HealthHealth Conditions

Doctors Explain Everything You Need To Know About COVID-19 Antibody Tests

COVID-19 antibody tests just got approved by the Food and Drug Adminstration (FDA). Here, experts answer all your FAQs about the new tests.

alt
Graphics: Well+Good Creative
Published May 27, 2020

Written by 

Kells McPhillips

On April 1, the Food and Drug Administration (FDA) approved the first COVID-19 antibody test: the “qSARS-CoV-2 IgG/IgM Rapid Test” created by biotechnology company Cellex Inc. The announcement came on the heels of the Mayo Clinic developing its own antibody test to be released April 6.

This development was heralded as a potential new way to see if someone has ever been exposed to SARS-CoV-2 (aka the novel coronavirus that causes the disease COVID-19), and potentially even if they are now immune to the deadly virus. Dozens of companies jumped on the antibody testing bandwagon and rushed tests to market in the past few weeks—with mixed results. But while the test may mark a promising new phase in the fight to end COVID-19 (which reached 5.4 million cases globally on May 27), there’s a lot of confusion about how the antibody test differs from existing, albeit scarce, COVID-19 testing kits. (And a lot of controversy surrounding its efficacy.)

To clear up any head-scratching, we asked Rand McClain, DO, chief medical officer of Live Cell Research, a company dedicated to enhancing health and quality of life through biological innovation, and Seema Sarin, MD, board-certified Internal Medicine physician at EHE Health, to answer all the FAQ’s about the antibody test. Including: What is it? Who will get it first? And how could it help a nation where cases are mounting by the day?

First up: What are antibodies?

“Antibodies are part of the immune system that identifies what’s called an antigen, which is a bad guy,” says Dr. McClain. Antibodies are made out of proteins, and are produced by white blood cells in direct response to the presence of these “bad guy” antigens—which can be a virus, bacteria, or even a fungus, says Dr. McClain. “The antibodies mark the bad guys so that the immune system can more easily target them and eradicate that invader.” Antibodies attach to pathogens like viruses and neutralize them, which prevents them from further replicating inside of your body.

Your immune system produces antibodies that are designed to work on specific invaders that it’s encountered before, either from prior illness or a vaccine; the antibodies that target certain forms of the flu, for example, are different from the ones that would work against something like the mumps or the measles. So someone previously infected with a virus like SARS-CoV-2 who recovered would have special, COVID-19-specific antibodies that could help fight it off if it ever came back.

What is an antibody test, in the context of COVID-19?

“The [antibody] test works by testing your blood for coronavirus antibodies to see if they have already beaten the virus and gained some immunity to it,” says Dr. Sarin. This method is called serologic testing, and it determines if someone already has the antibodies associated with SARS-coronavirus-2—which indicates that they’ve been exposed to the virus and are now potentially immune to it. The Cellex test takes blood from a person’s vein; other types of antibody tests take blood using a finger prick.

This isn’t the only case in which antibodies are used to identify if someone has immunity to a disease. Antibody tests are used to test people for antigen p24 (which is and indicator of HIV), and seasonal influenzas also use this method of testing for research purposes (not for diagnosis).

The COVID-19 antibody test produced by Cellex looks for two categories of antibodies called immunoglobulin M (IgM) and immunoglobulin G (IgG). The immune system releases IgM first when fighting a new infection, and then a version of IgG is produced later to fight the specific invader. A positive test means you have been exposed to SARS-coronavirus-2—and could be immune to it.

How does the antibody test differ from the current testing available for COVID-19?

“When you hear about testing kits for COVID-19 in the news, they’re not talking about antibody testing,” says Dr. McClain. “The test they’re talking about is designed to actually identify the virus, which they call a viral antigen or a virion, in the body. They do that with something called polymerase chain reaction (PCR) technology.” This is performed by taking swabs of a person’s nose and throat, then sending them to a lab to analyze the cultures. “And, essentially, what they’re doing is [looking for] these pieces of the virus in the body and saying, ‘oh yeah you’re infected’ or not. That’s very different than finding someone who’s already been infected and may not have known it,” he says.

advertisement

These tests, says Dr. Sarin, require about 24 hours to go to a testing lab and return back to the medical facility with patient results. Antibody tests, by comparison, only take about 15 minutes to show results.

