Hyperbaric without extra oxygen

[Hip]

I have now written to four experts (professors) in hyperbaric medicine, asking whether breathing 100% oxygen alone would be almost as effective as breathing 100% oxygen within a mild HBOT chamber at 1.3 ATM.

So far, I have not received any replies.

But I think mild HBOT chambers may be a bit of a con.

Such chambers cost around $6000, which is very expensive (not to mention the issues with their cumbersome size once you get them home), whereas I think you will get almost as good a result just by breathing oxygen from an oxygen concentrator machine (which extracts oxygen from the air to provide a supply of oxygen at 90% concentration or higher).



This article explains how either breathing 100% oxygen and/or breathing under increased hyperbaric pressure, raises the quantity of oxygen dissolved in the blood:

At physiological PO2, only a small amount of oxygen is dissolved in plasma since oxygen has such a low solubility.

At elevated PO2 (breathing 100% oxygen or during hyperbaric oxygenation), however, the physically dissolved form of oxygen can become significant. Henry's law states that the amount of oxygen dissolved in plasma is directly proportional to PO2

Note that PO2 = the partial pressure of oxygen (O2).

Partial pressure is proportional to the oxygen concentration in the air (there is a 21% concentration of O2 in normal air, versus 100% concentration when you breath pure oxyegn).

 

[boohealth]

They're not at all a con. I had no response (beyond feeling a little relaxed) to using my 02 concentrator in my room. HBOT even mild has a tremendous effect and I consider it one of my ongoing medicines. There is no comparison clinically, but you're welcome to try an 02 concentrator and see if it benefits you. They *are* rx for refractory cluster headaches but I believe at a low LPM of 2-3 per minute.. BTW for a chamber you need one that will go to 10LPM as it gets slowed down by the chamber pressure.

I don't know about all those laws you cited--here's an explanation that is rather brief. For more, consult the textbook of Hyperbaric Medicine and write the authors themselves.

http://emedicine.medscape.com/article/1464149-overview#a2

 

[Jesse2233]

@boohealth what sort benefits do you notice from HBOT?

 

[Hip]

I had no response (beyond feeling a little relaxed) to using my 02 concentrator in my room.

I read that when people use oxygen concentrators with an ordinary face mask, they will not be breathing anywhere near the 100% oxygen that some concentrator can supply, because a lot of ordinary air gets in. To breathe close to the 100% oxygen that some oxygen concentrators can supply, you need to have non-rebreather mask, which includes an attached reservoir bag.

And even then, you may still not get close to 100% oxygen, because many disposable non-rebreather masks do not fit the face tightly enough (there is no proper hermetic seal), so again you will be breathing in some ordinary air as a result of this poor fitting mask.

In addition, most non-rebreather masks have an open safety valve that lets in some air anyway (in case the oxygen supply runs out, as the patient could then suffocate if it were not for this open safety valve).

So even if you have an oxygen concentrators that supplies 100% oxygen, it does not mean that you will be breathing 100% oxygen. I read that even with non-rebreather masks, you may still only be breathing in around 60% to 85% oxygen.

And if you have an ordinary face mask, it will be much less than that.

To get near to 100% oxygen, I think you'd have to find a non-rebreather mask with a good hermetic seal to the face, and you would have to block the open safety valve, to prevent ordinary air getting in.



So although your oxygen concentrator may supply near 100% oxygen, if you used an ordinary simple face mask, you might in fact only be breathing in something like 40% oxygen or thereabouts.

 

[Sasha]

Thanks for starting this thread, @Hip. I've been reading it with interest, since I'd like to try HBOT but the nearest communal chamber is further than I'm safely able to travel and home HBOT chambers don't seem to be available to buy in the UK (and are of course bulky and expensive).

So even if you have an oxygen concentrators that supplies 100% oxygen, it does not mean that you will be breathing 100% oxygen. I read that even with non-rebreather masks, you may still only be breathing in around 60% to 85% oxygen.

Would 100% oxygen be necessary for beneficial effects, even if it would be optimum? I read what you said about Henry's Law (through brainfog) and took from it that the amount of oxygen in the plasma etc. would be proportional to the concentration of oxygen breathed in, so it wouldn't be an all-or-nothing effect.

And I wonder if the relatively low concentration could be compensated for by longer exposure.

 

[Hip]

Would 100% oxygen be necessary for beneficial effects, even if it would be optimum? I read what you said about Henry's Law (through brainfog) and took from it that the amount of oxygen in the plasma etc. would be proportional to the concentration of oxygen breathed in, so it wouldn't be an all-or-nothing effect.

That's right, if you were breathing say 95% oxygen, that would be almost as good as 100%, because it is a proportional thing: ie, the increase in oxygen dissolved in your blood is proportional to the increase in oxygen concentration that you are breathing.


So for example, with the normal oxygen concentration in air being 21%, if you went up to breathing say 42% oxygen, then that would double the amount of oxygen that gets dissolved in your bloodstream.

And if you were breathing 63% oxygen, that would triple the amount of oxygen dissolved in your blood.

