EBO2 (EBOO) for Lyme Disease: Clinic Claims, the Missing Evidence, and Standard Care

If a clinic has offered EBO2 (also called EBOO) for Lyme disease, or for symptoms that have lasted after treatment for Lyme disease, this guide sets the offer against what the record holds: what clinics’ own pages claim, what has been tested, what regulators have said, and the care CDC describes. The short answer is that we found no study of ozone or EBO2 against Borrelia burgdorferi, the bacterium that causes Lyme disease, in the laboratory, in animals, or in people. Two reviews of alternative Lyme treatments, in 2015 and 2026, found no trial evidence that oxygen-based therapies help [16][17]. CDC lists antibiotic courses for every form of the disease and says that, after a recommended course, more antibiotics are unlikely to help lasting symptoms [1][2]. Questions to take to a clinic, and the searches we ran so anyone can repeat them, are near the end.

What clinics’ EBO2 pages say about Lyme disease

We read the EBO2 pages of the clinics in our directory and recorded, in each clinic’s own words, the health benefits it claims. As of October 4, 2026, we could read the pages of 174 clinics, and 90 of them claim a benefit for Lyme disease or for mold illness; we record the two together, so the “From our data” bar below counts them as one. To separate them we use the claim wording itself. Of those 90, the claim wording we recorded names Lyme disease for 76 clinics and mold, mycotoxins, or biotoxins for 51. We save up to four quotes per clinic, so these splits are a floor: a clinic can name Lyme disease on a page without that sentence being among its saved quotes.

Within the 76 clinics whose recorded wording names Lyme disease:

• Lyme disease is usually one item in a list. 64 of the 76 name it in the same sentence or list as other conditions. 72 of the 76 also claim a benefit against infections or pathogens, 69 for autoimmune conditions, and 35 for long COVID.
• Most pages do not say whether EBO2 is FDA-approved. 60 of the 76 EBO2 pages do not say whether EBO2 or its equipment is FDA-approved, 14 say EBO2 is not FDA-approved, and 2 say their equipment is FDA-cleared, registered, or approved, which concerns a device and not the treatment; our guide to EBOO devices and FDA status explains the difference.
• 17 of the 76 pages carry patient testimonials.

Across all 174 readable clinics, the recorded wording of 29 says the procedure kills, destroys, inactivates, or neutralizes bacteria, viruses, or other microbes, and 17 of those 29 also name Lyme disease. (We count a clinic when one recorded quote pairs one of those four verbs with a word for a microbe, such as bacteria, virus, pathogen, fungus, mold, or parasite; looser rules, such as matching the verb and the microbe in different quotes, give slightly higher counts.) On September 28, 2026, at least one page said EBOO had been found to destroy the bacterium that causes Lyme disease, and we found no such study; as of October 4, 2026, none of the claims we recorded says it. The recorded wording of 15 clinics refers to “co-infections”, and that of 2 lists Lyme disease among autoimmune conditions, although CDC describes it as an illness caused by bacteria spread by blacklegged ticks [1]. We publish these claims only as counts. A claim on a clinic’s page is the clinic’s statement, not evidence; our guide to reading a clinic’s EBO2 page covers the wording to look for.

What has been tested: ozone against bacteria, and nothing against Borrelia

No entry in our research library tests ozone against Borrelia, and none of the six entries the library tags as EBOO studies, listed in the “From our data” table below, reports on anyone with Lyme disease; the 2023 ozone-uptake series among them does not say what its 12 patients were treated for. The closest evidence we hold is three papers on ozone and bacteria.

The two pig studies are the most direct test in our library of what a blood circuit with ozone does to bacteria in the blood. A single pass through the device reduced the bacteria in the blood flowing through it, in human blood in the laboratory in one study and in the pigs in the other, yet in neither study did the animals’ circulating bacteria fall compared with untreated animals [19][20]. Neither involved Borrelia. Lyme disease adds a further problem: if untreated, CDC’s report says, the bacterium “can disseminate throughout the body to cause meningitis, carditis, neuropathy, or arthritis” [10], so much of the infection sits in tissues that a blood circuit does not pass through.

Two reviews have looked at oxygen-based treatments marketed for Lyme disease. In 2015, a review in Clinical Infectious Diseases searched clinic websites and the medical literature, found more than 30 alternative treatments, including “oxygen and reactive oxygen therapy”, and reported that the literature “did not substantiate efficacy or, in most cases, any rationale for the advertised treatments” [16]. In 2026, a review in the journal Brain, whose authors include researchers at NIH’s National Institute of Neurological Disorders and Stroke, noted that some laboratory and animal studies and case reports suggest oxygen-based treatments, ozone among them, may improve well-being in chronic Lyme disease, then concluded: “there is a critical lack of well-designed, large-scale clinical trials to substantiate the clinical benefits of oxygen or reactive oxygen species” [17]. It added that such a treatment “might appear effective in some individuals and not others simply because their symptoms have a different underlying cause” [17].

