Do You Have These Unusual Symptoms of Lyme Disease?

Don’t Let Lyme Disease Go Undiagnosed and Untreated

• Common Lyme Disease Symptoms|
• Unusual Symptoms of Lyme Disease|
• Lyme Disease Diagnosis|
• Does Lyme Disease Affect Gut Health?|
• Lyme Disease Can Be Treated at Any Stage|

Lyme disease is the most common tick-transmitted bacterial infection in the United States. The infectious disease occurs when a blacklegged tick carrying the bacteria known as Borrelia burgdorferi infects a human through its bite.

The Centers for Disease Control and Prevention (CDC) estimates that nearly a half-million Lyme infections occur every year in the U.S. Infections are most common in the northeast and upper midwest portions of the country. However, there’s recent data showing that this territory is expanding to include more and more parts of the U.S. [1].

An acute Lyme infection commonly presents with symptoms like:

• Joint and muscle pain
• Fever
• Malaise
• Headache
• Flu-like symptoms

However, symptoms of chronic Lyme disease tend to be more severe and unusual. A few categories of these issues are vision, heart, and neurological problems, including cognitive impairment.

In this article, we’ll discuss the common symptoms of acute and chronic Lyme disease, unusual symptoms of Lyme disease, Lyme disease diagnosis, and the relationship between Lyme and gut health.

Common Lyme Disease Symptoms (Acute vs. Chronic)

Before we dig into unusual symptoms of Lyme disease, we should make a distinction between acute and chronic Lyme disease and the common symptoms of each. Though the two share some similar symptoms, they also have distinct differences, and treatment varies greatly depending on the stage of the disease.

Acute Lyme Symptoms

Here’s one obvious difference: You’ve probably heard of acute Lyme disease presenting with a bull’s-eye-shaped rash. This rash is called an erythema migrans. Truthfully, this rash may or may not take the classic bull’s-eye shape, and it only appears in 70-80% of Lyme cases. It typically appears one to two weeks after the tick bite occurs [2].

However, this means that up to 30% of cases may not present with a rash at all, so more symptoms may need to be considered to make an accurate diagnosis.

These common symptoms of acute Lyme infection (borreliosis) include:

• Flu-like symptoms
• Malaise
• Headache 
• Low-grade fever
• Neck stiffness
• Red and watery eyes 
• Muscle pain (myalgia) 
• Joint pain (arthralgia)

If the infection is caught early, antibiotic treatment (with doxycycline, amoxicillin, or cefuroxime) is more likely to be effective [2]. Antibiotics are typically given for 10 days to two weeks, but they may be continued for longer if the patient has severe symptoms.

Chronic Lyme Symptoms

Chronic lyme disease often brings more complex and challenging (but still common) symptoms.

A systematic review of 55 studies found that the most common symptoms of chronic Lyme disease include the following [3]:

For chronic Lyme disease that was untreated: 

• Joint pain (arthralgia)
• Fatigue 
• Sensory changes (numbness, burning, tingling, or prickling sensation)
• Joint swelling
• Headache
• Skin discoloration

For chronic Lyme disease that had been previously treated:

• Joint pain (arthralgia)
• Fatigue
• Headache 
• Sensory changes (numbness, burning, tingling, prickling sensation, or lack of pain sensitivity) 
• Impaired memory
• Muscle pain (myalgia)

Comparing these acute and chronic symptoms, chronic symptoms appear to involve more long-term fatigue, pain (often in joints and muscles), and neurological symptoms like sensory changes and memory impairment.

Treatment of chronic Lyme is more complex, and co-infections with other tick-borne diseases such as ehrlichiosis and babesiosis may also have to be taken into account. If long-term antibiotics aren’t well tolerated or not recommended, antimicrobial herbs like Artemisia annua (sweet wormwood), Juglans nigra (black walnut), and Uncaria tomentosa (cat’s claw) may be effective to begin reducing the bacterial load [4].

Unusual Symptoms of Lyme Disease

This brings us to unusual symptoms of Lyme disease, especially in chronic cases.

Uncommon chronic Lyme disease symptoms may include the following [3]:

• Weight gain
• Difficulty breathing 
• Heart problems (abnormal heart rhythm, heart palpitations)
• Vision problems (blurred vision, double vision, progressive vision loss, fear of light/sensitivity to light, involuntary eye movement, eyelid swelling)
• Facial pain 
• Facial palsies (Bell’s palsy) 
• Stiff neck
• Ringing in the ears
• Hearing loss
• Orthostatic intolerance (lightheadedness and low blood pressure when going from sitting to standing)
• Vertigo
• Meningitis
• Poor memory
• Inability to concentrate
• Paralysis
• Tremors
• Numbness
• Loss of reflexes
• Balance issues 
• Urinary issues (incontinence, urgency, frequency, pain)
• Shooting pain or generalized pain

These symptoms may come along with common issues like fatigue and joint pain, and they may also come and go. You might also notice that many of these symptoms are quite general and could pertain to any number of conditions. This is how chronic Lyme disease earned the nickname “the great imitator,” making it difficult to diagnose in the late stages (long after the acute infection and any of its signs have passed, if there were any to begin with). 

Some additional conditions that can occur with chronic Lyme disease include fibromyalgia, meningitis (inflammation of the lining of the brain and spinal cord), inflammation of the heart (aka Lyme carditis), Parkinsonism (any condition that causes abnormal movement such as tremors), carpal tunnel syndrome, and arthritis [3].

