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Late and Chronic Lyme Disease: Symptom Overlap with Chronic Fatigue Syndrome & Fibromyalgia

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By Sam Donta,M.D.


Following the introduction of Borrelia burgdorferi into the skin

by an infected tick, the organisms begin to spread both locally

and systemically. Several days typically elapse before the

appearance of the first sign of infection, i.e., erythema

chronicum migrans (ECM), or other less typical rashes (29).

The rash occurs in fewer than 50% of patients with Lyme Disease

(8,10), but the true incidence of Lyme Disease in the absence

of a rash is unknown.

The occurence of multiple rashes is indicative of systemic spread

of the organisms. Multiple rashes usually do not occur until 2-4 weeks following the initial tick bite. This is the same time

period during which the organisms are being disseminated to their

target tissues and cells. The incidence of multiple rashes was

initially reported to occur in as many as 50% of cases, but has

been much less common in the last two decades, probably because

of frequent use of antibiotics.

Approximately 4-6 weeks following the tick bite, the first

systemic symptoms (other than multiple rashes) occur in some

patients, usually in the form of “flu” (15). These symptoms

include sore throat, severe headaches and neck aches, and severe

fatigue. Rhinitis, sinusitis, and cough are not usually present,

distinguishing this “flu” from other influenza-like illnesses.

While the Lyme-flu symptoms can spontaneously resolve, patients can experience recurrent “flu”.

Soon after the onset of Lyme-flu, fatigue, arthralgias and/or

myalgias may begin. The arthralgias appear to primarily involve

the large joints (i.e., knees, elbows, hips, shoulders), although

smaller joints (e.g., wrists, hands, fingers, toes) may be

involved(29). Some patients may have actual arthritis, often oligoarticular, more frequently in men than in women. Earlier estimates were that 50-75% of patients who developed late Lyme Disease had arthritis, but more recent analyses suggest that the incidence of actual arthritis in patients with late or chronic disease is closer to 25% (33).

Neck stiffness is common. The pains are described as severe, jumping from joint to joint, and may be present for only short periods of time. Pain in the teeth or in the temporal-mandibular joints is not uncommon. Rib and

chest pains occur frequently, leading some patients to seek care

in emergency rooms and urgent care centers for evaluation of

possible cardiac disease. Frequently as well are paresthesias such

as burning, numbness and tingling, and itching. Some patients

experience crawling sensations, vibrations, or electric shock-like

sensations. Rarely is there any actual palsy of the affected areas, making this much more of a neurosensory, rather than a motor, disease.

In addition to paresthesias, purely neurological symptoms and signs include headaches, an aseptic meningitis, facial nerve (Bell’s)

palsy, and encephalitis or encephalopathy that may be manifested by cognitive dysfunction, especially short-term memory loss, and

psychiatric symptoms such as panic, anxiety, or depression (14).

The aseptic meningitis and Bell’s palsy tend to occur within the

first few months following the tick bite, but may also occur as

part of reactivation disease (9).

Other symptoms may include fevers (usually low grade, but may be high), sweats (which may be severe), visual dysfunction (described

primarily as blurriness, but can include optic neuritis or uveitis),

tinnitus, sensitivity to sounds, or hearing loss. Shortness of

breath, palpitations and/or tachycardia, abdominal pains, diarrhea or irritable bowel, testicular or pelvic pain, urinary frequency

or urgency, dysequilibrium, and tremors are also common symptoms.

Some of the dysautonomia symptoms can be disabling.

Rarer symptoms may relate to panniculitis and hepatitis. Rarely as well are

congenital and intrautero infection; when this occurs, it appears

to be similar to toxoplasmosis and rubella, i.e., a primary infection

during the first trimester. The occurrence of optic neuritis or

uveitis raises other possibilities such as multiple sclerosis, but

can be part of Lyme Disease.

The course of the disease can best be described as persistent, but

with periods of worsening symptoms, often cyclical every few weeks

or monthly. Especially disconcerting are persistent symptoms such

as headaches and fatigue that can be exhausting. Some patients are more symptomatic than are others, which may reflect genetically- determined differences in responsiveness or extent of infection.

The disease does not appear to be progressive or destructive, as

with cancer, nor is it fatal, but can be very debilitating.

