HEAD PAIN AND MIGRAINES EDUCATION
Head pressure, head pain, ice pick pain and migraines are some of the most common struggles with Lyme and co-infections. At my sickest, head pain was my very worst symptom, even worse than my seizures. There were days I couldn't see my children because of it, so I truly understand. What was behind it could change from day to day: one day it was POTS, the next a Babesia flare. This post explains why head pain and migraines can happen with Lyme and co-infections, what makes a migraine different, and what can set one off, so you can better understand what may be behind yours.
Short on time or energy? A quick-view graphic with the key points is at the bottom of this post.
HEAD PAIN / HEAD PRESSURE - POSSIBLE SOLUTIONS
MIGRAINES - POSSIBLE SOLUTIONS
WHAT ILADS AND ILADEF SAY
- ILADS lists headaches among the common symptoms of chronic Lyme, along with fatigue, trouble thinking and sleep problems (updated 2026).
- ILADS's guide for providers lists headache with the flu-like symptoms of early Lyme, and severe headaches with neck stiffness once Lyme has spread or reached the late stage. It also lists headaches with the co-infections Anaplasma and Babesia (updated 2026).
- ILADEF lists headache for many other tick-borne infections too, including Ehrlichia, Rocky Mountain spotted fever, tick-borne relapsing fever, Powassan virus and tularemia, and severe headaches for Anaplasma (2024).
- ILADEF notes that Lyme bacteria can get into the brain within the first 24 hours after a tick bite (2024).
- Dr. Cory Tichauer, a naturopathic doctor on the ILADS board, names stubborn headaches among the chronic illnesses that drew him to look for root causes, which he often found were infections (2024).
WHY HEAD PAIN HAPPENS
LYME
- Dr. Richard Horowitz includes headaches on his list of Lyme symptoms, along with a stiff neck and sensitivity to light and sound (2024).
- Bay Area Lyme Foundation lists headaches or a stiff neck in early Lyme, and severe headaches or migraines in late-stage Lyme (2025).
- Where it's felt: a Global Lyme Alliance writer describes her Lyme headaches as a throbbing pressure that took over her whole skull (2019).
- Dr. Joe Burrascano shares that untreated Lyme can bring headaches week after week, and that Lyme symptoms often come and go in about a four-week cycle (2025).
- A 2024 review from Mass General and Harvard notes that Lyme can involve almost any of the cranial nerves (nerves running from the brain to the head and face) and can cause several types of headache.
- Tulane research: in a 2022 lab study using monkey brain and nerve tissue, even dead pieces of Lyme bacteria set off strong inflammation, often more than live bacteria did, and also caused cell death. The researchers say leftover bacterial pieces may keep driving brain inflammation after treatment. This was lab research, not a study of headaches in people.
BABESIA
- Dr. Bill Rawls explains that when Babesia destroys red blood cells, it can lead to symptoms like anemia and headache (2025).
- A 2023 study of 163 adults hospitalized with Babesia found that more than half had at least one neurological symptom, and headache was the most common one.
- Where it's felt: ILADEF lists Babesia headaches as often at the top of the head (2024), while Dr. Marty Ross shares that they are often in the front of the head, so where it hurts can vary.
- The same Global Lyme Alliance writer felt her Babesia pain as a searing migraine on one side of her head, with nausea and light sensitivity, very different from her Lyme headaches (2019).
BARTONELLA
- Where it's felt: ILADEF lists Bartonella headaches as often in the front of the head (2024).
- Dr. Horowitz explains that Bartonella can cause headaches, fevers, chills, fatigue, nerve pain and trouble thinking, much like Lyme (2025).
- Dr. Rawls notes Bartonella can invade the cells lining small blood vessels, which can limit blood flow, and it can reach the nervous system (2025).
- In a 2025 NC State case study of a family with both Bartonella and Babesia, the father and oldest daughter had headaches along with fatigue, insomnia and other neurological symptoms, and the mother had ocular migraines.
- My favorite description of the different head sensations is from Dr. Wayne Anderson. I have both Bartonella and Babesia, so I know these feelings well:
"Bartonella can also cause headaches and ice pick-like pain. Both Babesia and Bartonella cause headaches, but Bartonella headaches are worse. A Babesia headache produces more weird sensations in the head and pressure in the head. People with active Babesia infections will say, 'I don't know if I'd really call what I have a headache. It's more like a pressure in the head.' Babesia can cause migraines as can Bartonella, but Babesia migraines are generally less severe. Bartonella prefers the occipital areas of the head; the back of the head and neck are generally painful." - Dr. Wayne Anderson
- So where Bartonella pain is felt can differ from person to person.
POTS AND DYSAUTONOMIA
- In a small 2023 study of 34 people with headaches, almost half had trouble standing up (orthostatic intolerance) and about a third had POTS.
- Dr. Tania Dempsey sees POTS symptoms in about half of her patients, some as young as 10 (2023).
HERXING AND AMMONIA
- Dr. Horowitz lists headaches among the Lyme symptoms that can get worse during a Herxheimer reaction (2024).
- A Global Lyme Alliance writer suggests noticing whether your headaches come during herxes, antibiotic pulses or at a certain point in your monthly cycle (2019).
- MedlinePlus lists headache among the signs of high ammonia (updated 2026).
- Dr. Susan Marra, a Lyme-literate naturopathic doctor, believes most patients whose Lyme and co-infections affect the brain and nerves have ammonia building up in the brain (2025). This is her view as a doctor and hasn't been studied yet.
MIGRAINES
WHAT A MIGRAINE IS
- A migraine is a type of headache that keeps coming back. The pain is moderate to severe, throbbing or pulsing, and often on one side of the head. Nausea and sensitivity to light and sound can come with it (MedlinePlus, updated 2025).
