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**

102 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 • • 2h ago

Image Why the term "Post-Treatment Lyme Disease Syndrome" is harmful - Dr. Steven Phillips Spoiler

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5 Upvotes

r/Lyme • • 1h ago

Article New drug reverses severe fatty liver disease by repairing the gut

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• Upvotes

This seems like it could be a promising treatment for Lyme.


r/Lyme • • 3h ago

Question Covid and flu vaccine?

3 Upvotes

Newly diagnosed with late stage chronic Lyme and co infections— for context I went 28 years undiagnosed with symptoms coming and going not knowing it was this. I’ve always gotten flu and covid vaccines, but my naturopath I’m working with cautioned against the covid vaccine due to some new research that was found about the spike proteins? All of this I gathered her warning was that it causes reactivation in some people with chronic Lyme. I tried to recall if I ever had symptoms flare or worsen after each shot but I went so long writing these symptoms off that I couldn’t tell you. Has anyone experienced a flare after getting the covid vaccine?

My core issue is: I have a toddler, and I’d like to stay vaccinated to prevent getting badly ill as much as possible. I’m more concerned with his health than my own reaction to a vaccine, but I am also newly and slowly treated my Lyme and co infections for the first time. Hope this makes sense.

Edit to add: I am not an anti-vaxxer and never will be. My toddler is still too young I think for the Covid vaccine. But he has the flu shot already.


r/Lyme • • 2h ago

PEMF

2 Upvotes

Anyone use a PEMF mat? Looking into it for sleep + anxiety + inflammation support. But the mats are expensive. Would love to know if anyone uses one and experiences any relief.


r/Lyme • • 7h ago

Bee Venom Therapy Update at 16.5 months, 10 stings 3 days weekly

4 Upvotes

Those who have completed their BVT treatment tell me that after a year of stinging, the venom brings up old layers of Lyme disease symptoms that have to be dealt with. I can tell that this week, the neuro Lyme symptoms are coming up full force. I am still having a load of relief after each time I sting, and look forward to sting days. However, the nerve damage pain in my legs was off the chart this week.

I am so grateful that I am able to use my legs again, after not being able to walk and in a wheelchair just 3 years ago. The numbness was still present (with horrible stabbing nerve pain and hot feet for the past five years) but the tingling and attempts for the nerves to heal has been really obvious this week. Even as I write this, my toes and feet are tingling, a warm, nice sensation with occasional knife-like jabs.

My legs felt extra heavy today, similar to what I remember years ago, around 1977, just a few years after a tick embedded in my spine for five days on a camping trip in Colorado. I was always an active kid; loved running and playing. I switched schools and the teacher lined us up for relays. I was excited, and couldn't wait for my turn to grab the baton and blow away the other teams. I reached out my arm and grabbed it from my teammate. Something in me felt off, like my legs had sandbags attached to them. I tried to move them, tried to tell my brain to move them like usual, and they would not go. Helplessly, I watched the other teams laughing hysterically at me and my team yelling and screaming for me to move. The name calling started, the embarrassment was something I would not live down. After that incident, where I ended up almost crawling with the baton to the next person 25 yards away, team captains fought to NOT have me on their teams. The teacher angrily scolded me for ruining my team's chance to win, and "on purpose". Crying, I curled up in a ball in the corner of the playground and cried, hoping that I would disappear.

That feeling today caused me to have quite a few flashbacks to the past, when I wanted to run and play, swim and surf so badly and my legs would not cooperate. I was only recently diagnosed with chronic Lyme in 2024, and now all those times make a lot more sense.

The rage and mood swings have reappeared. Today, I burst out in tears for no reason, then had rage (that I have not felt for decades) which surfaced and it took all the prayer and slow breathing I could muster to bring myself to not let that torrent out of my mouth.

I remember in the early 1990's, I had a few friends over to my house, and we were all having a fun time playing card games. Suddenly, the rage built up in me after catching someone cheating. I regret to share that all three friends left my house quickly, soon after the rage came out of my mouth. I lost their trust that day; and there was talk about me having a psychotic episode (which is ironic, since I was working on my second college degree to become a child. psychologist). I apologized to them, but had no explanation for why I could not control the anger. I prayed it would not happen again.

Neuro Lyme is one of the scariest symptoms to have resurface, but it is necessary to wipe out that nasty bacteria, parasites, and biofilm that manifest in a form of mind control. I pray that this part of my journey does not last much longer, and that healing continues.

