Hyperbaric Oxygen Therapy and Lyme Disease: Current Evidence

Important: Hyperbaric oxygen therapy is not FDA-approved for Lyme disease. This is an investigational use. Evidence is preliminary. Insurance will not cover HBOT for this condition. All costs are out-of-pocket.

Persistent symptoms after Lyme disease treatment are genuinely difficult to live with. Fatigue, joint pain, and cognitive fog that don’t resolve after antibiotics leave many patients searching for answers. HBOT is one of the options that comes up. Here’s what the evidence actually shows.

Why Lyme Patients Are Looking at HBOT

Lyme disease is caused by Borrelia burgdorferi bacteria, spread through the bite of infected ticks. When caught early, most cases respond well to a standard course of antibiotics.

Some patients develop what’s called post-treatment Lyme disease syndrome, or PTLDS. These are persistent symptoms, including fatigue, pain, and cognitive difficulties, that continue after antibiotic treatment ends. PTLDS isn’t fully understood. Patients often struggle to find effective care, and that gap creates openings for unproven treatments.

The main rationale for HBOT in Lyme goes like this: Borrelia is a microaerophilic organism, meaning it prefers low-oxygen environments. Flooding tissue with high-pressure oxygen might kill it or inhibit its growth. The argument has some surface logic. But in established PTLDS, active bacterial infection may not be the primary driver of symptoms, which weakens the rationale further.

What the Research Shows (and Doesn’t Show)

There are very few rigorous studies on HBOT for Lyme disease. Case series and anecdotal reports exist, but these don’t provide reliable evidence of effect. Without control groups, it’s impossible to separate what HBOT did from what time and other factors did.

No large randomized controlled trial has evaluated HBOT specifically for Lyme disease or PTLDS. That’s a significant gap. The scientific literature does not support HBOT as an established treatment for either condition.

This isn’t an argument that HBOT definitely doesn’t work for Lyme. It’s an argument that we don’t know. And for a treatment that costs hundreds of dollars per session, that uncertainty matters.

The Risk of Unproven Treatments in Lyme

The Lyme community has been targeted by a long list of unproven treatments over the years. Long-term IV antibiotics, various supplements, and alternative therapies have all been marketed to patients who haven’t found relief through standard care.

HBOT is now part of that list at some clinics. Without proper research, there’s no way to know whether reported benefits reflect HBOT, natural symptom fluctuation, or other treatments being used at the same time.

Clinics that market aggressively to the Lyme community and make specific outcome promises deserve extra skepticism. Absence of evidence isn’t proof of harm, but it’s not a reason to spend thousands of dollars either.

Practical Considerations

If you’re considering HBOT for PTLDS, talk with your doctor first. Your physician knows your history, your other treatments, and your overall health in ways a hyperbaric clinic doesn’t.

Costs are entirely out-of-pocket. Sessions run $250-450 each. For more on what costs look like, see the cost guide.

A good hyperbaric provider will take a full medical history before treating you, not promise specific outcomes for Lyme disease. For help finding providers, see the provider directory.

Work with a doctor who is familiar with Lyme disease and PTLDS. HBOT in isolation, without a broader treatment plan and monitoring, is a poor use of both money and time.

Frequently Asked Questions

Is HBOT ever used alongside antibiotic treatment for Lyme? Some patients and clinics have used HBOT in combination with antibiotics, theorizing that more oxygen might enhance antibiotic effectiveness. This hasn’t been evaluated in controlled trials for Lyme specifically. Combining unproven treatments doesn’t multiply their evidence base.

What does HBOT actually do in the body? HBOT increases the amount of dissolved oxygen in plasma, which can reach tissues that blood flow doesn’t reach well. It also reduces inflammation and supports certain immune functions. For more on the mechanism, see what is HBOT.

Are there other treatments with better evidence for PTLDS? Research into PTLDS treatment is ongoing. The National Institute of Allergy and Infectious Diseases (NIAID) has funded studies on PTLDS management. Your doctor is the right resource for evaluating current treatment options.

Could HBOT make Lyme symptoms worse? There’s no established evidence that HBOT worsens Lyme symptoms. HBOT does carry general risks, including ear and sinus pressure, temporary vision changes, and rare oxygen toxicity. A medical evaluation before starting any HBOT course is appropriate regardless of indication.

For more on HBOT conditions, visit the conditions hub.

Medical Disclaimer: This page is for informational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before pursuing any medical treatment.