What the antibiotic trials show about lasting symptoms

At least five randomized, placebo-controlled trials have tested longer antibiotic courses for symptoms that last after Lyme disease [10], and their placebo groups matter for anyone weighing an uncontrolled report of improvement.

• Klempner, 2001. Two trials gave 30 days of intravenous ceftriaxone and 60 days of oral doxycycline, or matching placebos, to 129 people with lasting symptoms; they were stopped early because a difference was highly unlikely. Among seropositive patients, 37% on antibiotics and 40% on placebo improved [12].
• Krupp, 2003. In 55 people with severe fatigue, 28 days of intravenous ceftriaxone, compared with placebo, improved fatigue but not thinking speed or a laboratory marker of infection, and the authors concluded the study “does not support the use of additional antibiotic therapy” [13].
• Fallon, 2008. In 37 people with memory problems randomized to 10 weeks of intravenous ceftriaxone or placebo, ceftriaxone brought a moderate improvement at week 12 that was not sustained at week 24 [14].
• Berende, 2016. After 2 weeks of intravenous ceftriaxone for everyone, 281 people were randomized to 12 weeks of doxycycline, clarithromycin with hydroxychloroquine, or placebo. Quality of life did not differ between the groups, and it rose significantly from baseline in all three, placebo included [15].

CDC says that people with lasting symptoms “usually get better over time without additional antibiotics, but it can take many months to feel completely well”, and that careful studies have generally found extended antibiotic treatment no better than placebo [2]. The trials also show what an uncontrolled before-and-after report cannot: in the two that report it, many people on placebo got better [12][15]. The FTC makes the same point about health claims generally, that improvement in a treated group alone “could result from a placebo effect, spontaneous changes in subjects’ health” or other factors unrelated to the product [22].

What regulators have said

No regulatory record in our tracker addresses ozone or EBO2 for Lyme disease by name. The records that apply are general.

• FDA. Its device rule states that “Ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy” [25]. Ozone therapy is not FDA-approved for Lyme disease or any other condition.
• FTC standard for health claims. The FTC’s 2022 guidance says that substantiation of health benefits “will need to be in the form of randomized, controlled human clinical testing”, and that anecdotal evidence about consumers’ experiences is “never sufficient to substantiate claims about the effects of a health product” [22]. When the FTC warned a California clinic in 2020 about ozone claims for COVID-19, it also told the clinic to review all its other claims against that standard [23].
• UK advertising regulator. In 2022 the Advertising Standards Authority ruled against a UK clinic’s claims that IV ozone therapy was “Anti-Bacterial, Anti-Viral and Anti-Fungal”, and told it not to repeat such claims unless it held “a substantive body of evidence to support those claims, including clinical trials conducted on people” [24].
• CDC. Its 2017 report states that treatments offered for chronic Lyme disease, “such as prolonged antibiotic or immunoglobulin therapy, lack data supporting effectiveness and are not recommended” [10].

What CDC describes as care for Lyme disease

This section describes what CDC tells patients and clinicians; it is information, not a treatment plan. CDC says most cases “can be treated with 10 days to 4 weeks of antibiotics”, and that people treated with appropriate antibiotics early “usually recover rapidly and completely” [1]. Its clinician pages list regimens by form of the disease, consistent with the 2020 guideline of the Infectious Diseases Society of America, the American Academy of Neurology, and the American College of Rheumatology [5][11]. For adults, without doses:

Two points in CDC’s pages bear on an EBO2 offer. First, timing: untreated infection can bring later signs, days to months after the bite, that include arthritis of the large joints, an irregular heartbeat, facial palsy, nerve pain, and inflammation of the brain and spinal cord [4], and CDC tells clinicians to treat suspected Lyme carditis with antibiotics immediately, without waiting for test results, and to hospitalize suspected severe cases [8]. Second, testing: CDC recommends FDA-cleared antibody tests used in two steps, warns that some laboratories that do not accept private insurance may offer tests that are not FDA-cleared, and notes that antibody tests stay positive for months to years after the bacteria are gone, so a positive result alone does not show an active infection [3].

For symptoms that last after treatment, CDC uses the name post-treatment Lyme disease syndrome, says its cause is unknown, and discourages the term chronic Lyme disease “because it implies that prolonged symptoms are caused by an ongoing bacterial infection when, in fact, the cause is not currently known” [2]. It says “more antibiotics are unlikely to help”, lists other causes of the same symptoms, including other infections, medications, depression, diabetes, and cancer, and suggests strategies developed for myalgic encephalomyelitis/chronic fatigue syndrome [2]. For persistent Lyme arthritis it suggests referral to a rheumatologist [9]. On co-infections, CDC says the most common one, anaplasmosis, is treated with the same antibiotic as Lyme disease, that babesiosis needs different medicines, and that “there is no evidence” Bartonella or Mycoplasma are spread by ticks [3]. Our long COVID guide covers CDC’s similar advice for symptoms after COVID-19.

