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
Oh, how I suffer with my body’s thermometer. My poor husband.
I have a question.
How am I able to sit in a far infra red sauna , at 67 degrees centigrade, for 30 minutes and then jump into a cold shower and feel great , and then experience extreme restlessness and irritability when the room temperature is 30 degrees centigrade??
Enjoy your articles.
Thank you for caring.
Margaret
The sensory system is so poorly understood
I used to always be cold. Then when I came down with Lyme Disease I could not tolerate the heat. I almost felt that I could never cool down and I would be in a panic. One day I was walking my dogs around my neighborhood in the winter. It was about 35 degrees and I was in a long sleeve T-shirt. My neighbor stopped me and asked, “Aren’t you cold?” I never thought about it. It felt like it was 65 degrees. I got to the point that I almost moved away from DC’s hot and humid summers because I felt so desperate. I have been in remission for many years now. I find that every summer that goes by, I am tolerating the heat more so and happy I never moved because I do love where I live.
So relieved to read that this is Lyme related. I’ve been miserable in my skin for years! Thank you for the information!
I was bit by a tick a year and 3 months ago. I received antibiotics and felt so sick! I’m experiencing very cold chills and assumed it was flu or my body fighting an infection. I am outside a lot and m finding I was either too hot or too cold. Just resting now. I hope it passes. Also, my heart hums when tested. I use to feel it vibrate at night so much it would wake me up. I thought it was anxiety or fast heart. I saw a heart specialist 4 years ago and he said I’m fine. I’ve never been given Lyme diagnosis just preventative measure. I’m having a lot of right knee problems and assumed it was from a fall. So many variables to think of.
I’ve had Lyme for about 10 years and in the past few years heat/cold intolerance has started to become a major symptom/problem. After about 4 hours in bed I get uncomfortably hot, especially my feet, and have to hang them out the cover. This combines with body itching, runny eyes, tinnitus and waking up.
I know if I just stick it out, after about 2 hours I will then get cold and have to pull on another cover. I then fall asleep again and when I finally get up I am really cold and have to do warm up exercises or I will just keep getting colder. Sometimes I struggle to decide if I’m hot or cold, it often comes with an overall sense of malaise.
autonomic issues typically involve Malaise
Oh yes for many years!
Heat g’ets My heart beating and the pulse get crazy (160). Dissyness. I Can cool My self Down with cold water on the hands or feet. I have to eat/drink also, it helps. W’et sooks or wrist bandage helps
Cold is worse. The body goes completely Down. It Can take 4 hours with Electric pillow/blankets to g’et warm again. The body Can be exhausted for days or weeks. I always have warm clothing in My car, and wool neck warmer, wool wrist warmer, cap, gloves, Scharf etc
Lyme disease can be overlooked as a cause.
I completely know about this issue. I also had a problem by body reacting to temperature . While suffering with lyme symtems I would be very cold in the summer at times even when outside temps were 80 and above , I would have get into a warm tub to warm up. In the winter I would be hot and have take heavy cloths off to cool down. Now after treatment including many supplements and almost four months of doxy twice a day I switched back to normal. I also did not sweat in the summer at all until after treatment. Even in a sauna for getting rid of toxins . Now ten years later I still react to temps as you describe I get very cold quickly under fifty degrees and above 65 I still get sick feeling and very unstable. I was luckl to find ND that understood lyme issues And knew what to do Most MD are useless when it comes to lyme