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Lyme disease

By Maggie Aime, MSN, RN

Lyme disease is one of those conditions you may have heard of, in connection with tick bites and the outdoors, especially during warmer months. But you may have questions about it. How do you know if you’ve been infected?

What symptoms should you watch for? And what happens if the disease isn’t caught early? Whether you’ve recently found a tick, are trying to make sense of lingering symptoms, or simply want to understand the condition better, here’s what to know about Lyme disease, including how it develops, how it’s diagnosed, and how it’s treated.

What Is Lyme Disease?

Lyme disease is a bacterial infection spread through the bite of an infected blacklegged tick, known as a deer tick, and it’s the most common tick-borne illness in the United States (Mead, 2022).

Ticks live in grassy, brushy, and wooded areas, so anyone who spends time outdoors, even in their own yard, can be exposed to them.

In the early days after a tick bite, Lyme disease can cause symptoms that resemble a mild flu. You may also notice a circular red rash at the site of the bite, along with other symptoms we’ll cover in more detail below.

What Causes Lyme Disease?

For Lyme disease to develop, the tick that bites you must be carrying the bacteria that cause the infection. In the United States, the most common bacteria are Borrelia burgdorferi, and more species are being identified.

The time it takes for the bacteria to spread after a tick bite can vary. While it’s widely believed that a tick needs to be attached to the skin for 36 to 48 hours for the bacteria to pass into the bloodstream, transmission can happen sooner in some cases (Cook, 2015). That’s why it’s important to remove any attached tick as promptly as possible, regardless of how long it’s been attached. Once inside the body, the bacteria can cause inflammation, which leads to many of the symptoms people experience.

Who Is At Risk?

Anyone can get Lyme disease, but some people are more likely to cross paths with an infected tick than others. Risk largely comes down to where you live, travel, and spend time outdoors.

You may be at higher risk if you:

  • Live in or visit the Northeast, Mid-Atlantic, or Upper Midwest, where blacklegged ticks are most widespread, though cases have been reported in other parts of the country

  • Spend time outdoors during the warmer months, especially late spring through early fall, when ticks are most active, and people tend to be outside more

  • Hike, camp, garden, hunt, or work outdoors in wooded or grassy areas

  • Have children or pets who play outside and may bring ticks indoors

  • Live near wooded areas, where ticks can be present right in your backyard

Lyme disease does not spread through casual contact from person to person. But untreated Lyme disease during pregnancy can, in rare cases, pass from mother to baby. Appropriate antibiotic treatment can significantly reduce that risk.. The condition is more common in children ages 5 to 15 and adults over 50, though many people outside of this age group get infected each year (Mead, 2022).

Because ticks are small and their bites are usually painless, many people don’t realize they were exposed. This means anyone who spends time outdoors in areas where ticks live should be aware of the risk, even if they don’t recall an actual bite.

What Are The Symptoms?

Symptoms typically appear in stages, starting with flu-like discomfort and sometimes progressing to other parts of the body if the infection isn’t treated early. Some people feel sick within days of a tick bite, while others don’t notice any symptoms for weeks or don’t connect their symptoms to a tick bite at all.

Early symptoms may include:

  • A circular red rash called erythema migrans, sometimes described as a “bull’s-eye” rash at the site of the bite, that typically gets wider over several days. It’s usually not itchy or painful.

  • Fever and chills

  • Fatigue

  • Headache

  • Muscle and joint aches

  • Swollen lymph nodes

Only about one in three people with Lyme disease develops the classic red rash, and when it does appear, it doesn’t always look like a typical bull’s eye, which is one reason Lyme disease can be misdiagnosed initially.

If left untreated and the infection spreads, symptoms can progress to include:

  • Severe headaches and neck stiffness

  • Facial palsy, or drooping on one or both sides of the face

  • Joint pain and swelling, often in the knees

  • Heart palpitations or irregular heartbeat

  • Dizziness

  • Shortness of breath

  • Nerve pain

  • Tingling in the hands or feet

  • Memory problems

  • Difficulty concentrating

  • Brain fog

  • Mood changes, such as anxiety or depression

Because these symptoms overlap with many other health conditions, and tick bites can go unnoticed, Lyme disease can sometimes be mistaken for something else or diagnosed later than it should be.

But not everyone who is bitten by an infected tick becomes ill. Experts are still studying why symptoms vary so much from person to person, but they do know that your immune function, nutrition, sleep, stress, and environmental exposures can influence how your body responds to the bacteria and how quickly it recovers (Morrissette et al., 2020).

Even after completing antibiotic treatment, some people continue to experience symptoms like fatigue, pain, or difficulty concentrating for months. This is known as post-treatment Lyme disease syndrome (PTLDS) or chronic Lyme disease (CLD), and the reasons it happens are not fully understood. Researchers believe that, in many of these cases, the immune system remains active even after the infection is cleared, and certain genetic factors make it harder for that overactivity to settle down (Williams et al., 2025).

