The Lyme Disease, Tick-Borne Illnesses & POTS Connection: Could These Infections Be Affecting Your Nervous System?

In my telehealth functional medicine clinic, it’s common for me to see patients with a slew of unexplained symptoms. Dizziness, racing heart, brain fog, and fatigue are all things that tend to be dismissed in conventional medicine but often point to a larger problem brewing underneath the surface.

For people living with postural orthostatic tachycardia syndrome (POTS), these symptoms are part of daily life due to a dysfunction with the autonomic nervous system that controls everything from blood pressure to heart rate.  

While POTS can have many possible triggers, infections — like ones from tick bites — are becoming increasingly recognized as an important piece of the puzzle. In fact, more than half of people with POTS had some type of infection (whether that be EBV, COVID-19/long COVID, or Lyme disease) before diagnosis. (1) And it’s because of this correlation that researchers are starting to investigate whether tick-borne illnesses are a bigger trigger for POTS than we previously thought. 

So even though the Lyme disease and POTS connection is finally gaining traction in conventional medicine, the research is finally starting to catch up with what we’ve suspected in functional medicine for years. Let’s take a closer look and break down exactly how these two conditions influence one another.

What is POTS?

Short for Postural Orthostatic Tachycardia Syndrome, POTS, is classified as a type of dysautonomia — a group of conditions involving a dysfunction of the autonomic nervous system (ANS). This system is responsible for many things, including controlling your heart rate, blood pressure, temperature, digestion, and breathing.

Normally, when you stand up, gravity causes some blood to pool in your lower body, which can trigger orthostatic hypotension or related blood pressure drops. In a healthy individual it is your autonomic nervous system’s job to counteract gravity’s effects when standing by constricting blood vessels and adjust your heart rate in order to maintain adequate blood flow to your brain. However, POTS disrupts this process, resulting in a variety of symptoms such as:

• Increased heart rate or heart palpitations (the hallmark symptom of this condition)
• Dizziness or lightheadedness
• Sleep disruptions
• Fatigue
• Headaches
• Brain fog
• Anxiety
• Shakiness
• Exercise intolerance
• Heat intolerance
• Difficulty standing for prolonged periods of time

What Does Lyme Disease Have To Do With the Nervous System?

But in order to see how Lyme disease and POTS are connected, we first need to understand how Lyme disease can affect the body in general. Lyme disease is a bacterial illness (and just one of many tick-borne illnesses), caused by a black-legged tick, also called a deer tick. When the tick bites, it spreads the Borrelia burgdorferi, or b. burgdorferi, bacteria. 

While many cases of Lyme disease go away after a short course of antibiotics, many of my patients experience broad, chronic symptoms months or even years after treatment that affect multiple areas of the body, including the nervous system. In fact, studies have found that up to 20% of people end up developing Post-Treatment Lyme Disease Syndrome with more than half having these sort of dysautonomic POTS-like symptoms.

While these neurological symptoms like cognitive dysfunction, fatigue, dizziness, and anxiety can look different for different people, they are extremely common because this infection ultimately can lead to a neuroinflammatory dysregulation of the neuroendocrine axis — an intersection between the nervous system, the immune system, and the endocrine system.

This is where the Lyme disease and POTS connection becomes particularly interesting. Emerging research has started to pinpoint how Lyme disease and other tick-borne infections can trigger a broader immune and inflammatory nervous system response resulting in these long-term effects.

One of the most exciting reviews exploring the connection between Lyme disease and autonomic dysfunction was published in Frontiers in Neurology in 2024, offering some surprising insight into the potential pathways through which Lyme disease may affect the autonomic nervous system and contribute to the development of POTS: (2)

• Immune system regulation: Lyme infection can potentially trigger changes to the immune system that result in nervous system dysfunction.
• Autoimmunity: Lyme disease has long been considered a precursor or trigger for autoimmunity. And for those with POTS, this infection could trigger autoimmunity that specifically affects autonomic function.
• Small-fiber neuropathy: Lyme infection could potentially damage the body’s small autonomic nerve fibers wrestling in impaired vascular regulation and other vital autonomic processes.
• Vascular dysfunction: Orthostatic intolerance could be a result of impaired blood flow regulation from Lyme infection.
• Central nervous system changes: Lyme infection could potentially alter the central nervous system with downstream effects on the autonomic nervous system.

