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Why Can't I Get Better? Solving the Mystery of Lyme and Chronic Disease: Solving the Mystery of Lyme and Chronic Disease

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From one of the country's foremost doctors comes a ground-breaking book about diagnosing, treating and healing Lyme, and peeling away the layers that lead to chronic disease.

You may not know that you have Lyme. It can mimic every disease process including Chronic Fatigue Syndrome, Fibromyalgia, autoimmune conditions like MS, psychiatric conditions like depression and anxiety, and cause significant memory and concentration problems, mimicking early dementia. It is called the “Great Imitator,” and inaccurate testing—combined with a fierce, ongoing debate that questions chronic infection—makes it difficult for sufferers to find effective care.

When Dr. Richard Horowitz moved to the Hudson Valley over two decades ago to start his own medical practice, he had no idea that he was jumping into a hotbed of Lyme disease. He would soon realize that many of the chronic disease diagnoses people were receiving were also the result of Lyme—and he would discover how once-treatable infections, in the absence of timely intervention, could cause dis­abling conditions. In a field where the number of cases is growing exponentially around the world and answers remain elusive, Dr. Horowitz has treated over 12,000 patients and made extraordinary progress. His plan represents a crucial paradigm shift, without which the suffering will continue.

In this book, Dr. Horowitz:

• Breaks new ground with a 16 Point Differential Diagnostic Map, the basis for his revolutionary Lyme treatment plan, and an overarching approach to treating all chronic illness.

• Introduces MSIDS, or Multiple Systemic Infectious Disease Syndrome, a new lens on chronic illness that may prove to be an important missing link.

• Covers in detail Lyme’s leading symptoms and co-infections, including immune dysfunction, sleep disorders, chronic pain and neurodegenerative disorders – pro­viding a unique functional and integrative health care model, based on the most up-to-date scientific research, for physicians and health care providers to effectively treat Lyme and other chronic illnesses.

Cutting through the frustration, misinformation and endless questions, Dr. Horowitz’s enlightening story of medical discovery, science and politics is an all-in-one source for patients of chronic illness to identify their own symptoms and work with their doctors for the best possible treatment outcome.

544 pages, Hardcover

First published September 3, 2013

166 people are currently reading
894 people want to read

About the author

Richard I. Horowitz

9 books33 followers
Dr. Richard Horowitz is a board-certified internist and the medical director of the Hudson Valley Healing Arts Center, an integrative medical center which combines both classical and complementary approaches in the treatment of Lyme disease and other tick-borne disorders. He has treated over 13,000 Lyme and tick-borne disease patients in the last 30 years, with patients coming from all over the US, Canada, and Europe to his clinic. He is former Assistant Director of Medicine of Vassar Brothers Hospital in Poughkeepsie, N.Y., and is one of the founding members and past president elect of ILADS, the International Lyme and Associated Diseases Society. He is also past president of the ILADEF, the International Lyme and Associated Diseases Educational Foundation, a non-profit organization dedicated to the education of health care professionals on tick-borne diseases. Dr Horowitz has trained over 200 healthcare providers in diagnosing and caring for patients with treatment-resistant tick-borne disorders and was previously awarded the Humanitarian of the Year award by the Turn the Corner Foundation as well as awards from Project Lyme for his treatment of Lyme Disease. He has dedicated his life to helping those stricken with this devastating illness.

He is also the author of two best-selling books on Lyme disease, Why Can’t I Get Better? Solving the Mystery of Lyme and Chronic Disease (2013, St Martin's Press, NY Times Best Seller), and How Can I Get Better? An Action Plan for Treating Resistant Lyme and Chronic Disease (2017, St Martin's Press, National bestseller). These books incorporate recent scientific advances and explain in detail how healthcare providers can effectively diagnose and treat resistant chronic illness. In addition, he has co-authored peer-reviewed Lyme guidelines, and published in the medical literature on novel “persister” drugs for the treatment of Lyme disease and coinfections, as well as the role of the 16-point MSIDS model in chronic illness.

Other projects include Dr Horowitz serving as a consultant to governmental agencies around the world, including those in China, Australia, Belgium, France, the United Kingdom, and the United States. Dr Horowitz was a member of the HHS Tick-borne Disease Working Group and Co-chair of the “Other Tick-borne Diseases and Coinfections” subcommittee from 2017-2019 which provided recommendations to Congress to help the US improve the care of those suffering with tick-borne disorders. He recently served as a member of the HHS Babesia and Tick-borne Pathogen Subcommittee and was elected by Governor Cuomo to serve as a member of the NYS DOH Tick-borne disease Working Group in 2021.

Finally, Dr Horowitz recently published several scientific articles on classical and integrative solutions for COVID-19 which have been effective in helping those with acute and chronic illness, and he will be releasing his first novel, Starseed R/evolution, ‘The Awakening’ a cli-fi (science fiction/climate change) novel in the Fall of 2021, which will provide novel, potential solutions to our present climate crisis.

