5 Signs of Lyme Disease You Really Shouldn’t Ignore

You might develop multiple rashes (even from a single bite) and some 20% of people don’t see any skin changes whatsoever, so it’s possible your first Lyme symptoms may be a little different. If the tick is engorged (meaning, it’s bloated because it’s been there several days feasting on your blood) or if you think it’s been there long enough, you should make a note of that and call a doctor if you’re concerned. (The CDC doesn’t typically recommend antibiotics for tick bites unless you have symptoms, but talk it over with your health care provider.)

2. It might feel like you’re coming down with the flu.

When your body responds to the bacteria, you may have a fever, headaches, chills, and muscle pain. The timeline can be a little wonky though, per Dr. Pierre. “The symptoms don’t happen in lockstep—it’s not like you get the rash and then two days later develop a fever. You might not get a rash, or it fades before you can even see it—then a week or two later you feel other symptoms.” (Note: These stage 1 symptoms can occur within one to 28 days following a tick bite, per the National Library of Medicine.)

Of course, there are a ton of other things that can cause these symptoms too, per Dr. Bass. So when you’re trying to figure out if it was due to a tick bite, you really have to take several things into consideration, including where you live in the country, what time of year it is, if you’ve spent time outdoors recently, and any other symptoms that are paired with your fever.

“The flu tends to come in the winter, roughly December through April, and people don’t typically get early Lyme disease at that time,” Dr. Bass points out. “Lyme disease also does not normally cause respiratory or gastrointestinal symptoms, so if you get a stuffy nose, sore throat, or even diarrhea or nausea, you’re probably dealing with a virus.” You’re more likely to encounter Lyme-infected ticks between April and October in the Northeast, Northwest, or Upper Midwest, particularly if you’re hanging out in habitats where ticks thrive, like wooded, brushy places with tall grass and lots of dead leaves on the ground.

3. You’re having heart issues, strange dizziness or weakness, or you’ve developed another condition.

After you’ve been infected for a few weeks or months (which is plausible if you didn’t see or notice a rash from the bite or shrugged off any early flu-like symptoms), the bacteria can travel through your bloodstream to other parts of your body (a.k.a. stage 2 of Lyme disease, which usually happens about three to 12 weeks after the bite). This includes the heart. It’s called “Lyme carditis,” and it can cause things like heart palpitations, chest pain, and dizziness.

The bacteria might also migrate to your brain and spinal cord, which can cause vertigo and difficulty with coordination, or even meningitis, says Dr. Bass. This is a serious inflammation of the membranes surrounding the brain and can result in headaches, neck stiffness, and fever. Bell’s palsy—an inflammation that affects the facial nerves—can also sometimes show up and cause your face to get weak or droop on one side. However, Dr. Bass reiterates that, even at this stage, you can still recover. “These [later symptoms] all typically respond very nicely to antibiotics.”

4. There’s major swelling in one, or several, joints.

It’s possible to get bit by an infected tick and have zero symptoms up until stage 3, Dr. Bass says. “If you haven’t been treated for several months, or even years, after the [initial] infection, the bacteria can often settle in a joint, most commonly the knee,” she says. However, Dr. Pierre notes that any big joint can be affected, including the hip and elbow. The swelling isn’t always painful, but it can be: Research shows that roughly 60% of untreated Lyme-related infections cause arthritis. You might also develop those neurological issues we mentioned that can happen with stage 2—Bell’s palsy, meningitis—but it’s important to remember that this is still treatable, Dr. Bass points out. You might just have to be on antibiotics a bit longer (or take a combo of them on a more rigorous regimen), she notes.

5. You fit the profile of someone who’s recently been bitten by an infected tick.

Okay—this one isn’t *necessarily* a medical symptom, but per Dr. Pierre, it’s really important. She says that a lot of people who struggle with chronic fatigue or pain (and once had Lyme disease several years ago) believe their issues are tied to that previous infection. That’s not always the case—and they’re sometimes unnecessarily put on rounds of antibiotics.