Dr. Jason Sonners, creator of the e-book, “Oxygen Underneath Stress: Utilizing Hyperbaric Oxygen to Restore Well being, Scale back Irritation, Reverse Getting older and Revolutionize Well being Care,” began out as a chiropractor. His ardour, nonetheless, is hyperbaric oxygen remedy (HBOT), which is the main target of his Ph.D. research on the College of Miami.
Whereas generally used to hurry up cussed wounds and tissue infections, hyperbaric medication can be useful within the remedy of infectious illnesses resembling 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 collection of hyperbaric remedies as shortly as potential.
HBOT for Basic Well being and Illness Reversal
Each cell in your physique, excluding your purple blood cells (which don’t have any mitochondria that require oxygen), requires oxygen to create vitality. Many continual illnesses of the fashionable world contain decreased mitochondrial perform, elevated systemic irritation, and an incapability of cells to generate the required quantities of vitality for optimum perform.
“We use hyperbaric oxygen, historically, for these horrible and extreme situations,” Sonners says. Sadly, it’s usually 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 gasoline embolism.
“So, we solely give it some thought, historically, to assist save the life or limb of someone in a very 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 cut back irritation, enhance mitochondrial perform … and thereby growing the vitality that these cells are capable of generate …”
HBOT for Persistent Illnesses
Sonners’ purpose is to develop using HBOT from the acutely life-threatening points like gangrene to extra continual situations, resembling autoimmune and neurodegenerative illnesses.
“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, perhaps 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 diseases …
So, if we might actually house in on these mechanisms and perceive them higher, after which get a greater feeling for what time and stress settings we require with the intention to get these mechanisms to kick in, then we are able to actually, with extra confidence, apply this remedy to those different situations and have extra constant leads to doing so.
Loads of the work I am proposing to do is tagging onto a few of this work in regenerative medication, the place they have been wanting 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% enhance 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 a complete cytokine panel, so we are able to perceive the mechanisms of the anti-inflammatory aspect.
We will have a methylation panel in order that we are able to begin wanting on the epigenetic results of hyperbaric. We will have a telomere part, just like the telomere research that was finished a yr 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 higher perceive which pressures are getting which results, and once more, what time frame ought to we expect earlier than we get the outcomes that we’re on the lookout for?”
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 identical 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 completed 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. Perhaps the research crew actually thought that 1.3 wasn’t going to have an impact and it is a reputable sham …
I am undecided, however there are some nice research. There is a research that was finished on cerebral palsy (CP) and 1.3 was used because the sham group … On this specific research, with 1.3 being the sham group, there was additionally a … management group that received no hyperbaric in any respect.
Inside the sham group, there was important enchancment on the metrics they have been measuring. Then they’d a 1.5 [atmospheres at] 100% oxygen, which additionally had a superb enchancment after which, a 1.75 [atmospheres at] 100% oxygen, which had even a higher enchancment.
The difficulty 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 important enchancment.
So, as a result of the sham group was not thought of 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 stage of what the sham and the remedy arms should be, however that was by no means redone.
So, consequently, 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 must have a big curiosity in attempting to give you the precise solutions to place forth the time and effort and cash to get that sort of work finished.”
Mechanisms of Motion
In case you breathe 100% oxygen underneath stress, it’s intuitively apparent that you’ll ship extra oxygen to your tissues. That’s one clear mechanism, however it’s not the one and even main motive for a lot of the advantages of hyperbaric remedy.
Proof suggests a part of the profit may be 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. Meaning among the profit would possibly truly be occurring once you get out of the chamber. Sonners explains:
“We do not have an actual quantity proper now, however roughly half of the remedy is going on when 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 answer. It actually begins attempting to bubble out of answer. As that occurs, it is not inert, it is truly very energetic. So, because it’s popping out of answer, it is interacting with all of our cells.
Because of this, it is triggering a large cascade of occasions, mobile communication that appears to stimulate a number of collection of regeneration and anti inflammatory [events], even throughout the reactive oxygen species themselves.
