Hyperbaric Oxygen Therapy For Lyme Disease

Introduction

Brief overview of Lyme disease

Lyme disease, which is an infection transmitted to humans through the bite of an infected tick, is caused by the bacterium known as Borrelia. It can cause symptoms of fever, headache, fatigue and a skin rash that will look like a bullseye around the site of the tick bite. If Lyme disease goes untreated, the infection can spread to other areas of the body, including joints, the nervous system and the heart. Generally, when caught early, it can be treated via a couple of weeks of antibiotics. However, if early intervention is not initiated, long-term health issues may occur.

Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) involves breathing pure oxygen (100% oxygen) in a space known as a hyperbaric chamber. The hyperbaric chamber has an air pressure higher than normal air pressure which helps the lungs to collect more oxygen.¹ This allows more oxygen to get to tissues that need it for fighting certain infections and helping the body to heal. The chambers are generally tubes large enough for one person to lie in.

Purpose of HBOT for Lyme disease

HBOT has been proven to be an effective treatment for relieving symptoms and improving the quality of life for Lyme disease patients. Lyme disease is microaerophile, which means that it thrives in environments with low oxygen, therefore, HBOT can directly target the infection by significantly increasing the oxygen levels in the body.²

Understanding Lyme disease

Definition and common Symptoms

Also known as Lyme Borreliosis, Lyme disease is a bacterial infection spread to humans via ticks. Ticks are small bugs that are found in woodlands and moorlands and they borrow their head into skin, in order to feed on blood.

Symptoms of Lyme disease include:³

• A rash that develops between 3-30 days after you’ve been bitten – It will appear as a red, circular rash around the bite site, often described as looking like a bulls-eye on a dartboard. However, 1 in 3 people will not develop a rash.
• Tiredness/fatigue
• Muscle pain
• Joint pain
• Headaches
• Fever
• Chills
• Neck stiffness

Mechanism of action

The borrelia bacteria that causes Lyme disease primarily does so through the induction of inflammation in the human body.⁴ During transmission from the tick, the bacteria adapt to the environment within the body in order to multiply and spread efficiently. This induces an inflammatory response, which causes the symptoms seen with Lyme disease, such as fever and headaches. It is because of the bacteria’s ability to adapt to the environment, including temperature and pH, that it is such a persistent infection that can be difficult to get rid of.

Potential benefits of HBOT for Lyme disease

HBOT has many potential benefits for treating Lyme disease

• Enhances antibiotic effectiveness - The increased levels of oxygen within the body can enhance the ability of antibiotics to kill the bacteria
• Reduced inflammation - HBOT can reduce inflammatory responses in the body that is triggered by Lyme disease, which can relieve symptoms
• Pain relief - HBOT has been found to be effective in reducing chronic pain by increasing pain thresholds and improving quality of life⁵ 
• Improved immune response - The increase in oxygen in arteries during HBOT stimulates an increased immune system response to infection which can enhance healing⁶

Goals of HBOT for Lyme disease

Addressing chronic symptoms

Post-Lyme disease syndrome is a condition which can occur following infection and is defined as continuing or relapsing non-specific symptoms. These symptoms may include chronic fatigue, musculoskeletal pain and cognitive issues. Despite large amounts of research surrounding the topic, there is no definitive evidence that this syndrome is caused by a persistent infection of Borrelia, and no significant improvement is seen with long-term antibiotic treatment.⁷ 

One condition which has been linked to chronic Lyme disease is Fibromyalgia, which is a chronic condition that causes pain and tenderness throughout the body.⁸ It is hypothesised that degeneration of muscles in patients with fibromyalgia is linked to reduced blood flow and, therefore, a reduction in oxygen supply to the muscles. This reduction causes an increase in a substance known as lactic acid, which can cause damage to the tissue. Therefore, it is thought that HBOT can be beneficial to this condition by improving oxygen delivery to the muscles, which will reduce lactic acid buildup and prevent tissue damage. This is effective in reducing symptoms of pain.⁹

Risks and considerations 

Due to the increased pressure within hyperbaric oxygen chambers, there is a risk of ear and sinus pain, temporary vision changes, as well as injury to the middle ear, including tympanic membrane rupture (perforated ear drum). A rare complication of HBOT is a lung collapse. 

A consideration that should be made before receiving HBOT, is the potential to experience claustrophobia (the fear of small spaces). The chambers are often enclosed, tight spaces with little room to move around, therefore if you have a history of claustrophobia, you may not be able to tolerate this treatment. 

The high concentration of oxygen within the chambers also poses an increased fire risk, therefore proper precautions should be taken. 

Contraindications 

• Asthma - a phenomenon known as air trapping may occur in asthmatic patients which can lead to an increased risk for a collapsed lung. 
• Implanted devices -  such as implantable cardioverter defibrillators should be pressure tested prior to the patient undergoing HBOT.
• Epilepsy - The increased risk of oxygen toxicity with HBOT in epileptic patients’ can reduce the threshold for seizures, increasing the chances of a seizure.
• Current upper respiratory or sinus infection - increased risk of ear pain and discomfort 
• Insulin-dependent diabetes mellitus - risk of HBOT-induced hypoglycemia 

Procedure 

Lyme disease is not currently a condition which has been cleared by the Food and Drug Administration for HBOT, therefore, there are no specific guidelines stating a protocol for the treatment. However, researchers have developed their protocols. For example, William Fife, PhD, calls for the protocol to be a pressure of 2.36 atmospheres (which is the equivalent of being 45 feet below sea level).¹⁰ Each treatment lasts one hour, with two treatments per day for 5 days per week. It is common for 30 to 60 treatments to be administered during this phase of treatment. 

Cost and accessibility 

In the UK, the NHS currently only funds HBOT for two conditions: decompression illness and arterial gas embolism. Therefore, if you were interested in HBOT for the treatment of Lyme disease, you would have to fund it yourself or through private health insurance, which can be expensive. In the UK the price of a single treatment session can vary between £70-150. 

Summary 

Lyme disease is a vector-borne infection caused by ticks which can cause chronic health problems. The standardised treatment for Lyme disease is antibiotic therapy, however, many still report long-term effects of the infection for years following, even in the absence of the bacteria in the blood.

Hyperbaric oxygen therapy involves being in an enclosed chamber or room where there is an induced high-atmospheric pressure and 100% oxygen. These conditions have been proven to aid in the healing of many illnesses. It is thought that HBOT has anti-inflammatory properties, which can be beneficial in preventing the effects of Lyme disease. Whilst there is research investigating the effectiveness of this treatment, it is not currently a service which is provided by the NHS, therefore it can be an expensive treatment. More research would be beneficial in this field in order to gain a deeper understanding of the potential benefits that this therapy could have for short-term and chronic conditions, such as Lyme disease.