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What Causes Extreme Weakness And Joint Pain With A History Of Tick Bite?

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Posted on Fri, 10 Jun 2016
Question: I was bitten by a tick about 1-1/2 years ago. I got tested immediately and it was negative. Then I began having difuse joint pain. I have been incapacitated with it. This past winter I have a new symptom- extreme weakness. My doctor did a lyme titer on me. I have a feeling it will be negative.
doctor
Answered by Dr. Shoaib Khan (47 minutes later)
Brief Answer:
Lyme's should be ruled out, but check on menopause as well recommended

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. Your symptoms could be related to Lyme's (except for the time period), anyway it is good that your doctor has gone about a test, so we can rule it out. Joint pain is commonly seen about a month after the bite, but it has been almost 18 months now, and you should have exhibited some other quite obvious symptoms of Lyme's by now.

But also important to note is the appearance of the joint pain could also be associated with arthritis or even menopause-related changes in the skeletal structure.

The extreme weakness is what makes me ponder over the possibility of this being related to a hormonal imbalance or peri-menopause or menopause itself. Which is why I would also recommend a check on your hormone levels and guidance and correction by a gynaecologist.

I hope you find my response helpful. Please feel free to write back to me for any further clarifications, I am always here to help.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (15 minutes later)
I am post menopause. My family doctor told me this after checking hormone levels 5 years ago and then again last year by a gynecologist. He tested hormone levels. He said my current symptoms were not related to menopause.
doctor
Answered by Dr. Shoaib Khan (57 minutes later)
Brief Answer:
My question is about the duration between joint pain appearance and bite

Detailed Answer:
Hello once again ma'am.

So your hormone levels are way within normal range? I only ask because even if they are mildly borderline they can be related to your current symptoms. But if your doctor is sure about it, then it should be ruled out.

But what my main question here is: how long after the tick bite did your joint pain appear? Was it soon after (maximum within about 45 days from the bite) or was it much later?

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (9 minutes later)
It was approximately 30 days, 1 month after the bite that my severe joint paint hit. I was tested initially the day after I had the bulls eye rash and it was negative.

It started on the left side of my neck. The pain was so severe I could not bear the weight of my head on my neck. I would also sweat and then get real cold throughout the day. My heart rate was about 150 or up. I have fever off and on. In the summer it moved to the dorsum of my right foot. Then into both hands. it was in my MPJ and my DIPs. I started losing my sight. I could not see clear enough to drive. I saw a rheumatologist that said I did not have RA. The pain has gone into other joints.


Please pardon me, I used to practice as a an Orthopedic Chiropractor for 17 1/2 yrs. I don't think my doctor took it seriously. She referred my to a pain specialist and he put me on the oxycodone.
I had also developed seizures. I keep getting rashes. I get large dark red/purple bruises that just pop up with injury.
doctor
Answered by Dr. Shoaib Khan (9 minutes later)
Brief Answer:
Strongly recommend a check on vitamin D and serum calcium levels

Detailed Answer:
Hello once again ma'am.

There are a few points I would like to state from your last response:

1. Arthritis is even present in Lyme's disease; so if it was ruled out then even Lyme's seems unlikely

2. Have you checked your vitamin D levels? A drop in your vitamin D levels can also result in the exact same symptoms you have mentioned? I would like to emphasise on a check on your vitamin D levels.

3. Have you checked your serum calcium levels? Only second to your vitamin D levels, I would like to emphasise on checking your serum calcium levels as well.

Please do get the above mentioned parameters checked and write back to me at the earliest.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (5 hours later)
The rheumatologist that I saw didn't even get my records. He did a brief exam and said that I did not have arthritis. I had seen another rheumatologist prior to that and she said I had some type of rheumatoid. I was actually vitamin D toxic. It took 6 months to get the vitamin D in the normal range. I just had it checked along with serum CA levels. Both were within normal range. I am just so sick. I can't drive. The pain is unbearable. I am totally incapacitated. I can't sleep. Mostly due to pain but when the pain is under control with the oxydrocodone and Prednisone, I still can't sleep. I am not sleepy but I am extremely weak. In the past year I am getting worse. The I just had the titer for Lyme on 4-11-16. I also had a sedimentation rate done which is very high. The results for the Lyme Titer have not come in yet. I read that the Lyme Titer is not very reliable. My doctor is trying to refer me to UMSC XXXXXXX Rheumatology. I am also worried about taking the oxycodone 5 mg 3 x a day. I have had to take it 3 x a day since January 2016. When I started on it, I was on the maximum dose but then I was able to cut back. Now I ca't cut back due to the pain. Excuse my typo, I get large dark red/purple bruise to pop up WITHOUT INJURY. My potassium was very high last summer and the doctor called me at home and I had to have it tested again the next day at another office because it was a Saturday. She said if it was still that high I would have to be hospitalized. The results of the test were lost. Then the pain specialist who she referred me too got them in November of last year. He said my potassium was even higher. He said it was very serious and he would get in touch with my family doctor. They work in the same group. She said it was too late to do anything about it?? I also had an MRI on my C spine and my foot that showed bone marrow edema throughout, The pain specialist reviewed it in December and he was very concerned and said we would have to address it after my vacation. In January when I saw him, he did not remember when I asked about it. He was just concerned that I was much worse.
doctor
Answered by Dr. Shoaib Khan (15 hours later)
Brief Answer:
I am sorry to hear this, was your RA factor checked by your rheumatologist?

Detailed Answer:
Hello once again ma'am.

The unexplained bruising along with joint pain are both warning signs to check for all types of arthritis and associated conditions like:

+Osteoarthritis (Has your RA factor and CSR values been checked before)
+Psoriatic arthritis (of course requiring the typical rash)
+Rheumatic fever (need RA factor and CSR values also)
+Rheumatoid arthritis ( " )
+Gout (has your serum uric acid ever been checked?)

But along with these they also raise doubt for other conditions such as:

+Systemic lupus erythematosus
+Lyme Disease
+Gout
+Herpes Zoster (should have other symptoms as well)

I would also like to ask how your bowel movements have been? Not just in the recent few days (last week or so), but from the last say 5 years? Please take time to think and respond as there are a few digestive conditions that also require ruling out based on your presentation.

I hope you understand that your case requires some thinking and numerous investigations in order to find the cause, but I shall work with you and your doctors to help do just that ma'am, please be patient, you are also in my prayers.

What was done about your hyperkalemia (high potassium levels)?
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

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What Causes Extreme Weakness And Joint Pain With A History Of Tick Bite?

Brief Answer: Lyme's should be ruled out, but check on menopause as well recommended Detailed Answer: Hello ma'am and welcome. Thank you for writing to us. I have gone through your query with diligence and would like you to know that I am here to help. Your symptoms could be related to Lyme's (except for the time period), anyway it is good that your doctor has gone about a test, so we can rule it out. Joint pain is commonly seen about a month after the bite, but it has been almost 18 months now, and you should have exhibited some other quite obvious symptoms of Lyme's by now. But also important to note is the appearance of the joint pain could also be associated with arthritis or even menopause-related changes in the skeletal structure. The extreme weakness is what makes me ponder over the possibility of this being related to a hormonal imbalance or peri-menopause or menopause itself. Which is why I would also recommend a check on your hormone levels and guidance and correction by a gynaecologist. I hope you find my response helpful. Please feel free to write back to me for any further clarifications, I am always here to help. Best wishes.