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<div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Belief that symptoms are caused by an unproven infection</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Neuroborreliosis" title="Neuroborreliosis">Neuroborreliosis</a> or <a 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.infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: aquamarine">Chronic Lyme disease</th></tr><tr><th colspan="2" class="infobox-header"><a href="/wiki/Alternative_medicine" title="Alternative medicine">Pseudomedical diagnosis</a></th></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk" title="Risk">Risks</a></th><td class="infobox-data"><a href="/wiki/Nocebo" title="Nocebo">Nocebo</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Treatment_risks" class="mw-redirect" title="Treatment risks">Treatment risks</a></th><td 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.sidebar-list-title-c{padding:0 0.4em;text-align:center;margin:0 3.3em}@media(max-width:640px){body.mediawiki .mw-parser-output .sidebar{width:100%!important;clear:both;float:none!important;margin-left:0!important;margin-right:0!important}}body.skin--responsive .mw-parser-output .sidebar a>img{max-width:none!important}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sidebar:not(.notheme) .sidebar-list-title,html.skin-theme-clientpref-night .mw-parser-output .sidebar:not(.notheme) .sidebar-title-with-pretitle{background:transparent!important}html.skin-theme-clientpref-night .mw-parser-output .sidebar:not(.notheme) .sidebar-title-with-pretitle a{color:var(--color-progressive)!important}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sidebar:not(.notheme) .sidebar-list-title,html.skin-theme-clientpref-os .mw-parser-output .sidebar:not(.notheme) .sidebar-title-with-pretitle{background:transparent!important}html.skin-theme-clientpref-os .mw-parser-output .sidebar:not(.notheme) .sidebar-title-with-pretitle a{color:var(--color-progressive)!important}}@media print{body.ns-0 .mw-parser-output .sidebar{display:none!important}}</style><table class="sidebar sidebar-collapse nomobile nowraplinks vcard hlist"><tbody><tr><td class="sidebar-pretitle">Part of <a href="/wiki/Category:Alternative_medicine" title="Category:Alternative medicine">a series</a> on</td></tr><tr><th class="sidebar-title-with-pretitle"><a href="/wiki/Alternative_medicine" title="Alternative medicine">Alternative medicine</a></th></tr><tr><td class="sidebar-image"><a href="/wiki/File:Outline-body-aura.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6c/Outline-body-aura.svg/60px-Outline-body-aura.svg.png" decoding="async" width="60" height="100" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6c/Outline-body-aura.svg/90px-Outline-body-aura.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6c/Outline-body-aura.svg/120px-Outline-body-aura.svg.png 2x" data-file-width="720" data-file-height="1200" /></a></td></tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:lavender;;color: var(--color-base)">General information</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Alternative_medicine" title="Alternative medicine">Alternative medicine</a> <ul><li><a href="/wiki/History_of_alternative_medicine" title="History of alternative medicine">History</a></li> <li><a href="/wiki/Terminology_of_alternative_medicine" title="Terminology of alternative medicine">Terminology</a></li></ul></li> <li><a href="/wiki/Alternative_veterinary_medicine" title="Alternative veterinary medicine">Alternative veterinary medicine</a></li> <li><a href="/wiki/Quackery" title="Quackery">Quackery</a> (health fraud)</li> <li><a href="/wiki/History_of_medicine#19th_century:_rise_of_modern_medicine" title="History of medicine">Rise of modern medicine</a></li> <li><a href="/wiki/Pseudoscience" title="Pseudoscience">Pseudoscience</a></li> <li><a href="/wiki/Antiscience" title="Antiscience">Antiscience</a></li> <li><a href="/wiki/Skepticism" title="Skepticism">Skepticism</a> <ul><li><a href="/wiki/Scientific_skepticism" title="Scientific skepticism">Scientific</a></li></ul></li> <li><a href="/wiki/Therapeutic_nihilism" title="Therapeutic nihilism">Therapeutic nihilism</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:lavender;;color: var(--color-base)">Fringe medicine and science</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Acupressure" title="Acupressure">Acupressure</a></li> <li><a href="/wiki/Acupuncture" title="Acupuncture">Acupuncture</a></li> <li><a href="/wiki/Alkaline_diet" title="Alkaline diet">Alkaline diet</a></li> <li><a href="/wiki/Anthroposophic_medicine" title="Anthroposophic medicine">Anthroposophic medicine</a></li> <li><a href="/wiki/Apitherapy" title="Apitherapy">Apitherapy</a></li> <li><a href="/wiki/Applied_kinesiology" title="Applied kinesiology">Applied kinesiology</a></li> <li><a href="/wiki/Aromatherapy" title="Aromatherapy">Aromatherapy</a></li> <li><a href="/wiki/Association_for_Research_and_Enlightenment" title="Association for Research and Enlightenment">Association for Research and Enlightenment</a></li> <li><a href="/wiki/Auriculotherapy" title="Auriculotherapy">Auriculotherapy</a></li> <li><a href="/wiki/Bates_method" title="Bates method">Bates method</a></li> <li><a href="/wiki/Biological_terrain_assessment" title="Biological terrain assessment">Biological terrain assessment</a></li> <li><a href="/wiki/Black_salve" title="Black salve">Black salve</a></li> <li><a href="/wiki/Bodywork_(alternative_medicine)" title="Bodywork (alternative medicine)">Bodywork</a></li> <li><a href="/wiki/Traditional_bone-setting" title="Traditional bone-setting">Bone-setting</a></li> <li><a href="/wiki/Bowen_technique" title="Bowen technique">Bowen technique</a></li> <li><a href="/wiki/Breathwork_(New_Age)" title="Breathwork (New Age)">Breathwork</a></li> <li><a href="/wiki/List_of_unproven_methods_against_COVID-19" title="List of unproven methods against COVID-19">Fake COVID-19 treatments</a></li> <li><a href="/wiki/Camel_urine" title="Camel urine">Camel urine</a></li> <li><a href="/wiki/Alternative_cancer_treatments" title="Alternative cancer treatments">Cancer treatments</a></li> <li><a href="/wiki/Activated_charcoal_cleanse" title="Activated charcoal cleanse">Charcoal cleanse</a></li> <li><a href="/wiki/Chiropractic" title="Chiropractic">Chiropractic</a> <ul><li><a href="/wiki/Chiropractic_treatment_techniques" title="Chiropractic treatment techniques">Chiropractic treatment techniques</a></li> <li><a href="/wiki/Vertebral_subluxation" title="Vertebral subluxation">Vertebral subluxation</a></li></ul></li> <li><a href="/wiki/Christian_Science" title="Christian Science">Christian Science</a></li> <li><a href="/wiki/Chromotherapy" title="Chromotherapy">Chromotherapy</a></li> <li><a