Chronic Lyme disease information

Chronic Lyme disease
Chronic Lyme disease
Pseudomedical diagnosis
Risks	Nocebo
Treatment risks	Dangers of long-term antibiotic therapy, delaying appropriate care
Legality	Some jurisdictions have legislated to protect doctors offering worthless and potentially dangerous treatments

Chronic Lyme disease (CLD) is the name used by some people with non-specific symptoms, such as fatigue, muscle pain, and cognitive dysfunction to refer to their condition, even if there is no evidence that they had Lyme disease.^[2]^[3] Both the label and the belief that these people's symptoms are caused by this particular infection are generally rejected by medical professionals.^[2] Chronic Lyme disease is distinct from post-treatment Lyme disease syndrome, a set of lingering symptoms which may persist after successful antibiotic treatment of infection with Lyme-causing Borrelia bacteria, and which may have similar symptoms to those associated with CLD.^[3]

Despite numerous studies, there is no evidence that symptoms associated with CLD are caused by any persistent infection.^[4] The symptoms attributed to chronic Lyme are in many cases likely due to fibromyalgia or chronic fatigue syndrome.^[5]^[6] Fibromyalgia can be triggered by an infection, and antibiotics are not a safe or effective treatment for post-infectious fibromyalgia.^[7] Fatigue, joint and muscle pain are also experienced by a minority of people following antibiotic treatment for Lyme disease.^[3]

A number of alternative health products are promoted for chronic Lyme disease,^[8] of which possibly the most controversial and harmful is long-term antibiotic therapy, particularly intravenous antibiotics.^[9]^[10] Recognised authorities advise against long-term antibiotic treatment for Lyme disease, even where some symptoms persist post-treatment.^[11]^[12]^[13]

In the United States, after disciplinary proceedings by state medical licensing boards, a subculture of "Lyme literate" physicians has successfully lobbied for specific legal protections, exempting them from the standard of care and science-based treatment guidelines. Such legislation has been criticised as an example of "legislative alchemy", the process whereby pseudomedicine is legislated into practice.^[14]^[15]^[16] Some doctors view the promotion of chronic Lyme disease as an example of health fraud.^[17]

^ Auwaerter, PG; Melia, MT (2012). "Bullying Borrelia: when the culture of science is under attack". Transactions of the American Clinical and Climatological Association. 123: 79–89, discussion 89-90. PMC 3540629. PMID 23303970.
^ ^a ^b Cite error: The named reference nejm-feder was invoked but never defined (see the help page).
^ ^a ^b ^c Wong, Katelyn H.; Shapiro, Eugene D.; Soffer, Gary K. (February 2022). "A Review of Post-treatment Lyme Disease Syndrome and Chronic Lyme Disease for the Practicing Immunologist". Clinical Reviews in Allergy & Immunology. 62 (1): 264–271. doi:10.1007/s12016-021-08906-w. ISSN 1080-0549. PMID 34687445. S2CID 239461094. In some cases, some of the subjective symptoms such as fatigue, myalgia, or arthralgia can persist following antibiotic therapy
^ Baker, P. J. (14 July 2010). "Chronic Lyme disease: in defense of the scientific enterprise". The FASEB Journal. 24 (11): 4175–77. doi:10.1096/fj.10-167247. PMID 20631327. S2CID 36141950.
^ Cite error: The named reference FMWars was invoked but never defined (see the help page).
^ Hall, Harriet (2013-09-03). "Does Everybody Have Chronic Lyme Disease? Does Anyone?". Science Based Medicine.
^ Ranque-Garnier, S.; Eldin, C.; Sault, C.; Raoult, D.; Donnet, A. (March 2019). "Management of patients presenting with generalized musculoskeletal pain and a suspicion of Lyme disease" (PDF). Médecine et Maladies Infectieuses. 49 (2): 157–66. doi:10.1016/j.medmal.2019.01.008. ISSN 1769-6690. PMID 30765287. S2CID 73420955.
^ McSweegan, Edward (28 June 2017). "Lyme Disease: Questionable Diagnosis and Treatment". Quackwatch.
^ Lantos PM (June 2015). "Chronic Lyme disease". Infect. Dis. Clin. North Am. (Review). 29 (2): 325–40. doi:10.1016/j.idc.2015.02.006. PMC 4477530. PMID 25999227.
^ Salzberg, Steven (2016-04-04). "Long-Term Antibiotic Use For Lyme Disease Doesn't Work, Study Finds". Forbes.
^ Cite error: The named reference idsa guideline was invoked but never defined (see the help page).
^ Cite error: The named reference pmid17522387 was invoked but never defined (see the help page).
^ Cite error: The named reference nih-cld was invoked but never defined (see the help page).
^ Bellamy, Jann (2014-05-15). "Legislative Alchemy 2014 (so far)". Science Based Medicine.
^ Mason DJ, Leavitt JK, Chaffee MW (2014). Policy & Politics in Nursing and Health Care. Elsevier Health Sciences. pp. 310–11. ISBN 978-0323316064.
^ Warner, Susan (2007-02-07). "State official subpoenas infectious disease group". The Scientist.
^ Cite error: The named reference ct was invoked but never defined (see the help page).