The incidence of asymptomatic infection has not been adequately

delineated. There appear to be substantial numbers of patients

who remain asymptomatic, but reactivate their disease a number of

months or years later, following trauma, pregnancy, a medical

illness for which an antibiotic is prescribed, or other stresses,

including psychological stresses (9). The Lyme OspA vaccine has

appeared to reactivate Lyme Disease in a number of individuals who

knew, but some who did not know, they had prior Lyme Disease (11).

The mechanisms responsible for the reactivation of the disease

have not been defined, but may include both molecular mimicry and

underlying infection.


The pathogenesis of Lyme Disease remains to be defined. From the

available studies, it would appear that the organisms are trophic

for either the endothelial cells of the blood vessels that serve

the nervous system or for the glial or neural cells themselves

(4,24,26,31). Accumulating evidence supports the hypothesis of

a persistent infection as the cause of the persisting or relapsing

symptoms (26,31). Whether molecular mimicry is involved in the

pathogenesis of some of the symptoms remains more speculative (18).

Although arthritis can occur in Lyme Disease, the organisms can

only rarely be found in synovial tissue. And as many of the

arthralgias that occur in the disease do not respond well to

antiinflammatory agents, the disease is more of an infectious

neuropathy than an actual invasion of synovial or bursal tissues.


The diagnosis rests heavily on the clinical symptomatology.

When there are clinical signs, e.g., rash, aseptic meningitis,

optic neuritis, arthritis, an appropriate differential

diagnosis must be pursued. On a clinical basis, “chronic

fatigue syndrome” or “fibromyalgia” cannot be readily

distinguished from chronic Lyme Disease. Indeed, accumulating

experience suggests that Lyme Disease may be a frequent cause

of fibromyalgia or chronic fatigue (8,12).

Other microbes have been proposed as causative agents of multisymptom disorders that are being termed chronic fatigue and fibromyalgia, especially

more recently recognized mycoplasma species such as M.fermentans

and M.genitalium, but definitive proof of cause and effect has

not yet been established (6, 23).

There has been an attempt to separate “late” Lyme Disease

from “chronic” Lyme Disease, the former being manifested by

objective signs of arthritis or neurological disease (32).

Some have denied the existence of chronic disease, inferring

that these patients suffer from psychiatric disorders; some

have used the term “chronic” to mean post-treatment disease

(“post-Lyme”), assuming that the infection has been treated,

and the remaining symptoms are in the same realm as those

patients who have “fibromyalgia” or “chronic fatigue” (27, 30).

These assertions are speculative and remain unproven. That

chronic Lyme Disease actually exists, and is likely the most

common form of the disease, is supported by epidemiologic

studies demonstrating that 30-50-% of treated and untreated

patients go on to develop a multisymptom disorder typical of,

and indistinguishable from, fibromyalgia and chronic fatigue

(1, 28). As with other multisymptom disorders, chronic Lyme

Disease is a clinical syndrome consisting of fatigue,

arthralgias and myalgias,and other nervous system dysfunction(7).

Furthermore, the results of treatment studies appear to support

the hypothesis that persistent infection is responsible for the

chronic symptoms. It is likely that Lyme Disease will serve as

a useful model for other chronic multisymptom disorders. Whether

the pathogenesis of “late” Lyme Disease differs from that of

the chronic form of the disease remains to be established.

Routine laboratory tests are usually normal in Lyme Disease.

The ESR is most often normal, distinguishing it from some of

the inflammatory disorders such as rheumatoid arthritis or

lupus. Culture of the borrelia is possible early in the

disease, usually from biopsies of the erythema migrans rash;

however, most laboratories are not capable of culturing the


The only currently available useful laboratory tests are the

immunologically-based ELISA and Western blot assays. The

recommendation was made in 1994 to have a two-tiered testing

system in which the Western Blot would only be done on ELISA- positive samples (5). The recommendation was based primarily on

the results obtained from patients with arthritis (13), did not

take into account the chronic form of the disease, and was made

despite the lack of consistent reproducibility of results between

various laboratories (2, 16).

The ELISA has been shown to be an unreliable test in many patients with Lyme Disease, both in early infection and later disease (8, 10). Part of the reason for the lack of sensitivity of the ELISA is the use of whole organisms, resulting in a high amount of background absorbance.

