Yes, here we go again.
Chronic Lyme is (still) not a genuine medical diagnosis and people who think they suffer from chronic Lyme don’t really suffer from chronic Lyme. They (usually) do really suffer, though, and since most real doctors and medical organizations have standards and want to avoid lying and misinformation, they often struggle to help this group of people. And that, of course, provides a room for hucksters and opportunists, such as the group of conmen, conspiracy theorists and confused medical providers (it’s often hard to assign particular members to particular subcategories) known as Lyme-literate Doctors, people who have – probably for a variety of reasons – jumped in to offer these people recognition, affirmation, pseudoscience and costly nonsense. Such ‘Lyme-literate Doctors’ – they are fairly and even-handedly described here – are organized in the all-round frightening group International Lyme and Associated Disease (ILADS) to provide support and legal protection for whatever nonsense its members want to offer.
Richard Horowitz, MD, is an ILADS board member and scientific advisor and a patron to Lyme Disease Association of Australia. It’s notable that lyme isn’t even endemic to Australia; neither, for that matter, is Horowitz, who is medical director of the Hudson Valley Healing Arts Centre, an “integrative medical center which combines classical and complementary approaches in the treatment of Lyme Disease and other tick-borne disorders”. He is, however, a pretty central figure in the chronic Lyme movement, and has put in plenty of effort to spread the myth of chronic Lyme, e.g. through speaking tours and at least two books that have apparently helped popularize the nonsense and pseudoscience behind it, Why Can’t I Get Better? Solving the Mystery of Lyme and Chronic Disease (2013) and How Can I Get Better? An Action Plan for Treating Resistant Lyme and Chronic Disease (2017).
Horowitz claims to have treated more than 12,000 patients for chronic Lyme – or “Lyme-MSIDS” (‘multiple systemic infectious disease syndrome’), as he likes to call it. To diagnose them, he tends to use one of his own most influential contributions to Lyme pseudoscience, the Horowitz Lyme-MSIDS Questionnaire and similar symptom list; the questionnaire and symptom list have most emphatically not been validated for diagnostic purposes and are not useful for diagnosis if actually aligning with reality is part of one’s standards for usefulness. But according to Horowitz, most of his patients can be diagnosed with a range of associated tick-borne illnesses (Borrelia hermsii, Babesia, Bartonella, Mycoplasma, Chlamydia, Rocky Mountain spotted fever, Q-fever, Ehrlichia or Anaplasm), and he claims that MSIDS “involves not only the bacterial and parasitic infections mentioned above, but also associated viral and fungal infections, immune issues, inflammation, hormonal disorders, mitochondrial dysfunction, sleep disorders, environmental toxins with heavy metals, and detoxification problems”. Whatever fits his bill, in other words. To treat his patients, Horowitz doesn’t only use antibiotic therapy (“you can’t just blow up bugs”) but “[d]etoxification, hormone balancing, heavy metal removal and ramping up immune function”.
One thing that is worth noting, by the way, is how the mythology of chronic Lyme has influenced pseudoscientific nonsense involving ivermectin treatments during COVID (some details here).
Diagnosis: A serious threat to health, well-being and personal finances. And he has, apparently, a serious number of fans – like, seemingly, many of the figures we are currently covering. Things are not going well.



