Can Lyme disease cause bone loss?

man with lyme disease having leg bone examined by doctor

Arthritis is a well-known manifestation of Lyme disease. And although studies have detected Borrelia burgdorferi (Bb) by culture and PCR in bone and marrow of humans and dogs,¹ little is known about the effects of Bb infection on bone tissue, outside articular surfaces.

In a 2003 case report, “Bone marrow manifestation of Lyme disease (Lyme Borreliosis),” Kvasnicka et al.² describe a 35-year-old man, who presented with fever, night sweats, inguinal lymph node enlargement and splenomegaly. He also exhibited neurologic symptoms including hyperkinesis and ataxia.

Based on results from a lumbar puncture, doctors initially suspected the patient had infectious meningoencephalitis. However, a bone marrow trephine biopsy was also performed and revealed several small- to intermediate-sized epithelioid granulomas, according to the authors.

“Bone marrow abnormalities have rarely been reported in Lyme borreliosis. In this patient the bone marrow lesions had a characteristic ring-like appearance” which is occasionally seen with infectious diseases.

Western blot testing showed “an increased IgM antibody titre for Borrelia burgdorferi indicating a recent infection,” writes Kvasnicka et al.

The patient was treated with antibiotics and recovered.

The authors suggest “In patients with neurological symptoms, fever and granulomatous myelitis, an early disseminated infection with Borrelia burgdorferi, should be considered in the differential diagnosis and specific serological tests should be performed.”

Lyme disease induces bone loss in mice

In their article “The Lyme Disease Pathogen Borrelia burgdorferi Infects Murine Bone and Induces Trabecular Bone Loss,” investigators provide the “first evidence that B. burgdorferi infection induces bone loss in mice and suggest that this phenotype results from inhibition of bone building rather than increased bone resorption.”

The authors examined “whether B. burgdorferi infection affects bone health in mice,” and point out that “bone pathologies are observed in diseases associated with other spirochete bacteria, including syphilis and periodontitis.”

“Bone pathologies are observed in diseases associated with other spirochete bacteria, including syphilis and periodontitis.”

Other studies have found that long bones from mice infected with Borrelia burgdorferi tended to be more brittle than bones of mock-infected controls.

The authors found that “B. burgdorferi infection in mice causes a level of osteopenia in the trabecular regions of long bones that would be considered a clinically significant finding in humans.”

However, “structural and biomechanical properties of cortical bone were not affected by infection.”

  1. Tang TT, Zhang L, Bansal A, Grynpas M, Moriarty TJ. The Lyme Disease Pathogen Borrelia burgdorferi Infects Murine Bone and Induces Trabecular Bone Loss. Infect Immun. 2017;85(2):e00781-16. Published 2017 Jan 26. doi:10.1128/IAI.00781-16
  2. Kvasnicka HM, Thiele J, Ahmadi T. Bone marrow manifestation of Lyme disease (Lyme Borreliosis). Br J Haematol. 2003 Mar;120(5):723. doi: 10.1046/j.1365-2141.2003.04084.x. PMID: 12614200.

9 Replies to "Can Lyme disease cause bone loss?"

  • Maria Perez
    05/15/2024 (2:27 am)

    Was Dx with Lyme desease 6 years ago. Now I have been Dx with multiple myeloma. Have a lot of pain in my extremities. Constant pain and cramping on both feet. Could this pain I’m experiencing be from the Lyme desease??

    • Dr. Daniel Cameron
      05/15/2024 (6:32 am)

      The hematologist and oncologist would better address the question. I have patients with Lyme and another condition who have benefited from treatment both conditions.

