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Several factors may contribute to false-negative or seronegative presentations: Testing performed too early in infection Variation in immune response between individuals Prior antibiotic exposure Differences among Borrelia species or strains Laboratory limitations These limitations are one reason clinicians often rely on a combination of exposure history, symptoms, physical findings, and laboratory data when evaluating suspected Lyme disease

Although easily absorbed into the blood stream, water-soluble vitamins are also lost in urine and perspiration

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