The symptoms

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The classic symptoms of Lyme disease

Symptoms of Lyme disease vary greatly depending on a number of factors. First, they will differ according to the stage of infection. The disease has three main stages:

Early localized Lyme disease

This corresponds to the start of the infection, before the bacteria enter the bloodstream. Erythema migrans (redness of the skin) is the most common feature.

*In approximately 50% of cases, patients have no recollection of being bitten by a tick, nor of having exhibited the characteristic reddening of the skin. At this stage, some people will also present flu-like symptoms (usually between 3 and 30 days after the tick bite), while others will have no symptoms at all.

Early disseminated Lyme disease

It develops a few weeks to a few months after the initial infection, and represents the entry of bacteria into the bloodstream. It usually occurs if the disease has not been successfully treated in the previous stage. During this period, the patient will generally begin to show multi-systemic symptoms, such as skin, neurological and heart disorders.

Late disseminated Lyme disease (chronic Lyme)

Generally develops months to years after the initial infection. By this stage, the bacterium has generally already caused damage to numerous systems (nervous, heart, digestive, respiratory, reproductive, etc.), resulting in a number of bodily and cognitive dysfunctions. An interesting feature of this stage is that the bacteria can remain inactive for months or years, re-emerging in times of stress or illness. According to the literature, the disease generally worsens when the immune system is weakened.

It’s also worth mentioning that, since each individual is different, symptoms and manifestations will tend to be different for everyone.

A complete list of symptoms, along with examples showing what erythema migrans looks like, can be found in this comprehensive document by the INESS:

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Here is a partial list of symptoms that may appear in the acute phase of infection

  • Skin rashes (erythema migrans)
  • Fatigue
  • Fever and chills
  • Headaches
  • Flu-like symptoms (fever, headache, muscle and joint pain)

  • Stiff neck

  • Lymphadenopathies (swollen lymph nodes)
  • Neurological disorders
  • Arthritic symptoms

  • Palpitations

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The following is a chart for each system, including an extensive list of possible symptoms in the disseminated phase of the disease:

Head, face and neck

  • Headaches

  • Convulsions

  • Head pressure
  • White matter lesions on MRI
  • Facial or other muscle spasms

Eyes and vision

  • Double or blurred vision
  • Eye floaters
  • Pain and swelling around the eyes
  • Light hypersensitivity
  • Visual “Flashes”

  • Tunnel vision, peripheral vision disorders

Ears and hearing

  • Unilateral or bilateral hearing loss
  • Ear ringing
  • Feeling of blocked ears
  • Ear pain
  • Hypersensitivity to sound
  • Ringing in one or both ears

Digestive and excretory system

  • Diarrhea
  • Constipation
  • Stomach disorders (pain and nausea)
  • Gastro-esophageal reflux disease

  • Bladder irritability and Interstitial cystitis

Musculoskeletal system

  • Bone pains
  • Joint pain, stiffness and swelling
  • Muscle tensions

Respiratory and circulatory systems

  • Shortness of breath, difficulty breathing
  • Cough
  • Chest and rib pains
  • Night sweats and/or chills
  • Heart palpitations
  • Endocarditis, arrhythmia

Neurological system

  • Unexplained tremblings
  • Burning sensations, throbbing pains
  • Peripheral neuropathies
  • Feeling of pressure in the head
  • Numbnesses, tinglings and pricklings
  • Dizziness and motion sickness

  • Loss of balance and trouble walking

  • Lightheadedness
  • Drowsiness
  • Weakness and chronic fatigue

General well-being

  • Extreme fatigue
  • Unexplained weight loss or gain
  • Swollen lymph nodes
  • Fever flare-ups
  • Repeated infections
  • Multiple symptoms that appear, disappear and return
  • Pain in various parts of the body
  • Problems regulating body temperature
  • Allergies and multiple hypersensitivities
  • Alcohol intolerance

Psychological well-being

  • Mood swings, irritability, bipolarity
  • Unusual depression
  • Feeling disoriented or lost
  • Feeling like you’re losing your mind
  • Emotional hypersensitivity, crying easily
  • Hypersomnia or insomnia
  • Difficulty falling asleep or staying asleep
  • Narcolepsy and sleep apnea
  • Panic attacks and anxiety

Cognitive skills

  • Memory losses (short–and long-term)

  • Confusion, trouble thinking clearly
  • Brain fog
  • Difficulty focusing
  • Speech difficulties (slurred speech, search for words)
  • Forgetting how to perform simple tasks

Reproduction and sexuality

  • Loss of libido

  • Sexual dysfunction

  • Menstrual disorders
  • Breast pain and discharge

  • Testicular and pelvic pain

*IMPORTANT :

If you have 20 or more of these symptoms, we strongly recommend investigation for Lyme disease.

Since these symptoms are not specific to the disease and can be found in several other medical conditions, medical attention is required to clarify the situation.

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Co-infections

In addition to the Borrelia burgdorferi bacterium, ticks often carry other pathogens. Symptoms and clinical manifestations of each of these infections can either resemble or differ from those of Lyme disease, making diagnosis and treatment extremely difficult. In Quebec, babesia and anaplasma are the most common pathogens, but can also include bartonella, mycoplasma pneumonia and many others.

