[henearkr]

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.

[KraftKacke]

I don't think that's a very scientific approach as a vaccine may have other effects on the symptoms.

Finding lingering bacteria would be the right call. Autopsy or biopsy. And then get better testing, less "false positive".

With no specific (set of) symptoms, symptom based evidence seems inherently weak.

[atian]

Bacteria is latent. CFS is not not strep throat. Generally body-wide immune dysfunction is present.

https://pubmed.ncbi.nlm.nih.gov/19393200/

[monopoledance]

Yes, but we're interested in the _causal relationship aren't we?

I don't see how the linked article contributes to your argument.

Tho, it's an interesting read and a warning to those supplementing vitamin D like it's the solution to everything.

[henearkr]

This potential role of vitamin D is very exciting!

[monopoledance]

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":

https://en.wikipedia.org/wiki/Antagonistic_pleiotropy_hypoth...

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!

[henearkr]

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.

[monopoledance]

But they argue, it will make things worse and promote bacterial spread and growth...

They say the VD supplementation is comparable to steroid treatment. I don't see what's to be enthusiastic about, tbh.

[OskarS]

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.

[henearkr]

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.

[OskarS]

> 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.

[henearkr]

Sorry if I was a wee bit harsh in my comment.

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.