13 Signs and Symptoms of Lyme Disease


Lyme disease is an underreported, under-researched, and often debilitating disease transmitted by spirochete bacteria. The spiral-shaped bacteria, Borrelia burgdorferi, are transmitted by blacklegged deer ticks. Lyme’s wide range of symptoms mimic those of many other ailments, making it difficult to diagnose .

The blacklegged ticks can also transmit other disease-causing bacteria, viruses, and parasites. These are known as coinfections (1). These ticks that transmit Lyme are increasing their geographical spread. As of 2016, they were found in about half the counties in 43 of 50 states in the United States.

Lyme is the fifth most reported of notifiable diseases in the United States, with an estimated 329,000 new cases found annually . But in some states, estimates suggest that Lyme disease is profoundly underreported. Some studies estimate that there are as many as 1 million cases of Lyme in the United States every year .

Most people with Lyme who are treated right away with three weeks of antibiotics have a good prognosis.

But if you’re not treated for weeks, months, or even years after infection, Lyme becomes more difficult to treat. Within days of the bite, the bacteria can move to your central nervous system, muscles and joints, eyes, and heart .

Lyme is sometimes divided into three categories: acute, early disseminated, and late disseminated. But the progression of the disease can vary by individual, and not all people go through each stage .

Every individual reacts to the Lyme bacteria differently. You may have some or all of these symptoms. Your symptoms may also vary in severity. Lyme is a multi-system disease.

Here is a list of 13 common signs and symptoms of Lyme disease.

1. Rashes

The signature rash of a Lyme tick bite looks like a solid red oval or a bull’s-eye. It can appear anywhere on your body. The bull’s-eye has a central red spot, surrounded by a clear circle with a wide red circle on the outside.

The rash is flat and usually doesn’t itch. The rash is a sign that the infection is spreading within your skin tissues. The rash expands and then resolves over time, even if you’re not treated.

Thirty percent or more of people with Lyme disease don’t remember having the rash  .

Even fewer people remember a tick attachment. Estimates range from 20 to 50 percent  . The ticks in the nymph stage are the size of poppy seeds, and their bites are easy to miss.

The initial red rash usually appears at the site of the bite within 3 to 30 days  . Similar but smaller rashes can appear three to five weeks later, as the bacteria spread through tissues  . Sometimes the rash is just a red blotch . The rash can also take other forms, including a raised rash or blisters  .

If you do have a rash, it’s important to photograph it and see your doctor to get treated promptly.

2. Fatigue

Whether or not you see the tick bite or the classic Lyme rash, your early symptoms are likely to be flu-like. Symptoms are often cyclical, waxing and waning every few weeks .

Tiredness, exhaustion, and lack of energy are the most frequent symptoms. The Lyme fatigue can seem different from regular tiredness, where you can point to activity as a cause. This fatigue seems to take over your body and can be severe.

You may find yourself needing a nap during the day, or needing to sleep one or more hours longer than usual.

In one study, about 84 percent of children with Lyme reported fatigue (8). In a 2013 study of adults with Lyme, 76 percent reported fatigue.

Sometimes Lyme-related fatigue is misdiagnosed as chronic fatigue syndrome, fibromyalgia, or depression (8).

In some Lyme cases, fatigue can be disabling .

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