href="/wiki/Colloidal_silver" class="mw-redirect" title="Colloidal silver">Colloidal silver</a></li> <li><a href="/wiki/Colon_cleansing" title="Colon cleansing">Colon cleansing</a> <ul><li><a href="/wiki/Coffee_enema" title="Coffee enema">Coffee enema</a></li></ul></li> <li><a href="/wiki/Colorpuncture" title="Colorpuncture">Colorpuncture</a></li> <li><a href="/wiki/Conversion_therapy" title="Conversion therapy">Conversion therapy</a></li> <li><a href="/wiki/Craniosacral_therapy" title="Craniosacral therapy">Craniosacral therapy</a></li> <li><a href="/wiki/Crystal_healing" title="Crystal healing">Crystal healing</a></li> <li><a href="/wiki/Cupping_therapy" title="Cupping therapy">Cupping therapy</a></li> <li><a href="/wiki/Dental_amalgam_controversy" title="Dental amalgam controversy">Dental amalgam controversy</a></li> <li><a href="/wiki/Detoxification_(alternative_medicine)" title="Detoxification (alternative medicine)">Detoxification</a> <ul><li><a href="/wiki/Detoxification_foot_baths" title="Detoxification foot baths">Foot detox</a></li></ul></li> <li><a href="/wiki/Dry_needling" title="Dry needling">Dry needling</a></li> <li><a href="/wiki/Ear_candling" title="Ear candling">Ear candling</a></li> <li><a href="/wiki/Energy_medicine" title="Energy medicine">Energy medicine</a> <ul><li><a href="/wiki/Correactology" title="Correactology">Correactology</a></li> <li><a href="/wiki/Energy_(esotericism)" title="Energy (esotericism)">Esoteric energy</a></li> <li><a href="/wiki/Reiki" title="Reiki">Reiki</a></li> <li><a href="/wiki/Therapeutic_touch" title="Therapeutic touch">Therapeutic touch</a></li></ul></li> <li><a href="/wiki/Estrogen_dominance" title="Estrogen dominance">Estrogen dominance</a></li> <li><a href="/wiki/Fabunan_Antiviral_Injection" title="Fabunan Antiviral Injection">Fabunan Antiviral Injection</a></li> <li><a href="/wiki/Facilitated_communication" title="Facilitated communication">Facilitated communication</a></li> <li><a href="/wiki/FasciaBlaster" title="FasciaBlaster">FasciaBlaster</a></li> <li><a href="/wiki/Feldenkrais_Method" title="Feldenkrais Method">Feldenkrais Method</a></li> <li><a href="/wiki/Functional_medicine" title="Functional medicine">Functional medicine</a></li> <li><a href="/wiki/Hair_analysis_(alternative_medicine)" title="Hair analysis (alternative medicine)">Hair analysis</a></li> <li><a href="/wiki/Holistic_dentistry" title="Holistic dentistry">Holistic dentistry</a></li> <li><a href="/wiki/Hologram_bracelet" title="Hologram bracelet">Hologram bracelet</a></li> <li><a href="/wiki/Homeopathy" title="Homeopathy">Homeopathy</a> <ul><li><a href="/wiki/Bach_flower_remedies" title="Bach flower remedies">Bach flower remedies</a></li></ul></li> <li><a href="/wiki/Hydrotherapy" title="Hydrotherapy">Hydrotherapy</a></li> <li><a href="/wiki/Hypnotherapy" title="Hypnotherapy">Hypnotherapy</a></li> <li><a href="/wiki/Ionized_jewelry" title="Ionized jewelry">Ionized jewelry</a></li> <li><a href="/wiki/Iridology" title="Iridology">Iridology</a></li> <li><a href="/wiki/Jilly_Juice" title="Jilly Juice">Jilly Juice</a></li> <li><a href="/wiki/The_Lightning_Process" title="The Lightning Process">Lightning Process</a></li> <li><a href="/wiki/Lymphotherapy" title="Lymphotherapy">Lymphotherapy</a></li> <li><a href="/wiki/Magnet_therapy" title="Magnet therapy">Magnet therapy</a></li> <li><a href="/wiki/Manual_therapy" title="Manual therapy">Manual therapy</a></li> <li><a href="/wiki/Manual_lymphatic_drainage" title="Manual lymphatic drainage">Manual lymphatic drainage</a></li> <li><a href="/wiki/Medical_intuitive" title="Medical intuitive">Medical intuitive</a></li> <li><a href="/wiki/Megavitamin_therapy" title="Megavitamin therapy">Megavitamin therapy</a></li> <li><a href="/wiki/Animal_magnetism" title="Animal magnetism">Mesmerism</a></li> <li><a href="/wiki/Mind%E2%80%93body_interventions" title="Mind–body interventions">Mind–body interventions</a></li> <li><a href="/wiki/Miracle_Mineral_Supplement" title="Miracle Mineral Supplement">MMS</a></li> <li><a href="/wiki/Myofascial_release" title="Myofascial release">Myofascial release</a></li> <li><a href="/wiki/Nambudripad%27s_Allergy_Elimination_Techniques" title="Nambudripad's Allergy Elimination Techniques">NAET</a></li> <li><a href="/wiki/Naturopathy" title="Naturopathy">Naturopathy</a></li> <li><a href="/wiki/Oil_pulling" title="Oil pulling">Oil pulling</a></li> <li><a href="/wiki/Orgone" title="Orgone">Orgone</a></li> <li><a href="/wiki/Orthomolecular_medicine" title="Orthomolecular medicine">Orthomolecular medicine</a></li> <li><a href="/wiki/Orthopathy" title="Orthopathy">Orthopathy</a></li> <li><a href="/wiki/Osteomyology" title="Osteomyology">Osteomyology</a></li> <li><a href="/wiki/Osteopathy" title="Osteopathy">Osteopathy</a></li> <li><a href="/wiki/Ozone_therapy" title="Ozone therapy">Ozone therapy</a></li> <li><a href="/wiki/Parapsychology" title="Parapsychology">Parapsychology</a></li> <li><a href="/wiki/Phrenology" title="Phrenology">Phrenology</a></li> <li><a href="/wiki/Postural_Integration" title="Postural Integration">Postural Integration</a></li> <li><a href="/wiki/Psychic_surgery" title="Psychic surgery">Psychic surgery</a></li> <li><a href="/wiki/Psychodermatology" title="Psychodermatology">Psychodermatology</a></li> <li><a href="/wiki/Quantum_healing" title="Quantum healing">Quantum healing</a></li> <li><a href="/wiki/Radionics" title="Radionics">Radionics</a></li> <li><a href="/wiki/Rapid_prompting_method" title="Rapid prompting method">Rapid prompting method</a></li> <li><a href="/wiki/Reflexology" title="Reflexology">Reflexology</a></li> <li><a href="/wiki/Reichian_body-oriented_psychotherapy" class="mw-redirect" title="Reichian body-oriented psychotherapy">RBOP</a></li> <li><a href="/wiki/Rolfing" title="Rolfing">Rolfing</a></li> <li><a href="/wiki/Scientific_racism" title="Scientific racism">Scientific racism</a></li> <li><a href="/wiki/ThetaHealing" title="ThetaHealing">ThetaHealing</a></li> <li><a href="/wiki/Thomsonianism" title="Thomsonianism">Thomsonianism</a></li> <li><a href="/wiki/Thought_Field_Therapy" title="Thought Field Therapy">Thought Field Therapy</a></li> <li><a href="/wiki/Urophagia" title="Urophagia">Urophagia</a></li> <li><a href="/wiki/Vaginal_steaming" title="Vaginal steaming">Vaginal steaming</a></li> <li><a href="/wiki/Vegetotherapy" title="Vegetotherapy">Vegetotherapy</a></li> <li><a href="/wiki/Vision_therapy" title="Vision therapy">Vision therapy</a></li> <li><a href="/wiki/Vitalism" title="Vitalism">Vitalism</a></li> <li><a href="/wiki/Young_blood_transfusion" title="Young blood transfusion">Young blood transfusion</a></li> <li><a href="/wiki/Zero_balancing" title="Zero balancing">Zero