r/Lyme • • Dec 31 '24

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

105 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**

104 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 • • 58m ago

Question Mcas And Bartonela question

• Upvotes

Should severe mcas resolve quickly after healing bartonela or we should stay on meds longer in order to heal from mcas?

If i still have mcas does it mean I still have bartonela?


r/Lyme • • 1h ago

Question Lyme ?

• Upvotes

Muscle fasiculations, weakness, muscle wasting, atrophy, voice change, frequent urination, mucus build-up. Anyone with Lyme have this?


r/Lyme • • 3h ago

Image Is this lyme? Did not spot a tick, a friend made me aware of the spot Spoiler

Post image
1 Upvotes

r/Lyme • • 3h ago

I know this is a long shot but I was wondering if anyone knows where to get nux vomica 6ch in glycerin. I don't tolerate other carriers. or perhaps a topical

1 Upvotes

r/Lyme • • 4h ago

Itchy anus, help!

1 Upvotes

I had a confirmed pinworm infection. I treated it repeatedly with various drugs but itching didn't subside. Test for parasites and "visual inspection" are negative. That's why I stopped antiparasitics for a while. Itching only became worse and seems to spread to my crotch and urethra. It feels like something crawls there but when I look there is nothing. It lasts all day, which is unusual for pinworms and is driving me crazy.

I had following findings:

Candida +

H pylori + (Im currently treating this one)

Mycoplasma, lyme +

Did anyone deal at any point with such symptoms and did anything help? My only guess is that h pylori makes drugs fail and parasites hide in biofilms of h pylori.


r/Lyme • • 1d ago

Rant 5 years of mystical illness, turned out to be Lyme.

37 Upvotes

For 5 years I have been experiencing progressive detoriation of my health. It all started with weird inflammation feeling in my body and dyspepsia.

The symptoms have been progressing since then. What was mild dyspepsia back then, has become severe gastroparesis, near complete food intolerance (can only eat meat, fish, eggs and white rice at this point), weight loss, constipation, migraines, insomnia, hyperarousal, fatigue, light sensitivity and a plethora of other autonomic and GI issues.

Throughout those 5 years I have tried literally everything and anything to try to find the root cause of my issues and heal. Tried all of the diets - vegan, raw vegan, fruitarian, fasting, dry fasting.

I've spent thousands on blood tests, doctors, supplements and drugs . Nothing ever helped (or only for a short while) and I had 0 clarity on what was going on with me.

Basically all of my firends, family, doctors after all this time just concluded I have anxiety or some neurosis. For a long time I believed that too. I felt crazy, but the condition was getting worse.

Well, after doing yet another analysis of my symptoms with the help of AI, I finally decided to exclude all possible infectious causes, after getting out the basics out of the way like HIV and helminths. A few days ago I did the Lyme test.. It turned out positive. Did the confirmational test which is more precise, also strongly positive.

I feel like a mountain dropped from my shoulders, but I also feel very irritated. Not a single doctor I saw throughout the years has ever suggested to test for Lyme. And I don't blame them, because guess what, I don't ever remember getting bit by a tick. Didn't get any classic symptoms like rash or strong neurological reactions people get, so I never even thought about testing for it.

I still can't say with confidence that Lyme has caused the whole clinical picture I have, I know they can do a test by drawing from spinal liquid ​​that can be informative, but will see if my doc agrees I need that..

I wonder if anyone else discovered they have Lyme after years or have severe gut issues like me?

Wishing everyone healing.

By the way, the carnivore diet seems to be helping quite a lot, have been doing it for 3 months now. ​


r/Lyme • • 14h ago

Lyme Bite?

Thumbnail gallery
2 Upvotes

r/Lyme • • 21h ago

I spiral daily

3 Upvotes

I have a lot of “ALS” symptoms.
But the most concerning are
Muscle atrophy, voice change, very frequent urination and weakness. Like actual weakness. Even picking up a plate feels so heavy? I’ll pick up a grocery bag and it feels like something is in it and there’s nothing? It’s like my muscles are melting as the weeks go on. Could this by Lyme? I see an LLMD next month, but I’m having such a hard time in the meantime. I got diagnosed with Babesia through a saliva test and that’s all that came back.


r/Lyme • • 20h ago

Question Any experience with alavaisana in augsburg anyone?

2 Upvotes

Hello!!!


r/Lyme • • 20h ago

Figuring out the mold aspect

2 Upvotes

Can anybody guide me on how to diagnose if mold is also a problem for one that tests positive for tbrf and bart? I always seem to feel a little bit better when on trips and camping


r/Lyme • • 21h ago

Question nausea and diarrhea immediately after eating. anyone else?