But with all this said, it’s important to note that although the connection between these two conditions clearly does exist, there is still no definitive evidence that establishes Lyme disease as a direct cause of POTS or other forms of dysautonomia. 

This is vital to point out since not everyone who gets Lyme disease is also going to develop POTS. Everyone’s biochemistry is different and bio individuality is a very real thing due to the nature of the Lyme bacteria, genetics, lifestyle factors, etc.

READ MORE: Are You Predisposed To Lyme Disease And Mold Toxicity?

What About Other Tick-Borne Illnesses?

Although Lyme disease gets most of the attention, it’s actually only one of 19 known tick-borne illnesses (researchers don’t believe they have even identified all of the possible infections that ticks can transmit). Known as co-infections, these additional pathogens are transmitted by the same tick that carries the Borrelia burgdorferi bacterium that results in Lyme disease. These types of co-infections can include various bacteria, parasites, and other microorganisms such as:

• Ehrlichia
• Babesia
• Bartonella
• Anaplasma

Essentially these various infections hitch a ride on the same tick, making diagnosis even more difficult than it already is. Not only can symptoms overlap other non tick-borne illnesses like ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) or autoimmune conditions, but symptoms between tick-borne illnesses also vary. There’s also not a single test that looks for the presence of every possible co-infection, further complicating the guessing game.

This is another piece of the puzzle that is worth calling out since the research surrounding tick-borne illnesses and POTS is only really looking at Lyme disease. We currently don’t have an accurate representation in clinical research of how these co-infections could also affect the development of POTS or other forms of dysautonomia. However, we can at least be aware that there may be a deeper connection and gives us a baseline to explore whether or not additional infections could play a role in a person’s case.

How to start healing

Even though the connection between Lyme disease and POTS is still being clinically established, there is so much we can do to start healing from the symptoms that are clearly present. 

1. Run labs

If you are dealing with persistent symptoms, the first step is to determine whether or not the current infection has been dealt with or not. Labs can help determine if the Lyme infection was fully dealt with through antibiotic treatment or if there is still a need for various antimicrobials and anti-pathogenic support.

In functional medicine we also run various other tests like gut microbiome labs, genetic testing, and more to determine if there are other things happening underneath the surface that need to be addressed. 

For example, people with HLA (human leukocyte antigen) gene variants have a harder time getting their body to calm down after periods of stress and infection, no matter how many rounds of antibiotics and herbal supplements are completed and may need additional protocols to restore balance. Also, if you don’t have good metabolic health you don’t have good gut health which is foundational to proper function of the nervous system, immune system, and endocrine system.

LISTEN: Navigating Chronic Lyme Disease: Protocols, Practical Tips, Labs + Insights To Heal

2. Incorporate nervous system practices

For anyone struggling with POTS or other forms of dysautonomia, it’s essential to bring in various practices to encourage nervous system regulation. Breath work, EMDR, vagal nerve stimulation, journaling, and meditation are all practices that help to metabolize that stress and trauma that’s in the body from previous or current infections. 

3. Target your supplements

If labs confirm the presence of any current infections, there are many beneficial antimicrobials that have been shown to help combat the Borrelia burgdorferi the bacteria responsible for Lyme:

