The Western Blot test is the most popular test used for diagnosing chronic Lyme disease. Unfortunately, the results aren't always clear-cut, therefore current symptoms, along with other lab work, may be needed to reasonably diagnose.
Symptoms + Positive Results
Beginners luck! You have managed to achieve the near impossible.
Many people who actually have an active Lyme infection with symptoms have Western Blot results that come back negative or aren't just convincing enough.
Symptoms + Negative Results
Try again! No really, try again. You could still be positive for Lyme
It's possible to have an active Lyme infection with symptoms, but yield a negative Western Blot test. From inadequate lab techniques, to different strains of Borrelia, to co-infection, a number of reasons could explain why your lab results came back negative despite your very active and debilitating symptoms.
No Symptoms + Positive Results
Congratulations! Either the Lyme vaccine you received is working and/or you've come into contact with the Lyme spirochete in your past and the immune system was able to shut it down.
No Symptoms + Negative Results
What are you, a glutton for punishment?
When it comes to diagnosing Lyme disease, don't rely on lab results alone. It's not uncommon for professional Lyme physicians to consider not a Western Blot, but current symptoms, a patient's history, and other lab work to diagnose.