I was looking for stats to see how reliable EKGs really are in determining whether one has Lyme if nothing…. Here’s something from Johns Hopkins: http://www.hopkinsarthritis.org/arthritis-info/lyme-disease/lyme-signs-and-symptoms/
Radiculoneuropathy overall CNS or PNS involvement in 10-20%
Atroventricular nodal block overall cardiac involvement in 4-10%
Pericarditis overall cardiac involvement in 4-10%
Myopericarditis overall cardiac involvement in 4-10%
Eye involvement probably uncommon
(months to years later) Arthritis up to 60% of untreated patients, most often monoarticular and large joint
Encephalopathy subtle cognitive dysfunction probably uncommon
Polyneuropathy distal paresthesias or radicular pain probably uncommon
I’ll be posting the PDF checklist soon!
I am compiling a list of symptoms that I have experienced; this is an ongoing thing and will be updated accordingly. I want to raise awareness for people whose symptoms do not fit the “typical” grid… as I constantly repeat on this blog, I write with discretion and cannot emphasise enough how important it is for you, blog readers, to decide for yourselves what information makes sense to you. Do your own research. More than ever before, the amount of information is overwhelmingly abundant and accessible to anyone, anywhere. Some citations I use are “credible” by peer-review standards. Other resources have been targeted with heavy scrutiny. I choose to take what makes sense to me, and what resonates with my experience. After all, although the experts know best, they do not know half the hell that Lyme sufferers experience.
With that said, and since it’s been three years, and given that one of the main symptoms of Lyme is memory problems (see Amen, 2015: The CDC Reveals Truth About Lyme Disease and Cairns & Godwin, 2005: Post-Lyme borreliosis syndrome: a meta-analysis of reported symptoms), PLEASE UNDERSTAND THAT EARLY SYMPTOMS LISTED HERE ARE JUST OVERVIEWS OF WHAT I CAN RECALL, except where indicated otherwise. Recent issues and treatments are covered more accurately in more details.
I should add that I truly feel for people who have Chronic Lyme Disease, (also see Jacek et al, 2011) but since I was never treated to begin with, I have hope that once I am done killing these terrible spirochetes, I’ll resume my life outside of that controversy. I know, denial on my part.
How I Got Bit
My Lyme problems began in October 2013, around Halloween. I was out with my girlfriends, at a park near a corn farm by a small creek in Ontario, Canada. I was psyched to be home having been working oversees at the time. I recall going to a park and just falling into the orange and red leaves. Something I’d done almost EVERY FALL.
For some reason, the possibility of Lyme never crossed my mind. It’s just one of those things you hear about on TV. I wasn’t even sure how you get Lyme or what it was exactly. Being a fearless nature lover, I didn’t mind getting bit by bugs or mosquitos or so on. Not once did I think you can get a DISEASE… things like malaria are not first-world concerns. And my parents made sure I got every vaccines under the sun. I was protected. So being exposed to bugs and plant poisoning was part of the experience for me I guess..
A day or two later I remember the rash, spot on (pun intended). I was fresh out of the shower, where the lights are so so bright, defying the darkness of fall and winter, and I recall seeing a red lumpy spot near my right elbow with a red rash around it. It was not very itchy but just bothersome. I showed it to my mom who thought it looked like an eye. I rolled mine at that and showed it to my sister, and we both assumed it was “probably a mosquito bite with someone’s bad blood” (beat that Taylor!). Nothing to worry about, right? Their reactions and comments is what made it stay in my mind.
