Ozone Therapy Improves Hepatitis C Fatigue, and Reduces Viral Load. Could it Work for ME/CFS Too?


Senior Member
Chronic hepatitis C virus infection has a lot of similarly to ME/CFS: it is caused by a virus, and has much of the symptoms of ME/CFS. The following study on ozone treatment for hepatitis C virus is interesting, as the treatment reduced viral loads, and significantly improved symptoms such as fatigue:

Preliminary Results of Ozone Therapy as a Possible Treatment for Patients with Chronic Hepatitis C (full paper here)

Patients with chronic hepatitis C infection were given ozone therapy three times per week (they were all given a combination of three forms of ozone therapy: major autohemotherapy, minor autohemotherapy and rectal ozone insufflation).

Around half the patients were given a total of 30 sessions of ozone therapy, and the other half were given a total 60 ozone treatment sessions. There was also a control group which was not given ozone.

After 30 such ozone treatments (2.5 months), 25% of patients no longer had hepatitis C virus RNA in their blood. After 60 ozone treatments (5 months), 44% of patients no longer had hepatitis C virus RNA in their blood.

There was also a significant improvement in chronic hepatitis C virus symptoms such as fatigue, abdominal pain, arthralgia, and loss of libido. See the graph below which illustrates the improvements achieved:

The levels of the liver enzymes ALT and AST normalized in 58% and 60% respectively of the 30 and 60 session patients.

Improvements in Symptoms After Ozone Therapy

The major autohemotherapy ozone treatment used in this study is described here. Essentially, autohemotherapy involves drawing some blood from the patient, injecting medical grade ozone gas into that blood, and then intravenously infusing this blood back into the patient. Major autohemotherapy requires trained professionals in a clinical setting.

Rectal insufflation of ozone (putting a small amount of ozone gas into the rectum) is considered to be almost (95%) as effective as major autohemotherapy. Ref: 1 But rectal insufflation of gas can easily be self-administered at home, if you have a machine that makes ozone gas (which cost around $1,000 for a medical grade device).

Thus ozone therapy at home, in the form of rectally administered ozone, would be quite feasible, and easy to do.

There seems to be very little online about ME/CFS patients trying ozone treatment, and certainly no studies on this that I could find. That could of course be because it is not particularly helpful for ME/CFS.

Though it is possible ozone therapy may help fluoroquinolone toxicity syndrome (FTS). There have been a few accounts of ozone therapy leading to recovery from fluoroquinolone toxicity syndrome (FTS). See here:

Bill’s Recovery Story – Avelox Toxicity

Ricardo’s Story – Recovery from Ciprofloxacin Toxicity

I think the treatments were by ozone autohemotherapy, which requires a doctor to do.

It's possible that the easy ozone application technique that I devised (see this post), which costs very little and can be done at home might be a good substitute for ozone autohemotherapy, but I am not sure.
Last edited:


Senior Member
It is worth noting that according to FDA :"Ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy. In order for ozone to be effective as a germicide, it must be present in a concentration far greater than that which can be safely tolerated by man and animals". (R)


Senior Member
It is worth noting that according to FDA :"Ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy. In order for ozone to be effective as a germicide, it must be present in a concentration far greater than that which can be safely tolerated by man and animals". (R)
That is true. But according to Dr Velio Bocci, it may be ozone's effects on the metabolism (possibility an immunomodulatory effect) that have benefits. As you point out, ozone levels in the blood during ozone therapy are far too low for ozone to have any direct germicidal action against viruses and bacteria.

It certainly is a common misconception that ozone therapy directly kills viruses and bacteria. It doesn't have a direct germicidal action. Rather, ozone therapy puts the body under transient oxidative stress, and this activates biological mechanisms which may provide benefits, including the possible release of stem cells.

Some info about Dr Velio Bocci's book on ozone given here:

Hematologic Ozone put me in remission | Health Rising

The following is the conclusion of chapter 4 of Dr Velio Bocci's book:
What Happens When Human Blood is Exposed to a Therapeutic Dose of Oxygen-Ozone?

Both gases dissolve in the water of plasma depending upon their solubility, partial pressure and temperature. While oxygen readily equilibrates between the gas and the blood phases, the ten-fold more soluble ozone cannot equilibrate because it reacts with biomolecules (PUFA, antioxidants) present in the plasma. The reaction yields hydrogen peroxide (among other possible ROS) and lipid oxidation products (LOPs).

The sudden rise in plasma of the concentration of hydrogen peroxide generates a gradient, which causes its rapid transfer into blood cells where, in a few seconds, it activates several biochemical processes and simultaneously undergoes reduction to water by the efficient intracellular antioxidant system (GSH, catalase, GSH-Px).

