Many of our patients with Lyme and associated diseases (LAD) present with headaches as one of their main symptoms. Indeed, a peer-reviewed study of 3,000 Lyme patients by lymedisease.org showed that over 80% suffered from headaches, with more than 40% describing them as moderate and more than 20% describing them as severe or very severe. Lyme headaches can range from occasional or persistent intracranial pressure to debilitating migraines.
Why are headaches such a common Lyme and associated diseases symptom?
There are several different factors that cause headaches in LAD. One simple cause is spirochete activity itself. When Lyme bacteria crosses the blood-brain barrier, the spirochetes enter the central nervous system. The spiral-shaped bacteria twist and coil into the brain, which can of course cause pain.
Another important cause of Lyme headaches is inflammation. Lyme is a multi-system inflammatory infection. In his book Why Can’t I Get Better? Solving the Mystery of Lyme & Chronic Disease, Dr. Richard Horowitz describes inflammation as “a type of ‘fire’ in the body…defined by five cardinal signals: heat, redness, pain, swelling, and loss of function. It can occur anywhere in the body. Inflammation is also internal and can take many forms, from a headache to nasal congestion to arthritis to heart disease.” In his article “Inflammation and Central Nervous System Lyme Disease,” Dr. Brian Fallon corroborates that neurological involvement “often caus[es] inflammation, particularly in the subarachnoid space and perineural tissue.” He adds that “approximately 10-15% of patients with untreated Lyme disease develop neurological manifestations, typically due to inflammation in either the peripheral nerves, the meningeal lining or parenchyma of the brain itself.” Though you may not be able to see all the signals of internal neurological inflammation, they are there, causing pressure and pain. Sometimes these headaches are localized to one side as migraines, inducing nausea, vomiting, and light sensitivity.
Functional imaging studies of patients with later stage neurological Lyme disease often show impaired blood flow and/or metabolism.3 Inflammation can impact blood flow to the brain, which can manifest as a headache. The co-infection babesia, a parasite that consumes oxygen in the red blood cells, can also cause headaches due to this “air hunger”. Ehrlichia is also known to cause excruciating headaches, as is Tick Borne Relapsing Fever (TBRF), which is transmitted by fast feeding soft ticks endemic to Colorado, California and the Pacific Northwest. Like other symptoms of TBRF, headaches tend to last several days, then go away, then come back again.
In terms of impaired metabolism, LAD can affect adrenal function, which can cause reactive hypoglycemia (blood sugar swings). Hypoglycemic patients can get headaches when they don’t eat, or midday fatigue accompanied by headaches after eating too many carbohydrates at lunch. Headaches can also be a result of food allergies, mineral deficiencies, environmental toxins, mold, stress, and sleep deprivation, all factors that impact LAD patients.
The good news is that treating LAD tends to resolve headaches. Pediatric patients studied in “Lyme Disease Presenting with Persistent Headache” were treated with antibiotics and showed complete resolution of symptoms. Dr. Maderis also notes improvement of headaches after treating LAD. If you have already been diagnosed with LAD and are experiencing headaches, do not despair; we will work with you to reduce all of the factors described above, and help alleviate your pain. If you are suffering from undiagnosed headaches, make an appointment with us to see if LAD could be the cause.
 Johnson L, Wilcox S, Stricker RB (2014) Severity of chronic Lyme disease compared to other chronic conditions: a quality of life survey. PeerJ 2:e322 https: doi.org/10.7717/peerj.322
 Horowitz, Richard I. Why Can’t I Get Better? Solving the Mystery of Lyme & Chronic Disease. New York: St. Martin’s Press. 2013. (186)
 Fallon, A., et al. Inflammation and Central Nervous System Lyme Disease. Neurobiology of Disease 37 (2010): 534-41.
 Horowitz, 124.
 Horowitz, 47-50, 74.
 Moses JM, Riseberg RS, Mansbach JM. Lyme Disease Presenting With Persistent Headache. Pediatrics. 2003; 112 (6). doi:10.1542/peds.112.6.e477.