- Migraines can have four phases: early warning signs up to a day before, an aura, the headache, and a recovery phase afterward. Not every phase happens every time, and a migraine can even happen without a headache (MedlinePlus, updated 2025).
- A migraine can come with or without an aura, such as seeing flashing lights or zigzag lines, and an attack usually lasts 4 to 72 hours (MedlinePlus, 2025).
- Around 12% of people in the US have migraines, and women are three times as likely as men to have them (MedlinePlus, updated 2025).
LYME AND MIGRAINES
- A Global Lyme Alliance writer shares that her migraines turned out to be caused by Lyme, Ehrlichia and Babesia, and a scan later showed too little oxygen reaching the left side of her brain, which she ties to these infections. She explains that most Lyme patients name headache as a main symptom, that some have migraines so bad they end up in bed in a dark room with light sensitivity and nausea, and that Lyme bacteria can cross the blood-brain barrier and inflame the nervous system (2018).
MAST CELLS (MCAS), HISTAMINE AND MIGRAINE
- In a 2025 survey of 553 people with MCAS and 558 people without it, Dr. Leonard Weinstock, Dr. Lawrence Afrin, Dr. Tania Dempsey and colleagues found migraines or severe headaches in 70% of women with MCAS, compared with 27.9% of women without it. For men, it was 47.4% compared with 10.4%.
- Dr. Dempsey explains that mast cells release histamine when they react to things like viruses, bacteria, parasites, fungus, toxins and even stress, and histamine released in the brain can bring on a migraine (2017, updated 2023).
- Mast cells sit right next to pain nerves in the coverings of the brain. A 2023 review explains how they work with the trigeminal nerve and CGRP, a messenger thought to play a part in migraine.
- Weather changes (temperature, humidity and air pressure) can stir up mast cells and bring headaches, according to LymeDisease.org (2023).
POTS AND MIGRAINE
- Dr. Svetlana Blitshteyn, a neurologist, writes that migraine ranks among the most common conditions seen with POTS, hypermobility and MCAS, and those conditions are common in people with migraine, especially those who also have dizziness, trouble standing, joint pain or allergy symptoms (2023).
COMMON MIGRAINE TRIGGERS
- Dr. Dempsey names the best-studied triggers as stress, food, your surroundings (such as weather, allergy triggers, bright lights, strong smells and noise), hormones and infections. Knowing your own triggers matters, because some of them can be controlled (2017, updated 2023).
- She also explains that migraines are more likely as cortisol drops after a stressful time has passed, so the crash after the stress can be the real trigger.
- A 2026 review of patient reports found that 13.9% of people with migraine named chocolate as a trigger, 12.0% named caffeine and 8.0% named cheese. Results varied a lot from person to person, so the author says cutting these foods isn't right for everyone, and a headache diary can help you find your own triggers.
WHEN TO GET HELP RIGHT AWAY
Dr. Tania Dempsey lists these as reasons to go to the ER: a headache after a head injury, sudden vision changes, weakness or numbness in your arms or legs, a stiff neck with fever, or severe light sensitivity. Please also get medical care right away for a sudden, severe or new kind of headache.
RELATED POSTS
Brain and Neurological Effects
Internal Vibrations, Tremors, Brain Zaps, Electric Shock Sensations and Cranial Neuropathy
Neck Pain and Lyme
SOURCES
ILADS, Controversies and Challenges (updated 2026)
ILADS, Lyme Disease Basics for Providers (updated 2026)
ILADEF, Tick-Borne Diseases Other Than Lyme (2024)
ILADEF, Big Data Case (2024)
Dr. Cory Tichauer, ILADEF (2024)
Dr. Richard Horowitz, Medical Detective, LymeDisease.org (2024 and 2025)
Bay Area Lyme Foundation, Symptoms of Lyme Disease handout (2025)
Dr. Joe Burrascano, Bay Area Lyme Foundation interview (2025)
Lyme, cranial nerves and headache review (2024)
Tulane, Lyme bacteria pieces and brain tissue lab study (2022)
Dr. Bill Rawls, Herbs for Bartonella and Babesia, ILADEF (2025)
Babesia neurological symptoms study (2023)
Dr. Marty Ross, How to Diagnose Babesia in Chronic Lyme Disease (2023)
NC State, Bartonella and Babesia family case study (2025)
Dr. Wayne Anderson, New Paradigms in Lyme Disease Treatment excerpt, LymeDisease.org (no date shown, older source, still worth reading)
POTS and headache study (2023)
LymeDisease.org, Coping with POTS and Chronic Lyme (2023)
Global Lyme Alliance, Not All Headaches Are Alike (2019, older source, still worth reading)
MedlinePlus, Ammonia Levels (updated 2026)
Dr. Susan Marra, Ammonia Toxicity in the Brain of Tick-Borne Disease Patients (2025)
MedlinePlus, Migraine (updated 2025)
MedlinePlus, Migraine encyclopedia (2025)
Global Lyme Alliance, My #1 Headache Trigger? Lyme Disease (2018, older source, still worth reading)
Weinstock, Afrin, Dempsey and others, MCAS study (2025)
Dr. Tania Dempsey, Top Triggers for Migraines (2017, updated 2023)
Mast cells and migraine review (2023)
LymeDisease.org, Weather and mast cells (2023)
Dr. Svetlana Blitshteyn, migraine, POTS and MCAS review (2023)
Migraine food triggers review (2026)
Disclaimer: Rise Above Lyme makes no claims about any possible benefit of using any product mentioned within this site. Always consult with your doctor before adding anything. The information shared is based on personal experience, years of accumulated researched resources from Lyme Literate doctors and polls conducted within Lyme groups from actual patient experience using these solution ideas.
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