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POSSIBLE INDICATORS OF LYME DISEASE, EXHAUSTIVE LIST

compiled by Jentri Anders, Ph.D.

[Note: Virtually all of the following can be caused by something else, which is one of the reasons Lyme disease is so difficult to diagnose. The reader is advised that it is an accumulation of these indicators, and their spread over a number of different body systems that raises the question of Lyme disease. Because the most debilitating symptoms, such as fatigue and joint pain, are so nonspecific, it may well be the accumulation of symptoms minor in their impact and usually dismissed by doctors, that turn out to be the best indicators of Lyme disease. Therefore, this list includes anything that was ever mentioned, even once, by doctors, diagnosed Lyme patients and Lyme-educated lay persons, as referenced at the end. No attempt has been made to prioritize items as to diagnostic importance. Chronic Lyme symptoms can be intermittent, as well. If seemingly unrelated symptoms tend to flare up together, it logically raises the chances that they have a mutual cause, including Lyme disease. Older sources were consulted less frequently because the volume of research in the last decade may have rendered them out of date. Please use advisedly.] Please scroll to the bottom of this page for a list of the references cited. Thanks!

System/Symptom	Source

Brain: seizures	Reik, et al
Circulation: cold hands and feet in warm environments	Bleiweiss, Murray
Ears: (see also “sensations” for balance references) middle ear infections hearing loss tinitus (ringing or buzzing) sound sensitivity sudden sound causes falling or retching pain	Murray V-F V-F, Burrascano, Logogian Neilds, Burrascano Nields Lymenet
Eating: anorexia-like behavior unexplained weight loss unexplained weight gain difficulty chewing cravings	Paschner/Steere Murray Burrascano Lymenet Murray
Emotional: anxious agitation, restlessness mood swings loss of: initiative creativity desire to start projects desire to engage in social interaction depression alternates w/anxiety not accompanied by low self-esteem, despair, hopeless euphoria baseline irritability super critical impatient with self and others low exasperation threshhold explosive at end of work period trouble at work rage, anger volcanic rage verbal aggressiveness child abuse social withdrawal physical symptoms may have social triggers emotional lability/bursts of crying, affective instability	Bleiweiss Paschner/Steere,Bleiweiss,V-F Bleiweiss, Paschner,Murray Fallon, Burrascano Bleiweiss Anders Bleiweiss Bleiweiss Bleiweiss,Fallon,Krupp,Burrascano Bleiweiss Krupp Kollikawski Bleiweiss, Fallon, Paschner,Murray,V-F,Burrascano Bleiweiss Bleiweiss Bleiweiss Bleiweiss Nields Bleiweiss,V-F Bleiweiss V-F Nields Paschner/Steere Bleiweiss Kollikawski,Ackerman, V -F, Nields
Eyes: conjunctivitis ocular myalgia (eye pain) swelling around eye orbit blindness (total or partial) photophobia/light sensitivity “idiosyncratic responses to light,” esp.flourescent swollen, red eyes pinkeye inflammation, any part double or blurry vision involuntary squint pain decreased perception of light or color drooping eyelid abnormal number of floaters lazy eye iritis uveitis optic neuritis optic atrophy	Bleiweiss, Murray, Fallon Bleiweiss Bleiweiss Steere, V-F Nields, Murray, Bleiweiss,V-F, Fallon Nields Murray V-F V-F V-F, Burrascano V-F V-F V-F V-F V-F, Burrascano V-F Fallon Fallon Fallon Fallon
Environmental factors: insect bites, increased sensitivity to environment triggers symptom recurrance or increase: new tick bite physical stress emotional stress sleep deprivation exercise hot tub booze fasting dehydration humidity low barometric pressure cold or rain allergies make symptoms worse abhorrence of extremes of temp chemical hypersensitivity sensitivity to synthetic fabrics decreased conscious awareness of environment	Murray Murray Murray Murray Murray Murray Murray Bleiweiss Murray Murray Murray Murray Murray Bleiweiss Bleiweiss Bleiweiss Murray Sorwell