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Displaying 1 - 30 of 46 reviews
Profile Image for Darcia Helle.
Author 30 books731 followers
December 26, 2013
First, I want to emphasize that this is not easy reading material. While, Dr. Horowitz does his best to break the information down into easy to understand chunks, the content is comprehensive and highly scientific. For the average person, this is the type of book requiring time and concentration. For those in the medical profession, this is an absolute must read.

I've had a lifetime of health problems and have a list of diagnoses containing words like 'chronic' and 'idiopathic'. Finally, five years ago, I was diagnosed with chronic, late-stage Lyme disease. Even with that knowledge, my doctors have been at a loss as to how to help me. Various treatments have buried me financially while doing very little (if anything) to improve my health. This book explains everything I've gone through, connecting all the seemingly random symptoms and complications I've experienced throughout the years.

Unfortunately, traveling to see Dr. Horowitz for treatment isn't an option for me at this time. Also, the average person simply cannot afford all the recommended supplements and medications. Many of us who have faced years of chronic health problems will not be able to afford his recommended protocol, particularly since insurance companies are given so much power in deciding what we do and do not need for treatment. I am lucky to have a doctor who is totally open to alternative treatments, and I plan to bring her this book. With luck, we'll happen about the right combination of treatment and affordability.

Dr. Horowitz offers tremendous insight into many chronic health problems, from Lyme disease to fibromyalgia, chronic fatigue syndrome, MS, and much more. He has risked his career and reputation in order to help those of us the medical system has failed so miserably. For that alone, he has my eternal gratitude.
Profile Image for Marlene.
Author 1 book4 followers
Currently reading
November 11, 2013
Just received an advance copy of this book to review. It goes on sale on Nov. 12, 2013. Updated points will be posted here as I work through this book.
Firstly, thank you to Dr. Horowitz for tackling the job of writing a book about the darkness we, as Lyme disease patients, face every day.
Profile Image for Lia.
14 reviews
April 3, 2015
I was lucky enough to receive this book free through Goodreads First Reader and although I didn’t anticipate it, I was very impressed with this book! At first I was put off by the Author seeming to get side tracked, and the unending case studies, however, the further you read the more his observations reveal how much he cares about his patients and is listening to them. He worked with his patients and created a system, which could be used by other medical professionals.

The book breaks down the areas that may need to be addressed, explains how symptoms often have multiple sources and ways he has dealt with each possible source. Now while many of the treatments are not new the idea you need to identify and treat each possible cause to fix the whole is a very new idea to western medicine. The book is also excellent in the full explanation of why it is so important to avoid toxic chemicals, eat healthy, and take all these supplements.

Out of all the well-written chapters, I must note that the chapter on Postural orthostatic tachycardia syndrome (POTS) was the best and most comprehensive explanation I have ever read regarding the chronic low blood pressure, near fainting and fainting that occurs with many people with Lyme, Fibromyalgia and

The book has inspired me, given me new goals, and given me a feasible plan of action!
This entire review has been hidden because of spoilers.
Profile Image for Mira.
180 reviews14 followers
July 29, 2016
"Cognitive Behavioral Therapy" and "exercise" improve symptoms in patients with CFS, Fibro, and Lyme?? Really?? So Post Exertional Malaise is not a hallmark of Chronic Fatigue Syndrome, according to Dr Horowitz?! And, what, some of the fatigue is just in our heads and can be corrected through behavioral therapy? I can't take this. I just can't. This is why patients are forced to become their own doctors. Drs who bother to write 500+ page books about a disease really ought to make sure all their facts are correct. The idea that CBT will help is the same as saying Lyme patients aren't really sick, which is what most of us have heard from our doctors, friends, and families for years before being diagnosed. It's called gaslighting. It makes me sad that Dr Horowitz is probably the most highly respected Lyme "expert" out there, as this book contains many problems such as the aforementioned. Until our disease is treated as though it is entirely physical, like malaria or rabies or any other life-threatening vector borne illness, Lyme patients will continue to be prescribed antidepressants and woo-woo hippy dippy treatments that will do nothing to ease their suffering, and will only serve to further the perception that we are crazy/lazy.
Profile Image for Justin Reilly.
4 reviews19 followers
October 1, 2014
The Master Speaks!

If you have ME"cfs", Fibromyalgia, ALS, MS or are undiagnosed with serious physical and mental fatigue, pain and/or neurological symptoms and tired of going from doctor to doctor looking for an answer, GET THIS BOOK! Sorry to shout, but this is very important.

