How hyperthermia treats Lyme disease
The deep science: Borrelia thermolability, the three mechanisms of action, why whole-body vs. localized, and how it addresses persister forms.
Read more →Reviewed by Julian Douwes M.D., Chief Medical Officer, Klinik St. Georg
What happens from the day you arrive to the day you go home. A complete, honest walkthrough of every phase of treatment—so you can prepare practically, physically, and emotionally for what lies ahead.
Total program: Typically 2–3 weeks as an inpatient at St. George Hospital in Bad Aibling, Germany.
Phases: Comprehensive diagnostics (days 1–3), preparation and pre-treatment (days 3–5), the hyperthermia session itself (day 5–7), recovery and integrative therapies (days 7–14+), follow-up protocols (weeks 2–3).
The session: Performed under deep sedation (propofol). Core temperature raised to 41.6–41.8°C using the Heckel HT3000. Total session duration: 6–8 hours including warm-up and cool-down. Continuous medical monitoring throughout.
After treatment: A structured follow-up protocol continues for weeks to months after discharge, coordinated with your home physicians.
Hyperthermia is not a standalone treatment. It is the central element of a comprehensive, individualized treatment program that addresses Lyme disease from multiple directions simultaneously. The program is designed to be thorough enough to give you the best possible chance of meaningful improvement—and honest enough to prepare you for the physical and emotional demands of the process.
Every patient's program is different in its details, but the overall structure follows a consistent pattern developed over more than three decades of clinical practice and refined across more than 12,000 Lyme disease patients. What follows is a realistic day-by-day guide to what you can expect.
The typical duration of a complete treatment program. This includes diagnostics, preparation, the hyperthermia session, recovery, additional integrative therapies, and initial follow-up. The exact duration depends on your individual clinical needs and how your body responds to treatment.
Your treatment begins not with a procedure but with understanding. The first two to three days are dedicated to the most thorough diagnostic workup most patients have ever experienced. For many, this phase alone is revelatory—it often identifies co-infections, immune dysfunction patterns, and biomarkers that previous physicians never tested for.
The diagnostic evaluation includes:
Your physician reviews all results with you personally. This is not a conveyor belt. It is an individualized evaluation by a medical team that has seen thousands of cases like yours and understands the nuances that standard testing misses.
Based on your diagnostic results, your physician designs a personalized treatment protocol. The preparation phase ensures your body is in the best possible condition to respond to hyperthermia and to recover safely afterward.
Pre-treatment therapies may include:
During this phase you will also have a consultation with the anesthesiologist who will be present during your hyperthermia session. This is a thorough evaluation of your anesthesia fitness—your airway, medication history, allergies, and any factors that could affect sedation. The anesthesiologist will explain the sedation process, answer your questions, and confirm that you are a safe candidate for the procedure.
Your treating physician will also sit with you to explain the treatment plan in detail, set expectations for the session and recovery period, and address any concerns. We understand that this is a significant medical decision, and we want you to feel fully informed and genuinely ready.
This is the central event of your treatment program. The day of your hyperthermia session follows a carefully structured protocol that has been refined over 30,000 procedures.
The first several days after hyperthermia are the most physically demanding part of your treatment. You will feel fatigued, and many patients experience what is sometimes called a Herxheimer-type reaction—a temporary worsening of symptoms caused by the rapid die-off of bacteria and the release of inflammatory toxins.
What to expect:
Throughout this period, you remain in the hospital. Your medical team monitors your recovery, provides IV fluids and detoxification support, manages symptoms, and adjusts your post-procedure care as needed. You are not alone during this phase.
As you recover from the hyperthermia session, the treatment program continues with additional therapies tailored to your specific needs. Hyperthermia is powerful, but it works best as part of a comprehensive protocol.
Follow-up therapies may include:
Before discharge, your physician provides a detailed written follow-up plan. This includes continued medication schedules, supplement recommendations, dietary guidance, and activity guidelines for the weeks and months following treatment.
Treatment does not end when you leave the hospital. The follow-up period is critical to sustained improvement. Your medical team coordinates with your local physicians to ensure continuity of care.
Most patients begin to notice meaningful improvement 4–12 weeks after treatment, with continued gradual progress over 6–12 months. Some patients return for a second treatment cycle several months later, particularly those with longstanding or complex infections.
Because the hyperthermia session itself is the part of the process that understandably generates the most questions and anxiety, here is a more detailed account of what happens.
On the morning of your session, you fast from midnight. An IV line is placed, and you change into a hospital gown. Your physician and anesthesiologist visit you to confirm that you are feeling well, answer any last questions, and review the session plan. Blood samples may be drawn for baseline comparison.
You are then transferred to the hyperthermia suite—a dedicated treatment room equipped with the Heckel HT3000 system and full monitoring equipment. The atmosphere is calm and the team is experienced. For most patients, the moments before sedation are the most anxious part of the experience. The team understands this and takes the time to put you at ease.
Once you are positioned comfortably, the anesthesiologist begins propofol sedation. You lose consciousness within seconds. From this point forward, you will not be aware of the procedure.
Monitoring equipment is connected: continuous ECG, arterial blood pressure line, pulse oximetry, multiple core temperature sensors (rectal and/or esophageal), and respiratory monitoring. Once stable sedation is confirmed, the Heckel HT3000 infrared panels begin the warming phase.
Core temperature rises gradually—approximately 1°C per 30–40 minutes. This controlled rate of warming is important for safety and physiological stability. The warm-up phase typically takes 2–3 hours to reach the target temperature of 41.6–41.8°C.
Once core temperature reaches the therapeutic range, it is maintained for approximately two hours. During this phase, the infrared output is adjusted continuously to hold the temperature within the narrow target window. IV antibiotics are administered during this period for maximum synergistic effect, as bacterial membranes are most permeable at this temperature.
The medical team monitors all vital parameters continuously and records data at regular intervals. Any deviation from expected values triggers an immediate assessment and response protocol.
After the therapeutic plateau, the infrared panels are turned off and the cooling phase begins. Core temperature decreases naturally, assisted by ambient cooling measures. The cool-down takes approximately 1–2 hours. Sedation is maintained until core temperature returns to a safe range, typically below 39°C.
As you emerge from sedation, you will feel groggy and disoriented. This is normal. You are transferred to a recovery bed where nursing staff monitor you closely. Most patients sleep for several hours after the procedure and may not be fully alert until the following morning.
Understanding the medical process is important. But so is practical preparation. Here are the things patients most often wish they had known before arriving.
For detailed information about traveling to Germany for treatment, accommodation options near the hospital, and logistical guidance, see our international patients guide.
If you want to understand the safety profile and potential risks in more detail before making your decision, continue to our safety and risks page.
Share your medical history with our team. A case review takes the uncertainty out of the process and tells you honestly whether treatment at St. George Hospital is a realistic option for you.
The deep science: Borrelia thermolability, the three mechanisms of action, why whole-body vs. localized, and how it addresses persister forms.
Read more →Honest information about side effects, rare risks, contraindications, and how safety is managed before, during, and after treatment.
Read more →Travel logistics, accommodation, visa guidance, insurance documentation, and everything you need to plan your trip to Germany.
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