  • Sue Kolarich
    03/20/2024 (8:30 am)

    Was diagnosed with Lyme disease about 3 years ago by one of the few Lyme literate practitioners in my area. I had worsening neurological symptoms for about 8-10 years until I almost became bedridden. Had previous regular Lyme test before that appears the level it was should have been retested in a few weeks, but that practitioner did not follow up. Anyway, with my current practitioner finding Lyme disease with the more sensitive testing there is got my Lyme disease diagnosed to go away after about 18 months of antibiotics with some pulsing done and with two well known herbs for it I could only handle in very small dose and many supplements. Developed more neurological symptoms a few months ago and joint pain, the more sensitive testing came back I had a high level of anaplasmosis. Currently being treated with daily antibiotics, the two herbs and same supplements. Unfortunately I am allergic to the line of the antibiotics recommended for both Lyme and anaplasmosis (dioxycline), so other antibiotics have to be used. Anyway, the beginning of this year I developed bad back pain after no known cause and my Internist ordered an MRI which showed two compression fractures of my spine with about 25% loss of height. Did DEXA scan after that wirh doctors telling me I have osteoporosis. Doctor they referred me to for that did blood work and 24 urine test to check out for things that could be contributing to the osteoporosis and have a follow up appt. in about two weeks. Besides the long term undiagnosed Lyme disease, other risk factors for osteoporosis includes having Crohn’s disease for 44 years, though not on Predisone for it except for about two years a long time ago to keep me alive until I could have my colon removed. Have taken low dose hydrocortisone for chronic fatigue for about 6-8 years which some of the doctors I’ve seen said even that amount affects your bones so I am working on tapering off from that completely if I can. Anyway both the spinal doctor I saw after the spine fractures and the endocrinologist following up with the osteoporosis I have mentioned the Lyme and anaplasmosis to and asked how much that is contributing to my osteoporosis. Of course not being Lyme literate in their opinion if a regular Lyme test did not show Lyme disease and one of their infectious doctors did not diagnose the anaplasmosis, then they don’t exist. My concern is they have already talked to me about the osteoporosis meds especially two that build bone and will again at my next appointment. All those meds have their own concerns/side effects and you have to take something the rest of your life to keep any gains made with your bones. I’m 62 years old. My concern no one can answer is how much the Lyme/anaplasmosis is also affecting my bones and can those meds help the bones if I still have one of these diseases?

    • Dr. Daniel Cameron
      03/21/2024 (9:08 am)

      I have has patients with unresolved Lyme disease and osteoporosis at the same time. I am not sure if they are connected.

  • Hannan Ahmad
    10/05/2023 (2:26 am)

    Lyme disease’s potential implications on bone tissue are of paramount significance, especially given its known ties with arthritis. The uncovering of Borrelia burgdorferi in bone and marrow lends a compelling dimension to our understanding of this disease. The case report from 2003 presents intriguing findings, especially with the ring-like appearance of bone marrow abnormalities occasionally associated with infectious diseases. It underscores clinicians’ need to consider a broader spectrum of symptoms and their potential origins, particularly when they veer into the neurological realm. The emphasis on proactive diagnostics and the potential for recovery with timely intervention serves as a reminder of the multifaceted nature of Lyme disease and the importance of holistic patient evaluations.

  • Linda Shaw
    10/28/2021 (8:44 am)

    Looking for more information on how Lyme disease might affect bone loss.

    • Dr. Daniel Cameron
      10/29/2021 (7:31 am)

      Sorry, I have run across other information.

    • Deborah Meredith
      10/27/2022 (5:49 pm)

      My teenager tested positive for Lyme in 2019 and has suffered with chronic fatigue, knee, neck and hip pain (all joints really) and has been misdiagnosed and under diagnosed for nearly three years. We’ve been the to pediatric rheumatologist and pediatric neurologist and they didn’t have a diagnosis or offer any help. Took my child to the orthopedist and after a year of them thinking my child was faking, gave in and ordered an MRI for one knee. Turns out chronic stress fractures in the patella. I demanded the left knee for MRI and it also has chronic stress fractures. Finally got the DEXA bone scan and resulted that my 15 year old has osteoporosis. It’s severe in both hips, neck and spine. It’s been a very frustrating and heartbreaking journey as my child has suffered for years and childhood is slipping away. Waiting for the referral to see an Endocrinologist at UVA. I need help. Someone please point me in the right direction for proper treatment.

      • Dr. Daniel Cameron
        10/28/2022 (12:57 pm)

        I have advised my patients to include a doctor with experience treating Lyme disease to address chronic fatigue and joint pain in addition to their other evaluation. I posted this blog based on peer reviewed paper to encourage research in this area.

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