This critical step corresponds to a controlled, acute and transient oxidative stress necessary for biological activation, without concomitant toxicity, provided that the ozone dose is compatible with the blood antioxidant capacity.

While ROS are responsible for immediate biological effects (Figure 1), LOPs are important as late effectors, when the blood, ozonated ex vivo, returns into the circulation upon reinfusion (Figures 2 and 3).

LOPs can reach any organ, particularly the bone marrow where, after binding to receptors in submicromolar concentrations, elicit the adaptation to the repeated acute oxidative stress, which is the hallmark of ozonated autohemotherapy. Upon prolonged therapy, LOPs activity will culminate in the upregulation of antioxidant enzymes, appearance of oxidative stress proteins (haeme-oxygenase I as a typical marker) and probable release of stem cells, which represent crucial factors explaining some of the extraordinary effects of ozonetherapy (Chapter 8).

It must be emphasized that blood exposed to ozone undergoes a transitory oxidative stress necessary to activate biological functions without detrimental effects. The stress must be adequate (not subliminal) to activate physiological mechanisms, but not excessive to overwhelm the intracellular antioxidant system and cause damage. Thus, an excessive ozone dose or incompetence in manipulating this gas can be deleterious. On the other hand, very low ozone doses (below the threshold), are fully neutralised by the wealth of plasma antioxidants and can produce only a placebo effect.

The concept that ozonetherapy is endowed with an acute oxidative stress bothers the opponents of this approach because they consider it as a damage inflicted to the patients, possibly already under a chronic oxidative stress. they do not believe that ozonetherapy induces a multivaried therapeutic response already well documented in some diseases.

Moreover they do not distinguish the chronic oxidative stress (cos) due to an endogenous and uncontrolled hyperoxidation with the small and transient oxidative stresses that we can precisely perform ex vivo with the ozone dose.

Source: Chapter 4 of the book OZONE. A New Medical Drug, by Velio Bocci, Springer 2005.


Senior Member
Chronic hepatitis C virus infection has a lot of similarly to ME/CFS: it is caused by a virus, and has much of the symptoms of ME/CFS. .
interestingly reduced IDO activity was found in HCV infection, and traitement with Direct Acting Antiviral Agent greatly improve fatigue and mood in patients, and is associated with increased Kynurenines (IDO activation)

Low serum tryptophan levels, reduced macrophage IDO activity and high frequency of psychopathology in HCV patients

First published: 23 March 2006

Prof. Flavio Moroni, Dipartimento di Farmacologia Preclinica e Clinica, Università di Firenze, Viale Pieraccini 6, 50139 Florence, Italy. E‐mail: flavio.moroni@unifi.it

Summary. Indoleamine 2,3‐dioxygenase (IDO), a key enzyme of tryptophan (TRP) metabolism, is induced in various tissues of patients with bacterial and viral infection or with neoplastic diseases. This induction is considered the main cause of the decreased serum TRP levels, the reduced brain serotonin synthesis and the occurrence of psychopathological disorders often detected in patients with chronic infections or different forms of cancer. We studied 89 subjects including: (a) 39 patients with chronic hepatitis C virus (HCV) infection and mild liver damage (b) 40 healthy controls, and (c) 10 patients with chronic hepatitis B virus (HBV) infection. We measured serum TRP and kynurenine levels and IDO activity in macrophages. Furthermore, each patient had an accurate psychopathological evaluation. HCV‐infected patients had lower (−28%) serum TRP concentrations than healthy volunteers or HBV‐infected patients with comparable liver damage. Depression and anxiety symptoms were particularly common in HCV patients. Unexpectedly, serum kynurenine levels and IDO activity in cultured macrophages (under both basal or stimulated conditions) were lower in HCV patients than in controls. Our study shows that HCV patients have reduced serum TRP levels and confirms that they frequently suffer from anxiety and depression‐related symptoms. The reduced IDO activity found in the macrophages of these patients suggest that HCV infection may hamper macrophage functions.'

Antidepressant effects of direct‐acting antivirals against hepatitis C virus—Results from a pilot study

First published: 02 September 2018

Background and Aims

The new direct‐acting antiviral agents (DAA) have revolutionized the treatment of patients with chronic hepatitis C virus (HCV) infection. This study investigates to which extent DAA affect fatigue and mood and, if so, whether this results from changes to tryptophan (TRP) metabolism, as reflected by two critical biosynthetic pathways, serotonin (SRT) generation from TRP and TRP degradation through kynurenines (KYN) via indoleamine 2,3‐dioxygenase (IDO).

In this study, DAA exert positive and persistent effects on both fatigue and mood in patients with chronic HCV infection. These extrahepatic benefits are, at least in part, related to the modulation of TRP metabolism. The robust elevation of KYN concentrations challenges the current paradigm of low KYN levels as prerequisite for mental health.