So they are already ruling out part of the population with persistent lyme in which additional antibiotics could help, those with underlying medical conditions. And yes I agree with you, because the co-infection testing is so piss poor how do you really know you've even ruled out all those folks? You treat the lyme, but not the co-infections of course they are not going to report improvement, they're still sick! Pulling one nail out of ten isn't going to show you much improvement.Martian wrote:Subjects with "multiple issues and co-infections, not just Lyme" were excluded from the study:
Some of the exclusion criteria are:
However, I don't think they have (extensively) checked for possible tick bite co-infections, at least not all, let alone other diseases and issues. So, some subjects may have had an unknown comorbidity, but do you want to suggest all of them had? If so, why would you think so?
- Subjects with a known diagnosis of HIV-seropositivity or other immune disorders. (No HIV serologic testing is required for the study).
- Subjects with positive syphilis serology or signs of other spirochetal diseases.
- Subjects with moderate or severe liver disease defined as alkaline phosphatase, ALAT, or ASAT greater than 3 times upper limit of normal.
- Severe physical or psychiatric co-morbidity that interferes with participation in the study protocol, including previous medical diagnosis of rheumatic conditions, chronic fatigue syndrome or chronic pain conditions as well as insufficient command of the Dutch language.
- Co-morbidity that could (partially) account for the symptoms of the subject (e.g. vitamin B12 deficiency, anemia, hypothyroidism).
By definition they have chosen a very select group of individuals who have already failed probably many of the standard lyme treatments, so why are we expecting a simple solution to suddenly help? My personal opinion is that the reality of persistent lyme has many shades of gray. Will additional antibiotics help some of the CL population, yes. Is it going to help everyone, no? Do we need individualized treatment and through investigation for every patient? Yes. Trying to treat everyone the same with these types of cases does not work.
I'm not really sure how useful this study is, when they're already ruling out parts of the persistent lyme population. Can't we have a study that encompasses ALL persistent lyme patients? Then we could study them as whole and see if we can find subpopulations to target, like untreated co-infections, immune disorders, permanent damage, autoimmune issues, etc. And then see if we can start tailoring therapy to some of these subpopulations.