Lyme is referred to as the great imitator which is similar to Syphilis and Celiacs disease. It can mimic many different diseases and each patient has different symptoms. It neutralizes the immune system enough so that opportunistic virus's like the Epstein Barr Virus (EBV) or any other virus living in a person will reactivate itself and start infecting the person again. Although Lyme may be the primary cause of why a person is sick, patients may not have any Lyme symptoms present and the only symptoms that the patient may have are the symptoms from another disease that has free reign throughout the body with no competition from the immune system. Some Lyme patients for the first year only have flu like symptoms that do not go away, others have severe memory problems where they do not remember where they live, even if they are standing in front of their house, while others have very painful and debilitating symptoms from the start.
Seek a Lyme Literate Medical Doctor for a diagnosis
Although many doctors are told that they can diagnose and rule out Lyme in their diagnosis of patients, the only person with adequate knowledge to declare a person is not infected with Lyme disease is a Lyme expert called a Lyme Literate Medical Doctor (LLMD) due to how complex this disease is. Anyone that suspects they have Lyme disease should seek out a LLMD by contacting their states Lyme disease support group, or by contacting the International Lyme and Associated Diseases Society (ILADS). Because many doctors who do not know anything about Lyme disease decide they can diagnose Lyme patients while following the IDSA guidelines without truly understanding the controversy, many Lyme patients are misdiagnosed as having Fibromyalgia, Chronic Fatigue Syndrome (CFS), Arthritis (rheumatoid, reactive, infectious, juvenile, or osteoarthritis), Autoimmune conditions such as Lupus and Multiple Sclerosis (MS), Guillian-Barré syndrome (GBS), Lou Gehrig's disease, Ménière’s syndrome, Early Alzheimer's, Parkinson's disease, or psychiatric disorders like bipolar or depression. If a Lyme patient is misdiagnosed as having an autoimmune disease and receives steroids which shuts down the immune system, the Lyme patient will have extreme difficulties in becoming healthy again which will require over a year of treatment under the guidance of a Lyme Literate Medical doctor.
The immune system does not treat Borrelia the same way as it does with other infections such as the Epstein Barr Virus (EBV) where 90% of our population will always test positive for EBV antibodies. The antibodies that the immune system creates to combat Lyme stop being produced after a certain period of time. This is why Lyme patients can have a positive test one year, and a negative the next, but even if a test goes from positive to negative, it does not mean the infection is over because Borrelia can change their protein coatings to ones that the Lyme tests do not test for. The early Lyme tests tested for 5 different antibodies based on the most common outer surface protein (Osp) coating Borrelia uses in humans. Since it is a chameleon and its assumed that Borrelia can change its Osp coating to 1,000 coats, the tests will always have false negatives, meaning the person has Lyme disease, but because the spirochete used a coat that the test does not look for, the Lyme patient will go undiagnosed. Since the vaccine Lymerex in 2000 used Borrelias 2 most common protein coatings they use in humans, the IDSA thought fit to remove looking for these proteins in the tests which means standard Lyme tests will only look for 3 antibodies out of the 1,000. LLMD's will use Igenex tests that will look for the 5 most common antibodies found in Lyme patients which is more accurate, but still only at best 65% accurate in confirming a person has Lyme disease.
Common areas for symptoms of Lyme disease
There are four common areas that Lyme disease causes symptoms; skin, joints, heart, and the central nervous system (CNS), although Lyme patients can have symptoms in all places of the body. CNS symptoms are the most severe and it only takes Borrelia 12 hours after infection to reach the CNS in rats, but in humans, Borrelia may take up to 7 days to reach the human CNS. 
Lyme disease checklist
Dr. Burrascano, a leading expert in Lyme disease made a checklist to determine what are the chances a patient has Lyme disease which can be found on the website here: http://www.lymedisease.org/resources/handouts1.html If a patient is checking many of these symptoms listed, consider seeking a Lyme Literate Medical Doctor for an examination of your symptoms.
Most defining symptom is the Bull's Eye Rash: 25% of Lyme patients get this rash
Other defining Symptoms of Lyme disease
Acrodermatitis chronica atrophicans (inflammation of fatty tissues under the skin.)
