The symptoms of Lyme disease are numerous and can vary significantly from case to case, perhaps due to differences in the strain of Borrelia, genetics and immune responses, the mixture of co-infections or other opportunistic infections present and environmental factors.

The symptoms can change from day to day as well as over longer periods of time. They can start suddenly or develop slowly over time – some people report an initial flu-like illness followed by a period of wellness before a slow decline whereas some become unwell and simply don’t recover.

You do not have to have all the symptoms listed to have a Lyme disease infection and symptoms in children can present differently. The most frequently reported symptoms are as follows:

Early symptoms

  • Fatigue
  • Muscle and joint pain
  • Headaches
  • Fever and chills
  • Neck stiffness
  • Nausea
  • Digestive issues
  • Bull’s-eye rash, known as erythema migrans (EM). This is diagnostic of Lyme disease but it isn’t always present.

Late Symptoms

  • Pain and swelling in the joints (inflammatory arthritis)
  • Problems affecting the nervous system – such as peripheral neuropathy, paralysis of facial muscles (Bell’s palsy)
  • Cognitive problems such as memory issues, word finding difficulties and ‘brain fog’
  • Headaches and migraines
  • Heart problems – such as inflammation of the heart muscle (myocarditis) or peridcardial sac surrounding the heart (pericarditis), heart block and heart failure
  • Inflammation of the membranes surrounding the brain and spinal cord (meningitis) – which can cause a severe headache, stiff neck and increased sensitivity to light
  • Disturbed sleep – either too little or too much
  • Fatigue and post exertional malaise
  • Dysautonomia – dysfunction of the autonomic nervous system causing issues with heart rate, blood pressure etc
  • Vision and hearing problems
  • Vertigo and dizziness
  • Anxiety and depression

The symptoms can overlap with many other conditions. The most common other diagnoses for people with Lyme disease are:

  • ME, Chronic Fatigue Syndrome and post viral fatigue syndrome
  • Fibromyalgia
  • MS
  • Dementia
  • Hashimoto’s thyroiditis
  • Other autoimmune diseases
  • Depression and Anxiety disorders
  • Migraine
  • Labyrinthitis

There are many more symptoms and full lists, including a scoring system, have been produced by experienced Lyme doctors and can be found here:


N.B. We are not medical professionals