Four years ago, I became fascinated with the idea of using oxygen as a way of helping people with chronic illness and I added Exercise with Oxygen Therapy (EWOT) to the office as therapy. Because of the nice results with EWOT, I purchased a hyperbaric oxygen chamber (HBOT) and am now devoting a room in the office for oxygen therapy, PEMF, and Infrared light therapy. All these therapies improve mitochondrial function which research in the past decade is showing to be an integral approach in treating chronic inflammation and illness. Why add HBOT as another therapy and what advantages does hyperbaric oxygen offer? That is what this newsletter will “dive” into.
While both HBOT and EWOT do increase the oxygen concentration of the blood plasma and increase the blood oxygenation to those cells and tissues that need it, HBOT offers a way of doing so with no exertion. For mild concussions and traumatic brain injuries (TBI’s), fibromyalgia syndrome, wound healing, someone who has had a stroke, or someone who has been chronically ill for a while such as with chronic Lyme or long Covid, the exertion required with EWOT could be difficult to do. For children who have neurodevelopmental delays, learning disabilities or ADD or ADHD, HBOT might offer an easier way of treating them in comparison to EWOT. In the case of a small child, it is even possible for both a parent and the child to enter the chamber together while the child gets the benefit of the treatment. While these conditions are considered off label uses of HBOT and HBOT should not be considered a cure for these conditions, there are many studies pointing to its effectiveness for problems like this. A PubMed search on mild hyperbaric oxygen therapy will yield over three hundred studies, many for conditions outside of what is approved by insurance reimbursement. Unfortunately, at this time HBOT is only approved by insurance companies for carbon dioxide poisoning from decompression sickness such as from scuba diving, diabetic and selected wound care, osteomyelitis, intracranial abscess, crush injuries and compartment syndromes, radiation injury and for burn victims.
Mild HBOT is a soft-shelled chamber that pressurizes to 1.3 atmospheres (ATM). To give you an idea of how atmospheric pressure works, sea level measures at 1.0 atmosphere so at 1.3 ATM it is equivalent to being below sea level, underwater at about ten feet and why HBOT treatments are referred to “dives.” If you wanted to climb a mountain to be at a half an atmosphere (.5 ATM) you would need to climb 23,000 feet. 2.0 ATM would be about thirty feet underwater.
While in the hyperbaric chamber you have the option of breathing the ambient air being used to keep the chamber inflated which is 21% oxygen or to wear a mask where you would breathe 95% oxygen delivered into the chamber through an external hose. Although there would be some benefit to breathing ambient air under 1.3 ATM of pressure, the benefit of breathing 95% oxygen results in a greater amount of oxygen that would dissolve into the plasma (the liquid portion of the blood).
The idea of dissolving a gas like oxygen into a liquid (blood) is easy to imagine when thinking of seltzer. The bottle of seltzer looks like water until you open the cap and pour out the seltzer into a glass and then you see the bubbles and the release of carbon dioxide that was dissolved into water under pressure. With a glass of seltzer sitting on a table it might take a few hours for all the carbon dioxide to disperse and for the seltzer to taste flat like water. It is no different with oxygen. Once you leave the chamber the more oxygen you took in during your session, the longer it will take for that oxygen to disperse out of you and for your body to return to where it was before you entered the chamber. However, in the few hours that you had that increased level of oxygen in your body, you have improved mitochondrial function and upregulated ATP production, helped kill harmful anerobic bacteria, lowered inflammatory cytokines, and increased nitric oxide and created angiogenesis of vascular connections in areas that may have a need for more oxygen like a damaged brain from a concussion or a stroke. The oxygen provides an opportunity for neuroplasticity and cognitive recovery. The mitochondrial benefits also include an increased size and number of mitochondria with the repeated use of HBOT.
It varies according to the individual case and problem as to how many treatments are necessary to see significant improvements. Outside of using it 1-2 times for muscle recovery from an athletic event, most chronic conditions usually see satisfactory results within 10-50 treatments.
HBOT is very safe but there are several precautions that people should be aware of before using it. If you have an acute asthmatic attack, have a high fever, a seizure disorder, have optic neuritis, pneumothorax, have emphysema, have an active ear or sinus infection, have glaucoma, have an aneurysm, are pregnant, have congenital spherocytosis, suffer from claustrophobia, or currently take one the following medications: Cisplatinum, Disulphiram, or Doxorubicin, then you should not do HBOT. Because of the pressure change in the chamber, you must be able to clear the pressure in your ears by swallowing or moving the jaw to “pop” the ear like you would if you were at altitude in an airplane.
There are several types of hyperbaric chambers. There are hard-shell varieties with the capability of reaching atmospheric pressures of 2.5-3.0 ATM. These are found in some hospitals and specialized medical facilities. In some circumstances increased strength is important but not in every case. The lower pressure in some cases works better and with higher pressures there are greater risks as well.
We all know that oxygen is essential for life. We have five liters of blood of which three liters are plasma and extraordinarily little oxygen is carried in the plasma. HBOT allows the oxygenation of plasma. Supplying extra oxygen like any other supplement can improve health. Angiogenesis is a term to describe the formation of new blood vessels in the body. With repeated treatments, HBOT promotes angiogenesis, and this becomes important to get oxygen delivered through the vascular system so that it can be delivered to the muscular system, the digestive system, and the nervous system.
Special thanks to Dr. Jason Sonner and his book Oxygen Under Pressure and his many videos on YouTube and Zayd Ratansi ND.
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