The course · 11 chapters
The whole library,
in the order it helps.
11 chapters, each a short orientation and a link into the full guide. The sequence is the point — the illness before testing, prevention early, coinfections before treatment, because that is the order in which each one becomes useful.
Free, no account, and nothing is saved — including how far you get. Leave and come back at whichever chapter you need.
Review statePending clinical review
Everything clinical the course shows: the glossary it renders, its two clinical drawings, the quiz answers, and the chapter framing that states how often the rash appears. A clinically-informed reviewer has not yet signed this off, and it stays marked until one does.
- Chapters
- 11
- Full guides linked
- 10
- No account needed
- Free
- Saved about you
- Nothing
Chapter 1 of 11. Chapter 1
What Lyme is, and why it is so often missed
Everything after this depends on knowing what is actually being argued about. Start here even if you think you know — most of the confusion downstream comes from disagreements that are never made explicit.
Read the full guideUnderstanding TicksThe biology behind the bite.Chapter 2 of 11. Chapter 2
The ticks themselves
Which tick, how long it was attached, and what stage it was in change what is worth doing. This is the chapter that turns a frightening event into a set of specifics.
Three life stages, drawn to one scale.
CDC: “In general, adult ticks are approximately the size of a sesame seed and nymphal ticks are approximately the size of a poppy seed.”
The seeds beside the nymph and the adult are drawn at the same scale as the ticks.
Silhouettes for scale only — not an identification aid. Size varies by species and sex, and a tick that has already fed is larger than any of these.
Life stages and seed sizes: US Centers for Disease Control and Prevention, How Lyme Disease Spreads, read 12 October 2026. The three silhouettes and the two seeds are drawn to one scale; no absolute measurement is shown.
Chapter 3 of 11. Chapter 3
Not getting bitten again
Placed early on purpose. It is the only part of this you fully control, and it applies to everyone in the house including the animals.
Read the full guideTick PreventionProtect yourself, your family, and your yard.Chapter 4 of 11. Chapter 4
The rash, and what it does and does not tell you
A rash is the clearest early evidence there is. CDC reports the expanding rash in roughly 70 to 80 percent of people with Lyme disease — so some people never get one — and it is not always a bull’s-eye (Signs and Symptoms of Untreated Lyme Disease, read 25 September 2026). Knowing both halves of that prevents the two opposite mistakes.
Read the full guideRash IdentificationRecognize the signs on your skin.Chapter 5 of 11. Chapter 5
What the infection is doing
Read this before the testing chapter. Understanding what the infection is actually doing is what makes a test result interpretable rather than just a word on a page.
Read the full guideImmune System & LymeHow Lyme evades your defenses.Chapter 6 of 11. Chapter 6
Testing, and why a negative is not an answer
The single most useful chapter to have read BEFORE you are handed a result. You cannot interpret a test until you know what it looks for and when it looks.
Two-step testing process
CDC currently recommends a two-step testing process for Lyme disease serologic testing.
Start
Blood sample
Both steps are required and can be done using the same blood sample.
Negative
No further testing
If this first step is negative, no further testing is recommended.
End of the path
Positive or indeterminate
Second step
If the first step is positive or indeterminate (sometimes called "equivocal"), the second step should be performed.
Overall result
The overall result is positive only when the first test is positive (or equivocal) and the second test is positive (or for some tests equivocal).
End of the path
Serologic assays may be falsely negative during the first 4-6 weeks after infection.
Source
US Centers for Disease Control and PreventionClinical Testing and Diagnosis for Lyme DiseaseRead 3 October 2026 · For health care providers · page dated May 15, 2024
This shows the shape of the testing process, not what a result means for one person.
Chapter 7 of 11. Chapter 7
What else one bite can carry
Placed after testing because it is one of the questions worth asking when treatment is not working and nobody can say why. The guide separates what one tick can pass on from what it cannot, including Bartonella.
Read the full guideCoinfectionsOther infections the same tick can carry, and what each test can and cannot settle.Chapter 8 of 11. Chapter 8
What treatment looks like
There is no single correct protocol, and the honest version of this chapter is a map rather than a recommendation. What is right depends on things only you and a clinician can weigh.
Read the full guideTreatment ProtocolsStandard-of-care approaches, explained.Chapter 9 of 11. Chapter 9
Integrative approaches, and what the evidence says
Widely used and unevenly studied. The point of this chapter is to be able to tell those two things apart — including where the honest answer is that nobody has looked.
Read the full guideIntegrative ApproachesWhat patients use — with honest evidence.Chapter 10 of 11. Chapter 10
Alpha-gal and food safety
A different tick-borne condition entirely, and one that gets missed for years because nobody connects a bite to a reaction that happens hours after dinner.
Read the full guideAlpha-gal Food SafetyThe meat allergy — hidden sources & swaps.Chapter 11 of 11. Chapter 11
Advocating for yourself
The chapter with no article behind it, because it is not medical. It is about records, appeals, and how to be believed — which for this illness is a skill you are forced to learn.
