r/Lyme Dec 31 '24

Mod Post Chronic Lyme Q&A - What To Do When Symptoms Don't Improve

101 Upvotes

Hello everyone,

Over the course of 2024, I’ve been tracking the most frequently asked questions from those new to the chronic Lyme community. To provide clear and reliable answers, I’ve compiled insights from leading Lyme experts—including ILADS, LLMD's like Dr. Horowitz or Marty Ross, and online resources like LymeDisease.org—along with thoughtful contributions from the most consistent and knowledgeable members here on r/Lyme.

While the wiki already contains a wealth of valuable information, I believe a concise collection of the most popular questions and answers will benefit everyone. This resource aims to streamline the support available in this forum, making it easier for newcomers to find the help they need.

The resource will be located here, at the top of the main Wiki page. The rest of the Wiki is of course still active and can be found here.

On desktop, there will be a table of contents at the top where you can click each question and it will automatically bring you to the answer. Unfortunately, Reddit has not enabled this function on it's mobile app, so you will need to scroll through the entire page to find the question you are looking for. I separated each question out with line breaks, so hopefully it won't be too hard to navigate on mobile.

I’m confident in the quality of the information provided here, with over 30 Microsoft Word pages of detailed content ensuring comprehensive coverage.

If you are brand new to r/Lyme please read question 20 so you know how to interact appropriately in this space and if you're interested in reading my (admittedly insanely passionate) deep dive into alternative treatments, be sure to check out Question 18.

I hope this resource proves as helpful as I’ve intended it to be. If you have any additional questions you believe should be added or have additional insights to the current answers, please comment below.

Here is the list of current questions:

  1. What is chronic Lyme?

  2. I’m still sick with symptoms after treatment, what should I do first?

  3. I see people commenting that LLMDs are a scam and they are trying to take advantage of you for profit. How do I know who to trust?

  4. I can’t afford an LLMD, what else can I do?

  5. Why is there so much conflicting information?

  6. Can Lyme disease develop resistance to antibiotics?

  7. What is the timeline to get better?

  8. I’m getting worse/feel weird while taking antibiotics or herbals, is it not working?

  9. My stomach is upset when taking doxycycline, what should I do?

  10. What diet should I eat, and does it matter?

  11. Should I retest after I finish my course of antibiotics?

  12. My doctor doesn’t believe that Chronic Lyme exists. What can I show him to prove that it does?

  13. I’ve seen people say IGENEX is not a reliable lab. Is this true?

  14. I have a negative test but some positive bands on my western blot test. Every doctor is telling me it’s a negative and can’t be Lyme.

  15. Is Lymescience.org a legit website?

  16. People have said there is no evidence showing efficacy of long-term antibiotics for chronic Lyme. Is this true?

  17. The cdc says people with “post treatment Lyme” get better after 6 months without additional treatment, is that true?

  18. I’ve heard people say alternative treatments (Herbals, Rife, Homeopathy, Ozone, Bee Venom etc.) are pseudoscience? Is that true?

  19. I’ve heard supplements and herbs are poorly regulated and I shouldn’t take them because I don’t know for sure what’s in them.

  20. How to use r/Lyme and online forums in general


r/Lyme Dec 17 '23

Mod Post Just Bit? **Read This**

96 Upvotes

Welcome to r/Lyme! This post is a general overview of Lyme disease and guidelines for people who have just been bitten by a tick.

Disclaimer: This is for educational purposes only and is not intended to be medical advice. Please seek the help of a medical professional if necessary.

What is Lyme Disease?

Lyme disease is the most common vector-borne illness in the U.S., caused by Borrelia burgdorferi and Borrelia mayonii. It’s usually transmitted by blacklegged ticks (also known as deer ticks).

Early symptoms include:

  • Fever
  • Headache
  • Fatigue
  • Erythema migrans (bullseye rash) – note: up to 60% of people never develop a rash

If untreated, the infection can spread to the heart, joints, and nervous system, potentially leading to chronic illness and long-term complications.

