Is It Lyme or One of These Three Other Conditions?

It can be incredibly frustrating to navigate health issues, especially without a proper diagnosis. Many chronic and infectious diseases have similar or overlapping symptoms, which can complicate the diagnostic process and prevent someone from getting the treatment they need.

Lyme disease is often called the “great imitator,” as many symptoms are similar to other chronic health conditions. So, how does someone know if they have Lyme disease or another disorder? We will explore the differences between this tick-borne illness and the many conditions it can be confused with. 

What is Lyme disease?

According to the CDC, with an estimated 300,000 infections occurring each year, Lyme disease is the most commonly reported vector-borne illness in the U.S.. Lyme disease is caused by a spiral-shaped bacteria called Borrelia burgdorferi, transmitted to a human host through a tick bite. 

In the United States, Lyme disease is transmitted by the blacklegged, or deer tick, in the northeastern and upper midwestern part of the country, and the western blacklegged tick along the Pacific coast.

How does someone know if they have Lyme disease? Without a proper diagnosis, there is no guaranteed way to confirm the presence of Lyme disease. Being aware of the symptoms may aid in receiving the appropriate testing. 

These are the most common symptoms of Lyme disease:

• Chills
• Headache
• Fatigue
• Fever
• Joint and muscle aches
• Swollen lymph nodes
• Erythema migrans or bull’s eye rash (25-50% of patients)

These early-stage symptoms typically appear within 3 to 30 days after a tick bite from an infected tick. People who do not receive a prompt diagnosis and treatment may develop chronic Lyme disease. Approximately 5% of people who do receive treatment will still develop Post-Treatment Lyme Disease Syndrome (PTLDS).

Both chronic Lyme and PTLDS are considered late-stage Lyme disease. Common late-stage symptoms may include Bell’s palsy (a droop or loss of muscle tone on one or both sides of the face), shortness of breath, nerve pain, spinal cord or brain inflammation, and numbness, tingling, or shooting pains in the hands or feet. 

Common conditions that Lyme disease can be confused with

Hashimoto’s disease

Hashimoto’s thyroiditis is a chronic autoimmune disease that affects the thyroid gland. The thyroid is a small butterfly-shaped gland at the front of the neck that plays a prominent role in the endocrine or hormonal system. In cases of Hashimoto’s disease, the immune system erroneously targets healthy tissues, namely the hormone-producing cells within the thyroid, resulting in hypothyroidism. 

The thyroid helps regulate metabolism, blood pressure, heart rate, and body temperature, among other processes. Hashimoto’s can cause low thyroid levels, unexplained weight loss, energy levels, and cognitive functioning.

Hashimito’s disease vs. Lyme disease 

Many symptoms of Lyme disease and Hashimoto’s overlap, such as chronic fatigue, joint pain, brain fog, and mood issues. These conditions not only have similar symptoms, but a growing amount of research suggests that a Lyme infection may trigger Hashimoto’s and other autoimmune disorders.

Symptoms of Hashimoto’s disease that are not present with Lyme include a goiter (swelling of the thyroid), brittle nails, hair loss, an enlarged tongue, and increased sensitivity to cold. 

Amyotrophic lateral sclerosis (ALS)

ALS is a neurodegenerative disease affecting nerve cells in the spinal cord and brain, leading to hardening (sclerosis) and loss of muscle control. While it does not affect mental functioning, people with ALS lose voluntary control of their arms and legs over a period of 3 to 5 years. ALS is often referred to as Lou Gehrig’s disease. 

The diaphragm is also affected by ALS, making breathing difficult. ALS is a fatal disease, with respiratory failure as the most common cause of death. Researchers are not sure what causes ALS, although there may be a genetic link involved. 

ALS vs. Lyme disease 

Symptoms of late-stage Lyme disease can mimic those of early-stage ALS. Overlapping symptoms include muscle atrophy, facial palsy, weakness, and fasciculations (twitching.) Some of these symptoms are brought on by Lyme’s effect on the nervous system over time. 

ALS symptoms not typically present in Lyme include excessive and untimely crying, laughing, or yawning, slurred speech, lack of coordination, and hand weakness. 

PANDAS

PANDAS stands for “pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections.” This is not one specific condition, but rather a group of conditions that can affect children who have had strep infections such as scarlet fever or strep throat. 

PANDAS typically affects children between the ages of 3 and 12 and may be more common in those with a family history of autoimmune diseases or rheumatic fever. Symptoms often occur in episodes that last for a few days or weeks and eventually dissipate, only to re-emerge later. 

PANDAS vs. Lyme disease 

Children with PANDAS may display psychological and neurological changes such as anxiety, depression, difficulty sleeping, reduced coordination, difficulty concentrating, and changes in mood or personality. PANDAS is often associated with symptoms attributed to obsessive-compulsive disorder, such as vocal or motor tics. 

Although they are distinct conditions, both PANDAS and Lyme are caused by a bacterial infection and can impact the central nervous system. It’s important to note that children can contract Lyme disease. Parents are encouraged to monitor unusual symptoms present in their children.

Is it Lyme, ALS, Hashimoto’s disease, or PANDAS?

The following table compares and contrasts symptoms of Lyme disease, Hashimoto thyroiditis, ALS, and PANDAS. While this is not a replacement for diagnosis, it may be helpful in starting a conversation with a healthcare provider. 

There are exceptions to these symptoms, and not all signs will be present in all cases of these diseases. Testing is the most reliable way to attain an accurate diagnosis. 

The importance of Lyme disease testing

When monitoring developing symptoms, patients are urged to consider the possibility of Lyme disease. Early treatment for Lyme involves the use of antibiotics and is effective in most cases. If left untreated, however, symptoms of chronic Lyme may begin to impact the individual’s quality of life, including muscle and joint issues and nervous system and cognitive effects. 

Many patients do not recall or may not have realized they’ve come in contact with a tick – tick bites do not hurt, and they do not always result in a rash, even when an infection is present. Because of this initially asymptomatic nature, many patients do not seek out testing until late-stage symptoms begin to develop. Even when prompt antibiotic treatment therapy is in place, some individuals still develop PTLDS.

How do you know if you have Lyme disease? Testing is essential in receiving a proper diagnosis, whether the experienced symptoms are acute or chronic. IGeneX offers the most comprehensive and accurate tests for Lyme and other tick-borne diseases, no matter the stage of infection. 

If you suspect you may have Lyme disease, it’s important to discuss your testing and treatment options with a healthcare provider. Finding a Lyme literate doctor can help someone feel supported and understood as they seek diagnosis and begin treatment.