infections, doctors are looking at the CRP and IgM indications. The issue is that when we deal with chronic infections, you don’t usually have elevated IgM or C-reactive proteins. Because of this, most doctors will say it’s no longer there. Doctors will often mistakenly label any positive IgM as a “false positive” because of their oversimplified view of the immune system.
With updates in filtration, antigen processing, and lab quality control, these tests are accurate and are not false positives! This can be incredibly frustrating for patients who are experiencing chronic symptoms and for patients who caught an infection and never recovered. Doctors tell them it’s no longer active because of their rigidity in following this chart and from what they were taught in medical school.
It’s not a safe assumption for doctors to assume that because IgM is no longer elevated after a month, the patient is completely better. Unfortunately, many patients don’t get better and continue having symptoms after 30 days and even after a round of treatment.
This chart illustrates what is supposed to happen, but what happens when you continue feeling sick 3, 6, 12 months, or even years later? What happens when your acute illness turns into a long-term problem?
Just because your immune system is supposed to work as the chart example displayed, it doesn’t mean it will. Too many factors can throw it off. You’re also supposed to be sick for a couple of days to a couple of weeks and then get better.
Chronic illness is like a check engine light appearing on the dashboard of your car. Your car may still be running, but something is wrong with the engine and needs to be addressed immediately.
The medical community needs to find ways to help people who are chronically sick for months and years at a time.
Patient Example of IgG vs. IgM
Sally’s pain is a 10/10 pain. She has neuropathy in the joints in her arms and legs, horrible headaches, and light sensitivity that started abruptly two years ago. When we ran tests in January 2026, she had high IgGs for Lyme and still has high IgMs for two species of Borrelia (Lyme)--Hermsii and Maritima. Two years later isn’t what we’d consider a new infection, yet her IgM levels are still sky high. I can promise she wasn't re-exposed to these same infections two weeks before retaking the test, as the IgM dogma would suggest.
Lyme Myths Debunked: Other Infections Become Chronic
Although many doctors deny the reality of infections becoming chronic after the acute phase, there are actually several examples of known chronic infections. This reminds me a little bit of the “doublespeak” mentioned in the famous George Orwell novel, 1984. Chronic infections aren’t real… until you start asking doctors about well-known chronic infections. It just doesn’t make sense.
Syphilis is a perfect example. Just like Lyme, syphilis confuses doctors because it goes through phases of being active and dormant.
Leprosy is an example of a slow-growing, chronic bacterial infection, and the fact that you can develop shingles after having chickenpox is another illustration of how infections can stay in your body and reemerge.
HIV, malaria, tuberculosis, and polio can all become chronic infections. In other words, this isn’t anything new. The existence of chronic infections has been around forever, so why was it and is it so difficult to admit that other infections can go from acute to chronic stages?
Similarities Between Long-Haul COVID and Lyme
Our most recent example of acute infections that can become chronic has been long-haul COVID.
At a recent seminar, we were looking at some of these long-haul/chronic/post-COVID numbers. It’s hard to get much data on long-haul COVID, but the latest numbers report that about 7 percent of people who have had COVID haven’t returned to their baseline level of health and have developed chronic symptoms. This correlates well with Lyme disease.
While many people who get acute Lyme disease are able to treat it and prevent it from becoming a chronic problem when treated swiftly, not everyone is as fortunate. There are many people who don’t realize they’ve been bitten or who weren’t able to completely eradicate the infection after taking a round of antibiotics (though taking antibiotics within the first three months is highly effective).
The similarities between long-haul COVID and Lyme don’t end there, with many symptoms of long-haul COVID shared with those of chronic Lyme. However, from what we can observe so far, the majority of the time, Lyme and other chronic tickborne illnesses still seem to debilitate even more extensively than long-haul COVID. The daily impact of any chronic illness can be devastating for both the one suffering and their family.
Many who contract Lyme don’t recover (without continued, proper treatment), and it becomes a chronic issue, leaving them debilitated or disabled. What is happening to them, and what do their tests look like? Their immune response doesn’t look like the normal test chart shown earlier, and that’s the whole point.
This is another reason why everyone in the medical community should stop making simplistic assumptions and listen to their patients’ experiences with an open mind.
What We Do in Our Clinic: Good, Thorough Testing and Listening to Symptoms
This is why we like testing IgM, IgG, PCR testing, and immune system markers to try to get a better, more thorough look at the state of your immune system and why it’s having difficulties getting over chronic infections. The IgM vs. IgG testing “past infection” Lyme myth needs to be exposed.
In order to help you fight back and recover your health, we want to know how your immune system is stuck and why it got stuck in the first place. Patients can’t be put on a one-size-fits-all plan for healing. If you’re curious about how newer Lyme tests are addressing some of these challenges, we cover that in detail in our recent Lyme testing advances article.
Summary
- After 40 years of being taught that chronic Lyme isn’t real, doctors are slowly becoming more aware that chronic Lyme (aka, PTLDS) exists and is a very real problem for many patients who are chronically ill.
- The IgM/IgG/CRP chart illustrating how the immune system is supposed to react to acute infections is what doctors are taught. Unfortunately, this doesn’t illustrate what happens when people develop chronic infections.
- Doctors are also becoming more aware of the presence of other chronic infections. This has been the silver lining of the COVID-19 pandemic.
- With about 7 percent of the population of those who have had COVID developing long-haul COVID, more research is starting to be done on chronic infections. This will help us all gain more knowledge and understanding about what the immune system is doing when people are chronically sick.
- Doctors will still stand by this chart because it’s what they learned in medical school. In its simplicity, this model doesn’t explain chronic illness well, only acute infections where the person recovers after a few days or weeks.
- It’s cognitive dissonance when we teach how something is supposed to work when we’re surrounded by examples of how it doesn’t work that way much of the time.
- Understanding your unique situation and the state of your immune system is vital to getting better.
I am hopeful that the CDC’s recent acknowledgment of chronic Lyme (PTLDS) and the research coming out of COVID will also help a myriad of other chronic debilitating diseases, as opposed to only the acute phases of illnesses.
We hope this article has been useful for you in your journey toward healing. Follow us on Instagram and Facebook for more information, and share with friends and family on social media if a post has been helpful for you. Request a consultation today or learn more about our Lyme Disease Holistic Protocol and discover how we can help you move toward real recovery.
