Chronic Lyme disease | |
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Pseudomedical diagnosis | |
Risks | Nocebo |
Treatment risks | Dangers of long-term antibiotic therapy, delaying appropriate care[1] |
Legality | Some jurisdictions have legislated to protect doctors offering worthless and potentially dangerous treatments |
This article is part of a series on |
Alternative medicine |
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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]
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