Right, good, but I was asking about Lyme testing. If you are going to point out limitations to Lyme testing, do you offer alternatives to those you try to dissuade from a given test, and do you qualify that gold standard with appropriate limitations?I'm consistent about not recommending patients use testing that lacks any good evidence of value. I also try to be clear about the limited value of an ME/CFS diagnosis. There is no reliable objective test that we can be confident distinguishes those who have ME/CFS from those who do not, and I expect that within the ME/CFS diagnosis there will be groups of people suffering from different causes of ill-health. Also, while a diagnosis of ME/CFS can be of value when accurately applied, there certainly are prejudices associated with it which mean that some patients might be better of without any diagnosis for the time being, even though that can bring its own difficulties
I do not wish to belabor this. I just find it hard to take a high ground when it comes to Lyme diagnostics OR treatment, as I find it all dangerously unreliable. I mean, I will make recommendations, but for me to say cytokine profiling, for instance, is quackery, I wouldn't presume to know this. I have seen shoddy validation efforts, and I am left trusting very very few, including so-called conventional TBD metrics which come with their own purported issues.