Skip to content EBOO therapy is not a proven treatment for Lyme disease. No clinical trials have studied EBOO specifically for Borrelia burgdorferi infections. What exists is a plausible biological mechanism, a growing body of practitioner observations, and a rationale that makes sense when you understand why chronic Lyme is so difficult to treat in the first place.
This guide explains what EBOO therapy for Lyme disease may and may not do, what the evidence supports, and how to decide whether it fits into your existing treatment plan. If you are new to EBOO, start with our overview of EBOO therapy. This article assumes you understand the basics and focuses specifically on the Lyme question.
Before discussing whether EBOO can help, it is important to understand why chronic Lyme disease is so resistant to treatment. This context matters because it explains why some practitioners and patients have turned to EBOO as an adjunct therapy, and why the standard “EBOO detoxifies the blood” description isn’t specific enough to be useful for Lyme patients.
Borrelia burgdorferi, the bacterium that causes Lyme disease, can form antimicrobial-tolerant biofilms. These protective structures, made of alginate, proteins, and extracellular DNA, shield the bacteria from antibiotics. Research by Sapi et al. has documented Borrelia biofilms in human tissues, including the heart, brain, kidney, and liver, even after 16 years of continuous antibiotic treatment.
This biofilm formation is a major reason why chronic Lyme persists despite aggressive conventional therapy. It is also why some practitioners propose ozone therapy as a complementary approach, since laboratory studies show ozone has oxidative effects that may disrupt biofilm structures. No controlled trial has tested whether EBOO achieves this in a clinical setting.
A single tick bite can transmit multiple pathogens simultaneously. Many chronic Lyme patients deal not only with Borrelia but also with Babesia (a parasite that infects red blood cells), Bartonella (bacteria that cause fatigue, joint pain, and neurological symptoms), Ehrlichia or Anaplasma (bacteria that target white blood cells), and sometimes Mycoplasma or viral co-infections. Each of these requires different treatment.
A standard Lyme antibiotic protocol may address Borrelia but leave co-infections untreated, which is why comprehensive testing through a Lyme-literate medical doctor is essential before considering any adjunct therapy like EBOO.
When Lyme treatment works and pathogens begin to die, they release endotoxins into the bloodstream. This can temporarily worsen symptoms including fatigue, brain fog, joint pain, fever, and chills. This is known as a Jarisch-Herxheimer reaction, and it is one of the most challenging aspects of Lyme treatment.
Some practitioners suggest that EBOO may help manage Herxheimer reactions because the filtration component removes inflammatory byproducts from the blood during the session, potentially reducing the toxic load that causes die-off symptoms. This is a plausible mechanism and is supported by clinician observations, but it has not been tested in a controlled study.
The proposed benefits of EBOO therapy for Lyme disease are based on three mechanisms. None of these are proven for Lyme specifically. All are plausible based on broader ozone therapy research and clinical observations.
Ozone has demonstrated antimicrobial properties in laboratory settings against a range of pathogens including bacteria, viruses, and parasites. The theoretical case is that ozone exposure during EBOO may help reduce pathogen load, including Borrelia in its various forms. However, demonstrating antimicrobial activity in a test tube is not the same as demonstrating it in a living patient’s bloodstream during a 45- to 60-minute session. No study has measured Borrelia-specific pathogen reduction after EBOO treatment.
Broader evidence for ozone’s effects comes from EBOO therapy research and clinical evidence.
Unlike standard ozone therapy, EBOO passes blood through a dialysis-like filter that can trap larger molecular debris, including inflammatory proteins, endotoxins, and cellular waste. For Lyme patients dealing with high inflammatory loads and Herxheimer reactions, practitioners most often cite this filtration component as potentially beneficial. The filter does physically capture debris above its cutoff size. No controlled study has shown whether this provides meaningful clinical relief for Lyme patients.
For more on what the filter does and does not capture, read what EBOO filters actually capture from your blood.
Chronic Lyme disease is associated with elevated pro-inflammatory cytokines and a dysregulated immune response. Ozone therapy has been proposed to modulate immune function by stimulating anti-inflammatory pathways without suppressing the immune system overall. This distinction matters for Lyme patients because, unlike autoimmune medications that broadly suppress immune function, ozone’s proposed mechanism is to rebalance rather than suppress.
This is an active area of research with some laboratory support, but clinical evidence specific to Lyme patients receiving EBOO does not exist. The immune modulation mechanism is discussed in detail in EBOO therapy benefits: what is proven, proposed, and just marketing.
Being honest about the limits is part of responsible care, and it is especially important for Lyme patients who have often spent years and significant money on treatments that overpromised. EBOO will not cure Lyme disease. No study has demonstrated that EBOO eradicates Borrelia from the body. EBOO will not replace antibiotics.
If you are in active treatment with a Lyme-literate doctor, consider EBOO only as an adjunct to your existing protocol, not a substitute. EBOO will not reliably remove heavy metals. Some clinics market EBOO as a heavy metal detoxification therapy. The filter is not designed for this purpose, and chelation therapy is the established treatment for heavy metal toxicity. And EBOO will not address co-infections directly. If you have untreated Babesia, Bartonella, or other co-infections, those require their own targeted treatment.