Face: cranial nerve problems facial tics, eyelid twitch	Ackerman Murray
Fatigue: exercise precipitates flareup following day alternates with insomnia	Nields, Bleiweiss Bleiweiss Murray
Fever: low grade to 104.5, esp. 1st wk routinely low temp recurrent, no explanation chills	Bleiweiss Bleiweiss Murray Murray
General LD: symptoms are intermittant, fluctuating, cyclical, as well as related to environmental factors and stress insomnia	Nields, Burrascano,Bleiweiss V-F, Murray, Bleiweiss
GI: nausea vomiting persistent vomiting diarhhea acid reflux upset stomach abdominal cramps irritable bowel syndrome (LD can cause it)	Murray, Bleiweiss,Fallon Murray,Fallon V-F Murray V-F Burrascano Lymenet Sowell
Heart: palpitations cardiac infection (myocarditis, periocarditis) slowed heart rate shortness of breath chest discomfort history of murmer history of prolapse heart arrhythmia enlarged heart ECG shows non-specific ST and T-wave changes	V-F V-F, Lymenet V-F V-F V-F Burrascano Burrascano Murray Lymenet McKay
Immune system: recurrent URI predeliction to cancer traumas heal slowly reactivates viral infections, esp herpes J-H reactions to antibiotics	Bleiweiss Bleiweiss Bleiweiss Burrascano Burrascano
Joints: large joints swollen swollen knee painful pain one side more than other pain intermittant or cyclical warm elbow won’t straighten w/o pain crack and snap jaw pain, crepitis (crunchy) appears earlier in disease than rheumatoid arthritis bony bumps on, esp. elbow elbow, knees, fingers	V-F, Fallon Murray V-F V-F, Kaell V-F V-F Murray Murray Murray, Kaell Kaell Kaell V-F
Lab: high levels of vasoconstricting hormones low magnesium/potassium (++) chronic high sed rate high CPK level=inflammed or wasting muscles	Bleiweiss Bleiweiss Murray Lymie
Mental: forgetful where things are what going to say why came into room previous sentence plot content, rereading names bypass exits short term memory loss in general hard to concentrate easily confused can’t understand road signs can’t understand technological manuals can’t think can’t apply logic inattention decreased awareness of environment (can be mistaken for attention deficit disorder in children) disorientation in intellectual tasks paper shuffling misplace things wierdly disoriented in general spelling deterioration math deterioration writing deterioration too much detail word reversals (wrong word,seems right) letter reversals illogical/incoherent/no train of thought cryptic overinclusive circumstantial in general learning deterioration seems like too much info too much info=fatigue, frustration developmental delay (children) topographic disorientation get lost a lot go to wrong place bump into things a lot drop things a lot, more one side than other place objects on edge of table knock over objects when reaching for them stumble on curbs and steps, didn’t raise foot high enuf turn the wrong way when exiting buildings a lot “spatial dyslexia” turn on wrong faucet turn switches, jar lids, thermostats wrong way miss a step going up or down stairs altered consciousness speech problems can’t find right word incoherent speech stutter get your tongue tangled a lot	Bleiweiss, Murray Bleiweiss Bleiweiss Bleiweiss Bleiweiss Bleiweiss Bleiweiss Bleiweiss V-F Bleiweiss,Murray,V-F Bleiweiss, V-F,Burrascano Bleiweiss Anders V-F V-F Bleiweiss Sowell Sowell Bleiweiss Bleiweiss Bleiweiss V-F Bleiweiss Bleiweiss Bleiweiss Bleiweiss Bleiweiss Nields Bleiweiss Bleiweiss Bleiweiss Bleiweiss Burrascano Bleiweiss, Paschner,V-F Bleiweiss Bleiweiss Sowell Bleiweiss, Nields Burrascano Burrascano Nields, Fallon Nields, Fallon Nields, Fallon Nields, Fallon Anders Anders Lymies, newsletters Lymies Lymies Bleiweiss Ackerman Burrascano Fallon,Murray Kollikawski Bleiweiss Anders