After correction for the high background, only a small percentage of

positives can be detected. Because Western blots separate the

proteins of the borrelia, specific reactions can be visualized,

and more accurate interpretations of the results made. Over 75%

of patients with chronic Lyme Disease are negative by ELISA,

while positive by Western blot (8, 10). Patients with

oligoarticular arthritis may be more likely to have robust IgG

responses and positive ELISA tests and IgG Western Blots (13).

By Western blot analyses, the first immunologic reactions in

Lyme Disease are to the 41kd flagellar protein, and the 23kd

OspC protein. Typically, at the time of the ECM rash, there will

be an IgM reaction against the 23kd and 41kd proteins, and no IgG

reactions. Within the next few weeks, the IgM reactions persist,

sometimes accompanied by less specific reactions against 60kd and

66kd proteins, and IgG reactions are now visible against the 23kd

and 41kd proteins. Thus, in the presence of an appropriate

clinical picture, the immunoreactivity against the 23kd and 41kd

proteins appear to be diagnostic of Lyme Disease.

Whereas the 41kd protein is not unique to B. burgdorferi, the 23kd

protein appears to be unique. Also apparently unique proteins of

B.burgdorferi are the 31kd (Osp A) and 34kd (Osp B) outer membrane proteins, and the 35kd, 37kd, 39kd, and 83/93kd proteins. Reactions

to the 31kd proteins are not usually seen until after a year or more following the onset of disease. Not all patients with symptoms for

more than one year, however, display reactions to the outer membrane


Most symptomatic patients have specific reactions on IgM

Western blots (8,10). With resolution of the symptoms, the IgM

reactions disappear or attenuate. IgG reactivity may continue

to be present with resolution of symptoms, but it typically also

disappears or attenuates with successful therapy. There are some

patients (20%) who have symptoms, but whose Western blots are

negative (8,10). If the borrelial organisms remain intracellular,

with no extracellular reemergence once established, this could

explain the absence of additional or persistent immune responses.

PCR (Polymerase Chain Reaction) is a highly sensitive means to

detect microbial DNA or RNA, and it was hoped that this technique

would find an important role in the diagnosis of Lyme Disease.

Thus far, however, despite the specificity of this method,

borrelial DNA or RNA has not been reliably detected in the blood,

urine, or spinal fluid of patients with early or later forms of

Lyme Disease, findings again supportive of an intracellular

reservoir for the borrelia.

It should be possible to develop a better, highly specific ELISA

for Lyme Disease, using recombinant 41kd, 23kd, 31kd and/or 34kd

(and perhaps other B.burgdorferi-specific) proteins. Currently,

however, the Western blot assay is the most reliable immunologic



In vitro, B. burgdorferi is sensitive to several antibiotics

(20,25). This assumption is complicated, however, because of

the long incubation times needed to determine minimum

inhibitory concentrations (MIC), as the borrelia have doubling

times of 20-24 hrs. With these limitations, the results of a

few studies show minimum bactericidal concentrations (MBC) to

penicillin of 8ug/ml, ampicillin: 2ug/ml, tetracycline: 1-2ug/ml,

doxycycline: 2ug/ml, ceftriaxone: 0.5ug/ml, cefotaxime: 0.5ug/ml,

cefuroxime: 1-2ug/ml, cefixime: 8ug/ml,erythromycin: 0.5ug/ml,

clarithromycin: 0.5ug/ml, azithromycin: 0.5ug/ml,

and ciprofloxacin: 4ug/ml.

At the time of the first rash, any one of several antibiotics

appear to be effective, if given for 2 weeks, according to several

published studies. However, a number of patients so treated

developed subsequent symptoms of arthralgias, fatigue, and

paresthesias, with positive Western blots, who were then

successfully treated with longer courses of antibiotics (8, 10).

The recommendation at this time, therefore, is that tetracycline,

doxycycline, or amoxicillin be used for 1 month if ECM is the

only symptom of Lyme Disease.

Once any other symptoms appear, the treatment of Lyme Disease

for only 2-4 weeks is associated with frequent failures and

relapses (8, 10). Our initial experience suggested that a 3 month course of tetracycline was associated with a higher success rate(8).

