[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.