The classic Lyme Disease symptoms of fatigue, arthritis, bulls-eye rash, and flu-like indicators are the most common complaints of those who suffer from the illness, and they’re pretty much common knowledge even among those who don’t.

Lady looking at thermometer for Lyme disease symptoms

Lyme disease symptoms can include headache and fever

What many people don’t realize is that most of these symptoms are characteristic of particular stages of Lyme Disease. While Lyme can present a mélange of painful symptoms that mimic other ailments, with the exception of fatigue (which gets progressively worse with each stage) they usually occur in a certain sequence.

So let’s take a look at typical symptoms for each of the primary stages of LD.

Stage 1: Early Localized Infection, 1-4 weeks

The first stage of Lyme Disease often includes the appearance of the famous bull’s-eye rash, or erythema migran (EM), at the site of the initial tick bite. This is a (usually) circular red rash with a central clearing, hence the name. It fails to occur about 40% of the time, and is easily mistaken for bruising in dark-skinned individuals.

Other standard Stage 1 Lyme Disease symptoms include a generalized lack of energy, stiff neck, joint pain, muscle ache, headache, fever and chills, and sometimes, swollen lymph nodes. It’s easy to see why, at this point, doctors require either an EM rash or positive ELISA/Western Blot tests for a Lyme diagnosis.

Assuming a doctor is willing to treat with oral antibiotics during this stage, and often for longer than traditionally accepted, you can eradicate the infection fairly easily. However, re-infection is always a possibility if you’re not careful, and relapses are common.

Stage 2: Early Disseminated Infection, 1-4 months

If Lyme Disease isn’t caught and aggressively treated with antibiotics within the first four weeks of infection (and it usually isn’t), then the disease will spread through the entire body, causing widespread systemic effects that can linger for years.

The lack of energy noted in Stage 1 deepens into true tiredness, and other notable symptoms appear, affecting the skin, joints, heart, and nervous system. Other rashes, not always recognizable as EM, may appear elsewhere on the body. The joint and muscle pain becomes acute and may migrate.

Weakness and numbness may also occur in some parts of the body, as can facial paralysis (Bell’s Palsy). Other neurological symptoms can include memory loss, trouble sleeping, severe headaches, fainting, and an inability to concentrate.

Conjunctivitis (pink-eye), eye damage, and heart problems may also emerge as Lyme Disease continues to spread.

Stage 3: Late Disseminated Infection (Chronic Lyme)

While the idea remains controversial, it’s possible that an out-of-control immune response may cause some or all of the symptoms of Late Disseminated Lyme Disease. This does not mean, however, that this isn’t a real illness, even if the Borrelia spirochetes are gone from the patient’s body (not a foregone conclusion).

Most or all of the Stage 2 symptoms persist in this stage, and others join them. The tiredness noted above may deepen to a severe, debilitating fatigue. Also common are sweating, persistent arthritic inflammation of the joints, numbness and tingling in the extremities or back, and more severe facial paralysis.

In addition, chronic Lyme patients may suffer heart disease and more advanced neurological changes, including change of mood and personality, loss of vision and hearing, meningitis (swelling of the brain and spinal cord) and encephalitis (inflammation of the brain).

Ultimately, the quality of life deteriorates, until it’s about the same as those dealing with congestive heart failure. These Lyme Disease symptoms may come and go, but by the time the patient reaches this Late Disseminated stage, it’s rare for them to disappear altogether under traditional treatment guidelines.