I have been sick for 12 years with an ME"cfs" diagnosis. Only two years ago did I find out the CDC's recommended test, which they and the Infectious Disease Society of America claim is 100% accurate (sensitive and specific) is actually only 40 - 60% accurate (depending on the study). I then did an Igenex PCR test, which is much better (but not 100% accurate either- but at least they admit it), which CDC and IDSA warn against. Thanks to the Igenex test, I found out I have Lyme Disease. And thanks to Medicare, which pays for this expensive test, because they deem it "medically necessary."

There are an estimated 1 Million people in the United States that contract Lyme each year, but most are not diagnosed. Many are misdiagnosed with the above-listed diseases. This is a huge epidemic.

Dr. Horowitz's book is fun to read (for a medical book) and tells you what you need to know to get diagnosed and begin healing. Dr. Horowitz is recognized as the top Lyme doc in the world and this is his first and only book. Just released recently, it is up to date.

Oh yeah, also get this book if you know you have Lyme! :)

Enjoy and happy healing everyone!
Profile Image for Jann.
243 reviews
February 10, 2014
This is a must read for anyone suffering from Lyme disease, arthritis, chronic fatigue or any of several difficult, chronic diseases---or for anyone who knows and loves such a person. Dr, Horowitz is thoughtful, open and and systematic. He takes a difficult subject which has been misunderstood, and, I think, mistreated, for years by most of the medical community, and gives hope and new perspective. It is rather technical, so to read it, you must be committed or truly concerned.
Profile Image for Susan.
1,677 reviews38 followers
January 26, 2020
This is an incredible reference for anyone suffering from Lyme or anyone who wants to learn more about it. It's very technical and includes a lot of detailed and specific information that seems more for doctors than the average person but I found it contained a ton of useful sections. I should note that I suffered from neurological Lyme for 10 years, 3 of which I suffered such terrible pain that I couldn't walk. I've done a lot of treatments over the years but nothing was able to clear it up completely. This last year I started a new treatment based on Dr. Horowitz's protocol and after 9 months I'm now in remission and no longer have Lyme. I guess you could say I'm a believer! It's ironic that I'm just reading this now when I am finally Lyme free but I'm finding it to be an interesting and still useful resource. This really is "the Bible" of Lyme treatment for good reason.
Profile Image for Maria.
19 reviews40 followers
May 30, 2014
Also a great book for providers- at the back is an Appendix for MD's showing how and what etc to prescribe.
Profile Image for Rosemary.
190 reviews
May 30, 2017
got a new copy.. back and forth through out the book. looking up stuff.
Great book. Found a dr to treat me but won't do my SSD papers. so i quit.
Profile Image for Louis Lapides.
Author 4 books14 followers
August 18, 2014
If you have been diagnosed with chronic Lyme, then you or someone you trust needs to read Dr. Horowitz's book on Lyme disease. Horowitz is a medical detective and in dealing with his patients he does not stop with one protocol and send the patient home still ill if the protocol does not work. The doctor will try another protocol and then another until he sees improvement.

I've read other books on Lyme and if you can only read through one, this is the best one. Have you doctor read it, even if he claims to be Lyme literate. Many LLDoctors are stuck with one way to try to manager or cure Lyme. Horowitz is aware of all the protocols out there and he will try them or move on to another one if the patient does not respond. Horowitz relies heavily on Western medicine but he also employs alternative medicine (herbs, supplements, etc) to help the Lyme patient.

The book is long and filled with so much information. I would read through it once and then refer to the book as a reference in the future. Horowitz has shared his findings at ILADS and other Lyme organizations. He is trustworthy; not out to sell his specialized compounded concoctions. He wants to help the patient and he will show you and your doctor what paths are available.
Profile Image for Greg Allan Holcomb.
275 reviews9 followers
February 6, 2014


This isn’t the first book on Lyme to read, but it possibly should be the second. There’s little to no mention of spirochetes or biofilms or incompetence, so you do need to be familiar with the subject.

This was my summary of chapter two: "So Horowitz's solution for diagnosing co-infections is wonderful. It's like he grabbed the medical community by the neck, shook it like you don't shake children, made eye contact, and said with all the condescension and contempt of a middle schooler "Duh" with many added syllables for emphasis.


A dooieeaaaaahuh!"



From chapter three on the book got technical and mentioned cases and symptoms. This book is dense with fact and not a quick easy read.

Lastly if you think compassion and Lyme don’t go together stay away from this book. Horowitz writes and informs (treats) with compassion.

I won a copy of this on Goodreads and in the fine print it indicates that the Guvment wants me to mention that.
Profile Image for Peg.
Author 5 books3 followers
July 17, 2014
Very detailed. Enjoyable to read at times, but also difficult at times. Every doctor should have this book as a reference for the treatment of Lyme Disease,and its co-infections, especially for patients with multiple health issues. Lots of good information to sort through, but don't regard it as the authority on Lyme as there are many other good books on the topic. Read more than one. Cure Unknown is an excellent read.
Profile Image for Julie.
71 reviews
March 25, 2014
This book was very informative and I learned a lot about Lyme disease and chronic illness in general. I also went to my latest doctors appointment with my Lyme doctor with a ton of questions and he asked me if I had read this book.

