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What are the symptoms of Lyme disease?

Lyme disease symptoms are wide-ranging, with more than a hundred different symptoms recorded. Symptoms can also change over time, as the bacteria spreads throughout the body. To make things more confusing, Lyme disease symptoms will also vary from patient-to-patient.


What are the symptoms of Lyme diseaseLyme disease can mimic hundreds of other conditions since its symptoms mirror many medical problems such as multiple sclerosis, arthritis, chronic fatigue syndrome or lupus, and is sometimes known as “The Great Imitator” because of this. Click here for a more complete list of possible symptoms.

Symptoms can play a key role in diagnosing Lyme disease. Due to the lack of an accurate diagnostic test, many patients are diagnosed based on a combination symptoms and diagnostic testing. This makes it extremely important for patients to keep track of all the symptoms they experience, to share with their healthcare provider.

Lyme disease symptoms can vary based on stage of the disease (early, late, post-treatment, or chronic) and if other tick-borne infections are present and can change over time.

Symptoms in acute Lyme disease

Acute Lyme disease (aka: early localized LD) occurs days to weeks after the initial tick bite and infection, in which the bacteria have not yet spread from the site of infection in the skin.

ESymptoms in acute Lyme diseaseThe most common symptoms in acute (aka: early localized) Lyme disease are the ones people are most familiar with, because they are symptoms often shared with other illnesses; however, it’s important to recognize that they could indicate Lyme, and you should see a Lyme-treating physician right away.

  • Erythema migrans (AIR-ih-THEEM-ah MY-grans) rash or EM rash. This rash begins at the site of the tick bite about a week after the bite, and gradually expands. Note: The center of the rash may clear, giving the rash the appearance of a “bulls-eye.” Rashes may take on many different shapes and not all rashes will have a bulls-eye appearance. There can be multiple rashes on the body. While a rash is characteristic of Lyme disease, many people will not develop a rash at all.
  • Fever
  • Fatigue
  • Aches
  • Chills
  • Swollen lymph nodes
  • Other flu-like symptoms
Symptoms in early disseminated Lyme disease

Early disseminated Lyme disease occurs days to months after infection, in which the bacteria have begun to spread. There is a wide range of possible symptoms at this stage, including:

  • Severe headaches and neck stiffness
  • Arthritis, especially in the knees or other large joints
  • Muscle aches and pains
  • Heart palpitations or shortness of breath (Lyme carditis)
  • Facial paralysis on one or both sides (also known as Bell’s palsy)
  • Numbness or tingling in the hands or feet
  • Extreme fatigue
Symptoms in late stage Lyme disease

Late stage Lyme disease, which can include post-treatment, chronic, and neurological, occurs months to years after infection, in which the bacteria have spread throughout the body.

The symptoms of late disseminated disease are similar to those of early disseminated disease, but may be more extensive, more severe, and longer lasting. Late symptoms may also include:

  • neurologic features including vertigo or dizziness,
  • difficulty sleeping
  • mental fogginess
  • difficulty following conversations
  • difficulty processing information
Some common questions …
When should you see a doctor for Lyme disease?

As soon as you have visual proof of a tick bite (remember to save the tick and send in for testing) or you suspect Lyme disease based on the symptoms listed above, consult a Lyme treating physician. The sooner treatment is started after a tick bite, the more effective it is.

Is it OK to stop treatment if symptoms disappear?

No. The absence of symptoms does not mean the disease is gone. It’s important to consult with your doctor even if symptoms disappear.

What if symptoms persist after treatment?

It’s important to remember that up to 20% of those diagnosed and treated early will continue to have symptoms. This means that even if you have undergone treatment, you could still have Lyme disease. Keep track of all symptoms and share with your healthcare provider.

It remains unclear why some patients, despite antibiotic treatment, continue to experience symptoms of Lyme disease. Possible explanations include persistence of antibiotic-tolerant bacteria, autoimmunity triggered by prior infection with the Lyme bacteria, or perhaps co-infection with other tick-borne pathogens. These mechanisms of chronic disease are not mutually exclusive.

What if you suspect Lyme disease and have never been diagnosed or treated?

If you suspect Lyme disease, even though you don’t recall a tick bite or a rash, it’s important to consult with a Lyme physician right away. Untreated, Lyme disease can spread to other parts of your body for several months to years after infection, causing arthritis and nervous system problems.