Lyme disease vs. chronic fatigue syndrome


I'm wondering about Lyme disease and chronic fatigue syndrome — the differences and similarities?

— Tired

Dear Tired,

It may seem difficult to distinguish between two distinct conditions that have similar symptoms, as is the case with Lyme disease and chronic fatigue syndrome (CFS). In fact, there are some in the medical community who believe that individuals with CFS may actually have undiagnosed and untreated chronic Lyme disease. While more research may help clarify the possible links between CFS and Lyme disease, individuals suffering from CFS-like symptoms may want to consider seeing a health care professional who can distinguish between the two conditions through diagnostic tests.

Lyme disease is transmitted to humans by the bite of a tick that is infected with the Borrelia burgdorferi bacteria (FYI — these ticks most commonly live on deer and mice). The Centers for Disease Control and Prevention (CDC) report that in most cases, the first symptom of Lyme disease is a circular rash (erythema migrans) that develops at the site of the tick bite (typically three to 30 days after being bitten). This peculiarly named rash resembles a bulls-eye and expands up to twelve inches in diameter. Other symptoms of Lyme disease may include fatigue, chills, achy muscles and joints, fever, headache, and swollen lymph nodes.

Lyme disease may be cured with antibiotics, especially if it is still in its early stages. Individuals who have not been treated, or who have not been treated successfully, may experience complications from Lyme disease weeks, months, or potentially years after an infected tick bite. These complications include facial paralysis, heart rhythm abnormalities, and arthritis, because the disease affects the nervous, cardiovascular, and musculo-skeletal systems.

While the causes of Lyme disease are known, those of CFS are not as clear. The most obvious symptom of CFS is debilitating fatigue lasting for at least six months, but additional signs may include:

  • Muscle and joint pains
  • Awaking from sleep unrefreshed
  • Malaise lasting more than 24 hours following exertion
  • Sore throat
  • Painful lymph nodes
  • Headaches
  • Impaired memory and concentration

Adapted from Chronic Fatigue Syndrome, General Information from the Centers for Disease Control and Prevention. 

CFS significantly affects a person's ability to work and perform activities of daily living, though CFS may impact individuals differently. There is no set treatment for CFS, though strategies exist to manage or alleviate the symptoms. Some may recover enough to work, while others may remain homebound. In a few cases, individuals fully recover from CFS.

Finally, keep in mind that other conditions may also cause fatigue, including hypothyroidism, narcolepsy, sleep apnea, alcohol/drug abuse, depression, cancer, autoimmune disease, obesity, infection, and chronic mononucleosis. In any case, if you are experiencing fatigue that affects your ability to function, it's best to discuss this with your health care provider. For more information on Lyme disease and CFS, you may want to check out the following resources:

Last updated Sep 09, 2014
Originally published Feb 16, 1995

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