If you haven't researched Bee Venom Therapy, please do so. I am so glad I decided to try it. It is packed with over 14 strong peptides and amino acids, the strongest being Mellittin, which wipes out Lyme and coinfections on contact.


r/Lyme • • 6h ago

Diarrhea with Cryptolepis and Artemesia

1 Upvotes

My wife has been attempting a Lyme disease cure for the past 3 weeks. She started taking Artemesia and found that this gave her constant diarrhea. She then switched to Cryptolepis (just one drop with food) and the diarrhea continued. Is this a common symptom? Will this side effect eventually end?


r/Lyme • • 19h ago

Rant IGENEX/TLABS results & update

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10 Upvotes

Summary: Ranting about my results and fears.

I see my Dr. on Tuesday to discuss everything, but in the meantime, I’ve been stewing over my IGENEX and TLAB results.

So… Babesia odocoilei.😭 If anyone has this and has any tips, please share! As glad as I am to finally get an actual positive for Babesia and know the specific species, you won’t catch me celebrating! It seems like everything I read about treating it sounds horrible, which is… encouraging… (heavy sarcasm!)

Finally getting a positive for Lyme is pretty humorous to me, considering I’ve known I’ve had it for about 8 years now, but this is the first time I’ve gotten a positive result!!Validating nonetheless.

As for Anaplasmosis, I initially thought I read that it was positive, but now I’m not sure if I interpreted that correctly. At this point, why not add another coinfection to the collection? (More sarcasm.🙄🙄) Looks like Bart is still playing hide and seek, so maybe another time, you evil sneaky bastard.

I’m scared of so many things right now: treatment, the cost of treatment, and what my new baseline might look like during. If I didn’t have MCAS complicating things, I’d throw myself into treatment! I know I need treatment, and even though my current baseline is still disabling, it’s something, and I’m scared of losing that.

These infections have already taken so much from me and completely turned my life upside down. I’m scared of going through another round of hell. Sometimes I just wish I only had Lyme, if someone can even wish for such a thing…

Anyway, I’d love to hear from anyone who has experience with Babesia odocoilei, or if there’s anything else you’d like to share!


r/Lyme • • 8h ago

Question Does Ivermectin have a role in Lyme treatment?

1 Upvotes

Hey all,

I'm just wondering if Ivermectin has a role in Lyme disease treatment?

I've had Lyme for 8 years, undiagnosed. I took 4 months of Doxy last year which helped eliminate my pain for a few months. Symptoms are now returning and I'm looking at treatment options once more.

Honestly, I'll try anything that won't kill me (because they Lyme damn near killed me).

Thanks.


r/Lyme • • 8h ago

Bad cramps on Cryptolepis, mostly legs

1 Upvotes

Hi, guys )) Hope you're having a better day today.

I had cramps before, it's always related to herx, and they often happen at night when I'm in a horizontal position. No other way but to get up several times at night and start walking.

Now I'm on Cryptolepis alone because I tried to add it several times to my regime, and it always was too much. At a certain, still low, dose bad cramps started again. I take good vitamins and multiminerals, I have Potassium Chloride and electrolytes. Don't really know what else I can do.

Maybe, take higher dose of Potassium? If so, how much? I took electrolytes in the past with no results. Cramps only passed when herx passed. But with pain and broken sleep...

Any suggestion is welcome!


r/Lyme • • 10h ago

Pentoxifylline as novel treatment/herx stabiliser? Spoiler

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1 Upvotes

I've been researching this drug and it appears to have a lot of beneficial effects for us

Initially I wanted it for my bartonella leg pain, it's used to improve microcirculation but then I discovered it has a lot cytokine modulating activity - reduces a lot of the same ones buhner herbs do

I'll post AI Google summary (sorry I know)

Cheap to buy from Indian generics too, I'm thinking about experimenting with it??


r/Lyme • • 20h ago

Question Is it actually possible to treat bartonella without rifampin?

5 Upvotes

As we all know, bartonella is the most difficult thing to get rid of. But what if you can’t take rifampin? Me and many others simply can’t tolerate this medication.

