Lyme Disease vs. Babesia: What’s the Difference — Could You Have Both?

By Dr Cynthia Hall, ND

5 MIN READ

If you’ve been treated for Lyme disease but still experience fatigue, headaches, body aches, night sweats, or symptoms that seem to come and go without explanation, Lyme may not be the only infection.

Babesia is a tick-borne infection that can occur alongside Lyme disease. Because symptoms overlap, it isn’t always obvious that more than one infection may be contributing to your symptoms.

But Lyme disease and Babesia are not the same infection.

Lyme disease is caused by Borrelia bacteria, while babesiosis is caused by Babesia, a microscopic parasite that infects red blood cells.

And yes — it is possible to have Lyme disease and Babesia at the same time.

Understanding the differences between them can be especially important when symptoms persist despite Lyme disease treatment (previous or current).

What Is Lyme Disease?

Lyme disease is a tick-borne illness caused primarily by the bacterium Borrelia burgdorferi in the United States.

It is transmitted through the bite of an infected blacklegged tick. Early Lyme disease may cause symptoms such as:

• Fatigue

• Fever or chills

• Headaches

• Muscle and joint aches

• Swollen lymph nodes

• A characteristic erythema migrans, or “bull’s-eye,” rash

However, not everyone develops or notices a rash.

When Lyme disease is not recognized and treated early, symptoms can sometimes involve the joints, heart, and nervous system.

For some patients, the story becomes more complicated when symptoms persist — particularly when another tick-borne infection may also be present.

Learn more about Lyme disease in Women

What Is Babesia?

Babesia is not a bacterial infection.

Babesiosis is caused by microscopic Babesia parasites that infect red blood cells. In the United States, Babesia microti is the species responsible for most reported cases. But there are many other species of Babesia that cause symptoms.

Like Lyme disease, Babesia can be transmitted through the bite of an infected tick or flea.

Because some of the same ticks can carry multiple disease-causing organisms, exposure to one tick-borne infection does not necessarily rule out another.

Babesia infections can range from having no noticeable symptoms to causing significant illness affecting daily life.

Common symptoms can include:

• Fever

• Chills

• Fatigue

• Headaches and Migraines

• Muscle or body aches

• Sweating

• Nausea or reduced appetite

• Numbness and tingling

Babesia affects red blood cells, which is why laboratory findings such as anemia or low platelets may occur.

Learn more about Signs Your Chronic Fatigue is More Than Just Stress

Lyme Disease vs. Babesia: What’s the Difference?

Although Lyme disease and Babesia can produce similar symptoms, they are fundamentally different infections and respond to different treatments.

Lyme disease is caused by bacteria and may affect multiple systems in the body, including the nervous system, joints, and heart.

Babesia is caused by a parasite that infects red blood cells.

One of the challenges is that symptoms such as fatigue, headaches, body aches, and feeling generally unwell occurs with either infection.

There are, however, certain symptoms that may raise greater suspicion for Babesia.

Symptoms more commonly associated with Lyme disease may include:

• Migrating joint or muscle pain

• Facial weakness or Bell’s palsy

• Numbness or tingling

• Neck stiffness

• Neurological symptoms

• Heart rhythm abnormalities in some cases

• Erythema migrans rash during early infection

Symptoms that raise suspicion for Babesia include:

• Fevers or chills

• Drenching or unexplained sweats

• Night sweats

• Significant fatigue

• Headaches, band like migraines

• Muscle aches

• Anemia

• Low platelet counts

Symptoms alone, however, cannot reliably tell you which infection you have.

That is why your history, symptoms, possible tick exposure, physical examination, and appropriate laboratory testing all matter.

Can You Have Lyme Disease and Babesia at the Same Time?

Yes. Lyme disease and Babesia can occur together. This is known as a coinfection.

Blacklegged ticks can transmit several different pathogens, including those responsible for Lyme disease, babesiosis, and anaplasmosis.

This means that a single tick exposure — or multiple exposures over time — may potentially result in more than one tick-borne infection.

In fact, babesiosis is recognized as one of the more common coinfections associated with Lyme disease in the United States.

This is one reason I look beyond a single diagnosis when someone tells me:

“I was treated for Lyme disease, but I still don’t feel well.”

Persistent symptoms don't automatically mean Babesia is present. There are many possible reasons someone may continue to feel unwell.

But when the clinical picture doesn’t quite fit — particularly when symptoms such as unexplained sweats, fevers, chills, headaches, or profound fatigue are present — it may be worth taking a broader look.

How Do You Know If Your Symptoms Are From Lyme Disease or Babesia?

Laboratory testing is the subject of great debate, because the wildly available testing are not very accurate. Outside of testing, this can be difficult because there is no single symptom that definitively separates Lyme disease from Babesia.

Instead, I look for patterns.

When did your symptoms begin? And how have they changed?

Was there a known tick bite?

Did you develop a rash?

Do you experience night sweats or episodes of feeling unusually hot and cold?

Are your symptoms constant, or do they fluctuate?

Which symptoms improved with previous treatment — and which ones didn't?

Have you had blood-count abnormalities such as anemia or low platelets?

And perhaps most importantly:

Does the diagnosis you have actually explain the symptoms you are experiencing?

This type of detailed history is particularly important for patients who have been dealing with chronic or complex symptoms for months or years.

How Is Babesia Tested?

Testing for Babesia is different from testing for Lyme disease.

Depending on the clinical situation, conventional evaluation for babesiosis may include:

• Microscopic examination of a blood smear

• PCR testing to look for Babesia DNA

• Antibody testing

No test should be interpreted completely in isolation.

