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Hyperbaric oxygen therapy is typically defined as the inhalation of 100% oxygen at greater than 1 atmosphere absolute (ATA) in a pressurized chamber. This definition is now popularly defined as the inhalation of varying degrees of oxygen at greater than 1 atmosphere absolute (ATA) in a pressurized chamber. You will hear many terms used interchangeably by lay people and professionals alike: hyperbaric oxygen therapy (HBOT), mild hyperbaric oxygen therapy (mHBOT), hyperbaric therapy (HBT), hyperbaric oxygen (HBO), hyperbaric air therapy (HBAT), hyperbaric enriched air therapy (HBEAT), etc. However, the most common way the term is used to just say “HBOT”. Then most patients will state what they are doing, e.g. “we’re using 1.5, 1.75, or 2.0 atmospheres in a hard chamber with 100% oxygen, or we’re using a soft chamber (also referred to as a mild chamber) at 1.3 atmospheres ‘with or without a mask’ to which ‘concentrated oxygen’ is be supplied at concentrations varying from 24% to 70%.” Conventional wisdom states that unless one receives HBOT in a hard chamber with 100% oxygen at atmospheric pressures greater than 1.5 ATA, little or no benefit will be seen.
However, as history has shown repeatedly throughout the years, convention is only convention until challenged, proven wrong, and then changed. Such is the case with HBOT and chronic health conditions/neurologic disorders. Based on published studies by Dr. Rossignol, the early work of Dr. Buckley and Dr. Kartzinel, and the tremendous number of children that have been treated for autism by physicians such as Dr. Bradstreet, Dr. Feingold, Dr. Freedenfeld, Dr. Stoller, and a growing number of other physicians who are now using HBOT routinely in their offices, there remains no doubt that HBOT works and that it works well for children with autism and a gambit of other challenging health conditions.
There is also no doubt that it works well at low pressures with varying degrees of oxygen concentrations as well as at varying degrees of high pressures with 100% oxygen, which is why it is being implemented by a growing number of hyperbaric oxygen treatment centers .
The reason hyperbaric oxygen treatment centers recommend HBOT for their patients is because there is scientific evidence that pressure, independent of the concentration of oxygen, decreases inflammation and that any concentration of oxygen under any increased amount of pressure will allow more oxygen to dissolve into the extracellular fluids of the body: plasma, lymph, cerebrospinal fluid, and interstitial fluid.
Because dissolved oxygen is not confined to a hemoglobin molecule, it can go wherever “body water goes” and therefore reach ‘deeper tissues’ more easily and more consistently than ever before. Fortunately evidence exists and continues to accumulate of the great success stories experienced by patients worldwide.
A few of the multiple mechanisms demonstrating how HBOT may work include:
- Angioneogenesis from the addition of oxygen:
The growth of new blood vessels has been shown to occur from soft chambers as well as from hard, and is a process that may continue to increase subsequent to discontinuing therapy for a period of time after oxygen loading. Though it has been stated often on the internet boards that angioneogenesis does not occur unless pressures are 1.5 ATA or greater, the South American physician Dr. Efrain Olszewer has pre- and post-angiograms documenting collateral circulation beginning as early as ten to twenty hours after initiating hyperbaric therapy for cerebral vascular disease and peripheral arteriosclerosis at pressures lower than 1.3 ATA. For example, one of the problems children with autism have is decreased blood flow to the brain (cerebral hypoperfusion). And many conditions which typically entail chronic inflammation, also include the reduction of blood flow to the vital body regions.
Therefore is has been speculated that angioneogenesis is the way that HBOT helps relieve and improve health conditions. - However, though angioneogenesis increases oxygen delivery, helping patients through HBOT, angioneogenesis is not the only mechanism by which HBOT works. The extra amount of increased oxygen needed by the cells to improve their function does not necessarily require new blood vessel formation to accomplish health improvement. Therefore cells work more efficiently while receiving an increased oxygen delivery from increased blood vessel formation that delivers a greater oxygen load because it carries more hemoglobin.
- Increases in blood flow independent of new blood vessel formation, not only due to the competing mechanisms of vasodilation and vasoconstriction, but also due to decreasing the inflammation that constricts blood vessels. Because inflammation is accompanied by swelling, tissue expansion or compression will occur. Therefore, whenever inflammation brings more fluid to a region of the body that is comprised of solid tissue and hollow blood vessels, the first thing to happen is that the hollow blood vessel walls will be compressed and deliver fewer red cells carrying oxygen to the area. Once inflammation is reduced the vascular narrowing is improved allowing increasing amounts of red blood cells carrying oxygen to reach the hypoxic (damaged and sick) areas.
