Others may also complain of day sweats, night sweats and chills, as well as shortness of breath, with an unexplained cough if they have contracted babesiosis. A different tick-borne infection than Lyme disease, babesiosis can be transmitted with the same tick bite. It's a malaria-type parasite which makes people much sicker and difficult to treat with resistant symptoms.
2. You have good days and bad days.
A hallmark of Lyme disease is that the symptoms tend to come and go with good and bad days. Patients often tell me that some days they feel worse and other days they feel better, without having changed anything in their diet or exercise regimen.
3. The pain changes and moves around the body.
Another classic trait of Lyme disease is the migratory nature of the pain. The muscle and joint pain, as well as the tingling, numbness and burning sensations often tend to come and go and move around the body. For example, one day the joint pain might be in the knees. Three days later, it's in the shoulders, and two days later it's in the ankles.
The same symptoms can happen with Lyme neuropathy, where the bacteria have affected the nerves, and the tingling, numbness and burning sensations migrate to different areas around the body.
4. If you're a woman, your symptoms worsen right around your cycle.
Women will often have a worsening of Lyme symptoms right before, during, or after their menstrual cycle. Lyme disease symptoms are known to change with fluctuating levels of estrogen and progesterone.
5. Your symptoms improve when you're taking medication for other ailments.
Patients taking antibiotics for an unrelated problem (such as upper respiratory infection or urinary tract infection), will often report that their symptoms are much better while taking the antibiotic, and worsen when the antibiotic is stopped. Conversely, some individuals feel much worse on antibiotics, where all of their symptoms are intensified. This is called a Jarish-Herxheimer reaction, where the Lyme bacteria are being killed off, and temporarily worsen the underlying symptoms.
6. Blood tests have confirmed this.
The sixth and final point to determine if your symptoms are due to Lyme disease is to ask your health care provider to run a blood test called a Western Blot through a reliable laboratory, like IgeneX labs in California. There are over 100 different strains of Lyme disease in the US, and 300 strains worldwide, and IgeneX uses several strains to improve their testing.
Although there are several different laboratory tests to diagnose Lyme disease (like an ELISA test, Western Blot, PCR (DNA) test or occasionally a culture), these tests each have their pros and cons, and can miss establishing the diagnosis because they are not sensitive enough to always pick up the presence of the bacteria.
There are, however, five bands (proteins) on the Western Blot that are specific for exposure to Lyme. These proteins (bands) are the 23, 31, 34, 39 and 83/93 kdA bands. Any one of these bands on a Western blot with the above symptoms mentioned (having been properly ruled out for other diseases) is pathognomonic for Lyme disease.
A bullseye rash is also a classic manifestation of Lyme disease, and does not require a positive blood test, but less than 50% of people may get the rash, and it may be located in a part of the body where the rash cannot easily be seen.
If you suffer from chronic unexplained symptoms, including fatigue and musculoskeletal pain, here's a questionnaire to evaluate your probability of having Lyme disease. We did a study in my medical office of 100 patients with fatigue, aches and pains, and cognitive difficulties, and found that a score of 46 or higher was associated with a high probability of exposure to Borrelia burgdorferi, the agent of Lyme disease.
This six-step approach combined with the questionnaire can help you determine your likelihood of having Lyme disease.