The After Bite
Boy, was I WRONG! I returned to work within a week. And surely in that following month I got the worst flu I have ever had in my entire life. I am generally healthy. And though I did sport a bad nicotine habit, I was fit as a glove despite that. I ran 3 times a week, lifted 4, and was training to be a rescue and divemaster 5-6 times a week. I was in the best shape of my life. After that flu, recovery took months; the coughing and fever went down, but I still had congestion and low temperature, low blood pressure, low vitamin D and K, and I was tired. I was so so so tired. But thought it was training. My periods were also out of whack, after working SO hard for YEARS to fix an existing PCOS condition. I went to my GP and she suggested I visit an OB/GYN who prescribed Diane birth controls (BC). That really did it. I was depressed and suicidal. The cysts, which disappeared, were now back, and back with vengeance and nothing I did got rid of them. I ate clean at the time, sticking to an intense paleo diet. My family rejected the diet, so anything I said was attributed to my “anorexia” and that it “finally took a toll on me.” By “it” they meant my fitness and eating habits. But I ate 1600 a day and had a cheat meal on Sundays which consisted of anything such as spaghetti to a 1/2 lbs burger, or a humongous chocolate cake. And trust me, I ate. The overweight high schooler still lived somewhere within.
Always doubting myself when it comes to what my family says, I went back to my GP. She took me off the BC, and started investigating. She came to the conclusion that it must be the vitamin D. So I had to undergo a treatment that lasted three months consisting of a injection on my behind. I felt better, but not by much. My Vitamin D stabilised but remained on the lower side. Again, I went back to her, and she decided it was post-flu fatigue coupled with IBS. So I removed EVERYTHING known to cause IBS out of my diet. The result, I gained weight. More so ’cause I couldn’t carry out the exercises I used to be able to and because I lived on eggs, rice, chicken, quinoa and oats since I was too tired to prepare more veggies and fruits. I realized it couldn’t be my diet… I was already eating pretty healthy. In fact I started eating less when this weirdness started.
Being me, I got frustrated at the doctor… IBS? Seriously? NO! But I went back because at this point I was in pain… and this time she said I have IBS AND fibromyalgia… seriously!!! She pointed out something very odd.. she said that diarrhea in IBS can get backed up behind constipated stool or something like that, and so you can have a weird combination of both constipation and diarrhoea at the same time… I never really looked this up as it wasn’t my main concern, the pain was. So, I was prescribed some pain killers which I didn’t take because, at that point, I just wanted to know what was going on and I was still under the impression that my body is invincible, and that it would take care of this itself…. it didn’t, and I never found out what it was.
Now this was during the 8 months following my Canada trip in October 2013. Here’s a recap of my Symptoms up ’till then:
- Late October early November 2013, I spotted the rash…erythema migrans! I am sure of it now….
- Flu in mid-end of November, house-bound for a week
- My period started going all weird by end of November too
- Terrible bronchitis in December lasting well into January–I remained bed-ridden for about two weeks
- January-March 2014 the right side of my face began to droop. At first it was just when I was exhausted (mornings, when I first got up, or late in the evening… or after any type of non-sedentary activity). My best friend noticed the droopy eyelids… I always thought I had an asymmetrical face, but my right eye never drooped like that before. My pupil also looked lazy… mad-eye qp? (get it? Mad-Eye Moody? had to throw that in there!)
- Feb-March Fatigue + digestive problems (vitamin D diagnosis and post-flu fatigue)
- May another flu/cold like week (ps. I have an odd habit of taking ill-selfies….)
- April-June back for more digestive problems and now pain! My muscles hurt even without exercise. My skin hurt just by touching certain parts. This is also when morning stiffness began… I was not only tired, I felt like a log. Basically, what I imagine dead people feel like… if they felt like anything… you know what I mean. In addition to this, I was always cold…. I was working in a country that is 40°C all year except for Dec-Jan-Feb where it was an average of 25°C. Let me remind you, I have survived Canadian winters. And in this heat, I was sooooo cold I usually tucked my feet under my best friend’s bum sitting down on the couch while we watched TV, me wrapped up in all the blankets in the house. It was also around the time my feet started turning blue excessively… I’ve been told Reynaud’s disease runs in the family, and I’ve seen my feet turn blue while sitting still in the past, but this was purple. Cross between smurf and Zombie feet, almost 70% of the time.
- I got the second-cold sore I’ve ever had in my life….nothing prompted it except maybe the ongoing coughing.