I will also say this also made me slighly more paranoid about tick borne illnesses than I already am.
Profile Image for Laura Garner.
Author 22 books8 followers
July 13, 2014
Complex and insightful. A lot of information and detail to take in, for someone who's had Lyme for 30+ years, but what I could glean was helpful.
Profile Image for Maria.
19 reviews1 follower
July 19, 2015
Reading for 3rd time! IT'S THAT GOOD! A MUST-READ!!!
Profile Image for Renee Coppola.
2 reviews1 follower
January 25, 2015
Incredible for anyone suffering with Lyme and co-infections but is a tough read written for both practitioners and patients alike.
Profile Image for Lisa.
488 reviews6 followers
September 19, 2019
This is a super comprehensive book on Lyme disease, coinfections and how it is diagnosed (very tricky) and treatment options. If you want to know about Lyme, read this book. I personally know multiple patients of Dr. H, as the author refers to himself. He has an outstanding track record. This book explains why.
140 reviews2 followers
August 30, 2019
A doctor doing incredible work. A lot of helpful tips and guidance in here. A bit more in the weeds on Lyme vs. a more intro-level book like “Cure Unknown.”
Profile Image for Megan McSherry.
338 reviews32 followers
April 30, 2022
so many fucking patient case studies. appreciate the breakdown of MSIDS though, as there are so few lyme-literate doctors and even fewer that recognize the connection between other chronic / autoimmune issues.
Profile Image for Bookworm.
2,078 reviews
August 31, 2022
If you read only one book on Lyme disease - let it be this one.
153 reviews1 follower
March 19, 2024
A doctor that thinks he's an author.
Profile Image for Caitlin McGrory.
25 reviews1 follower
February 26, 2017
5 stars for the book. Negative 2000 stars for our health insurance industry denying coverage for anything after 2 weeks.
Profile Image for Lillian Martin.
Author 2 books8 followers
October 12, 2015
Very well written, medically informative book of Dr. Horowitz' clinical practice and his various approaches to treating chronically ill Lyme patients. This man is a detective, and unwilling to just let his patients stay sick. Lyme affects all systems in the body. I especially liked how each chapter took a system or illness/symptoms and broke down the how and why and what to treat it with. For example, in one chapter, he explains why people with allergies might have a harder time getting rid of Lyme. In another chapter on Environmental toxins, he explains why a doctor should test a patient for heavy metal exposure, even though it might not seem like it matters.

Most of his patients suffer from multiple systemic illnesses (he believes from previous Lyme exposure) that have them going round and round to different specialists with no answers.This book is for all the people who have been told they are hypochondriacs and brushed off by their doctors. The book contains many patient's stories and how he treated them. If one is ill and out of options, one might need to look into Lyme as a reason for why they feel sick.

This isn't an easy read. Dr. Horowitz goes into extremely detailed accounts of the bio-chemistry and physiological systems of the human body. Take it slow - it is fascinating!
Profile Image for Karen Badea.
Author 1 book1 follower
January 15, 2016
This book should be on everyone's list to give to their family practitioners. Dr. Richard Horowitz is a foundation pillar for all those suffering Lyme.... His You Tube videos have helped me out so much in my Chronic Lyme journey. I cannot say enough about his wonderful detailed work that he has put together in this book. This book is literally a 'life saver'...... If you have Lyme or have a loved one with Lyme, please gift them this book. Sadly, Lyme is a 'political disease'. Without physicians like Dr. Horowitz that puts their reputation and license on the line, so many chronic Lyme patients would die. Many do not realize that the 'system' punishes physicians for treating Lyme after 28 days. Dr. Horowitz trains physicians, politicians, lyme patients, as well as, lyme patient families, globally. He is a 'GURU' of Lyme & Coinfections (MSIDS...Multi Systemic Infectious Disease Syndrome). Dr Richard Horowitz deserves a huge applause for writing this priceless book.... I cannot thank him enough for what his Lyme awareness efforts have done for me......
22 reviews
December 29, 2015
Dr. H, was my Dr before the great Lyme disease war. I contracted 3 tick diseases, and lived the roller coaster ride along with him. What he went through for us, almost losing his license, being considered a quack by other physicians, and fighting Insurance Companies. He touches on the war, but we really don't feel the pain come through in his book. This is more of his findings and research. What he did to help us. Hopefully some day, the ignorant Dutchess County Drs that still don't get it, will read this book and have some guts to step up to the plate and help their patients instead of worrying about the big insurance companies profits.
Displaying 1 - 30 of 46 reviews

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