by Jenny Lelwica Buttaccio and Mark Casey
Posted 5/14/21

One of the most challenging aspects of reclaiming your health from chronic Lyme disease is knowing where to turn when new or different symptoms pop up. “My perception after studying a variety of intracellular microbes for years is that each microbe has a preference for different types of cells in the body,” says Dr. Bill Rawls, Medical Director of RawlsMD and Vital Plan.

For example, Borrelia burgdorferi, the predominant bacteria that causes Lyme disease in the United States, has an affinity for collagenous tissues in the body. Therefore, the symptoms that come with borrelia infection tend to impact those areas with high concentrations of collagen: the brain, joints, muscles, etc. But some additional, unexpected symptoms can arise from Lyme coinfections (simultaneous infections), and it’s not always easy to figure out which microbe is the chief, problem-causing culprit, especially since testing for Lyme disease and coinfections is woefully inaccurate.

Coinfections at a Glance

Though the symptoms of borrelia often get top billing when it comes to Lyme disease, there’s rarely a single microbe at play when you’re dealing with persistent symptoms. Besides Lyme, the main coinfections that patients often contend with include babesia, bartonella, and mycoplasma. Below is a brief description of each one:

  • Babesia: A distant cousin of malaria, babesia is a protozoan and parasite most commonly transmitted by blacklegged ticks.
  • Bartonella: Typically spread by biting insects (fleas, ticks, mosquitoes, sandflies, lice, chiggers, biting flies, scabies, mites, and louse-eating spiders), there are more than a dozen species of bartonella that can impact human health, giving rise to the broader-named category called bartonella-like organisms (BLO).
  • Mycoplasma: Mycoplasma is the smallest of all bacteria, and because it lacks a cell wall, it can alter its shape and travel to areas of the body where other microbes can’t go. It’s spread by biting insects (ticks, mosquitoes, fleas, biting flies), sexual contact, contaminated food, and airborne droplets. The majority of people will have exposure to some form of mycoplasma in their lifetime.

The reason you’re having symptoms from Lyme and coinfections is that each of these microbes is affecting certain cells in the body, and it could be either one microbe or several microbes contributing to the problem,” says Dr. Rawls. “Every person’s symptoms are a little bit different because the spectrum of microbes they carry is different.”

Thus, understanding key characteristics of these more common Lyme disease coinfections can serve as a guide for you and your physician to best target your treatment. “Knowing if you have, say, bartonella or babesia can help you figure out if you need to add on additional herbal therapies or remedies to support your recovery efforts,” explains Dr. Rawls.

So to assist you, we’ve put together seven coinfection comparison graphics, highlighting the similarities, differences, and telltale signs between borrelia, babesia, bartonella, and mycoplasma, frequent infections that often go hand in hand.

Lyme Disease Coinfection Comparisons

The following two graphics demonstrate the telltale and shared signs and symptoms of borrelia, babesia, bartonella, and mycoplasma that you might not be aware of. Having information about which symptoms are distinct to a particular infection and which ones overlap with others can aid you in identifying the various pathogens you might be dealing with or may have overlooked in your current treatment regimen.

Telltale and Shared Signs and Symptoms

circle chart of telltale symptoms. Borrelia: stiff neck, lyme carditis, eye floaters, bulls eye rash, bells palsy, migrating arthritis, joint welling. Mycoplasma: respiratory infection, sinus problems. Babesia: chest or rib pain, drenching night sweats, body temperature fluctuations, air hunger. Bartonella: rage, swollen lymph nodes, unexplained cough, stretch-mark like rash, pain in shins, pain in soles of feet
overlapping circle chart os shared symptoms: depression, anxiety, headache, cognitive difficulties, brain fog, sleep problems, fatigue, fever, chills, autoimmunity, gastrointestinal function, bladder irritation, muscle pain, joint pain

Borrelia and Beyond

Here, we’ve detailed a more complete snapshot of the range of symptoms borrelia, babesia, bartonella, and mycoplasma infections can cause. Bear in mind that many symptoms are similar, so it’s crucial to evaluate your overall symptom profile to get a more accurate diagnosis of what might be going on with you.

The next four graphics allow you to see how Lyme and coinfections could be affecting different systems of the body and influencing how you feel:


symptoms of borrelia infection: depression, anxiety, headache, cognitive difficulties, brain fog, sleep problems, dizziness, visual changes, eye floaters, sound sensitivity, ringing in ears, bells palsy, stiff neck, heart symptoms, lyme cariditis, fatigue, fever, chills, autoimmunity, migrating arthritis, burning or tingling hands, tremors, gastrointestinal dysfunction, bladder irritation, bulls eye rash, muscle pain, joint pain, joint swelling, muscle twitching


symptoms of babesia infection: depression, anxiety, headache, cognitive difficulties, brain fog, sleep problems, dizziness, heart symptoms, anemia, chest or rib pain, air hunger, fatigue, fever, chills, autoimmunity, drenching night sweats, body temperature fluctuations, gastrointestinal dysfunction, bladder irritation, petechiae, jaundice, dark urine, muscle pain, joint pain


symptoms of bartonella infection: depression, anxiety, rage, headache, cognitive difficulties, brain fog, sleep problems, eye infection and eye problems, tooth pain, swollen lymph nodes, heart symptoms, anemia, unexplained cough, fatigue, fever, chills, autoimmunity, gastrointestinal dysfunction, bladder irritation, stretchmark-like rash, muscle pain, joint pain, pain in shins, pain in soles of feet


symptoms of mycoplasma, depression, anxiety, headache, cognitive difficulties, brain fog, sleep problems, eye infection and eye problems, ringing in ears, sinus problems, heart symptoms, respiratory infection, fatigue, fever, chills, autoimmunity, burning or tingling hands, gastrointestinal dysfunction, bladder irritation, muscle pain, joint pain

The Takeaway

chart marking borrelia, babesia, bartonella, and mycoplasma for general, neurological, visual, lymphatic, cardiovascular, respiratory, immune, urogenital, gastrointestinal, musculoskeletal, or integumentary symptoms

Final Thoughts

When it comes to overcoming chronic Lyme disease, gauging what to treat can sometimes be confusing due to the widespread set of symptoms you may be experiencing. However, you can use these graphics to help distinguish between overlapping symptoms and those that are distinct to specific pathogens. Combine this information with a comprehensive natural protocol and work your way through potential coinfections to move toward better, more vibrant health again.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.

You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.


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Unfortunately, MSM still believes this is a one pathogen, one drug disease when nothing could be further from the truth.  Dealing with coinfections is a must and they are just as severe and dangerous as Lyme.  Treating this complex illness is like peeling back the layers of an onion.  Symptoms will wax and wane and new ones will crop up.  Understanding how to treat this requires a Lyme literate doctor.  Don’t mess around with MSM.  All it will do is take your money, abuse you, and cause you more suffering and pain.