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HomeHealthHyperbaric Remedy — A Vastly Underused Therapy Modality

Hyperbaric Remedy — A Vastly Underused Therapy Modality

Dr. Jason Sonners, writer of the e-book, “Oxygen Below Stress: Utilizing Hyperbaric Oxygen to Restore Well being, Cut back Irritation, Reverse Growing old and Revolutionize Well being Care,” began out as a chiropractor. His ardour, nevertheless, is hyperbaric oxygen remedy (HBOT), which is the main focus of his Ph.D. research on the College of Miami.

Whereas generally used to hurry up cussed wounds and tissue infections, hyperbaric drugs may also be useful within the remedy of infectious ailments akin to COVID. It’s additionally enormously helpful for stroke sufferers. I can not consider a more practical intervention than to get the stroke affected person right into a sequence of hyperbaric therapies as shortly as potential.

HBOT for Normal Well being and Illness Reversal

Each cell in your physique, excluding your crimson blood cells (which haven’t any mitochondria that require oxygen), requires oxygen to create power. Many continual ailments of the fashionable world contain decreased mitochondrial operate, elevated systemic irritation, and an incapability of cells to generate the required quantities of power for optimum operate.

“We use hyperbaric oxygen, historically, for these horrible and extreme circumstances,” Sonners says. Sadly, it’s sometimes a final resort, actually proper earlier than an amputation surgical procedure or as a life-saving mechanism for someone with carbon monoxide poison or air fuel embolism.

“So, we solely give it some thought, historically, to assist save the life or limb of someone in a extremely extreme situation, however the mechanisms which might be working for these people are similar to the explanations that you simply and I would think about using hyperbaric oxygen:

For upregulating the oxygen ranges inside your physique, which can assist scale back irritation, improve mitochondrial operate … and thereby rising the power that these cells are capable of generate …” 

HBOT for Persistent Ailments

Sonners’ objective is to develop using HBOT from the acutely life-threatening points like gangrene to extra continual circumstances, akin to autoimmune and neurodegenerative ailments.

“My thought course of is that the mechanisms of motion of hyperbaric are the identical whether or not we’re speaking about gangrene, radiation burns and osteonecrosis, or TBI [traumatic brain injury], concussion, possibly MS [multiple sclerosis] and post-stroke.

If we actually get a mastery of the mechanisms of motion, we are able to begin to apply these mechanisms throughout the board. Clinically, we have seen hyperbaric work for therefore many of those different continual sicknesses …

So, if we might actually dwelling in on these mechanisms and perceive them higher, after which get a greater feeling for what time and stress settings we require so as to get these mechanisms to kick in, then we are able to actually, with extra confidence, apply this remedy to those different circumstances and have extra constant ends in doing so.

Numerous the work I am proposing to do is tagging onto a few of this work in regenerative drugs, the place they have been trying on the collagen, fibroblast and stem cell response to hyperbaric. A research got here out in 2020 on telomeres, and taking a look at this potential, upwards of 20% improve in telomere size, particularly in sure immune system cells.

I wish to construct on that information base, so what I am doing is I am making a research that is going to have a lower-pressure group and a higher-pressure group, and we will be taking a look at an entire cytokine panel, so we are able to perceive the mechanisms of the anti-inflammatory aspect.

We’ll have a methylation panel in order that we are able to begin trying on the epigenetic results of hyperbaric. We’ll have a telomere part, much like the telomere research that was performed a 12 months and a half in the past.

And we will begin evaluating all of these metrics throughout roughly a three- to six-month timeframe of remedy, and over two separate stress settings, to raised perceive which pressures are getting which results, and once more, what time period ought to we expect earlier than we get the outcomes that we’re searching for?”