“This is simply identifying those people who have made the antibodies, and therefore it’s assumed that they’ve been exposed to the virus previously.” —Rand McClain, DO, chief medical officer of Live Cell Research

It’s worth noting that the antibody test is not a vaccine for COVID-19. “We don’t have a vaccine yet. We don’t have a treatment so far that’s been confirmed so far with ideal gold standard trials. This is simply identifying those people who have made the antibodies, and therefore it’s assumed that they’ve been exposed to the virus previously,” says Dr. McClain.

When will COVID-19 be over? Here’s what an immunologist has to say: 

If a person has antibodies to the novel coronavirus, does that make them immune to it in the future?

Possibly, but there are some limitations. Just because you have antibodies to something doesn’t mean that those antibodies are particularly effective, virologist Angela Rasmussen, PhD, told the New York Times. Antibodies also don’t last in the body forever, which is why we have to periodically get re-vaccinated for things like whooping cough and tetanus; so a one-time exposure to the virus likely wouldn’t keep a person protected forever. Plus, the novel coronavirus is so new (it first was discovered in December 2019) that we don’t have a ton of data showing how long a recovered person would be protected from reinfection.

Initially, doctors’ expectations of immunity for this strain of coronavirus largely stemmed from their experience with other coronaviruses throughout history. “In our experience with coronaviruses—and we’ve got five of them in our history other than the SARS and the MERS that we can go back and see—is that the odds are very strong that you won’t be infected for at least another year,” says Dr. McClain. But that particular hypothesis is coming into question, thanks to some new documented cases of people who had seemingly recovered from COVID-19 contracting the disease again a few months later. (But there’s not enough consistent data to show whether that’s a common possibility.)

Currently, there’s evidence that COVID-19 antibodies can potentially last in the body for up to five months, according to a study published in late October in the journal Nature. The study also found that the majority of people with mild to moderate cases of COVID-19 produce a “robust” immune response (although some people do not produce any or many antibodies). However, the study authors note that “it is still unclear if infection with SARS-CoV-2 in humans protects from reinfection and for how long.”

“The problem is, some of these viruses, like the flu, mutate. Every year we have a new strain,” adds Dr. McClain. Right now, the medical community just doesn’t know for sure if SARS-CoV-2 will mutate. And if it does, that could mean immunity against this year’s strain wouldn’t be quite as valuable of an asset.

advertisement

“The cool thing about that, though,” says Dr. McClain, “is because the viruses have mutated, they’re still somewhat similar. So, even if it was a mutated strain, you’re likely to have better immunity than someone who’s never been inoculated with that virus.” Doctors, again, are assuming that you’ll retain some kind of immunity based on their experience with other types of coronavirus.

Why are people putting so much stock in this test for combatting COVID-19?

A number of medical professionals, Dr. McClain included, have expressed excitement about the antibody tests—first and foremost for what they could mean for the medical community. An estimated 25 percent of individuals who contract SARS-CoV-2 are asymptomatic, and a large percentage (about 80 percent) of cases are believed to be mild, so it’s likely that plenty of health-care professionals have contracted the virus, built up the antibodies, and have no idea that they’re now potentially immune.

“There are people out there who are risking their lives, literally. If we can identify that they’ve already inoculated the virus, and are therefore [potentially] immune, then [the fear of getting sick] doesn’t have to add stress to everything else is going on,” Dr. McClain says. “They can also go into work without a mask, so they don’t have to waste supplies. We can put those people on the front lines, and those who don’t have the antibodies we can choose to be more careful with.”