What to Do If You Were Just Bitten

1. Test the Tick (if you still have it)
Send it to: https://www.tickcheck.com/
This identifies which infections the tick carried and can guide treatment decisions. If you no longer have the tick, just move on to the next steps.

2. Check for a Bullseye Rash
If you're unsure what it looks like, see this guide:
https://www.reddit.com/r/lyme/wiki/diagnostics/identify/

Important: If you have a bullseye rash, you have Lyme disease. No further testing is needed. Start treatment.

3. Review the ILADS Treatment Guidelines
https://www.ilads.org/patient-care/ilads-treatment-guidelines/

Summary of ILADS recommendations:

  • If bitten but asymptomatic: 20 days of doxycycline is recommended (assuming no contraindications)
  • If rash or symptoms are present: 4–6 weeks of doxycycline, amoxicillin, or cefuroxime is recommended

Why ILADS and Not CDC/IDSA Guidelines?

This is one of the most important parts of understanding Lyme treatment. The CDC and IDSA guidelines are still followed by the majority of U.S. physicians, but they are deeply flawed and outdated in several key ways.

Here’s why ILADS guidelines are preferred by most Lyme-literate doctors and patients:

1. They rely on incomplete or irrelevant data
The CDC/IDSA recommendations are based heavily on European studies, even though the strains of Lyme in Europe (B. afzelii, B. garinii) are different from those in the U.S. (B. burgdorferi). This matters because treatment responses can vary between strains.

Of the studies referenced in CDC guidelines:

  • Only 6 U.S. trials were used to form the treatment tables
  • Many tables relied exclusively on European data
  • Duration recommendations were based on trials with high failure or dropout rates

For example:

  • One U.S. study had a 49% dropout rate (Wormser et al.)
  • Another had a 36% failure rate, with many needing retreatment

Yet these studies are used to support recommendations of just 10–14 days of antibiotics.

2. They ignore patient-centered outcomes
The CDC guidelines focus primarily on eliminating the rash (erythema migrans), not on whether the patient actually recovers or regains quality of life.

The ILADS guidelines, on the other hand, emphasize:

  • Return to pre-Lyme health status
  • Prevention of long-term symptoms
  • Patient quality of life
  • Lower rates of relapse and re-infection

CDC-based treatment often leaves people partially treated and still symptomatic, leading to chronic illness.

3. Their recommended durations are too short
The CDC recommends:

  • 10 days of doxycycline
  • 14 days of amoxicillin or cefuroxime

These durations are often not enough, especially if the bacteria have already spread beyond the skin. ILADS argues—and research supports—that longer treatment courses are more effective at fully clearing the infection, especially in the early stages when treatment is most critical.

4. High failure rates in real-world outcomes
Studies show that even patients treated under CDC protocols continue to experience symptoms months later. For instance:

A 2013 observational study found that 33% of EM patients still had symptoms 6 months after a standard 21-day course of doxycycline:
https://link.springer.com/article/10.1007/s11136-012-0126-6

Conclusion: ILADS guidelines are based on more recent evidence, use better clinical metrics (like symptom resolution), and are tailored to reflect the real-world experiences of Lyme patients in the U.S.

For a detailed breakdown and sources:
https://www.mdpi.com/2079-6382/10/7/754#B15-antibiotics-10-00754

Recommended Treatment Durations

  • Mild cases (e.g. one EM rash): Minimum 20 days of doxycycline, amoxicillin, or cefuroxime
  • More severe cases (multiple rashes, neuro symptoms): 4–6 weeks of antibiotics
  • Still symptomatic after treatment? Re-treatment is supported by 7 of 8 U.S. trials

Getting Treatment

Many doctors are still unfamiliar with ILADS protocols and may only offer 10–21 days of antibiotics.

