Dr. Jason Sonners, creator of the ebook, “Oxygen Underneath Stress: Utilizing Hyperbaric Oxygen to Restore Well being, Scale back Irritation, Reverse Ageing and Revolutionize Well being Care,” began out as a chiropractor. His ardour, nonetheless, 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 can be useful within the remedy of infectious ailments equivalent to COVID. It’s additionally enormously helpful for stroke sufferers. I can not consider a simpler intervention than to get the stroke affected person right into a sequence of hyperbaric remedies as shortly as potential.
HBOT for Normal Well being and Illness Reversal
Each cell in your physique, apart from your purple blood cells (which haven’t any mitochondria that require oxygen), requires oxygen to create vitality. Many persistent ailments of the trendy world contain decreased mitochondrial perform, elevated systemic irritation, and an incapacity 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 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 can 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 in a position to generate …”
HBOT for Continual Illnesses
Sonners’ objective is to develop the usage of HBOT from the acutely life-threatening points like gangrene to extra persistent situations, equivalent 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 will begin to apply these mechanisms throughout the board. Clinically, we have seen hyperbaric work for thus many of those different persistent diseases …
So, if we might actually residence in on these mechanisms and perceive them higher, after which get a greater feeling for what time and strain settings we require as a way to get these mechanisms to kick in, then we will actually, with extra confidence, apply this remedy to those different situations and have extra constant ends in doing so.
A number of 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 examine 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 examine 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 will perceive the mechanisms of the anti-inflammatory facet.
We will have a methylation panel in order that we will begin trying on the epigenetic results of hyperbaric. We will have a telomere element, just like the telomere examine that was performed 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 strain 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 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 onerous chambers at two totally different pressures. The decrease strain group will probably be at 4.2 psi, which is identical as tender chamber pressures.
“There’s nowhere close to the quantity of analysis in tender chambers as there are in onerous 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 tender chamber analysis.
There’s undoubtedly some [research] on sports activities restoration. There’s really 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 examine group actually thought that 1.3 wasn’t going to have an impact and it is a reputable sham …
I am unsure, however there are some nice research. There is a examine that was performed on cerebral palsy (CP) and 1.3 was used because the sham group … On this specific examine, with 1.3 being the sham group, there was additionally a … management group that bought 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 an excellent enchancment after which, a 1.75 [atmospheres at] 100% oxygen, which had even a larger enchancment.
The difficulty within the examine 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 examine was subsequently 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 of a remedy, that was the conclusion of that examine. Now, the pure consequence of that ought to have been redoing the examine and creating a unique stage of what the sham and the remedy arms should be, however that was by no means redone.
So, in consequence, there’s this examine with outcomes that say hyperbaric doesn’t work for CP. In the meantime, clearly, what it means is we’d like 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 fitting solutions to place forth the time and effort and cash to get that sort of work performed.”
Mechanisms of Motion
In case you breathe 100% oxygen underneath strain, 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 a lot of the advantages of hyperbaric remedy.
Proof suggests a part of the profit is likely to be associated to the degeneration of a molecule known as hypoxia-inducible issue alpha (HIF-1 alpha), which is generated while you decrease the strain. The strain is excessive contained in the chamber, and is lowered while you exit the chamber and enter the conventional environment. Which means among the profit would possibly really be occurring while 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 strain, being uncovered to the oxygen and actually accumulating a surplus of oxygen due to the remedy itself.
The opposite half of the remedy is while you get out of the chamber, as that oxygen can not keep in resolution. It actually begins attempting to bubble out of resolution. As that occurs, it isn’t inert, it is really very energetic. So, because it’s popping out of resolution, it is interacting with all of our cells.
In consequence, it is triggering a large cascade of occasions, mobile communication that appears to stimulate a number of sequence of regeneration and anti inflammatory [events], even inside 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 possibly can say, ‘This is an individual, they have been in a chamber, they have been at this strain, respiratory this proportion of oxygen for this period of time,’ and you possibly can actually calculate the theoretical dose of oxygen that individual was uncovered to and may have been in a position to take in.
We have sort of simply stayed in that mindset for all these years. [However], there was a fantastic 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 really.”
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 essential progress and restore, as progress components equivalent to VEGF (vascular endothelial progress issue), and BDNF (mind derived neurotropic issue) are each stimulated.
Once more, these progress components usually are not stimulated by the hyper-oxygenation. They seem to be a consequence from the hypoxic element, the method your physique goes by way of because the oxygen is leaving your physique.
“The essential factor to notice is that when you have accrued all this further oxygen, your hyper-oxygenation element, 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.