The timing of testing, the specific test performed, your symptoms, medical history, and potential exposure all need to be considered together.

This is one reason a thorough clinical history remains such an important part of evaluating complex tick-borne illness.

Why Might Babesia Be Considered When Lyme Treatment Hasn't Resolved Your Symptoms?

If you have received treatment for Lyme disease but still don't feel well, it can be tempting to assume that you simply need more of the same treatment.

Sometimes the better question is:

What else could be contributing to these symptoms?

Depending on your individual situation, that may mean evaluating for other tick-borne infections such as Babesia.

But it may also mean looking beyond infections altogether.

In my practice, I often work with women whose symptoms involve multiple interconnected systems — including fatigue, sleep, digestion, stress response, menstrual cycles, and hormonal symptoms.

A history of Lyme disease does not mean that every symptom you experience afterward is necessarily caused by Lyme.

The goal is to understand the whole clinical picture rather than forcing every symptom into a single diagnosis.

Can Lyme Disease and Babesia Affect Women's Hormones?

This is an area where careful language matters.

Lyme disease or Babesia should not automatically be assumed to be the cause of a hormonal imbalance.

However, chronic illness can place considerable stress on the body, and symptoms related to infection, inflammation, sleep disruption, nutritional status, stress physiology, and hormonal changes can overlap.

For women, that can make an already complicated symptom picture even harder to untangle.

For example, fatigue, poor sleep, headaches, changes in body temperature, mood changes, brain fog, and changes around the menstrual cycle may have more than one potential explanation.

This is why my approach as a Lyme-literate naturopathic doctor working with women's hormones is not simply to ask:

“Which infection do you have?”

I also want to understand:

“What else is happening in your body that could be contributing to how you feel?”

For some women, evaluating tick-borne illness is one piece of a much larger clinical picture.

What If You Have Lyme Disease Symptoms but Live in California?

You do not have to live in the Northeast to have a history of Lyme disease or another tick-borne infection.

People move, travel, hike, camp, and may have had tick exposures years before their current symptoms began.

California also has its own tick populations capable of transmitting Lyme disease.

This is why I focus on your complete exposure and medical history, rather than assuming your current ZIP code tells us whether Lyme disease and tick-borne infection should or shouldn't be considered.

For patients searching for a naturopathic doctor for Lyme disease with telehealth in California, virtual care can also make it easier to access a clinician experienced in evaluating complex tick-borne illness without needing to live near the doctor's physical office.

When Should You Consider Looking Beyond Lyme Disease?

It may be worth having a more comprehensive evaluation if:

• You have a history of Lyme disease but still experience unexplained symptoms

• Your symptoms don't completely fit your previous diagnosis

• You experience significant night sweats, chills, fevers, or episodes of feeling unusually hot and cold

• Fatigue remains severe despite previous treatment

• You have unexplained anemia or other blood-count abnormalities

• You have had significant tick exposure

• You have multiple symptoms affecting different systems of the body

• You feel that pieces of your medical history have never been connected

This doesn't necessarily mean you have Babesia.

It means there may be value in asking a broader question:

What is driving my symptoms now?

Frequently Asked Questions About Lyme Disease and Babesia

Is Babesia the same thing as Lyme disease?

No. Lyme disease is caused by Borrelia bacteria, while babesiosis is caused by microscopic Babesia parasites that infect red blood cells. Both can be transmitted by ticks, but they are different infections.

Can you test positive for Lyme disease and Babesia?

Yes. A person can have evidence of both Lyme disease and Babesia infection. When two tick-borne infections occur together, this is called a coinfection.

Can one tick give you Lyme disease and Babesia?

Potentially, yes. Certain ticks can carry more than one disease-causing organism, which is why coinfections are possible.

What are the biggest differences between Lyme disease and Babesia symptoms?

There is substantial overlap. Lyme disease may be associated with symptoms involving the joints, nervous system, heart, and skin. Babesiosis more commonly causes fever, chills, sweats, fatigue, headaches, and body aches and can cause abnormalities such as hemolytic anemia and low platelet counts.

Symptoms alone cannot confirm either infection.

Are night sweats a symptom of Babesia?

Sweating, including significant sweats, can occur with babesiosis. However, night sweats have many potential causes and are not specific to Babesia.

Why do I still feel sick after being treated for Lyme disease?

There isn't one answer that applies to everyone.

Persistent symptoms after Lyme disease can have multiple possible explanations. Depending on your history, a comprehensive evaluation may consider other tick-borne infections as well as sleep, nutrition, medications, hormonal health, gastrointestinal health, and other medical conditions.

The important question isn't simply whether you've had Lyme disease.

It's what is contributing to your symptoms now.

A Whole-Person Approach to Lyme Disease and Complex Chronic Illness

When you've been unwell for a long time, it is easy for your medical history to become a collection of separate diagnoses, laboratory results, supplements, medications, and symptoms.

My goal is to help put those pieces back together.

As a naturopathic doctor working with Lyme disease and complex chronic illness, I take the time to understand your complete history — including previous infections and treatment, current symptoms, nutrition, sleep, digestive health, stress physiology, menstrual and hormonal health, and other factors that may be influencing how you feel.

For women in particular, this whole-person perspective can be important because symptoms associated with chronic illness and women's hormones can overlap considerably.

If you are looking for a Lyme-literate naturopathic doctor or a naturopathic doctor for Lyme disease offering telehealth in California, I offer individualized virtual consultations to help you better understand what may be contributing to persistent symptoms and what your next steps may look like.

You don't necessarily need another protocol. You may need someone to look at the entire picture.

This article is for educational purposes only and is not intended to diagnose or treat any medical condition.