What Are the Symptoms?

The range of Lyme symptoms is expansive, and trying to figure out what’s wrong can be overwhelming. Read this guide to better understand Lyme so that you can more accurately identify the illness.


Early-Stage Lyme Disease

In the early stages of Lyme disease, the illness may present as flu-like symptoms: fatigue, fever, enlarged lymph nodes, headaches, muscle aches, and joint pain. A neurological symptom known as Bell’s palsy or facial drooping may occur in certain people. 

Additionally, some individuals experience a rash known as erythema migrans or a bull’s-eye rash. Although the bull’s-eye rash is considered the hallmark symptom of Lyme disease, many patients never see one, or if they do, it looks nothing like a typical bull’s-eye and can easily be brushed off as something else. The statistics on the number of people who develop a Lyme rash differ greatly, stretching from approximately 30% to 80%

What’s more, many Lyme rashes documented in medical literature or online are shown on lighter skin tones. Though Lyme disease can affect anyone, on darker skin tones, the presentation of a bull’s-eye rash may be less noticeable due to variations in size and color and can easily be missed. 

The fact that Lyme rashes look different on various skin tones underscores the importance of healthcare providers to familiarize themselves with the gamut of signs and symptoms instead of an overreliance on the rash as diagnostic criteria for Lyme disease. 

Recent research also suggests heart involvement like Lyme carditis, a life-threatening symptom, may occur in 4% to 10% of Lyme disease cases.

Persistent, Chronic Lyme Disease

Persistent or “chronic Lyme disease” represents a large portion of the Lyme patient population. When a Lyme disease diagnosis is missed or delayed, the illness can progress to late-stage Lyme, in which ongoing, widespread, multi-systemic symptoms are present.  

Also, an estimated 10% to 20% of patients treated early with the CDC-recommended 10- to 14-day course of antibiotics will remain symptomatic for six months or more. This condition is known medically as post-treatment Lyme disease syndrome (PTLDS), and it insinuates patients are no longer infected with Lyme disease. But PTLDS is an ambiguous diagnosis, and the evidence for persistent Borrelia is building. Because the symptoms of PTLDS continue, many people categorize this condition as chronic Lyme disease as well.  

As persistent or chronic Lyme disease arises, some of the symptoms of the early stage might remain. However, several new ones emerge because Lyme bacteria disseminates (spreads) through the body. It can hide in tissues for months or years, avoiding detection by the immune system. 

When symptoms resurface, they may affect a multitude of organ systems, joints, and tissues. Though it’s not always so clear-cut, symptoms may correspond to the body system that’s been impacted. For example, cognitive impairment, sleep problems, and mood changes like depression and anxiety could indicate brain and nervous system involvement. Shortness of breath, heart palpitations, or fluttering in the chest might suggest cardiac issues. Other affected systems include gastrointestinal, endocrine, musculoskeletal, reproductive, lymphatic, skin, and urinary.   

Lyme is called “The Great Imitator” because its symptoms mimic many other health conditions. Many people experience symptoms in more than one body system. Symptoms of Lyme disease can appear and disappear without much rhyme or reason, jumping from one body part to another. 

The range of Lyme symptoms is expansive, and trying to figure out what’s wrong can be overwhelming. Persistent, chronic symptoms of Lyme disease can be life-altering and have a devastating impact on your quality of life. Project Lyme has partnered with Richard Horowitz, M.D., a board-certified internist, renowned Lyme disease specialist, author, and researcher, to bring you an interactive MSIDS questionnaire to track your symptoms and potential risk factors for exposure to Lyme disease. 

Published in peer-reviewed medical journals, the MSIDS model is a 38-point assessment to identify sources of infections, immune dysfunction, and inflammation contributing to your illness. After you’ve filled out the questionnaire, you can have the report emailed to you to print off and take with you when you visit your healthcare provider and begin the journey to feeling better.