Ticks can also carry other infectious organisms, such as Babesia, Bartonella, Anaplasma, or Ehrlichia, meaning a single bite can result in more than one infection, called a co-infection. In this case, symptoms tend to be more varied or severe, leading to a more complicated illness.

How Is Lyme Disease Diagnosed?

Diagnosis usually starts with a review of your symptoms and history. If you have the classic “bull’s-eye” rash and recently visited or live in a high-risk area, your healthcare provider might start treatment based on the clinical history and exam alone.

But many people never see a rash or remember a tick bite, so blood work is often the next step. These tests look for antibodies, which are proteins the body makes to fight infection. One thing to remember is that it can take a few weeks for antibodies to develop, so testing too early might give a negative result even if you’ve been infected. In some cases, testing too late or having a weakened immune system can also affect results.

If you suspect Lyme disease, have a frank discussion with your provider about any recent outdoor exposure, even if a tick bite seems unlikely.

How Is Lyme Disease Treated With Regenerative Therapies?

Antibiotics like doxycycline are the standard treatment for Lyme disease and work well for most people (Rauer et al., 2025). Some integrative approaches are being explored as supportive treatment for PTLDS, though research on regenerative therapies specifically for Lyme disease and PTLDS is still limited. Other therapies aimed at supporting the immune system are also being researched. Here are a few treatment approaches being studied and what the evidence shows.

Plant-Based Antimicrobials

A lab study found that certain botanical extracts showed stronger activity against drug-resistant Borrelia burgdorferi than standard antibiotics, with Cryptolepis sanguinolenta (Ghanaian quinine) being the most effective of all agents tested (Feng et al., 2020).

While these findings are based on test-tube studies and haven’t been confirmed in human trials, many healthcare professionals use combinations of herbal therapies alongside antibiotics in clinical practice. If you’re considering herbal treatment, talk to your provider first since they can interact with medications.

Hyperbaric Oxygen Therapy (HBOT)

HBOT involves breathing concentrated oxygen in a pressurized chamber, and some people with CLD have reported improvement with it (Huang et al., 2014; Fife et al., 2017). It’s thought to work by supporting oxygen delivery and reducing inflammation, rather than directly treating the infection.

The evidence so far comes only from older case reports, which means they describe individual experiences without comparison groups, and we don’t yet know how effective HBOT works for most people.

Nutrition, Gut Health, and Lifestyle

Borrelia may affect how the immune system functions, potentially contributing to ongoing inflammation even after the infection is treated (Gutierrez-Hoffmann et al., 2020). People with PTLDS also tend to show distinct changes in their gut bacteria compared to healthy individuals, and antibiotics themselves can further disrupt that balance (Morrissette et al., 2020).

While a nutrient-rich diet, probiotics, movement, good sleep, and stress management won’t treat the infection itself, these habits may help give your body a better foundation for recovery.

What Are Possible Complications?

When Lyme disease is caught and treated early, most people recover fully. But without prompt treatment, the infection can spread and damage the joints, heart, and nervous system. Being older, very young, or having a chronic health condition might make someone more vulnerable to complications from Lyme disease.

Some people develop Lyme carditis, which can disrupt the heart’s electrical system, while others experience long-term neurological symptoms or debilitating arthritis (Radesich et al., 2022). These complications can significantly impact your quality of life and energy levels. In some cases, the immune system continues to react even after the infection is treated, which can lead to ongoing symptoms.

Can Lyme Disease Be Prevented?

The best way to prevent Lyme disease is to avoid tick bites. Wear long sleeves and pants outdoors, use insect repellent, and treat clothing with 0.5% permethrin. EPA-registered repellents like picaridin or oil of lemon eucalyptus are alternatives that can be used on the skin and may be better tolerated by some people.

After coming indoors, check your body carefully for ticks and shower within two hours. If you find a tick, remove it with fine-tipped tweezers using steady, even pressure. Avoid twisting or using heat or petroleum jelly. In high-risk areas, a single dose of doxycycline after a tick bite may help lower the risk of infection.

As for a vaccine, there isn’t one approved yet for humans, but that may be changing. A recent meta-analysis found that OspA-based formulations, which target a protein on the surface of the Lyme bacteria, show the most promise among vaccine options currently in clinical trials (Tamanna & Kim, 2025). Until then, avoiding tick bites remains your best defense.

Takeaway

Lyme disease is a tick-borne bacterial infection that often responds well to early treatment. Factors like gut health, immune function, and lifestyle may influence your recovery. While research on regenerative therapies used for Lyme disease is still limited, focusing on nutrition, good sleep, movement, and stress can give your body a better foundation to heal. To get help managing lingering symptoms from Lyme disease, talk to a healthcare provider familiar with both conventional and integrative care.