balancing</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:lavender;;color: var(--color-base)">Controversies</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Big_Pharma_conspiracy_theories" title="Big Pharma conspiracy theories">Big Pharma conspiracy theories</a></li> <li><a href="/wiki/HIV/AIDS_denialism" title="HIV/AIDS denialism">HIV/AIDS denialism</a> <ul><li><a href="/wiki/Oral_polio_vaccine_AIDS_hypothesis" title="Oral polio vaccine AIDS hypothesis">OPV AIDS hypothesis</a></li></ul></li> <li><a href="/wiki/Anti-vaccine_activism" title="Anti-vaccine activism">Anti-vaccinationism</a> <ul><li><a href="/wiki/Vaccine_misinformation" title="Vaccine misinformation">Vaccine misinformation</a></li> <li><a href="/wiki/Vaccines_and_autism" title="Vaccines and autism">Vaccines and autism</a></li> <li><a href="/wiki/MMR_vaccine_and_autism" title="MMR vaccine and autism">MMR vaccine and autism</a></li> <li><a href="/wiki/Anti-vaccinationism_in_chiropractic" title="Anti-vaccinationism in chiropractic">in chiropractic</a></li></ul></li> <li><a href="/wiki/Water_fluoridation_controversy" title="Water fluoridation controversy">Water fluoridation controversy</a></li> <li><a href="/wiki/COVID-19_misinformation" title="COVID-19 misinformation">COVID-19 misinformation</a> <ul><li><a href="/wiki/Turbo_cancer" title="Turbo cancer">Turbo cancer</a></li></ul></li></ul></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:lavender;;color: var(--color-base)"><a href="/wiki/Alternative_medicine#NCCIH_classification" title="Alternative medicine">Classifications</a></div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Category:Alternative_medical_systems" title="Category:Alternative medical systems">Alternative medical systems</a></li> <li><a href="/wiki/Category:Mind%E2%80%93body_interventions" title="Category:Mind–body interventions">Mind–body intervention</a></li> <li><a href="/wiki/Category:Biologically_based_therapies" title="Category:Biologically based therapies">Biologically based therapy</a></li> <li><a href="/wiki/Category:Manual_therapy" title="Category:Manual therapy">Manipulative methods</a></li> <li><a href="/wiki/Category:Energy_therapies" title="Category:Energy therapies">Energy therapy</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="text-align:center; background:lavender;;color: var(--color-base)"><a href="/wiki/Traditional_medicine" title="Traditional medicine">Traditional medicine</a></div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Traditional_African_medicine" title="Traditional African medicine">African</a> <ul><li><a href="/wiki/Muti" title="Muti">Muti</a></li> <li><a href="/wiki/Traditional_healers_of_Southern_Africa" title="Traditional healers of Southern Africa">Southern Africa</a></li></ul></li> <li><a href="/wiki/Ayurveda" title="Ayurveda">Ayurveda</a> <ul><li><a href="/wiki/Dosha" title="Dosha">Dosha</a></li> <li><a href="/wiki/Maharishi_Vedic_Approach_to_Health" title="Maharishi Vedic Approach to Health">MVAH</a></li></ul></li> <li><a href="/wiki/Balneotherapy" title="Balneotherapy">Balneotherapy</a></li> <li><a href="/wiki/Brazilian_traditional_medicine" title="Brazilian traditional medicine">Brazilian</a></li> <li><a href="/wiki/Bush_medicine" title="Bush medicine">Bush medicine</a></li> <li><a href="/wiki/Traditional_Cambodian_medicine" title="Traditional Cambodian medicine">Cambodian</a></li> <li><a href="/wiki/Traditional_Chinese_medicine" title="Traditional Chinese medicine">Chinese</a> <ul><li><a href="/wiki/Blood_stasis" title="Blood stasis">Blood stasis</a></li> <li><a href="/wiki/Chinese_herbology" title="Chinese herbology">Chinese herbology</a></li> <li><a href="/wiki/Dit_da" title="Dit da">Dit da</a></li> <li><a href="/wiki/Gua_sha" title="Gua sha">Gua sha</a></li> <li><a href="/wiki/Gill_plate_trade" title="Gill plate trade">Gill plate trade</a></li> <li><a href="/wiki/Long_gu" title="Long gu">Long gu</a></li> <li><a href="/wiki/Meridian_(Chinese_medicine)" title="Meridian (Chinese medicine)">Meridian</a></li> <li><a href="/wiki/Moxibustion" title="Moxibustion">Moxibustion</a></li> <li><a href="/wiki/Pressure_point" title="Pressure point">Pressure point</a></li> <li><a href="/wiki/Qi" title="Qi">Qi</a></li> <li><a href="/wiki/San_Jiao" title="San Jiao">San Jiao</a></li> <li><a href="/wiki/Tui_na" title="Tui na">Tui na</a></li> <li><a href="/wiki/Zang-fu" class="mw-redirect" title="Zang-fu">Zang-fu</a></li></ul></li> <li><a href="/wiki/Chumash_traditional_medicine" title="Chumash traditional medicine">Chumash</a></li> <li><a href="/wiki/Curandero" title="Curandero">Curandero</a></li> <li><a href="/wiki/Faith_healing" title="Faith healing">Faith healing</a></li> <li><a href="/wiki/Herbal_medicine" title="Herbal medicine">Herbal medicine</a></li> <li><a href="/wiki/Hilot" title="Hilot">Hilot</a></li> <li><a href="/wiki/Iranian_traditional_medicine" title="Iranian traditional medicine">Iranian</a></li> <li><a href="/wiki/Jamu" title="Jamu">Jamu</a></li> <li><a href="/wiki/Kayakalpa" title="Kayakalpa">Kayakalpa</a></li> <li><a href="/wiki/Kambo_cleanse" class="mw-redirect" title="Kambo cleanse">Kambo</a></li> <li><a href="/wiki/Kampo" title="Kampo">Japanese</a></li> <li><a href="/wiki/Traditional_Korean_medicine" title="Traditional Korean medicine">Korean</a></li> <li><a href="/wiki/Maya_medicine" title="Maya medicine">Maya</a></li> <li><a href="/wiki/Mien_Shiang" title="Mien Shiang">Mien Shiang</a></li> <li><a href="/wiki/Traditional_Mongolian_medicine" title="Traditional Mongolian medicine">Mongolian</a></li> <li><a href="/wiki/Naftalan_oil" title="Naftalan oil">Naftalan oil</a></li> <li><a href="/wiki/Prophetic_medicine" title="Prophetic medicine">Prophetic medicine</a></li> <li><a href="/wiki/Shamanism" title="Shamanism">Shamanism</a></li> <li><a href="/wiki/Shiatsu" title="Shiatsu">Shiatsu</a></li> <li><a href="/wiki/Siddha_medicine" title="Siddha medicine">Siddha</a></li> <li><a href="/wiki/Sri_Lankan_traditional_medicine" title="Sri Lankan traditional medicine">Sri Lankan</a></li> <li><a href="/wiki/Thai_massage" class="mw-redirect" title="Thai massage">Thai massage</a></li> <li><a href="/wiki/Traditional_Tibetan_medicine" class="mw-redirect" title="Traditional Tibetan medicine">Tibetan</a></li> <li><a href="/wiki/Unani_medicine" title="Unani medicine">Unani</a></li> <li><a href="/wiki/Traditional_Vietnamese_medicine" title="Traditional Vietnamese medicine">Vietnamese</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible"><div class="sidebar-list-title" style="text-align:center; background:lavender;;color: var(--color-base)">Alternative diagnoses</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Adrenal_fatigue" title="Adrenal fatigue">Adrenal fatigue</a></li> <li><a href="/wiki/Aerotoxic_syndrome" title="Aerotoxic