Insights From ILADS–Discerning The Symptoms of Four Major Infections

I was fortunate to be able to attend the ILADS (International Lyme and Associated Diseases) conference a few weeks ago. I had never been to an ILADS conference, and learned a few new things about Lyme disease and treatments while there.

Of particular interest to me was a presentation by Dr. Burrascano, in which he shared insights into how to discern different Lyme disease co-infections. Since lab tests for co-infections are often negative or unreliable, and tests don’t exist for many strains of the different infections, it can be difficult discovering whether these are present and active in the body. Dr. Burrascano cited different means for discovering the presence of such infections, including the patient’s symptom picture and response to treatments.


The onset of symptoms for those with Borrelia burgdorferi can be slow and gradual. You may notice that you are no longer sleeping well, for instance, or are losing weight. In my own case of illness, I had back pain and extreme anxiety for several years before the onset of other symptoms. Then, months before my “crash” in 2004, I began to lose weight, as well as my appetite. I didn’t think much of it at the time, even though people commented to me that I was getting thinner.

Borrelia is also a multi-system bug, that usually causes multiple (and sometimes, a multitude!) of symptoms. These symptoms can change over time, and wax and wane over several weeks. For instance, you may start off with a pain in your upper back that over time, moves to the lower back and varies in intensity (When the pain doesn’t migrate but remains constant, however, then this can sometimes be indicative of damage done by Borrelia, rather than the bug itself). So one year, you might have gut pain, and in the next, experience buzzing in your head. That’s the nature of the Borrelia beast.

Some other patterns seen in those with Borrelia include:

* Having energy mid-morning until approximately noontime, as well as in the late afternoon or evening. The nighttime energy creates an inability to sleep
* Slow response to treatments
* Symptom flares every four weeks (the pathogen’s life cycle is re-set by treatments if these are effective, so once a regimen is started, symptom flares can be expected at approximately four weeks beginning from the date of the onset of the treatment)
* Sub-normal morning body temperatures
* Joint cracking


Those with Babesia, according to Dr. Burrascano, often exhibit the following distinguishing patterns/symptoms:

* Tiredness/fatigue all day long
* A rapid onset of symptoms, often with a sudden high fever, severe headaches, night sweats (but which can also happen during the day), and fatigue
* Air hunger, which causes a need to frequently sigh and take deep breaths. People with this symptom often feel as though they run out of air when they talk. A dry cough may also be present
* Headaches, which can be severe. These headaches are global (all over), unlike Borrelia headaches, which are often found at the back of the head/neck
* Unexplained chest symptoms
* Fatigue is a prominent symptom of babesia, and manifests much like the fatigue in those with CFS (chronic fatigue syndrome)
* Feeling worse after exercise, instead of better
* Mental dullness and a slowing of reactions and responses
* Dizziness, but not like the vertigo that is found in those with Borrelia. This is more of a “tippy” feeling
* Rapidly cycling symptoms, with flares every 4-6 days. So a person with Babesia might have a particulary bad symptom day about once a week
* Rarely, an enlarged spleen may be present

People who present with very serious symptoms of Lyme disease may also have Babesia, since this infection makes Lyme symptoms worse and Lyme treatments less effective. If you are responding slowly to Lyme treatments, you might also have a Babesia infection that needs to be treated, as well.


According to Dr. Burrascano, Bartonella is often characterized by the following:

* Like Borrelia, a slow onset of symptoms
* Brain symptoms that are out of proportion to the person’s physical/bodily symptoms
* Sensations of overstimulation, anxiety and tremors
* Extreme agitation
* Muscle twitches
* Sore soles, especially in the morning
* Tender nodules, especially on the outer thigh and shins
* Gastrointestinal problems, which may present as gastritis or abdominal pain that is similar to symptoms of a Helicobacter Pylori infection (Note: One experienced Lyme physician with whom I spoke believes that gut pain can also be a Babesia symptom)
* Occasional lymphadenopathy (swelling of the lymph nodes)
* Morning fevers, usually around 99 degrees Fahrenheit.
* Occasionally, light sweats (milder than those found in Babesia)
* Sometimes, papular or linear red rashes (like stretch marks), especially those with gastrointestinal problems
* Rapid responses to treatment changes. Often, symptoms will improve within days of treatment, but relapses occur quickly if the treatment is withdrawn too soon


Finally, Ehrlichia may be distinguished by the following:

* A rapid onset of illness, which may include fevers and headaches, that are sharp, knife-like and found behind the eyes
* Muscle pain, which can be mild or severe
* A low white blood cell count and elevated liver enzymes
* A diffuse vasculitic rash

Keep in mind that these symptom patterns are only generalizations, as infections can cause a multitude of symptoms that overlap with those of others, especially Borrelia, since it can cause over 300 different symptoms which encompass every bodily system. Discerning infections in those who are multiply co-infected may therefore be difficult, but by studying this list, you may notice certain patterns in your symptom picture which enable you to discover whether you have one or more of these infections. Through my experiences of talking with other Lyme disease sufferers, I have found that more often than not, people are infected with at least one of, if not all of, the above infections, in addition to Borrelia. In my new book on Lyme disease, Dr. Steve Harris notes that those who have been sick for more than twenty years tend to be those who have only Borrelia as their main infection. Whether this is because ticks twenty or thirty years ago weren’t carrying around as many nasty infections as they do now, I don’t know, but the finding is intriguing.

Hopefully, this information will help you and your physician to navigate your healing process, as Lyme disease tests, by themselves, are rarely sufficient for making an accurate diagnosis.