6 Signs You Might Have Lyme Disease

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Lyme disease expert Dr. Richard Horowitz explains the six biggest signs that indicate you might be infected. 

By Richard Horowitz

Many people are confused when they first get a diagnosis of Lyme disease. You might be suffering from a myriad of seemingly unconnected symptoms, or have received conflicting diagnoses and/or treatments from your healthcare providers, some of which may work and others may not.

The reason for this confusion is not just that Lyme disease is complex, but more to the point, that you are unique. Your genetic makeup, and even the bacterial populations within the microbiome of your gut, is specific to you.

These factors affect how you react to infections as well as how you absorb nutrients, detoxify chemicals, create hormones, and handle inflammation. Each of us also carries different infectious burdens, including bacteria, parasites, viruses and/or fungi; varying levels of inflammation and immune dysfunction; possible food and environmental allergies; different toxic loads, detoxification abilities, hormone levels, and sleep and exercise habits; as well as different levels of cellular and organ damage from previous or underlying infections. In short, your prior and current medical status determine exactly how Lyme disease will affect your health. So how can you tell if you have Lyme disease?

Here are 6 major signs that you might be struggling with Lyme disease and co-infections:

1. You have more than one symptom. Lyme disease is a multi-systemic illness. Many of my patients present with a constellation of symptoms, which oftentimes include fatigue, pain, stiffness, tingling/numbness/burning/stabbing sensations, memory and concentration problems, and mood and sleep disorders. A score greater than 63 on the Horowitz Lyme - MSIDS Questionnaire (HMQ) infers a high probability of exposure and a score of 45-62 indicates probable exposure.

2. Your symptoms come and go with good and bad days (without an obvious reason).

3. Your pain migrates around your body. Joint, muscle, and nerve pains that come and go and migrate around the body are classic for Lyme disease and are not seen in other diseases like CFS/SEID, fibromyalgia, or most autoimmune illnesses. One exception is inflammatory bowel disorders, where transient migratory arthritis can be part of the clinical picture; however, we would expect a predominance of gastrointestinal manifestations.

4. Women’s symptoms tend to worsen right before, during, and after the menstrual cycle (hormonal changes and low estrogen levels often affect symptoms).

5. Symptoms often worsen or improve after antibiotic therapy (for Lyme or an unrelated infection like a urinary tract infection or upper respiratory infection). If you have been diagnosed with a nonspecific fatiguing, musculoskeletal illness and get better with antibiotics, it implies a bacterial origin to your illness. Worsening of symptoms can occur with antibiotic treatment due to a Herxheimer reaction (JH reaction), which is an inflammatory process secondary to the killing off of spirochetes. This usually resolves shortly after the antibiotic course is stopped, but symptoms may continue if you have angered the bacteria and “woke them up.”

6. You have positive blood tests for Lyme and associated tickborne diseases. The tests are not reliable (such as the ELISA and Western blot), and this is due in part to the different strains of borrelia that exist in the United States and Europe, which cannot all be picked up on standard testing. One way we can determine if you have been exposed to one of these borrelia species is that there are five bands (proteins) on the Western blot that are specific for borreliosis. These are the 23 (Osp C), 31 (Osp A), 34 (Osp B), 39, and 83–93 kdA (kilodalton) proteins. If you have many of the six signs and symptoms of Lyme disease, with a high score on the HMQ, and even one borrelia specific band on a sensitive Western blot, this implies that you have been bitten by a tick and that your symptoms may be due to Lyme disease or other borrelia species, especially if you have ruled out overlapping medical conditions.