Different Healing Expectations for Later Stages
Dr. Kyle Warren
Meghan Feir Walker
“What stage of Lyme am I in?” This is a question I often get asked in our clinic, and being able to answer this is important for your health. Today we’re going to address how quickly Lyme enters a chronic state, the ins and outs of each stage, and how long the initial Lyme antibiotics are effective.
How do I know what stage of Lyme disease I have?
Before diving any deeper into the stages of Lyme disease, it’s important to understand the basics of Lyme first.
Lyme and co-infections are most commonly transmitted through deer ticks, but other ticks can also carry these bacteria and parasites. Research needs to be done on the possibility of other insects carrying Lyme and co-infections, but it’s likely that other insects do, too.
Lyme disease is caused by a bacteria called Borrelia. The most common species of Borrelia is Borrelia burgdorferi, but there are at least 18 other species of Lyme that should be tested.
For example, let’s say you have Borrelia mayonii. If you only test for Borrelia burgdorferi, Lyme won’t show up on the test and you’ll cross Lyme off the list of possibilities. All the while, you do have Lyme, you just didn’t have the most commonly tested species.
Although many doctors think Lyme species and co-infections are regional and that you can’t get certain types if you live in specific areas, this isn’t accurate. Whether ticks are hitching a redeye flight on the wings of birds or traveling by land safely burrowed in the fur of deer or other four-legged friends, ticks can be very well-traveled creatures.
If you are mysteriously sick, you should be tested for all species of Lyme and all species of co-infections.
Stage one: Early localized Lyme disease
First month: Early stage
One of my favorite summertime hobbies is mountain biking. Last summer, even though I was cruising through the woods, I found four ticks had landed on me. Ticks can fall and jump from trees, blades of grass, wherever, so whether you’re doing something active, camping, or gardening in your front lawn, ticks are, unfortunately, always a potential threat. This is why wearing an effective bug spray, wearing appropriate clothing, and checking yourself after being outside in the spring, summer, and fall is always recommended.
As soon as you get bitten by an infected tick, the first stage of Lyme begins in a matter of hours or days. Although you may not develop symptoms immediately, it’s crucial to get an accurate diagnosis as quickly as possible. This early or local stage of Lyme disease lasts for about a month. Symptoms typically develop within a couple of days to a week or two after the tick bite.
Stage one Lyme symptoms:
- EM rash
- Fever
- Chills
- Joint aches
- Swollen lymph nodes
- Headaches
For those lucky enough to develop a bullseye rash (called an erythema migrans rash), early diagnosis can be much easier and doctors will take you more seriously and will usually put you on antibiotics immediately. It’s the dead giveaway that you have just acquired a Lyme infection.
Unfortunately, many, if not most people don’t develop the classic bullseye rash, and getting a proper diagnosis is often much more difficult. You can get testing done, but it's hard to catch it. It takes your body three to seven days to make immunoglobulin M against Lyme, and it can take three to four weeks to make immunoglobulin G for Lyme. In this early phase, you might find IgMs, but you might just have to go based on symptoms and history of exposure to know your illness is coming from Lyme.
The nickname for Lyme is also the summer flu, so if you develop a rash, fever, chills, headaches, swollen lymph nodes, and/or muscle and joint aches, you may have just been infected with Lyme.
Thankfully, antibiotics are 80-90% effective in this first stage. If you start taking doxycycline within this first month, you will likely be able to defeat the infection before it progresses any further. Typically you can get better in 14-28 days.
Stage Two: Early disseminated Lyme disease
Months two to four: Early disseminated stage
Between 30 and 60 days after getting infected, the Lyme bacteria starts to transition into its second stage, aka early disseminated Lyme disease.
In a study at Tulane, researchers took mice, gave them Lyme disease, and waited 60 days to administer antibiotics. They found that by the time the mice had been infected for 60 days, the Lyme had become much more resistant.
Somewhere between 30 and 60 days, Lyme starts becoming much more resistant and enters into the disseminated stage of Lyme disease. After a few weeks to a couple of months after getting bitten, more symptoms can develop as the bacteria spreads throughout your body.
Stage two Lyme symptoms:
- Multiple EM rashes
- Neurological problems such as facial palsy, meningitis (severe headaches, neck stiffness), limb numbness/pain
- Joint swelling and pain
- Cardiovascular symptoms such as heart palpitations, dizziness, lightheadedness, Lyme carditis (irregular heartbeat)
You may develop additional rashes beyond the area where you were bitten or begin developing neurological problems. Lyme’s favorite tissues are found in the nerves and joints, so it’s common to experience joint swelling, joint aches, and pain throughout the body. It can also cause cardiovascular complications. If you start getting heart palpitations, dizziness, or lightheadedness, it has undoubtedly started affecting the cardiovascular system.
Those are some of the main areas Lyme likes to cause problems. This stage typically begins 30 days after getting infected and lasts 2-4 months. There is no consensus as to when this stage ends.
