Signs and Symptoms of Lyme Disease
by Kamau Kokayi, MD
The presentation and progression of Lyme disease symptoms typically occur in a series of stages. The first indication that an individual has contracted Lyme is often—though not always—the red circular or oblong bull's-eye rash described in our overview, called erythema migrans (EM), sometimes also referred to as erythema chronicum migrans (ECM) as it may develop and present at different locations on the body over time.
The telltale rash may emerge as a small red macule or papule at the site of the bite that expands to form a circular or oval-shaped (rarely triangular or irregular) rash on the skin. The EM rash can be described as a "bulls-eye," as the central, red, dark blue or purplish lesion may be encircled by a ring of clearing that is itself ringed by a band of reddened rash. Depending on the source, this condition is said to occur in anywhere between 37% and 70% of those infected with Lyme-causing bacteria.
As the infection spreads, a rash may develop at other sites around the body. Additional symptoms that can accompany the early stages of infection include neck stiffness, headaches, body aches and pains, fatigue, and depressed mood.
About half of those who are not treated with antibiotics develop recurrent joint swelling and pain within a period of months, most often in the knees. Approximately one or two out of ten people with untreated Lyme develop chronic arthritis (Lyme arthritis). These figures are estimates only, however, and remain in strong dispute, with many Lyme researchers and sufferers contending that conventional medical treatments fall short of success in many infected individuals.
For these individuals, problems in the nervous system, such as Bell's palsy, and numbness in the legs or arms, can also arise. Where antibiotic therapy fails, symptoms may progress to where there are multisystem manifestations. Less commonly, untreated individuals can develop hepatitis, heart problems, and severe fatigue.
Symptoms can vary markedly between individuals. Not everyone infected displays all the characteristic symptoms. Lyme disease symptoms overlap significantly with those of other tick-borne infections, including anaplasmosis and babesiosis. They also overlap significantly with symptoms of infections conveyed by Borrelia species other than B. burgdorferi, including B. afzelii or B. garinii, the primary causal agents of European and Asian Lyme disease, respectively. And they can additionally overlap significantly with symptoms of other debilitating health conditions, such as arthritis, fibromyalgia, chronic fatigue syndrome, and lupus. Any one or more of these conditions and infections can coexist in any given individual. Both this wide overlap of symptoms and the ability of spirochetes to cause "markedly different symptom pictures at different times in different people in different places" can make accurate identification and treatment of the causal agent extremely difficult.
The incubation period for Lyme disease—the interval between infection and onset of symptoms—varies from person to person, as well, but is usually of one to two weeks' duration. The incubation period can be much shorter (days) or much longer (months). In certain cases where the body's immune system is strong and its fighting capacity efficient, it can even take as long as a year or longer to manifest.
As a group, spirochete bacteria are highly adaptable masters of disguise, and can quickly undergo alterations in their physical form when conditions are unfavorable. These "encysted" forms can remain viable for many months and emerge when conditions improve.
The season during which initial symptoms most often occur is from May through September. The nymphal stage of the tick is responsible for most cases earlier in the season—after they have hatched out from the eggs that were laid by the adult tick late the prior season. At the nymphal stage the tick, and its bite, is very small and not easily noticed. As the tick grows into its adult stage it becomes about the size of an apple seed. It is just as capable of infecting humans in this form as in the nymphal stage.
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The effects of chronic Lyme disease can significantly affect your health, livelihood, and overall well-being. Conventional antibiotic therapy may provide an initial sense of relief, but if your symptoms should return, continue, or worsen in spite of conventional therapy, as they do in many Lyme sufferers, broadening your therapeutic options is a worthwhile step toward restoring both your health and your sense of well-being.
At Patients Medical we draw upon both modern and ancient healing arts to tackle the oft-times bewildering problems chronic Lyme disease presents in our patients. Our team of Lyme experts can develop a personalized, integrative treatment protocol designed to optimize your long-term health and support you in countering the symptoms and detrimental effects of Lyme disease.
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Signs and Symptoms of Lyme Disease—Citations and Further Reading
Date of Publication: 09/05/2005
Article Last Updated: 11/17/2011