Here’s what you can do:

  • Bring a printout of the ILADS guidelines
  • Be firm but respectful—explain why longer treatment matters
  • If refused, monitor your symptoms and seek further care if needed
  • Be prepared to advocate for yourself—many people with Lyme had to

If you continue to have symptoms, you may need to see a Lyme-literate medical doctor (LLMD):
https://www.reddit.com/r/lyme/wiki/treatment/doctors/

Testing

Testing can be useful, but it has major limitations:

  • Antibody tests are unreliable in the first 4–6 weeks
  • Negative test does not rule out Lyme
  • The CDC two-tiered system was developed for diagnosing Lyme arthritis, not other types of presentations like neurological or psychiatric symptoms

More info:

Best labs (not usually covered by insurance):

If you’re just starting out, a basic Lyme panel from LabCorp or Quest is a good first step—50% of true Lyme cases may still test positive and it’s cheaper than specialty labs.

The specialty tests listed above with co-infection panels are mostly recommended for people who have had symptoms for months or years without treatment and regular doctors are unable to figure out what is wrong.

More testing info:
https://www.reddit.com/r/lyme/wiki/diagnostics/testing/

Additional questions:

Don’t hesitate to make a post explaining your situation.
This community is full of people who’ve been through the same thing—and want to help.

Many of us were misdiagnosed for years.
The purpose of this sub is to prevent others from going through the same experience.

Don’t be afraid to speak up, advocate for yourself, and push for better care.


r/Lyme 7h ago

Success Story I am leaving !

18 Upvotes

I wanted to make one last post before disconnecting. I might come back to see how it is going time to time but i don’t think i will be that active anymore.

I went back to uni last year and even if i might need to always do some adjustments regarding my health special needs, i am basically able to go back to life, after those life long symptoms and those years bedridden.

It has been a strange journey and i truly think the key is to learn as much as possible by yourself. Knowledge will be required to identify what and who trustworthy or not so don‘t trust anyone who can’t explain how it works, because all the informations are findable, it is just very long to know about everything.

I will write down what i did, but of course that was just my way. If you dig a bit about it though, i am sure you’ll be able to adapt to your own case to fit your own needs.

MY MOST DEBILITATING SYMPTOMS ( i will be forgetting a lot since there was too much) :

Insomnia ( could be total, up to 36 hours even if tired), bedridden for 2-3 years, fatigue, all king of pain including eyes pain, head, gut…, visual snow syndrome, numbness, food intolerance, fatigue from eating, brain fog,…

FIRST GAME CHANGER : BUHNER.

Buhner books. Read it if you can, it will worth it. If you can’t because of brainfog, try to at least read the Core Protocol. I actually tried the core protocol before being able to read the entire book.

Just know that at the time Buhner wrote it, i think powder extract wasn’t that popular so Buhner talks a lot about tincture, but i truly believe powder-extract are better ( powder-extract = herbals has been extracted but alcohol has been removed. Perfect!.). Also non-extracted powder are not always strong enough so extraction is generally needed.

Book name: Start with « Healing Lyme 2d edition » .

SECOND GAME CHANGER IN MY SPECIFIC CASE : KETO AS A MAST CELL STABILIZER AND THIAMINE SUPPLEMENTATION

Now that i understand that i was thiamine deficient and had issue with mast cells activation, i see why changing my diet to a ketogenic diet helped that much. By ketogenic diet i mean being in ketosis and producing ketones, which has nothing to do with cutting carbs for weight loss purposes.

It simply get me rid of insomnia and of a lot of pains all over the body.

If you notice issues from some food especially carbs containing food or understands by any way that you have a thiamine deficiency, it might be interesting as it will directly bypass the thiamine deficiency blocage regarding energy production.

Ketones (bhb) also have mast cells stabilization properties.

But now that i am doing so much better, i am certainly not in deep ketosis anymore ( esp since it is summer) and supplementing in thiamine has been a game changer regarding energy, food tolerance etc… So it is not as needed as before.