Misc: swollen glands sore throat difficulty swallowing symptoms worse in afternoon ridged and pitted fingernails white spots on nails roof of mouth tender epithelial ulcers, roof of mouth red sores edge of tongue, gums “unexpected spates of muscle cramps, sprains, tendonitis, bone or jt pain at sites of load bearing” high cholesteral characteristic of late stage more unfavorable HDL/LDL ratio in late inflammation abdominal wall muscles persistant dry cough vocal cord spasm/weak or hoarse voice night sweats profuse sweating abnormal tissue growth diminished reflexes exagerrated reflexes startle reflex (ie, you scare easy) exagerrated hangovers from alcohol rising cholesteral abnormal results on nerve conduction tests headaches, mild to severe	Murray, Burrascano V-F, Burrascano V-F Murray Murray, Doherty Doherty Murray Lymies, newsletters Lymies, newsletters Bleiweiss Burrascano Burrascano Bleiweiss Murray V-F Murray V-F V-F V-F Bleiweiss Burrascano Burrascano Burrascano Nields Fallon, Murray
Movement: myclanic jerking, limbs or trunk facial twitch body twitch when falling asleep clumsiness prone to musculoskeletal injuries frequent falling drop things a lot sloppy handwriting partial leg paralysis limb paralysis facial palsy lower motor neuron weakness abnormal movement arms or legs disrupted function upper back/neck tremor whole body stiffness in morning	Bleiweiss,V-F Burrascano Murray Bleiweiss Bleiweiss Sowell Fallon, Nields Bleiweiss Ackerman Murray, V-F V-F Fallon V-F V-F Burrascano Lymies, newsletters
Muscles: loss of tone lack of muscle coordination gait problems cramps pain tenderness swelling labwork shows high CPK level=inflammed or wasting muscles	V-F Ackerman,V-F V-F V-F, Burrascano Burrascano Sowell Sowell Lymie, newsletter
Pain: musculo-skeletal, changes areas (migratory pain) ear headache mimic migraine mimic muscle tension cervical/radicular arthralgia (joint pain) bone pain chest pain back pain middle low back ache sacroilitis paravertebral lumbo/sacral muscle spasms herniated discs (LD can cause) can’t straighten back after bending spasms feet cramps heel top of foot instep neck and shoulders stiff can’t rotate or tilt head ribs front of neck palpatory tenderness, tibia shaft, periostitis sore throat shooting pains, muscles buttocks, legs fingers “sausage digits,” swollen,blue, stiff, extreme pain typical of psoriatic arthritis, which LD mimics hips face scalp forehead temple eye teeth testicular or pelvic	Fallon Lymenet Fallon Bleiweiss Bleiweiss Bleiweiss, Fallon Bleiweiss Bleiweiss Bleiweiss,Murray Murray Bleiweiss, Murray Bleiweiss Bleiweiss Bleiweiss Murray V-F Murray Murray Murray Murray Anders Murray V-F Murray, Burrascano Murray Bleiweiss Murray Murray, V-F Murray Murray Anders Kaell Murray V-F V-F V-F V-F V-F V-F Burrascano
Personality: generally pessimistic morbid fear of hidden illness maudlin,overly sentimental, overly dramatic prone to “fatal attractions” imagined conspiracies perception of being in a hurry, no deadline inability to be calm agoraphobia claustrophobia gives impression of erratic gives impression of inappropriate behavior neglect of appearance/hygiene changes in general phlegmatic sullen distracted hyperkinetic misbehavior (children)	Bleiweiss Bleiweiss Bleiweiss Bleiweiss Bleiweiss Bleiweiss Bleiweiss Bleiweiss Bleiweiss Bleiweiss Reik, et al Paschner/Steere/V-F Bleiweiss Bleiweiss Bleiweiss Bleiweiss V-Fs
Psychiatric: profound fatigue insomnia panic attacks hallucinations auditory olfactory inappropriate laughter inappropriate behavior violent outbursts manic/depressive behavior loss of contact w/reality feeling of depersonalization feeling of loss of control paranoia schizophrenic-like states dementia psychosis suicidal thoughts	Murray, V-F Murray, V-F V-F Paschner, et al Reik, et al Fallon V-F Fallon,V-F V-F V-F Fallon Fallon V-F V-F V-F V-F Fallon, V-F