“If someone has developed immunity to this disease, this virus, what they’re able to do is extract these antibodies and give them to somebody else so they can better fight the disease.” —Dr. McClain

For the average citizen, the test could also be a game-changer. “People are being told to stay home, and in doing so may be losing their jobs, losing income, or may just be frustrated that they can’t get out and about to do exercise, or whatever it is,” says Dr. McClain. An antibody test that comes back positive could give the okay for someone to go back to work or go about the normal activities that make a life.

Dr. Sarin adds that these types of tests also have the potential to give the medical community a closer look at how COVID-19 operates. “Such a test may help scientists learn how widespread the infection is, and how long people remain immune after recovering,” she says. Plus, as research fellow Larisa Labzin, PhD, of the Institute for Molecular Bioscience at The University of Queensland told The Conversation, the test could give health-care experts a better sense of what populations are more prone to infection and why—which could inform future prevention and treatment guidelines. 

Researchers and doctors are also hopeful that antibody tests could eventually pave the way for plasma therapy. “Meaning, if someone has developed immunity to this disease, this virus, what they’re able to do is extract these antibodies and give them to somebody else so they can better fight the disease,” says Dr. McClain. “That’s something that would have to be done voluntarily by those people, but we’re all humans, and I can’t imagine that there will be anything less than a fairly large percentage of the population who would want to donate their plasma.” In fact, blood centers across the United States are already beginning to gather plasma and clinical trials on plasma therapy for COVID-19 are in the works.

It’s important to caveat that antibody testing is not a silver bullet—and many issues with the tests on the market have been revealed in recent weeks. Many companies, as mentioned before, took advantage of relaxed regulations to rush shoddy tests to market, to the point where the FDA has had to step in to investigate certain tests. They also come with a big risk of false positives, meaning there’s a chance it could tell someone they have antibodies to the virus when they don’t. Even the CDC now says antibody tests may be providing false positives up to 50 percent of the time in certain populations. We also still don’t know whether the presence of antibodies equals immunity—or if it does, how long that immunity will last. So the value of the antibody test continues to be pretty theoretical.

If I wanted a test, where can I get one?

Thanks to the CARES Act (which passed in April and provides stimulus money to coronavirus testing measures, among other things), health insurance companies are required to fully cover all COVID-19 tests, including antibody tests, with no out-of-pocket expenses. Most people should be able to get one for free, although, as Money reports, your insurance plan may have particular approved providers or tests that it covers; if you visit a provider not on their list, you might have to pay a bit upfront for the test.

If you’re interested in an antibody test, the best bet is to check the urgent care clinics in your zip code to see if they’re offering the tests. CityMD, for example, is offering the tests throughout its New Jersey and New York locations. You can also visit a LabCorp (a patient care-oriented drug developer) near you to get tested on-site. (The test itself is free, but they do charge a $10 fee for the physician order of the test.) Just be sure to cross-reference with your insurance company to make sure that a visit to those clinics will be covered. It also can’t hurt to run any and all of these options by your primary care doctor to hear their recommendations for moving forward with a test. Either way, take those results with a grain of salt and be sure to still practice safe social distancing, hand washing, and mask-wearing.

This post was originally published on April 3, 2020; it was updated on November 2, 2020.

Sign Up for Our Daily Newsletter

Get all the latest in wellness, trends, food, fitness, beauty, and more delivered right to your inbox.

HealthHealth Conditions

‘It’s Amazing How It’s All Connected.’ Here’s How Trauma Can Affect Your Pelvic Floor

Trauma and your pelvic floor are connected. Here's how trauma affects your pelvic floor, according to health experts.

alt
Photo: Stocksy/Marija Savic
Published Feb 2, 2025

Written by 

Heather Mayer Irvine

Content warning: This story contains references to suicide and physical and emotional trauma, which may be upsetting or triggering for some readers.