In patients with symptoms present for more than six months, the

treatment course may need to be more prolonged, or a retreatment

course of varying length may be needed. In patients with symptoms

for more than a year, 12-18 months may be needed for complete resolution of symptoms. The rationale for a longer treatment course is based on extensive observations (8,10), plus the analogy to the longer treatment courses required for tuberculosis, leprosy, Q fever, and certain fungal diseases.

With Lyme Disease, the slow growth rate and metabolic activity of the borrelia would seem to correlate with the need for longer treatment periods.

Once treatment is initiated for patients beyond the earliest

signs of infection, their symptoms frequently increase during

the first several days, or even for the first several weeks of

therapy. For patients with preexisting symptoms of more than a

few months, relief of any of their symptoms may not occur until

after 4-6 weeks of therapy (8, 10). Typically, there are short

periods of relief, followed by relapsing or migrating symptoms;

with continued therapy there are longer symptom-free periods.

Some arthralgias may require 3 months or more to resolve, and

fatigue may be the last symptom to disappear.

The preference for tetracycline evolved because of the large

number of failures that were noted in patients who had been

on ampicillin and doxycycline. Patients generally had some

response to doxycycline, but it was uaually not complete, nor

long-lasting. Tetracycline may be more effective than

doxycycline simply because of the greater dose, i.e., 100mg

of doxycycline twice daily is not equivalent to 500mg of

tetracycline three times daily; also, doxycycline is highly

protein-bound, compared to tetracycline, which could limit the

availability of free drug to diffuse into tissues and cells.

Some physicians use doxycycline at doses of 300-400mg daily to

try to achieve a successful result. A strict comparison

between doxycycline and tetracycline has not yet been

made. Minocycline has also been used by some physicians, with

varying success, but faces the same issues of dosage and

protein binding.

Of the beta lactams used for the treatment of Lyme Disease, the

most efficacious appears to be ceftriaxone. In limited comparitive trials, cefotaxime appears to be equally efficacious, and high-dose

IV penicillin may also be effective.

In early Lyme Disease, oral amoxicillin is as effective as doxycycline. In later disease, many failures are noted, despite the use of up to 3 grams of amoxicillin daily, with probenicid. Cefixime would also not appear to be

effective therapy. Cefuroxime axetil has been evaluated only in

the treatment of early Lyme Disease, and appears comparable to

doxycycline. Limited reports of its use in later Lyme Disease have

not shown it to be efficacious.

The role of the newer macrolides in the treatment of Lyme

Disease needs further assessment. Erythromycin has been regarded

as ineffective, despite its good in vitro sensitivities.

Azithromycin has been reported to be less effective in the

treatment of early Lyme Disease than amoxicillin (21). Some

physicians use clarithromycin and azithromycin in higher dosages

and for longer periods of time, but there have been no reports of

greater success with these drugs than with the tetracyclines or

beta-lactams. In our experience, all macrolides are effective

when combined with a lysosomotropic agent, especially

hydroxychloroquine(see below)(10).

In evaluating the possible factors, it would appear that

antibiotics that can achieve intracellular concentrations and activity are the most efficacious drugs. The results of studies in Klempner’s laboratory using a tissue culture model of borrelia infection demonstrated that ceftriaxone was incapable of eradicating intracellular organisms (17); similar experiments in Raoult’s laboratory using an endothelial cell model

demonstrated that tetracycline and erythromycin were effective,

but beta lactam antibiotics were not (3). These results are in line with our experience that the tetracyclines and macrolides achieve the greatest success.

In contrast to beta lactams, antibiotics of the tetracycline and macrolide classes are capable of good intracellular penetration. Experience with the macrolide antibiotics has been disappointing, however, when compared with

its in vitro activities against the Lyme borreliae, and with the established efficacy of macrolides against other intracellular parasites such as chlamydia, legionella, mycobacterium-avium intracellulare, and toxoplasma. If, though, the Lyme borreliae reside in intracellular vesicles that are acidic, the macrolides’ activity would be sharply decreased at the lower pH.

This is in contrast to the tetracyclines, which are active at acid pH; even

so, the activity of doxycycline was shown to be further increased by increasing the pH. In a tissue culture model of ehrlichia infection, the use of lysosomotropic agents such as amantidine, NH4Cl, and chloroquine increased the killing of intracellular organisms by doxycycline (22).

