Bella Hadid's Lyme diagnosis spotlights new—and controversial—treatments patients are chasing
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Some people can have persistent symptoms such as fatigue, pain, sleep problems, depressed mood, and clouded thinking that go beyond six months. Unfortunately, we don’t yet understand the mechanism why this occurs, and do not have a clear pathway.
—Paul Auwaerter, MD, infectious diseases physician
Supermodel Bella Hadid has been quite open about her long struggle with Lyme disease—she was diagnosed in 2013, but her symptoms reportedly started years earlier, and included neurological complaints, fatigue, joint pain, and brain fog. []
Recently, Hadid was hospitalized again, and her mother, Yolanda Hadid, described the disease as a “silent struggle” —“an invisible disability” with “an unknown hell” of repeated flare-ups and treatment setbacks in a recent Instagram post. []
For many in medicine, her case underscores the tension between what patients experience (persistent, sometimes debilitating symptoms) and what the clinical evidence strongly does or does not support.
What the literature says: Definitions, scope, and controversies
PTLDS vs Chronic Lyme Disease
The term Post-Treatment Lyme Disease Syndrome (PTLDS) refers to patients who have had well-defined or probable Lyme disease, have been treated with standard antibiotic regimens, and after treatment continue to experience symptoms (fatigue, musculoskeletal pain, cognitive difficulties) for at least six months. []
“Chronic Lyme” is more controversial: There is no uniform diagnostic definition, and some providers use that term to include ongoing infection, co-infections, immune-dysregulation, or even non-specific symptom complexes. Because of this lack of definition, there is disagreement in the ID/infectious disease community over how to categorize, treat, or even study these patients. []
“Some people can have persistent symptoms such as fatigue, pain, sleep problems, depressed mood, and clouded thinking that go beyond six months. Unfortunately, we don’t yet understand the mechanism why this occurs, and do not have a clear pathway,” infectious diseases physician Paul Auwaerter, MD, said in an AMA report. “It’s individualized treatment according to predominating symptoms, but additional antibiotics we know don’t benefit patients at this point.” []
Prevalence of persistent symptoms
Estimates vary: One recent study found about 14% of patients treated early can go on to have lingering symptoms. []
Other sources put it somewhat lower, closer to 10%—noting it depends a lot on how "lingering symptoms" are defined, how early treatment occurred, and what symptoms are included. []
Diagnostic challenges
Modified two-tier testing (e.g., two ELISAs rather than ELISA + Western blot) is being explored as more sensitive/specific; FDA recommends only cleared tests, and warning has been issued about unreliable or non-cleared labs. []
Brain fog, cognitive deficits, neurologic symptoms are harder to pin to active infection vs immune sequelae vs other comorbid conditions. Many trials are now explicitly focusing on cognitive outcomes. []
Emerging and experimental therapies
Below are some of the most current lines of investigation—some preclinical, some early phase, others still speculative—that may be asked about by patients.
1. Experimental and emerging treatments for Lyme Disease
Neoantibiotics are among the most promising breakthroughs. Specifically, piperacillin, a penicillin-class antibiotic, has shown strong efficacy in mice models—clearing Borrelia burgdorferi infections at doses 100 times lower than conventional doxycycline and without disrupting the gut microbiome. []
Developed by Northwestern University researchers, this drug interferes with B. burgdorferi's unique cell wall synthesis mechanism.
2. Neurostimulation for cognitive symptoms
A pilot study at UCSF is investigating the use of transcranial direct current stimulation (tDCS) combined with computerized cognitive training for patients with lingering “brain fog” after Lyme treatment. []
This 12-week randomized trial (started July 2025) pairs daily 30-minute home sessions of adaptive training with either active or sham stimulation, aiming to enhance information processing speed and assess whether effects persist after treatment ends.
3. Autonomic modulation: Vagus nerve stimulation
An allied trial at Columbia University examines vagus nerve stimulation as a non-pharmaceutical option for alleviating fatigue, pain, and autonomic dysfunction in PTLDS. []
Scores of patients complain of dysautonomia-linked symptoms, and this study may be among the first to examine it systematically in Lyme patients.
4. Future vaccine
Valneva and Pfizer are completing a Phase 3 vaccine trial targeting Borrelia Outer Surface Protein A (OspA). []
A complementary strategy includes recent development of oral medications to kill ticks before they bite, using new formulations of lotilaner from Tarsus Pharmaceuticals. []
What physicians should keep in mind when patients ask for experimental therapies
Listen carefully to the patient’s history: Timing of symptom onset, prior treatments, objective findings (labs, imaging), impact on functional status.
Be clear about which aspects of Lyme/PTLDS are well supported by evidence, which remain speculative.
Discuss the risk/benefit ratio explicitly. For experimental therapies (e.g., new antibiotic regimens, non-pharmacologic neurostimulation), make sure the patient understands what is known and unknown.
Consider referral to centers conducting formal clinical trials, so patients can access experimental therapies within a structured, monitored, and ethical framework.
Monitor for adverse effects rigorously, especially when using high doses, IV antibiotics, or prolonged therapy.
Focus also on symptom management: Pain control, rehabilitation, cognitive support, mental health—these may offer the greatest immediate clinical benefit even when etiologic treatments are uncertain.