Experts in This Article

Alexandra T. Milspaw

an international consultant and educator for chronic pelvic and sexual pain

Lauren Garges

a women’s clinical specialist and the director of the pelvic health rehab program at St. Lukes University Health Network

advertisement

The only thing that stopped Zoe* from taking her own life was the love she had for her two children. But the indescribable chronic pain she was experiencing was all-encompassing. And none of her doctors—nearly a dozen—knew what was wrong. Worse, perhaps, they wrote her off, condescended her, passed her around from physician to physician. “They washed their hands of me,” Zoe, now 48, tells Well+Good.

After a year of medication and doctor visits and dismissed cries for help, for what was first suspected (never confirmed) to be a urinary tract infection that morphed into excruciating pelvic pain, Zoe found herself speaking with a pelvic floor physical therapist. She was diagnosed with a hypertonic—tight, overactive—pelvic floor. Now, the healing and treatment could begin.

What is the pelvic floor?

The pelvic floor is made of important muscles and tissues that hold pelvic organs, including the bladder, bowel, and uterus. Lauren Garges, PT, DPT, a women’s clinical specialist and the director of the pelvic health rehab program at St. Lukes University Health Network, likens the pelvic floor to a hammock of muscles. And, like the muscles in your neck, legs, or back, they can be too weak or too tight. But when a person experiences trauma, acute or over an extended period of time, it can lead to pelvic floor dysfunction, explains Garges.

Pelvic floor dysfunction is an umbrella term that refers to a host of issues, including urinary incontinence, pain during intercourse, constipation, and urinary frequency and urgency, Garges says. If left untreated, pelvic floor dysfunction can lead to chronic conditions, including back and hip pain. It can be hard to diagnose at this point because the root of the problem, in the pelvic floor, presents itself in the hip and back.

How trauma can affect the pelvic floor

Not only does the pelvic floor hold numerous organs, but it’s also where the vagal nerves are rooted. These nerves are part of the autonomic nervous system, which controls digestion, heart rate, and immune system, explains Alexandra T. Milspaw, PhD, an international consultant and educator for chronic pelvic and sexual pain.

The human fight-or-flight response to stress is linked to the autonomic nervous system, which means it’s impossible for a person to experience fight-or-flight without the pelvic floor tightening, Milspaw says.

Garges, who frequently refers her physical therapy clients to mental health professionals, says that trauma is incredibly individualized and subjective. Giving birth, for example, falls into the realm of trauma.

“Birth trauma would be the physical things that need to heal—torn muscles, stitches, nerve damage,” Garges says. “Some people recover quickly, in three to six months, but for others, it can persist for much longer, and that’s when you should see someone who can treat it.” Birth trauma can also be emotional, if, say, a woman’s healthcare team didn’t listen to her wishes, or the labor and delivery were traumatic.

advertisement

Garges also treats patients who have suffered from sexual assault or abuse, and she describes vaginismus, a type of dysfunction, as a protective mechanism—the body is literally closing itself off. (This can happen after other forms of trauma, too.)

But not all trauma, Garges explains, has to be physical for the pelvic floor to experience distress. “Emotional trauma presents physically in the body, tightness in the muscles,” she says, reiterating that the pelvic floor is made up of muscles. Someone who’s stressed or anxious might have tension in their shoulders and neck, others in their pelvic floor muscles.

Physical tension and stress create a cycle of inflammation that isn’t typically visible on imaging or through bloodwork, Milspaw says, which can make diagnosing these complaints and concerns incredibly challenging. “Anxiety or stress or a head injury can lead to a tight pelvic floor, which can cause [gastrointestinal] upset, which creates inflammation, which can be felt in the brain, and then we’re trapped in this cycle until we can turn off the switch at both ends at the same time,” Milspaw explains.

Eventually, Zoe started working with a pelvic floor physical therapist, who told her, “Your brain has learned this pattern [of pain],” Zoe recalls. “It goes far beyond the acute symptoms, which have resolved. Now your neurons are remembering this pain pattern.”

So in addition to pelvic floor physical therapy, which includes manual therapy, exercises, and breathing techniques, Zoe started seeing Milspaw for counseling. She says although she was surprised at the connection between mental health and pelvic floor dysfunction, “ultimately it made sense. If your nervous system is in constant fight-or-flight mode, it’s bound to have physical effects.”

