What You Need to Know About Lyme Disease

Learn about Lyme symptoms and treatment.

Medically reviewed in February 2022

Think you know Lyme disease?

You’ve probably heard of Lyme disease, but if you’re like most people, you probably don't know too much about it. You know that you don’t want to contract it, but do you know the symptoms, treatments and ways to prevent it?  

Lyme disease is a condition fraught with misconceptions because it can have so many symptoms which might not show up for months or even years. Read on to learn more about Lyme disease and how you can avoid it. 

What is Lyme disease?
Lyme disease is one of the most common illnesses spread by the black-legged tick (also known as the deer tick or Ixodes scapularis, if you’re curious) in the United States. 

Why do they misspell the word Lime?
They don’t, actually. A little bit of trivia: the name comes from Lyme, Connecticut, where the first outbreak was detected in the 1970s.

Where is Lyme?
Sadly, these days it extends well beyond the borders of Connecticut. Lyme tends to concentrate along the East Coast (Virginia through Maine) and the Upper Midwest (specifically, Minnesota and Wisconsin). But since 2006, at least one case of Lyme has been reported in every state in the continental U.S.

What are the symptoms of acute Lyme infection?
The symptoms of Lyme are extremely variable and manifest in three stages over months to years. The first symptom tends to be a rash, which shows up anywhere from 3 to 30 days after the tick bite, but usually around 7 to 14 days after the bite. Roughly 70 to 80 percent of people will have a rash at the tick-bite site that may look like a bull’s eye. Early on, you may also have nonspecific symptoms such as fatigue, low-grade fever, mild joint or muscle aches.

Over the next days to weeks, Lyme can progress to more widespread symptoms, including problems with heart rhythm or memory, and even meningitis.

I hear you can get Lyme symptoms months or years lateris this true?
Months to years after an infection, you can develop what’s called “late disease,” which involves muscle and joint pain and, rarely, nerve symptoms.

Is there a treatment?
Yes. Lyme disease can usually be treated by a course of oral or IV antibiotics depending on its stage.

Can you develop “chronic Lyme disease?”
This is hotly debated. It’s definitely true that some patients can experience Lyme disease symptoms for several months after they have completed their antibiotics, but there’s no evidence that repeat antibiotics can be helpful (and at times, they can be harmful). Some doctors call these symptoms “post-treatment Lyme disease syndrome,” meaning that you no longer have the infection, but have remaining symptoms.  My concern with this? What’s been initially described as “chronic Lyme disease” has in some cases, been found to be other conditions, including cancer, sleep apnea, autoimmune conditions or uncontrolled endocrine disorders. So, it’s crucial to rule out and address other potentially harmful conditions first.   

Can you get tested?
Yes. There is a blood test and a cerebrospinal fluid test. Both test for the presence of antibodies to Lyme, which is why a test is often negative in the first few weeks—your body hasn’t produced antibodies yet.

In the first few weeks of infection, generally when a rash begins to develop, testing for Lyme can produce a negative result. So, if you’ve been in an area where the deer tick resides and have a rash characteristic of Lyme, your physician will often prescribe you antibiotic treatment based on your clinical symptoms alone.

If you’ve had the illness for a few weeks and have not yet received treatment, these tests would likely detect a “positive” response, indicating acute illness.

For most people, these antibodies will start to decline once you’ve been successfully treated. However, for some patients, antibody responses may remain present for years even if they no longer have the infection. A positive test does not necessarily mean you’re still infected.

Meanwhile, there are some misconceptions about Lyme that are worth trying to clear up.

1. Lyme disease does not have a cure.
In fact, Lyme disease is treatable and often disappears with treatment. Only a small percentage of patients experience prolonged symptoms. 

2. If you’ve never had the bull's-eye rash, you don’t have Lyme disease.
False! It is possible to have Lyme disease if you’ve never had a rash. Only 70 to 80 percent of patients develop a rash. 

3. You can get Lyme disease from a pet.
It’s not Fido’s fault... well, not entirely.  You can’t get Lyme disease from a pet, but pets can carry ticks.

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