“…Paparone 15 described a case in which Lyme disease was superimposed on primary hypothyroidism and made the diagnosis of Borrelia infection challenging due to similar manifestations in both diseases. Dhliwayo et al 16 reported a case of a 22-year old woman with Lyme disease whose thyroid function tests were consistent with transient thyrotoxicosis and decreased radioiodine uptake in the thyroid.…”