• Andrographis: This herb enhances immune response, fights bacteria, and reduces inflammation and joint pain, which is common in long-term Lyme. (3) 
• Artemisia annua: Also known as sweet wormwood, this anti-parasitic combats brain fog common in Lyme patients. You may find it combined with black walnut or juglans nigra. (4) 
• Ashwagandha: This adaptogen helps manage anxiety, fatigue, and brain fog common in Lyme disease.
• Cat’s claw: Also known as uncaria tomentosa, this powerful immune booster is a popular natural remedy for arthritis pain and inflammation. (4)
• Chinese skullcap (Scutellaria baicalensis): This anti-inflammatory contains flavonoids that inhibit Lyme bacteria. It may also protect against neurological symptoms seen in Lyme. (4)
• Cryptolepis sanguinolenta: Studies show this African plant is a powerful anti-inflammatory that is effective against growing and non-growing forms of B. burgdorferi. (4)
  

SHOP: My Lyme & Tick-Borne Collection features a curated selection of herbal supplements including Cat’s Claw, Desmodium molliculum, Magnesium malate, specifically designed to target tick-borne illnesses and bacteria.

4. Bring in electrolytes

People with dysautonomia require significantly more sodium than the average person — I’m talking 2-3 times what you think you should be having. Start off slowly and gradually increase your daily intake of high-quality electrolytes without an abundance of added sugar or other unnecessary additives.

SHOP: Engineered for optimal cellular hydration and performance, I formulated Cellular Hydration alongside LongevityRX. It is the only leading brand with a balanced 1:1 ratio of sodium to potassium. Powered by Celtic Sea Salt®, this whole unrefined mineral blend is synergistically combined with red marine algae, organic watermelon, coconut water, and celery to provide hydration from head-to-toe. This comprehensive blend goes beyond hydration – it’s a sugar free, scientifically formulated approach to support your body’s ideal electrolyte balance.

5. Start a new exercise routine

One of the biggest symptoms of POTS is exercise intolerance, however, daily movement can be extremely beneficial for your healing journey. I love recumbent biking because it is a horizontal exercise that helps to limit the gravity effects of the heart pumping blood back up to the brain. The typical pooling that can happen when you are sitting on a regular bike versus being more horizontal doesn’t happen, but can actually instead build up cardiovascular health and blood volume over time to ease symptoms.

The Takeaway

As a functional medicine practitioner, the Lyme disease and POTS connection is obvious. While the exact mechanisms are still being studied and Lyme disease isn’t considered a definitive cause of POTS, the anecdotal evidence I see on a daily basis can’t be ignored. Every person’s health case is unique but we can clearly see how this bacteria and other tick-borne co-infections play a role in the development of this neuroinflammatory dysregulation associated with dysautonomia.

If you suspect your symptoms are related to POTS, in my telehealth functional medicine clinic we specialize in running comprehensive labs alongside a detailed health history to better determine whether or not your symptoms are connected to previous or current tick-borne infections — and come up with a tailored plan to reclaim your health.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. 

Photo: Unsplash.com

Sources

• Shaw, B. H., Stiles, L. E., Bourne, K., Green, E. A., Shibao, C. A., Okamoto, L. E., Garland, E. M., Gamboa, A., Diedrich, A., Raj, V., Sheldon, R. S., Biaggioni, I., Robertson, D., & Raj, S. R. (2019). The face of postural tachycardia syndrome – insights from a large cross-sectional online community-based survey. Journal of internal medicine, 286(4), 438–448. https://doi.org/10.1111/joim.12895
• Adler, B. L., Chung, T., Rowe, P. C., & Aucott, J. (2024). Dysautonomia following Lyme disease: A key component of post-treatment Lyme disease syndrome? Frontiers in Neurology, 15, 1344862. https://doi.org/10.3389/fneur.2024.1344862
• Li, X., Yuan, K., Zhu, Q., Lu, Q., Jiang, H., Zhu, M., Huang, G., & Xu, A. (2019). Andrographolide Ameliorates Rheumatoid Arthritis by Regulating the Apoptosis-NETosis Balance of Neutrophils. International journal of molecular sciences, 20(20), 5035. https://doi.org/10.3390/ijms20205035
• Shor, S. M., & Schweig, S. K. (2023). The Use of Natural Bioactive Nutraceuticals in the Management of Tick-Borne Illnesses. Microorganisms, 11(7), 1759. https://doi.org/10.3390/microorganisms11071759