Borrelia are bacterial pathogens that infect the cell interior. All organ systems can be affected (multisystem disease). However, Lyme disease rarely occurs alone: other pathogens (co-infections) and additional stresses (e.g. with heavy metals) are frequent accompanying factors. The symptoms are correspondingly varied. The number and severity of symptoms vary greatly from person to person. In the course of time, the symptoms change when the inflammations, immune phenomena and secondary disorders caused by the pathogens develop a potentiating momentum of their own. Often, it is no longer possible to distinguish between directly pathogen-related symptoms and indirect secondary symptoms.
Neurological symptoms are particularly common. Chronic exhaustion and fatigue (so-called chronic fatigue syndrome = CFS), sleep disturbances, memory and concentration disorders, psychological changes (depression, anxiety), tingling and numbness or nerve pain and headaches are some of them. Some symptoms, such as paralysis, walking and visual disturbances, or even dementia development, not infrequently lead to diagnoses such as multiple sclerosis, Parkinson's syndrome, amyotrophic lateral sclerosis (ALS), or dementia. What all these diseases have in common is that their causes are generally not yet known. However, a chronic infection with Borrelia or other pathogens should be considered in such cases.
These neurological symptoms occurring in the context of chronic Lyme disease must be differentiated from the clinical picture of acute neuroborreliosis. Despite similar terminology, there is an important diagnostic difference: In acute neuroborreliosis, there are always altered cerebrospinal fluid (CSF) findings, whereas in chronic Lyme disease with neurological involvement there are no such findings. A cerebrospinal fluid puncture with an inconspicuous result therefore excludes acute neuroborreliosis, but not chronic Lyme disease.
Furthermore, complaints in the muscles and joints are in the foreground. Alternating joint pain with and without swelling (sometimes here, sometimes there), muscle pain, muscle burning and a feeling of heaviness in the extremities or backbone pain are frequently complained symptoms. Similarities with rheumatic diseases are not always coincidental and must be differentiated.
Internistic symptoms are also regularly encountered: Cardiac arrhythmias and cardiac insufficiency, chronic cough and shortness of breath (especially in co-infections with babesia or chlamydia), digestive problems with mal-colonization of the intestinal flora or chronic sinus and bladder infections (often in co-infections with fungi) are in the foreground here.
Due to the variety of symptoms and the inconspicuous standard diagnostics in most patients, these people are often considered to be psychosomatically ill. It is assumed that the physical complaints have purely psychological causes. However, this is often inaccurate or only half the truth. Almost every Lyme disease patient undoubtedly suffers from psychological symptoms. How can the psyche remain untouched when years of physical limitations and the resulting social consequences (job, withdrawal from friends/family) appear as almost unsolvable problems? So instead of a psycho-somatic (the psyche causes physical symptoms) there is rather a somato-psychic impairment (physical complaints cause psychological symptoms). Psychological or even psychiatric help is also necessary for these people, but not without therapy of the underlying multi-system disease.