Persistent symptoms can affect energy, sleep, pain, concentration, movement, and everyday function. This program gives you practical, evidence-informed ways to work on those areas while staying connected to appropriate medical care.
Persistent symptoms can be complicated, and there is no single self-care routine that works for everyone. Current guidance emphasizes regular reassessment and individualized support for symptoms such as fatigue, pain, sleep problems, cognitive difficulties, and reduced daily function.
This framework is not a treatment for Lyme disease. It is a practical guide for the parts of daily life you can work on and track.
Every layer is labeled so you can see what kind of guidance it rests on.
The research supports the components of symptom management and rehabilitation. It does not show that this 10 layer program itself treats PTLDS.
These tools are not diagnostic, and this page is not an emergency service. Please seek medical evaluation for any of these:
If you have a new, severe, or rapidly worsening symptom, seek appropriate medical attention rather than relying on this self-care tool.
After Lyme treatment, persistent symptoms deserve attention rather than assumptions. Your current symptoms, daily limitations, treatment history, medications, and other health conditions all matter.
Current guidance recommends ongoing assessment of people with persistent symptoms and consideration of alternative explanations, treatment effects, complications, or other conditions.
This is not a diagnostic tool. Answer four quick questions about how persistent symptoms are affecting your day.
Which symptoms affect you most?
Choose all that apply.
How much do your symptoms interfere with your normal day?
Which area is currently hardest?
How predictable are your symptoms?
Fatigue is one of the symptoms reported by people with persistent symptoms after Lyme disease. Managing fatigue is not about simply pushing harder. It is about understanding how your activities affect your day.
NICE rehabilitation guidance recommends assessing how fatigue affects daily life and using individualized fatigue-management approaches that may include energy-conservation strategies and appropriate physical activity.
This layer does not prescribe activity targets or rigid increases. It helps you notice how activity affects your own day.
Tell us how much energy you have and what matters today. You will get a simple order for your day, with recovery built in.
Current energy
1 is very low and 10 is very high.
Today’s workload
Important commitments
Choose everything that matters today.
Available recovery time
Sleep disturbance can accompany persistent symptoms following Lyme disease. Sleep problems should be addressed as their own health issue rather than treated as something you simply have to tolerate.
NICE specifically recommends attention to sleep disturbance in people with ongoing symptoms after Lyme treatment. HAS also recommends management of sleep problems using usual appropriate approaches.
Tell us when you wake, how long you want to sleep, and what gets in the way. We will build an evening timeline.
Wake time and typical bedtime
Target sleep duration
How often do symptoms disturb your sleep?
What is the main problem?
Pain and other persistent physical symptoms can affect movement, sleep, mood, and daily function. They deserve direct attention.
The 2025 HAS PTLDS guidance identifies pain management as a priority, including approaches with and without medication where appropriate.
Rate what you notice. You will see which symptom is taking the most from your day, what to track, and when to bring it to your healthcare provider.
Which symptoms are you noticing?
Choose all that apply. A rating box appears for each one.
Intensity
Frequency
How much does it interfere with daily life?
Intensity
Frequency
How much does it interfere with daily life?
Intensity
Frequency
How much does it interfere with daily life?
Intensity
Frequency
How much does it interfere with daily life?
Intensity
Frequency
How much does it interfere with daily life?
Intensity
Frequency
How much does it interfere with daily life?
Intensity
Frequency
How much does it interfere with daily life?
Intensity
Frequency
How much does it interfere with daily life?
Physical rehabilitation and appropriately adapted activity are important parts of care for people with persistent symptoms after Lyme disease.
The 2025 HAS guidance identifies physical rehabilitation and adapted physical activity as important parts of PTLDS care, with precautions for possible post-exertional malaise.
A 2026 preliminary online yoga study found that a small PTLDS group completing a 12 week program showed improvements in pain, physical function, and some cognitive measures. This is promising, but it is preliminary and not definitive evidence.
Answer six questions and get a gentle plan for today that is adapted to how you feel.
Current energy
Current activity
Current balance
Does activity sometimes cause delayed worsening?
For example, feeling worse the next day after doing more than usual.
Available time
Goal
Difficulty thinking, concentrating, or remembering can occur among people reporting persistent symptoms after Lyme disease.
Cognitive symptoms are recognized in current CDC and Lyme guidance, but there is not strong evidence that a particular supplement, detox, or self-care routine treats PTLDS related cognitive symptoms.
Therefore this layer focuses on practical functional strategies.
This is a planning tool, not a cognitive test. It helps you shape the day around the focus you have.
How clear do you feel today?
What requires the most concentration?
Choose everything that applies.
How long can you comfortably focus?
Persistent symptoms can affect mood, relationships, confidence, and quality of life. Needing psychological support does not mean your physical symptoms are imaginary.
The 2025 HAS PTLDS guidance recommends psychological support for patients with PTLDS, while current Lyme guidance recognizes the importance of assessing depression and anxiety among ongoing symptoms.
Rate five statements from 1 to 5. This is a simple self check, not a screening or diagnostic instrument.
Good nutrition, hydration, and a careful review of medications and supplements are part of responsible self-care. But there is currently no high-quality evidence establishing a specific diet or supplement regimen as a treatment for persistent symptoms after Lyme disease.
This layer is general health advice. It is not presented as a treatment for Lyme disease or for persistent symptoms after it.
Five quick questions about meals, water, and supplements. This never suggests doses and does not recommend products.
How consistent are your meals?
How often do you drink water throughout the day?
How many supplements do you currently take?
Do you regularly review labels for duplicate ingredients?
You can skip this one if you take no supplements.
Do you know why you are taking each supplement?
You can skip this one if you take no supplements.
Persistent symptoms can affect work, family responsibilities, social life, exercise, and everyday independence. Good self-care is not only about symptoms. It is also about function.
NICE recommends support around ongoing symptoms and, where relevant, communication with employers, schools, and others about a gradual return to activities.
Choose what matters and how much you can handle. You will get a simple weekly map with recovery built in.
What is most important this week?
Choose everything that matters.
How much energy do you realistically have?
How many major activities can you comfortably handle?
What activity matters most to your quality of life?
Persistent symptoms can fluctuate. A simple record can help you recognize trends and communicate more clearly with the people involved in your care.
CDC recommends working with a healthcare provider to identify the symptoms having the greatest impact on daily life, while NICE recommends regular clinical review and reassessment.
Track eight areas on five check in days. Your entries stay in this browser on this device.
Rate each area from 0 to 10 using the labels under each slider. For every area except Pain, a higher score is better. For Pain, a higher score is worse. Save Day 1 today, then return on Day 7, 14, 21, and 30.
Set your Day 1 baseline
You do not need to change everything at once. Start with the areas that affect you most, build habits you can actually maintain, and track what changes over time.
And when you want to learn more about persistent symptoms after Lyme disease or ask questions about Dr. McKinney’s approach, you have two places to go deeper.
Learn more about persistent symptoms after Lyme disease and Dr. McKinney’s approach.
Watch the Chronic Lyme WebinarBring your questions to Dr. McKinney’s weekly group Q&A and learn alongside others.
Join the Weekly Q&A