When Your Body Stops Regulating Temperature Normally
Many patients with Lyme disease describe something they never struggled with before: they suddenly can’t tolerate heat or cold. They walk into a warm room and feel flushed or dizzy. A mild chill hits them and their body reacts as if winter has arrived. Some swing from sweating to shivering in minutes, unable to find a comfortable middle ground.
This is temperature dysregulation — one of the most overlooked autonomic effects of Lyme disease. For many, it begins abruptly, often within weeks or months of infection, as the autonomic system becomes too unstable to regulate temperature the way it once did.Adler et al. 2024
Understanding Lyme Heat and Cold Intolerance
Temperature regulation relies on the autonomic nervous system and the brain’s temperature-sensing pathways.Cheshire et 2015 When Lyme disease affects these systems — sometimes through inflammation, sometimes through neural irritation — the body has trouble interpreting temperature signals and responding to them appropriately.
Autonomic instability can interfere with normal sweating and shivering. Neuroinflammatory processes may alter how temperature is perceived. Circulatory instability can make everyday temperatures feel harsher than they should. Together, these overlapping disruptions help explain why Lyme heat and cold intolerance is so common in clinical practice.Adler et al. 2024
Why Heat Feels Overwhelming
Heat intolerance is often the first major shift patients notice. A hot shower that once felt soothing suddenly causes dizziness or exhaustion. Warm weather drains them. Even stepping into a heated car can provoke an immediate sense of overheating.
This pattern aligns with autonomic dysfunction, where heat becomes a physiologic stressor instead of something the body can comfortably adapt to.Cheshire et 2015 Post-infectious dysautonomia — including patterns seen after Lyme disease — is well known to worsen with heat exposure. .Adler et al. 2024, Bryarly M et al
Why Cold Feels Too Intense
Cold intolerance shows up in a similar way but in the opposite direction. Patients describe a deep chill that lingers even after warming up. They feel cold indoors when others are comfortable, or chilled “to the bone” without any obvious trigger.
This happens when the nervous system misreads temperature signals or responds too slowly to environmental changes.Cheshire et 2015 The sensation feels exaggerated, persistent, and out of sync with the environment — and patients often notice it long before a diagnosis is made.
Temperature Swings Are Part of the Same Pattern
Some patients don’t experience only heat or only cold intolerance. Instead, they swing between the two — overheating one moment, shivering the next.
This reflects an autonomic system that is trying, and failing, to recalibrate.Bryarly M et al These swings are common in post-infectious autonomic dysfunction and increasingly recognized in Lyme disease.Adler et al. 2024
Why This Symptom Is So Misunderstood
Heat and cold intolerance rarely appear on traditional Lyme symptom lists. Without that context, many patients are told their symptoms stem from anxiety, thyroid issues, menopause, dehydration, or stress.
These explanations may play a role in some people — but they do not explain sudden, persistent temperature dysregulation that begins after a tick-borne infection. When other causes are ruled out, Lyme-related autonomic dysfunction becomes the most consistent explanation.Adler et al. 2024
If you’d like more about how Lyme affects the autonomic nervous system, see my guide on Lyme and dysautonomia (insert your internal link here).
What Recovery Looks Like
As treatment reduces inflammation and stabilizes autonomic function, temperature sensitivity slowly improves. Patients notice fewer heat triggers, fewer deep chills, and fewer swings between the two. Over time, they describe “getting my thermostat back,” as the internal sense of temperature becomes stable again.
This follows a familiar recovery pattern seen in other forms of post-infectious autonomic dysfunction.Adler et al. 2024,Bryarly M et al
What This Means for Clinical Communication
It’s medically accurate — and deeply validating — to explain that **heat and cold intolerance are common in Lyme disease because the infection can disrupt autonomic and temperature-sensing pathways.Cheshire et 2015 ,Adler et al. 2024 Patients often feel immediate relief when their experience is named and understood.
Tracking heat and cold sensitivity over time can also help clinicians evaluate autonomic stability as treatment progresses.
For more on dysautonomia, see the Johns Hopkins overview
Share Your Experience
Have you noticed heat intolerance, cold intolerance, or swings between the two since Lyme?
Your story may help someone finally understand what their body has been trying to tell them — share it below.
Key References
- Cheshire WP Jr. Thermoregulatory disorders and autonomic dysfunction. Auton Neurosci. 2016.
- Adler BL et al. Dysautonomia following Lyme disease. Front Neurol. 2024.
- Bryarly M et al. Postural Orthostatic Tachycardia Syndrome: JACC Focus Seminar. J Am Coll Cardiol. 2019.
- Dr. Daniel Cameron: Lyme Science Blog. Autonomic Dysfunction in Lyme Disease
- Dr. Daniel Cameron: Lyme Science Blog. Autonomic dysfunction, small fiber neuropathy and Lyme disease
