Although Lyme disease has become commonly associated with joint pain and flu-like symptoms, the symptoms can imitate almost any disease under the sun.

For many, itchy arms, migraines and loose stools may not appear to have anything in common. That is why so many people can become infected with Borrelia and not even realize it.

And depression is so universal in our country that any stigma once associated with depression is long gone, and nobody even raises an eyebrow when their doctor prescribes anti-depressants.

When Lyme disease was first isolated, The Yale researchers focused on what they could see: the swollen joints and called the illness Lyme Arthritis.  However Polly Murraysuspected Lyme disease was causing prominent neuropsychiatric symptoms in her neighbors. Dr. Fallon, who was chosen to head the Columbia Lyme Research Center, made a home visit, interviewed her neighbors with Lyme disease, and then conducted a survey of over 1,000 people in the United States diagnosed with Lyme. The results surprised us; we learned that depression occurred far more commonly in these Lyme disease patients than in patients with lupus or rheumatoid arthritis.”

Lyme disease? Depression?

As a person who suffers from chronic Lyme disease myself I remember crying to my cousin in frustration after being diagnosed by a top Harvard Infectious Disease doctor in Boston with depression and fibromyalgia, “Of course I’m depressed, I am so sick…I am in so much pain…and I’ve been sick for over a month!” Little did I know then that I would be bedridden for 7 years and sick for decades.

The Lyme disease MSIDS epidemic is still growing and medical doctors are just beginning to understand some of the complexities.

Due to the ability of the disease to imitate just about any other disease, it is critical that a medical diary be kept and every symptom recorded (no matter how depressing that may feel, it could help you get care faster and recover faster!)

In the last few years, the answers are rolling in from research studies around the world. Lyme disease is a relapsing multi systemic infectious disease syndrome – hence the acronym MSIDS now accepted by most Lyme-literate medical doctors and researchers.  It is rarely a stand-alone infection, and in addition to the co-infections (SEE CO-INFECTIONS OF LYME DISEASE).

Dr. R. Horowitz who has treated over 12,000 patients from around the world, and other respected experts on Lyme disease, have agreed that is a sixteen point differential when diagnosing the other systemic conditions that contribute to the Lyme disease infectious “soup” that destroys a person’s health. This list is further explained in his new book “Why Can’t I Get Better?: Solving the Mystery of Lyme and Chronic Disease” published in November, 2013

  1. Lyme disease and co-infections (from tick bite)
  2. Immune Dysfunction
  3. Inflammation
  4. Environmental Toxins
  5. Functional Abnormalities and Nutritional Deficiencies
  6. Mitochondrial Dysfunction
  7. Endocrine Abnormalities
  8. Neurodegenerative Disorders
  9. Neuropsychiatric Disorders
  10. Sleep Disorders
  11. Autonomic Nervous System Dysfunction and POTS (chronic low blood pressure)
  12. Allergies
  13. Gastrointestinal Disorders
  14. Liver Dysfunction
  15. Pain Disorders/Addiction
  16. Lack of Exercise/Deconditioning

Lyme disease and tick-borne co-infections have enough complexity to drive even the most astute diagnostician” up the wall” in frustration.  Symptoms overlap, rashes can mimic others and some may seem completely insignificant when if fact it may be a key clue.  Or a rash that seems terribly important may be an allergic reaction having nothing to do with the most important symptoms and diagnosis.

So although this list at first seems to further muddy the water, MSIDS is an important diagnosis tool to help doctors to “see the forest through the trees”, or rather, to cross reference salient health conditions that could hide, amplify or further complicate the long list of Lyme disease symptoms.

The following list should not be used  to diagnose or rule out Lyme disease.  However, it is important to take these specific symptoms under consideration when you evaluate your own condition and before you see your doctor, and to make sure that your licensed medical practitioner is aware of all relevant medical information.

Remember, Lyme disease and co-infections can sometimes disable or increase mortality risk in patients of any age if not diagnosed and treated early in the infection. Writings in the past fifteen years have either viewed Babesia and Bartonella as mere “co-infections,” of Lyme even though they may be far more serious and/or life threatening.

Either infection can hide for decades, and then possibly disable or kill a person by causing a clot, heart arrhythmia or by other means.

Before you visit your Lyme expert for the first time, consider:


  • Weight loss or gain in excess of 20 pounds in 12 weeks
  • A round or oval rash with a dark center was or is present in a loose “bulls-eye pattern” or other size and shape rashes that have no other cause after exposure to ticks and vectors
  • Healing is slow after scratches or surgery. For example, after a cat scratch, flea bite or tick bite the mark is still visible later.
  • Skin on arms, hands or feet has a texture like rice paper.
  • Clear reaction and effect is seen with antibiotic treatment. Specifically, a marked improvement or worsening of a serious medical problem or function is observed with a spirochete killing treatment, e.g., doxycycline, tetracycline, minocycline, any penicillin such as amoxicillin, azithromycin, clarithromycin or cefuroxime.
  • Presence of skin tags, red papules of any size, excess blood vessels compared to peers, and stretch marks with color or in significant excess of peers.
  • Moles and raised or hard plaques in excess of the few on normal skin
  • Areas of skin with ulcerations such as those seen in syphilis, but at any location on the body
  • Areas of clear hypo-pigmentation and hyper-pigmentation
  • Positive ACA ( Acrodermatitis chronica atrophicans) which is a sign of long term untreated Lyme disease. Some report ACA begins as a reddish-blue patch of discolored skin, often of the hands or feet. It may include the back in some patients. The lesion slowly atrophies over months to years, with many developing skin that is thin, dry, hairless, wrinkled and abnormally colored. The color of the extremities such as hands and feet can be red, dark red, brown, dark blue or purple.