And if you were breathing 100% oxygen, you will get nearly 5 times the amount of oxygen dissolved in your blood (since 100 / 21 = 4.8).

I think with a good non-rebreather mask set up properly and tight fitting to your face (so that there are no air leaks), you should be able to get up to at least 90% oxygen.

 

[Hip]

Note that it may be a good idea for anyone undergoing HBOT, mild HBOT or just breathing pure oxygen to ensure that their antioxidant status is adequate.

Oxygen toxicity can cause DNA damage, as well as lung damage.

This study found that the supplement Glisodin (an orally available form of the antioxidant superoxide dismutase) was able to protect against DNA damage during HBOT. And this study found that the antioxidant vitamin E was able to prevent lung injury in rabbits exposed to 100% oxygen for 48 hours.

 

[Sasha]

I think with a good non-rebreather mask set up properly and tight fitting to your face (so that there are no air leaks), you should be able to get up to at least 90% oxygen.

To get near to 100% oxygen, I think you'd have to find a non-rebreather mask with a good hermetic seal to the face, and you would have to block the open safety valve, to prevent ordinary air getting in.

I'd be worried about blocking a safety valve, and if there's no need to do so (if increasing the exposure length compensated for a lower concentration of oxygen), I think I'd want to avoid this.

Note that it may be a good idea for anyone undergoing HBOT, mild HBOT or just breathing pure oxygen to ensure that their antioxidant status is adequate.

Oxygen toxicity can cause DNA damage, as well as lung damage.

Very interesting - how do you find out about your antioxidant status?

This study found that the supplement Glisodin (an orally available form of the antioxidant superoxide dismutase) was able to protect against DNA damage during HBOT. And this study found that the antioxidant vitamin E was able to prevent lung injury in rabbits exposed to 100% oxygen for 48 hours.

Again, very interesting - thanks.

Do you know which consultant speciality this would fall under?

 

[Hip]

I'd be worried about blocking a safety valve, and if there's no need to do so (if increasing the exposure length compensated for a lower concentration of oxygen), I think I'd want to avoid this.

I can't myself see how it could cause a problem for an able-bodied person who is conscious: if the oxygen supply were to stop for any reason, you'd just pull the mask of your face. But, yes for unconscious patients or patients in delirium, I guess it could be dangerous.

Very interesting - how do you find out about your antioxidant status?

I am not sure how you can measure it, but what I mean is that it may be a good idea to take antioxidants such as vitamin E, Glisodin and others so that you ensure a good antioxidant status.

Do you know which consultant speciality this would fall under?

Do you mean which speciality HBOT falls under? I am not really sure. It's something of a fringe area of medicine, and I believe its use in treating illness is still controversial and unproven.

 

[Hip]

And I wonder if the relatively low concentration could be compensated for by longer exposure.

That is a hard question to assess: if we are talking about killing Borrelia bacteria in the body via exposure to increased oxygen levels, it's possible that small increases in oxygen level might not be as effective as higher levels, even if you were to compensate for the lower levels by doing longer sessions of breathing oxygen. But the answer to this question is anyone's guess.

 

[Sasha]

That is a hard question to assess: if we are talking about killing Borrelia bacteria in the body via exposure to increased oxygen levels, it's possible that small increases in oxygen level might not be as effective as higher levels, even if you were to compensate for the lower levels by doing longer sessions of breathing oxygen. But the answer to this question is anyone's guess.

That's a good point about Borrelia. I don't think I have Borrelia, though - I was thinking of the oxygen in general terms of healing damaged nerves and tissues (I don't know if I have them but it wouldn't surprise me).

 

[Hip]

That's a good point about Borrelia. I don't think I have Borrelia, though - I was thinking of the oxygen in general terms of healing damaged nerves and tissues (I don't know if I have them but it wouldn't surprise me).

Possibly there might be some therapeutic effects like that in ME/CFS.

But what grabbed my attention was @Jesse2233's recent thread about mild HBOT, performed daily for 18 months, curing one Lyme patient. Since Borrelia is more-or-less an anaerobic bacterium, higher levels of oxygen are likely toxic to Borrelia.

However the issue is the cost of a mild HBOT chamber, which would make mild HBOT inaccessible for many Lyme patients, especially since at this stage HBOT is an uncertain treatment for Lyme which may or may not work, so many people would not like to gamble the $6000 cost of a mild chamber.

However, if breathing 100% oxygen is almost as good as mild HBOT, that would dramatically improve the accessibility of this treatment (oxygen concentrators cost around $300), such that lots of Lyme patients could try it.

 

[boohealth]

Breathing 02 in a room doesn't help the way hbot, mild or deep dive does, period.

This is from years of experience.

Secondly 48 hours in an animal study, and Vitamin E, really isn't applicable to one hour in a chamber. However, if you want, take antioxidants in the morning or evening, but not during a chamber session.

If you are interested, there are a lot of threads on lymenet. Just go on to medical questions, and put in "hbot" "mild hbot" "oxgyen" into the search box and all the threads over the last few years will come up.

Good luck!