syndrome">Aerotoxic syndrome</a></li> <li><a href="/wiki/Candida_hypersensitivity" title="Candida hypersensitivity">Candida hypersensitivity</a></li> <li><a class="mw-selflink selflink">Chronic Lyme disease</a></li> <li><a href="/wiki/Electromagnetic_hypersensitivity" title="Electromagnetic hypersensitivity">Electromagnetic hypersensitivity</a></li> <li><a href="/wiki/Heavy_legs" title="Heavy legs">Heavy legs</a></li> <li><a href="/wiki/Leaky_gut_syndrome" title="Leaky gut syndrome">Leaky gut syndrome</a></li> <li><a href="/wiki/Multiple_chemical_sensitivity" title="Multiple chemical sensitivity">Multiple chemical sensitivity</a></li> <li><a href="/wiki/PANDAS" title="PANDAS">PANDAS</a></li> <li><a href="/wiki/Vertebral_subluxation" title="Vertebral subluxation">Vertebral subluxation</a></li> <li><a href="/wiki/Wilson%27s_temperature_syndrome" title="Wilson's temperature syndrome">Wilson's temperature syndrome</a></li></ul></div></div></td> </tr><tr><td class="sidebar-navbar"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Alternative_medicine_sidebar" title="Template:Alternative medicine sidebar"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Alternative_medicine_sidebar" title="Template talk:Alternative medicine sidebar"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Alternative_medicine_sidebar" title="Special:EditPage/Template:Alternative medicine sidebar"><abbr title="Edit this template">e</abbr></a></li></ul></div></td></tr></tbody></table> Chronic Lyme disease (CLD) is the name used by some people with <a href="/wiki/Non-specific_symptoms" class="mw-redirect" title="Non-specific symptoms">non-specific symptoms</a>, such as fatigue, muscle pain, and <a href="/wiki/Cognitive_dysfunction" class="mw-redirect" title="Cognitive dysfunction">cognitive dysfunction</a> to refer to their condition, even if there is no evidence that they had <a href="/wiki/Lyme_disease" title="Lyme disease">Lyme disease</a>.<a href="#cite_note-nejm-feder-2">[2]</a><a href="#cite_note-:2-3">[3]</a> Both the label and the belief that these people's symptoms are caused by this particular infection are generally rejected by medical professionals.<a href="#cite_note-nejm-feder-2">[2]</a> Chronic Lyme disease is distinct from <a href="/wiki/Lyme_disease#Post-treatment_Lyme_disease_syndrome" title="Lyme disease">post-treatment Lyme disease syndrome</a>, a set of lingering symptoms which may persist after successful antibiotic treatment of infection with Lyme-causing <a href="/wiki/Borrelia" title="Borrelia">Borrelia</a> bacteria, and which may have similar symptoms to those associated with CLD.<a href="#cite_note-:2-3">[3]</a> Despite numerous studies, there is no evidence that symptoms associated with CLD are caused by any persistent infection.<a href="#cite_note-4">[4]</a> The symptoms attributed to chronic Lyme are in many cases likely due to <a href="/wiki/Fibromyalgia" title="Fibromyalgia">fibromyalgia</a> or <a href="/wiki/Chronic_fatigue_syndrome" class="mw-redirect" title="Chronic fatigue syndrome">chronic fatigue syndrome</a>.<a href="#cite_note-FMWars-5">[5]</a><a href="#cite_note-SMB-Hall-6">[6]</a> Fibromyalgia can be triggered by an infection, and antibiotics are not a safe or effective treatment for post-infectious fibromyalgia.<a href="#cite_note-:1-7">[7]</a> Fatigue, joint and muscle pain are also experienced by a minority of people following antibiotic treatment for Lyme disease.<a href="#cite_note-:2-3">[3]</a> A number of <a href="/wiki/Alternative_medicine" title="Alternative medicine">alternative health products</a> are promoted for chronic Lyme disease,<a href="#cite_note-Quackwatch-Tests-8">[8]</a> of which possibly the most controversial and harmful is long-term <a href="/wiki/Antibiotic" title="Antibiotic">antibiotic</a> therapy, particularly intravenous antibiotics.<a href="#cite_note-lantos-9">[9]</a><a href="#cite_note-Forbes-LTA-10">[10]</a> Recognised authorities advise against long-term antibiotic treatment for Lyme disease, even where some symptoms persist post-treatment.<a href="#cite_note-idsa_guideline-11">[11]</a><a href="#cite_note-pmid17522387-12">[12]</a><a href="#cite_note-nih-cld-13">[13]</a> 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 <a href="/wiki/Standard_of_care" title="Standard of care">standard of care</a> and science-based treatment guidelines. Such legislation has been criticised as an example of "legislative alchemy", the process whereby pseudomedicine is legislated into practice.<a href="#cite_note-SBM-Bellamy-14">[14]</a><a href="#cite_note-Mason-15">[15]</a><a href="#cite_note-The-Scientist-16">[16]</a> Some doctors view the promotion of chronic Lyme disease as an example of <a href="/wiki/Health_fraud" class="mw-redirect" title="Health fraud">health fraud</a>.<a href="#cite_note-ct-17">[17]</a> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Description_and_background">Description and background</h2>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=1" title="Edit section: Description and background">edit</a>]</div> Chronic Lyme disease is distinct from untreated late-stage Lyme disease, which can cause <a href="/wiki/Arthritis" title="Arthritis">arthritis</a>, <a href="/wiki/Peripheral_neuropathy" title="Peripheral neuropathy">peripheral neuropathy</a> and/or <a href="/wiki/Encephalomyelitis" title="Encephalomyelitis">encephalomyelitis</a>. Chronic Lyme disease is also distinct from the post-treatment Lyme disease syndrome (PTLDS), when symptoms linger after standard antibiotic treatments.<a href="#cite_note-cdc_postlds-18">[18]</a><a href="#cite_note-Cairns-19">[19]</a> PTLDS is estimated to occur in less than 5% of people who had Lyme disease and were treated.<a href="#cite_note-20">[20]</a> In contrast to these recognized medical conditions, the promotion of chronic lyme disease has been accused of being <a href="/wiki/Health_fraud" class="mw-redirect" title="Health fraud">health fraud</a>.<a href="#cite_note-ct-17">[17]</a> In many cases there is no objective evidence that people who believe they have chronic Lyme have ever been infected with Lyme disease: standard diagnostic tests for infection are often negative.<a href="#cite_note-nejm-feder-2">[2]</a><a href="#cite_note-IDSA_FAQ-21">[21]</a> While it is undisputed that people can have severe symptoms of an illness, the cause and appropriate treatment promoted by "chronic Lyme" advocates are controversial. The symptoms are similar to those of <a href="/wiki/Fibromyalgia" title="Fibromyalgia">fibromyalgia</a> or <a href="/wiki/Chronic_fatigue_syndrome" class="mw-redirect" title="Chronic fatigue syndrome">chronic fatigue syndrome</a>.<a href="#cite_note-FMWars-5">[5]</a><a href="#cite_note-:1-7">[7]</a> Fibromyalgia can be triggered by an infection, and then persist when the infection is completely removed from the body.