- From May to August I kept having recurring conjunctivitis. It’s so gross I had the urge to document it with many many pictures of me stuck in bed with eye mucous…
- June-July unusual vaginal discharge that’s thick and white. Allergies from mould, the cat, panty liners, dairy…. I also experienced major hair loss… My hair was falling in locks. I treated the latter with cortisone, and although locks stopped falling, my hair still sheds like a cat and is considerably thinner.
- Also, about the same time (June-Julyish) my hair texture began changing. It went from fine curls to a mix of fine-coarse waves… very odd. My blood pressure and temperature both were down, which alerted the nurses every time I went in to see my family doctor. I got accustomed to saying “oh that’s ok” or “that’s my baseline/normal.” The truth is, I am not sure when that became my normal…
- By July 2014 I forced myself to try to go diving more frequently again. Since January, my diving averaged at 3 times or less a month, something I tracked easily with my dive-computer. I didn’t attribute it to illness then, but it coincides with all my sick-leaves. So upon trying to do 3-dives-a-week again, I noticed I started getting motion sickness. I don’t get “sickness” or “phobias” or anything weird like that… I vomited for the first time in my life in August (that story for another time! And I promise you a funny one at that.)
- I spent most of the summer through September in bed, at my desk, or on a couch. Sick.
- By early October, I got another flu/cold and no meds seemed to work. Not even codeine Tylenol — something I avoided unless I am really not doing well. At this point, my lymph nodes started swelling up under my arms. It has been a constant ever since.
By September 2014, I moved to a new country to start my degree… I still had no idea what’s wrong… I figured I was depressed or something and once I settled things will get better… see, another scary thing about Lyme is that, unlike other diseases, your body does NOT form antibodies that protect you from re-infections. In fact, “[r]e-infections are common in endemic regions” (bold emphasis added), this implies “a lack of functional immune responses” (Elsner et al., 2013). This means, unlike your annual flu shot, “[t]here is no vaccine available for human beings” (Stanek et al., 2012). This is worrying because “Bb infection suppresses the development of long-lived antibody production and immunological memory formation [… this] indicates that Bb may achieve this by suppressing the function and/or causing the rapid and global collapse of germinal centers” (Elsner et al., 2013). What this means is that not only can you get re-infected, but the bacteria is smart enough to screw with your other immune functions, which react to other infections! Yes, including influenza. I hate placing my own analysis, but in my case, this seems to answer why I kept getting sick all the time.
Anyway, I spent the end of 2014 (September-January 2015) trying to get myself back into my fitness routine. I kept pinning my failure on moving, but by that time I was set and well-adjusted. It wasn’t the move. My periods were a mess… I went to see a PCOS specialist, and he had me on Metformin… it didn’t do anything for my irregular periods. Knowing that I am a PhD researcher, he did share his book about PCOS and asked me to edit it for him…
I kept getting sick (respiratory problems), so I quit smoking in October 2014 for exactly 100 days thinking all these years of nicotine abuse had finally caught up with me. It did nothing for me. In fact, I got worse and I lost my sense of smell. At this stage I got my third fever, which got pretty bad. I recall staying in for 3 days on my own until it subsided. At that point I began self-medicating and looking into vitamin deficiencies. I ordered every supplement under the sun starting with all the vitamin B family. Here are the symptoms I developed in 2015:
- Cracked lips (sometimes they bled and they wouldn’t go away… I changed toothpaste and used all sorts of treatments to no avail)
- Weird “bugs-under-my-skin” sensation. Almost like twitching but not… My eyes were twitchy (again, this is how I came to think I was lacking vitamin B), my legs were restless, I couldn’t sleep without jerking. Sometimes my whole body was shaky…and sometimes it felt like hundreds of spiders were running wild under my skin. I should note that these symptoms started in 2014 actually but were not as intense as they were in 2015.