Reproductive: abnormal vaginal bleeding symptoms worse with periods impaired fertility loss of libido heightened PMS unexplained menstrual irregularity unexplained milk production or breast pain unusual pregnancy miscarriage,stillbirth premature birth birth defect	Murray Murray, Beiweiss Bleiweiss Nields, Bleiweiss Bleiweiss Burrascano Burrascano Lymenet Lymenet Lymenet
Respiratory: wheeze recurrant URIs shortness of breath persistent cough (unproductive) asthma pneumonia can worsen existing conditions sinusitis, asthma, bronchitis, allergies	Murray Bleiweiss V-F Burrascano Lymenet Lymenet Bleiweiss Bleiweiss
Sensations: profound fatigue diminished exercise tolerance lowered stamina numbness or tingling: central face, scalp, fingertips, extremeties in general spastic paraparesis burning or prickling anywhere areas of heightened sensitivity electric shock sensation/pain dizzy lightheadedness imbalance vertigo motion sickness abnormal smell abnormal taste loss of taste sensitivity to vibrations feel vibrations when no source for them increased drug sensitivity jitters sensory loss in general	V-F, Fallon V-F Burrascano Bleiweiss Murray, V-F,Burrascano Fallon Lymenet V-F Bleiweiss Bleiweiss,Burrascano Burrascano Bleiweiss,Murray,Burrascano Bleiweiss Bleiweiss,Burrascano Nields Nields, V-F V-F Nields Anders Murray Murray Fallon
Skin: erythema migrans rash (w/ or w/o tick) purple lumps, esp earlobe mimics eczema mimics psoriasis mimics hives mimics psoriasis mimics poisen ivy (and, presumably, oak) mimics flea bites mimics pityriasis rosea (but is spongiotic dermatitis) odd sensations on skin: crawly, buggy feeling tender itchy flushing excess sweating or none increased sensitivity to fabrics, esp synthetic cankers/cold sores red sores, edge of tongue or gums small round painless sores that scab over, >>leave a mark resembling a vaccination scar epithelial ulcers, roof of mouth blood spots under skin, esp after heat scalp tender or itchy unexplained hair loss round black and blue spots, similar to bruises Murray but don’t hurt when touched easy bruising fingernails have tiny pits between vertical ridges abnormally accelerated age/liver spots on hands unusual growths (Borrelial lymphocytoma) on ear lobes, axillary skin folds and nipples	V-F V-F Bleiwiess Bleiweiss,Murray Lymenet Lymenet Lymenet Lymenet Duray Bleiweiss,Murray Lymies, newsletters Bleiweiss Bleiweiss Bleiweiss, Burrascano Bleiweiss Murray Murray Murray Anders Murray Murray Burrascano Murray Prehn Doherty Doherty Duray
Sleep: vivid nightmares disturbance (incl subtle) excessive daytime sleepiness inappropriate hypersomnolence insomnia in general insomnia at bedtime early awakening loss of dreams	Bleiweiss,Murray Fallon Fallon Bleiweiss, Burrascano Murray, V-F Bleiweiss Burrascano Murray
Syndromes, conditions, diseases imitated: arthritis asthma attention deficit disorder(children) pneumonia hepatitis jaundice elevated liver enzymes responds to antibiotics (most hep is virus-caused) fibrocystic breast disease cysts in general urinary infections hesitancy frequency incontinence bladder or kidney dysfunction Irritable Bowel Syndrome periostitis of ribs (inflammation of sheath covering bone) tendonitis (incl tennis elbow) sternoclavicular/costochondral arthritis esophagitis acid reflux gastritis MS ALS Guillian-Barre Dementia/Alzheimers’ stroke laryngitis fibromyalgia LD can trigger it Kaell meningitis lupus chronic fatigue syndrome (LD may trigger it) gout herniated disc	Bleiweiss Lymenet Sowell Lymenet Bleiweiss Murray Lymenet Bleiweiss Bleiweiss Bleiweiss Bleiweiss, Ackerman Bleiweiss Bleiweiss Bleiweiss V-F Bleiweiss Bleiweiss Bleiweiss Bleiweis Bleiweiss Bleiweiss Bleiweiss Logigian, Halperin Logigian, Halperin Clavelous (Europe) MacDonald Kohler Murray Fallon Kaell, Barbour Lymenet Murray Krupp, Coyle, Barbour Kaell Stiernstedt