<a href="#cite_note-:1-7">[7]</a> A few doctors attribute these symptoms to persistent infection with Borrelia, or co-infections with other tick-borne pathogens, such as <a href="/wiki/Ehrlichia" title="Ehrlichia">Ehrlichia</a> and <a href="/wiki/Babesia" title="Babesia">Babesia</a>.<a href="#cite_note-gaito-22">[22]</a><a href="#cite_note-IDSAReviewPanel-23">[23]</a><a href="#cite_note-cameron-24">[24]</a> Some conclude that the initial infection may cause an <a href="/wiki/Autoimmunity" title="Autoimmunity">autoimmune reaction</a> that continues to cause serious symptoms even after the bacteria have been eliminated by antibiotics.<a href="#cite_note-Ercolini-25">[25]</a> A <a href="/wiki/Literature_review" title="Literature review">review</a> looked at several animal studies that found persistence of live but disabled spirochetes following treatment of B. burgdorferi infection with antibiotics. The authors noted that none of the lingering spirochetes were associated with inflamed tissues and criticized the studies for not having considered adequately the different <a href="/wiki/Pharmacodynamics" title="Pharmacodynamics">pharmacodynamics</a> and <a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">pharmacokinetics</a> of the antibiotics used to treat the animals in the trials versus what would be expected to be used to treat humans. The authors concluded, "There is no scientific evidence to support the hypothesis that such spirochetes, should they exist in humans, are the cause of post-Lyme disease syndrome."<a href="#cite_note-Wormser2009-26">[26]</a> Major US medical authorities, including the <a href="/wiki/Infectious_Diseases_Society_of_America" title="Infectious Diseases Society of America">Infectious Diseases Society of America</a>, the <a href="/wiki/American_Academy_of_Neurology" title="American Academy of Neurology">American Academy of Neurology</a>, and the <a href="/wiki/National_Institutes_of_Health" title="National Institutes of Health">National Institutes of Health</a>, have stated there is no convincing evidence that Borrelia is involved in the various symptoms classed as CLD, and particularly advise against long-term antibiotic treatment as it is ineffective and potentially harmful.<a href="#cite_note-nejm-feder-2">[2]</a><a href="#cite_note-idsa_guideline-11">[11]</a><a href="#cite_note-pmid17522387-12">[12]</a><a href="#cite_note-nih-cld-13">[13]</a> Prolonged antibiotic therapy presents significant risks and can have dangerous, even deadly, side effects.<a href="#cite_note-mandell_chap242-27">[27]</a> Randomized placebo-controlled studies have shown that antibiotics offer no sustained benefit in people with chronic Lyme, with evidence of both placebo effects and significant adverse effects from such treatment.<a href="#cite_note-Marques-28">[28]</a> Many people who believe that they have chronic Lyme have fibromyalgia.<a href="#cite_note-FMWars-5">[5]</a><a href="#cite_note-:1-7">[7]</a> Fibromyalgia can be difficult to treat, and antibiotics do not work at all for fibromyalgia.<a href="#cite_note-:1-7">[7]</a> A <a href="/wiki/Pressure_group" class="mw-redirect" title="Pressure group">pressure group</a> called the <a href="/wiki/International_Lyme_and_Associated_Diseases_Society" title="International Lyme and Associated Diseases Society">International Lyme and Associated Diseases Society</a> (ILADS)<a href="#cite_note-Tonks-29">[29]</a> says that the persistence of B. burgdorferi may be responsible for manifestations of chronic Lyme disease symptoms. False chronic Lyme disease diagnoses are frequently justified due to non-specific symptoms that are common in the population.<a href="#cite_note-nejm-feder-2">[2]</a> <a href="/wiki/Harriet_Hall" title="Harriet Hall">Harriet Hall</a> examined a long list of symptoms attributed to CLD and remarked that it "pretty much covers everyone."<a href="#cite_note-SMB-Hall-6">[6]</a> Consistent with this observation, a study found that a questionnaire of non-specific symptoms based on an ILADS symptom checklist could not distinguish between patients with possible post-Lyme symptoms and those with other conditions.<a href="#cite_note-zomer-symptoms-30">[30]</a> While many people who receive CLD diagnoses have unexplained symptoms (including chronic fatigue and fibromyalgia), others have well-defined diagnoses.<a href="#cite_note-nejm-feder-2">[2]</a> Cases of cancer, a brain tumor, ALS, lupus, multiple sclerosis, a thyroid disorder, and mental disorders have each been misdiagnosed as CLD.<a href="#cite_note-boodman-31">[31]</a><a href="#cite_note-itani-32">[32]</a><a href="#cite_note-MS-33">[33]</a><a href="#cite_note-lupus-34">[34]</a><a href="#cite_note-neoplasms-35">[35]</a><a href="#cite_note-bacterial-36">[36]</a> Scientists from the Centers for Disease Control and Prevention (CDC) also documented life-threatening infections caused by unnecessary treatment with intravenous antibiotics and <a href="/wiki/Immunoglobulin_therapy" title="Immunoglobulin therapy">immunoglobulins</a>.<a href="#cite_note-bacterial-36">[36]</a><a href="#cite_note-unproven-37">[37]</a> An adolescent girl and a woman were hospitalized for septic shock, with the woman eventually dying. Other patients developed <a href="/wiki/Staphylococcus_aureus" title="Staphylococcus aureus">Staphylococcus aureus</a> and intractable <a href="/wiki/Clostridioides_difficile_infection" title="Clostridioides difficile infection">C. difficile</a>.<a href="#cite_note-bacterial-36">[36]</a><a href="#cite_note-unproven-37">[37]</a> <div class="mw-heading mw-heading2"><h2 id="Identity">Identity</h2>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=2" title="Edit section: Identity">edit</a>]</div> Among people who self-identify as having chronic Lyme, the idea of chronic Lyme functions as a type of <a href="/wiki/Social_identity" class="mw-redirect" title="Social identity">social identity</a>. In this sense, the goal of the label is not to identify particular objective facts that differentiate one medical condition from another; instead, the main goal is to validate the real suffering experienced by people living with an <a href="/wiki/Invisible_disability" title="Invisible disability">invisible illness</a> and to provide <a href="/wiki/Social_support" title="Social support">social support</a> for them as they cope with it.<a href="#cite_note-nymag-quote-38">[38]</a> To some patients, receiving a CLD diagnosis can provide a sense of relief and optimism for the future.<a href="#cite_note-pathway-39">[39]</a> They may also become dedicated to fighting for recognition of CLD.