This isn’t to say that you should worry about developing these conditions. We only mention them because, although they’re not considered common, they have occurred in some cases. These conditions also underline the importance of finding a Lyme-literate practitioner and pursuing diagnosis and treatment as soon as possible. 

Lyme Disease Diagnosis

Getting a Lyme disease diagnosis can be difficult. If the signs of Lyme disease are caught early, treatment has to be based on clinical evaluation and history (residing in or traveling to an area where Lyme disease is common), because blood tests are unreliable within the first few weeks of infection. In this case, time is of the essence to start antibiotic treatment while the infection is still recent and localized.

But in the later stages of the disease, lab testing consists of two steps:

• Step 1: Screening for antibodies to Borrelia burgdorferi using a sensitive enzyme immunoassay (EIA) or immunofluorescent antibody assay (IFA)
• Step 2: Western blot analysis (Step 2 is performed only if results from step 1 come back positive or uncertain)

The problem for most patients is simply getting to the point of lab testing. 

A 2011 survey study of 2,424 patients with chronic Lyme disease found that 37.5% of CLD patients reported seeing 10 or more doctors before obtaining a Lyme disease diagnosis, and nearly half reported having Lyme disease for more than 10 years [5].

Forty-one percent of responders reported being diagnosed based on a CDC-positive two-tier test result (ELISA and Western blot) or a CDC-positive Western blot alone, while 58.7% were diagnosed with other laboratory tests.

This suggests that over half of responders may have had a disease other than Lyme disease. The study authors concluded that Lyme disease patients frequently endure long delays in obtaining an initial diagnosis, have poor access to adequate healthcare, and suffer a severe burden of illness.

Does Lyme Disease Affect Gut Health? 

Gut symptoms occurring with Lyme disease seem to be discussed less than others. Most research focuses on the symptoms we outlined above — like fatigue, joint pain, and various sensory and neurological symptoms — as the typical manifestations of the disease [2, 3]. However, there are a few studies showing significant connections between Lyme and gut issues. 

One observational study examined the symptoms of 200 patients previously diagnosed with Lyme disease, who had presented to a medical clinic that specializes in treating Lyme disease. All 200 patients had been diagnosed with Lyme disease by a physician based on having an erythema migrans rash and/or positive lab test results.

The results showed that 79.5% of the Lyme disease patients had gut symptoms, of which [6]:

• 5% had gluten sensitivity 
• 5% had Celiac disease 
• 1% had colitis
• 21.5% had a yeast infection
• 7.5% had leaky gut
• 17.5% had parasites
• 8.5% had H. pylori exposure
• 18.5% had GERD
• 41.5% had IBS-type symptoms

Although the results of this study likely do not represent the average population of Lyme disease patients (since subjects in this study had presented to a specialty Lyme medical clinic), these patients do illustrate the possibility of gut symptoms with Lyme. 

Another study showed that patients with three or more digestive symptoms had double the odds of testing positive for a tick-borne disease. Food intolerances, indigestion, nausea, vomiting, constipation, and heartburn were each associated with testing positive for a tick-borne illness [7].

The study authors suggested that tick-borne illnesses should be considered in patients with chronic or unexplained digestive conditions that do not resolve. This may be especially true for patients who live in areas where Lyme and other tick-borne diseases are common.

The patients in these studies likely had more severe symptoms than what’s typically seen with a Lyme infection. Still, we can consider gut issues as potential Lyme symptoms if they’re showing up in suspected or confirmed cases of Lyme disease alongside other typical symptoms. 

Does Having Lyme Disease Change Your Microbiome?

Another angle on the question of gut health and Lyme disease is how the microbiome is affected by the illness. 

A 2020 observational study compared the gut microbiomes of patients with post-treatment Lyme disease syndrome (PTLDS) to that of healthy controls and patients from an intensive care unit (ICU). The PTLDS patients had been previously diagnosed with Lyme based on CDC criteria and received antibiotic treatment for their symptoms. 

Stool samples from 87 PTLDS patients were compared to samples from 169 healthy donors and 123 ICU patients. The results showed that the microbiomes of PTLDS patients strongly differed from both that of the healthy controls and ICU patients.

The authors stated that even though PTLDS patients had taken antibiotics, the differences in their microbiomes from the other groups couldn’t be explained by antibiotic use alone.

In particular, the PTLDS patients had an increased abundance of a bacteria (Blautia) that’s been associated with Alzheimer’s disease, non-alcoholic fatty liver disease, obesity, and multiple sclerosis.

Much more research needs to be done on changes to the microbiome with Lyme disease, but it doesn’t hurt to support your gut health with a healthy nutrient-dense diet, lifestyle practices like daily movement, and natural supplements like probiotics where needed. If you have Lyme and you want to improve your gut health, consult with your healthcare provider on the right strategies for you. 

Lyme Disease Can Be Treated at Any Stage 

When you have Lyme disease — or if you’re trying to figure out whether you have it or not — it might be a little anxiety-inducing to know all of the potential symptoms that can occur, common and uncommon. But none of these symptoms are guaranteed. We only share this knowledge to help you pinpoint your symptoms and then quickly move on to find a practitioner who can guide your treatment and help you feel better as soon as possible.

There are treatment options for any stage of the disease, whether you think you had a tick bite two weeks ago or you’ve been experiencing fatigue, joint pain, and brain fog for years. If you need a place to start, book a consultation with us at the Ruscio Institute for Functional Medicine.

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