- Decreasing levels of inflammatory biochemicals: Recent studies have demonstrated that chronically ill people frequently have neuro-inflammatory and gastrointestinal inflammatory conditions occurring. Multiple studies demonstrate the beneficial effect of hyperbaric oxygen therapy in inflammatory conditions. C-reactive protein and high levels of cytokines have been shown to decrease with HBOT. One study demonstrates that the anti-inflammatory effect from HBOT is probably due to pressure effects and not necessarily increased oxygen tension.
- Up-regulation of key antioxidant enzymes and decreasing oxidative stress: Patients have been shown to have increased oxidative stress and active glutathione, one of the body’s most important antioxidants. HBOT, especially when using pressures less than 2.0 atmospheres, can up-regulate these antioxidant enzymes and afford antioxidant protection against oxidative stress.
- Increased oxygenation to functioning mitochondria: Mitochondria are the energy producing organelles of the body. A growing number of studies are focusing on the mitochondria and its relationship to many disorders The possibility exists that some chronic symptoms may occur because these organelles are dysfunctional and fewer in number than the number found in normal people. HBOT may have the potential to activate dysfunctional mitochondria and/or to activate “dormant/idling cells” thereby allowing more “mitochondrial product” to be appreciated by the body.
- Increased production of new mitochondria from HBOT.
- Bypassing functionally impaired hemoglobin molecules, the result of abnormal porphyrin production, which thereby allows the increased delivery of oxygen directly to cells: A recent study documented impaired production and abnormal ratios of porphyrins in children with autism. Because porphyrin is involved in the production of functional heme/hemoglobin, and because this appears to be disordered in autism, the impaired delivery of oxygen to cells will be improved when HBOT bypasses hemoglobin-dependent oxygenation.
- Improvement in immune and autoimmune system disorders: HBOT has been shown to benefit the immune system and multiple studies have shown that many neurological and chronic conditions are frequently associated with various types of immune and autoimmune system biomarkers.
- Decreases in the bacterial/yeast load found systemically and in the gut: Many ill patients with have increased amounts of abnormal bacteria and yeast in their gastrointestinal tracts. These same patients have shown clinical improvements when this overgrowth phenomenon is treated with hyperbaric oxygen therapy. HBOT has been shown to decrease abnormal bacteria/yeast in the gut.
- Decreases in the viral load found systemically and possibly decreases in a viral presence that may exist in the intestinal mucosa: Patients with developmental & neurological disorders and chronic conditions typically have difficulty handling viral infections, most likely due to immune dysfunction. It has been postulated many times these people generally have a chronic low grade viral gastroenteritis and viral encephalitits. HBOT has been shown to decrease HIV viral loads. I speculate that one of the primary reasons HBOT works so well for so many patients whose abnormal stools improve once they start HBOT, is because the chronic, low-grade, smoldering live viral load harbored in the intestinal mucosa (Wakefield/Krigsman hypothesis) does poorly when surrounded by higher oxygen concentrations.
The literature states that in order to kill viruses 100% oxygen at 2.7 ATA or above is required. However, there is no reason to believe that even mildly increased oxygen tensions may inhibit viral activity and/or make the host less hospitable to chronic viral inhabitation. This explanation is in keeping with the clinical results that so many hyperbaric oxygen treatment centers are seeing. It’s noted that improved bowel function is in the top 20 most commonly seen benefits. To get cockroaches out of the kitchen, you can either kill them with your shoe or turn on the light. Interestingly it only takes a little bit of light for them to leave the room.
Likewise it only takes a little bit of increased oxygen tension for viruses to leave. - Increases in the production of stem cells in the bone marrow with transfer to the CNS: Studies have shown that HBOT increases the production of stem cells in the bone marrow and that transfer of stem cells to the central nervous system is possible.
- (Theoretical only) Direct production of stem cells by certain areas in the brain.
- Increased production and utilization of serotonin: Studies have shown abnormities in the autistic brain whereby it does not produce and subsequently does not use serotonin properly. Newer studies have shown that HBOT can work like an anti-depressant by increasing brain serotonin levels.
- (Theoretical only) The possibility that oxidation may help rid the body of petrochemicals.
- (Theoretical only) The possibility that oxidation may help rid the body of mercury and heavy metals.