The difficulty of arriving at a Lyme Disease diagnosis is legendary, both within the medical profession and in the community of LD sufferers. Even a glance at the literature reveals dozens of stories of people who’ve suffered for months or years before a proper diagnosis… and there are thousands more such tales.

White Gloved Hand holding Petri Dish

Getting a Correct Lyme Disease Diagnosis Can be Difficult

Why is this so? Why can’t a doctor just take a look at the symptoms, do a few tests, and make a diagnosis, like they can with the flu, or diabetes, or even cancer?  There are many reasons, but they boil down to the fact that the cause of LD is a stealthy bacterium that’s good at masking itself as something else.

Basic Symptomology

One of the greatest difficulties with diagnosing Lyme Disease comes from the fact that there’s only one symptom that’s considered immediately diagnostic, and even its utility is limited by the fact that a) it doesn’t always appear; b) it can be mistaken for other things; and c) other things can be mistaken for it.

The erythema migrans (EM) rash has a characteristic bull’s-eye shape that’s easy to recognize, when it shows up — which it doesn’t about 40% of the time. Even when it does, it can take another form that’s not as recognizable, and other ailments can, occasionally, mimic it. So it’s not 100% diagnostic.

Other Symptoms

The other common Lyme Disease symptoms are even worse. Chronic fatigue; arthritis; flu-like symptoms of joint pain, muscle aches, fever, and headache; and neurological symptoms are also symptoms of other nasty illnesses, even when they occur in combination, which they don’t always.

The  causative agent, the corkscrew bacterium known as Borrelia burgdorferi, is an inveterate mimic in the symptoms it produces, so it’s easy for even an experienced medical practitioner to diagnose LD as something else — and end up treating the wrong illness altogether.

Even today, medicine can be a hit-and-miss process, where things are less clear-cut than we’d like them to be — or that the doctors would like to pretend they are.

The Stealth Bacterium

Speaking of Borrelia burgdorferi, the bacterium is simply hard to detect. Apparently, it doesn’t take many to start making the host ill, so it’s very, very hard to find in the host’s body at first. It’s almost impossible to identify and culture the bacteria anyway, so the tests have to look for antibodies to Borrelia instead.

Despite the sincere efforts of many medical scientists over the years, the tests are still unreliable; in fact, they can produce more false results (both positive and negative) early in an infection than later on.

Even later they might not work, because antibodies can be concentrated elsewhere than in the bloodstream, or may be bound to the bacteria instead of free-floating. Add the fact that Borrelia likes to hide in out-of-the-way places, like the brain and spinal fluid, and it can be very hard to detect at all.


On top of all this, there are medical attitudes to deal with. Some professionals are reluctant to diagnose LD, because it’s easy to mistake it for other things, and vice versa. Some won’t diagnose it if a single test comes back negative — although the tests are not especially reliable.

Others just don’t want to put in the effort it takes to diagnose LD.

Even the Centers for Disease Control are uncertain of how to treat the disease, and officially don’t recognize chronic LD, especially if it lingers after antibiotic treatment. Until the medical community adjusts its attitudes, getting a Lyme Disease diagnosis will remain difficult for the foreseeable future.

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