Pace Setter : October 2025

Interview with Bill Hoffman: Running Through Lyme Disease

1. Starting Out
 Q: Can you take us back to when you first noticed something was off with your training and recovery? What were the red flags?
 A: Looking back, maybe my DNF at Manitou’s Revenge was related, but at the time it didn’t seem that way. After that, training actually went well. Two weeks later I had a great weekend in the Adirondacks. Then, on Monday, July 7, I woke up to very low HRV. The next day I had a workout—3x1 mile repeats. The intervals went okay, but the rest of the run was a real struggle. Wednesday I cut short a 12-mile run because I was moving so slowly and ran out of time before work. That evening, at the run club, I could barely hang on at an easy pace. By Friday, I was struggling to run a 5K at 13-minute pace. That’s when I knew something was really wrong. Since I was leaving for Japan in a week, I went to urgent care and asked for a Lyme test. Less than 24 hours later, it came back positive.

2. Tech as a Clue
 Q: You mentioned that your HRV dropped and your resting heart rate went up before you even felt fully sick. How important were those metrics in tipping you off that this wasn’t just normal fatigue?
 A: It was a big part of the picture. I’ve seen HRV dips before, but never paired with such a big drop in performance. My resting heart rate was also up about 8 beats per minute. That combination told me something was off. Plus, I’d pulled a tick off on Father’s Day weekend that didn’t come out clean, so Lyme was already in the back of my mind.

Q: For athletes who might not be as dialed into their wearables, how would you explain the value of paying attention to these trends?
 A: I’d say: don’t let them run your life, but don’t ignore them either. HRV and resting HR go up and down naturally with training stress, travel, or work. But when they don’t bounce back—or they line up with unexplained fatigue—that’s worth paying attention to. Last year when I had COVID, my watch flagged “poor sleep” even though I felt fine. I went for a mountain run in Aspen, hit 10K feet, and suddenly felt awful. Turns out it was COVID. Sometimes the numbers know something before you do.

3. Getting a Diagnosis
 Q: Once you suspected something more serious, how did you go about getting checked out?
 A: I called my doctor, but they couldn’t see me for a few days. Since I was traveling soon, I went to urgent care. It meant a four-hour wait, but they drew blood and sent it off.

Q: Lyme disease can be tricky to diagnose. What was your experience navigating the medical system and finally getting an answer?
 A: In my case, I was lucky—it was caught early and the quick test came back positive. I can see how, if you weren’t a runner or tuned in to your body, you might let it drag on a lot longer. Other than being suddenly unable to run my normal paces, I didn’t feel that bad.

4. Treatment & Recovery
 Q: What was it like starting antibiotics? How quickly did you feel a change?
 A: Honestly, the first 24 hours on antibiotics were the worst. I was completely wiped out. I later learned that’s normal—when the bacteria die off, they release toxins and your body reacts. My running stayed sluggish for about three weeks while I was on the meds.

Q: Many runners are used to “pushing through” fatigue—what helped you decide to pull back and respect the recovery process?
 A: With Lyme, I didn’t have much of a choice. My body just wouldn’t go faster—it was like having a built-in governor. I kept moving, but it was slow. At the same time, I had a family trip to Japan planned, including a marathon up and down Mt. Fuji with my oldest son. Lyme or not, I wasn’t missing that. It was an incredible experience, even though I had to take it easy.

5. Racing Through Lyme
 Q: You had a big summer goal race on the calendar. How did Lyme affect your build-up, and what was your mindset going into race day?
 A: My training was basically derailed. By the time Twisted Branch 100K came around, I was just starting to feel like I could run again.

Q: You ultimately had to stop during the race. Can you walk us through what that was like and how you made that decision?
 A: The race actually went better than I expected, just slower. I felt pretty good for the first 40 miles, and my son joined me as a pacer. But I made a mistake—I thought my wife couldn’t crew at the next aid station, so I didn’t have a headlamp. I overheated, sat down at an aid station, and that was pretty much it. I lost the will to keep going, and I figured I’d be pulled at the next checkpoint anyway.

6. Looking Back
 Q: Do you think catching it early made a big difference in how you’re doing now?
 A: I think so. I’m still not 100%, and sometimes it’s hard to tell if I’m dealing with lingering Lyme or just the fitness I lost during those three or four weeks. But I know it would have been worse if I’d ignored it longer.

Q: If you hadn’t been tracking HRV and resting HR, how long do you think it would have taken to realize something was wrong?
 A: A lot longer. The numbers confirmed what my body was telling me: something wasn’t right.

7. Lessons Learned & Moving Forward
 Q: What are the biggest lessons you’ll carry forward from this experience as both an athlete and a person?
 A: I should’ve gone for testing sooner—probably on Monday, not Friday. If you feel something’s off, don’t wait. Bigger picture, I’ve been reminded to enjoy the good days. Running can be taken away quickly, and it’s important to appreciate it while you have it.

Q: How do you see this shaping your training and race plans going into the fall and beyond?
 A: Right now, it’s one day at a time. I feel maybe 80% back. I probably won’t do any big fall races, but I’m aiming for the St. Croix Scenic 50K in January.

8. Advice to Others
 Q: What advice would you give other athletes—especially trail and ultrarunners who spend so much time outdoors—about staying aware of ticks, Lyme disease, and the importance of listening to your body?
 A: Pay attention. If you’re feeling off for no good reason, get checked out. Don’t ignore it. At the same time, don’t let the fear of ticks keep you from the trails. Just be aware, check yourself after runs, and listen to your body.