From Lyme to ‘wi-fi allergy,’ these 4 medical mysteries often evade diagnosis

By Alpana Mohta, MD, DNB, FEADV, FIADVL, IFAAD | Fact-checked by Barbara Bekiesz

Published December 20, 2024

Key Takeaways

Patient Insights

"I purchased a big wifi router last year and started to get worse brain fog, especially when [I'm] near it. I swear I feel better when I turn it off." — Reddit user @explodedgiraffe
"I know Morgellons has a negative association with people calling it imaginary, but more and more people are getting diagnosed and have proof that it is real, just seems like it's very difficult to treat and most medical providers don't want to touch it." — Reddit user @tkt2rd

They come in with a stack of old lab results, a long list of vague symptoms, and stories of years spent bouncing from specialist to specialist—every clinician has seen such patients.

Those who don’t fit neatly into any diagnostic box. They may describe fatigue that doesn’t go away, pain that seems to migrate, skin sensations no one can explain. Their tests are "normal," yet they insist something is wrong. And maybe they’re right.

In a system designed to treat what we can measure, these patients often fall through the cracks. Let’s look at some of the most controversial conditions that continue to stump even experienced doctors.

Chronic Lyme disease (CLD)

Lyme disease is a tick-borne illness caused by Borrelia burgdorferi. However, CLD is hotly debated. While early Lyme can be confirmed with tests and treated effectively, CLD refers to persistent symptoms like fatigue, joint pain, and cognitive issues lasting months to years after treatment.

Mainstream medical societies, like the Infectious Diseases Society of America (IDSA), assert there’s no evidence of ongoing infection after standard antibiotic treatment. Yet, the International Lyme and Associated Diseases Society (ILADS) argues that the infection persists in a low-grade, chronic form and should be treated with long-term antibiotics.^[]

Some in-vitro animal and human models suggest B. burgdorferi can survive antibiotic exposure. Furthermore, a report from mBio suggests using extended or combination therapies with drugs like doxycycline, ceftriaxone, daptomycin, cefoperazone, azlocillin, and vancomycin to target chronic infection due to persistent and biofilm-associated forms of B. burgdorferi.^[]

Morgellons disease

Morgellons disease (MD) is one of the most controversial conditions, with the medical community divided on its existence. As discussed in Clinics in Dermatology, it is characterized by unusual skin sensations (itching, crawling) and the presence of thread-like fibers under or emerging from the skin.^[]

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Patients report extreme discomfort, often leading to self-harm, like eye damage or even amputations, in attempts to extract these fibers.

MD, first reported in 1674, got mainstream attention in 2002 after lab technician Mary Leitao reported fibers emerging from her son’s skin. Believing it infectious, she founded the Morgellons Research Foundation, linking it with Lyme disease and drawing media attention—and even CDC involvement.

However, a majority of the scientific community labels this as a delusional parasitosis, a psychiatric condition where patients falsely believe they are infested with parasites. A CDC study found that many patients suffering from MD, mostly women around age 55, had underlying mental health issues. The fibers were often identified as cotton or skin proteins like keratin, and they were not infection-related.

Despite this, some patients believe it’s infectious, fueled by online forums, media, and antibiotic responses. MD has even been referred to as a “socially transmitted disease over the internet.”^[]

Multiple chemical sensitivity (MCS)

MCS, or idiopathic environmental intolerance (IEI), involves hypersensitivity to common chemicals such as fragrances, cleaning products, pesticides, and smoke. Symptoms are broad and may include headaches, fatigue, upper respiratory distress, and cognitive dysfunction.^[]

Many clinicians view MCS as a psychosomatic condition or a form of panic or post-traumatic stress disorder, owing to the lack of consistent physiological markers.

However, multiple biological theories argue that even small doses of such chemical exposures can trigger neurological and immune responses in susceptible individuals.

A 2022 report from the Journal of Occupational Health noted that nearly one-fifth of patients with migraine had MCS, and these patients had higher rates of visual aura, photophobia, sensory aura, osmophobia, and central sensitization.^[]

Electromagnetic hypersensitivity (EHS)

EHS, the condition famously depicted by Chuck McGill in “Better Call Saul,” involves a variety of non-specific symptoms such as sleep disturbances, fatigue, cognitive impairment, headaches, dizziness, skin symptoms, and mood disorders. The patient links all these symptoms to electromagnetic fields (EMF) from devices in close proximity, like cell phones, wi-fi routers, and power lines.^[]^[]

The term "EHS" emerged in the 1980s; the condition was initially called “microwave syndrome” in Sweden. Its prevalence varies globally, with reports suggesting 1%–10% of the population experiencing EMF sensitivity. To cope, some patients avoid electronic devices and public spaces or even go so far as wearing EMF-shielding materials or isolating themselves in remote locations.

Despite patient claims, most clinical studies find no objective evidence of EMF as the cause.

The WHO recommends classifying EHS as "Idiopathic Environmental Intolerance," implying an unclear origin. Theories about EHS origins are divided: some suggest EMF exposure; others see it as a response to beliefs about EMF or a coping mechanism for unrelated health issues. Despite the debate, the biological impacts of EMF, like oxidative stress and neurological effects, are documented, but whether these cause EHS remains unconfirmed.

What this means for you

For conditions such as these four, which the medical community views skeptically, validate patient symptoms, but avoid over-testing. In chronic Lyme cases with persistent symptoms post-antibiotics, evaluate immune dysfunction before extending treatment. For psychosomatic conditions like Morgellons, MCS, or EHS—whether self-diagnosed or labeled by alternative sources—consider prompt referral to psychiatry, psychology, and neurology.