- Then the worst thing started… night sweats… they woke me up at night no matter what the UK weather was like. I resorted to wearing barely there PJs and got a microfiber blanket… still, the sweating continued. Sometimes I would be freezing, and as soon as I throw on the covers, BAM it’s like sprinklers were switched on.
- I began falling a lot more… this was around winter-spring (2015). For some reason, I like walking up or down escalators, it makes me feel like I am faster than human, and normally I have no problems doing that… but it got pretty bad at this point and I kept coming home with badly bruised legs. I also kept tripping for no reason as I walk down the streets of London. I am normally very coordinated. But I started misjudging the distance between my hand and the table when setting things down, or being unable to apply eyeliner steadily, I kept tripping on air, and narrowly missing the door frame when I existed a room at an angle… This never went away… unlike the other symptoms which came and went… coordination became an issue for me…
- Insomnia for days.
- Sensitivity to more foods and stimulants. I had to lay off coffee because of insomnia (even a bit of chocolate would make me stay up an extra hour I can’t afford to spare!) wheat made me bloat, so did legumes, dairy, anything fried or fizzy, anything with extra sodium. In fact, on some days my feet would swell up to the point I couldn’t wear my shoes and had to sit up with my legs to the wall to reduce the swelling. I am still unsure why this occurred.
- By summer 2015, I began developing terrible psychiatric symptoms. Some that cost me valuable relationships and set me back with work and fun.
- Depression set in… for the first time I understood what it meant to be down. It isn’t your usual mood blues… or the kind of sadness you get when you’re upset. This was a hopless, no-desire-to-live-let-alone-do-anything-else auto-pilotted existance. Although I was going through a rough LDH, I don’t believe it to be the cause. After all, I was the nutty one who was calling the shots (yes, I confess). My whole family noticed, and everyone reasoned the cause as it fit their frame of reference. I however, had no idea why I was sad… So of course, needing to have reason at all times, pinned it on my current living situation, as it were, converted back into that of a student. Now, granted there were some financial and living stressors at the time, which came with my life as a researcher, but it wasn’t unsual and definitley less daunting than other things I’ve encountered in the past.
- Anxiety. Anxiety hit by the end of August 2015, this is probably my most dreaded symptom. I already experienced a degree of anxiety before Lyme. So when this hit, it hit hard, without warrning, and unlike anything I have experienced before. One day, after a few days of trying to contain a rootless panic, I secretly drove to a private psychiatrist, in the town where my family and I were vacationing. I self-diagnosed as borderline, again the psychiatrist listened to me calmly and said he thought that these may be coping mechanisms and that I should see my GP when I am back home. At that, he gave me a few pills of zoloft I believe and sent me on my way. I took one on the day, and none since. Needless to say it only made me feel high. Weeks later, when I was back (school)home, I had bad heart palpitations to the point I fainted twice. Again I’ve only ever fainted once before, and that was from a stupid dangerous diet I tried in highschool. This however, occured in the shower, in the middle of my rinsing my hair… impromptu… nothing to cue it in. When I came to, it was still there and all I could do, all I did, was cry. I called my sister crying hysterically. As we talked, I stopped listening to her, and I could hear myself telling me that this is very strange and unusual and that there is nothing to fear. But my body wouldn’t have it and I was still freaking out. I tried to talk myself into belly breathing, a technique I learned in college back in Canada, and that didn’t do much. So I took some melatonin (something I got with me from Canada to deal with insomnia since they don’t sell it in the UK), and let myself drift into sleep….
- By September-October 2015 I stopped smoking for good (today is day 313!), again thinking it had something to do with my condition… what also started at this time was a strange state of hibernation…. I slept so much! I slept for days. If I woke up for an hour to go to a seminar or meet someone, I slept for a whole day to make up for it. This kept going until I started on psychiatric medication, which reverted me back to insomnia.
