20 Surprising Symptoms of Lyme Disease You Can't Afford to Ignore

From extreme fatigue to swollen feet, these are the diverse symptoms of the complex illness.

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When people think about Lyme disease, what immediately comes to mind is the so-called bullseye rash that's most often associated with the tick-borne illness. However, according to the Centers for Disease Control and Prevention (CDC), this erythema migrans rash only occurs in an estimated 70 to 80 percent of Lyme patients, which means that as many as 30 percent of those with the disease must rely on other symptoms in order to get a proper diagnosis. But unlike other conditions that have telltale signs and symptoms, Lyme disease is all over the map when it comes to how it manifests, making it especially difficult to diagnose.

"It is quite a complicated infection. There are a lot of non-specific systems—and that's part of the problem," explains Kenneth Liegner, MD, a New York-based board-certified internist who's been involved with Lyme disease research since 1988. "Anybody who thinks it's all cut and dry… that's definitely not true."

So, what can you do to make sure that you aren't infected? Familiarize yourself with these surprising—though not uncommon—Lyme disease symptoms you can't afford to overlook. And for more symptoms of something serious, check out 30 Warning Signs Your Heart Is Trying to Send You.

1
Sore throat

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One reason why doctors have so much difficulty diagnosing individuals with Lyme disease is because of how often the illness manifests as a sore throat. A 2011 study about the similarities between Lyme and other summer illnesses published in the journal Orthopedic Reviews notes that "respiratory symptoms such as sore throat may occur in non-viral summer infections such as Lyme disease." And for more about how this particular symptom relates to COVID-19, check out 13 Coronavirus Symptoms That Are More Common Than a Sore Throat.

2
Jaw pain

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Does it feel like your head is about to explode every time you chew? Well, this too could be a sign that you have Lyme disease. The Lyme Disease Association in New Jersey notes that TMJ—short for temporomandibular joint dysfunction—is one of the many ways that this tick-borne illness can present itself in patients.

3
Trouble sleeping

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Whether you've just contracted Lyme disease or have unknowingly had it months, odds are that you're having trouble sleeping. According to LymeDisease.org, approximately 41 percent of people with early-stage Lyme disease have sleep issues, while 66 percent of chronic Lyme patients do. And for more on the side effects of a bad night's rest, check out 7 Ways Being Sleep Deprived for One Night Affects Your Body.

4
Extreme fatigue

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It's normal to feel fatigued after a long day at work. What's not normal is getting nine hours of uninterrupted sleep only to wake up and feel like someone kept you up all night blasting music. If you find that no amount of sleep is doing the trick for you, Tufts University School of Medicine professor Linden Hu, MD, notes that this could be a sign of Lyme disease—one that could potentially linger for months after being treated.

5
Headaches

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If you're worried that you might have contracted Lyme disease, then make sure to monitor the frequency of your headaches. According to the CDC, one of the early signs of Lyme disease that tends to occur within the first 30 days of a tick bite is head pain.

And one 2003 study published in the journal Pediatrics detailed two cases of Lyme disease in which patients presented with headaches. The researchers concluded that "it is important for practitioners to consider Lyme disease when patients present with persistent headache," particularly in areas where the disease is common.

6
Joint pain

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You shouldn't assume that you have regular age-related arthritis just because you're in your 50s or 60s. Rather, the CDC notes that joint pain is one of the more surprising symptoms of late-stage Lyme disease. According to one 2013 study published in the Journal of the American Academy of Orthopaedic Surgeons, as many as 60 percent of untreated patients will experience so-called Lyme arthritis.

7
Dizziness

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One of the main reasons why Lyme disease can be so hard to treat is because, within the first 30 days or so of contraction, it tends to mimic more common illnesses like influenza. As certified nurse practitioner Joyce Knestrick, PhD, explains, "within one week of infection, half of the people with Lyme disease experience symptoms commonly associated with the flu like… dizziness."

