IS LYME DISEASE CREATING MY SYMPTOMS?

Lyme Disease leaves no system of the body untouched. It wreaks its havoc eveywhere. It is called "the great mimicker" because, with its wide array of symptoms, it can look like countless other conditions. However, seeing the constellation of bizzare symptoms together in concert can often point toward Lyme Disease. Lyme Disease can also present differently depending on whether it is in the acute or chronic stage. Some people never have an acute stage and only become symptomatic well into the chronic stage.

Symptoms of Acute Lyme Disease occur within 1 month of a tick bite and may include: 

• Bullseye (erythema migrans) rash

• Flu like illness: fever, headaches, joint pain, swollen lymph nodes and fatigue

  
  

Acute Lyme Disease is typically treated with Doxycycline. If left untreated, it is conventionally associated with the following symptoms which can develop months after a tick bite:

• Bell’s Palsy

• Neuropathy

• Vertigo

• Lyme Carditis

• Arthritis 

• Myalgia 

• Tendonitis

Symptoms of Chronic Lyme Disease 

Chronic infection with Lyme Disease has been associated with extensive and far reaching symptoms, as it damages tissues and creates widespread inflammation. Some of the most common symptoms of chronic Lyme Disease include: 

• Extreme Fatigue

• Insomnia

• Migrating Joint Pain 

• Headaches 

• Generalized Pain 

• Myalgia

• Neuropathy 

• Depression 

• Cognitive Disruptions 

• Heart Problems

In addition to these general symptoms, Lyme Disease can profoundly impact nearly every system in the body. 

Systemic Impacts

Nervous System

One of the most impacted systems is the nervous system. Some type of system of nervous system involvement is present in almost all Lyme patients. This may be due to the presence of neurotoxin, a toxin produced by Borrelia capable of creating inflammation in the brain, and the

persistence of Borrelia cysts in nervous tissue. Neurological testing, including brain scans, while infrequently performed in clinical practice, reveals changes in the brain architecture of Lyme Disease patients. Some of the most common neurological manifestations include: 

• Nerve problems: neuropathies and nerve pain

• Cognitive Disruptions: memory loss, difficulty with concentration or focus. 

• Lyme Encephalopathy: non-specific symptoms of brain inflammation including but not limited to headaches, insomnia, difficulty with words, difficulty with recall. 

• Demyelinating Diseases: Lyme Disease can be a trigger for diseases such as MS and Guillain Barre. 

• Diseases of Motor Function: Lyme Disease can be a contributing factor to many diseases of the nervous system that impact motor coordination and function, including ALS. 

• Transient Paralysis: Paralysis of isolated muscle groups, as seen in Bell’s Palsy and hemiparesis have been associated with Lyme Disease. 

• Transverse Myelitis: This is caused by inflammation of the spinal cord and creates sharp, shooting pains along with bowel and bladder problems. 

Rheumatological System

Lyme Disease can be seen as a comorbidity or trigger for many autoimmune conditions, due to the widespread inflammation it creates and its intrinsic ability to trigger autoimmunity. Here are some of the most common rheumatological presentations of Lyme Disease:

• Joint Pain: Because Borrelia can persist in joints, it can create the joint pain characteristic of most autoimmune conditions. Unlike most autoimmune related joint pain, which follows a characteristic pattern, joint pain caused by Lyme Disease is migratory. 

• Persistent Fevers: Persistent or cyclical fevers may occur with Lyme Disease due to presence of co-infections. 

• Tendon & Myositis: Lyme Disease commonly creates inflammation of tendons, ligaments, and muscles.

• Autoimmune Conditions: Lyme Disease is most commonly associated as a trigger for Sjogren’s Disease, Scleroderma, Lupus, Antiphospholipid Syndrome and Rheumatoid Arthritis. 

• Syndromes: In those with Fibromyalgia and Chronic Fatigue Syndrome, a diagnosis of Lyme Disease may have been missed. Lyme is also a culprit to consider with mast cell activation, as one of its co-infections is associated with mast cell activation. 