<a href="#cite_note-pathway-39">[39]</a><a href="#cite_note-nymag-quote-38">[38]</a> <div class="mw-heading mw-heading2"><h2 id="Discredited_beliefs">Discredited beliefs</h2>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=3" title="Edit section: Discredited beliefs">edit</a>]</div> Patients who receive a false chronic Lyme diagnosis are frequently told that they have other diagnoses that are not scientifically recognized.<a href="#cite_note-coinfections-40">[40]</a><a href="#cite_note-nymag-41">[41]</a> Infections may be diagnosed even without compatible symptom history, exposure in an endemic area, and credible positive test results.<a href="#cite_note-coinfections-40">[40]</a> Some inappropriately diagnosed "co-infections" may be based on known tick-borne infections, such as <a href="/wiki/Babesiosis" title="Babesiosis">Babesia</a> or <a href="/wiki/Anaplasma_phagocytophilum" title="Anaplasma phagocytophilum">Anaplasma</a>.<a href="#cite_note-coinfections-40">[40]</a> Others, like <a href="/wiki/Bartonella" title="Bartonella">Bartonella</a> or <a href="/wiki/Mycoplasma" title="Mycoplasma">Mycoplasma</a>, have not been shown to be tick-borne or a co-infection of Lyme disease.<a href="#cite_note-coinfections-40">[40]</a><a href="#cite_note-nymag-41">[41]</a><a href="#cite_note-bullying-1">[1]</a><a href="#cite_note-CDC-lyme-faq-42">[42]</a> Some may be told that they are being poisoned by mold.<a href="#cite_note-nymag-41">[41]</a> NIH doctor Adriana Marques has noted that patients may also be told that they have "metabolic and hormonal imbalances, immune dysfunction, heavy metal toxicity, allergies, damage by toxins, mitochondrial dysfunction and enzyme deficiencies".<a href="#cite_note-marquest-cld-chapter-43">[43]</a> CLD advocates have also attempted to link Lyme disease to <a href="/wiki/Morgellons" title="Morgellons">Morgellons</a>, another condition unrecognized by medical science.<a href="#cite_note-Atlantic-44">[44]</a> Morgellons—which is generally considered a form of delusional parasitosis by mainstream doctors—involves a belief that fibers are being produced by the skin.<a href="#cite_note-Beuerlein2021-45">[45]</a> Among the top promoters of Morgellons is former ILADS president Raphael Stricker, who claims that CLD is causing the fibers to grow.<a href="#cite_note-Atlantic-44">[44]</a><a href="#cite_note-Beuerlein2021-45">[45]</a> In 2015, The Atlantic reported that Stricker treats people who believe they have Morgellons with long-term antibiotics.<a href="#cite_note-Atlantic-44">[44]</a> A belief in chronic Lyme disease is often reinforced based on fallacious reasoning.<a href="#cite_note-Jarisch-Herxheimer-46">[46]</a><a href="#cite_note-label-47">[47]</a> For example, if a patient either feels better or feels worse after a treatment, it may be wrongly interpreted as evidence both that the diagnosis is appropriate and that the treatment is working.<a href="#cite_note-Jarisch-Herxheimer-46">[46]</a><a href="#cite_note-label-47">[47]</a> In the chronic Lyme world, a patient with worsening symptoms may be told that they are "herxing".<a href="#cite_note-nymag-41">[41]</a><a href="#cite_note-label-47">[47]</a> The "herxing" claims are based on a real phenomenon called a <a href="/wiki/Jarisch%E2%80%93Herxheimer_reaction" title="Jarisch–Herxheimer reaction">Jarisch–Herxheimer reaction</a>, but often do not resemble it.<a href="#cite_note-Jarisch-Herxheimer-46">[46]</a> True Jarisch-Herxheimer reactions are generally transient, mild, and found only within the first 24 hours of beginning antibiotics.<a href="#cite_note-guidelines-2020-48">[48]</a><a href="#cite_note-Quackwatch-Tests-8">[8]</a> But in online Lyme groups, patients have claimed to "herx" long after initial antibiotic treatment for durations that can last weeks.<a href="#cite_note-Quackwatch-Tests-8">[8]</a> A mistaken belief that a treatment is working can cause patients to ignore serious drug side effects of antibiotics or prevent diagnosis and treatment of other true causes of worsening symptoms.<a href="#cite_note-Quackwatch-Tests-8">[8]</a><a href="#cite_note-Jarisch-Herxheimer-46">[46]</a> If a patient improves while on a treatment, experts warn that this also should not be interpreted as evidence of Lyme infection and that the treatment is working.<a href="#cite_note-nejm-feder-2">[2]</a><a href="#cite_note-guidelines-2020-48">[48]</a> Randomized controlled trials found that close to 40% of people with post-Lyme symptoms felt better while on placebo.<a href="#cite_note-nejm-feder-2">[2]</a> An assumption that a treatment is working can be reinforced because antibiotics can have anti-inflammatory effects and many conditions tend to naturally improve over time.<a href="#cite_note-nejm-feder-2">[2]</a> <div class="mw-heading mw-heading2"><h2 id="Political_actions">Political actions</h2>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=4" title="Edit section: Political actions">edit</a>]</div> While there is general agreement on the optimal treatment for Lyme disease, the existence of chronic Lyme is generally rejected because there is no evidence of its existence.<a href="#cite_note-Tonks-29">[29]</a><a href="#cite_note-Ballantyne_2008-49">[49]</a><a href="#cite_note-:0-50">[50]</a> Even among those who believe in it, there is no consensus over its prevalence, symptoms, diagnostic criteria, or treatment.<a href="#cite_note-Tonks-29">[29]</a><a href="#cite_note-Ballantyne_2008-49">[49]</a><a href="#cite_note-:0-50">[50]</a> The evidence-based perspective is exemplified by a 2007 review in <a href="/wiki/The_New_England_Journal_of_Medicine" title="The New England Journal of Medicine">The New England Journal of Medicine</a>, which noted the diagnosis of chronic Lyme disease is used by a few physicians despite a lack of "reproducible or convincing scientific evidence", leading the authors to describe this diagnosis as "the latest in a series of syndromes that have been postulated in an attempt to attribute medically unexplained symptoms to particular infections."<a href="#cite_note-nejm-feder-2">[2]</a> Medical authorities agree with this viewpoint: the <a href="/wiki/Infectious_Diseases_Society_of_America" title="Infectious Diseases Society of America">Infectious Diseases Society of America</a> (IDSA), the <a href="/wiki/American_Academy_of_Neurology" title="American Academy of Neurology">American Academy of Neurology</a>, CDC, and the <a href="/wiki/National_Institutes_of_Health" title="National Institutes of Health">National Institutes of Health</a> (NIH), advise against long-term antibiotic treatment for people who identify as having chronic Lyme disease, given the lack of supporting evidence and the potential for harmful side-effects<a href="#cite_note-51">[51]</a> including toxicities.