LIST OF REFERENCES CITED

Ackerman R., M.D. et al, Chronic Lyme Disease, Annual Report New York Academy of Sciences 539:16. 1988

Anders, Jentri, Ph.D., personal observation of own case.

Barbour, Alan G., M.D. Lyme Disease: the cause, the cure, the controversy. Johns Hopkins University Press.

Bleiweiss, John, M.D., (deceased), When to Suspect Lyme, online www.cassia.org/essay.htm

Burrascano, Joseph, M.D. The New Lyme Disease: Diagnostic Hints and Treatment Guidelines for Tick Borne Illnesses, Oct. 1998 and Advanced Topics in Lyme Disease, May, 2000. LymeNet online library.

Coyle, P.K., M.D., Antigen Detection and Cerebrospinal Fluid Studies, in Coyle, Lyme Disease, p. 136.

Doherty, Art (a longterm Lymie who actively researches). Online www.geocities.com/HotSprings/Spa/6772/lyme.html.

Duray, Paul H. M.D., Histopathology of Human Borreliosis in Patricia K.Coyle, Lyme Disease, p. 49.

Fallon, B.A., M.D. et al. The Neuropsychiatric Manifestations of Lyme Borreliosis, Psychiatric Quarterly, Vol. 63, No 1, Spring, 1992. Online, LymeNet on-line library. And his presentation at 1992 Lyme Conference, Stamford, Conn., quoted in Murray, p. 245.

Grier, Tom. Lyme Disease Survival Manual. Online www.lymealliance.org.

Halperin, J.J., M.D. et al. Nervous System Abnormalities in Lyme Disease. Annals of the New York Academy of Science 539:24-34, 1988.

Kaell, Alan T., M.D. Rheumatic Manifestations, in Patricia K. Coyle, Lyme Disease, 1993.

Kollikowski, H., M. D., et al. Meningoradiculitis and Bb, Lancet July 20, 1985, p. 148.

Krupp, Lauren B. M.D., et al. Fatigue in Patricia K. Coyle, M.D., Lyme Disease. Cognitive Function in Late Lyme Borreliosis. Archives of Neurology 48:1125-1129, 1991.

Logigian, E.L., M.D. Chronic Neurological Manifestations in Lyme Disease, New England Journal of Medicine 323: 1438-1444, 1990.

LymeNet. LymeNet Guide to Lyme Disease. LymeNet online library. Lymies. Either personal communication from a Lyme victim or a personal account of a Lyme victim published in a Lyme newsletter. NOTE: The compiler did not initially keep track of these particular sources, only the datum. The information is therefore anecdoctal, ie, not established through formal scientific research, but not necessarily untrue for that reason. Lyme research began only because of the careful observations made by a mother only partially trained in scientific research. Much scientific research begins that way.

McKay, LaNelle. Lyme Disease: presentation, diagnosis and treatment, Physician Assistant, June 1998, 28:6, p. 27(12)

Murray, Polly. (with another mother, she was the first to report LD symptoms; she is often called “the mother of Lyme Disease”) The Widening Circle: A Lyme disease pioneer tells her story. 1998.

Nields, J.A., M.D. Tullio phenomenon and seronegative Lyme Disease. Lancet 338:128-9, 1991.

Reik, L. M.D., et al, Demyelinating Encephalopathy in Lyme Disease. Neurology 35:267, 1985. et al. Neurologic Abnormalities in Lyme Disease, Medicine, vol.58:281-94, 1979.

Paschner, and Alan Steere. Tertiary Lyme Disease, Proceedings of the 2nd International Symposium on Lyme Disease, Vienna, Sept. 1985, p.38. The Triad of Lyme Disease..., Neurology 35:47, 1985.

Sowell, Michael K. , M.D. Nervous System Manifestations of Lyme Disease in Children, Spotlight on Lyme (Lyme Alliance newsletter), 11/12, 1999, p. 7.

Stiernstedt, G.T. et al, 3rd International Conference on Lyme Disease on Lyme Borreliosis, quoted in Murray, p. 242.

Vanderhoof-Forschner, Karen, Everything You Need to Know About Lyme Disease, 1999.

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System/Symptom

Source

LIST OF REFERENCES CITED