The following images show the different types of infection.

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The telltale signs Borrelia, Babesia, Bartonella et Mycoplasma

Shared symptoms

Borrelia

  • Stiff neck

  • Lyme carditis
  • Eye floaters
  • Bullseye rash
  • Bell’s palsy

  • Migrating arthritis

  • Joint swelling

Babesia

  • Chest and rib pain
  • Drenching night sweats
  • Body temperature fluctuation
  • Dyspnea (air hunger)

Bartonella 

  • Rage
  • Swollen lymph nodes
  • Unexplained cough
  • Stretchmark-like rash
  • Pain in the shin bones
  • Pain in the soles of feet (plantar fasciitis)

Mycoplasma

  • Respiratory infection
  • Sinus problems
Telltale signs of Borrelia, Babesia, Bartonella and Mycoplasma

The shared symptoms

  • Depression
  • Anxiety
  • Headaches
  • Cognitive difficulties
  • Brain fog
  • Sleep disorders
  • Heart symptoms
  • Fatigue
  • Fever
  • Chills
  • Autoimmunity
  • Digestive disorders
  • Bladder irritation
  • Muscle pain and aches
  • Joint pain

Mycoplasma symptoms

  • Depression
  • Anxiety
  • Headaches
  • Cognitive difficulties
  • Brain fog
  • Sleep disorders

  • Eye infection and eye problems

  • Ringing in the ears

  • Sinus problems

  • Heart symptoms

  • Respiratory infections

  • Fatigue
  • Fever
  • Chills
  • Autoimmunity

  • Burning and tingling in the hands

  • Digestive disorders

  • Bladder dysfunction

  • Muscle pain

  • Joint pain
Symptoms of a Mycoplasma infection
Symptoms of a Bartonella infection

Bartonella symptoms

  • Depression
  • Anxiety
  • Rage
  • Headaches
  • Cognitive difficulties
  • Brain fog
  • Sleep disorders

  • Eye Infections and eye problems

  • Tooth pain

  • Swollen lymph nodes

  • Heart symptoms
  • Anemia

  • Unexplained cough

  • Fatigue
  • Fever
  • Chills
  • Autoimmunity

  • Digestive disorders

  • Bladder dysfunction

  • Stretchmark-like rash

  • Muscle pain

  • Joint pain

  • Shin pain

  • Pain in the soles of the feet (plantar fasciitis)

Borrelia symptoms

  • Depression
  • Anxiety
  • Headaches
  • Cognitive difficulties
  • Brain fog
  • Sleep disorders

  • Dizziness

  • Visual changes

  • Eye floaters

  • Sensitivity to sound

  • Ear ringing

  • Bell’s palsy

  • Stiff neck

  • Heart symptoms

  • Lyme carditis

  • Fatigue
  • Fever
  • Chills
  • Autoimmunity

  • Arthritis

  • Burning, numbness, tingling of the hands

  • Trembling

  • Digestive disorders

  • Bladder dysfunction

  • Bullseye rash

  • Muscle pain

  • Joint pain

  • Joint swelling

  • Muscle fasciculations (spasms)

Symptoms of a Borrelia infection
Symptoms of a Babesia infection

Babesia symptoms

  • Depression
  • Anxiety

  • Cognitive difficulties

  • Brain fog
  • Sleep disorders
  • Dizziness
  • Heart symptoms
  • Anemia

  • Chest and rib pain

  • Shortness of breath

  • Fatigue

  • Fever
  • Chills
  • Autoimmunity

  • Drenching night sweats

  • Body temperature fluctuation

  • Digestive disorders

  • Bladder dysfunction

  • Petechiae

  • Jaundice

  • Dark urine

  • Muscle pain

  • Joint pain
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Symptoms of co-infections overview

Symptoms overview

General

  • Chills
  • Fatigue
  • Fever
  • Headaches

Neurological

  • Anxiety

  • Bell’s palsy

  • Body temperature fluctuations

  • Brain fog

  • Burning, numbness, tingling of the hands

  • Cognitive difficulties

  • Depression
  • Dizziness

  • Night sweats

  • Rage

  • Ringing in the ears

  • Sleep disorders

  • Hypersensitivity to sound

  • Trembling

Visual

  • Eye floaters

  • Infections and eye disorders

  • Visual changes

Lymphatic

  • Swollen lymph nodes

Immune

  • Autoimmunity

Cardiovascular

  • Anemia

  • Heart symptoms

  • Lyme carditis

Respiratory

  • Shortness of breath 

  • Recurrent respiratory infections

  • Sinus disorder

  • Unexplained cough

Uro-genital

  • Urinary dysfunctions

Gastrointestinal

  • Dark urine

  • Digestive disorders

  • Jaundice

Musculoskeletal

  • Chest and rib pain

  • Joint pain

  • Swelling (joint swelling)

  • Arthritis

  • Muscle pain

  • Muscle twitching

  • Pain in the shin bones

  • Pain in the soles of the feet

  • Stiff neck

  • Tooth pain

Integumentary

  • Bullseye rash

  • Petechiae (small red spots on the skin)

  • Stretchmark-like rash

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