Risks for people with a Lyme diagnosis

The risk CDC has documented is from unproven treatment itself. Its 2017 report describes five people given treatments for chronic Lyme disease, most through long-term intravenous lines, whose complications included septic shock, Clostridium difficile colitis, an infection of the spinal bones and disc, an abscess, and one death [10]. CDC lists among such treatments intravenous hydrogen peroxide and hyperbaric oxygen [10], which the 2026 review groups with ozone as oxygen-based treatments [17], and warns of “missed opportunities to diagnose and treat the actual underlying cause” [10]. EBO2 was not among the treatments the report names. Ozone given through the blood has a record of its own: after an outbreak investigation at a hospital outpatient department in Rome, six of 31 patients tested had hepatitis C, one of them known to be infected since 1986, and all six had received ozone-enriched transfusions of their own blood in the first half of 2001 [21]. Our compilation of ozone therapy adverse events covers the reported harms by route, and the side effects guide covers the procedure itself.

Questions to ask a clinic that offers EBO2 for Lyme disease

These are questions, not a verdict on any clinic. Our questions for your doctor tool builds a printable list.

• Which study shows that ozone or EBO2 affects Borrelia, in a dish or in a person? (We found none.)
• How was Lyme disease diagnosed, and was it an FDA-cleared two-step test [3]? If the diagnosis is a co-infection such as Bartonella, what does the clinic make of CDC’s statement on tick transmission [3]?
• Is EBO2 offered instead of, or alongside, the antibiotics CDC lists, and does the clinic coordinate with the physician who prescribes them?
• What will be measured before and after the sessions, and at what point would the clinic recommend stopping?
• How many sessions, at what total cost in writing, and what is refunded if sessions stop? The session cost planner helps with the arithmetic.
• Which anticoagulant is used in the circuit, and has it been checked against current medicines, including any long antibiotic course? Our guide to EBOO, blood thinners, and medications covers what to ask.

How to check for evidence yourself

We ran these searches on October 2, 2026, and anyone can repeat them for free.

1. Europe PMC, the free index that includes PubMed, searching titles and abstracts: TITLE_ABS:(ozone OR ozonated OR ozonation OR "oxygen-ozone") AND TITLE_ABS:(Borrelia OR Lyme OR borreliosis) returned three records. All three are studies of the health effects of climate change that count air pollution and Lyme disease among their measures; none tested ozone against Borrelia.
2. Europe PMC, EBOO and Lyme: TITLE_ABS:(EBOO OR "extracorporeal blood oxygenation") AND TITLE_ABS:(Lyme OR Borrelia OR borreliosis) returned none.
3. ClinicalTrials.gov, with “Lyme disease” as the condition and “ozone” as the intervention, returned no registered studies; “EBOO” as an intervention returned none for any condition.

A clinic that cites a study should be able to give its title or PubMed number. The test is whether that study tested ozone against Borrelia or enrolled people with Lyme disease, and whether it compared the treatment with something.

What we could not verify

• The full text of the 2020 IDSA, AAN, and ACR guideline. The publisher refused our automated request, so we read only its abstract [11], which does not mention ozone; we rely on CDC’s statement that its regimens follow the guideline [5].
• The laboratory and animal studies the 2026 review cites as suggesting benefit from oxygen-based treatments in chronic Lyme disease [17]. We could not identify them from the review’s text.
• The full text of the 2015 review of alternative treatments, which we read as an abstract only [16].
• The study behind the clinic page that said, on September 28, 2026, that EBOO destroys the bacterium that causes Lyme disease. We could not trace it.
• How many people with a Lyme diagnosis have had EBO2, and with what results. CDC notes that the number of people who undergo treatments for chronic Lyme disease is unknown, as is the number of complications [10], and our dataset records clinics’ claims, not outcomes.

How this guide was made

This guide rests on 25 sources: nine CDC pages and a CDC report, the 2020 Lyme disease guideline and six other papers read through PubMed, four entries from our study library, and FDA, FTC, and UK regulatory documents. The clinic figures come from our own dataset of clinic pages, as of October 4, 2026 (174 readable pages), the searches were run on October 2, 2026, and study details come from our study cards, each quoted from the paper. Drafting used AI tools. A human editor has not yet checked this guide claim by claim against its sources, and no clinical reviewer has signed off yet.