Frequently Asked Questions

The standard treatment for Lyme disease is a course of antibiotics, most commonly doxycycline, amoxicillin, or cefuroxime. When started shortly after a tick bite, antibiotics are effective for most people.

Yes, Lyme disease is treatable, and antibiotics are the standard treatment. If symptoms linger, a combination of conventional medicine and supportive therapies, like improving gut health and nutrition, good sleep, and stress management, can help give your body a better foundation as it recovers.

If the infection has spread to your central nervous system or heart, your doctor might recommend intravenous (IV) antibiotics for a few weeks. This usually involves placing a small tube (catheter) in your vein to deliver the medication directly into your bloodstream, often at home or in an outpatient setting. You’ll be closely monitored to ensure the infection is clearing.

What treatments may support Lyme disease

Regenerative and integrative therapies may support individuals with Lyme disease by addressing immune dysregulation, persistent inflammation, mitochondrial dysfunction, and nervous-system stress that can follow infection. These approaches are supportive and are used alongside infectious-disease and medical management, not as replacements.

References

  • Cook M. J. (2014). Lyme borreliosis: A review of data on transmission time after tick attachment. International Journal of General Medicine, 8, 1–8. https://doi.org/10.2147/IJGM.S73791

  • Feng, J., Leone, J., Schweig, S., & Zhang, Y. (2020). Evaluation of natural and botanical medicines for activity against growing and non-growing forms of B. burgdorferi. Frontiers in Medicine, 7, 6. https://doi.org/10.3389/fmed.2020.00006

  • Fife, C.E., Eckert, K.A. (2017). Hyperbaric oxygen therapy and chronic lyme disease: the controversy and the evidence. In: Textbook of Hyperbaric Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-47140-2_15

  • Gutierrez-Hoffmann, M. G., O'Meally, R. N., Cole, R. N., Tiniakou, E., Darrah, E., & Soloski, M. J. (2020). Borrelia burgdorferi-induced changes in the class ii self-immunopeptidome displayed on HLA-DR molecules expressed by dendritic cells. Frontiers in Medicine, 7, 568. https://doi.org/10.3389/fmed.2020.00568

  • Huang, C. Y., Chen, Y. W., Kao, T. H., Kao, H. K., Lee, Y. C., Cheng, J. C., & Wang, J. H. (2014). Hyperbaric oxygen therapy as an effective adjunctive treatment for chronic Lyme disease. Journal of the Chinese Medical Association : JCMA, 77(5), 269–271. https://doi.org/10.1016/j.jcma.2014.02.001

  • Mead P. (2022). Epidemiology of Lyme disease. Infectious disease clinics of North America, 36(3), 495–521. https://doi.org/10.1016/j.idc.2022.03.004

  • Morrissette, M., Pitt, N., González, A., Strandwitz, P., Caboni, M., Rebman, A. W., Knight, R., D'Onofrio, A., Aucott, J. N., Soloski, M. J., & Lewis, K. (2020). A distinct microbiome signature in posttreatment lyme disease patients. mBio, 11(5), e02310-20. https://doi.org/10.1128/mBio.02310-20

  • Radesich, C., Del Mestre, E., Medo, K., Vitrella, G., Manca, P., Chiatto, M., Castrichini, M., & Sinagra, G. (2022). Lyme carditis: From pathophysiology to clinical management. Pathogens (Basel, Switzerland), 11(5), 582. https://doi.org/10.3390/pathogens11050582

  • Rauer, S., Kastenbauer, S., Dersch, R., Hofmann, H., Fingerle, V., Huppertz, H. I., Hunfeld, K. P., Krause, A., Salzberger, B., & Consensus group (2025). Guidelines for diagnosis and treatment in neurology - Lyme neuroborreliosis. German Medical Science: GMS e-journal, 23, Doc13. https://doi.org/10.3205/000349

  • Tamanna, S., & Kim, D. M. (2025). Revolutionizing Lyme disease vaccination: a systematic review and meta-analysis of promising candidates. Frontiers in Cellular and Infection Microbiology, 15, 1554360. https://doi.org/10.3389/fcimb.2025.1554360

  • Williams, M. A., Hernandez, S. A., Arvikar, S. L., Sulka, K. B., Strle, F., Wells, C. C., Petnicki-Ocwieja, T., Steere, A. C., & Strle, K. (2025). Toll-like receptor 1 polymorphism is associated with impaired immune tolerance, dysregulated inflammatory responses to Borrelia burgdorferi, and heightened risk of post-infectious Lyme arthritis. Frontiers in Immunology, 16, 1711765. https://doi.org/10.3389/fimmu.2025.1711765

About this article

Written by

Maggie Aime, MSN, RN

Maggie Aime is a health, wellness, and medical personal finance writer. With over two decades in healthcare, she draws on her nursing background and clinical...

Medically reviewed by

Dr. Kristann Heinz is a double board-certified family medicine and integrative medicine physician and registered dietitian. She is the Medical Director of Re...

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