It has been a difficult battle against anxiety and other psychiatric issues… I have been to several doctors for depression and anxiety. It’s been a year now since the psychiatric symptoms began. Xanax is a miracle; Pregablin is hell. CBT works, Psycho Analysis doesn’t. Both seem to focus on one thing not the other. It was during this time that Lyme became apparent. My best friend was first to suggest it to me, having doubt only about whether or not I had a bite. As I was walked through the symptoms, I was shocked to hear about the tick bite! Again, like I said earlier, I didn’t know how one would contract the disease. I couldn’t believe it… I called my sister and my mother and asked them, they both confirmed having seen it (although now they seem to be unsure… and since this counts as witness evidence.. we all know it’s unreliable). At this point I told my university GP… she was hesitant but she went along with it…
It is worth mentioning here that the pain was worse by a 1000, and I looked like garbage… I had to put major effort to avoid being asked if I was ok. At one visit to the doctor, my left leg was in sever burning achy pain. She barely touched it and I was already screaming in pain… That’s when I had my first western blot. This was around 2015. It was negative. I dismissed Lyme happily and went back to my vitamin supplementation. But that set me back months… The symptoms only got weirder and worse throughout 2015:
- strange loose skin on my belly and inner thighs and face
- hair shedding again
- Sinus infection, yeast smell from nose, loss of smell
- ear, lower back, and jaw popping
- lymph node under right jaw was swollen it was visible and felt
- vertigo in the mornings that lasted for about 20 to 40 minutes everyday
- pain in the soles of my feet
- aching muscles, shoulders and neck (neck cramps were very frequent at this point)
- teeth grinding (lead me to custom order a night guard)
- dark urine
- blurry vision, my eyes would lose focus and can’t adjust quick enough, floaters, and the notorious blue stars
- the worst headaches/migraines
- worse anxiety attacks
Towards the end of winter 2016, around March, I developed new terrible symptoms that kept building up slowly: edema and podagra (feet gout). Feet and leg edema was evident but took a long time to reach full-blown form. Podagra however crept in slowly. At first I thought I had bad shoes, which lead me to think I was developing bunions, and then a change in shoe size (where my feet grew in a matter of months!), nothing seemed to alleviate the pain. And because the soles of my feet were always achy in the morning, I assumed I was walking too much for too long and that it’s finally deforming my toes. i.e. I couldn’t distinguish the pain. Click here for the difference between bunions and podagra.
At this point I was still unsure of what can and can’t be a symptom of Lyme, and my family was calling me hysterical and dramatic. At that, I kept the level of pain to myself, and only alluded to it when something was requested of me and I couldn’t do it… I started buying bunion support braces. I was also angry. Angry that no one could help me, and instead made it sound like I am Victorian socialite with hysteria. I had nowhere to funnel the anger except into research.
The bunion braces made things worse… I became unable to walk or stand for long periods of time, and the pain seemed to stay even when I was resting. In spring 2016, a new symptom surfaced… My vision changed and my prescription doubled in a span of three months. One day I woke up to the most excruciating eye headache I have ever had. And having worn glasses and dealt with opticians from a very early age, I knew these weren’t sinus headaches. Surely, I went to SpecSavers and had an eye exam. My existing prescription was off. BY A LOT! The doctor was worried, especially that I had my vision and eyes checked only about a year ago confirming my vision was still the same as it was.
It is worth mentioning that when I went to the doctor who checked my eyes last, he noted that my eyes were abnormally dry and that I couldn’t perform corrective surgery due to low cell count, my vision however was unchanged. The SpecSavers optometrist sent me to an eye hospital to get my eyes fully checked. There, they wanted to examine the physical eye–not my vision. They measured pressure for possible glaucoma (since it runs in the family) and checked my retina and so on… The end of a 7-hour day at the hospital landed me with a doctor saying he cannot detect any physical deformation, he couldn’t say why I was having headaches or why my vision changed so rapidly, and the only thing he can note is excessive dryness and extreme sensitivity to light– these are symptoms of Lyme. Of course, I didn’t know it at the time… My family insisted it was staring at computers, playing video games, and reading for a PhD.