After we take a look at the primary half, which is the dosage of oxygen an individual is getting, and that is measurable, you would 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 would actually calculate the theoretical dose of oxygen that individual 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 excellent paper out of Israel known as ‘The Hypoxia-Hyperoxia Paradox,’ and what they’re saying is we all know that there is superb advantages of hypoxia truly.”
Advantages of Relative Hypoxia
A few of these advantages embrace 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 elements resembling VEGF (vascular endothelial progress issue), and BDNF (mind derived neurotropic issue) are each stimulated.
Once more, these progress elements aren’t stimulated by the hyper-oxygenation. They seem to be a outcome from the hypoxic part, the method your physique goes via because the oxygen is leaving your physique.
“The vital factor to notice is that after you have gathered 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 elements that reply to conventional hypoxia are additionally seemingly responding to this relative hypoxia.
In case you take a look at that paper [‘The Hypoxia-Hyperoxia Paradox’] … it appeared to delineate this. With hypoxia alone, you’ll nonetheless get VEGF, which implies you will nonetheless get quite a 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 will get these stem cell releases, this potential for enhance within the regenerative nature of cells. You will get this enhance within the HIF-1 alpha. However in the event you’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 perform.
Sirtuins might play an excellent 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 exchange it with a brand new stem cell, and even the genetic and epigenetic restore mechanisms. Loads of 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. Somewhat than inhibiting sirtuins, that are vital for well being and longevity, you truly get an upregulation of sirtuin exercise. It additionally upregulates mitochondrial perform 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 sort of oxidative stress, however it doesn’t have the opposed results you’d anticipate. Sonners explains:
“There was an excellent paper finished by Dominic D’Agostino and Angela Poff, again in 2017 or 2018, particularly wanting on the reactive oxygen species or the free radical part of hyperbaric oxygen. What are the advantages or penalties as we upregulate, as we enhance the quantity of oxygen into the physique?
Because the cells and the mitochondria begin to uptake that oxygen, producing extra vitality, 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 similar 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 must always make. One is that among the free radicals our our bodies are uncovered to come back from the surface world in. Radiation, smoking, air air pollution, the listing goes on and on. So, we have to have a sturdy, intrinsic capability to tolerate these free radicals with our personal antioxidant system.
However in extra, we may very well be getting an excessive amount of free radicals and we may very well be depleting our personal techniques, through which case supplementation ought to actually be thought of and used. On the flip aspect, we take a look at hyperbaric oxygen as this software that theoretically has all these nice results, however a kind of penalties would even be this enhance in free radical publicity.
There appears to be a really massive delineation between a physique that is uncovered to free radicals from the surface world, versus a physique that’s uncovered to free radicals that it is creating by itself.
A type of distinctions is that via 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 enhance 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 probably uncovered to in your surroundings.
So, I’d say two issues. One, particularly with sufferers who’re somewhat bit extra fragile with regards to oxidative stress, these folks, I’d are inclined 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 enhancing their intrinsic antioxidant techniques …
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 frame, we’d use issues like sure SOD precursors, or molecular hydrogen.
By conversations with you, it has change into one my favourite antioxidants that we use. Between 45 minutes to an hour earlier than [hyperbaric treatment], we’ll begin loading folks 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 needs to be this steadiness.
We do not wish to quelch all of the free radicals as a result of free radicals are a vital signaling molecule for a lot mobile exercise and on the similar time, we wish to pay attention to the truth that hyperbaric does enhance that, and we wish to make it possible for 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 folks in hyperbaric medication for 25 years, and the curriculum Sonners created has been taught as a useful medication hyperbaric course for clinicians for the previous yr.
“A giant push for me, and even for the analysis I am doing, is to assist create consciousness that will get extra medical doctors enthusiastic about [HBOT], that wish to truly use it of their apply,” Sonners says. “So, this has been an try to essentially enhance the schooling so that individuals aren’t simply going to hyperbaric programs to find out about wound care.
We would have liked programs to assist practitioners like myself or different folks within the regenerative aspect to have the ability to discover ways to apply it that method. So, we now have a course that I train a number of occasions a yr to get folks on the identical web page.