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 suggests you will nonetheless get plenty 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 a fantastic 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 will change it with a brand new stem cell, and even the genetic and epigenetic restore mechanisms. A number 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. Reasonably than inhibiting sirtuins, that are essential for well being and longevity, you really 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, nevertheless it doesn’t have the adversarial results you’d count on. Sonners explains:
“There was a fantastic 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 element 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 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 come back from the surface world in. Radiation, smoking, air air pollution, the record goes on and on. So, we have to have a sturdy, intrinsic means 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 methods, during which case supplementation ought to actually be thought of and used. On the flip facet, we take a look at hyperbaric oxygen as this software that theoretically has all these nice results, however a type of penalties would even be this enhance in free radical publicity.
There appears to be a really large 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 by way of the usage of hyperbaric oxygen, even with out supplementation, and the rise in free radical manufacturing from mitochondrial ATB manufacturing, the physique itself — assuming it has the fitting uncooked supplies — will really enhance its personal superoxide dismutase, catalase and glutathione pathways.
This is able to 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 atmosphere.
So, I’d say two issues. One, particularly with sufferers who’re a bit of bit extra fragile relating to oxidative stress, these individuals, 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 more likely to wish to begin shortly upregulating their very own system, getting the fitting supplementation for bettering their intrinsic antioxidant methods …
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 change 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 implications. 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 a vital signaling molecule for a lot mobile exercise and on the identical time, we would like to concentrate on the truth that hyperbaric does enhance that, and we wish to be sure that we’re not over-exposing someone.”
HBOT Practical Medication Course Now Accessible
Sonners additionally opinions 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 yr.
“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 really use it of their observe,” Sonners says. “So, this has been an try to essentially enhance the training 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 facet to have the ability to learn to apply it that method. So, we now have a course that I train just a few occasions a yr to get individuals on the identical web page.
Nearly all of this final yr, 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 facet of hyperbaric use …
Presently, I nonetheless see a reasonably large combine between tender chamber use and onerous chamber use. A number of these docs are both Dos, MDs, chiropractors or naturopaths, entering into extra of a practical drugs 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 essential for mobile efficiency. It simply appears to make sense to begin 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 record of potential makes use of for HBOT is extraordinarily lengthy, within the U.S., the Meals and Drug Administration has accepted and most insurance coverage can pay for HBOT for the next 14 situations:1
Air or fuel embolism
Carbon monoxide poisoning
Clostridial myositis and myonecrosis (fuel gangrene)
Crush accidents, compartment syndrome and different acute traumatic ischemia
Arterial insufficiencies, equivalent to central retinal artery occlusion
Necrotizing tender tissue infections
Delayed radiation damage (tender tissue and bone necrosis)
Compromised grafts and flaps
Acute thermal burn damage
Idiopathic sudden sensorineural listening to loss
When it comes to situations that may profit from HBOT, I will surely add stroke, TBI, coronary heart assault, anytime there’s submit ischemic reperfusion damage, and most neurodegenerative situations. Internationally, there are about 100 acknowledged indications. Whereas which may make it sound like a magical cure-all, it’s essential to do not forget that it doesn’t treatment something immediately.
What it does is present your physique with a foundational nutrient, oxygen, that nearly 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 may assist enhance such all kinds of well being situations.
Even autoimmune ailments equivalent to MS, lupus and rheumatoid arthritis, simply to call just a few, 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 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 ideas of fuel alternate in numerous methods to assist so many differing kinds and numerous sorts of situations,” Sonners says.
“One situation or subclass that we talked about it at first is, from the immune system standpoint, upregulating your means to struggle an infection by growing 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 foremost causes that hyperbaric works in these extreme situations is these micro organism are anaerobic. They do not stay in excessive oxygen environments.
So, we all know that placing a affected person in a excessive oxygen atmosphere massively decreases micro organism’s means 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 means to assist struggle an infection.”
As a basic 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 on the whole … 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 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 instance 4 to 6 hours every week for eight weeks, the frequency of these … the area 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 presumably might, on the highest strain we might tolerate to get probably the most oxygen absorption. I do not suppose that that is the place nearly all of profit exists.
Each time your strain 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 can create the advantages we’re on the lookout for, greater than the bodily dose of oxygen over time.”
To be taught extra about HBOT on the whole, you’ll want to decide up Sonners’ ebook, “Oxygen Underneath Stress: Utilizing Hyperbaric Oxygen to Restore Well being, Scale back Irritation, Reverse Ageing and Revolutionize Well being Care.”
Within the interview, we additionally talk about 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, you’ll want to hearken to the interview in its entirety, or learn by way of the transcript.