<a href="#cite_note-idsa_guideline-11">[11]</a><a href="#cite_note-pmid17522387-12">[12]</a><a href="#cite_note-nih-cld-13">[13]</a> A minority, primarily not medical practitioners, holds that chronic Lyme disease is responsible for a range of <a href="/wiki/Medically_unexplained_physical_symptoms" title="Medically unexplained physical symptoms">unexplained symptoms</a>, sometimes in people without any evidence of past infection.<a href="#cite_note-Ballantyne_2008-49">[49]</a> This viewpoint is promoted by many who have been told they have the condition by people who lack experience in science or medicine.<a href="#cite_note-Tonks-29">[29]</a> Groups, advocates, and the small number of physicians who support the concept of chronic Lyme disease have organized to lobby for recognition of this diagnosis, as well as to argue for insurance coverage of long-term antibiotic therapy, which most insurers deny, as it is at odds with the guidelines of major medical organizations.<a href="#cite_note-Ballantyne_2008-49">[49]</a><a href="#cite_note-forbes-52">[52]</a> Paul G. Auwaerter, director of infectious disease at <a href="/wiki/Johns_Hopkins_School_of_Medicine" title="Johns Hopkins School of Medicine">Johns Hopkins School of Medicine</a>, cited the political controversy and high emotions as contributing to a "poisonous atmosphere" around Lyme disease, which he believes has led to doctors trying to avoid having Lyme patients in their practices.<a href="#cite_note-amnews-53">[53]</a> <div class="mw-heading mw-heading3"><h3 id="IDSA_lawsuit">IDSA lawsuit</h3>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=5" title="Edit section: IDSA lawsuit">edit</a>]</div> In 2006, <a href="/wiki/Richard_Blumenthal" title="Richard Blumenthal">Richard Blumenthal</a>, the <a href="/wiki/Connecticut_Attorney_General" title="Connecticut Attorney General">Connecticut Attorney General</a>, opened an <a href="/wiki/Antitrust" class="mw-redirect" title="Antitrust">antitrust</a> investigation against the IDSA, accusing the IDSA Lyme disease panel of undisclosed <a href="/wiki/Conflict_of_interest" title="Conflict of interest">conflicts of interest</a> and of unduly dismissing alternative therapies and chronic Lyme disease. The investigation was closed on May 1, 2008, without charges when the IDSA agreed to submit to a review of its guidelines by a panel of independent scientists and physicians which would occur on July 30, 2009,<a href="#cite_note-amnews-53">[53]</a> citing mounting legal costs and the difficulty of presenting scientific arguments in a legal setting.<a href="#cite_note-cid-danger-54">[54]</a> According to the agreement with Blumenthal, the IDSA Lyme disease guidelines remained in place and unchallenged.<a href="#cite_note-idsa_2008-55">[55]</a> A <a href="/wiki/Forbes_(magazine)" class="mw-redirect" title="Forbes (magazine)">Forbes</a> piece described Blumenthal's investigation as "intimidation" of scientists by an elected official with close ties to Lyme advocacy groups.<a href="#cite_note-forbes-52">[52]</a> The <a href="/wiki/Journal_of_the_American_Medical_Association" class="mw-redirect" title="Journal of the American Medical Association">Journal of the American Medical Association</a> described the decision as an example of the "politicization of health policy" that went against the weight of scientific evidence and may have a <a href="/wiki/Chilling_effect_(term)" class="mw-redirect" title="Chilling effect (term)">chilling effect</a> on future decisions by medical associations.<a href="#cite_note-Kraemer_2009-56">[56]</a> The expert panel's review was published in 2010, with the independent doctors and scientists in the panel unanimously endorsing the guidelines, stating "No changes or revisions to the 2006 Lyme guidelines are necessary at this time", and concluding long-term antibiotic treatments are unproven and potentially dangerous.<a href="#cite_note-singer_2010-57">[57]</a> The IDSA welcomed the final report, stating that "Our number one concern is the patients we treat, and we're glad patients and their physicians now have additional reassurance that the guidelines are medically sound."<a href="#cite_note-idsa_besttreat_2010-58">[58]</a> <div class="mw-heading mw-heading3"><h3 id="Legal_mandates_to_cover_unproven_treatments">Legal mandates to cover unproven treatments</h3>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=6" title="Edit section: Legal mandates to cover unproven treatments">edit</a>]</div> The state of Connecticut, meanwhile, enacted a law on June 18, 2009, "to allow a licensed physician to prescribe, administer or dispense long-term antibiotics for a therapeutic purpose to a patient clinically diagnosed with Lyme disease."<a href="#cite_note-CT_law-59">[59]</a> The states of Rhode Island,<a href="#cite_note-RI_law-60">[60]</a> California,<a href="#cite_note-Providence-61">[61]</a> Massachusetts,<a href="#cite_note-Providence-61">[61]</a> New Hampshire,<a href="#cite_note-Providence-61">[61]</a> Vermont,<a href="#cite_note-Providence-61">[61]</a> New York,<a href="#cite_note-62">[62]</a> Maine,<a href="#cite_note-63">[63]</a> and Iowa<a href="#cite_note-64">[64]</a> have similar laws. Massachusetts (2016)<a href="#cite_note-65">[65]</a> and Rhode Island (2003)<a href="#cite_note-state.ri.us-66">[66]</a> have laws mandating insurance coverage for long-term antibiotic therapy for Lyme disease when deemed medically necessary by a physician.<a href="#cite_note-state.ri.us-66">[66]</a> In 1999 Connecticut had passed a similar, though somewhat more restrictive law.<a href="#cite_note-67">[67]</a> <div class="mw-heading mw-heading2"><h2 id="Harassment_of_researchers">Harassment of researchers</h2>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=7" title="Edit section: Harassment of researchers">edit</a>]</div> In 2001, <a href="/wiki/The_New_York_Times_Magazine" title="The New York Times Magazine">The New York Times Magazine</a> reported that <a href="/wiki/Allen_Steere" title="Allen Steere">Allen Steere</a>, chief of immunology and rheumatology at <a href="/wiki/Tufts_Medical_Center" title="Tufts Medical Center">Tufts Medical Center</a> and a co-discoverer and leading expert on Lyme disease, had been harassed, stalked, and threatened by patients and patient advocacy groups angry at his refusal to substantiate their diagnoses of "chronic" Lyme disease and endorse long-term antibiotic therapy.<a href="#cite_note-nyt-steere-68">[68]</a> Because this intimidation included <a href="/wiki/Death_threat" title="Death threat">death threats</a>, Steere was assigned security guards.