I changed my glasses and continued to take my two Advils a day, and wearing my bunion braces and cushioned insoles. The flashing orbs of light remained, and my eye blurriness continued among all the other symptoms. Unmedicated, the headaches took over and it was hard to contain them. On June 6th, 2016, I sent my blood samples to ArminLabs to test for Lyme. Two weeks later I tested positive for a strand known as b.B Sensu Stricto. Click here to learn more about borrelia types in an article by Baranton et al. (1992) or download the PDF. Here’s a newer article by Ryffel et al. (1999).
At this stage my partner had managed to get his hands on doxycycline, minocycline and tinidazole antibiotics. I refrained from taking them until I met the doctor my family insisted would be the maker or braker of my diagnosis. I had an appointment in late June 2016 with a “world-renowned infectious diseases” physician. Not only was he an abhorrent human who formulated his preconception of his patients just by looking at his clinical-duty roster (which gives the doctor a mini profile of his patient), he was a racist passive aggressive sort that reveled in his white man’s burden bubble to “save africa from aids” or something along those lines (don’t get me started on postcolonialism). He completely dismissed Lyme as a psychological problem I was having, more specifically as hypochondriasis. Since my family was egging him on, I stood no chance. His evidence of this? Well, my EKG turned out NORMAL. But duh, I knew that before going in! He asked for some tests and said that a negative is a negative and a positive is a false positive. He also suggested I read about Lyme controversy before pursuing it as something that I have (yes, he did! As if anyone would want such a thing), and that with the right price tag, anyone will sell me a diagnosis (I wasn’t sure if he was implying I should pay him more at that to be honest or if he meant others would take bribery).
I knew I did not want to go back to him again, so I just clapped my hands (figuratively) for his “artistic” diagnostic skills (because “science can only do so much, before turning into an art” said this oh-so-humble (not!) doctor). I couldn’t wait to go home and start my medication.
In a controversial article that, in itself, has a lot of holes, but mainly undermines the pain of a lot of people–not to mention their sanity–one “misconception” was presented as such: “[a]lthough Lyme disease can cause heart or brain abnormalities, there have been remarkably few—if any—deaths attributable to this infection” (Halperin et al, 2012). The operative word is CAN. It can but doesn’t have to… The article only shows how insanely diverse are the manifestations of Lyme. And that as of yet, we do not know much about anything! The article also goes on to say how heart disease isn’t necessarily a symptom in all cases. Now although I could write a whole article reviewing Halperin et al. (2012), advocating the devil’s side on their subject, I won’t. It’s useless arguing established views. And since I like to quote things, here’s one that fits this situation perfectly: “if the only tool you have is a hammer, to treat everything as if it were a nail” is an easy out (Maslow, 60s). The hammer here is psychiatry… because we do not fully understand the human brain either, it is easier to say “oh, your brain is broken, and no possible alternative exists” than it is to say “we don’t know everything.” I accept that heart disease would have aided in the diagnosis, but it doesn’t mean it’s the master symptom to determine the existence of Lyme.
In a letter that doctor composed to the GP I visited early in my days in the UK, he wrote to his colleague implying an apology for entertaining me, the crazy patient, and stated that although I had mentioned some concerning symptoms (including my latest vision, small joints, and podagra pains and problems) my “condition was asymptomatic” and that he agrees that this is a psychiatric adaptive stress mechanism. I didn’t mind because I have no intention to go back to either of them. After the infectious diseases doctor’s appointment, I began taking the antibiotics my companion had ordered in this way:
Antibiotics Pulsing Treatment
- Tinidazole ________________ 500 mg x 1 in the morning for 4 days
- Minocycline _______________ 100 mg x 2 a day in the evening for 4 days
- break for three days then start again in the same way, for 6 weeks.
This process is called pulsing because the bacteria has a slow growth rate and has the ability to remain dormant for long periods of time. By pulsing my treatment, I can target the bacteria at different stages. My partner, who has a PhD in science and can understand how this works better than myself, has done the research on the chemical and biological interactions of the medications. According to him, one antibiotic tackles one form of the bacteria while the other deals with another. Here‘s something to read about the Lyme spirochete forms.