[bullying-1] Auwaerter, PG; Melia, MT (2012). "Bullying Borrelia: when the culture of science is under attack". Transactions of the American Clinical and Climatological Association. 123: 79–89, discussion 89-90. PMC 3540629. PMID 23303970.

[nejm-feder-2] Cite error: The named reference nejm-feder was invoked but never defined (see the help page).

[:2-3] Wong, Katelyn H.; Shapiro, Eugene D.; Soffer, Gary K. (February 2022). "A Review of Post-treatment Lyme Disease Syndrome and Chronic Lyme Disease for the Practicing Immunologist". Clinical Reviews in Allergy & Immunology. 62 (1): 264–271. doi:10.1007/s12016-021-08906-w. ISSN 1080-0549. PMID 34687445. S2CID 239461094. In some cases, some of the subjective symptoms such as fatigue, myalgia, or arthralgia can persist following antibiotic therapy

[4] Baker, P. J. (14 July 2010). "Chronic Lyme disease: in defense of the scientific enterprise". The FASEB Journal. 24 (11): 4175–77. doi:10.1096/fj.10-167247. PMID 20631327. S2CID 36141950.

[FMWars-5] Cite error: The named reference FMWars was invoked but never defined (see the help page).

[SMB-Hall-6] Hall, Harriet (2013-09-03). "Does Everybody Have Chronic Lyme Disease? Does Anyone?". Science Based Medicine.

[:1-7] Ranque-Garnier, S.; Eldin, C.; Sault, C.; Raoult, D.; Donnet, A. (March 2019). "Management of patients presenting with generalized musculoskeletal pain and a suspicion of Lyme disease" (PDF). Médecine et Maladies Infectieuses. 49 (2): 157–66. doi:10.1016/j.medmal.2019.01.008. ISSN 1769-6690. PMID 30765287. S2CID 73420955.

[Quackwatch-Tests-8] McSweegan, Edward (28 June 2017). "Lyme Disease: Questionable Diagnosis and Treatment". Quackwatch.

[lantos-9] Lantos PM (June 2015). "Chronic Lyme disease". Infect. Dis. Clin. North Am. (Review). 29 (2): 325–40. doi:10.1016/j.idc.2015.02.006. PMC 4477530. PMID 25999227.

[Forbes-LTA-10] Salzberg, Steven (2016-04-04). "Long-Term Antibiotic Use For Lyme Disease Doesn't Work, Study Finds". Forbes.

[idsa_guideline-11] Cite error: The named reference idsa guideline was invoked but never defined (see the help page).

[pmid17522387-12] Cite error: The named reference pmid17522387 was invoked but never defined (see the help page).

[nih-cld-13] Cite error: The named reference nih-cld was invoked but never defined (see the help page).

[SBM-Bellamy-14] Bellamy, Jann (2014-05-15). "Legislative Alchemy 2014 (so far)". Science Based Medicine.

[Mason-15] Mason DJ, Leavitt JK, Chaffee MW (2014). Policy & Politics in Nursing and Health Care. Elsevier Health Sciences. pp. 310–11. ISBN 978-0323316064.

[The-Scientist-16] Warner, Susan (2007-02-07). "State official subpoenas infectious disease group". The Scientist.

[ct-17] Cite error: The named reference ct was invoked but never defined (see the help page).

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