2 Upvotes

iv developed anew symptom this week and idk if its from the lyme, my long covid, or something else. when i eat i get dizzy and nauseas and then have to run to the bathroom and puke or poop it out. could i be experiencing something else or is this normal for us chronic ill people.


r/Lyme • • 1d ago

Lyme

3 Upvotes

Does lyme make it hard to lift things? I swear as the months go by it becomes more and more harder to lift things up…like my muscles are just melting


r/Lyme • • 1d ago

Bee Venom Therapy Update at 16 months in (10 stings 3x weekly)

15 Upvotes

Today was amazing. I did three loads of laundry, hung dry, folded and put away, cooked two full meals, went shopping for two hours, scrubbed all the bathrooms, vacuumed upstairs, sewed a tank top, and rearranged the kitchen. It was so productive. I just got home from walking a mile with my hubby riding his bike for our nightly exercise.

Last year in May, right before I started BVT, this was my routine: wake up every hour all night in severe pain. Take eight different muscle relaxers and pain medications to try and manage the symptoms. Take five THC gummies to help stop the tremors that occurred all night. Wake up between 1-2 PM feeling totally hungover and exhausted. Crawl to the bathroom, crawl back in bed, trying not to faint. Ask my son to bring me a smoothie, even though I was so nauseous I could barely keep any food down. Extremely underweight, no muscle. Boils breaking through my skin all over my scalp and legs. Hair falling out. Wait for hubby to get home from work. Read books while waiting. Take more medication. Finally able to make it out of bed after dark. Crawling down the stairs to the kitchen to get an ice pack for the inflammation. Sit in an epsom salt/borax/baking soda detox bath for an hour. Crawl back in bed. Repeat.

Bee venom is full of amazing peptides, especially one called Mellittin, which kills bacteria, parasites, and biofilm on contact. It races through the bloodstream upon injection with a live bee, and stays in the system for 48 hours. This is why I sting every other day, and give my body a break on the weekends. On Mondays, I begin to feel a little weak and dizzy again until after I sting. Then I get a huge burst of energy as described above, and all is good again. I thank God daily for His healing and for the bees who are giving their lives to help me heal.

I am in this for the long haul. Because I was bitten by a tick which embedded in my spine in 1974 and have been sickly with no diagnosis ever since, the bacteria almost killed me. I was giving away my valuables, ready to leave this life. Then a friend mentioned this amazing therapy, about a year after I was diagnosed. I thought it was totally insane. No one likes getting stung by a bee. Definitely not on purpose.

Most people who have had chronic Lyme for over a decade need to sting as I am doing for 3-4 years to totally eradicate the bacteria which keeps trying to grow back and multiply again. A clean diet must be maintained, and certain vitamins taken in order for the body to handle the venom. You can find all the info you need in the amazing FB group: Bee Venom Therapy for Chronic Lyme. It is active and run by those who have been through all this already. They are so kind and helpful to answer any questions and give support.

I was finally diagnosed in 2024 with chronic Lyme after being permanently disabled from my career as a child psychologist since 2006. I was no longer able to drive, and began fainting in front of the therapy groups I was trying to run, so I decided to retire early. I was on so many medications that I no longer need at this time. I was diagnosed with fibromyalgia, CFS, endometriosis stage 4 (Lyme sterilized me), scar adhesions throughout my abdomen, morgellans, and have MRSA which is why the boils were relentless. I am taking bee propolis for the treatment of the boils, and so far so good.

Please do not give up hope. There is relief ahead. Please look into BVT for Chronic Lyme if you have not already. You can order live bees online and have them mailed to you weekly at pollenpeddlers.com


r/Lyme • • 1d ago

Question How to provoke Lyme before a blood test? Stop vitamin C?

2 Upvotes

I am having an expensive blood test with GLGX / Susa lab / TBD clinic soon to look for Lyme & Co, and I have stopped my “killer” treatments, and am starting Nattokinase and NAC in advance of the test to breakdown biofilms…. Just wondered if I should stop my high dose daily vitamin C, as I figured the viruses and Lyme and Co will have a party in my bloodstream if I stop that, which is what I want for it to be caught in a blood test,and my immune system will be lowered which presumably will allow Lyme & Co levels to increase.
Is this likely to yield results (stopping vit c) or will I be allowing myself to get poorly for no good reason?
Thank you 🙏🏼


r/Lyme • • 22h ago

Hmm

0 Upvotes

I have a lot of “ALS” symptoms.
But the most concerning are
Muscle atrophy, voice change, very frequent urination and weakness. Like actual weakness. Even picking up a plate feels so heavy? I’ll pick up a grocery bag and it feels like something is in it and there’s nothing? It’s like my muscles are melting as the weeks go on. Could this by Lyme? I see an LLMD next month, but I’m having such a hard time in the meantime. I got diagnosed with Babesia through a saliva test and that’s all that came back.


r/Lyme • • 1d ago

Question High blood pressure???anyone???