8
Eye inflammation

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When left untreated for several weeks, Lyme disease can even spread to your eyes. Thankfully, the University of Illinois College of Medicine notes that "involvement of the eye is uncommon in Lyme disease," but the experts still warn that "inflammation of the eye may develop." And for other sight-related symptoms, check out 17 Warning Signs Your Eyes Are Trying to Tell You About Your Health.

9
Heart palpitations

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When the bacteria that causes Lyme disease enters the heart tissue, it causes what is known as Lyme carditis. According to the CDC, symptoms of Lyme carditis include shortness of breath, heart palpitations, and chest pain—and though it's usually treatable by antibiotics, the CDC notes that between 1985 and 2018, there were nine reported cases of Lyme carditis that were ultimately fatal.

10
Slurred speech

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Because there is still so much to learn about Lyme disease—it was only first recognized as its own condition in 1975—doctors are still continuing to diagnose patients with it based on previously unknown symptoms.

For instance, Liegner notes that one of the first Lyme disease patients he encountered in the late '80s presented to him with "a cerebellar syndrome where she had difficulty walking, her speech was uncoordinated, and her movements were uncoordinated." Today there are several studies on Lyme disease's impact on the cerebellum, and doctors who specialize in Lyme disease know to look out for these related symptoms when screening for the disease.

11
Facial paralysis

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According to specialty hospital Massachusetts Eye and Ear, approximately 5 percent of Lyme patients develop some form of facial weakness, or facial palsy, categorized by either one or both sides of the face drooping. Though this looks similar to Bell's palsy, the former is caused by a bacterial infection, while the latter is the result of a virus.

12
Memory issues

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Similar to speech impairment, in many cases, Lyme disease can cause confusion, memory loss, and brain fog. As the American Lyme Disease Foundation explains, "these [symptoms] are the effects of chemicals produced by the body in response to an infection or inflammation."

13
Numbness in the feet

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The longer it takes for Lyme disease to get diagnosed, the worse a person's symptoms are. Case in point: According to The Foundation for Peripheral Neuropathy, people with late-stage Lyme disease can experience "pain, numbness, or weakness in the limbs," which can be debilitating.

14
Neck stiffness

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Sure, that stiff neck you're feeling could be the result of your bad mattress—but it could also be a sign of Lyme disease. The Bay Area Lyme Foundation notes that when some people are first infected, a stiff neck—often accompanied by a headache—is one of the first symptoms they experience.

15
Irritability

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Are you lashing out at friends and family members for no reason? That could be the Lyme talking. The Bay Area Lyme Foundation lists mood issues as one of the symptoms of untreated, late-stage Lyme disease.

16
Hearing problems

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In one 2018 study published in the Polish Journal of Otolaryngology, researchers analyzed 216 patients with tick-borne diseases and found that 162 presented with otolaryngological symptoms—or those related to the ear, nose, and throat. Specifically, 76.5 percent of patients with such symptoms complained of tinnitus, and 16.7 percent complained of hearing loss in one ear.

17
Depression

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Lyme disease takes an emotional toll on its victims as well as a physical toll. In fact, according to the data compiled by LymeDisease.org, approximately 62 percent of patients with chronic Lyme experience depression as one of their main symptoms.

18
Chills

Woman shivering under a blanket because she is so cold
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Are you feeling unusually cold, despite the fact that it's a muggy 90 degrees outside? Well, this could be because Lyme disease is wreaking havoc inside your system. LymeDisease.org notes that approximately 60 percent of patients with Lyme in the early stages report having chills.

19
Hepatitis

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People tend to associate hepatitis, or liver inflammation, with things like alcohol abuse and hepatitis viruses. However, there are several other ways in which your liver can end up inflamed—and Lyme disease is one of them, as the Mayo Clinic points out. Liegner says that if treatment is delayed, Lyme disease "can go to virtually any site in the body, any organ."

20
Sensitivities to light and Sound

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One of the pioneers in Lyme disease research is Joseph J. Burrascano Jr., MD. In the early days of the disease, he came up with a checklist that doctors could use to diagnose it—and it includes all of the above signs, as well as other previously observed symptoms like sensitivities to light and sound, muscle weakness, erectile dysfunction, and dental pain.

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