Continual low-grade fever
flu like symptoms that do not go away
High fever, chills, or sweating (indicates co-infection)
Mild to moderate muscle and joint pain
Severe unremitting headache (indicates co-infections)
Bell's Palsy (partial facial paralysis)
Brain fog, difficult to think
Disorientation, getting lost or going to wrong places
Mood swings, irritability, depression
Fatigue, tiredness, poor stamina
Pressure of the eyes
Stiffness in joints or back
Twitching of face or other muscles
neck creaks, cracks, stiffness, pain
Tingling, numbness, burning or stabbing sensation, shooting pains
Chest pain, heart palpitations
Shortness of breath, cough
Buzzing or ringing in ears, sound sensitivity
Motion sickness, vertigo, poor balance
Sudden hearing loss
Weight gain or loss
Swollen glands (possible co-infection)
Irritable bladder or bladder dysfunction
Upset Stomach and/or abdominal pain
Since ticks, insects and other arachnids contain many different diseases, Lyme disease patients are often infected with multiple different infections at the same time called co-infections. If co-infections are not treated as well as their Borrelia infection, the Lyme patient will never get better. Co-infection tests are also inaccurate. Many tests fail to test for all of the different strains in the United States of these diseases which makes diagnosing co-infections a clinical diagnosis. A good mixture of co-infections plus Borrelia can be deadly for Lyme patients. It is vital that patients are evaluated by a LLMD because due to globalization, European and Asian strands of Borrelia are becoming more frequent in the United States, as well as their co-infections like pneumonia chlamydia which the vast majority of doctors in the United States will not know how to diagnose. Some of the common co-infections that we know of so far include: 
Tularemia (can be deadly)
Colorado Tick Fever
Tick Relapsing Fever
Powassan Viral Encephalitis
Rockey Mountain Spotted Fever
All the co-infections cause the same symptoms of Borrelia which includes headaches. Each parasite generally has different areas that they inflict pain during headaches. Babesia causes headaches at the top of the head, Bartonella at the front of the head, and Borrelia at the back of the neck. Ehrlichia causes severe headaches. Lyme patients should make a daily journal. A list of all their symptoms, and a number 1 through 10 depending on the pain of the day. Each co-infection has a life cycle where they take time to reproduce and symptoms ease up. For example, Babesia has a shorter life cycle which is between two to three weeks where as Borrelia has a longer life cycle between three to four weeks. Before a patients LLMD visit, it is advisable to write out all of the symptoms the patient is experiencing. Also, write a number from 1 to 10 (10 meaning the most painful days you have) for every day indicating how you were feeling that day. If numbers shoot down to 4 or 5 every 2 weeks we can assume the patient has Babesia, and this could be great information that your LLMD could use to help better find co-infections. Other good ways to determine which co-infections patients are infected with are to look at their defining symptoms since each co-infection also has a defining, more painful symptom. 
Ehrlichia: If patient complains that their worst symptom is profound fatigue, severe muscle pain with high liver enzymes, low white blood cell counts and fevers, they may have Ehrlichia.
Bartonella: If patients complain of their defining symptoms including ice picklike headaches, photophobia, anxiety, bi-polar symptoms, reflex sympathetic dystrophy, cardiac or gut problems, plantar fascial pain. Other key points include extreme anxiety and neuropathic symptoms like burning pain, heavy night sweats, weight loss, increased neurological symptoms out of proportion to Borrelia. Might include foot pain, and/or enlarged lymph nodes, more than what Borrelia causes.
Mycoplasma: Defining symptom is persistent arthritis, rheumatoid arthritis.
Babesia: Defining symptom is night sweats, flushing, severe pressure-like headaches, violent nightmares, vivid dreams, significant shortness of breath, frequent sighing/ dry coughing in the absence of cardiac issues. Neck pain, fatigue, and night sweats.
For a more complete list of the symptoms of co-infections, visit http://www.lyme-symptoms.com/LymeCoinfectionChart.html
Waiting for your LLMD appointment
If you are waiting for your LLMD appointment and your appointment is scheduled far away in the future due to how over-scheduled LLMD's are and have tested positive for Lyme, but cannot recieve antibiotics due to the controversy, a person can try improving their immune system by taking antibiotic-like herbs on a safe Lyme protocol such as Stephen Buhners  which can be bought at green dragan botanicals. Stephen Buhner also has herb advice for co-infections on his website. The Byron Write formulas are also good for strengthening the immune system which can be bought on their website , but patients would need to research a bit on which formula to take.
 Buhner, p41
 Strasheim, Connie. Insights into Lyme Disease Treatment. Biomed Publishing Group, 2009