  • Patient’s short-term memory is poor. For example, if asked to recall these numbers—23, 5, 76, 43 and 68—the patient cannot recall them.
  • Patient cannot reverse four numbers, so if given—18, 96, 23 and 79—the patient cannot do it.
  • If asked to subtract 17 from 120, (college graduate), it cannot be done in a timely manner. If a high school graduate, subtract 7 from 100 and continue to subtract by 7 four times in 20 seconds.
  • Light headedness upon standing quickly in excess of peers, and with no clear cause
  • Dizziness unrelated to position
  • Dizziness made worse by Lyme killing antibiotics
  • Trouble doing a nine step heel to toe straight line walk test with fingers slightly in pockets [The patient should not sway or need their hands pulled out to prevent a fall]. In patients with past experience in skating, skiing, dance or ballet this should be very easy and is rarely a challenge to such people. If it is not easy, it is suspicious medically, but not only for Lyme disease.
  • Trouble performing a one leg lift, in which one leg is lifted 12-18 inches off the ground in front of you, as you count, e.g., “one Mississippi, two Mississippi, etc.”
  • Positive nystagmus [your eye jerks when you look right or left]


  • Pets or farm animals positive with ANY tick borne virus, bacteria or protozoa, or clinical symptoms without a clear diagnosis or cause
  • The patient’s  mother is suspected of having or has been diagnosed with Babesia, Ehrlichia, Rocky Mountain Spotted Fever, Anaplasma, Lyme, Bartonella or other tick borne disease based on newer direct and indirect testing, or clinical signs and symptoms.
  • A sibling, father, spouse or child with any tick borne infection
  • Casual or work-related exposure to outdoor environments with brush, wild grasses, wild streams or woods (Examples- golf courses, parks, gardens, river banks, swamps, etc.)
  • Pets, e.g., horses, dogs or cats, have had  outdoor exposures to areas such as brush, wild grasses, wild streams or woods.
  • Exposure to ticks in your past homes
  • Clear exposure to ticks during vacations or other travels
  • You played in grass in the past.
  • You have been bitten by fleas.
  • You have been scratched by a cat or dog.

The Tick Bite 

Have you had any of the following? 

  • Tick bite (deer, dog, or other)
  • Rash at site of tick bite
  • Rashes on other parts of your body
  • Rash (basically circular – called “bulls-eye” rash) and spreading out
  • Raised rash, disappearing and returning

Head, Face, Neck 

  • Unexplained hair loss
  • Headache, mild or severe
  • Twitching of facial or other muscles
  • Facial paralysis (Bell’s palsy)
  • Tingling of nose, cheek, or face
  • Stiff or painful neck, creaks and cracks
  • Jaw pain or stiffness
  • Sore throat


  • Double or blurry vision
  • Increased floating spots
  • Pain in eyes, or swelling around eyes
  • Oversensitivity to light
  • Flashing lights
  • Ears/Hearing
  • Decreased hearing in one or both ears
  • Buzzing in ears
  • Pain in ears, oversensitivity to sound
  • Ringing in one or both ears

Digestive and Excretory Systems 

  • Diarrhea
  • Constipation
  • Irritable bladder (trouble starting, stopping)
  • Upset stomach (nausea or pain)

Musculoskeletal System 

  • Any joint pain or swelling
  • Stiffness of joints, back, neck
  • Muscle pain or cramps

Respiratory and Circulatory Systems 

  • Shortness of breath, cough
  • Chest pain or rib soreness
  • Night sweats or unexplained chills
  • Heart palpitations or extra beats
  • Heart blockage

Neurological System 

  • Tremors or unexplained shaking
  • Burning or stabbing sensations in the body
  • Weakness or partial paralysis
  • Pressure in the head
  • Numbness in body, tingling, pinpricks
  • Poor balance, dizziness, difficulty walking
  • Increased motion sickness
  • Lightheadedness, wooziness

Psychological Well-being 

  • Mood swings, irritability
  • Unusual depression
  • Disorientation (getting or feeling lost)
  • Feeling as if you are losing your mind
  • Overemotional reactions, crying easily
  • Too much sleep or insomnia
  • Difficulty falling or staying asleep

Mental Capacity 

  • Memory loss (short or long term)
  • Confusion, difficulty in thinking
  • Difficulty with concentration or reading
  • Going to the wrong place
  • Speech difficulty (slurred or slow)
  • Stammering speech
  • Forgetting how to perform simple tasks

Reproduction and Sexuality 

  • Loss of sex drive
  • Sexual dysfunction

Females only:

  • Unexplained menstrual pain, irregularity
  • Unexplained breast pain, discharge
  • Pelvic pain

General Well Being 

  • Unexplained weight gain or loss
  • Extreme fatigue
  • Swollen glands
  • Unexplained fevers (high- or low-grade)
  • Continual infections (sinus, kidney, eye, etc.)
  • Symptoms seem to change, come and go
  • Pain migrates (moves) to different body parts
  • Early on, experienced a flu-like illness, after which you have not since felt well

If you have symptoms in three or more of the bodily systems listed, you must face the fact that your body could be waging war with the stealth bacteria known as Lyme disease MSIDS

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