7 Conditions Lyme Disease Gets Misdiagnosed As, Because It's The Great Imitator

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Lyme disease is a notoriously difficult condition to test for, and many doctors aren't knowledgeable about it, which leads lots of Lyme patients to get misdiagnosed. The misdiagnoses of Lyme range from physical illnesses to psychological ones and often occur because Lyme can affect any organ system in the body in a multitude of ways, leading it to be labeled the "great imitator."

What further compounds the confusion is that many people don't notice contracting Lyme. "Infectious nymphal ticks are tiny — poppy seed sized — and tick bites can often go unnoticed. Most people never know they were bitten," Sunjya K. Schweig, MD, scientific advisor to Bay Area Lyme Foundation, tells Bustle. "The current 'gold standard' diagnostic for Lyme disease misses up to 60 percent of cases of early stage Lyme disease. If caught early, most cases of Lyme disease can be treated, but it is commonly misdiagnosed due to lack of awareness and unreliable diagnostic tests. If not treated promptly, Lyme may progress to a debilitating stage."

Late-stage Lyme symptoms include paralysis, arthritis, neurological problems, headaches, cognitive impairment, memory problems, hearing and vision problems, inflammation of the brain (meningitis), and inflammation of the heart (carditis or pericarditis), Dr. Schweig says. But when people present with these symptoms, doctors don't usually think to test for Lyme. "It is important to recognize that Lyme disease is the most common vector-borne disease in the US, and the diagnosis should always be part of an appropriate differential diagnosis," Dr. Schweig says. "There are about 329,000 new cases of Lyme disease each year."

Here are some conditions that Lyme is commonly mistaken for, according to experts.



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"The symptoms reported by patients diagnosed with fibromyalgia are almost identical to those associated with chronic Lyme disease," Bill Rawls, MD, an integrative health expert on Lyme disease and other chronic illnesses, tells Bustle. These include joint pain, stiffness, fatigue, and brain fog. It's unknown what exactly causes fibromyalgia, but Dr. Rawls believes it's likely that it is usually caused by Lyme and/or other microbes.


Chronic Fatigue Syndrome


Similar to fibromyalgia, chronic fatigue syndrome doesn't have a known cause, and there's a strong possibility that it is typically caused by Lyme and/or other microbes, according to Dr. Rawls. Fatigue is a hallmark sign of Lyme, and chronic fatigue syndrome is also associated with other Lyme symptoms, like impaired memory and joint pain.


Multiple Sclerosis

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Multiple Sclerosis is a central nervous system disease that affects myelin, the substance surrounding nerve fibers, causing symptoms like numbness, weakness, poor coordination, and vision problems. It has been linked to a variety of microbes including Borrelia burgdorferi, the bacteria known to cause Lyme, as well as chlamydia and the Espstein-Barr virus, Dr. Rawls says.



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Lyme can cause pain, swelling, stiffness, and loss of function in the joints — similar symptoms to osteoarthritis and rheumatoid arthritis, Timothy J. Sellati, Ph.D., the Global Lyme Alliance’s chief scientific officer, tells Bustle. You can sometimes distinguish these conditions because Lyme is more likely to affect the large joints of the legs and occasionally the wrists, while other types of arthritis are more often in the hands, wrists, shoulders, knees, and feet. But the distinction isn't always that clear-cut, so they're often confused.


Amyotrophic Lateral Sclerosis

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Amyotrophic lateral sclerosis (ALS) is a condition involving degeneration of nerve cells in the brain and spinal cord, leading muscles to atrophy. Its symptoms include muscle twitching and cramps and weakness in the hands, legs, feet, or ankles, Dr. Sellati says, which can also be symptoms of neurological Lyme disease. In fact, research has found that people with ALS are five times as likely to carry Borrelia Burgdorferi as the rest of the population.




One common byproduct of Lyme's effect on the brain is impaired concentration and memory, which can be confused with disorders like ADHD, Daniel Cameron, MD, MPH, an internist and epidemiologist who specializes in treating Lyme, tells Bustle. The brain fog and sleep disturbances that many people with Lyme experience compounds these issues.

In older people, these symptoms can sometimes be diagnosed as Alzheimer's disease — and in fact, some research has linked Alzheimer's to Borrelia burgdorferi. Research has also suggested that lipopeptides, the fatty acids created by Lyme bacteria, could interfere with communication between neurons, which may explain the memory and concentration difficulties.


Mental Illness

People with chronic illnesses, especially women, often face the misconception that the root of their symptoms is psychological. This is especially true for Lyme. Lyme can cause a range of mental health symptoms including anxiety, depression, and rage, leading many Lyme patients to be diagnosed with mental illness, Dr. Cameron says.

It's difficult to tell whether a psychiatric illness is caused by Lyme, but a sudden onset of psychiatric symptoms with no apparent cause, especially in conjunction with a tick bite or other Lyme symptoms, could point toward it.

Dr. Rawls believes anyone diagnosed with the most common Lyme misdiagnoses should look into the possibility that their condition is being caused by Lyme, co-infections, or similar microbes. But treatment doesn't mean taking a round of antibiotics, which are often ineffective for chronic infections. Most people with Lyme have many different microbes that are very antibiotic-resistant, he explains, so the key is not to go after them in isolation but to strengthen the gut and immune system in order to keep them at bay.

"Restoration of normal immune system functions with natural therapy and suppression of stealth microbes with herbal therapy is often highly effective for restoring a normal state of health in affected individuals," he says. "This approach is safe, nontoxic, and not dependent on a diagnosis. It should be the foundation for therapy for every one of these chronic illnesses."

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