First of all, let’s address the elephant in the room: It is and always has been accepted by all actual Lyme experts, infectious disease specialists, entomologists, and medical and scientific associations worldwide that “chronic Lyme” is a fake disease: a scam designed to take money from victims who may never have had Lyme in the first place. If you don’t accept that first, then you really need to get off Quora and read up on some facts. Start with the resources at LymeScience.org for information about the chronic Lyme scam, and plenty of myth debunking with real science about Lyme.

So, as an actual authority on Lyme, and not a deluded victim of the scam or someone who profits off the scam and peddles misinformation like some other Quorans, here is my answer to your question:

First, let’s talk about untreated Lyme. Lyme is very, very, very easy to cure, with a short course of antibiotics leading to total eradication of the microbe in all cases: but what happens if you don’t get treated? After the rash, flu-like symptoms, and joint aches, the following symptoms may occur:

• Severe headaches and neck stiffness
• Additional bulls-eye rashes on other areas of the body
• Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
• Facial palsy (loss of muscle tone or droop on one or both sides of the face)
• Intermittent pain in tendons, muscles, joints, and bones
• Heart palpitations or an irregular heart beat (Lyme carditis, which is rarely but potentially fatal)
• Episodes of dizziness or shortness of breath
• Inflammation of the brain and spinal cord
• Nerve pain
• Shooting pains, numbness, or tingling in the hands or feet
• Problems with short-term memory

As with many other diseases, the symptoms will persist until you see a real, regular medical doctor and get treated. A short course of antibiotics will cure you, and the symptoms will fade.

However, your symptoms may remain even after the bacteria has been wiped from your body. Compare this to a burn: just because you took your hand out of the fire, doesn’t mean you are immediately all better. The skin needs time to heal. Similarly, it will take time for some of the nerve and joint damage to heal, especially if you waited too long for treatment. And by “time,” I mean, unfortunately, months or even a year. This happens to a small minority of Lyme patients, but is significant and has its own name: Post-Treatment Lyme Disease Syndrome. That is what often gets confused for “chronic Lyme,” but it is not Lyme, and no further antibiotic treatment is necessary. That has been demonstrated time and time again: more treatment can only cause harm. However, PTLDS does not last forever. It does eventually go away: many of the people who think they have “chronic Lyme” never had Lyme in the first place, but were deliberately misdiagnosed by a Lyme scammer, and so, whatever they have, it’s not PTLDS and it’s clearly not being treated.

In summary, there are no “long-term” effects of Lyme, after it has been treated. However, it does not go away on its own, and the symptoms can persist for months after treatment is finished in a minority of cases.