Lyme disease is one of the most common vector-borne infections in the United States, and its clinical presentation can be complex, variable, and—in some cases—persistent well beyond initial treatment. At The Longevity Center FL, Dr. Benjamin Kosubevsky offers a comprehensive, functionally informed evaluation for patients in West Palm Beach and across South Florida who are dealing with suspected or confirmed tick-borne illness, including those experiencing symptoms that have persisted after standard antibiotic therapy.
The term Lyme literate refers to a clinical approach that recognizes the complexity of tick-borne illness—acknowledging that standard screening may not capture every case, that co-infections are common, and that persistent symptoms after treatment represent a real and clinically significant phenomenon. A landmark prospective study from the Johns Hopkins Lyme Disease Research Center found that approximately 14% of patients with early-diagnosed, promptly-treated Lyme disease went on to develop functionally impairing persistent symptoms (Aucott et al., International Journal of Infectious Diseases, 2022).
The evaluation described on this page is a physician-guided clinical assessment. It is intended to provide a comprehensive review of factors that may be contributing to persistent symptoms in patients with suspected or confirmed tick-borne illness. It is not intended to independently diagnose, treat, cure, or prevent any specific disease. Lyme disease and post-treatment Lyme disease remain active areas of medical research, and clinical understanding continues to evolve. Some laboratory tests referenced may be laboratory-developed tests (LDTs) not cleared or approved by the U.S. Food and Drug Administration. This evaluation is not a substitute for care by your primary care physician or infectious disease specialist.
Lyme disease, caused by the bacterium Borrelia burgdorferi and transmitted through the bite of infected black-legged ticks, can affect multiple organ systems including the musculoskeletal, neurological, cardiovascular, and immune systems (Steere et al., Nature Reviews Disease Primers, 2016). While most patients respond well to timely antibiotic therapy, a meaningful subset continue to experience symptoms—including severe fatigue, musculoskeletal pain, cognitive difficulty, and sleep disruption—that persist for months or longer after completing treatment.
This clinical picture, now commonly referred to as Post-Treatment Lyme Disease (PTLD), has been documented in multiple peer-reviewed studies. Research has shown that these symptoms are not only subjectively reported but are associated with measurable impacts on quality of life and daily functioning (Aucott et al., Quality of Life Research, 2013). The mechanisms underlying PTLD remain an area of active investigation, with hypotheses including persistent immune activation, residual inflammatory processes, and post-infectious autoimmune phenomena (Marques, Infectious Disease Clinics of North America, 2008).
Dr. Kosubevsky’s Lyme literate functional medicine evaluation goes beyond a single antibody test. It is designed to assess the broader clinical context in which tick-borne illness—or its aftermath—may be operating. This multi-dimensional approach considers:
Standard two-tier Lyme testing (ELISA followed by Western blot) has well-documented limitations in sensitivity, particularly in early or late-stage presentations (Wormser et al., Clinical Infectious Diseases, 2006). Where clinically indicated, our practitioners may recommend expanded serological and immunological testing, as well as evaluation for common co-infections such as Babesia, Bartonella, Ehrlichia, and Anaplasma species—organisms that are frequently transmitted alongside Borrelia and may complicate the clinical picture.
Persistent symptoms following tick-borne illness may involve ongoing immune activation or dysregulated inflammatory processes. Where appropriate, the evaluation may include inflammatory cytokines, immune cell markers, and autoimmune screening to assess whether the immune system’s response to infection has resolved or remains active.
Patients with persistent symptoms often have overlapping environmental exposures—heavy metals, mold, or other toxicants—that may compound immune burden. When clinical history suggests environmental co-factors, Dr. Kosubevsky may incorporate environmental exposure assessment into the evaluation, drawing on the specialty testing capabilities available at The Longevity Center FL.
Tick-borne illness and its treatment can affect hormonal balance, nutrient status, and metabolic function. Fatigue, cognitive difficulty, and mood disruption—hallmarks of PTLD—may also have hormonal or nutritional contributors. Where indicated, the evaluation may include thyroid, adrenal, sex hormone, and micronutrient panels to identify modifiable factors that may be compounding the symptom picture.
Emerging research suggests that tick-borne infections may affect gut health and nervous system function. When gastrointestinal symptoms, autonomic dysfunction, or neurological concerns are present, Dr. Kosubevsky may evaluate these systems as part of the broader clinical assessment.
For individuals who were diagnosed and treated for Lyme disease but continue to experience fatigue, pain, cognitive difficulty, or other symptoms months after completing antibiotic therapy.
For those with symptom patterns consistent with tick-borne illness—multi-system involvement, migratory pain, cyclical symptoms—who have not received a definitive diagnosis through standard testing.
For individuals who have been evaluated elsewhere but feel their concerns have not been adequately addressed, and who want a comprehensive, integrative review of their case.
For those experiencing overlapping symptoms across neurological, musculoskeletal, immune, and gastrointestinal systems that may suggest an infectious or post-infectious process.
Dr. Benjamin Kosubevsky combines conventional medical training with advanced experience in integrative, regenerative, and osteopathic medicine. For patients with complex tick-borne illness concerns, Dr. Kosubevsky provides:
Tick-borne illness is not always straightforward, and persistent symptoms deserve a thorough, multi-dimensional evaluation. The Longevity Center FL provides a structured clinical framework for patients in West Palm Beach and South Florida who need a deeper look at what may be driving their ongoing health concerns.
Schedule your consultation to discuss whether this evaluation is appropriate for your situation.
The information on this page is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment. This evaluation is a clinically informed wellness assessment and is not intended to diagnose, treat, cure, or prevent any disease. Lyme disease and Post-Treatment Lyme Disease remain active areas of medical research; clinical understanding of these conditions continues to evolve, and there is ongoing professional debate regarding diagnostic criteria, nomenclature, and management approaches. Some laboratory tests discussed on this page may be laboratory-developed tests (LDTs) that have not been cleared or approved by the U.S. Food and Drug Administration. This service is not a substitute for evaluation and care by your primary care physician or infectious disease specialist. Always consult a qualified healthcare professional regarding any medical condition, symptom, medication, or treatment decision. Peer-reviewed research cited on this page reflects population-level or cohort-level findings and does not predict individual outcomes.
1. Steere AC, Strle F, Wormser GP, et al. Lyme borreliosis. Nature Reviews Disease Primers. 2016;2:16090.
2. Aucott JN, Yang T, Yoon I, Powell D, Geller SA, Rebman AW. Risk of post-treatment Lyme disease in patients with ideally-treated early Lyme disease: A prospective cohort study. International Journal of Infectious Diseases. 2022;116:230-237.
3. Aucott JN, Rebman AW, Crowder LA, Kortte KB. Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here? Quality of Life Research. 2013;22(1):75-84.
4. Marques A. Chronic Lyme disease: a review. Infectious Disease Clinics of North America. 2008;22(2):341-360.
5. Wormser GP, Dattwyler RJ, Shapiro ED, et al. The Clinical Assessment, Treatment, and Prevention of Lyme Disease: Clinical Practice Guidelines by the Infectious Diseases Society of America. Clinical Infectious Diseases. 2006;43(9):1089-1134.
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