Lyme disease has a simple antibiotic treatment. The Lyme serology test has high false-positive rate. There might be many people who believe they have Lyme disease therefore sadly miss out on their actual diagnosis.
>Even if CLD lacks biological legitimacy, its importance as a phenomenon can be monumental to the individual patient. This is because many if not most patients who believe they have this condition are suffering, in many cases for years. Many have undergone frustrating, expensive, and ultimately fruitless medical evaluations, and many have become quite disaffected with a medical system that has failed to provide answers, let alone relief.
>Many patients referred for Lyme disease are ultimately found to have a rheumatologic or neurologic diagnosis. Rheumatologic diagnoses commonly misdiagnosed as Lyme disease include osteoarthritis, rheumatoid arthritis, degenerative diseases of the spine, and spondyloarthropathies. Some patients are found to have neurologic diseases, including multiple sclerosis, demyelinating diseases, amyotrophic lateral sclerosis, neuropathies, and dementia. Some CLD advocates have argued that these various conditions are simply manifestations of Lyme disease, but these hypotheses are untenable.
This is incorrect. Your link is from 2016. In the last few years several studies have brought to light that persister Lyme is real and very hard to eradicate with standard antibiotics. Even the CDC is starting to change their tune as their website now mentions persister Lyme as a viable theory.
From the study you linked, first sentence:
"Five clinical trials show that prolonged antibiotic therapy has no clear and lasting benefit in relieving posttreatment Lyme disease symptoms, a condition often called “chronic Lyme disease”;1, 2, 3, 4 no evidence of active infection was found in any of these studies by culture or molecular methods."
Almost all those citations are outdated studies from almost 20 years ago and one recent from 2016 where patients _did_ improve with antibiotics according to the data but the abstract concludes they didn't. ¯\_(ツ)_/¯
If they have to ignore recent studies and go back 20 years to "prove" antibiotics don't work then what does that tell us about bias in medicine?
2018:
>Conclusions: Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined.
https://www.researchgate.net/publication/324539470_Persisten...
2019:
>We collected data from an online survey of 200 of our patients, which evaluated the efficacy of dapsone (diaminodiphenyl sulfone, ie, DDS) combined with other antibiotics and agents that disrupt biofilms for the treatment of chronic Lyme disease/post-treatment Lyme disease syndrome (PTLDS). ... Conclusion DDS CT decreased eight major Lyme symptoms severity and improved treatment outcomes among patients with chronic Lyme disease/PTLDS and associated coinfections.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388746/
2020:
> This study, which drew on a sample of over 3500 patients ... Approximately half (53%) of the patients in the study reported some improvement, and more than a third (35%) were “high responders” to antibiotic treatment, underscoring the value of large samples, subgroup analysis, and real-world evidence as standard components of Lyme disease treatment studies. This spectrum of improvement is consistent with reports for most pharmaceuticals due to patient treatment response variation
https://www.mdpi.com/2227-9032/8/4/383
They only test for Borrelia Burgdorferi. We know there are several more out there that cause Lyme symptoms.
Borrelia
japonica – Discovered 1994
andersonii – Discovered 1995
lusitaniae – Discovered 1997
bissettii – Discovered 1998
spielmanii – Discovered 2006
californiensis – Discovered 2007
mayonii – Discovered 2016
I'm betting we can add the Australian variant to that list in the future.
If you’re not an expert why would you link a manuscript to stir up a thread?
CLD is real and even if it’s over diagnosed, it still doesn’t take away the many real diagnoses that exist and a vaccine would eliminate its potential permanently.
If you are posting in good faith...more recent studies are centered around making the findings in the European strain viable in the American one.
This misses that many many people get Lyme disease without knowing it (asymptomatic), particularly children, and if treatment it not given early in infection, permanent neurological damage occurs.
This is common in north eastern state rural areas and has been getting steadily worse.
We are constantly doing tick checks on the kids after one of our friends related that she suffered lifelong issues after being bitten by a tick 40 years ago in our neighborhood.
And in turn this misses that chronic lyme has become a catch-all self diagnosis people have for chronic medical problems with no clear cause. There is not really much evidence to believe it is a real thing.
But as the parent explained, many of these chronic Lyme patients may be just misdiagnosed. They believe they have Lyme, but the problem is some other disease.
If chronic Lyme illness is caused by lingering bacteria hidding in the body's tissues, the real way to eliminate any doubts about alternate causes is precisely to get a Lyme vaccine. Then, if the symptoms persist, we could easily deduce that the cause is other.
Except that one thing... the chronic Lyme could very well caused by an autoimmune side-effect (this is among the most serious explanations), in which case I don't think the vaccine would help.
I don't know if you can read the article apart from the abstract, so just in case:
It proposes the idea for the mechanism of vitamin D supplementation to better certain conditions in the short term, but worsen health long term, by acting as a immune suppressant similar to other steroids.
Here are some excerpts:
> "Consequently, if patients with autoimmune disease succeed in killing bacteria associated with their disease state, their symptoms should be expected to escalate, at least in the short-term, as cytokines and endotoxins are generated[28]. Conversely, in cases in which the immune response has been suppressed by supplementation with an immunosuppressant such as the secosteroid 25-D, one would expect to see fewer clinical manifestations of disease in the short-term, yet more advanced disease in the long-term. At a certain point, depending on the clinical symptom or physiological markers of disease, patients supplementing with vitamin D would be expected to approach a "crossover point" when additional reduction of the immune response is eclipsed by the advancing disease (Figure 2). This outcome has been demonstrated in longitudinal studies, with studies on sicker or older patients taking less time to realize the effect."
