Lyme Disease Symptom Checklist

Common symptoms of Lyme Disease include:
___Unexplained fevers, sweats, chills, or flushing
___Unexplained weight change–loss or gain
___Fatigue, tiredness, poor stamina
___Unexplained hair loss
___ Swollen glands: list areas____
___Sore throat
___Testicular pain/pelvic pain
___Unexplained menstrual irregularity
___Unexplained milk production: breast pain
___Irritable bladder or bladder dysfunction
___Sexual dysfunction or loss of libido
___Upset stomach
___Change in bowel function-constipation, diarrhea
___Chest pain or rib soreness
___Shortness of breath, cough
___Heart palpitations, pulse skips, heart block
___Any history of a heart murmur or valve prolapse?
___Joint pain or swelling: list joints_____________
___Stiffness of the joints, neck, or back
___Muscle pain or cramps
___Twitching of the face or other muscles
___Headache
___Neck creeks and cracks, neck stiffness, neck pain
___Tingling, numbness, burning or stabbing sensations, shooting pains
___Facial paralysis (Bell’s Palsy)
___Eyes/Vision: double, blurry, increased floaters, light sensitivity
___Ears/Hearing: buzzing, ringing, ear pain, sound sensitivity
___lncreased motion sickness, vertigo, poor balance
___Lightheadedness, wooziness
___Tremor
___Confusion, difficulty in thinking
___Diffculty with concentration, reading
___Forgetfuiness, poor short term memory
___Disorientation: getting lost, going to wrong places
___Difficulty with speech or writing
___Mood swings, irritability, depression
___Disturbed sleep-too much, too little, early awakening
___Exaggerated symptoms or worse hangover from alcohol