 

[Hip]

Breathing 02 in a room doesn't help the way hbot, mild or deep dive does, period.

You say that, but were you using a decent non-rebreather mask, so that you are actually breathing close to 100% oxygen? Or were you just using a simple face mask, in which case, your oxygen level may not be that much above the normal atmospheric concentration?

 

[aaron_c]

So for example, with the normal oxygen concentration in air being 21%, if you went up to breathing say 42% oxygen, then that would double the amount of oxygen that gets dissolved in your bloodstream.

Wouldn't this only apply to someone whose hemoglobin was not being fully "filled" with oxygen? After that I assume we would see a marginal increase in dissolved oxygen, but how much of a difference would that make given that it's hemoglobin saturation that maintains the level of dissolved oxygen?

 

[Hip]

@aaron_c, I think the first 4 paragraphs of this earlier post should answer your question.

 

[Jesse2233]

@Hip I appreciate all the research here. I'm wondering though if the increased pressure on the body as a whole has beneficial properties beyond what could be achieved with a rebreather mask.

 

[Hip]

@Hip I appreciate all the research here. I'm wondering though if the increased pressure on the body as a whole has beneficial properties beyond what could be achieved with a rebreather mask.

That was my thought also, and I spent some time Google searching for possible physiological effects of pressure other than the increased dissolved oxygen in the blood, but could not find much — except for a possible involvement of the dissolved nitrogen, which can produce something called inert gas narcosis, an effect that occurs in the synapses of the brain, and which can be a problem for divers.

Hyperbaric nitrogen can act as an anesthetic agent, and the inert gas narcosis it can produce impedes mental functioning and physical performance in divers.

Dissolved nitrogen of course is also a problem for divers when they surface too quickly, as the dissolved nitrogen in their blood precipitates out into tiny bubbles in the bloodstream, the well-known diver's bends (decompression sickness). However, the bends is a different issue to inert gas narcosis caused by dissolved nitrogen.

You will get more nitrogen dissolved in the blood in a hyperbaric chamber if you are breathing air, or an air / oxygen mixture (the nitrogen concentration in air is 78%). But obviously you will get no dissolved nitrogen if you are breathing 100% oxygen in your HBOT chamber.

 

[Butydoc]

Wouldn't this only apply to someone whose hemoglobin was not being fully "filled" with oxygen? After that I assume we would see a marginal increase in dissolved oxygen, but how much of a difference would that make given that it's hemoglobin saturation that maintains the level of dissolved oxygen?

Oxygen content is the actually amount of total oxygen in your blood. Hemoglobin saturation is not directly related to oxygen content. At room air at sea level, most people have an O2 saturation of 95% or greater. Increasing the O2 to 42 percent can only increase the O2 saturation by 5%.

 

[aaron_c]

Thanks @Hip and @Butydoc.

Let me start by saying that I think my understanding must be wrong if 90% O2 saturation implies hypoxemia. But I'm not quite sure why I'm wrong and I'm not sure how to say this more concisely. Thanks for your patience!

What I'm trying to understand is how a tiny and possibly short-lived increase in dissolved oxygen content at the lungs can translate into...well much of anything. I get that a tiny increase in dissolved oxygen content could make a difference if it was sustained throughout the body, but my (rough) understanding of how hemoglobin works seems to suggest that the change would not be sustained.

@aaron_c, I think the first 4 paragraphs of this earlier post should answer your question.

Actually, those paragraphs are where the question came from. These parts in particular:

with the normal atmospheric oxygen concentration of 21%, most of the oxygen that gets into the blood is bound to the hemoglobin on the red blood cells.

However, even at increased pressures and oxygen concentrations, the amount of oxygen bound to hemoglobin stays around the same, because in people with normal healthy lung function, the hemoglobin is already almost 100% saturated with oxygen, and cannot carry any more.

OK, so what I'm trying to understand is how a tiny and possibly short-lived increase in blood oxygen content at the lungs can translate into...well much of anything. I get that a tiny increase in blood oxygen content could make a difference if it was sustained throughout the body, but my (rough) understanding of how hemoglobin works seems to suggest that the change would not be sustained.

So here is how I understand hemoglobin works: There are a number of factors that determine when hemoglobin will release oxygen into the blood, including the serum's existing oxygen, carbon dioxide, and carbon monoxide content. Since we're only talking about adding more oxygen I think the oxygen content is the only applicable variable in this case. All else being equal, hemoglobin will only release oxygen into the serum when the oxygen content of the serum drops low enough. The normal 95% O2 saturation that Butydoc referenced means that normally only 5% of our hemoglobin has 3 binding spots filled with oxygen instead of 4.

The way I imagine it each hemoglobin molecule has an oxygen that is waiting for the local concentration of oxygen to fall low enough that it can dissociate into the serum. But this only happens when the local oxygen content falls to a certain level. In my mind hemoglobin will maintain a level of dissolved oxygen until almost all of the hemoglobin is no longer saturated. Is this accurate? Or would adding more hemoglobin (or red blood cells containing hemoglobin) increase the oxygen dissolved in the serum?