Hyperbaric oxygen therapy (HBOT) is the application of higher atmospheric pressure and additional oxygen to your body in an enclosed chamber. Both variables matter, which is not always understood by the general public or medicine. This is a treatment that has been around for hundreds of years but with significant new insights in the 21st century. We consider it a foundational biological therapy for brain health for a wide variety of conditions including:
- Decompression Sickness
- Gas embolism
- CO and Cyanide poisoning
- Selected aerobic and anaerobic soft tissue infections
- Intracranial abscess
- Management of Fungal disease
- Radiation injury to tissue
- Exceptional blood loss/anemia
- Crush injury/compartment syndrome
- Ischemia reperfusion injuries
- Skin grafts and flaps
- Healing in selected problem wounds
- Treatment of thermal burns
Proper application of HBOT has been shown to:
• Dramatically change gene expression, especially genes associated with inflammation and healing. It appears that up to 8101 genes are either expressed or suppressed with HBOT making it one of the oldest, most enduring and most effective gene therapy.
• Improved healing and reduced inflammation. One of the ways this occurs is through changes in reactive oxygen (ROS) and nitric oxide (NOS) pathways. These pathways are triggered and create a four-hour window of time in which cellular debris is removed and there is generalized healing.
• Better neurologic and cognitive function, reduction in fatigue and improved performance. HBOT can be highly dose-dependent so it is important to adjust appropriately Most of the historical science behind hyperbarics was done in dive medicine for scuba injuries which required higher pressures (2 to 3 atmospheres) and higher amounts of oxygen (up to 100%). Over the last 10 years, there has been significant realization that both the dose and the pressure of oxygen are important variables that need to be individually optimized for each individual patient depending on their situation.
• Higher is not always better: Lower pressure hyperbarics in many situations are better if not comparable to higher pressure hyperbarics, especially in situations that require a longer period of time to recover such as neurologic conditions. In particular, the brain may be exquisitely sensitive to pressures above 1.5 atmospheres unlike other situations such as wound healing where 2.0 atmospheres is the right level. Hyperbaric is like most other drugs – the right dose matters.
• Synergies: If there are other therapies that are being used for a condition (e.g., intravenous medication, supplements, pharmaceuticals), less total dose of hyperbaric therapy is needed. There can be synergies between hyperbaric therapy and the other regimens.
• Brain resilience. Studies with patients with traumatic brain injury have shown that there can be a significant amount of the brain that is wounded that can recover with HBOT. It appears that cells may be “stunned” for years but can recover with the right dosage of HBOT.
• Dose response and duration. Given that hyperbarics may stimulate neuroplasticity, it is critical to get the right dose-response for treatment. We should be able to see an initial response within the first 40 sessions of treatment and there may be further benefits with additional treatment.
HBOT is a method of delivering extra oxygen into the body, mainly through the process of increasing the pressure that the body is normally under. In terms of HBOT, pressure is normally quantified in ATA and currently we are all standardized to be less than 1.0 ATA of atmospheric pressure. When someone undergoes hyperbaric therapy, the pressure becomes greater than 1.0 ATA and in hospitals and wound care centers can typically reach 2.0 or even 3.0 ATA. Each atmospheric pressure represents 33 feet of seawater, so at 2.0 ATA, it would be equivalent for you to be at a depth of 33 feet below sea level. Once at this depth, 100% oxygen will be administered for the full duration of the treatment, which normally lasts for 60 to 90 minutes per session, and this procedure can be repeated twice per day with a 4-hour break in between. For chronic or hard-to-heal wounds, this dosage is typically repeated daily from anywhere between 10 and 80 hours.
Many doctors and clinical researchers in the field of hyperbaric medicine believe that HBOT may help many more conditions and improve quality of life. Please be aware that if you are using this to treat a medical condition other than the 13 above conditions, then the FDA considers this an ‘off-label’ treatment and wishes you to make sure that you have sought out all FDA-approved treatments first and fully understand the benefit to risk ratio before making your decision.