Immune System 

Some of the most profound impacts of Borrelia are on the immune system. Some of the most significant interactions of Borrelia with the immune system include: 

• Immune Evasion: Borrelia can escape immune detection by hiding intracellularly and decreasing an immune process called complement, which helps the immune system tag foreign invaders for destruction. 

• Immune Suppression: Borrelia can kill or decrease the amounts of several types of white blood cells, including lymphocytes and natural killer cells. This makes the body more susceptible to infections, including viral infections. It can also decrease the communication between types of immune cells, responsible for alerting your immune system to the presence of an infection. 

• Immune Activation: Lyme Disease can activate autoimmunity by causing an overreaction of the immune system. It stimulates this increased reactivity in several ways. First, it causes the production of many types of inflammatory chemical messengers called cytokines. Two of these cytokines, CCL-2 and CXCL-13, recruit antibody producing immune cells to start inappropriately producing antibodies. Borrelia also creates DNA particles called blebs which can enter cells and turn on DNA responsible for autoimmunity. 

• Inflammation Promotion: Lyme Disease also creates something called a cytokine storm. This is a condition in which the immune system is so reactive, it is producing mass amounts of inflammatory chemical messengers. These damage tissues and can compromise brain function and energy levels. One of the major cytokines produced by Lyme Disease is called Nf- kB, which stands for NF- Kappa Beta. This is a master regulator of inflammation, turning on inflammation at the genetic level. It facilitates the production of other cytokines including IL-1B which increases risk of cardiometabolic diseases, TNF-Alpha which regulates the endocrine system and acute inflammation, IL-1 which promotes fever and sepsis, and IL-6 which increases intracellular superoxide and hydrogen peroxide and can activate the release of histamines.

Heart & Lung Impacts

Cardiovascular involvement is one of the widely recognized signs of late stage Lyme Disease. Lyme Disease can impact both heart and lungs. Here are a few of the most common types of cardiovascular and pulmonary involvement:

• Lyme Carditis: This is the most common type of cardiovascular involvement. Lyme Disease can cause inflammation of 1 or more layers of the heart wall creating pericarditis, myocarditis, endocarditis, or pancarditis. Symptoms included palpitations, chest pain, lightheadedness, or fainting. 

• Heart Block: This is a disruption of electrical rhythm that can occur as a result of Lyme Carditis. 

• Pulmonary fibrosis: This is scarring of lung tissue due to the fibrotic activity of Borrelia. Experts differ on how common this complication is.

Although these are the most common symptoms of heart and lung involvement, Lyme Disease may rarely cause sudden cardiac death; it may also have a role in the development of congestive heart failure. Lyme Disease has also begun to be implicated as a trigger for sarcoidosis and has potential to damage the diaphragm, leading to diaphragmatic paralysis. 

Gastrointestinal System

Lyme Disease can create primary symptoms in the gastrointestinal tract, symptoms created by the infection itself. These can include:

• Nausea &/or vomiting

• Diarrhea

• Abdominal Pain 

• Hepatitis

• Splenomegaly 

• Gastrointestinal Problems created by Borrelia damage to nerves: gastroparesis and pseudo-obstruction

Perhaps even more significant than these primary symptoms, are secondary symptoms created by the way Lyme Disease impacts the immune system. When immune function is compromised, patients are more susceptible to dysbiosis in the intestines as well as parasitic and yeast infections. Immune activation created by Lyme Disease can contribute to gastrointestinal inflammation and food sensitivities. The susceptibility to developing these conditions can create many different types of abdominal discomfort. 

Endocrine System

Lyme Disease neurotoxin may block hormone receptors in the brain and create dysfunction in

the HPA axis, the computer center in your brain that controls hormone production in the rest of your body.

