7 Common Lyme Disease Co-Infections & How To Stop Them
A woman with lyme disease lying down on a couch

Lyme disease has traditionally been thought of as an infection of the bacteria Borrelia burgdorferi. But more and more, researchers are coming to understand that ticks carry not only multiple species of Borrelia but also carry many other bacteria known as Lyme co-infections. When people are sick with Lyme disease, they are usually also infected with multiple Lyme co-infections as well.

While it was previously believed that each species of bacteria has a specific set of symptoms that it and only it causes, it's actually more complicated than that, Bill Rawls, MD, an integrative health expert on Lyme disease and other chronic illnesses, tells Bustle. Genetic variations, as well as what other microbes someone's carrying, will affect how their body responds to a particular infection. So, although there seem to be some patterns with particular co-infections, it's very difficult to say which bacteria are causing what symptoms in any given person.

Another thing to understand about Lyme co-infections, along with Lyme disease itself, is that simply carrying them doesn't necessarily mean you will be sick. In fact, some of them are carried by most people. Illness arises when the immune system malfunctions and allows the bacteria to take over, Dr. Rawls says. Carrying Lyme co-infections also doesn't necessarily mean you got them from a tick, he says. Many of them can be transmitted in other ways, although immune suppression from Lyme disease can cause them to become active even if they were latent before.

That said, here are some common Lyme co-infections and the symptoms that tend to be associated with them.



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Babesia is typically spread by deer ticks and infects red blood cells. "In Babesia, you often see a Lyme case that's quite resistant to treatment and much more severe than typical," Kristin Reihman, MD, family medicine doctor and author of Life After Lyme, tells Bustle. Babesia patients often report "air hunger" — the feeling that they can't get enough breath — as well as heart palpitations, anxiety, fevers, chills, and flu-like symptoms.




Bartonella, sometimes known as cat scratch fever, can be spread by cats as well as ticks and fleas. "Bartonella is probably present in most of us," Dr. Reihman says. "There are hundreds of different Bartonella-like organisms, and most of them are just part of our background microbiome without causing symptoms. When they do cause problems is when there are co-infections or other issues undermining the immune system."

A few symptoms of Bartonella are rashes that come and go, which can actually look like cat scratches, as well as rage and other mental health issues, swelling of the joints, and pain in the feet, says Dr. Reihman.



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"Mycoplasma is another one probably present in many of us that can reactivate when the immune system is undermined," says Dr. Reihman. It may cause symptoms including chronic fatigue, a cough, and a variety of neurological symptoms. Because it infects linings, it can also be responsible for gut, bladder, and gynecological issues, says Dr. Rawls.




Rickettsia, the bacteria behind "spotted fevers" like Rocky Mountain spotted fever, can cause fevers, rashes, flu-like illness, headaches, chills, and fatigue, says Dr. Reihman. It can also lower your white blood cell count, which can make blood tests misleading, since white blood cell counts typically rise with infections. A hallmark sign of Rickettsia is a rash on the palms or the soles of the feet. In severe cases, people with Rickettsia can lose fingers and toes because it has cut off their blood supply, says Dr. Rawls.




Similar to Rickettsia, Ehrlichia can cause flu-like symptoms as well as low white blood cell count, says Dr. Reihman, since it infects white blood cells called monocytes in humans. It's also associated with high fever, fatigue, muscle aches, and headache.




Chlamydia can affect myelin, the substance lining the nerves, says Dr. Rawls, and accordingly, there's been some research linking chlamydia to multiple sclerosis, a disease of the myelin that's commonly associated with Lyme. The most common kind to find with Lyme is chlamydia pneumonia, which, like mycoplasma, can cause a cough, says Dr. Reihman.


Epstein-Barr Virus


At least 95 percent of people have the Epstein-Barr virus, which is responsible for mono. Plenty of people with it are healthy, but with the compromised immune system characteristic of Lyme, it can cause chronic fatigue and other symptoms, says Dr. Reihman.

When you have Lyme and co-infections, there are probably many different microbes causing your illness, says Dr. Rawls, so going after them in isolation won't solve the problem.

"People think, 'I've got these six co-infections — I've got to treat these six,'" he says. "But you've got to treat a lot more than that. If you're treating the individual infections and not the chronic immune dysfunction, you're always going to be chasing your tail. Once you address the chronic immune dysfunction and address these things comprehensively with antimicrobial herbal therapy, you're going to get rid of all these things and reach the ultimate state of being symptom-free."

Talk to your doctor if any of these symptoms seem familiar to you, especially if you have been diagnosed with Lyme disease.