Glossary
The words you are expected to already know
Not knowing these is a large part of why appointments go badly. Each one defines a term — what a result means for you is a conversation with your clinician.
- Two-tier testing
- The standard approach: a first antibody test, then a second confirmatory one. Both look for your immune response rather than for the bacterium itself.
- Serology
- Any test that looks for antibodies in blood. It measures your response to an infection, which is why timing changes what it can find. "Seronegative" means no antibodies were detected.
- Western blot
- The confirmatory test in the standard pair. It reports antibodies to individual proteins as "bands" — separate markers that are read together rather than individually.
- Seroconversion
- The moment your antibody levels become high enough to detect. Before it, a test can be negative while an infection is present.
- Coinfection
- A second organism transmitted by the same tick in the same bite. Different organism, different illness, often different treatment.
- Herxheimer reaction
- A temporary worsening some people notice after starting or changing treatment. What it means in any individual case is a question for their clinician.
- EM rash
- Erythema migrans — the expanding rash sometimes called a bull’s-eye. CDC reports the expanding rash in roughly 70 to 80 percent of people with Lyme disease — so some people never get one — and it is not always a bull’s-eye (Signs and Symptoms of Untreated Lyme Disease, read 25 September 2026).
- Vector
- The organism that carries an infection between hosts. For Lyme, the tick.
- Nymph
- A juvenile tick stage. Small enough to be missed easily.
- Prophylaxis
- Treatment given to prevent an infection rather than to treat a confirmed one. Whether it applies is a clinical judgement.
- PTLDS
- Post-treatment Lyme disease syndrome — the label used for symptoms that continue after a completed course of standard treatment.
- Persisters and biofilms
- Forms of the bacterium seen in the laboratory that survive antibiotics. Whether they occur in people, and whether they explain symptoms that persist, is not settled.
- Alpha-gal syndrome
- A delayed allergy to mammalian meat that can follow a lone star tick bite. Reactions arrive hours after eating rather than immediately.
- IDSA and ILADS
- Two professional bodies that publish Lyme guidelines: the Infectious Diseases Society of America (IDSA), with the American Academy of Neurology and the American College of Rheumatology (2020), and the International Lyme and Associated Diseases Society (ILADS, 2014). What each recommends is in its own document; the Common ground page links both and says what each covers.
Questions
About this course
Do I need an account to read this?
No. The whole library and this course are public, free and need no account. An account adds symptom tracking and Beacon; it adds nothing to what you can read.
Is my progress saved?
No, deliberately. Nothing about your visit is stored — not which chapters you opened, not your quiz answers. The reading bar resets when you reload, which is honest about a document you can enter at any chapter.
Do I have to read it in order?
No. The order is the useful part if you are starting cold, but every chapter links to a full guide that stands on its own. Jump to what you need.
Why is the medical detail on other pages?
Each guide is the single canonical source for its subject, including its review flags. Repeating that content here would create two copies to keep in step, and a stale medical page is worse than a click.
Is this medical advice?
No. It is education. Nothing here diagnoses anyone or tells you what to take, and what is right for you is determined by the clinician treating you.
Who wrote this?
LymeHQ, a patient-built platform. Where evidence is thin we say so rather than rounding up, and where something has no human trial evidence we say that too.
Can I share it?
Please do. It is a public page with a plain URL, and it was written partly to be the thing you send to a relative who does not understand what is happening.
What if I disagree with something?
Some of this is genuinely contested among clinicians, and the guides say where. We would rather show you the disagreement than pick a side and hide it.
Knowledge check
Five questions about what you just read
These check the material, not you. Getting one wrong means a chapter did not land — the explanation is the point, and it appears either way.
Someone tests negative on the standard two-tier test. What does that establish?
Which of these is caused by a parasite rather than a bacterium?
A dog in the household tests C6 positive. What does that tell the people who live there?
What is a Herxheimer reaction?
Why does the course explain the illness before testing?
What this covered
- What Lyme is, and why it is argued about
- The ticks, and which one matters
- Not getting bitten again
- The rash, and what it does not tell you
- What the infection is doing
- Testing, and why a negative is not an answer
- Why it is rarely just Lyme
- What treatment looks like
- Integrative approaches and the evidence
- Alpha-gal, a different tick-borne illness
- Advocating for yourself
Where to go next
- GuidedThe six-step journeySymptoms, doctor, testing, funding, treatment, the long haul — the practical arc.
- ReferenceThe full libraryEvery guide, ordered by where you are rather than by subject.
- UrgentFound a tickRemoval and what to watch for. Free, no account, one tap.
- GuideCoinfectionsWhat else one bite can carry, and which of those the antibiotics used for Lyme do not treat.
- CareFind a clinicianMatched on the state you are in, because licensure is the real constraint.
- TrustHow your data is handledWhat we keep, what we do not, and what you can turn off.