Symptoms of HPA axis dysfunction may include: 

• Hypothyroidism

• Irregular or absent menstruation 

• PMS 

• Cortisol Imbalances 

Dermatological Impacts

There are a wide range of dermatological presentations of Lyme Disease. Borrelia can persist in skin cells called fibroblasts, which is responsible for making connective tissue. When overactive, fibroblasts can create fibrosis: a thickening or scarring of the connective tissue. Because of this, many of the skin conditions associated with Lyme Disease are fibrotic skin conditions or conditions involving thickened skin. Here are a few of the most common skin conditions associated with Lyme Disease:

• Erythema Migrans: This is the bullseye rash that indicates Lyme Disease. However, less than half of patients infected with Lyme Disease actually develop this rash. While its presence indicates Lyme Disease, its absence does not rule it out. 

• Fibrotic Changes: These included skin changes caused by thickening of connective tissue. One of the most common fibrotic skin changes seen with Lyme Disease is morphea: a skin condition characterized by patches of hardened, thickened skin. Those with Lyme Disease may also notice other skin conditions associated with thickened skin, such as lichen sclerosis or scleroderma. Although clinically uncommon, Acrodermatitis chronica atrophicans is widely recognized as associated with late stage Lyme Disease. In this skin condition, increased fibrotic activity leads to degradation of the skin to a tissue paper like consistency. 

• Vasculitis: Though not a skin condition, Lyme Disease may cause inflammation of the blood vessels with dermatological manifestations such as hives (urticarial vasculitis) or Raynaud’s disease. This vessel inflammation may also impact vessels internally, leading to more serious, non-dermatological conditions. 

• Lymphocytic Skin Conditions: These are skin conditions caused by the abnormal proliferation of a type of white blood cells called lymphocytes. This proliferation may be benign, simply causing a buildup of lymphocytes in skin, as seen in Jessner’s Lymphocytic infiltrate, or may be malignant as in the case of cutaneous lymphomas. 

• Eruptions of Chronic Disease: Lyme Disease can also present with skin eruptions characteristic of some type of viral or bacterial infection or autoimmune illness. These include erythema multiforme: a flat, red rash that starts on hands and feet and spreads, and granuloma annulare: a ring-like rash composed of red bumps. These can be seen with many different types of chronic illness and are not specific to Lyme Disease. 

• Hair Loss: This may occur due to the inflammation and physiological stress created by Lyme Disease or may occur due to the fibrotic scarring it promotes.

Renal Involvement

Lyme Disease can interfere with the filtration functioning of the kidneys and contribute to these kidney pathologies: 

• Nephropathies: This refers to a class of diseases caused by damage to kidney filtration. Specifically, Lyme Disease has been associated with IgA Nephropathy and Membranoproliferative Glomerulonephritis, conditions in which abnormal antibody reactions damage the kidneys. 

• Interstitial Cystitis: Lyme Disease can contribute to this chronic, painful bladder condition. Lyme Disease can also contribute to non-specific bladder pain and irritation.

Some doctors suggest that Lyme Disease may even play a role in promoting kidney failure.

Symptoms of dark, coke colored urine; blood in urine; elevated blood pressure; and retention of fluids suggest renal involvement of Lyme Disease. 

Eyes & Ears: 

Borrelia can persist in the eyes, creating a large range of ophthalmologic diseases. 

• Inflammatory: As with many types of chronic illness, Lyme Disease can create inflammation in the eyes and surrounding structures. This may present as red, painful eyes. 

• Vascular and Neural Inflammation: The potential for Lyme Disease to impact nerves and blood vessels can extend to eyes and create serious ophthalmological conditions.

  
  

Lyme Disease notoriously creates mitochondrial damage or damage to the energy production centers in our cells. Ears are full of mitochondria and are susceptible to the impacts of Lyme Disease, with symptoms such as: 

• Ringing in the ears

• Hearing changes

• Vertigo

  
  

Most of us could check off a few of these symptoms. Often, with Lyme Disease, these sympotms will accumulate gradually over the course of a few years, with no apparent common thread. In my own case, I slowly developed a renal disease, then an autoimmune condition, then an endocrine disease, then recurring fevers- all with slightly mysterious features. If you supsect you might have Lyme Disease, I recommend filling out the Lyme Horowtiz Questionnaire, which can give you a statistically backed score, quantifying your risk of Lyme Disease compared to other chronic conditions. I also recommend an accurate test. Knowing if you have Lyme Disease just might change your life.