Basics – Symptoms Checklist

In addition to Lyme, the co-infections of Babesiosis, Anaplasmosis, Ehrlichiosis, Bartonellosis, and Rocky Mountain spotted fever are prevalent in tick-endemic areas.

Here is a list of symptoms associated with Lyme and tick-borne co-infections. Many of these are symptoms of other diseases as well. An infected person may experience some or many of these symptoms, which is why diagnosis is often difficult. Check the boxes that apply to you. Remember that your doctor is looking for a pattern of symptoms. A tick bite may go unnoticed, especially in the spring and summer, when ticks are tiny. Not all cases of LD are caused by a tick bite. Some may result from placental transmission.

You may have symptoms now, or perhaps you had them in the past. Because LD symptoms often appear suddenly and tend to come and go, each symptom has two check boxes, labeled N and P, for “Now” and “Past.” Take this list with you when you see your doctor.

Even if you have many of these symptoms, it does not necessarily mean you have Lyme disease. Many Lyme symptoms are vague and overlap with many other diseases.

Early Symptoms
  • Tick Bite
  • Rash, often circular, usually spreading. The “bull’s eye” rash occurs in fewer than 50% of Lyme patients. It may be centered on the tick bite and/or anywhere else on your body.
  • Extreme or persistent fatigue
  • Any type of rash
  • Swollen glands
  • Unexplained fevers (high or low grade)
  • Headache — persistent/severe/intermittent
  • Stiff or painful neck
  • Bell’s Palsy (facial paralysis, usually one side only)
  • Burning or stabbing pains, in odd, shifting places
  • Muscle weakness
  • “Brain fog” (inability to concentrate; inattention)
  • Mood swings, irritability
  • Joint pain or swelling
  • Joint stiffness, especially back or neck
  • Muscle pain or cramps
  • Sensitivity to light
  • Sore soles (esp. in morning)
  • Shortness of breath, “air hunger”
  • Night sweats (drenching)
  • Unexplained chills
  • Heart palpitations or extra beats
  • Symptoms change, come and go
    c c Failure to get a diagnosis for odd symptoms

Additional Symptoms, often occurring later in the disease

Musculoskeletal System
  • Arthritis or arthritis-like symptoms
  • Creaking, popping, or cracking joints
  • Aches or burning in palms and/or soles of feet
  • Bone sensitivity, especially the spine
  • Shin splints
  • Foot pain (ankle, heel, plantar fasciitis)
  • Gait disturbance
  • Clumsiness
  • Pain or swelling moves to different joints
  • Backache (unexplained)
  • Rib soreness
  • Fibromyalgia (generalized muscle pain & tenderness)
  • Tendonitis
  • In babies, low muscle tone
Neurologic System
  • Headache — migraine
  • Sudden lightning-like jabs
  • Tremors or unexplained shaking
  • Numbness in parts of the body and/or extremities
  • Tingling sensations (like an insect crawling on skin)
  • Pinprick sensations
  • Weakness or partial paralysis
  • Pressure in the head
  • Cold or heat intolerance
  • Fainting
  • Poor balance, dizziness, difficulty walking
  • Increased motion sickness
  • Warm/cool sensations at various locations
  • Twitching of muscles
  • Constant low body temperature (below 98.6°F)
  • Seizure
  • Abnormal blood flow in brain
  • Diminished reflexes
  • Visual or auditory hallucinations
  • Abnormalities of taste or smell
  • Odor or taste hallucinations
  • Restless legs syndrome (RLS)
Mental Capabilities
  • Memory loss, short term
  • Memory loss, long term
  • Distorted memory
  • Confusion
  • Declining performance in school or work
  • Forgetting how to perform simple tasks
  • Speech difficulty (slurred or slow and hesitating)
  • Trouble finding the right word
  • Drop in measurable IQ
  • Dyslexia: letter, number, or word reversals
  • Stammering, stuttering speech
  • Going to the wrong place, disorientation
  • Becoming lost in familiar places
  • Dementia (Alzheimer’s diagnosis)
Psychological well-being
  • Easy frustration
  • Unusual depression
  • Overly-emotional reactions, crying easily
  • Panic, anxiety attacks
  • Aggression, rage, road-rage
  • Sleeping too much
  • Difficulty falling or staying asleep (total insomnia)
  • Napping during the day
  • Ferocious nightmares
  • Obsessive-compulsive behavior
  • Suicidal thoughts
  • Paranoia
  • Disorientation (getting or feeling lost)
  • Depersonalization (losing touch with reality, feeling “unreal”)
  • Bipolar disorder
  • Psychosis-like disorders
Head, Face, Neck
  • Twitching of facial muscles
  • Dental pain (unexplained)
  • Painful gums
  • Difficulty swallowing
  • Hoarseness (unexplained)
  • Drippy nose (unexplained)
  • Persistent head congestion
  • Pressure in head
  • Cracks around sides of mouth
  • Sore throat
  • Scalp rash
  • Sinusitis
Eyes, Vision
  • ”Floaters”
  • Double or blurry vision
  • Pain in eyes
  • Conjunctivitis
  • Pressure in eyes
  • Flashing lights
  • Tearing eyes
  • Dry eyes
  • Vision loss/Blindness
  • Decreased hearing in one or both ears
  • Buzzing, clicking, or ringing in ears (tinnitus)
  • Pain in ears with no medical cause
  • Sensitivity to sound (hyperacusis)
Digestive and Excretory System
  • Diarrhea (unexplained)
  • Constipation
  • Abdominal pain, cramps
  • Irritable bladder (trouble starting, stopping)
  • Frequent need to urinate
  • Upset stomach, nausea, vomiting
  • Frequent heartburn
  • Bloating
  • Gastroesophageal reflux (acid reflux, GERD)
  • Anorexia
Respiratory/Circulatory System
  • Chest pain (crushing sensation)
  • Heart block on EKG
  • Mitral valve prolapse
  • Heart murmurs
  • Elevated blood pressure
  • Low blood pressure
  • Vasculitis (inflamed blood vessels)
  • Cough (non-productive, odd, unexplained)
  • Anemia
  • Loss of sex drive
  • Sexual dysfunction
  • Unexplained menstrual pain, irregularity, flooding
  • Unexplained breast or nipple pain, discharge
  • Testicular or pelvic pain
General Well-being
  • Unexplained weight gain or loss
  • Malaise
  • Unexplained sweating
  • Itching
  • Continual infections (sinus, kidney, yeast, bladder, etc.)
  • Increased sensitivity to allergens
  • Exaggerated response to alcohol
  • In babies, failure to thrive
  • In babies, delayed development
Have you been diagnosed with:

These diseases have symptoms that overlap those of Lyme disease. Patients are sometimes misdiagnosed with these diseases when they may actually be suffering from Lyme disease.

  • MS (multiple sclerosis)
  • Parkinson’s disease
  • Fibromyalgia
  • Rheumatoid arthritis
  • Lupus
  • Chronic Fatigue Syndrome
  • Crohn’s disease
  • Carpal Tunnel Syndrome
  • Ménière’s disease
  • Hepatitis
  • Epstein-Barr virus infection
  • TMJ (jaw pain)
  • Gout
  • ALS (Lou Gehrig’s disease)
  • Psychological/psychiatric symptoms
  • ADHD (Attention Deficit Hyperactivity Disorder)
  • Alzheimer’s disease