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.

Some individuals may experience a rash or multiple rashes known as erythema migrans (EM). A rash may occur days or even a month after a tick bite. The EM rash is a less reliable symptom for diagnosis because the number of people who develop a Lyme rash differs greatly, ranging from approximately 27% to 80%. The presentation of a Lyme rash may also be less noticeable due to variations in size, or color, formation in hard-to-see locations such as in the hair, or on those with darker skin tones. A rash at locations other than the bite site may be associated with early disseminated infection.

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

Late-stage, disseminated, 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 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.

Symptoms List

Left untreated, Lyme patients often develop clusters of symptoms as the Lyme bacteria disseminates throughout the body. Lyme patients often describe symptoms that wax/wane and or migrate.

This symptom list is broken out by each bodily system that Lyme disease may impact but does not cover co-infections. To learn more about how other infections such as Bartonella, Babesia, Anaplasmosis, Ehrlichia, or Rocky Mountain Spotted Fever present in patients, check out our Introducing Co-infections page.

It is important to remember every patient is different and may not necessarily present with all of these symptoms. They are listed in no particular order. To see if you may have a clinical presentation of Lyme disease, take our Symptom Questionaire.


  • Fatigue
  • Swollen lymph nodes
  • Unexplained fevers, sweats, chills, or flushing
  • Sore throat


Any symptoms impacting your brain are known as Neuropsychiatric Lyme.

  • Headaches
  • Neuropathy (nerve pain, numbness, hot/cold/burning sensations, tingling)
  • Psychiatric (e.g. depression, anxiety, rage, mood changes, obsessive-compulsive disorder, etc.)
  • Bell’s Palsy
  • Sleep impairment (falling or staying asleep)
  • Cognitive impairment (brain fog)
  • Memory loss
  • Disorientation or confusion
  • Difficulty with speech or writing (slurred or slow; word finding)
  • Lightheadedness, dizziness, or poor balance
  • Facial paralysis (Bell’s Palsy)
  • Sensory sensitivity (light, sound, touch, taste)
  • Postural Orthostatic Tachycardia Syndrome (POTS)
  • Weakness or partial paralysis
  • Seizure or stroke-like symptoms

Cardiological System

Any symptoms impacting your heart are known as Lyme Carditis.

  • Fainting
  • Shortness of breath
  • Heart palpitations, skipped beats, flutter, premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
  • Chest pain
  • Irregular rhythms such as tachycardia, bradycardia, or pauses
  • New heart murmur

Musculoskeletal System

  • Facial nerve (Bell’s) palsy (facial muscle weakness or paralysis)
  • Muscle aches or stiffness
  • Muscle pain
  • Muscle spasms, twitching, or cramps
  • Joint pain, especially migratory pain in larger joints
  • Joint stiffness or swelling
  • Shin splints
  • Temporomandibular joint dysfunction (TMJ/TMJD jaw pain)
  • Restless leg syndrome

Endocrine and Reproductive System

  • Hormonal dysfunction
  • Loss of libido
  • Unexplained weight gain/loss
  • Unexplained hair loss
  • Testicular/pelvic pain
  • Unexplained menstrual irregularity
  • Unexplained breast pain

Gastrointestinal System

  • Nausea or vomiting
  • Change in bowel function (Constipation, Diarrhea)
  • Acid reflux (GERD)
  • Abdominal pain (including “abdominal migraines”)
  • Irritable bowel syndrome (IBS)

Urological System

  • Irritable bladder or bladder dysfunction
  • Cystitis
  • Urinary incontinence
  • Frequent urination
  • Painful urination
  • Eyes and Ears
  • Blurry or double vision
  • Buzzing or ringing in the ears
  • Motion sickness/vertigo
  • Light or sound sensitivity


  • Various types of rashes. Learn more about Lyme rashes.
  • Increased allergic reactions, Mast Cell Activation, hives