Could Lyme Disease Be Why You’re Still Sick? Symptoms, Testing, and What May Be Overlooked | E179

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In this Made for Health minisode, Dr. Aaron Hartman continues his series exploring an important question: Why are you still sick? Why does your body seem stuck even after you’ve tried so many things?
This time, he turns his attention to Lyme disease—an infection that can present in different ways and may sometimes enter the differential diagnosis when people are dealing with persistent fatigue, body pain, migrating joint or muscle symptoms, neurological complaints, or other unexplained problems.
Dr. Hartman shares examples from his clinical experience, including patients with symptoms such as chronic fatigue, widespread pain, Bell’s palsy, sciatica, and foot drop. His broader message is that when a patient’s symptoms do not fit neatly into the expected picture, clinicians may need to take another look at the history, exposure risk, symptom pattern, and appropriate testing rather than relying on one isolated result.
He also discusses the challenges surrounding Lyme disease testing, including antibody testing, Western blot testing, immunoblot testing, and symptom-based clinical evaluation. Current CDC guidance recommends a two-step, FDA-cleared serologic testing process and notes that antibody tests can be falsely negative during the first several weeks after infection. IDSA guidelines also recognize that a classic erythema migrans rash can be diagnosed clinically without laboratory testing.
Key Topics Covered
Why Lyme disease may be considered when someone remains chronically unwell
Persistent fatigue, body aches, and migrating pain
Neurological presentations discussed in the episode
Lyme disease and Bell’s palsy
Dr. Hartman’s clinical experiences with unusual symptom patterns
Why timing matters with Lyme antibody testing
Standard two-tier Lyme disease testing
Western blot and immunoblot testing
The limits of relying on a single laboratory result
The importance of symptoms, history, and possible tick exposure
Dr. Hartman’s approach when clinical suspicion remains high
The MSIDS questionnaire discussed in the episode
Why chronic illness may involve more than one contributing factor
When a deeper evaluation may be appropriate
Continuing the search for overlooked contributors when someone feels “stuck”
In This Episode, You Will Learn
✅ Why Dr. Hartman considers Lyme disease in some patients with persistent or unusual symptoms
✅ Why Lyme disease does not always present in exactly the same way
✅ How symptoms such as fatigue, migrating pain, and certain neurological complaints may prompt further evaluation
✅ Why the timing of antibody testing can affect results
✅ How standard Lyme testing generally uses a two-step serologic process
✅ Why Dr. Hartman emphasizes looking at the whole clinical picture, rather than interpreting one test result in isolation
✅ How he approaches situations in which symptoms and previous testing appear not to match
✅ Why finding Lyme disease does not necessarily mean it is the only factor affecting a person’s recovery
Follow Dr. Aaron Hartman and Richmond Integrative & Functional Medicine
🌐 Website: https://richmondfunctionalmedicine.com/
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📺 YouTube: @AaronHartmanMD
Mentioned in this episode:
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