7 Myths About Lyme Disease Doctors Want To Debunk

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Tick-borne illness is spreading fast, with the CDC estimating that the number of cases of Lyme Disease reported in the U.S. more than tripled from 2004-2016. Yet even as more and more people become infected, many myths about Lyme Disease prevent them from getting the proper diagnosis and treatment. Fortunately, we're starting to emerge from the dark ages, understand how the disease operates, and offer more compassion and empathy to the people suffering from it.

Some of the biggest myths about Lyme involve how it's diagnosed. "Individuals with Lyme Disease expect a tick bite, Bull’s eye rash, a positive Lyme disease test, and a good outcome after 21 days of antibiotics and no chronic illness," Daniel Cameron, MD, MPH, an internist and epidemiologist who specializes in treating Lyme, tells Bustle. "Instead, they often don’t see the tick bite, the rash is absent or atypical, the tests are not reliable, and they may not get better after 21 days of antibiotics."

Because Lyme is so prevalent, it's important to learn accurate information about it so that you can spot it in yourself and support loved ones who may contract it. Here are some myths about Lyme that are in desperate need of clearing up.

Myth #1: If You Don't Remember A Tick Bite, You Don't Have Lyme

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Not everybody remembers getting Lyme. Some people harbor it for years and keep it latent until a stressful situation triggers it to come out, Kristin Reihman, MD, family medicine doctor and author of Life After Lyme, tells Bustle.

"In today’s world of high stress, environmental man-made contamination, genetically modified foods, imbalances in the check-and-balance of species both internally and externally, well this can culminate to be the triggering event for someone’s system to break down," Mary-Beth Charno, APRN-C, a nurse practitioner who specializes in treating Lyme, tells Bustle.

Furthermore, Lyme is not always caused by tick bites. "Borrelia Burgdorferi has been found in all sorts of biting insects [like] fleas [and] mosquitos," says Reihman. "It's also found in human breastmilk and semen and in placentas of miscarried babies, so there are lots of ways Lyme can be transmitted."

Myth #2: If You Didn't Get A Rash, You Don't Have Lyme

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Many doctors will diagnose Lyme based on the presence of a rash shaped like a bull's eye, but only nine percent of Lyme patients get one, according to Lymedisease.org. If you don't get a rash, this is often a sign that your immune system is down. "The rash is a function of a robust immune response," says Reihman. "So if you do remember a rash, chances are your immune systems is doing a lot more work than someone who doesn't. A rash shows up if the immune system comes to do its work. I'm more concerned about someone who doesn't get a rash than someone who does."

Myth #3: If You Tested Negative, You Don't Have Lyme

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The Western Blot and ELISA, the tests most commonly given to patients suspected to have Lyme, produce many false negatives, says Reihman. Some doctors will give alternative tests like those from iGeneX, DNA Connexions, or Armin Labs. But ultimately, the International Lyme and Associated Diseases Society recommends that doctors make "a clinical diagnosis based on the history and physical findings, and supported by appropriate laboratory tests when they are indicated." In other words, you can be diagnosed based on your symptoms even without positive test results.

Myth #4: You Can Only Get Lyme In Certain Geographical Areas

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Some people with Lyme symptoms assume they don't have Lyme because they don't live in Lyme endemic areas like the U.S. Northeast. But in reality, nearly everyone is susceptible to it. "Lyme has actually been found in all 50 states and most countries," says Reihman. "It can really go anywhere."

Myth #5: Lyme Disease Can't Be Chronic

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Despite celebrities from Yolanda and Bella Hadid to Avril Lavigne speaking out about their experiences with chronic Lyme Disease, the coverage often describes the diagnosis as "controversial." Many doctors fail to diagnose it, instead suggesting that the illness is in patients' heads — a common pattern among diseases that disproportionately affect women. "Chronic Lyme disease is complex and often misunderstood, which means that many patients will struggle to obtain the care they need to regain their health," says Charno.

But while understanding of the condition is still in its infancy, there is research suggesting that Lyme can become chronic. One study in Healthcare, for example, found that Borrelia burgdorferi, the bacteria known to cause Lyme, was present in all 12 subjects diagnosed with chronic Lyme but none of the subjects in a 10-person control group. In addition, many doctors regularly see chronic Lyme in their practices. "The evidence I see most frequently are the anecdotes of the people who have been treated for Lyme and remain ill and after long treatment become well again," says Riehman.

"Chronic illness is not disputed in numbers of other health challenges," says Charno. "We don’t say that all congestive heart failure will resolve with treatment, or that once diabetes is adequately treated, that it doesn’t persist for some. Why is this concept so difficult to apply to tick illness?"

Myth #6: Lyme Looks The Same For Everyone

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"Borrelia burgdorferi has 132 lipoproteins," Charno says. "Its close cousin Syphilis has 22. The father of modern medicine, Dr. William Osler, was coined saying 'he who knows syphilis knows medicine' because of its ability to imitate many disease states. These lipoproteins are pro-inflammatory, they modulate immunity, and they enable the spirochete to evade the immune system. Depending on many factors, people will present vastly differently in how the inflammation shows up."

Lyme "can impact any organ system or tissue of the body," Reihman says. This means that it can cause a wide variety of symptoms, and they're not the same for everyone.

Another reason Lyme presents itself in so many different ways is that there are different Borrelia species that can cause it, and the Borrelia carries co-infections that are different in different patients. For example, some may be suffering primarily from Bartonella, while others are experiencing symptoms of Babesia. So, don't doubt that you have Lyme just because you don't have all the classic symptoms.

7. All You Need To Kill Lyme Is A Few Weeks Of Antibiotics

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Doctors typically treat early Lyme with 28 days of the antibiotic Doxycycline. While this does work in some cases, it doesn't work in others. "People have Lyme that persists after 28 days, but because of this myth, they're often denied further treatment," says Reihman. Because there are often stressors in someone's physical surroundings or personal life that keep the illness around, treatment also involves reducing stress, optimizing sleep, staying away from environmental toxins, and supporting the body's detox mechanisms, she says.

If you think you might have Lyme Disease, you can assess your symptoms by filling out the Horowitz Lyme-MSIDS Questionnaire and find a Lyme-literate doctor who can help determine if you have Lyme and treat it appropriately.