What can you do this in situation? As I understand there really aren’t any treatments as effective as rifampin.


r/Lyme • • 16h ago

Tick found in 2yo

2 Upvotes

Hello, my daughter is 2.5 and we found a deer tick in her scalp today. The body was not engorged but the head did not come out. We gave her some homeopathic and herbs but now she is asleep and the head is still in her poor head. We will go to urgent care tomorrow but wondering what folks here think as I have heard mixed things about the risk of leaving the head in. I have had 2 tick bites in my life and while I haven’t had serious problems from Lyme (took doxy both times) I have had a lot of serious health issues that I believe are related to Lyme so I am very worried about her long term health!!!


r/Lyme • • 15h ago

Article Mental issues check this out . Pyrole disorder

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1 Upvotes

Just reposting what someone posted in a different group.
Also if you do decide to supplement b 6 be aware of b6 toxicity.


r/Lyme • • 21h ago

Japanese Knotweed

3 Upvotes

Hi,

I had Japanese knotweed whole plant in raw herb tabelts from onlyx.com. But every time I try to take it, it tends to cause me diarhea, like not microbiome disruption, but like rapid bowel movement. Any idea if it gets better with time? Also, do you know any good brands from Poland, Slovakia, Czechia, Germany where one can buy quality herbs?

Thanks

UPDATE: Is resveratrol alone also active against lyme and bartonella?


r/Lyme • • 19h ago

Rant Hypnic jerks/sleep starts

2 Upvotes

This was one of my very first symptoms, years ago. I still occasionally get one or two going to sleep at night, and at a level that can be considered normal, but I am almost guaranteed to get them continuously while trying to nap in the day. Is this normal? I’ve read it can be, since your brain has a harder time shutting off in the daytime as you are generally more stimulated throughout the day.
I just take herbs at this point, and have been for about 1.5 years after treating with abx. Wondering if there are some specific herbs that could help with nervous system regulation that I’m not already taking.


r/Lyme • • 1d ago

Recovered for years, bartonella is flaring

8 Upvotes

Hi i am pretty sure my bartonella just reactivated for the first time in five years. Has anyone else experienced this and been able to pinpoint what would reactivate it?


r/Lyme • • 1d ago

Question My sauna routine somehow got way more complicated lol

7 Upvotes

I started out just sitting in the sauna for like 20 minutes and calling it a day. Now I’m messing around with different temps, timing, hydration, and all that stuff.

Lately I’ve been thinking about adding red light too. Has anyone actually combined the two for a while? Wondering if it’s worth making part of the routine or if I’m just overcomplicating it.


r/Lyme • • 21h ago

Question Ways to get meds from doctor who can't prescribe in my state?

2 Upvotes

I want to go to a medical practice that can't prescribe outside of their state, and I don't currently live there. They recommend having a second doctor locally who is willing to write prescriptions for whatever they recommend. I was referred there by my current doctor because they don't know what to do with me anymore, at least not for a specific problem that I'm currently having that's preventing me from being able to treat. My current doctor is fairly conservative, and I don't think she will go for this. I don't think my chances of finding a new doctor willing to do this is high (why would they be willing to for a new patient they don't even know?).

Does anyone know of any tricks or loopholes to safely get around this or to get a doctor willing to do this? Or, is my only option to fly back and forth every time I need to fill or refill an Rx? Some of it I could maybe get from online pharmacies that don't require an Rx, but I don't think that will be the case for everything.


r/Lyme • • 22h ago

Bug bite w/ red rash (streak) is Lyme/bartonella? Spoiler

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1 Upvotes

I got what appears to be a bug bite on my hip.

Afterwards, these red streaks on my shoulder and by my ribs appeared.

Could it be Lyme/bartonella/babesia?

Thanks in advanced.

I did also randomly find a little bug in my bed blanket but didn’t think about ticks in the moment so I killed it.


r/Lyme • • 22h ago

Question I know I have Lyme now what? Spoiler

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1 Upvotes

r/Lyme • • 22h ago

Can anyone help me interpret this result ? Spoiler

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1 Upvotes

r/Lyme • • 1d ago

Question Any Hallmark/Specific Lyme Symptoms? VS. Mold/CIRS

1 Upvotes

I can't currently do specialty testing where I am located. (Latin America)

So doing the IGG/IGM tests seems pointless.

Wondering if I have Lyme through my symptoms or just Mold/CIRS?


r/Lyme • • 1d ago

Question Does anyone experience this?

1 Upvotes

I wake every morning to a stiff/pain soreness in my hands and somewhat my legs. It's everyday and it allows me to not sleep past the early morning. Curious what thoughts are on causation?