Post Treatment Lyme Disease Symptoms (PTLDS)

After treatment is complete and the patient is released from combatting Lyme disease infections, some symptoms may persist in an intermittent manner. Some PTLDS symptoms may be mild while some may be more severe. Generally, the severe PTLDS symptoms work themselves out quickly; within 2-3 months.  True post treatment Lyme disease syndrome (PTLDS) symptoms come and go and become less and less, over time with a normal lifestyle. A normal lifestyle constitutes a normal healthy diet without dietary modifications, except for gluten most times. Symptoms associated with PTLDS continuously lessen with the ability to consistently increase exercise and with the ability to handle physical, mental, and emotional stressors without worsening of symptoms.

Depending Factors

Depending on the damage done by the Lyme disease infections, will depend on the symptoms associated with PTLDS. With true PTLDS, intermittent symptoms continue to slowly decrease in frequency and severity and over time, instead of increase. If symptoms continue to increase with a normal lifestyle and one continues to get sick and stay sick, then it could be likely the person’s Lyme disease treatment did not quite take them to true remission.

What Aggravates PTLDS

Seasonal viruses may aggravate symptoms during the PTLDS stage. When someone contracts a seasonal virus, it can be expected people will experience the same symptoms as they did when they had Lyme disease, however they will be less. It can be expected that people will contract 3 seasonal viruses every season and the duration of symptoms will last, on average, 3-7 days at a time. As time goes by, the type and location of the symptoms will be the same or similar, but less in severity.

There comes the time when those previous Lyme disease symptoms cease to present with exercise or seasonal viruses. Instead, people may present with only symptoms of the common cold or symptoms specific to the viral presentation. The PTLDS should be considered a rebuilding phase. To recover from PTLDS symptoms normally take between 1-3 years and even more for some people who have been debilitated for decades. For people who reach Lyme disease remission who have had extensive nerve damage and or who may be older may never reach freedom from reminders of what it was like to have Lyme disease. However, with true PTLDS their symptoms should not worsen and should continue to improve and decrease over time.

Physical Exercise

Moderate to severe PTLDS symptoms can be expected to manifest when one reintroduces physical exercise, therefore it is important to begin slowly. Instead of going out for a 10-mile bike ride when one is done with Lyme disease treatment, they should consider riding a bike as with virtually little intensity for mile or so. Then one should wait a few days while observing how the body responds. After careful observation, one could consider increasing intensity and distance slowly over time.

The same should go for jogging. Consider walking for a half mile, jog for an 1/8th of a mile, then walk again for a ¼ mile. Even with very light exercise, people should be aware that significant tachycardia could present in the middle of the night and into the next day after working the cardiovascular system in a way it hasn’t for quite some time. Consider repeating the exercise and increase slowly as the tachycardia will commonly resolve quickly as the cardiovascular system becomes more conditioned.

Workouts with the body or weights, such as pushups or weights should be done with very light intensity to begin. In some cases, it is best to begin with a plank for a few seconds, even if you can hold it much longer. Observe how the body responds for the next few days. Rib pain and severe pains in the chest can be expected for those with significant nerve damage and or lack of proper circulation in the chest region. Make sure to give the body a rest and observe for 72 hours before increasing intensity and frequency. As the body becomes more conditioned, the body will be able to handle more intensity, pains will lessen, and it will begin to feel strong.


People who continue to get worse in frequency and severity with a normal lifestyle, post treatment is not true PTLDS. This, many times is indicative of incomplete treatment, and the infection(s) are still active in the body causing immune reactions. People who get reminded of their previous Lyme disease symptoms from exercise or seasonal viruses, that come and go, but lessen over time instead of increasing without treatment, is true post treatment Lyme disease syndrome.

The Common Belief Lyme Disease Can Only be Managed

Many people and many doctors believe Lyme disease can only be controlled and not completely healed from or be put in true remission. Lyme disease is composed of infections. If one knows how to destroy unwanted microbes in the body, then they can reach remission, many times, for the duration of their life.

A Common Mistake

A common false PTLDS presentation is when someone takes antibiotics for 30 days and is then told by their doctor treatment is done. The patient’s Lyme disease symptoms progress and worsen, until the point where they are very uncomfortable at best, and they don’t get better again. This is many times referred to as PTLDS, but it is wrong. These may be examples when uneducated or unseasoned Lyme disease doctors tell people their treatment is complete, and they are experiencing PTLDS.

Lyme disease doctors who have helped put themselves and others in remission are the ones who have the best chance of helping people.

© Patrick Lynch, D.A.O.M. June 2021

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