Samuel, Shor, MD, FACP, past president, International Lyme and Associated Diseases Society, discusses the potential link between chronic fatigue syndrome and Lyme disease.
Interview Transcript (modified slightly for readability):
“To begin with, chronic fatigue syndrome is a diagnosis of exclusion, which means that you have to rule out other causes of chronic fatigue, whether it be hepatitis, hypothyroid, etc. There are no markers for chronic fatigue syndrome per se. Lyme disease is a potential cause of chronic fatigue and there is no test that can absolutely rule out chronic Lyme disease.
I published a paper in 2011 in an attempt to evaluate my patients who were presenting with a complex myriad of symptoms including chronic fatigue, fractured non-restorative sleep, autonomic blood pressure problems, chronic pain, [and] cognitive impairment. In an attempt to better evaluate and treat them, I made a connection with the potential that some of them may have Lyme disease.
I ultimately did a study that involved 210 patients who fulfilled international case definition for chronic fatigue syndrome—which is chronically fatigued for at least 6 months, to a degree of functionality less than 50% of where one is before they were ill—such that other causes of chronic fatigue have been ruled out.
Of those 210 [patients], I then looked for markers for Lyme disease and other markers such as highly specific proteins that are related to Lyme disease infection. Of the 210 that were all blood test-negative for Lyme disease using standard 2 tier systems, 209, or 99% of them, I thought potentially could have been exposed to the Borrelia or Lyme bacteria.
I then treated them cautiously, carefully, and after following them for a period of time, 62% had a statistically significant improvement using antibiotics. Another 26% said that they felt better, they just didn’t achieve statistical significance of 0.0002 p-value, which is very statistically significant. I argue from that 2011 paper, that anywhere from 62% to 88% of my diagnosed chronic fatigue syndrome patients actually had blood test negative Lyme disease.”