Is EWOT a "hack" to exercise without PEM?

[Jesse2233]

Has anyone here used EWOT (exercise with oxygen therapy) to get the benefits of exercising without PEM or a worsening of their condition?

I've been having success with mHBOT and I wonder if EWOT would be a good adjunct given recent findings on impaired OXPHOS. I haven't seen many patient reports on PR, HR, MyPatientMatch, ProHealth, or Reddit, and of course there are no formal studies.

Dr Jamie Deckoff-Jones has however covered its potential ME benefits in a blog post from 2012

She discusses EWOT literature on athletes, COPD, and CHF

For some time, I’ve wanted to try EWOT or exercise with oxygen therapy. I use oxygen to prevent PEM, but I have never exercised with it on. It requires a high flow concentrator (> 8L/min) and a mask with a reservoir that will stay on, but not restrict air flow. There is literature to support the idea that elite athletes (and rats) can do more work while wearing supplemental oxygen, though results have been equivocal as to whether exercising while hyperoxic improves performance in the long run.

• Effect of Hyperoxic-Supplemented Interval Training on Endurance Performance in Trained Cyclists
• Effects of Hyperoxic Training on Performance and Cardiorespiratory Response to Exercise
• The effects of training in hyperoxia vs. normoxia on skeletal muscle enzyme activities and exercise performance

I have wondered if it might not also be true that our exercise capacity could be increased this way, we who are on the low end of the bell curve. There isn’t much to go on in the literature, but there are a few papers about exercising with COPD and an oldie but goodie about using periodic hyperoxia to improve exercise capacity in CHF.

• Effects of increased inspired oxygen concentrations on exercise performance in chronic heart failure.
• Hyperoxic interval training in chronic obstructive pulmonary disease patients with oxygen desaturation at peak exercise
• Effect of acute hyperoxia during exercise on quadriceps electrical activity in active COPD patients

Later, and even more interestingly, she references two papers on mitochodnrial myopathies

Here is another dot to connect:

• Supplemental oxygen and muscle metabolism in mitochondrial myopathy patients. In summary, patients with MM show impaired oxidative ATP production in their skeletal muscle, consistent with mitochondrial disease. This study has also shown that increased inspired oxygen concentration improves oxidative function in patients with mitochondrial myopathy, but not sedentary healthy individuals. It is hypothesised that the improvement in oxidative function with increased oxygen inhalation could be the result suboptimal oxygen conductance during exercise.
• Oxygen Therapy for Mitochondrial Myopathy. Letter to the editor, so no abstract, but here are excerpts: We report on a physician-patient with a diagnosis of undifferentiated autoimmune disease, pandysautonomia, and mitochondrial dysfunction… Her functional capacity has gradually improved, and her prednisone dose has been substantially decreased for the first time in 8 years. She can now drive around town, walk in a shopping mall, and perform some household chores. In addition, the hair that had previously disappeared from her extremities (thought to be secondary to either the autoimmune disease or medication side effect) has regrown. Prior to oxygen therapy, her soft tissues in the extremities were painful with a boggy firmness, a fibromyalgia-like finding also thought to be part of the autoimmune syndrome. This symptom has gradually, but significantly, improved through a combination of body work (osteopathy and massage) and oxygen therapy. Prior to receiving supplemental oxygen, the same type of body work had been only minimally effective… This case report suggests that supplemental oxygen can enable patients to perform higher levels of cardiopulmonary work with less lactic acid accumulation than room air alone. The use of supplemental oxygen may not only improve functional capacity and certain physiologic abnormalities but may also minimize the mitochondrial stress, which has been postulated to increase the proportion of mutant mitochondria.

Caveat: what would be best is likely sensible gentle exercise at gradually increasing intensity and duration for mild to moderate patients who are stable on other treatments

 

[junkcrap50]

I've wondered the same thing. Especially since people with CFS have their CPET (Cardio Pulmonary Exercise Testing) show that they quickly and prematurely enter an anerobic state (as opposed to lasting in aerobic state), far earlier than healthy people. As a result, their VO2 Max and other results of the CPET are abnormal, compared to controls.

 

[Alvin2]

I will be a bit surprised if this works because oxygen is not the limiting factor (our blood oxygenation is the same as everyone else), it seems to be energy (glucose) utilization ability.

 

[Wishful]

If it's the t-cells cleaning up damaged muscles that causes exercise induced PEM, then extra oxygen shouldn't help, and might possibly even make it worse (imagining supercharged t-cells).

Sounds like a health scam to me.

 

[Jesse2233]

@junkcrap50 good point!

@Wishful I don't think it's a scam as it seems to be effective for some indications. The question is whether it would help us.

I understand your point on T-cells and don't know the answer, but a worsening due to increased oxygen has not been my personal experience with mHBOT

 

[Jesse2233]

Did some light yoga and a few push ups tonight while wearing an oxygen mask hooked up to my condenser running at 7L/m

Felt less out of breath and my heart rate returned to normal quicker

I will slowly increase intensity and oxygen flow rate