Lyme Disease Symptoms

The symptoms of Lyme disease are highly varied and can manifest at different times after infection, often progress through distinct pages. It is important to understand that not all individual will experience every symptom, and the way the disease unfolds can vary slightly from one person to another, making it a challenging condition to track and diagnose.

This stage is sometimes marked by the most well-known sign of Lyme: the erythema migrans (EM) rash. Oftend described as a bull’s eye, this rash can be solid red or appear in other shapes. It’s important to know that many people do not get this classic rash. 

Other symptoms at this stage may include:

  • Fever, chills, and sweats
  • Fatigue, malaise, and a general ill feeling may be present
  • Headache
  • Muscle soreness and joint aches
  • And swollen lymph nodes

If the initial infection is not treated, the bacteria can spread throughout the body. Symptoms in this stage can be more widespread and severe, including:

  • Multipe erythema migrans (EM) rashes
  • Bell’s palsy (facial paralysis)
  • Severe headaches, and neck stiffness
  • Pain in joints, tendons, and muscles
  • Heart palpitations, dizziness, irregular hearbeat
  • Short-term memory problems and difficulty concentrating
  • Fatigue may increase
  • And neurological symptoms like shooting pains, numbness, or tingling in the hands and feet

 In the most advanced stages, the infection can cause chronic, severe symptoms. This can manifest as:

  • Chronic arthritis, often in the large joints like the knees
  • Neuropathy
  • Cognitive dysfunction
  • Severe fatigue and general lack of stamine
  • Neurological issues can also be more profound, leading to cognitive problems, memory issues, nerve damage, and extreme fatigue.

 

Dr. Horowitz MSIDS (Lyme) Questionnaire

The Horowitz MSIDS (Multiple Systemic Infectious Disease Syndrome) Questionnaire is a symptom-based screening tool designed to estimate how likely it is that someone has Lyme disease or another tick‑borne illness. It is not a formal diagnostic test, but a structured way to decide whether further medical evaluation and lab testing are warranted.1 It was created by Dr. Richard Horowitz, a clinician who treats Lyme disease, to systematically capture typical Lyme-related symptoms and exposure risk factors.

It helps clinicians and patients decide whether symptoms are consistent enough with Lyme disease to justify specific testing or specialist referral: Answers are scored; higher total scores correspond to a higher probability that symptoms could be due to Lyme or related tick‑borne infections. It can also be repeated over time to track symptom changes and response to treatment.

In the future, we plan to fully integrate the questionnaire and make it directly accessible on our website, allowing you to complete it online and immediately gain insight into your symptom profile.

For now, you can search on Google for Lyme MSIDS questionnaire or Lyme questionnaire (MSIDS) to find the assessment. This comprehensive questionnaire is designed to provide a structured overview of your symptoms and to give an indication of whether Lyme disease may be likely or less probable based on your overall symptom pattern.

Please note that this questionnaire does not provide a definitive diagnosis. However, it can be a helpful first step in mapping out your symptoms and identifying whether further evaluation by a Lyme-literate healthcare professional may be advisable.

  1. Citera M, Freeman PR, Horowitz RI. Empirical validation of the Horowitz Multiple Systemic Infectious Disease Syndrome Questionnaire for suspected Lyme disease. Int J Gen Med. 2017 Sep 4;10:249-273. doi: 10.2147/IJGM.S140224. PMID: 28919803; PMCID: PMC5590688. ↩︎