Hyperbaric Oxygen Therapy's Impact on Health and Aging

HBOT has a proven track record of treating a number of illnesses. Lately, there has been a surge in interest in the potential for HBOT to slow down the aging process. While some unscrupulous advertisements promise that their paid HBOT treatments will cure anything from autism to cancer, some celebrities are going so far as to purchase HBOT chambers for their own homes. What can we conclude from the evidence? Let's examine.

Hyperbaric Oxygen Therapy and Wound Healing

A cut or other typical wound has an abrupt loss of blood supply, which results in a shortage of oxygen and serves as a signal for the wound to heal. Nevertheless, this signal is not triggered when the decrease in blood flow happens gradually, as in the case of diabetic foot ulcers, which causes the wounds to heal slowly or resistantly.

HBOT may promote the healing of these wounds in a number of ways. Red blood cells that carry oxygen can no longer reach some wounds, but plasma—the fluid in which red blood cells are suspended—is still delivered to those areas. The majority of oxygen is transported by red blood cells, but a small amount is also carried by plasma. HBOT greatly increases this amount of plasma oxygen, which helps the tissue recover by restoring oxygen. Elevated oxygen concentrations in the blood may stimulate the production of new blood vessels, increase the activity of cells involved in tissue healing, and aid in the immune system's defence against infections.

Another explanation could be that when a patient undergoes HBOT, the injured areas of the body are less affected while the healthy portions of the body experience a dramatic increase in oxygen concentration. In order to restore the oxygen supply, this difference serves as a kind of wake-up call, starting the healing process and encouraging the creation of new blood vessels.

Although burns, crush injuries, radiation injuries, and vascular dementia are among the illnesses for which the potential of HBOT to promote healing has been investigated, the effects of HBOT on diabetic wounds have been studied the most.

People with diabetes mellitus may develop slow-healing lesions on their feet with restricted blood flow, known as diabetic foot ulcers. They are brought on by metabolic abnormalities brought on by high blood sugar as well as damage to the extracellular matrix, which is the web that binds cells together and is crucial to tissue healing. If the infection becomes severe and spreads to the bones and joints, these incisions may potentially need to be amputated. According to certain randomized, placebo-controlled trials, HBOT may hasten healing and lower the number of diabetic foot ulcer amputations. While HBOT decreased the likelihood of severe amputations, it did not significantly improve wound healing, according to a 2020 systematic evaluation of 11 trials including 729 individuals. However, further research is likely needed. A diverse spectrum of individuals participated in the trials, and it's possible that some patients respond better to HBOT than others.

Hyperbaric Oxygen Therapy and Exercise

High altitude training, with its low oxygen pressure, is a common practice for athletes looking to increase red blood cell formation that carries oxygen. You could be forgiven for supposing that being exposed to high oxygen concentrations would have the opposite effect; however, hyperbaric oxygen therapy has been investigated as a potential way to improve exercise performance. High-level athletes may experience "overtraining syndrome" and a heightened risk of sickness and damage if their bodies repeatedly deplete oxygen for an extended period of time. Athletes may be able to prolong muscular activation and improve recovery rates by using HBOT prior to, during, or following exercise. Nevertheless, a recent meta-analysis and systematic review of ten research studies, including 166 participants on this topic, found that HBOT only increased endurance when given during exercise—not prior to or following it. Further research is necessary because there is currently insufficient information available regarding the use of HBOT.

Since oxygen saturation is essential to keeping hospitalized COVID-19 patients alive, HBOT has been investigated as a COVID therapy in a number of settings. HBOT has been shown in numerous randomized trials to be safe and helpful in hastening the recovery of COVID-19 patients with low oxygen levels. A recent systematic analysis of eight trials indicated that the majority of the studies that reported benefits were of high quality.

A recent small study with ten patients revealed that HBOT might also be helpful for those with "long COVID," an ill-defined condition in which patients can have a wide range of symptoms (including fatigue and difficulty concentrating) for several months after the initial infection. Significant improvements in cognitive performance and decreased fatigue were observed in ten patients who underwent ten 105-minute sessions of HBOT over a period of twelve days. These are very preliminary results, though, as there was no control group in the research, so it's possible that all improvements were placebo-induced or that the patients just healed on their own.

It's unclear how HBOT would benefit long-term COVID patients. One theory is that HBOT reverses the alterations in long COVID brought on by extended low oxygen. Additional possibilities include the possibility that dormant virus pieces could reawaken or that the patient's immune system could go into overdrive and attack the body's own tissues. Either way, if further research validates HBOT's capacity to cure long-term COVID, its impacts on the immune system may account for this.

What About Aging

Thus, the idea that HBOT helps treat specific diseases is well supported by a wealth of research. But what about the idea that HBOT can actually slow down the aging process? Can HBOT postpone the start of age-related diseases in healthy individuals if it can boost immunity and enhance tissue repair in diseased individuals? The simple answer is that there are some encouraging signs, but overall, we don't really know.

If you have been following this blog, you are surely aware of how challenging it can be to ascertain whether a given therapy truly slows down the aging process in people. In an ideal world, patients would be randomly assigned to undergo HBOT on a regular basis. After that, researchers would monitor the patients for decades to observe when age-related disorders manifested and how long they survived. Conducting such an experiment would be challenging, expensive, and time-consuming. A more useful strategy would be to assess how HBOT affects aging biomarkers. These are quantifiable elements that are assumed to be related to an individual's actual biological age.

The effects of HBOT on telomere length were examined in one study. Our chromosomal ends are covered in strings of nonsense DNA code called telomeres, which serve as protective caps. A small portion of the telomere is lost with each round of cell division because the copying machinery of the cell is unable to replicate the entire DNA strand. This keeps crucial genetic information from being lost, but when the telomeres get too short, the cell can no longer divide. These cells either kill themselves or develop into senescent "zombie cells," which are believed to hasten the aging process.

For 60 days, 35 healthy adults 64 years of age and older were included in the trial and received daily HBOT therapy. Blood samples were taken at the beginning of the experiment and then again 30, 60, and 1–2 weeks after the sessions ended. By the end of the trial, they discovered that the receivers' white blood cells had telomere lengths that were more than 20% longer. By the end of the trial, B cells, or the cells that make antibodies, had the largest increase in telomere length, showing a 37% increase. 

Although these are encouraging findings, they do not demonstrate that HBOT reduces aging. The degree to which telomere shortening contributes to or results from aging is currently unknown. We don't know if genetic therapies that reduce telomere shortening delay aging in humans, but they certainly appear to do so in mice. 

Therefore, although the theory that HBOT may decrease aging is not unjustified, it is not yet confirmed. More high-quality research is required to examine the effects of HBOT on several biomarkers of aging and age-related illnesses.