Analysis Underway

On the low finish, Sonners will probably be utilizing 1.3 atmospheres (4.2 PSI) at 100% oxygen, and on the excessive finish, he’ll use 2.0 atmospheres (14.7 PSI) at 100% oxygen. All sufferers will use exhausting chambers at two completely different pressures. The decrease stress group will probably be at 4.2 psi, which is similar as gentle chamber pressures.

“There’s nowhere close to the quantity of analysis in gentle chambers as there are in exhausting chambers,” Sonners says. “The overwhelming majority of analysis is finished at that 2-atmosphere vary, which is why I am selecting that because the higher finish of the analysis that I am doing within the gentle chamber analysis.

There’s positively some [research] on sports activities restoration. There’s truly some ongoing research proper now on hyperbaric for stem cell use that we’re ready for. In some circumstances, 1.3 [atmospheres] has been used because the sham group, against a remedy arm within the analysis. Possibly the research staff actually thought that 1.3 wasn’t going to have an impact and it is a professional sham …

I am undecided, however there are some nice research. There is a research that was performed on cerebral palsy (CP) and 1.3 was used because the sham group … On this explicit research, with 1.3 being the sham group, there was additionally a … management group that acquired no hyperbaric in any respect.

Inside the sham group, there was vital enchancment on the metrics they have been measuring. Then they’d a 1.5 [atmospheres at] 100% oxygen, which additionally had a very good enchancment after which, a 1.75 [atmospheres at] 100% oxygen, which had even a better enchancment.

The problem within the research was that whereas all three of these teams improved, there was no statistical distinction or sufficient of a statistical distinction between the 1.3, the 1.5 and the 1.75. So, the conclusion of the research was due to this fact that hyperbaric doesn’t work for CP, though all three of these teams had vital enchancment.

So, as a result of the sham group was not thought-about a remedy, that was the conclusion of that research. Now, the pure consequence of that ought to have been redoing the research and creating a unique degree of what the sham and the remedy arms should be, however that was by no means redone.

So, because of this, there’s this research with outcomes that say hyperbaric doesn’t work for CP. In the meantime, clearly, what it means is we want extra research. It is simply that research are costly. They’re very time consuming and you actually need to have a big curiosity in making an attempt to provide you with the precise solutions to place forth the time and effort and cash to get that sort of work performed.”

Mechanisms of Motion

If you happen to breathe 100% oxygen beneath stress, it’s intuitively apparent that you’ll ship extra oxygen to your tissues. That’s one clear mechanism, nevertheless it’s not the one and even main motive for many of the advantages of hyperbaric remedy.

Proof suggests a part of the profit is perhaps associated to the degeneration of a molecule known as hypoxia-inducible issue alpha (HIF-1 alpha), which is generated once you decrease the stress. The stress is excessive contained in the chamber, and is lowered once you exit the chamber and enter the conventional ambiance. Which means among the profit would possibly truly be occurring once you get out of the chamber. Sonners explains:

“We do not have a precise quantity proper now, however roughly half of the remedy is happening whilst you’re within the chamber, being uncovered to the stress, being uncovered to the oxygen and actually accumulating a surplus of oxygen due to the remedy itself.

The opposite half of the remedy is once you get out of the chamber, as that oxygen can not keep in resolution. It actually begins making an attempt to bubble out of resolution. As that occurs, it isn’t inert, it is truly very energetic. So, because it’s popping out of resolution, it is interacting with all of our cells.

Because of this, it is triggering an enormous cascade of occasions, mobile communication that appears to stimulate a number of sequence of regeneration and anti inflammatory [events], even throughout the reactive oxygen species themselves.

Once we take a look at the primary half, which is the dosage of oxygen an individual is getting, and that is measurable, you could possibly say, ‘Here is an individual, they have been in a chamber, they have been at this stress, respiration this proportion of oxygen for this period of time,’ and you could possibly actually calculate the theoretical dose of oxygen that particular person was uncovered to and may have been capable of take up.