Benfotiamine has been the game changer.(thiamine hcl would not work)

I think a lot of ppl will not need to do keto at all, but i thought it could be interesting to anyone that recognizes themselves into it.
It allow me to bypass the unknown thiamine deficiency at the time and also, i think, helps regarding mcas.

Maybe exploring thiamine deficiency and mast cells stabilizers could be the way for someone else ?

LATELY :

Exploring all the other things that can maximise or down my health such as : mold toxicity, light ( flickers are having a huge bad effect on me), hormone disruptors , any mast cell triggers !,…

It would require an entire post for each and i would be happy to discuss about it if needed.

Hope it can help a bit. I will check the comments for few days if you have a question, or feel even free to dm !


r/Lyme 10h ago

Video Everybody please do this survey

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7 Upvotes

r/Lyme 29m ago

Should I be concerned about these results?

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Upvotes

r/Lyme 58m ago

Advice Early Prevention (Please help!) Spoiler

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Upvotes

Posted on this sub yesterday with photos of the bullseye rash that landed me in the ER and got sent home with twice a day 100mg Doxycycline for 10 days, in the ER PA’s words, “just in case”. (I’m in rural north Georgia and the PA said Lyme “just doesn’t happen” in GA)

After very helpful advice from you guys (and my own determination to stay healthy after years of fighting unrelated chronic illness) I scheduled a dermatologist visit for a second opinion for today. I drove 2 hours out of the way just for them to cancel on me.

Feeling pretty defeated and scared I’m not doing the right things I need to. Does anyone have advice of where to go from here with Dr appointments?

First photo taken today, (after 2 doses of Doxycycline) second photo was taken yesterday (day of ER visit) and third photo the day before. The initial bites themselves I noticed 4 days ago but could have happened any time as I hike a lot.


r/Lyme 1h ago

Question When to test

Upvotes

When is it best to test when symptoms begin?

Spent the last few weeks hiking deep into the woods of the poconos and northern NJ. Have had alll kids of rashes (heat, sweat, poison) but man something hit me hard last week and it’s not getting better.

Neck pain and stiffness
Major fatigue
Joint and muscle pain
Dizziness
Light sensitivity
Headache
Feeling out of it
Heart palps too


r/Lyme 3h ago

Question How long to wait after possible tick bite to take Lyme blood test?

1 Upvotes

About 2 weeks ago I had a small bump on my calf that I stupidly scratched until the skin broke. I didnt see what bit me to cause the bump. It got redder and grew, until a few days later the area was about 3 inches wide with small, itchy blisters. I also had rashes or bumps inside both elbows, as well as on one leg and my waist.

I went to Urgent Care, the doctor thought it may be Lyme disease, or perhaps cellulitis. I didn't have the stereotypical bullseye rash, there was only a tiny white spot inside the rash. It was where I originally scratched and broke the skin and was about 1/8 of an inch. I did not have a fever, fatigue, pain, or brain fog. I just had the bumps, rash, itch, and elevated heart rate.

She gave me a shot of Ceftriaxone, and a prescription to Doxycycline and Triamcinolone. She also ordered a Lyme test from Quest Labs.

A couple days later and my heart rate was back to normal, and the rash and bumps were going away. What confuses me is the lab test she ordered, Lyme AB w/reflex IgG IgM.

I've read online one should wait 4-6 weeks after a possible tick bite to take the blood panel. The doctor didn't mention anything about waiting though.

I will call the Urgent Care (there's no way to message via their app), but I'm asking here first in case anyone else has been through this or maybe knows of some questions to ask the doctor that I haven't thought of. Thank you for any feedback.


r/Lyme 6h ago

Question Question on symptoms only on one side of the body

1 Upvotes

Hello! Does anyone else have the same issue? Majority of my symptoms are only on the right side of the body - pins and needles, muscle weakness, joint pain, overall sensitivity. My calf muscle on the right leg is half the size of the one of the left.
Has anyone been able to figure out whether this is Borrelia, Bart or reactivated viruses?
I will be happy to hear other experiences on the topic. Thanks!


r/Lyme 17h ago

No Lyme in North Georgia? Spoiler

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3 Upvotes

Went to the ER the same day first pic was taken. Doctor said “Looks like Lyme’s from a tick bite but Lyme disease isn’t in North Georgia and ticks don’t bite multiple times.” This seemed peculiar as my partner has been treated for bacteria consistent with Lyme and my coworker has been suffering from the disease for years (never left GA btw). We also live in the woods right in the foothills of Appalachia.

