I'm Dr. Daniel Cameron, and today I’m addressing a question I often see in my practice: What are the risk factors for chronic Lyme disease?

Chronic Lyme Symptoms

Some patients do not fully recover from Lyme disease. They experience a broad range of symptoms, including ongoing fatigue, pain, sleep problems, neurologic changes, emotional strain, and disruption of daily life. These challenges can affect school, parenting, and work responsibilities.

Common chronic Lyme manifestations include:

Musculoskeletal: chronic arthritis, muscle pain, stiffness, and tendon inflammation.

Neurologic and psychiatric: brain fog, memory issues, neuropathy, sensory changes, depression, irritability, mood swings, and PANS. Post-treatment Lyme disease syndrome (PTLDS) is often debated, but I view it as a potential ongoing infection rather than simply a syndrome.

Cardiovascular/dysautonomia: POTS, Lyme carditis, arrhythmias, chest pain, and dizziness.

Other manifestations: sensory overload (light, sound, heat, cold, or smell sensitivity), sometimes related to dysautonomic issues.

Risk Factors for Chronic Lyme Disease

While formal assessments are ongoing, in my practice I see several consistent contributors:

Severe initial infection such as neurologic Lyme meningitis or carditis.

Treatment delays, sometimes months or years.

Early systemic involvement at onset—widespread fatigue, pain, neurological symptoms, or functional loss.

Co-infections such as Babesia and other tick-borne pathogens.

Reinfections and relapses, which can increase the likelihood of chronic complications.

Key Takeaways for Clinicians

Screen patients carefully for these risk factors.

Monitor for co-infections, especially in high-risk or relapsing patients.

Do not dismiss persistent symptoms, even if a formal diagnosis has not yet been established.

Advice for Patients

Seek early treatment—timing matters.

If symptoms persist, pursue a second opinion or find a physician experienced in managing chronic manifestations of Lyme disease.

Watch for co-infections, especially Babesia, which may complicate recovery and even mimic other conditions (e.g., menopause).

Advocate for comprehensive care for yourself and your family.

Thank you for joining me. Please leave your questions and comments below—I read them all and respond where I can.