Anyway since starting my treatment (I started week 5 today!), my podagra has VANISHED! It sometimes reappears on the third day of my break, but doesn’t last at all. My fatigue is significantly reduced (and I was able to last my first all-nighter for the first time since getting Lyme). I did experience several herxing episodes which I will detail in another post, but they didn’t last long and weren’t as bad in comparison to the years of suffering.
In getting better, I was pushed to look into the relationship between Lyme and some of the symptoms that disappeared to see if I were the only one experiencing them, and whether or not those were likely coincidences.
Here’s what I found: There is at least one other documented case of podagra gout and Lyme observed and treated by Siddiqui et al. (2015). I was told that Lyme arthritis hits big joints, and I believed my doctors. I now know that that’s not true. It can hit your small joints. Conjunctivitis can occur early on (Steere et al., 1985) and may go unnoticed because of how simple it is. The frequency should tell you something though. You should know that in combination to your other symptoms this may paint a complete picture rather than an accumulation of separate conditions.
I haven’t taken doxycycline yet. I will save it for later in case this 6 week pulsing treatment doesn’t work. I will follow the Mino and Tini with the Alfons Ven, which I first read about here. You can click on the following links for more information by people who have been using it:
If nothing else, I hope it detoxes my body. I also purchased some Otoba Bark and Cat’s Claw (a.k.a banderol samento) from Amazon by a company called Nutramedix. I will keep posting about any further updates in hopes that this may help someone somewhere…
Further Readings On Lyme and its Symptoms
- Lyme Research Alliance, Some Of The Many Symptoms of Lyme Disease Are, http://www.lymeresearchalliance.org/signs-symptom-list.html
- Kaplan, 2003, Master Symptom List for CFS, FMS, CMP & Lyme Disease
- Pachner (1989) Neurologic Manifestations of Lyme Disease, the New “Great Imitator” http://cid.oxfordjournals.org/content/11/Supplement_6/S1482.short
Barbour (1984) Isolation and cultivation of Lyme disease spirochetes http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2589996/
- Microbe Wiki (2011), Borrelia burgdorferi sensu stricto https://microbewiki.kenyon.edu/index.php/Borrelia_burgdorferi_sensu_stricto
- Branton et al. (1992), Delineation of Borrelia burgdorferi Sensu Stricto, Borrelia garinii sp. nov., and Group VS461 Associated with Lyme Borreliosis, http://www.microbiologyresearch.org/docserver/fulltext/ijsem/42/3/ijs-42-3-378.pdf?expires=1469460481&id=id&accname=guest&checksum=8D3592BC2DFDC50FA763BA0F3BF80890
- Lymedisease.org (2015), Lyme Disease Symptoms, https://www.lymedisease.org/lyme-basics/lyme-disease/symptoms/
- Stanek et al. (2012), Lyme borreliosis, http://www.sciencedirect.com/science/article/pii/S0140673611601037?np=y
- Lantos (2015), Chronic Lyme Disease, http://www.sciencedirect.com/science/article/pii/S0891552015000203
- Amen (Nov 2015), The CDC Reveals The Truth About Lyme Disease, http://webcache.googleusercontent.com/search?q=cache:nUSEdEVMHyYJ:www.amenclinics.com/blog/the-cdc-reveals-the-truth-about-lyme-disease/+&cd=1&hl=en&ct=clnk&client=firefox-b
- Cairns & Godwin (2005), Post-Lyme borreliosis syndrome: a meta-analysis of reported symptoms, http://ije.oxfordjournals.org/content/34/6/1340.short
- Halprin et al (2013), Common Misconceptions About Lyme Disease, http://www.sciencedirect.com/science/article/pii/S0002934312008753?np=y
- Under our Skin documentary http://www.veoh.com/watch/v21055812yWtmpgB8