Once you're 60 days in, the initial two- to four-week course of doxycycline does not work nearly as well. You likely either need more antibiotics or we need to start doing a more holistic approach. If I catch you in stage two, I am hoping you can feel back to normal and heal in 3-6 months.
Stage Three: Late disseminated Lyme disease
By month four: Late disseminated stage (this stage can go on for years until treated)
If Lyme is left untreated, it can progress into late-stage or disseminated Lyme disease months to years after the initial infection begins. This stage can significantly impact your joints, nerves, and cognitive function.
At this point, Lyme bacteria has become a chronic problem and has entered its stationary form, protected by biofilms that are difficult to penetrate. This can lead to years or a lifetime of suffering, if not addressed properly.
Some people say it is no longer in its active form, but it’s still anything BUT inactive. It may be less active, but it is still causing ongoing, horrible symptoms and damage to your body.
Stage three Lyme symptoms:
- Chronic arthritis – severe joint pain and swelling (commonly in knees)
- Neuropathy – numbness, tingling, shooting pains in extremities
- Cognitive impairment – memory loss, difficulty concentrating, brain fog
Late-stage Lyme disease often causes persistent inflammation, joint pain, swelling, memory and other cognitive problems, nerve symptoms, and much more. Many of these symptoms can overlap with other chronic conditions, which is why it can take several doctors to figure out that the root cause of your problems is a chronic Lyme infection.
You may develop chronic arthritis and neuropathy. Because of this, you may get referred to a rheumatologist. Unfortunately, the rheumatologist will probably just be confused. Then you end up seeing a neurologist, and they’re confused. You try an infectious disease doctor, but they use an outdated test from 30 years ago that only checks for one species of Borrelia. You’re fatigued, feel cognitively impaired, have trouble sleeping, trouble finding words, and many other neurological symptoms, yet they don’t know what’s going on with you.
If you have any of these ongoing symptoms, especially if you've had a history of tick exposure or live in a tick-endemic area (anywhere there is deer), you must be tested for multiple species of Lyme and co-infections. Click here to learn more.
By the time Lyme has entered into this disseminated phase, a comprehensive approach must be taken.
You need special support for your immune system, to rebuild the broken parts of your body, and effective means to attack the Lyme and biofilms. Research shows that herbs and the natural route are the best, most effective way to help chronic Lyme.
Once a person is in stage three, about 90% of my patients take between 6-24 months to heal from chronic Lyme once it is this deep in your system. The longer you have had it and the more co-infections and other health complications you have along with it tend to make the process take longer. It may take longer once it enters this stage, but you can still heal and live a healthy life!
What is stage four of Lyme disease?
In the last few years, a new term for chronic Lyme was released by the CDC. Instead of chronic Lyme, they coined the term “post-treatment Lyme disease syndrome,” or PTLDS. I’m personally not a fan of the new name because it still leaves out a group of people who have chronic Lyme—those who have chronic Lyme but have never been treated for it. I also don’t like unnecessarily long acronyms, but c’est la vie.
The third and fourth stages of Lyme get blurred. While most people consider PTLDS/chronic Lyme as the third stage of Lyme and there is no official “stage four,” some people are now referring to post-treatment Lyme disease syndrome (PTLDS) as stage four. The argument is over whether more killing of the Lyme bacteria needs to be done, which we will delve into in future articles.
Regardless, by this point, you can expect to experience symptoms like chronic fatigue, chronic pain, and cognitive difficulties.
To learn more about when Lyme disease goes from an acute to a chronic infection, click here.
Can you fully recover from Lyme disease? Absolutely!
I am here to tell you that you can absolutely recover from Lyme disease!
My wife was sick for several years, but she was able to recover while on my then-experimental protocol. She's now been healthy for nine years, and we're extremely thankful.
In our clinic, I've had the privilege of witnessing thousands of patients go from feeling severely sick to being well again. Check out our testimonials to hear a few of these examples.
Key points:
- Early treatment with antibiotics can lead to full recovery
- Late-stage Lyme will require longer, more intensive treatment
- Functional health approach includes:
- Comprehensive care – addressing and killing the infection while supporting overall health
- Immune system support – nutrition, lifestyle changes, and supplementation
- Personalized treatment – addressing individual symptoms and recovery needs
We believe the functional medicine and functional health approach can support your long-term healing and wellness. No matter how long you've had Lyme, you can get better.
Once Lyme has entered its chronic, long-term phase, you need a protocol that can dissolve and penetrate biofilms, attack the bacteria, repair the damage that’s been done to your body, and support your recovery toward health.
Whether you’ve had it for decades, a few years, or months, I’ve had thousands of patients recover and feel healthy again, and you can, too.
I hope this article helped you understand the different stages of Lyme disease as it progresses.
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If you have or suspect you have Lyme disease and/or co-infections, Restorative Health Solutions is here to help. Schedule a consultation with Dr. Warren to explore personalized testing options and protocols for a helpful and effective path to recovery.
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