Based on those studies, and the hypothesis that late Lyme Disease symptoms are due to persisting intracellular infection, we have been successfully treating patients using the combination of a macrolide and hydroxychloroquine (10).

As regards “CNS” disease, there is no evidence that ceftriaxone

is more successful than either the tetracyclines or the combination of macrolide and hydroxychloroquine; if our presumption that the pathogenesis of the disease involves the localization of the borrelia to the endothelial cells of the blood vessels serving the nervous system or to glial or neural

cells is correct, then one would not need to have a drug that can cross the blood-brain barrier to be effective. Indeed, the tetracyclines can cross the blood-brain barrier to some extent, and were used when initially introduced into clinical medicine for the treatment of meningitis, with some success.

Macrolide antibiotics do not cross the blood-brain barrier, but have been

effective in treating other CNS infections (e.g., toxoplasmosis), and in our experience have been effective in reversing the neuropsychiatric symptoms and signs (eg SPECT scans) of Lyme Disease (10). With regard to the issue of bactericidal vs bacteristatic effects, any such effect in vivo has not been demonstrated.

Finally, there have been no reports showing any change in antibiotic resistance patterns during the course of treatment. Ultimately, the determination of efficacy of therapy depends on the clinical response.


The diagnosis and treatment of Lyme Disease have been

hampered by less than adequate diagnostic tests and inadequate

comparisons of antibiotic regimens. Specific antigen-based

ELISA tests should result in greater specificity, but

sensitivity of any tests based on measurements of the host

immune response might still be of limited value if the borrelia

remain intracellular. Most useful would be the development of

tests that can determine the presence and extent of any residual

borreliosis. In the therapy of Lyme Disease, double-blind,

placebo-controlled and comparitive trials are needed to answer

the questions relating to duration and class of antibiotic


The apparent failure of a regimen of one month of

IV ceftriaxone, followed by two months or oral doxycyline,

to improve the outcomes of patients with chronic Lyme Disease

(19) was not surprising, based on prior observations that neither

regimen used for a limited duration was capable of yielding

patient improvement (8,10,33). Additional trials are needed to

evaluate whether longer durations of treatment, using tetracycline

itself, or the novel combination of macrolide and lysosomotropic

agent, would be proven effective treatments.


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Sam T. Donta, M.D.

Professor of Medicine,

Divisions of Infectious Disease and BioMolecular Medicine Director, Lyme Disease Unit Boston University Medical Center, Boston, Massachusetts

Corresponding author for proof and reprints:

Sam T Donta M.D.

Boston Medical Center

650 Albany Street, 8th floor

Boston MA 02118

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28 thoughts on “Late and Chronic Lyme Disease: Symptom Overlap with Chronic Fatigue Syndrome & Fibromyalgia”

  1. Graham Mustow says:

    Wow, finally I have some answers, I had Lymes Disease in 1992. My symptoms come and go even now. Excellent, Thank You.

  2. Mariette says:

    Just fabulous. I have been diagnosed with chronic lyme disease as of October 27, 2010 It is a long story which I have started to write. So many years of miss diagnosis,such as fybromyalgia, heart arithmya with no cause, depression because of my extreme fatigue, not counting the series of specialist that came up with nothing. Only one of them validated that something was terribly wrong but just could not diagnose it. How? you may ask did it get diagnosed… by a passing comment of one of my lifelong girl friend. Asked for the test and voila… years later I have hope for my future. This article is the best so far. I have taken notes and will refer to it in my writing. I am working on establishing a blog in order to perhaps help others hope in this voyage that can be lonesome. Humm! you may want to look for words from a teacher such as ¨Sick of being sick¨.

  3. jesseharr says:

    Does anyone know the affects of lymes antibiotics have on the lymes testing. I have been sick for 3 yrs (Fatigue dizzyness,brain fog,trouble sleeping, achey all over, chest pain, no strenght) and am certain its lymes but tested negative. Iv been tested for everything else and my bloodwork always comes back excellent. I was on lyme antibiotics a month before i got tested for lymes could that affect the results? Also every spring and summer i am overcome with extreme fatigue much worse then fall and winter does that sound like something lymes does.

