Unusual symptoms of Lyme disease may include heart problems like arrhythmia and palpitations, neurological issues like tremors or numbness, and difficulty with memory and concentration.
On the surface, there appears to be less of a connection between Lyme disease and gut symptoms, but the clinical experience of Lyme-focused physicians may differ.
Lyme disease can seem overwhelming and scary to address, but it’s absolutely treatable at any stage — and patients can live a normal life again.
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 burgdorferiinfects 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 Trusted SourcePubMedGo to source].
An acute Lyme infection commonly presents with symptoms like:
Joint and muscle pain
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 chronicLyme 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 anerythema 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 Trusted SourcePubMedGo to source].
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:
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 Trusted SourcePubMedGo to source]. 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 Trusted SourcePubMedGo to source]:
For chronic Lyme disease that was untreated:
Joint pain (arthralgia)
Sensory changes (numbness, burning, tingling, or prickling sensation)
For chronic Lyme disease that had been previously treated:
Joint pain (arthralgia)
Sensory changes (numbness, burning, tingling, prickling sensation, or lack of pain sensitivity)
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 Trusted SourcePubMedGo to source].
Unusual Symptoms of Lyme Disease
This brings us to unusual symptoms of Lyme disease, especially in chronic cases.
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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source, 3 Trusted SourcePubMedGo to source]. 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.
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 Trusted SourcePubMedGo to source].
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.
The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.
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