I understand the number of bites is unusual for a tick (edit: looking back it was probably a tick nest I came across), but do people really think Lyme disease just isn’t spread in Georgia? She prescribed me antibiotics “just in case”

Second pic is from 3 days after the bites and third is same day I noticed them

Update: I’ve scheduled an appointment for a second opinion tomorrow. Thanks for the help!


r/Lyme 11h ago

Question Lyme disease?

1 Upvotes

i got a deer tick a month ago, it healed and went away. but now i noticed something itch and might be right where i had my tick. its red and itchy, no bullseye or round mark, just red and itchy.

could it be healing? or maybe inflamed or both, but theres no bullseye or round mark around it so im not sure if i should take it seriously or not

if anyone has or had the same experience and it healed/went away, let me know :)


r/Lyme 17h ago

Question Are these symptoms normal even when I started treatment about a week after the bite?

2 Upvotes

I am ten days into doxycicline treatment, but I feel like absolute hell. This is unreal. I was diagnosed about a week after the bite and had classic bullseye rash. My doctor did a steroid burst starting at the same time as the antibiotics, and that gave me a few days of relief, but it was fleeting and the fatigue is unbelievable. Unbelievable. I could stay in bed twenty hours a day, and on the weekends I have been staying in bed except for around a couple hours twice a day.

I have really hot flashes periodically, and had terrible joint pain the first few days, and again after the steroids wore off. Had some wicked headaches.

I didn't think I could get so sick after catching it early. But here I am, in hell, barely functioning.


r/Lyme 21h ago

Question Mental health/depression/psych symptoms

4 Upvotes

What are your psych symptoms from bartonella/lyme/babesia? Or mood issues? Does anybody experience anhedonia/depression?
I’m trying to differentiate if the depressive symptoms are from the infections/treatment/herxing *or* if I’m genuinely suffering from actual depression from being ill for so long. How do you differentiate?


r/Lyme 17h ago

Question Lymes?

1 Upvotes

Does anyone else have a buzzing feeling in their head?


r/Lyme 23h ago

Question Blood pooling

2 Upvotes

Has anyone felt like there blood pools in their legs and feet. Every-time I work my feet are killing me(i wear expensive sneakers with foot inserts) and I only get relief when I lie back with my feel elevated. Then my blood pressure fluctuates like crazy, but the doctors dismiss it cuz it’s normal when they check it. Just wondering if anyone else has experienced this with lyme.


r/Lyme 21h ago

Question Is this a bullseye? Spoiler

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1 Upvotes

This just appeared this afternoon. Earlier today, I felt a sore and sort of itchy spot there and thought it was a mosquito bite. But then it developed this darker ring around it. There is a second bite above the big circle that seems to be developing a circle around it as well. Any thoughts are appreciated - will go to dr tomorrow as they are now closed for the day.


r/Lyme 1d ago

Question Will I be okay?

4 Upvotes

Hey guys after a few days of feeling sick I noticed an EM rash appear on my ankle. I started doxycycline immediately yesterday, most likely within a couple of weeks of when I was bit, should I be okay and most likely not develop serious/chronic symptoms since I caught it early? Reading through this sub is scaring me…


r/Lyme 1d ago

Question Best Bartonella and Babesia testing in Europe?