  4. jesseharr says:

    Does anyone know the affects of lymes antibiotics have on the lymes testing. I have been sick for 3 yrs (Fatigue dizzyness,brain fog,trouble sleeping, achey all over, chest pain, no strenght) and am certain its lymes but tested negative. Iv been tested for everything else and my bloodwork always comes back excellent. I was on lyme antibiotics a month before i got tested for lymes could that affect the results? Also every spring and summer i am overcome with extreme fatigue much worse then fall and winter does that sound like something lymes does.

    1. racjaa says:

      excellant article, Lyme disease does not always go away after initial treatment. Many doctors will not even treat patients after initial antibiotics course. It is great to read that studies support increased antibiotic treatment for those who have long term Lyme symptoms

    2. ddrsi says:

      This article could not be any more informative!! Long term symptoms, are right on, and the treatment discussion
      leaves the reader confident with the knowledge of the options.
      Anyone with long term symptons, knows how hard it is to describe their experiences to physicians.
      Thank you for writing this article

    3. rosterspot says:

      Having been recently diagnosed after a year of Lyme symptoms, I hope more patients and doctors find this information. The pathology of Lyme disease is very misunderstood by everyone but this article does a great job of explaining it.

    4. Classique says:

      My symptoms of Lyme Disease lasted over 18 months before I was diagnosed. Attributing the aches and pains and other problems with getting older. I was diagnosed and was put on a course of tetracycline for 30 days and it relieved my symptoms in the first week. Now though, I have reoccurring problems that I attribute to the Lymes. But going back to a health professional is something that I dread for the very reasons in the article. Will it be the Lyme’s Disease? If after tests show a negative to it where does one go from there. Hopefully the medical experts will come up with a more postitive test for this reoccurring problem.

    5. Ann-RA says:

      Very informative and helpful. Was told that my Rheumatoid Arthritis may have been caused by Lyme Disease. Glad to find some information relating to that poosibility and will talk to my rheumatologist about testing me. But will dr agree that there may be a link?
      Looks like the Western blot assay may be the test to have done? Is there more info about the link between the two diseases?

    6. USAMaid says:

      Since 1995 I have been treated for fibromyalgia. None of the drugs worked, so I discontinued all four years ago. Coincidentally I had a diverticulitis flare-up and was kept overnight in the ER and put on IV with broad-based antibiotic Unisyn. Amazingly, for two weeks after that IV, I had no pain anywhere in my body. I began to doubt the fibromyalgia at that point. Since pain responded to antibiotics, I began to think Lyme Disease. I am an avid gardener and live adjacent to a wetlands and nature preserve, so deer ticks would certainly be present.

      A year or so ago, my doctor told me he saw faint Lyme bands in my bloodwork, so what we have here is a missed Lyme diagnosis.

      I have pain all over my body, cannot sit for more than half an hour without barely being able to walk upon arising, have tinnitus in my left ear, have crawling sensations across my neck and shoulders and have all-over itching at night. I actually keep a natural bristle brush by my bedside and scratch my body before going to bed at night.

      I own a retail store, so am on my feet six days a week. I’ve heard about Dr. Donta and would very much like to have him see me. After Christmas I will have more free time and will definitely make an appointment.

      The article was a treasure trove of information on every level. There is no doubt he knows his subject matter inside and out. I would give anything to be able to power walk again. I can barely walk without pain in my hips and the outsides of my thighs.

      This article gave me hope for the first time in 15 years.

    7. Matthew_McCabe says:

      I was looking for a gift for my friend suffering from CFS, and somehow stumbled upon this page with such an extensive collection of medical knowledge. My friend loves hand gels, and I was wondering if anyone knows a particular one that might be good for CFS patients.

    8. historygenie says:

      My husband has had this since October 1987, but it took 7 months before we had a diagnois on his medical problem, by chance it was our watching an article on 20/20 back then, we figured out what was wrong.

      He is now going through his 4th onslaught of this disease, and I will have to find a specialist in our area to treat him. Since the family doctor who is wonderful, does not grasp the dire medical problems this can and is causing him. It has taught me to be very pro-active on this matter, since so little is known and you have to become your own researcher if you want the medical facts.

