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Lyme disease is caused by a spiral shaped bacteria (spirochete) called Borrelia burgdorferi. These bacteria are found in deer ticks.

The most common indicator of infection with Borrelia burgdorferi is a bull's eye rash around the area of a tick bite. These rashes are called erythema chronicum migrans. Rashes can also be less typical in shape. The rash occurs approximately 2-4 weeks following the initial tick bite. However, the rash is absent in at least 25 - 35 percent of people who become infected.  Typical treatment for Lyme disease is oral antibiotics (Doxycycline) for approximately 14-21 days.

  1. Fewer than 50% of patients with Lyme disease recall any rash.
  2. Fewer than 50% of patients with Lyme disease recall a tick bite.

Due to the large percentage of people that do not present with a rash, Lyme disease can go undetected and become a chronic Lyme infection. 

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".  Patients with chronic Lyme disease most commonly have sore throat, headaches and neck pain, severe fatigue, joint and muscle pain, sleep disorders and cognitive problems, also known as “brain fog”.

In addition, infection with Borrelia often results in a low-grade encephalitis (infection of the brain) that can cause depression, bipolar disorder, panic attacks, numbness, tingling, burning, weakness, or twitching. Some patients experience Bell’s palsy, which causes the drooping of one side of the face.

After several months, approximately 60% of patients with untreated infection will begin to have intermittent bouts of arthritis, with severe joint pain and swelling. Large joints are most often affected, particularly the knees. Chronic Lyme is a persistent and debilitating disease.

Symptom overlap between ME/CFS and chronic Lyme Disease 

The major symptoms of chronic Lyme disease that overlap with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) are:

  • cognitive dysfunction and mood changes
  • central nervous system irritability, including parathesias (numbness, tingling crawling and itching sensations)
  • fatigue
  • flu-like illness: fevers, malaise, headache, muscle aches
  • joint aches (arthralga) and intermittent swelling and pain of one or a few joints.
  • sleep disturbance

Due to these similarities, it is very difficult to tell the difference between the two illnesses especially if there's no tick-associated rash.