@rodgergrummidge take a look at these studies and let me know what you think
There seem to be mechanisms at play beyond hemoglobin saturation.
- Mitochondrial function (1) (2)
- Blood flow to the brain and other organs (3) (4)
- Healing neurological damage (5) (6)
- Anti-viral and anti-bacterial effects (7) (8)
- Autoimmunity (9) (10)
- Studies on the use of HBOT for fibromyalgia, CFS/ME, and Lyme (11) (12) (13) (14)
I'm aware these studies are imperfect in their sample size / methodology / etc but given funding levels it's the best we have
Hi
@Jesse2233 , thanks for list of refs above. I had a quick look over. IMO, the pubs listed are fairly weak being either i) animal studies which are difficult to interpret in terms of human disease, ii) in vitro studies where cells are exposed to 20% O2 which is vastly different to the O2 levels exposed to cells in the body or iii) published in non-ISI journals (eg the Lyme study) which is often associated with weak science that is poorly controlled.
But, I had a look over some other published studies to see how strong the evidence is for HBOT in the treatment of various diseases. My summary and thoughts are below:
Clinical use of HBOT: Hyperbaric oxygen therapy (HBOT) provides pure, 100% oxygen at a pressure that is much greater than the atmospheric level. HBOT has been used to treat a range of conditions and is clinically approved by the FDA to treat 13 conditions including:
- CO poisoning
- Decompression sickness and gas embolisms (eg. From diving and surfacing too quickly)
- Radiation-induced tissue damage
- Skin infections such as Clostridial Myonecrosis (gangrene caused by bacteria)
- Chronic osteomyelitis that is unresponsive to standard surgical and antibiotic therapy
- Trauma and tissue damage that disrupts the microcirculation and results in ischemia, edema, and tissue necrosis.
- Increasing the oxygenation of skin grafts and reconstructive tissue flaps in order to increase the success of graft survival.
- Acute anemia due to large loss of blood.
- Wound healing in patients with poor circulation (eg. diabetic patients with microcirculation deficiencies)
HBOT and bacterial infections: HBOT has been shown to have anti-bacterial activity in some pathologies. Neutrophils and macrophages are amongst the first cells to arrive at damaged or injured tissue. Their role is to induce an inflammatory response that wards off bacterial infections so that the damaged/injured tissue can be repaired. The ability of the innate immune system (neutrophils and macrophages) to provide a first-line defence of damaged tissues against bacterial infections depends on a ready supply of O2. The defensive activities of neutrophils and macrophages are reduced in hypoxic conditions (low O2) and so there is an increased risk of infection. Neutrophils and macrophages require O2 to generate oxygen free radicals that are released as part of their "respiratory burst" that is used to kill bacteria. HBOT is thought to restore O2 levels in hypoxic tissues and so increase the ability of neutrophils and macrophages to defend against infection. In addition to its role in aiding bacterial killing by neutrophils/macrophages, increased O2 concentrations can be bactericidal for certain bacteria. So the increased O2 provided by HBOT may provide direct antibacterial activity. If a bacterial infection was the underlying cause of CFS, it is possible that HBOT might be of some benefit.
HBOT, pain and the treatment of fibromylagia: A number of clinical trials have provided evidence that HBOT can reduce pain symptoms.
1) In a clinical trial examining fibromylagia patients, fifteen 90-minute HBOT sessions at 2.4 atmospheres absolute (ATA) over 3 weeks significantly reduced the number of pain/tender points and pain threshold even after 1 HBOT session. The improvements obtained using HBOT persisted over the 15 sessions (J Int Med Res. 2004;32:263–267).
2) In another trial, HBOT was examined in post-trauma wrist pain using fifteen daily 90-minute HBOT sessions at 2.4 ATA. HBOT treatment reduced wrist swelling and pain after the final treatment. Reduced symptoms persisted 45 days post treatment (J Int Med Res. 2004;32:258–262).
3) In another Fibromyalgia trial, a HBOT protocol comprised 40 sessions, 5 days/week, 90 minutes, 100% oxygen at 2.0 ATA was examined. HBOT resulted in a decrease FMS pain symptoms. In addition, HBOT also provided some normalization of brain activity as measured by single photon emission computed tomography (SPECT) imaging. It was notable in this trial that patients often complained of symptom worsening during the first 4 weeks (PLOS ONE DOI:10.1371/ journal.pone.0127012).
One possible confounding issue in these human pain clinical trials is that the treatments cannot be blinded as the change of air pressure associated with HBOT is obvious to both staff and patients. Nonetheless, the findings are very encouraging.
HBOT and the treatment of CFS, mitochondrial diseases or fatigue. I couldn’t find any convincing publications examining the use of HBOT in any of the conditions associated with CFS including decreased mitochondrial functions, fatigue or recovery after exercise. Reference 12 cited above was published in an obscure journal of unknown quality in 2013 with no followup papers and so it is difficult to interpret the findings of that study.
Adverse effects of HBOT and potential clinical dangers. When used according to standard protocols within a clinical setting, and with O2 ATA not exceeding 3 atmospheres and treatment sessions limited to a maximum of 120 minutes, hyperbaric therapy appears to be relatively safe. Although rare, some deaths have occurred using HBOT in commercial non-clinical settings in several countries. Other adverse effects include reversible myopia, a consequence of the direct toxic effect of oxygen on the lens. Some patients may experience pain due to barotrauma if rupture of the middle ear or sinuses occur. Seizures due to HBOT can occur, but these are rare.
General HBOT conclusions: HBOT has been described as a “therapy in search of a diseases” (Chest 92:1074-82) which is very apparent from the proliferation of commercial HBOT clinics claiming to treat a wide range of conditions. The HBOT clinically approved protocols for treating the Bullet-Point conditions I listed above all use >2 atmospheres absolute (ATA). It is important to distinguish between HBOT which uses 100% O2 at >2.0 ATA and Normal Barometric O2 treatment (NBOT) that uses 100% O2 at 1.0 ATA. Several studies make the point that there is no evidence that 100% O2 at 1.0 ATA can provide any of the effects observed using clinical grade HBOT at >2.0 ATA. This is probably because of the vanishingly small increases in O2 dissolved in bodily fluids achieved by using NBOT with 100% O2 and 1.0 ATA (see the graph I posted earlier in this thread). NBOT that is commonly used in DIY home tents and masks may have no clinical activity for any condition or pathology. Thus, NBOT may be a waste of time, money and effort.
Conclusions regarding HBOT and the treatment of pain: Although there is no microscopic evidence of definitive pathology in the muscles/tissues of fibromyalgia patients, it is possible that hypoxia and ischemia may contribute to pain sensitization (Pain Manag. (2016) 6(4), 383–400). As outlined above, promising results have been published using HBOT performed in a clinical environment using >2.0 ATA in the treatment of pain. Thus, HBOT might be worth considering as an adjunct therapy for the management of pain in fibromyalgia and CFS..
To state the obvious, any HBOT treatment should always be performed under the supervision of clinically qualified doctors.
A Question: Has anyone made a compilation of costs for 15-50 HBOT sessions performed over 1-6 months in different clinics in different countries? It might be useful for individuals in decision-making as to whether HBOT might be a useful adjunct treatment for those of us with fibromylagia or CFS.
Rodger