> "The Iowa Women's Health study showed vitamin D intake seemed to protect against breast cancer in the first five years after it was taken. However, the effect began to reverse between years five and ten and was completely lost after year ten, trending towards an opposing effect[29]. Lappe et al published work, conducted over four years, that seemingly showed vitamin D might lower the incidence of colorectal cancer[30]. In a similar study looking at a larger cohort and over a longer period of time, Rossouw et al found no such effect[31]."
Why can't we have nice things, eh?!
Since, vitamin D is frequently advertised as the cure all supplement, I also want to mention "antagonistic pleiotropy" as something to keep in mind, as conceptual "immunization":
Edit: OMG. I just realized, it may very well be possible that winter's VD deficiency may be needed for good health to some extent, if the body is indeed more active against lingering pathogens. This may also explain the COVID19 and VD connection, as steroids have been shown beneficial as well, maybe it's the immune suppressant quality of VD, which turns out beneficial!
Thanks, but I read the article, and my enthusiasm is justified.
Because thus vitamin D would be a great solution against autoimmune diseases, among which are a lot of the cases under the umbrella Chronic Lyme Disease (it is supposed that the borreliosis can provoke an autoimmune dysfunction that continues beyond the disappearance of the bacteria).
A lot of cases of chronic fatigue would be treated by vitamin D, which is a huge news.
In the case where there are still Borrelia bacteria you're true, but if it can be checked that the intruders have vanished (which is the case in most cases of difficult to treat CLD or CF) then it should not pose any problem.
In the case where the Borrelia are just hiding and in a latent state, then all is a question of comparating the dynamics of the two sides: the time required by the Borrelia to wake up and proliferate, vs the time required by the vitamin D to reduce the autoimmunity to the point where the body is again desensitized about itself.
A short treatment of vitamin D would be sufficient to cure the immune problem and not long enough to allow the bacteria to take over. (Hypothetically. This is just a possibility and has to be researched, but this is exactly why I am enthusiastic.)
Also, contrary to steroidal treatment, vitamin D bolsters a part of the immunity (lymphocytes T), even if it dampens an other part. So, it would restore a balance which is lost in case of defective aquiered immunity.
There is no way to eliminate these doubts. If you made a magical cure that totally eliminated the bacteria that causes Lyme disease, then these patients would take it, and it would almost certainly not work (because "chronic Lyme" isn't a real syndrome, and these patients don't have this bacteria). However, that would not convince them, they'd just claim that the medical establishment has failed them yet again (or worse: they become anti-vaxxers). You can't treat fictitious diseases with real drugs.
People are not making up illness for the fun of it. Their ailments are very real and they have a cause.
Malingering exists, but the profile of the chronic Lyme patients you speak about is not at all the one of persons in need of being nursed by the society like babies...
Just imagine you go to the doctor and all you say is dismissed because he thinks you make it up? What a despair you would be in! Speaking of a closed logical system your physician would be in! The same kind as the ones making famous conspiracy theories.
"I had <insert illness> and I was not taken seriously for <X> years" is such a recurrent theme that it is very concerning.
Just recently, the "long covid" was very much mocked by smug doctors. Imagine the distress of the patients.
You're wrong, these patients just failback on Lyme as a default and would be very pleased to discover the real causes of their ailments if it was found. To suppose that people are that much irrational and to generalize to this extent is... sorry but I am shocked.
In medicine, a golden rule is always assume your patient is honest in describing his problems.
Finally, contrary to what you said, the problem is not outside of the real world. Just as a link was proved between some tickborne pathogens and red meat allergy, you cannot exclude that one day a scientific team would prove that under some conditions the borreliosis provokes an autoimmune illness. And such a study would most likely point towards chemical markers to look for in blood and, at last, be able to diagnose it with certitude.
> People are not making up illness for the fun of it. Their ailments are very real and they have a cause.
I have absolutely no doubt that their problems are real. I fully believe that these patients are honest and that they really suffer, and they need treatment. I do not believe at all that they are "making it up".
But they don't suffer from "chronic Lyme".
There's just no evidence that it's a real thing. But just like with electromagnetic hypersensitivity, Morgellon's disease, "Wind Turbine syndrome", or any of a legion of "diseases" from medical history, you can't treat them medically if there's no evidence they exist. It would be malpractice for doctors to prescribe real drugs for fictitious syndromes, and it wouldn't do anything to convince their patients either.
If these patients get a diagnostic, even if it is not Lyme, I am sure that would help them very much.
It is true that the medicine is more than often not yet capable of giving satisfying diagnostics, and that misdiagnostic is counterproductive...
However I remember I saw some sound studies on biofilm protein immunity that was triggering autoimmune disorder, in relation to the borreliosis. This is why I had this strong opinion. I will report here if I manage to retrieve the exact reference.
I am not an expert, but I think it would be amiss to omit the Lyme disease controversy with these statements. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477530/
Lyme disease has a simple antibiotic treatment. The Lyme serology test has high false-positive rate. There might be many people who believe they have Lyme disease therefore sadly miss out on their actual diagnosis.
>Even if CLD lacks biological legitimacy, its importance as a phenomenon can be monumental to the individual patient. This is because many if not most patients who believe they have this condition are suffering, in many cases for years. Many have undergone frustrating, expensive, and ultimately fruitless medical evaluations, and many have become quite disaffected with a medical system that has failed to provide answers, let alone relief.
>Many patients referred for Lyme disease are ultimately found to have a rheumatologic or neurologic diagnosis. Rheumatologic diagnoses commonly misdiagnosed as Lyme disease include osteoarthritis, rheumatoid arthritis, degenerative diseases of the spine, and spondyloarthropathies. Some patients are found to have neurologic diseases, including multiple sclerosis, demyelinating diseases, amyotrophic lateral sclerosis, neuropathies, and dementia. Some CLD advocates have argued that these various conditions are simply manifestations of Lyme disease, but these hypotheses are untenable.