Just wondering though, Lyme and ME aren't the same thing, right? Or do they both start with a Bb infection?
Technically, they are different. But it gets complicated very quickly. Did you know, for instance, there is something called Lyme Encephalomyelitis?
But Lyme is a disease whose etiology we - on paper - should always know. It is caused by a spirochete. End of story.
The cause of ME is still hotly debated.
There are symptom differences, too, although not nearly as many as some imagine. For instance, swollen knees are common in Lyme, not so common in ME. PEM is a hallmark of ME; it seems most people with Lyme never heard of the term.
Perhaps Lyme is a trigger, like an enterovirus or HHV. Or perhaps it creates at times a symptom cluster that approaches ME. For some, Lyme and ME can occur as co-morbid diseases.