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Some people claim that lyme disease can last for months or even years, and that they require long term medical treatment (usually antibiotics).

Is there any medical evidence for this? Or is it snake oil?

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Could you please link to a notable source for this claim and explain why are you skeptical of it? A quick look on Wikipedia already answers the question with references (yes, it can last years). –  nico Jan 10 '13 at 19:51
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Lyme symptoms can definitely last years without treatment. My understanding is that "Chronic Lyme Disease" is a type of lyme where people believe they need extended treatments as the disease persists beyond what conventional medicine believes. Here is an article from the New England Journal of Medicine: nejm.org/doi/full/10.1056/NEJMra072023 –  windfinder Jan 10 '13 at 20:13
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Lyme disease is a popular disease for fraudulent doctors and hypochondriacs, its sounds exotic and is pretty hard to actually get for most people in the U.S. The article you linked to practically says its a fake disease. –  Ryathal Jan 11 '13 at 14:37
    
There is a lot of back and forth on this. movies.nytimes.com/2009/06/19/movies/19under.html It doesn't seem so clear cut to me. –  windfinder Jan 11 '13 at 14:51
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@Stefan - He clearly means "Chronic Lyme" is fake, not that Lyme Disease itself is fake... >.< –  windfinder Jan 17 '13 at 15:38
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Chronic Lyme disease or also the Post-Lyme disease syndrome is regarded the third and last stage following an infection with Borrelia burgdorferi bacteria [1], usually acquired through tick bites. No, @Ryathal, it is NOT hard to get Lyme disease, especially not if you're in New England (incidence is over 30 in 100,000 in New England according to the CDC, around 8 for all of the US).

If you want to read up on Lyme disease, the Wikipedia Article is well written and documented, so I'm only going to address the original question:

Late-stage Lyme disease usually occurs months after the bite in unsuccessfully treated patients. It may cause symptoms such as arthritis, neurologic symptoms or even encephalitis, from mild to very severe [2].

What may have caused your hoax thought is that in some patients with chronic Lyme the Borrelia bacteria are undetectable, meaning neither live bacteria, nor antibodies against Borrelia antigens nor Borrelia DNA (via PCR) can be found. This means that there may be no hard evidence that Borrelia bacteria are still in the body, which is called lack of a biologic marker.

There have been a lot of studies about this issue, you can find a lengthy review of references in [3] (here), I'm not going to list them here again.

To synthesize (and no, I'm not an expert in this matter), the symptoms of the Post-Lyme disease are very real and occur in a few percent of Lyme disease patients. There is some uncertainty because in some patients it may be impossible to detect Borrelia or Borrelia markers, which has lead to numerous studies and the proposal of naming the condition Post-Lyme disease syndrome, acknowledging that the symptoms follow a Lyme disease even if the Borrelia are no longer detectable [3], this section specifically. As you can glance from this extensive presentation not everyone is happy with that name, however, because there is a lot of evidence pointing to a connection to Borrelia.

  1. Ryan KJ; Ray CG, ed. (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 434–37. ISBN 0-8385-8529-9.
  2. Nau R, Christen HJ, Eiffert H. Dtsch Arztebl Int. 2009 Jan;106(5):72-81; PMID 19562015
  3. Wormser GP et al. Clin Infect Dis. 2006 Nov 1;43(9):1089-134. Epub 2006 Oct 2. PMID 17029130
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Ineresting slideshow/research regarding the above topic. I am a chronic lyme sufferer. Until and unless one is afflicted, one can not comprehend the breadth and severity of symptoms, and the desperate measures as to attempts to find successful treatment methods. Those who do not experience the pain and disabling factors should refrain from making absolute statements.

http://www.ilads.org/lyme_research/chronic_lyme.html

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We're looking for long answers that provide some explanation and context. Don't just give a one-line answer; explain why your answer is right, ideally with citations. Answers that don't include explanations may be removed.

    
I don't think the contention is that the symptoms are faked, but that the cause isn't lyme disease. Unfortunately that slide show is beyond my knowledge of biology, so someone else will have to critique it. –  windfinder Jan 16 '13 at 19:10
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By the same argument, male gynaecologists should refrain from speaking about childbirth. That is a fallacy known as "special pleading". (p.s.: I hope you get some relief soon.) –  Oddthinking Jan 16 '13 at 21:44
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Lyme disease to begin with is not one disease agent but many infective agents that the individual has been exposed to. The disease is a man-made culprit that I will not get into the details of in this post. There are at least 7 infections that can be a factor of the exposure in lyme disease most bacterial in nature but they are also now finding in scientific studies of this disease that there is a viral element to it as well. Yes, this absolutely can be a chronic condition. Yes it absolutely is a REAL condition. Yes, it absolutely can debilitate and kill those who get it. It may not need to have become a chronic illness if there were not a political nature to the origin of it that keeps them from being honest about what all components of infection are bundled into this disorder. Piece by piece we are scientifically getting to the bottom of that question. The chronic comes in due to doctors only knowing a piece of the illness and only treating for that bacteria. if treated for ALL infectious conditions appropriately it is possible to get your life back from a chronic Lyme condition state. It is not an easy road but one exists. My concern is however, that we may still not be in the know of all the infectious agents that were applied to create this condition.

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Welcome to Skeptics! We require references for all significant claims here. Please edit your answer to include appropriate references. –  Fabian Jan 16 '13 at 17:24
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