LACK OF EVIDENCE

01.21.15 10:55 AM ET

Real Housewife, Fake Disease

‘Chronic Lyme disease’ is a controversial diagnosis with no scientific backing, no matter how much celebrity attention it gets.

Let’s get the disclaimers out of the way.

I have never seen an episode of The Real Housewives of Beverly Hills. My one brief viewing experience of any Real Housewives program left me awash in perplexity, and didn’t whet my appetite for a second helping of the franchise. For that reason, I had (until very recently) never heard of Yolanda Foster, a member of the Beverly Hills cast.

More particularly, she is not a patient of mine—that should probably go without saying, as I am a pediatrician in New England and she’s a full-grown woman in California. Unlike some prominent doctors, I am reluctant to make diagnoses of patients I have never examined. I don’t know what she is suffering from, and I have no reason to doubt that she is truly suffering from something.

But with all that said, I have grave concerns that she’s getting treated for a condition that doesn’t really exist.

As reported by People, Foster has written a blog post about her struggles with chronic Lyme disease. Reportedly diagnosed with Lyme a few years ago, she complains of ongoing, relapsing neurological symptoms that leave her unable to write, think, or watch her own show.

“Lyme Neuroborreliosis is a spirochete infection in the brain that can leave one with severe brain impairment and neurological issues,” she writes. “I have lost the ability to read, write, or even watch TV, because I can’t process information or any stimulation for that matter. It feels like someone came in and confiscated my brain and tied my hands behind my back to just watch and see life go by without me participating in it.”

I am genuinely sorry for Foster, and the very last thing I have any intention of doing is make light of her pain. Her Instagram account is loaded with pictures of her receiving medical treatments of some sort or another, and whatever skepticism I may have about her diagnosis doesn’t in any way extend to her distress. Whatever the cause, I wish her nothing but a full recovery.

However, there simply is no good evidence that chronic Lyme disease is an actual medical condition. As I have written before, while some patients may experience symptoms after appropriate treatment for Lyme,  treatment for persistent or recurrent infection has no grounding in legitimate medical science. On this point the Centers for Disease Control, the National Institutes of Health, and the Infectious Diseases Society of America are all agreed.

There are clues that Foster has been receiving erroneous treatment within her blog post itself. She writes of starting out with “conventional long-term antibiotics,” which has the ring of probity to it, certainly when compared to the “holistic protocol[s]” and “ancient therapies” to which she makes reference elsewhere. But long-term treatment with antibiotics is itself a false remedy for Lyme disease and the sign of a faux diagnosis. (Requests to Foster’s representatives for comment regarding her illness and therapies were not met by deadline.)

As an IDSA special review panel found in 2006, short-term antibiotic treatment is the best treatment for patients who truly have Lyme disease. In their words, long-term treatment (especially given intravenously, as Foster’s pictures seem to indicate she is receiving) is “unproven and unwarranted.” If that was the therapy recommended when the diagnosis was initially made, that alone is reason to question it.

I say all of this knowing full well that by doing so I am opening the floodgates for all manner of intensely vitriolic commentary. I do not exaggerate when I say that no medical issue—including the bogus link between vaccines and autism—generates such a vociferous response from those who believe in it, as does chronic Lyme. Foster’s shoutouts to her fellow “Lymies” fill me with dread, as those very same Lymies are almost certainly going to be calling for my head on a pike.

But no matter how strident the objection, it remains important to question the chronic Lyme diagnosis. From what I gather via Instagram, Foster has the means to pursue treatments in as far-flung a locale as Singapore. Others who succumb to the predations of providers who peddle medical chicanery under the guise of treating a condition despite evidence to the contrary may not be so lucky. By promulgating Foster’s claims about her illness without question, People magazine and outlets like it underline the ersatz legitimacy of practitioners who take advantage of credulous patients.

Whatever the source of Foster’s problems, I hope she finds her way to a medical provider who can address it properly. I have serious qualms about the people to whom she has turned for help, but that doesn’t mean I wish her anything but well. Yet I believe she is being taken for a very expensive ride, and one that nobody else should join her on. Chronic Lyme disease has no grounding in science, and no amount of celebrity attention can alter that fact.