Hi, I've been experiencing symptoms that might be lyme and I'm trying to figure out the next steps for a proper diagnosis of whatever I have. I'm a 24 year old male and my first symptoms started this May. My current symptoms are - widespread joint, finger and back pain, nodules/bumps (on wrist, shoulder, rib and lower back), muscle twitching, ringing ears, sore throat, small isolated darkish red spots, chest and rib pain, weakness in legs, eye discomfort, burping/hiccups, enlarged nasal blood vessels, tingling in arms and legs in certain positions, very slight purple rash on chest. Other quite infrequent symptoms are bloated stomach, stabbing in stomach, pain when urinating. Symptoms I've had that have more or less resolved - fatigue, dizziness/brain-fog, vertigo/motion sickness, headaches, difficulty to concentrate and forgetfulness, pain and pressure in the eyes, weight loss, heat waves and tingling on top of the head a few times. Onset - 15th May wrists and forearm muscles started to hurt after PC use, I also had tightness and tingling in my arms. I stopped using PC and it was getting better. Around 6th of June I had a very bad sore throat and in a day or two my wrists got worse. The pain was different now too, it was pretty much just joints. Also my hands were a bit puffy with a warm/burning sensation. I had a very slight fever in the next 4-5 days. I felt very tired and sick like I had caught flu. During then the first nodule/bump appeared on my wrist. They are somewhat firm and painless. After a few days my elbows started to hurt a little bit. Around 18th of June, my knees and shoulders started to hurt. In a few days SI joints and lower back followed. The pain was highly migratory - each day a different joint would hurt. The fatigue was still there and I experienced dizziness or weird brain fog that's hard to describe. Around 22nd June chest pain and tightness started. Around 27th June very minor muscle twitching started. It got worse in the next few weeks, but has stabilized and gotten slightly better since then. It Usually happens before sleep or when relaxing and mostly affects my arms or legs, but I’ve had it in my fingers, on my back, chest and even upper neck near near ears, too. Around 20th July my ears started to ring and it's been getting more and more noticeable. The end of June and start of July was the worst since then my condition has stabilized and some symptoms even improved, especially during mid August and early September, but I've been feeling worse again in the last few days. The brain fog and fatigue seems to be coming back and my sore throat that never fully cleared has been noticeable again for the past week. I've had a lot of blood tests. The only abnormal ones were slightly low D-vitamin (22 vs 30+), slightly high total bilirubin and albumin and double the normal conjugated bilirubin (liver tests). D vitamin supplements (2k IU per day) seemed to help with fatigue and brain fog. I was feeling the best when I was in California for two weeks at the end of August and have run out of the supplements for a week now. I saw a rheumatologist and a neurologist last week. The neurologist thinks my symptoms are post viral and decided to have and mri of brain and egm for muscles just in case. The rheumatologist thinks it's Ankylosing Spondylitis (my back pain is the worst of all symptoms, but I'm not sure how does AS explains my other symptoms) and I'll have an mri of my lower back/SI joints and right wrist. He also ordered a lot of blood tests (I don't know which ones yet), since I had done only a few of them in UK. Regarding lyme - I don't recall a recent tick byte or a bullseye rash. I don't have facial paralysis and my neck only gets stiff after using a laptop or reading in bed. At the same time I've been bitten a few times in the past and definitely was exposed to ticks this spring and summer. I'm originally from Latvia where ticks are quite common and moved to London only at the end of July. Last time I was bitten was 2 years ago and I actually felt a little bit sick for a few days, but had no rash or other symptoms afterwards. I had an Elisa test in Latvia on 3rd of July, which came back negative with IgM 6.2, borderline is 18-22, 22+ is positive IgG < 5.0, borderline is 10-15, 15+ is positive So while it was negative I've recently realized that I might have been tested too soon if I've been bitten recently, since I had some IgM and no IgG. Moreover, I was on amoxicillin for a week one week for my sore throat before the test which might affect the results. Thus I'm thinking of repeating it just in case, but after reading around I'm a bit unsure of its usefulness. I would appreciate some answers or pointers (research papers would be great) to questions I have: Does it look like I have lyme? Who with lyme has had similar or different symptoms? What were your test scores? Could you recommend a doctor experienced with lyme in UK? The only one I can find is Dr Matthew Dryden in Winchester travel clinic. Can someone share their experience with him? What's the sensitivity of Elisa and Western Blot? Some say it's 100 % after a few months while according to others it's around 50%. How does antibiotics affect the results, apparently they can prevent production of antibodies, but at the same time some people recommend to have a trial of antibiotics before the test to bring it out. So I'm confused about the contrary opinions. What are some good research papers on this topic? What are the effects and risks for taking NSAIDs and/or DMARDs (methotrexate, anti TNF) if I actually have lyme instead of AS? How do they affect Lyme blood tests? I'll definitely avoid steroids. What are the effects and risks of taking antibiotics for Lyme if I actually have AS or maybe something else? Would a trial of antibiotics help diagnosis? Are there other infections (viruses, bacteria) that would be worthwhile to look into other than lyme and its co-infections? How is lyme different in Europe and is the diagnosis here more reliable? Impact of vitamin D on Lyme? Would my brain or back mri be helpful for supporting/opposing lyme diagnosis? Anything else I should think or read about? I realize these are a lot of tough questions and I'll of course need to decide for myself, but even a few pointers for some of these would very helpful for me try to understand this mess. Also feel free to ask more about my symptoms, I tried to keep it short, rather unsuccessfully, I must say .