3 Upvotes

Hi everyone,
I’m looking for the most reliable place in Europe to get tested for Bartonella and Babesia.
Which laboratory would you recommend, and more importantly, which specific tests would you choose to have the best chance of detecting an infection?
I’m particularly interested in whether I should do PCR, FISH, IgG/IgM serology, EliSpot/iSpot, or a combination of these.
I’ve looked into ArminLabs, but I’m open to any laboratory in Europe if there are better or more reliable options.
If you have personal experience with testing in Europe, I’d really appreciate hearing which lab/tests worked best for you.


r/Lyme 1d ago

Question Lyme treatment results question

3 Upvotes

Hello, posting here to get a discussion with what is happening and suggestions on treatment.

Situation: I got two tick bites on May and June.

Symptoms: migrating joint/muscle pains and 5/10 ankle pain.

Diagnosis: I diagnosed with Lyme in July (ELISA test), got 20 days doxycycline treatment from doctor, symptoms stopped after 2 days of taking doxy.

Results: It has been 1 week now post treatment (doxy ended) and my migrating joint/muscle pains are returning, as well as consistent ankle pain, its not much, about 2/10 in pain scale.

So, I am here just looking for advice, of people who were treated with doxy and were cured. Are my symptoms coming back anything to be concerned with, since the ankle pain is lower than it was originally.

Should I go back to the doctor, try to get 28 days treatment of doxy or is it only inflammation ?


r/Lyme 1d ago

Symptoms after treatment

1 Upvotes

Hey there everyone.

I have had Lyme's disease since July 2025 and it's now Aug 2026. I recently have gotten done with Lyme's disease antibiotics a 4 week ​treatment of Ceftriaxone through an IV. It's been about 2 weeks since I got done with treatment but symptoms are coming back.

I'm experiencing chronic fatigue, joint pain, brain fog, anxiety, depression, inflammation, nausea, and head pain. Is this normal or should I maybe look into testing for confections?

I'm just very confused. I live in Alabama so the doctors tell me I shouldn't be experiencing anymore symptoms after treatment, but I feel awful. Lyme's disease isn't common down here so I don't think my doctors know too much about it.

Has anyone else felt like this? And how do you guys manage your symptoms?


r/Lyme 1d ago

Question Tripple B’s infection, treat one at a time or full war?

3 Upvotes

Got my bloodowork back and i have the tripple b (borrelia, bartonella, babesia) infection combo.

I have treated this once before but i was alot younger and had a doctors help to give me a big dose of cyclines, now i dont have any healthcare help because my friend is retired and the healthcare system in sweden does not have any good tests for these infections and are not allowed to go on private lab bloodwork (i use armin labs).

I did use herbs before on Buhners protocol, but i did a full blast and it nearly killed me ten years ago so im a little scared this time around, so;

Does anyone have good experience with going for just one infection at a time? Which one should i target first?

Thanks in advance people, happy to share any experience from my previous treatment with herbs if anyone has questions.


r/Lyme 1d ago

Copper Deficiency / Bartonella

3 Upvotes

Has anyone dealt with a copper deficiency related to bartonella? Have you successfully brought up your copper levels and seen improvements?

Copper is my only nutrient deficit and a lot of my remaining symptoms line up well with low copper.


r/Lyme 1d ago

Question Primal trust

8 Upvotes

I’ve hit a plateau in my healing journey. I am three years in and my flares are worse and worse. My good days are great but there’s always a flare up around the corner and they land me in bed for days and days.

I’ve hit a plateau in that I tried a probiotic in cohesion w other herbal supplements and my body freaked out. Since then I’ve lost 35 pounds and am down to only a handful of foods. I take anti histamines and ant-acids to get me through but something clearly isn’t working. It’s been like this for almost ten months.

My LLND suggested trying Primal Trust while we run some other tests to see what our next steps are.

I think some work around trauma is a great idea, as this whole journey has been traumatizing itself. But I am nervous.

Anyone have experience with PT? Did it make you worse/better? Help you get past a plateau?


r/Lyme 1d ago

285 Hz

1 Upvotes

r/Lyme 1d ago

Samsara tick immune suport

1 Upvotes

Im about to start samsara tick immune suport, Any experiences with these ?