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When Lyme vs Long COVID Feels Impossible to Tell Apart “Is this Lyme… or long COVID?” Patients ask me this with a mix of fear and exhaustion. They describe the same constellation of symptoms — the brain fog that makes conversations feel slippery, the dizziness that hits out of nowhere, the heart that races as […]

Many Lyme patients tell me the same story: “I used to tolerate a glass of wine — now it wipes me out.” What was once an ordinary social experience becomes unpredictable and uncomfortable. This shift is a hallmark of Lyme alcohol intolerance — a physiological change that now brings flushing, dizziness, anxiety, nausea, or next-day

Introduction: A Clinical Guide to Post-Exertional Malaise in Lyme Disease Patients often tell me they can complete a workout or a busy day without any immediate problem, only to crash hours later. This phenomenon—called post-exertional malaise Lyme patients frequently experience—is one of the most misunderstood patterns in post-infectious illness. Instead of symptoms appearing during exertion,

Babesia coinfection is one of the most overlooked reasons symptoms return after treatment seems to work. Patients often describe a familiar pattern: meaningful improvement after completing antibiotics, followed weeks later by returning symptoms. Fatigue comes back. Night sweats appear. Breathing feels difficult again. The gains they made seem to slip away. This pattern is one

Babesia blood screening saved this patient from months more of misdiagnosis. A routine donation uncovered what his doctors had missed all summer. A week after his donation, a letter arrived with the words no one expects to see: Your donation has tested positive for Babesia. In that moment, he realized the blood bank had identified

Babesia testing failed this patient for six months. She came to my office exhausted after fevers, sweats, and crushing fatigue. Her initial tests were negative—but she had Babesia all along. It wasn’t confirmed until much later, after PCR and antibody testing came back positive. By then, treatment was delayed, and her recovery was harder. Babesia

Tick bite antibiotics are one of the most contested decisions in Lyme disease prevention. Depending on which doctor you see, you might get a full course, a single pill, or nothing at all. When it comes to preventing Lyme disease, doctors disagree on the amount of antibiotics to prescribe — and the advice you get

When It’s Hard to Breathe: Could it be Lyme? Shortness of breath can feel frightening — especially when it strikes without warning or a clear cause. While heart and lung conditions are common culprits, there’s another, often-overlooked possibility: Lyme disease. This tick-borne infection doesn’t just cause joint pain and fatigue—it can also affect the nervous

Babesia treatment duration is one of the most misunderstood aspects of managing this co-infection. In my clinical experience, treatment often needs to go beyond the standard 7–10 days. I recently treated a patient who failed a 10-day course of atovaquone and azithromycin. He still had fatigue, sweats, and brain fog. We extended therapy based on

From the Archives (Summer 2015) This article reflects clinical observations from my practice at a time when the neuropsychiatric manifestations of Lyme disease were rarely discussed in mainstream medicine. At the time this patient was evaluated, Lyme disease was seldom considered when adults presented primarily with OCD-like or anxiety symptoms. She came in with a