We have sort of simply stayed in that mindset for all these years. [However], there was an important paper out of Israel known as ‘The Hypoxia-Hyperoxia Paradox,’ and what they’re saying is we all know that there is wonderful advantages of hypoxia truly.”

Advantages of Relative Hypoxia

A few of these advantages embody the stimulation of HIF-1 alpha, stem cell responses, collagen responses and the angiogenic responses. For these causes, Sonners views hyperbaric as an anabolic remedy — a remedy that stimulates vitally vital progress and restore, as progress components akin to VEGF (vascular endothelial progress issue), and BDNF (mind derived neurotropic issue) are each stimulated.

Once more, these progress components will not be stimulated by the hyper-oxygenation. They are a consequence from the hypoxic part, the method your physique goes by way of because the oxygen is leaving your physique.

“The vital factor to notice is that when you have collected all this additional oxygen, your hyper-oxygenation part, as that oxygen is leaving your physique, you are by no means really hypoxic,” Sonners says, “however the cell signaling components that reply to conventional hypoxia are additionally seemingly responding to this relative hypoxia.

If you happen to take a look at that paper [‘The Hypoxia-Hyperoxia Paradox’] … it appeared to delineate this. With hypoxia alone, you’ll nonetheless get VEGF, which suggests you may nonetheless get a whole lot of angiogenics, the rebuilding of the endothelial lining, the creation of a brand new micro-circulation mattress, all this capillary regrowth will occur from hypoxia.

You may get these stem cell releases, this potential for improve within the regenerative nature of cells. You may get this improve within the HIF-1 alpha. However if you happen to’re chronically hypoxic, you are additionally going to get a downregulation of sirtuins [longevity proteins] and you are going to get a downregulation of mitochondrial operate.

Sirtuins might play an important function in issues like cell cycle life, getting cells out of mobile senescence — kicking them again into energetic life — or apoptosis, killing that cell in order that we are able to substitute it with a brand new stem cell, and even the genetic and epigenetic restore mechanisms. Numerous that has to do with sirtuins, so we do not wish to downregulate these. We wish to upregulate these.”

So, to make clear, with HBOT, you get the advantages of hypoxia with not one of the downsides. Quite than inhibiting sirtuins, that are vital for well being and longevity, you truly get an upregulation of sirtuin exercise. It additionally upregulates mitochondrial operate and boosts mitochondrial replication, which the exact opposite to what occurs in true hypoxia.

What In regards to the Free Radical Element?

With none doubt, HBOT is a kind of oxidative stress, nevertheless it doesn’t have the antagonistic results you’d count on. Sonners explains:

“There was an important paper performed by Dominic D’Agostino and Angela Poff, again in 2017 or 2018, particularly trying on the reactive oxygen species or the free radical part of hyperbaric oxygen. What are the advantages or penalties as we upregulate, as we improve the quantity of oxygen into the physique?

Because the cells and the mitochondria begin to uptake that oxygen, producing extra power, there’s a pure consequence the place this byproduct of free radicals are launched as part of regular mobile respiration. Extra free radicals is clearly consequential to cell membranes, lipid peroxidation and protein degradation.

It might destroy cell membranes, mitochondrial membranes, nuclear membranes, genetic materials … On the identical time, it is a regular response to mobile respiration and our our bodies have their very own intrinsic mechanisms for coping with a few of this extra free radical, issues just like the superoxide dismutase, catalase and glutathione pathways.

So, there appears to be a distinction that we should always make. One is that among the free radicals our our bodies are uncovered to return from the skin world in. Radiation, smoking, air air pollution, the checklist goes on and on. So, we have to have a strong, intrinsic potential to tolerate these free radicals with our personal antioxidant system.

However in extra, we might be getting an excessive amount of free radicals and we might be depleting our personal programs, through which case supplementation ought to definitely be thought-about and used. On the flip aspect, we take a look at hyperbaric oxygen as this instrument that theoretically has all these nice results, however a kind of penalties would even be this improve in free radical publicity.