What happens if trauma goes unchecked

The body is designed to protect itself, sometimes at all costs. This became apparent to Dianna B., 55, when she found herself begrudgingly speaking to a therapist at the request of her husband who was seeing a sex therapist. The couple, who had four children, had stopped having sex when Dianna was 43 and her sister was diagnosed with breast cancer.

On top of that, Dianna had a traumatic second birth, one that required 75 internal stitches. For years, she experienced unidentified pain near her where her stitches had been and bathroom accidents—bowel movement and incontinence. She was sure she had an anal fissure (tests showed she didn’t). “I sat there crossing my arms, saying, ‘I don’t have a mental health issue. I have a physical issue,” Dianna recalls.

Eventually, Dianna started to open up. She recalled being held down by her legs when she was 10 years old while doctors took bone marrow from her hips to give to her older sister who had leukemia. “She was going to die unless she got a bone marrow transplant,” Dianna tells Well+Good. “I was her donor.”

These repressed memories, Dianna says, came flooding back during therapy, and she started to see the correlation: She held trauma in her legs from her childhood and was retraumatized during her second delivery as an adult. “It’s amazing how it’s all connected.”

Milspaw, who has been working with Dianna for years, explains that if a person experiences intense stress, anxiety, or depression for a period of just 10 days, the hardware of the brain starts to change. For example, a 2021 study1 published in Translational Psychiatry, found that trauma exposure during childhood could contribute to structural changes in the developing brain. “It can shrink and deteriorate,” Milspaw says. “This hardware is specifically related to emotional regulation, memory, executive function, and communication.”

advertisement

Milspaw says this trauma is cumulative, that “the body keeps score.” She explains that people assume if there is pelvic or sexual pain, it has to be related to sex-related trauma, but that’s just not true. “People forget the nervous system is one whole system,” she says. “The pelvis is the center of the wheel.”

“People forget the nervous system is one whole system. The pelvis is the center of the wheel.” —Alexandra T. Milspaw, PhD

What to do if you have trauma that’s affected your pelvic floor

Once people know where to turn, trauma to your pelvic floor is treatable. But there are more than a few barriers to treatment, Milspaw says. “People don’t want to touch pelvic pain with a 10-foot pole,” she says. “There is a lot going on in the pelvis, and no one wants to be responsible for it.” The example she gives is the reality Zoe faced: See a gynecologist who sends you to a urologist, who passes you to a gastroenterologist, who kicks you back to a urologist.

Part of this problem, Milspaw says, is that most healthcare professionals are not trained in pelvic health. Another part of the problem is the taboo around sexual health and pelvic pain. People, especially women, do not want to discuss their concerns—Zoe and Dianna are examples of how even when they did try to seek help, they were treated like petulant children with no obvious illness or problem. “The shame piece is huge,” Milspaw says. “You can’t talk about how your vagina hurts as easily as you can talk about how your head hurts.”

Some women think what they’re experiencing is normal because they don’t know anything else. Milspaw gives an example of a high school girl who had incredibly heavy periods—soaking through five pads an hour. She was told, “It’s your period. Get over it.”

Savannah T., 25, suspected what she was experiencing was not normal. She was diagnosed with endometriosis in her late teens and has been through a pharmacy full of medications to manage her symptoms, including debilitating pain. Savannah, a nurse, slipped into a deep depression in 2021 because of her worsening health and working in the COVID-19 intensive care unit. She had to take a leave of absence.

She searched for a pelvic floor physical therapist—something not many people know to do. “My pelvic floor physical therapist educated me on what the floor is and what it does. She validated all of the symptoms I was having,” Savannah tells Well+Good.

Pelvic floor physical therapists provide treatment that can be a mix of exercises, stretches, breathing techniques, and manual tissue release. “When it comes to manual therapy, we have to be mindful of that trauma and maintain an alliance with the patient,” Garges says, noting that a physical therapist will follow a patient’s lead, and hands-on work might not happen for weeks or months.