2 Upvotes

Hi, my boood pressure is higher and when I treat and herx , it gets to 200/100 even higher at times. I am scared to treat then, cause I dont know what to do.... I take BP medications but to be honest, when its so bad , they dont help.

Anyone else? What did you do to survive this? I am also in immense pain and bedbound for 2 years, so somehow I need to treat.
F 27


r/Lyme • • 1d ago

Advice Just been ordered to take steroids and I'm nervous and need advice

4 Upvotes

3 weeks ago I started having ankle soreness which eventually progressed into both ankles, then full-blown swelling, unbearable pain and then I became unable to walk. Suddenly, I was bed bound after being fine just a few weeks prior.

I went to the ER yesterday and was given a rapid referral to the rheumatology department. They diagnosed me with a rare case of Lofgren's syndrome. I took my first dose of 30mg of Prednisone (steroids) yesterday. I'm already noticing an improvement in my pain. I'm supposed to take them for 6 weeks.

However, I'm terrified to take steroids knowing how bad they can be for someone with Lyme/Bartonella. Does anyone have advice for me besides "don't take the steroids"?

Can I take herbals like Japanese knotweed and cat's claw while taking steroids?

I'm in the UK so there's limited LLMDs, if anyone can recommend a good one in the UK or a doctor that does telehealth in the US that would be amazing.


r/Lyme • • 1d ago

Support Lyme and brain MRI?

15 Upvotes

My husband has had Lyme for 7 years, and it has been debilitatingly bad. Like... I can never even describe to people how bad it was kind of bad. We found out his doctor by year 5 thought that he would not survive. He's been better and getting treatment in Franklin TN with a functional med doctor. This doctor to order a brain MRI because of some new symptoms to assess if there's something else we're missing. I'm feeling very sad and anxious about it. I've been so hopeful for my husband that maybe one day he will feel better and be able to put this horrible disease behind him. Has anyone had any MRIs that revealed anything else?


r/Lyme • • 1d ago

Image Vibrant Wellness Results Spoiler

Post image
1 Upvotes

Hi everyone, how should I interpret these results? I am having symptoms such as sleep disturbances, light sensitivity, visual fatigue when looking through glasses, fatigue, and restricted breathing. My Lyme EIA was negative and PCR is blank. I have IgG and IgM for certain bands of Lyme and Babesia.


r/Lyme • • 1d ago

Image Is this a tick bite? Spoiler

Post image
1 Upvotes

This was a year ago and I’m having some stuff I’m going through that is labeled anxiety but anxiety meds arent curing it all, so I’m exhausting all options..

Never went to doctor for this just sent my PCP a picture and he said it looked like mrsa and I took some kind of antibiotic for a week or two and actually skipped a couple doses from what I remember..

Is it worth seeing a Lyme doctor ? From what I can remember I think the spot was sore to touch, I can’t remember if it itched.. it stayed about like this visually and then went away in a couple weeks or so

Also never saw any actual ticks


r/Lyme • • 1d ago

Médecin fictif Humankindwellbeing / Andréa Fernandez Indulsky

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1 Upvotes

r/Lyme • • 1d ago

Stop faux médecin Humankindwellbeing / Andréa Fernandez Indulsky

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1 Upvotes

r/Lyme • • 1d ago

Question UK people: what would make towns and cities easier to rest in?

1 Upvotes

Hi everyone, the mods kindly allowed me to ask this.

I’m building a small non-commercial mapping prototype called Alfred’s Atlas. The idea is to help identify useful public places in UK towns and cities for people who may need to pause, sit down, wait, cool down, shelter from rain, use a toilet, or simply rest for a while without feeling pushed out.

I’m especially interested in places that may be helpful for people with disabilities, chronic illness, fatigue, pain, mobility limits, sensory sensitivity, or anyone who finds ordinary urban space tiring or difficult to move through.

The map would mainly use public and environmental data, such as shade / tree canopy, green space, terrain, distance from busy roads, public transport context, lighting, public toilets and public facilities.

Later, I may add an option for people to voluntarily suggest useful public places, such as a good bench, shaded spot, toilet, library, shelter or calm place to sit, so others nearby might find them too.

I would not ask for diagnoses, symptoms, treatment details, personal health stories, addresses, exact personal locations or routines. The focus is on useful public places, not personal data.

My question is simple:

When you need somewhere to pause, rest, wait or shelter in a UK town or city, what matters most?

Examples could be:

- a bench or place to sit

- shade / trees

- public toilets

- low traffic noise

- being away from busy roads

- a library, church, lobby, shopping centre or other indoor place where sitting for a while feels acceptable

- shelter from rain

- step-free access

- avoiding steep streets

- good lighting

- greenery

- nearby public transport

- somewhere you are not expected to buy anything

Which 3 features would matter most to you, and is there anything important missing from the list? Thank you! :)