eli5: what is the difference between chronic lyme disease and lyme disease? How can it be debilitating?
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Hi- this causes a lot of confusion.
It’s best to explain chronic Lyme disease (CLD) as a system of fake medicine, which is also often called quackery, pseudoscientific medicine, and health fraud.
It is a belief based on feelings that have been proven false.
Many systems of fake medicine think they have discovered the “[one true cause of all disease](https://sciencebasedmedicine.org/the-one-true-cause-of-all-disease/)”. For example:
* a popular fake medicine claims that “[toxins](https://en.wikipedia.org/wiki/Detoxification_(alternative_medicine))” are the cause of all problems.
* classical [chiropractic](https://en.wikipedia.org/wiki/Chiropractic) teaches that “subluxations” (which don’t exist) are the cause of all problems because they interfere with the magical “innate intelligence”
* Chinese medicine [claims](https://en.wikipedia.org/wiki/Traditional_Chinese_medicine) that qi (pronounced chee) energy flows along meridians, and that interferences or imbalances in the energy flow cause disease. Meridians and qi do not exist.
All of the above systems of fake medicine involve fake diagnostic criteria and fake solutions.
* For “toxins”, a fake urine test might be sold. And juices and supplements are often the fake treatment.
* Chiropractors are notorious for inappropriate X-rays, which that claim can reveal subluxations. Then they manipulate the spine, which they say can correct the subluxations.
* Chinese medicine uses [tongue](https://en.wikipedia.org/wiki/Tongue_diagnosis) and [pulse](https://en.wikipedia.org/wiki/Pulse_diagnosis) diagnosis. And acupuncture needles are used, supposedly to correct the flow of qi.
With CLD, Lyme is considered the cause of all of life’s problems. The believers in CLD are claimed to be “Lyme literate”. Just like only a chiropractor can detect subluxations, the “Lyme literate” practitioner is the only one who adherents believe can detect CLD and so-called “co-infections”.
The “Lyme literate” use fake diagnostic criteria (often with fake testing), facilitate fake diagnoses based on the fake diagnostic criteria, and then sell the fake treatments. Like all fake medicine, they provide feelings of hope and control, which perhaps are not provided by conventional medicine.
A major “innovation” of CLD fake medicine is the use of real drugs, including potentially harmful antibiotic regimens. This is similar to how real drugs like ivermectin and hydroxychloroquine are inappropriately used for COVID.
Besides inappropriate FDA-approved drugs, all manner of fake treatments are sold for CLD. The most popular are herbs, supplements, warming treatments like sauna, inappropriate diets, bee stinging, ozone, and homeopathy. (Here’s a [long list](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490322/))
If a treatment doesn’t work, the “Lyme literate” practitioner has many excuses:
* They claim feeling worse is a good thing. They say that it means the bacteria is dying.
* They claim that an undetected “co-infection” is causing problems. They then sell tests and treatments for a “co-infection”. They love to sell fake babesia, bartonella, mycoplasma, and “toxic mold” diagnoses, even though only babesia is a true but uncommon co-infection of Lyme.
* They claim that additional treatment at great cost and risk is needed (potentially over years)
* They claim that there is a conspiracy against them by mainstream medicine.
CLD is based on a real health problem (Lyme disease and its complications), which makes it difficult to understand what’s true and not true.
With [real Lyme](https://publications.aap.org/pediatricsinreview/article/35/12/500/32562/Borrelia-burgdorferi-Lyme-Disease), the bottom line is that:
* real Lyme disease is a readily curable infection with excellent outcomes,
* It is well-characterized and very geographically and seasonally restricted.
* In North America, if untreated for many months to 2 years, Lyme disease can cause [Lyme arthritis](https://www.cdc.gov/lyme/treatment/LymeArthritis.html), which is pain and swelling in one or a few large joints, typically a knee.
* Lyme arthritis is generally localized to the knee (or other large joint) and is not “all over”
* Lyme arthritis can last several years if untreated, but fades with time without antibiotics
* Lyme arthritis used to be frequently called “chronic Lyme arthritis” , when it was untreated or caused persistent symptoms after treatment. Because of confusion, this terminology is no longer used.
* Even if some symptoms persist after treatment, long-term antibiotics have not been found to be useful.
* There is an epidemic of falsely diagnosed Lyme disease, such that the most frequent reason for persistent symptoms is because Lyme wasn’t the cause in the first place. The assumption that persistent symptoms means persistent infection is not supported by evidence.
**references:**
[Chronic Lyme disease: Fake diagnosis, not fake disease](https://sciencebasedmedicine.org/fake-diagnoses-not-fake-diseases/)
[Dubious Alternative Lyme Treatments Are Killing Patients](https://www.bloomberg.com/news/features/2020-10-07/lyme-disease-dubious-alternative-treatments-are-killing-patients)
[What Happens When Lyme Disease Becomes an Identity?](https://www.thecut.com/2019/07/what-happens-when-lyme-disease-becomes-an-identity.html)
[Antiscience and ethical concerns associated with advocacy of Lyme disease](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489928/)
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