The vast majority of this final yr, aside from getting via college and writing the thesis, has been creating and selling that course. I believe we have licensed about 125 to 150 practitioners and technicians particularly on the useful medication aspect of hyperbaric use …
At the moment, I nonetheless see a reasonably large combine between gentle chamber use and exhausting chamber use. Loads of these medical doctors are both Dos, MDs, chiropractors or naturopaths, entering into extra of a useful medication base, simply on the lookout for different pure approaches to the issues they’re treating.
Hyperbaric provides the physique with a basic ingredient and it is so obligatory for mobile efficiency. It simply appears to make sense to start out implementing a software and a modality like that right into a setting the place you are attempting to cut back irritation, you are attempting to enhance vitality manufacturing cellularly.”
HBOT Has at Least 100 Indications for Use
Whereas the listing of potential makes use of for HBOT is extraordinarily lengthy, within the U.S., the Meals and Drug Administration has authorised and most insurance coverage pays for HBOT for the next 14 situations:1
Air or gasoline embolism
Carbon monoxide poisoning
Clostridial myositis and myonecrosis (gasoline gangrene)
Crush accidents, compartment syndrome and different acute traumatic ischemia
Arterial insufficiencies, resembling central retinal artery occlusion
Necrotizing gentle tissue infections
Delayed radiation damage (gentle tissue and bone necrosis)
Compromised grafts and flaps
Acute thermal burn damage
Idiopathic sudden sensorineural listening to loss
By way of situations that may profit from HBOT, I would definitely add stroke, TBI, coronary heart assault, anytime there’s put up ischemic reperfusion damage, and most neurodegenerative situations. Internationally, there are about 100 acknowledged indications. Whereas that may make it sound like a magical cure-all, it’s vital to keep in mind that it doesn’t treatment something instantly.
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 perform. That’s why it will probably assist enhance such all kinds of well being situations.
Even autoimmune illnesses resembling MS, lupus and rheumatoid arthritis, simply to call a number of, could profit, Sonners says. A complete different class of potential use can be wellness, longevity and regenerative-type therapies.
“We’re simply making use of the instruments barely otherwise to assist match the depth of the remedy to the severity of the situation. We will make the most of the ideas of gasoline change in varied methods to assist so many differing kinds and varied kinds of situations,” Sonners says.
“One situation or subclass that we talked about it at first is, from the immune system standpoint, upregulating your capability to struggle an infection by growing white blood cell activation via the reactive oxygen species mechanisms. We use it for anaerobic an infection, bacterial infections on a regular basis.
One of many principal causes that hyperbaric works in these extreme situations is these micro organism are anaerobic. They do not reside in excessive oxygen environments.
So, we all know that placing a affected person in a excessive oxygen surroundings massively decreases micro organism’s capability to perform, probably 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 software within the capability of immune system balancing and/or capability to assist struggle an infection.”
As a common steering, Sonners recommends doing hyperbaric for about two hours every week regularly. That’s his private routine. Along with that, 3 times a yr he does a 30- to 40-hour protocol over the course of six to eight weeks. He explains why:
“We all know that generally … three or 4 periods isn’t going to ever reduce it. The principle impact of hyperbaric is absolutely achieved via the cumulative impact and the growing and reducing — the wave of hyper-oxygenation again to regular oxygen ranges — creating that hyperoxia-hypoxia kind paradox …
Once you do a protocol just like like what I’d do for a affected person, for example 4 to 6 hours every week for eight weeks, the frequency of these … the house in between them, actually shrinks and also you get way more signaling to happen …
If all we cared about was the bodily dose, we might keep at 100% oxygen so long as we presumably might, on the highest stress we might tolerate to get probably the most oxygen absorption. I do not suppose that that is the place the vast majority of profit exists.
Each time your stress adjustments or your proportion of oxygen adjustments, 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 believe it is the quantity of occasions that you simply stimulate that swap that can create the advantages we’re on the lookout for, greater than the bodily dose of oxygen over time.”
To study extra about HBOT generally, be sure you choose up Sonners’ e-book, “Oxygen Underneath Stress: Utilizing Hyperbaric Oxygen to Restore Well being, Scale back Irritation, Reverse Getting older 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 enhance and upregulate mobile efficiency, restoration and regeneration. So, if that’s of curiosity to you, be sure you hearken to the interview in its entirety, or learn via the transcript.