      This article proves what we all have been telling the medical community, this disease does not come with simple instructions you have to listen and learn. Thank you Dr. Sam Donta.

    9. JeffP. says:

      The tests for lyme are not reliable. You sound like you have lyme disease. Most MDs are not fully equipped to treat or even understand the disease. Antibiotics would affect your tests as the spirochete would change form in your body and become undectable. It has 3 forms and once treated the spirochete hides in the body. So your lyme results would come back negative. You need to find a lyme literate doctor and push your way into prolonged(Months of) antibiotic treatment. 2 weeks does something… but not enough. Stay strong. There’s light at the end of the tunnel.

    10. StephGorsuch says:

      Has there ever been a study on the correlation between Lyme disease and Ehler Danlos Syndrome patients?

    11. rg02 says:

      Lyme is a spirochete. Syphilis is a spirochete. Why is Lyme not treated in a prophylactic manner as is syphilis. Same symptoms, same progression to include latent periods.

      Never had Lyme myself but had recurring tick fever(1972) in line with Rocky Mountain spotted fever. Diagnosed only after several months and several physicians. Cardiologist told me to get prophylactic antibiotics for any tick bite as I would now have limited resistance and disease could progress while never demonstrating a rash. This was an easy request from any physician until ~10yrs ago when physicians began to refuse as I did not present with ” bulls-eye” rash. I get the deer-in-headlights look when I say Rocky Mountain doesn’t have a bulls-eye rash.

      What has changed in medical thinking?

    12. richcarson says:

      I am impressed with the excellent article.

    13. Granny2Shoes says:

      Dr. Donta diagnosed me at 30 years after being sent to him by an acupunturist. My crazy history, plus brain sprct scan, were convincing. My scan belonged in a textbook, he said, the perfet picture of 30 years of Lyme.
      As an RN I wondered while so many die within months what do some of us have in our genes that we can live so long. Dr. Donta said he had patients over 40 yrs with it, and here I am. I’m in RI where I began, where docs still think I have fibromyalgia and chronic fatigue.
      I wish I could donate my brain to Lyme research. ~Granny2S.

    14. MickeyMousey says:

      I have been suffering for five years from Lyme Disease type symptoms. I go through periods of remission & as the years have progressed my symptoms seem to have got slightly milder which is great. However, the initial onset of symptoms were incredibly severe causing collapse & admission to hospital, (symptoms included severe disorientation, complete & utter fatigue, flu like illness, muscle pain in legs & knee joints, sometimes being unable to stand).
      I was given just about every test, (not for Lyme), & all was negative. Two years after the onset of the initial illness & after several chronic relapses l insisted on being tested for Lyme. This came back negative.
      Six months before the illness started l was on a walking holiday in rural France. We were in a forest that had some deer & l remembered l got bitten on the back of the leg. I thought it must have been a large horse fly as there was a lot of blood from the spot of the bite. My husband remembered that the site of the bite produced a round bullseye type of rash, (l had forgotten this). My illness symptoms did not start until six months after this incident. Can there be a six month delay from an initial bite to first symptoms?? I would be grateful if you could let me know.
      Some Doctors in Britain do not know enough about Lyme Disease or even recognise it as something that effects this country so it is very hard to get a definitive diagnosis over here which is very frustrating. Over time l have learnt to deal with the relapses as they occur & except it as something l have as fighting it makes you feel a lot worse.

    15. crowb1kanobe says:

      Contact ILADS they can find you a lyme specialist. I know British Columbia has them. Hope you are well.

    16. tickbit says:

      I am a male at 44yrs of age. I am an avid outdoorsman who was bitten on my neck over a year ago by a tick. My first symptoms started as blurred and double vision, followed by confusion, brain fog and short term memory issues. Then came severe fatigue, weakness, shortness of breath. blood in urine, enlarged heart with pains in chest and ribs. Now my arthritic symptoms are extreme throughout whole body. My fingers and knees, elbows, and ankles and toes will actually lock up at times. I now have glasses as my vision became so poor. At times can hardly catch my breath.About one month ago i literally thought i might die from this. I need to see a Dr who can help prove i am fighting Late stage or Chronic Lyme Disease. I am also experiencing pain in my temple areas of my skull that radiates upward, an and MRI proved it has damaged my brain. Uncontrollable itching at night, shooting pains throughout body,frequent urinating, loss of 20lbs in 6 week period of onset of these symptoms. really to many to list. I live in Northern Michigan and am fighting like crazy to cope with it. Can anyone help ????

