Could Lyme Disease Be Why You’re Still Sick? Symptoms, Testing, and What May Be Overlooked | E179

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In this Made for Health minisode, Dr. Aaron Hartman continues his series exploring an important question: Why are you still sick? Why does your body seem stuck even after you’ve tried so many things?

This time, he turns his attention to Lyme disease—an infection that can present in different ways and may sometimes enter the differential diagnosis when people are dealing with persistent fatigue, body pain, migrating joint or muscle symptoms, neurological complaints, or other unexplained problems.

Dr. Hartman shares examples from his clinical experience, including patients with symptoms such as chronic fatigue, widespread pain, Bell’s palsy, sciatica, and foot drop. His broader message is that when a patient’s symptoms do not fit neatly into the expected picture, clinicians may need to take another look at the history, exposure risk, symptom pattern, and appropriate testing rather than relying on one isolated result.

He also discusses the challenges surrounding Lyme disease testing, including antibody testing, Western blot testing, immunoblot testing, and symptom-based clinical evaluation. Current CDC guidance recommends a two-step, FDA-cleared serologic testing process and notes that antibody tests can be falsely negative during the first several weeks after infection. IDSA guidelines also recognize that a classic erythema migrans rash can be diagnosed clinically without laboratory testing.

Key Topics Covered

Why Lyme disease may be considered when someone remains chronically unwellPersistent fatigue, body aches, and migrating painNeurological presentations discussed in the episodeLyme disease and Bell’s palsyDr. Hartman’s clinical experiences with unusual symptom patternsWhy timing matters with Lyme antibody testingStandard two-tier Lyme disease testingWestern blot and immunoblot testingThe limits of relying on a single laboratory resultThe importance of symptoms, history, and possible tick exposureDr. Hartman’s approach when clinical suspicion remains highThe MSIDS questionnaire discussed in the episodeWhy chronic illness may involve more than one contributing factorWhen a deeper evaluation may be appropriateContinuing the search for overlooked cont