Updated:
October 6, 2026
Is It a Relapse?
At some point after a Lyme regimen is complete, many with Lyme disease and the co-infections will relapse. But how do you know if the decline in your health is due to Lyme, a co-infection, or another problem? And if it is a relapse what do you do?
In this article I lay out the steps to figure out if it is a Lyme disease relapse. I also describe how to prevent a relapse.
Step One: Is It Yeast?
In my experience from when I practiced in Seattle, 80% of the time someone’s health declines after a Lyme therapy regimen is complete too many yeast grow in the intestines. Yeast overgrowth in the intestines and Lyme disease can look the same. Why? Both of these conditions trigger an immune system reaction the creates more inflammatory cytokines. These cytokines are designed to boost the immune system. But when they are made in excess they give most of the symptoms we find in Lyme and in yeast overgrowth in the intestines.
Read A Silent Problem. Do you Have Yeast? to see if you have this problem. And if you do, read Kills & Prevents Yeast: A Brief Guide for options. If it is yeast and you support it with one of the options I discuss, usually in 3 weeks you will have your health back.
Step Two: Is It Bartonella or Babesia?
If you had bartonella or babesia as part of your Lyme disease, it is possible your decline is due to growth of one of these germs. A flare in Bartonella or Babesia symptoms I outline in
In my experience using the approaches in The Ultimate Bartonella Guide and in Kills Babesia: A Brief Guide, 95% of people will never have a relapse of one of these germs.
Step Three: Is It Lyme?
Follow steps one and two first. Also be sure your downturn is not due to a more recent infection like a cold virus or the flu. But if your symptoms remain, then it may be a Lyme relapse.
Do not test for Lyme again with western blot testing or with a CD-57 test. I also do not think testing using a Lyme elispot test is useful either. These test are not reliable in a relapse. Read more about testing in
In fact there is not a useful test to see if Lyme is active. It is a clinical decision.
For herbal and prescription antibiotic options see A Lyme Disease Antibiotic Guide. Also when you choose antibiotics look back to see which combinations worked best for you during your regimen. Consider trying these again.
Good News: Generally if you get back on a regimen quickly at the beginning of a relapse the recovery is relatively quick (compared to the average initial 2 year time frame) and takes around 4 months to recover.
Marty Ross MD Discusses How to Figure Out a Relapse
This video was recorded when Dr. Ross practiced in Seattle, Washington.
Step Four: Prevent Relapse at The End of a Lyme Disease Regimen.
Follow the steps outlined in Finished? And How to Prevent Relapse.
Disclaimer
The ideas and recommendations on this website and in this guideline are for informational purposes only. For more information about this, see the sitewide Terms & Conditions.
About The Author
Dr. Marty Ross, MD is a passionate Lyme disease educator and clinical expert. He helps Lyme sufferers and their physicians see what really works based on his review of the science and extensive real-world experience. Dr. Ross is licensed to practice medicine in Washington State (License: MD00033296) where he has treated thousands of Lyme disease patients in his Seattle practice.
Dr. Marty Ross, MD is a graduate of Indiana University School of Medicine and Georgetown University Family Medicine Residency. He is a member of the International Lyme and Associated Disease Society (ILADS), The Institute for Functional Medicine, and The American Academy of Anti-Aging Medicine (A4M).