{"id":52386,"date":"2022-07-06T09:30:16","date_gmt":"2022-07-06T13:30:16","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=52386"},"modified":"2023-08-05T09:49:17","modified_gmt":"2023-08-05T13:49:17","slug":"chronic-lyme-disease","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/chronic-lyme-disease\/","title":{"rendered":"What is chronic Lyme disease?"},"content":{"rendered":"

Most people have heard of Lyme disease. It\u2019s an infection <\/span>most commonly caused by one of three pathogenic species of the spirochete <\/span>Borreliella.<\/span><\/i> In the United States, it is most often caused by the bacteria <\/span>Borrelia burgdorferi (<\/span><\/i>or <\/span>B. burgdorferi)<\/span><\/i> and is transmitted by mosquitoes, fleas, and deer ticks. It\u2019s <\/span>common<\/span><\/a>\u2014about 20,000-30,000 new cases are reported annually, though many more likely go undetected. Chronic Lyme disease is a term that\u2019s not quite as well-known or understood. In fact, some people even question its existence. So what is it, and what should you do if you suspect you may have it?<\/span><\/p>\n

What is chronic Lyme disease?<\/span><\/h2>\n

Lyme disease occurs in two stages: acute and chronic.<\/span><\/p>\n

Acute Lyme<\/b> is an infectious disease that occurs right after the insect bite that caused the infection. This is the stage where it\u2019s most treatable because it\u2019s yet to spread through the body, says Jyotsna Shah, Ph.D., president of <\/span>IGeneX<\/span><\/a>, a company that specializes in tick-borne diseases. Erythema migrans (EM), the bull\u2019s-eye rash, is considered a telltale sign of early Lyme disease, but only about <\/span>70% of people<\/span><\/a> have this symptom, according to the Centers for Disease Control and Prevention (CDC). <\/span>EM is a rash that appears at the site of the tick bite, usually within seven to 14 days after the bite (but the rash can range from three to 30 days after the bite)<\/span>. <\/span>So, unless you see a tick bite and have the bull\u2019s-eye rash, you might not realize you\u2019re infected and may not seek treatment for Lyme.<\/span><\/p>\n

Chronic Lyme disease<\/b> is what happens when the bacteria from the initial infection spreads to muscles, joints, and organs. The original infection could have occurred months or even years ago, says Shah. This can happen if acute Lyme is not diagnosed and goes untreated. Or, if the original treatment doesn\u2019t work.\u00a0\u00a0<\/span><\/p>\n

The risk of acute Lyme disease transitioning into a chronic condition increases the longer a Lyme infection goes untreated. Patients are more likely to fully recover from Lyme disease if the infection is discovered and treated as early as possible after finding a tick bite.<\/span><\/p>\n

It\u2019s estimated that 5% to 15% of patients with a positive diagnosis of Lyme disease will have<\/span> symptoms that persist<\/span><\/a> even after treatment. This is known as post-treatment Lyme disease syndrome (PTLDS) or post-Lyme disease syndrome (PLDS). These terms are often used interchangeably with chronic Lyme. For the majority of patients, these symptoms improve gradually over six months to one year.\u00a0<\/span><\/p>\n

Is chronic Lyme disease real?<\/span><\/h3>\n

Chronic Lyme disease is a real, and serious condition. However, there is inconsistency in\u00a0 diagnosis and treatment in the medical community because chronic Lyme disease isn\u2019t well-defined and is difficult to definitively diagnose.<\/span><\/p>\n

There is no one clinical definition for chronic Lyme. It\u2019s often used as<\/span> an umbrella term<\/span><\/a> for a few groups of patients:\u00a0<\/span><\/p>\n

    \n
  1. People with late Lyme disease, where the original infection wasn\u2019t treated and has progressed<\/span><\/li>\n
  2. People with Lyme disease symptoms that continue even after treatment<\/span><\/li>\n
  3. People presenting \u201cnonspecific signs and symptoms of unclear cause\u201d who are given a chronic Lyme disease diagnosis based on unproven and\/or non-validated laboratory tests and clinical criteria<\/span><\/li>\n<\/ol>\n

    Lyme disease symptoms mirror many other common conditions, and it\u2019s easy to miss an insect bite. There is a <\/span>blood test<\/span><\/a> for Lyme, but it commonly produces false negative results.<\/span> Factors<\/span><\/a> like the stage of the disease, type of sample, and variations in tests all affect the sensitivity and interpretation of tests for Lyme disease. If the infection was recent, antibodies may not yet be present at the time of testing.\u00a0<\/span><\/p>\n

    If it\u2019s been some time since the original spirochete infection, as is usually the case with chronic Lyme borreliosis, \u201cthe active infection may no longer be picked up on a blood test,\u201d says Raphael Kellman, MD,<\/span> founder of <\/span>Kellman Wellness Center<\/span><\/a> in New York City. \u201cBy that point, a person\u2019s symptoms are often more related to the overactivation of the immune system, rather than the acute bacterial infection.\u201d<\/span><\/p>\n

    \u201cIn the medical field, we like to fit patients in neat little boxes and solve for their ailments,\u201d says Shah. \u201cIn relation to tick-borne illness, this can be extremely difficult due to the fact that Lyme disease can present as over 100 symptoms, and no two cases are alike.\u201d\u00a0<\/span><\/p>\n

    Chronic Lyme disease symptoms<\/span><\/h2>\n

    Chronic symptoms of Lyme disease aren\u2019t always clear-cut and manifest similarly to other conditions, which can lead to misdiagnosis. \u201cChronic Lyme disease is often used to describe a range of physical, cognitive, and emotional symptoms that crop up after getting Lyme disease and persist for months to years after infection,\u201d Shah says. Common persistent symptoms include:<\/span><\/p>\n