Lyme disease is a bacterial infection primarily caused by Borrelia burgdorferi and transmitted through the bite of infected black-legged ticks. It is the most common vector-borne disease in the United States.

Lyme disease can affect multiple body systems, including:

• The nervous system

• The joints and muscles

• The heart

• Cognitive and neurological function

Because symptoms often resemble other illnesses, Lyme disease is sometimes referred to as “the great imitator.”

Lyme disease is rarely transmitted alone. Typically, patients will also have been infected with co-infections (other bacterial infections) that need to be addressed.

• An estimated 476,000 Americans are diagnosed and treated for Lyme disease each year

• Lyme disease has been reported in all 50 U.S. states

• Many people with Lyme disease never recall a tick bite

• The classic “bullseye” rash only appears in 20% of cases.

Our approach is rooted in a comprehensive, patient-centered model of care.

Lyme disease is not always a simple, short-term infection. Many patients present with complex, multi-system illness requiring individualized evaluation and treatment.

We focus on:

• Hearing the patient’s story

• The best available evidence

• The most up-to-date therapies

• Combining multi-modal, allopathic and integrative approaches

• Rejecting tunnel vision and keeping an open mind about all aspects of the disease experience

Symptoms can vary greatly from person to person and may include, but are not limited to, the following:

General symptoms

• Fatigue

• Generalized weakness

• Fever, chills, or sweats (day and/or night)

• Sleep disturbances

Neurological and cognitive symptoms

• Headaches

• Brain fog

• Word loss

• Difficulty concentrating, thinking, or remembering

• Facial weakness or drooping

• Tingling, numbness, and/or other neurological symptoms

• Unsteady gait or difficulty walking

• Vision disturbances

• Dizziness or lightheadedness

• Fainting or near-fainting

Musculoskeletal symptoms

• Migratory muscle and joint pain and/or swelling

• Neck pain or stiffness

Gastrointestinal symptoms

• Nausea, vomiting, or abdominal discomfort

Skin and lymphatic symptoms

• Swollen lymph nodes

• An expanding rash at or near the site of a tick bite

• Generalized skin rashes, hives, or lesions that may appear throughout the body

Heart-related symptoms

• Heart palpitations

• Rapid, slow, or irregular heartbeat

• Chest pain or discomfort

• Shortness of breath

• Unusual fatigue

• Reduced ability to exercise

Less commonly, Lyme disease may cause cardiac complications, including:

• Lyme carditis

• Heart block

• Myocarditis

• Pericarditis

• Abnormal heart rhythms

Symptoms may fluctuate, migrate, or relapse over time.

No. Lyme disease is primarily a clinical diagnosis based on:

• Medical history and possible tick exposure

• Symptomatology

• Physical findings

• Supporting laboratory testing when appropriate

No single test can definitively rule Lyme disease in or out, and testing limitations may lead to missed or delayed diagnoses. Testing and evaluation for co-infections is also very important and based on the same clinical factors above.

Lyme disease can affect multiple body systems simultaneously, including:

• Neurological function

• Immune system regulation

• Endocrine function

• Musculoskeletal health

Because of this, symptoms may seem unrelated or change over time.

• A negative Lyme test does not always completely exclude Lyme disease, particularly if testing was done early in the course of illness or if the immune response was not yet detectable.

• Testing for coinfections should also be done in the setting of negative Lyme serology.

• Because Lyme disease is ultimately a clinical diagnosis that considers symptoms, exposure history, physical findings, and laboratory data together, misdiagnosis and delays in diagnosis can frequently occur.

• Patients with persistent symptoms may require further evaluation even when initial testing is negative.

Not necessarily.

A negative tick test does not definitively rule out Lyme disease. Tick testing has important limitations:

• Testing may not evaluate for every possible tick-borne pathogen

• Test accuracy can vary depending on the laboratory and testing methods used

• A person may have been exposed to a different tick bite that went unnoticed

Clinical decisions should be based on the full clinical picture, including symptoms, timing of exposure, physical findings, and medical evaluation—not solely on tick test results.
If symptoms develop after a known or suspected tick exposure, medical assessment is recommended regardless of tick testing results.

Some patients continue to experience symptoms after initial treatment, including:

• Fatigue

• Pain

• Cognitive difficulties

• Neurological symptoms

• Sleep disturbances

Research into persistent Lyme disease symptoms remains ongoing, and some patients may require individualized re-evaluation and treatment adjustments.

The term “chronic Lyme disease” is often used to describe persistent or relapsing symptoms lasting months or longer.
Symptoms may:

• Wax and wane

• Affect multiple body systems

• Persist for six months or more.

You may have also heard this referred to as Post Treatment Lyme disease Syndrome (PTLDS).

Ticks may carry more than one infectious organism. Common co-infections include:

• Babesia

• Bartonella

• Ehrlichia

• Anaplasmosis

Co-infections can:

• Change symptom patterns

• Affect treatment response

• Prolong illness

Comprehensive evaluation for co-infections is an important part of care.

We use an individualized, multi-faceted treatment strategy that may include:

• Targeted antimicrobial therapy when appropriate

• Evaluation and treatment of co-infections

• Immune and inflammatory support

• Addressing underlying contributors such as hormonal, nutritional, and neurological factors

Treatment plans are personalized because no single therapy works for every patient.

There is no one-size-fits-all treatment approach.

Treatment decisions are based on:

• Severity and duration of illness

• Presence of co-infections

• Patient response to therapy

• Risk-versus-benefit considerations

Shared decision-making between physician and patient is an essential part of care.

Patients with complex or long-standing illness may require longer care because:

• Infection may involve multiple body systems

• Co-infections may be present

• Immune dysfunction or inflammation may persist

• Recovery is often gradual and individualized.

• Some patients experience temporary worsening of symptoms during treatment, sometimes referred to as a Herxheimer reaction or Jarisch–Herxheimer reaction.

• This reaction is believed to occur when bacteria die off rapidly and inflammatory substances are released into the body.

Possible Herxheimer symptoms may include:

• Increased fatigue

• Fever or chills

• Muscle aches

• Headaches

• Brain fog

• Joint pain flare-ups

• Sweating

• Increased inflammation

• Temporary worsening of neurological symptoms

Not all patients experience Herxheimer reactions, and any symptom worsening should be discussed with a qualified healthcare professional to rule out medication side effects, allergic reactions, or disease progression.

• This is very common among Lyme disease patients.

• Because Lyme disease symptoms can overlap with many other conditions — and because testing has limitations — patients are sometimes told their symptoms are unexplained despite ongoing illness.

• A comprehensive clinical evaluation can be important in these situations.

• Wear long sleeves and pants outdoors

• Use EPA-approved tick repellents

• Check for ticks after outdoor activities

• Shower after spending time outside

• Remove ticks promptly using approved methods

No. We are an out-of-pocket, private-pay practice.

Yes, when appropriate and permitted by state regulations.

Please bring:

• Prior labs and imaging

• Current medication and supplement list

• A symptom timeline (very helpful)

• Previous treatment records if available

• Specialized focus on Lyme and tick-borne illness

• Comprehensive, individualized care

• Experience with complex and chronic presentations

• Collaborative, patient-centered approach

The following organizations support Lyme disease research, education, advocacy, and patient awareness:

• Bay Area Lyme Foundation

• Global Lyme Alliance

• Project Lyme

• Lyme Action Network

Early detection and medical evaluation are important. If you develop symptoms after a tick bite or outdoor exposure, seek guidance from a qualified healthcare professional.