    17. cazoome says:

      this artical is very good

    18. LymeDizease says:

      I had Bells Palsy 3 times. 1990 I had it and it was idiopathic (no idea what caused it) 2nd time a couple years later, saw neurologists , and still ideopathic. After the 3rd time, there was enough written about Lyme Disease that my family physician put it together, and said the BP was a result of the Lyme. Top Drs checked me and said I have all the symptoms of Lyme, but no positive test results, but they are calling it Lyme Disease, if it walks like a duck, and quacks like a duck, then its a duck. Here it is 22 years later, and I still feel like shit, am stiff, swollen, and arthritic.. This aint no fun.

    19. jackcornwell says:

      I am a long term Lyme patient, 30 plus years. Undiagnosed do 9 mo. And relapsed later with more tetracycline. After that my life changed long term.

    20. nedmedic says:

      I was originally diagnosed with Lyme in 1991 after ending up in CCU for chest pains. The determination was Peri-Myocarditis 2nd to Lyme disease. I received 30 days intravenous Antibiotic. and symptoms abated but they return approximately every other month and I have continual chest pain that is at about a level 3 ( all the time) but can get as high as 7-10 when I am stressed.

    21. crowb1kanobe says:

      Tickbite….you must get an ILADS doctor. They will find then in two days time. Your symptoms are severe and you need to seek an lyme specialist asap. I hope you are ok. I am an RN and have been infected myself. I used them and I am so happy to have my doc. I feel like crap but I know im good hands. They are specifically trained in lyme. Igenex lab in CA is who you need to get adequate testing from. Take care

    22. enna1921 says:

      There is a difference between chronic fatigue and Chronic Fatigue Syndrome. The defining characteristic of CFS is post-exertional malaise. There are also many other symptoms that have nothing in common with Lyme Disease. Read the International Consensus Criteria on CFS/ME for the complete list. You dismissed CFS in the same way that some medical professionals dismiss Lyme Disease. Do better research before you make claims of overlap.

    23. LymeDiseaseEditor says:

      Hi tickbit –
      I am so sorry for your poor health. I have chronic Lyme disease and have experienced what you describe and it is horrible and frightening. You are not alone.
      First you need to find a Lyme-literate doctor in your area. The Michigan Lyme Association should be able to help you find a good one. The only reliable test for diagnosing Lyme is a blood culture by Advanced Lab Services in PA – it must be ordered by a doctor and you have to pay for it yourself but it will be verified by DNA so you won’t be guessing. The western blot and ELISA assay tests lose up to 50% of positive test results due to lack of antibodies or lack of sensitivity – especially in chronic cases. Once you have a diagnosis, the treatment is long – a direct ratio to how long you have been infected. Antibiotics have the best results for full recovery but again, if you have been sick for a long time you need large doses of antibiotics according to lyme experts. You can get a free copy of Dr. J. Burrascano’s Lyme disease Treatment Guidelines. Google that and you will find many free download sites.

      Prohealth will soon be covering Lyme disease with new products and resources to help. As the Lyme editor I am happy to help in any way I can.

      Be well,

      Jenna Seaver
      Prohealth Lyme Writer and Editor

    24. crowb1kanobe says:

      You will have to use Igenex Lab in California to get accurate testing. They do extensive testing. Unfortunately, they do not bill insurance. If you have an out of network coverage then a portion would be able to be submitted. For the Lyme, Bartonella and Babesiosis its about 1459.00. I know this because my lyme doctor just ordered them and I am going to have to pay out of pocket for them. You can find many sites with people telling you to use them. Also you can contact ILADS and they can find lyme specialists in your area. That’s how I found mine. I waisted 6 weeks of very critical time on going to MDs and internal med docs. I am also a nurse and this disease has turned my life into a living nightmare. I listen to Eckhart Tolle on youtube as he is an uplifting speaker. He wrote the book In the Now. ILADS specialists are trained extensively on all the bacteria, suppliments, treatment , life stages of bacteria, co infections, etc… Be well

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