When it comes to Lyme disease, there’s no universal experience.

Some people won't have any of the tick-borne infection's classic symptoms, which include a tell-tale rash, fever and fatigue.

Others may experience months or even years of arthritis, joint pain and other poorly understood complications that remain the subject of an ongoing medical debate.

Prompt testing and treatment is critical. Most cases can be effectively treated with two to four weeks of antibiotics, as recommended by medical guidelines.

But the landscape of Lyme offerings has become crowded with unapproved tests and alternative treatments, which can include lasers, herbal remedies and hyperbaric oxygen therapy. Interest in these “nonstandard” Lyme treatments has been amplified by influencers and a growing list of celebrities attributing various health problems to the disease, most recently Justin Timberlake.

Lyme experts say the risks to patients are twofold: They may spend hundreds or thousands of dollars on bogus tests, which aren’t covered by insurance, followed by unapproved treatments that may do more harm than good.

In a recent consensus report from the National Academies of Sciences, Engineering, and Medicine, Smith and other experts called for greater recognition and research into the chronic symptoms experienced by a subset of Lyme patients, including fatigue, brain fog and pain.

For decades, patients reporting so-called chronic Lyme were often dismissed by mainstream health professionals. But awareness of long COVID — which carries similar symptoms and is also poorly understood — has many experts reconsidering the long-term effects of Lyme.

The challenge of diagnosing it begins with the standard laboratory test, which comes with a number of caveats that must be carefully weighed.

The bacteria that causes Lyme, carried by certain ticks in the Northeast and Midwest, doesn’t circulate throughout the body. Often it stays in the skin near the tick bite, making it hard to detect.

Instead, Lyme tests look for antibodies, proteins that help fight off foreign invaders, which usually only appear in the blood several weeks after an infection.

That’s the best approach available, but experts acknowledge its shortcomings: If the test is given too early it will come back negative because antibodies haven’t yet appeared.

Also, these antibodies continue to circulate in the blood long after the infection. That means the test can return a positive result years or even decades later — making it difficult to distinguish between a new case and an old one.

Medical guidelines deal with this ambiguity by recommending doctors diagnose and start antibiotics in all patients who have the signature bull’s eye rash associated with Lyme. But as many as 30% of those infected never get the rash, causing further uncertainty.

The complexities of detecting Lyme have opened the door to an entire industry of alternative tests, ranging from over-the-counter kits to specialty laboratories.

The more expensive tests are often ordered by self-described “Lyme literate” physicians and health providers, who may have backgrounds in fields unrelated to infectious disease, like homeopathy.

Spotting unproven Lyme tests is relatively easy, since only antibody blood tests are approved by the Food and Drug Administration.

While the downsides of ineffective Lyme tests are considerable, experts say they are often the gateway to even riskier therapies.

A recent medical paper documented nearly 120 clinics across the U.S. offering unproven Lyme treatments, some with consultation fees as high as $3,000.

Treatments include electrical stimulation, “ozone-based therapy” and hyperbaric oxygen therapy, procedures that aren’t covered by insurance and can carry price tags as high as $6,000.

While antibiotics are effective for quickly killing Lyme bacteria, multiple large studies have shown no benefits to their long-term use for chronic Lyme symptoms.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.