There appears to be a really large delineation between a physique that is uncovered to free radicals from the skin world, versus a physique that’s uncovered to free radicals that it is creating by itself.

A type of distinctions is that by way of using hyperbaric oxygen, even with out supplementation, and the rise in free radical manufacturing from mitochondrial ATB manufacturing, the physique itself — assuming it has the precise uncooked supplies — will truly improve its personal superoxide dismutase, catalase and glutathione pathways.

This may No. 1, assist make you extra resilient to hyperbaric oxygen, however No. 2, would additionally assist make you extra resilient to all the opposite free radicals that you simply’re doubtlessly uncovered to in your setting.

So, I’d say two issues. One, particularly with sufferers who’re just a little bit extra fragile on the subject of oxidative stress, these individuals, I’d are likely to not over oxidize to start with, so I would begin at a gentler hyperbaric protocol with them, and I am prone to wish to begin shortly upregulating their very own system, getting the precise supplementation for bettering their intrinsic antioxidant programs …

Then, as their system improves their tolerance for reactive oxygen species, we could not want as a lot of that, or if we will be utilizing excessive dose hyperbaric oxygen for a time period, we would use issues like sure SOD precursors, or molecular hydrogen.

By conversations with you, it has turn into one my favourite antioxidants that we use. Between 45 minutes to an hour earlier than [hyperbaric treatment], we’ll begin loading individuals with the molecular hydrogen as a mechanism to cut back the results. There are advantages, in different phrases. Reactive oxygen species by itself additionally helps stimulate hormone steadiness and helps stimulate cell restore by themselves. So, there must be this steadiness.

We do not wish to quelch all of the free radicals as a result of free radicals are an important signaling molecule for a lot mobile exercise and on the identical time, we would like to pay attention to the truth that hyperbaric does improve that, and we wish to be sure that we’re not over-exposing someone.”

HBOT Purposeful Medication Course Now Obtainable

Sonners additionally critiques the curriculum he developed for the Worldwide Board of Undersea Medication. The IBUM has been certifying individuals in hyperbaric drugs for 25 years, and the curriculum Sonners created has been taught as a practical drugs hyperbaric course for clinicians for the previous 12 months.

“A giant push for me, and even for the analysis I am doing, is to assist create consciousness that will get extra docs enthusiastic about [HBOT], that wish to truly use it of their observe,” Sonners says. “So, this has been an try to actually enhance the schooling so that folks aren’t simply going to hyperbaric programs to study wound care.

We would have liked programs to assist practitioners like myself or different individuals within the regenerative aspect to have the ability to discover ways to apply it that manner. So, we now have a course that I educate just a few occasions a 12 months to get individuals on the identical web page.

Nearly all of this final 12 months, apart from getting by way of college and writing the thesis, has been creating and selling that course. I feel we have licensed about 125 to 150 practitioners and technicians particularly on the practical drugs aspect of hyperbaric use …

Presently, I nonetheless see a fairly large combine between gentle chamber use and exhausting chamber use. Numerous these docs are both Dos, MDs, chiropractors or naturopaths, stepping into extra of a practical drugs base, simply searching for different pure approaches to the issues they’re treating.

Hyperbaric provides the physique with a elementary ingredient and it is so essential for mobile efficiency. It simply appears to make sense to start out implementing a instrument and a modality like that right into a setting the place you are making an attempt to cut back irritation, you are making an attempt to enhance power manufacturing cellularly.”

