Exactly What To Do If You Think You Have Acute Or Chronic Lyme Disease

Clear skies, green grass, warm breeze—summer's almost here, and this weather's basically begging you to whip out those jean shorts and start dining al fresco. Maybe you'll even head to the park, spread out a blanket, and get some much-needed vitamin D. Sounds great, right? That is, until you look down at your bare legs and spot a creepy, crawly little monster that makes you doubt whether you ever liked nature to begin with—a tick. 

Sadly, warm weather brings with it loads of ticks, and thereby Lyme disease—that notorious infection caused by the bacteria Borrelia burgdorferi, which is transmitted to humans through a bite from an infected black-legged or deer tick. Currently, the Centers for Disease Control and Prevention (CDC) estimates that 300,000 people1 contract Lyme disease in the U.S. every year—but many experts believe the true number of cases is much higher and that many people go undiagnosed (due, in part, to ineffective diagnostic tests).

Even if you don't personally know someone who's had Lyme, you likely have at least a rough understanding of its complexity, thanks to celebs, like Avril Lavigne, who have been vocal about their severe Lyme symptoms, and wellness influencers like Jordan Younger, who chronicles her battle with chronic Lyme on Instagram.

While there are plenty of strategies to help protect yourself from Lyme disease (like knowing where it's most common and how to properly remove a tick), so many people who contract Lyme end up suffering because neither they nor their doctors know how to identify the highly variable symptoms. If caught and treated early (in its acute stage), Lyme can often be resolved, but if Lyme goes undetected (or is treated inadequately), then you could be setting yourself up for chronic Lyme, which is significantly more debilitating.

If you're noticing these early symptoms of Lyme disease, you want to call your doctor ASAP. "We know that early treatment gives you the best opportunity to get rid of Lyme," says Darin Ingels, N.D., naturopathic doctor and author of The Lyme Solution.

A Lyme diagnosis should be a clinical diagnosis—meaning, based on your medical history, symptoms, and exposure to ticks. So if you have enough symptoms and you live in an area with Lyme, your doctor may choose to put you on a treatment protocol even without a lab test.

Getting a diagnosis can be complicated, however. On big reason: Many doctors aren't super familiar with Lyme and rely too heavily on blood tests2 (an ELISA test, and then, if that's positive, a Western blot test) to diagnose patients—and these tests are far from precise. They measure the patient's antibody response to the infection, not the infection itself, and they're most likely to be accurate once you've been sick for a few weeks. So, if you're tested too early, you're more likely to get a false negative (although, you could get a false negative at any time).

If you're lucky enough to get a quick diagnosis, most doctors will put you on the CDC-recommended 21-day course3 of antibiotics—and for many people, this takes care of things. But sometimes, symptoms persist.

"I would say the chance of recurrence would be 20 to 25 percent,” says Richard Firshein, D.O., NYC-based integrative physician. That's why some doctors—typically those who specialize in Lyme, called Lyme-literate doctors (LLMDs)—choose to follow the treatment guidelines outlined by the International Lyme and Associated Diseases Society (ILADS), which recommends antibiotic treatment for four to six weeks and additional treatment if symptoms recur.

So, if you strongly suspect you've recently contracted Lyme disease, but your doctor decides not to treat you based on your negative test results, it's worth getting a second opinion from a doctor who specializes in Lyme. The LymeDisease.org physician referral tool is a useful resource for finding a qualified doc in your area.

"Lyme has the potential to become chronic Lyme after about three weeks from your initial exposure to Lyme [via a tick bite]," says Firshein. At this point, symptoms can start to change or evolve. This can happen if someone is not treated for their acute Lyme, or if they've been inadequately treated and symptoms persist (the latter often being referred to as post-treatment Lyme disease syndrome).

Some doctors also believe it's possible for your immune system to keep Lyme at bay for months or even years after you've been bitten by an infected tick, only to have symptoms crop up after some sort of traumatic or intensely stressful event that compromises the immune system.

"I think it could be dormant for almost a whole lifetime," says Bill Rawls, M.D., integrative physician and author of Unlocking Lyme, who believes he contracted Lyme and other tick-borne microbes as a child but didn't develop symptoms until he "trashed" his immune system working intense hours as an OB-GYN. "Most of my patients don't remember a tick bite; most say something like, I got sick when my house burned down, or my business collapsed, or my wife left me, or when I got in a car accident—after this insult that affected their immune system."

Interestingly, Kristin Reihman, M.D., family medicine doctor and author of Life After Lyme, says she often notices that her patients fall into one of two camps: those with debilitating joint pain and those with brain fog and fatigue. But you can definitely have both—"Lyme can really do anything," she says.

Obviously, you want to see a doctor if you think you have chronic Lyme. But keep in mind, all the issues outlined above regarding ineffective diagnostic testing become that much more problematic when Lyme is considered chronic.

"The test was designed for acute exposure," says Ingels. "It measures quantity of antibodies. So if you're someone who might have been exposed 10 years ago, we know your immunity naturally wanes with time, and it's possible that your quantity of antibodies has gone down. Your body starts to treat it like it's part of you."

So in this case, seeking out a Lyme specialist who will diagnose you based on all of your clinical symptoms (not solely on lab tests) may be in your best interest. A specialist will also be able to help diagnose you with co-infections such as babesia, which are often passed along to you by ticks with Lyme.

Regardless of where you are in your Lyme journey (and even if you're just trying to prevent it), many respected integrative practitioners who treat Lyme believe that a strong immune system can make all the difference in your body's ability to minimize your symptoms and make you much more responsive to treatment.

"Is it possible to have Lyme and not get sick, or to have an acute infection and get over it by yourself? Absolutely. There are some people who encounter Lyme and their immune system just handles it—knocks it back and just walls it away," says Reihman. "That's why the focus of my Lyme interventions really center on the immune system."

So, what are some basic ways to support your immune system if you have either acute or chronic Lyme? Nourishing your body with nutrient-rich whole foods, healing your gut if it's compromised (80 percent of the immune system resides in the gut), getting plenty of deep sleep, exercising to tolerance (but not overdoing it), and minimizing stress are a few solid strategies.