Garges will prescribe yoga stretches that focus on the lower back to relieve tension, and pelvic exercises like lunges, squats, and hip work. Garges and Milspaw guide their patients through breathing techniques as well.

Milspaw teaches her clients a variety of tools, including emotional freedom techniques—a type of tapping that can assist with anxiety relief—bilateral stimulation music2 to help balance brain activity between the two hemispheres, and pendulation, which can help regulate the nervous system by alternating, or pendulating, between feelings of safety and discomfort.

advertisement

Once Milspaw establishes balance and a feeling of safety in her clients, then more traditional forms of therapy, including talk therapy, she says, are more effective.

Savannah didn’t realize how much her depression, stress, and anxiety connected straight to her pelvic floor. Whenever she had feelings of distress, they could be directly correlated to an increase in her pelvic symptoms. “With the combination of pelvic floor physical therapy and working with Dr. Milspaw, I’ve seen a huge difference,” Savannah says. She still takes medications for her endometriosis, but she knows what her life looks like without her physical and mental therapies. It’s dark.

There are brighter days ahead for Savannah, Zoe, and Dianna. They encourage others to advocate for themselves, even if a doctor—or doctors—is dismissive. They knew something wasn’t right and wouldn’t quit until someone took them seriously. “It’s been a journey,” Zoe says. “I’ve learned a lot about myself. I’ve rebuilt myself from the ground up, from the floor up.”

Dianna, who resented her husband for insisting she see a therapist because they weren’t having sex, now says it was the best gift he could have given her. They’re not quite on the same page yet, but Dianna says there’s hope. “That’s what I’m striving for.”

*Names have been changed, where indicated, to protect privacy.

  1. Jeong, H.J., Durham, E.L., Moore, T.M. et al. The association between latent trauma and brain structure in children. Transl Psychiatry 11, 240 (2021). https://doi.org/10.1038/s41398-021-01357-z

    ↩︎

  2. Amano T, Toichi M. The Role of Alternating Bilateral Stimulation in Establishing Positive Cognition in EMDR Therapy: A Multi-Channel Near-Infrared Spectroscopy Study. PLoS One. 2016 Oct 12;11(10):e0162735. doi: 10.1371/journal.pone.0162735. PMID: 27732592; PMCID: PMC5061320.

    ↩︎

Sign Up for Our Daily Newsletter

Get all the latest in wellness, trends, food, fitness, beauty, and more delivered right to your inbox.

All Stories

Food
Cooking
Recipes

25 Immune-Boosting Comfort Food Recipes

Cozy, comforting, *and* full of all the vitamins and minerals you could need to get yourself to spring happy and healthy? Look no further.

by Christina Manian, RD
on Mar 8
soba noodles
Shopping

Yes, You *Do* Need a Pair of Barrel Jeans—Because They Look Amazing on Everyone

If you think barrel-leg jeans seem too bold for your wardrobe, don't knock 'em until you've tried 'em.

by Jamey Powell
on Mar 8
barrel jeans trend
Shopping

The Best Wellness Sales This Weekend: Athleta, Cozy Earth, and More

Bargain shoppers, Well+Good is surfacing the best sales this weekend that you won’t want to miss. Ready, get set—shop!

by Khuyen Dinh
on Mar 7
alt
Health

It’s Time To Stop Believing These 7 Myths About Endometriosis

The biggest? That your pain is normal.

by Tabitha Britt
on Mar 7
person lying on their back on their bed while wearing a white tank top and light blue jeans, holding their stomach and worrying about endometriosis myths keeping them from getting diagnosed
Food
Nutrition

Hold Up: Is Your Nutrition App Working Against You?

Here are 6 warning signs experts say to watch out for when using nutrition and fitness apps.

by Korin Miller
on Mar 7
High angle shot of fitness young Asian sports woman relaxing after working out, lying on yoga mat and using her smartphone against sunlight in the morning, reusable water bottle and headphones by her side.