HBOT Has at Least 100 Indications for Use

Whereas the checklist of potential makes use of for HBOT is extraordinarily lengthy, within the U.S., the Meals and Drug Administration has authorized and most insurance coverage pays for HBOT for the next 14 circumstances:1

Air or fuel embolism

Carbon monoxide poisoning

Clostridial myositis and myonecrosis (fuel gangrene)

Crush accidents, compartment syndrome and different acute traumatic ischemia

Decompression illness

Arterial insufficiencies, akin to central retinal artery occlusion

Extreme anemia

Intracranial abscess

Necrotizing gentle tissue infections


Delayed radiation harm (gentle tissue and bone necrosis)

Compromised grafts and flaps

Acute thermal burn harm

Idiopathic sudden sensorineural listening to loss

By way of circumstances that may profit from HBOT, I will surely add stroke, TBI, coronary heart assault, anytime there’s submit ischemic reperfusion harm, and most neurodegenerative circumstances. Internationally, there are about 100 acknowledged indications. Whereas which may make it sound like a magical cure-all, it’s vital to do not forget that it doesn’t treatment something immediately.

What it does is present your physique with a foundational nutrient, oxygen, that just about all cells require. HBOT provides your physique oxygen in a surplus, creating an extra reservoir of oxygen to enhance that operate. That’s why it will probably assist enhance such all kinds of well being circumstances.

Even autoimmune ailments akin to MS, lupus and rheumatoid arthritis, simply to call just a few, could profit, Sonners says. A complete different class of potential use could be wellness, longevity and regenerative-type therapies.

“We’re simply making use of the instruments barely in another way to assist match the depth of the remedy to the severity of the situation. We are able to make the most of the rules of fuel change in varied methods to assist so many differing types and varied forms of circumstances,” Sonners says.

“One situation or subclass that we talked about it at first is, from the immune system standpoint, upregulating your potential to combat an infection by rising white blood cell activation by way of the reactive oxygen species mechanisms. We use it for anaerobic an infection, bacterial infections on a regular basis.

One of many major causes that hyperbaric works in these extreme circumstances is these micro organism are anaerobic. They do not dwell in excessive oxygen environments.

So, we all know that placing a affected person in a excessive oxygen setting massively decreases micro organism’s potential to operate, doubtlessly helps to kill that an infection, helps to dam the toxicity of that an infection and helps to interrupt down the biofilms round that an infection. So, hyperbaric turns into a tremendous instrument within the capability of immune system balancing and/or potential to assist combat an infection.”

Extra Info

As a common steering, Sonners recommends doing hyperbaric for about two hours per week frequently. That’s his private routine. Along with that, 3 times a 12 months he does a 30- to 40-hour protocol over the course of six to eight weeks. He explains why:

“We all know that typically … three or 4 periods is just not going to ever lower it. The principle impact of hyperbaric is admittedly achieved by way of the cumulative impact and the rising and reducing — the wave of hyper-oxygenation again to regular oxygen ranges — creating that hyperoxia-hypoxia sort paradox …

If you do a protocol much like like what I’d do for a affected person, for instance 4 to 6 hours per week for eight weeks, the frequency of these … the house in between them, actually shrinks and also you get much more signaling to happen …

If all we cared about was the bodily dose, we’d keep at 100% oxygen so long as we probably might, on the highest stress we might tolerate to get essentially the most oxygen absorption. I do not suppose that that is the place the vast majority of profit exists.

Each time your stress modifications or your proportion of oxygen modifications, you are stimulating HIF-1 alpha, the reactive oxygen species load, sirtuins, you are signaling a hormetic impact. I image them as switches. You are flipping that swap on, off, on, off, on, off. I feel it is the quantity of occasions that you simply stimulate that swap that may create the advantages we’re searching for, greater than the bodily dose of oxygen over time.”

To study extra about HBOT typically, you should definitely choose up Sonners’ e-book, “Oxygen Below Stress: Utilizing Hyperbaric Oxygen to Restore Well being, Cut back Irritation, Reverse Growing old and Revolutionize Well being Care.”

Within the interview, we additionally focus on how one can incorporate HBOT in your health routine, together with fasting, to reinforce and upregulate mobile efficiency, restoration and regeneration. So, if that’s of curiosity to you, you should definitely hearken to the interview in its entirety, or learn by way of the transcript.



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