Schutzer, S E, Natelson, B H · Neurology · 1999 · DOI
This study tested whether people with ME/CFS have signs of Lyme disease infection in their blood. Researchers compared 39 ME/CFS patients to 40 healthy people using a specialized test that looks for Borrelia burgdorferi, the bacterium that causes Lyme disease. None of the patients or controls showed signs of this infection, suggesting that Lyme disease is not the hidden cause of ME/CFS in people without typical Lyme disease symptoms like the characteristic rash or joint problems.
ME/CFS and Lyme disease can present with overlapping symptoms like fatigue and cognitive difficulties, raising concerns that undiagnosed Lyme disease might explain some ME/CFS cases. This study provides evidence that at least in patients without typical Lyme disease warning signs, Borrelia burgdorferi infection is not a hidden cause, helping to clarify the distinction between these conditions and redirect diagnostic efforts.
This study does not prove that Lyme disease never co-occurs with ME/CFS, nor does it rule out Bb infection in patients who do have Lyme disease symptoms. It also does not establish whether other infectious agents might contribute to ME/CFS development, nor does it address whether past, resolved Lyme disease could trigger lasting post-infectious fatigue.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Schutzer, S E & Natelson, B H (1999). Absence of Borrelia burgdorferi-specific immune complexes in chronic fatigue syndrome.. Neurology. https://doi.org/10.1212/wnl.53.6.1340
BibTeX
@article{mecfsatlas-schutzer-1999-absence-borrelia,
author = {Schutzer, S E and Natelson, B H},
title = {Absence of Borrelia burgdorferi-specific immune complexes in chronic fatigue syndrome.},
journal = {Neurology},
year = {1999},
doi = {10.1212/wnl.53.6.1340},
note = {PubMed: 10522896},
url = {https://www.mecfsatlas.com/evidence/schutzer-1999-absence-borrelia},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/schutzer-1999-absence-borrelia
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