<a href="#cite_note-uphill-69">[69]</a> <div class="mw-heading mw-heading2"><h2 id="Media">Media</h2>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=8" title="Edit section: Media">edit</a>]</div> A 2004 study in The Pediatric Infectious Disease Journal stated nine of nineteen Internet websites surveyed contained what were described as major inaccuracies. Websites described as providing inaccurate information included several with the word "lyme" in their domain name (e.g., lymenet.org), as well as the website of the International Lyme and Associated Diseases Society.<a href="#cite_note-pmid15626946-70">[70]</a> A 2007 article in <a href="/wiki/The_New_England_Journal_of_Medicine" title="The New England Journal of Medicine">The New England Journal of Medicine</a> argued media coverage of chronic Lyme disease ignored scientific evidence in favor of anecdotes and testimonials: <style data-mw-deduplicate="TemplateStyles:r1244412712">.mw-parser-output .templatequote{overflow:hidden;margin:1em 0;padding:0 32px}.mw-parser-output .templatequotecite{line-height:1.5em;text-align:left;margin-top:0}@media(min-width:500px){.mw-parser-output .templatequotecite{padding-left:1.6em}}</style><blockquote class="templatequote">The media frequently disregard complex scientific data in favor of testimonials about patients suffering from purported chronic Lyme disease and may even question the competence of clinicians who are reluctant to diagnose chronic Lyme disease ... [contributing] to a great deal of public confusion with little appreciation of the serious harm caused to many patients who have received a misdiagnosis and have been inappropriately treated.<a href="#cite_note-nejm-feder-2">[2]</a></blockquote> The 2008 documentary film <a href="/wiki/Under_Our_Skin" title="Under Our Skin">Under Our Skin: The Untold Story of Lyme Disease</a><a href="#cite_note-wapo_2008-71">[71]</a> is by a director whose sister self-identified with the condition.<a href="#cite_note-Ticked_Off-72">[72]</a> A columnist for <a href="/wiki/Entertainment_Weekly" title="Entertainment Weekly">Entertainment Weekly</a> wrote of the film: <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1244412712"><blockquote class="templatequote">[Under Our Skin] embraces, with bits and pieces of skimpy evidence and a whole lot more paranoid leftist fervor, the notion that "chronic Lyme disease" is a condition that the medical establishment is locked in a conspiracy to deny the existence of. The filmmakers actually bungle what should have been their real subject (that the belief in chronic Lyme disease has become something of a cult, one that can ruin the lives of the people who think they have it).<a href="#cite_note-73">[73]</a></blockquote> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=9" title="Edit section: See also">edit</a>]</div> <ul><li><a href="/wiki/List_of_diagnoses_characterized_as_pseudoscience" title="List of diagnoses characterized as pseudoscience">List of diagnoses characterized as pseudoscience</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=10" title="Edit section: References">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-bullying-1">^ <a href="#cite_ref-bullying_1-0">a</a> <a href="#cite_ref-bullying_1-1">b</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFAuwaerterMelia2012" class="citation journal cs1">Auwaerter, PG; Melia, MT (2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540629">"Bullying Borrelia: when the culture of science is under attack"</a>. 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Retrieved 19 December 2017.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Entertainment+Weekly&rft.atitle=Oscar+documentary+scandal%3A+The+real+reason+that+too+many+good+movies+got+left+out&rft.date=2009-11-20&rft.aulast=Gleiberman&rft.aufirst=Owen&rft_id=http%3A%2F%2Few.com%2Farticle%2F2009%2F11%2F20%2Foscar-documentary-scandal%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AChronic+Lyme+disease" class="Z3988"> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2>[<a href="/w/index.php?title=Chronic_Lyme_disease&action=edit&section=11" title="Edit section: External links">edit</a>]</div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDunning2020" class="citation web cs1"><a href="/wiki/Brian_Dunning_(author)" title="Brian Dunning (author)">Dunning, Brian</a> (March 10, 2020). <a rel="nofollow" class="external text" href="https://skeptoid.com/episodes/4718">"Skeptoid #718: Diagnosing Chronic Lyme Disease"</a>. <a href="/wiki/Brian_Dunning_(author)#Skeptoid_podcasts" title="Brian Dunning (author)">Skeptoid</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Skeptoid&rft.atitle=Skeptoid+%23718%3A+Diagnosing+Chronic+Lyme+Disease&rft.date=2020-03-10&rft.aulast=Dunning&rft.aufirst=Brian&rft_id=https%3A%2F%2Fskeptoid.com%2Fepisodes%2F4718&rfr_id=info%3Asid%2Fen.wikipedia.org%3AChronic+Lyme+disease" class="Z3988"></li></ul>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Chronic_Lyme_disease&oldid=1250071458">https://en.wikipedia.org/w/index.php?title=Chronic_Lyme_disease&oldid=1250071458</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a href="/wiki/Category:Medical_controversies" title="Category:Medical controversies">Medical controversies</a></li><li><a href="/wiki/Category:Alternative_diagnoses" title="Category:Alternative diagnoses">Alternative diagnoses</a></li><li><a href="/wiki/Category:Lyme_disease" title="Category:Lyme disease">Lyme disease</a></li><li><a href="/wiki/Category:Health_fraud" title="Category:Health fraud">Health fraud</a></li></ul></div><div id="mw-hidden-catlinks" class="mw-hidden-catlinks mw-hidden-cats-hidden">Hidden categories: <ul><li><a href="/wiki/Category:CS1_French-language_sources_(fr)" title="Category:CS1 French-language sources (fr)">CS1 French-language sources (fr)</a></li><li><a href="/wiki/Category:Articles_with_short_description" title="Category:Articles with short description">Articles with short description</a></li><li><a href="/wiki/Category:Short_description_is_different_from_Wikidata" title="Category:Short description is different from Wikidata">Short description is different from Wikidata</a></li><li><a href="/wiki/Category:Articles_with_alternative_medicine_infobox" title="Category:Articles with alternative medicine infobox">Articles with alternative medicine infobox</a></li></ul></div></div> </div> </main> </div> <div class="mw-footer-container"> <footer id="footer" class="mw-footer" > <ul id="footer-info"> <li id="footer-info-lastmod"> This page was last edited on 8 October 2024, at 09:37 (UTC).</li> <li id="footer-info-copyright">Text is available under the <a href="/wiki/Wikipedia:Text_of_the_Creative_Commons_Attribution-ShareAlike_4.0_International_License" title="Wikipedia:Text of the Creative Commons Attribution-ShareAlike 4.0 International License">Creative Commons Attribution-ShareAlike 4.0 License</a>; additional terms may apply. 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