The specific overclaims around EBOO are addressed in EBOO therapy myths and what the evidence says.
Based on practitioner observations and the theoretical mechanisms, the Lyme patients who tend to be the best candidates for EBOO therapy for Lyme disease as an adjunct are those who have an established diagnosis from a Lyme-literate medical doctor, are already on or have completed a course of antimicrobial treatment, continue to experience persistent symptoms despite standard therapy, can afford the investment without financial strain since insurance does not cover EBOO, and have been properly screened for contraindications including G6PD deficiency and anticoagulant use.
At Purefico Medspa and Longevity Center in Cornelius, NC, we require that Lyme patients be working with a treating physician before beginning EBOO. This is not a standalone therapy, and we will not market it as one.
If you are a chronic Lyme patient considering EBOO, Herxheimer management is one of the most important practical considerations. Responsible practitioners typically recommend the following steps. Make sure your treating physician knows you are adding EBOO to your protocol. Start with a lower ozone concentration for your first session and increase gradually.
Stay well hydrated before and after each session. Monitor your symptoms carefully for 24 to 48 hours after each session and report any significant worsening to both your EBOO provider and your treating physician. Consider spacing sessions further apart if Herxheimer reactions are severe.
For the complete preparation and recovery guide, read How to Prepare for Your First EBOO Session and EBOO Therapy Aftercare: What to Do After Your Session.
I see Lyme patients regularly, and I understand the frustration that comes with a condition where conventional medicine often falls short. EBOO is not a Lyme cure, and I will never market it as one. It offers a complementary tool that some patients find helpful alongside their existing treatment. If you are considering EBOO for Lyme, the most important thing you can do is work with a qualified Lyme-literate doctor first. Get properly diagnosed. Get your co-infections identified. Get your baseline treatment established. Then, if you and your doctor think EBOO could add value, we can discuss whether it makes sense for your specific situation.
If you are a chronic Lyme patient considering EBOO therapy for Lyme disease, book a consultation with our team. We will review your diagnosis, discuss whether EBOO could add value alongside your existing treatment, and coordinate with your physician.
No. No evidence shows that EBOO cures Lyme disease or eradicates Borrelia bacteria from the body. EBOO is being explored as an adjunct therapy that may help manage symptoms and support the immune system alongside conventional treatment, but it is not a proven cure for any condition.
No. EBOO therapy is not FDA-approved for Lyme disease or any other medical condition. It is classified as an experimental and elective therapy by regulatory bodies and insurance carriers.
No standardized protocol exists for EBOO in Lyme treatment. Most practitioners recommend starting with 3 to 6 sessions to assess response, with sessions typically spaced one to two weeks apart. Your treating physician and EBOO provider should coordinate to determine the appropriate schedule for your situation.
It is possible. Ozone exposure may trigger additional pathogen die-off, which could temporarily worsen Herxheimer symptoms. However, EBOO’s simultaneous filtration component is proposed to help offset this by removing inflammatory byproducts during the session. Starting with lower ozone concentrations and increasing gradually is the standard approach to minimize this risk.
No. EBOO should never be used as a replacement for antibiotics or antimicrobial therapy prescribed by your Lyme-literate doctor. It is an adjunct therapy only. If a clinic suggests using EBOO instead of working with a qualified physician, that is a red flag.
The ozone component is proposed to have antimicrobial properties, and the filter captures larger molecular debris. No clinical studies have shown that it meaningfully reduces Borrelia bacteria in a clinical setting. Claims that EBOO eliminates Lyme pathogens are not supported by controlled evidence.
A single EBOO session typically costs $250 to $800. A course of 3 to 6 sessions for a Lyme patient costs between $750 and $4,800. Insurance does not cover EBOO. Some clinics may accept HSA and FSA funds.
Yes. Purefico Medspa and Longevity Center in Cornelius, near Charlotte, offers EBOO therapy for patients who are working with a Lyme-literate physician. We require proper screening and coordination with your treating doctor before beginning sessions.
1. Sapi E, Kasliwala RS, Ismail H, et al. The long-term persistence of Borrelia burgdorferi antigens and DNA in the tissues of a patient with Lyme disease. Antibiotics (Basel). 2019;8(4):183.
2. Sapi E, Balasubramanian K, Poruri A, et al. Evidence for in vivo existence of Borrelia biofilm in borrelial lymphocytomas. European Journal of Microbiology and Immunology. 2016;6(1):9-24.
3. Di Paolo N, Bocci V, Salvo DP, et al. Extracorporeal blood oxygenation and ozonation (EBOO): a controlled trial in patients with peripheral artery disease. International Journal of Artificial Organs. 2005;28(10):1039-1050.
4. Bocci V, Zanardi I, Travagli V. Ozone acting on human blood yields a hormetic dose-response relationship. Journal of Translational Medicine. 2011;9:66.
5. Cacciatore S, et al. Effectiveness and safety of ozone therapy: an umbrella review. Medical Sciences (Medicina). 2026;14(2):289.
6. U.S. Food and Drug Administration. 21 CFR 801.415, Maximum acceptable level of ozone.
Melissa Lynch, NP, is a nurse practitioner with 28 years of clinical experience and the founder of Purefico MedSpa & Therapy, with locations in Cornelius and Archdale, North Carolina.
