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Infections
Off-label use of HBOT for infections includes treatment for conditions such as Lyme disease, chronic osteomyelitis, long covid, and necrotizing fasciitis. These infections can be challenging to treat with conventional methods alone, and HBOT’s potential to enhance antibiotic effectiveness, boost the immune system, and promote healing may offer additional benefits.
Lyme Disease
Description:
Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi and occasionally by other Borrelia species. It’s the most common vector-borne disease in the United States.
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How it occurs:
Lyme disease is transmitted to humans through the bite of infected black-legged ticks. The ticks become infected after feeding on infected deer, birds, or mice. The tick must be attached for 36 to 48 hours or more before the Lyme disease bacterium can be transmitted.
Early symptoms can include:
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A characteristic skin rash called erythema migrans (EM)
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Fever
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Chills
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Fatigue
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Body aches
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Headache
If left untreated, infection can spread to joints, the heart, and the nervous system.
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How HBOT Helps
How HBOT may help:
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Enhances the immune system’s ability to fight Borrelia bacteria
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Reduces inflammation associated with Lyme disease
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Improves oxygenation of affected tissues
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May help alleviate neurological symptoms
What’s happening in the body:
The high-pressure oxygen environment created by HBOT is inhospitable to the Borrelia burgdorferi bacteria that cause Lyme disease, as these bacteria are anaerobic. The increased oxygen levels enhance the immune system’s ability to combat the infection. HBOT’s anti-inflammatory effects may help reduce the chronic inflammation often associated with Lyme disease. For patients with neurological symptoms, the improved oxygenation of neural tissues may help alleviate cognitive issues and other neurological manifestations of the disease.
Additional Information:
Lyme disease can be challenging to treat, especially in its chronic form. While antibiotics remain the primary treatment, HBOT is being explored as a complementary therapy, particularly for patients with persistent symptoms.
How HBOT Helps
How HBOT may help:
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Increases oxygen delivery to infected bone tissue
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Enhances the effectiveness of antibiotics
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Promotes new bone formation
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Stimulates the growth of new blood vessels (angiogenesis)
What’s happening in the body: HBOT creates an oxygen-rich environment that is hostile to many anaerobic bacteria. The increased oxygen levels also enhance the function of white blood cells, improving their ability to fight infection. HBOT can increase the effectiveness of certain antibiotics, particularly aminoglycosides. The therapy also stimulates the formation of new blood vessels, which can improve blood supply to the infected area, promoting healing and the delivery of antibiotics to the site of infection.
Additional Information: Chronic osteomyelitis is notoriously difficult to treat, often requiring long-term antibiotic therapy and sometimes surgical intervention. HBOT is being studied as an adjunctive therapy to improve outcomes and potentially reduce the need for extensive surgery.
Chronic Osteomyelitis
Description: Chronic osteomyelitis is a persistent infection of the bone or bone marrow. It can be difficult to treat and may lead to permanent damage to the bone if left untreated.
How it occurs:
Chronic osteomyelitis typically develops from acute osteomyelitis that hasn’t been adequately treated. It can also occur due to:
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Open fractures
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Surgery
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Implanted orthopedic devices
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Poor blood supply to the bone
The most common causative organism is Staphylococcus aureus, but other bacteria or fungi can also be responsible.
Necrotizing Fasciitis
Description:
Necrotizing fasciitis, also known as flesh-eating disease, is a rare but serious bacterial infection that affects the tissue beneath the skin and surrounding muscles and organs (fascia).
How it occurs:
The infection often enters the body through a break in the skin, such as a cut, burn, or insect bite. It can be caused by several types of bacteria, including group A Streptococcus, Klebsiella, Clostridium, and Escherichia coli. The infection spreads quickly and can become life-threatening in a very short time.
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How HBOT Helps
How HBOT may help:
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Increases tissue oxygenation
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Enhances the effectiveness of antibiotics
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Reduces edema and inflammation
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Promotes wound healing
What’s happening in the body: HBOT creates an oxygen-rich environment that is toxic to anaerobic bacteria, which are often involved in necrotizing fasciitis. The increased oxygen levels also enhance the function of neutrophils, a type of white blood cell crucial in fighting bacterial infections. HBOT can potentiate the effects of certain antibiotics, particularly those that rely on oxygen for their bactericidal activity. The therapy also helps reduce tissue edema, which can improve blood flow and promote faster healing.
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Additional Information: Necrotizing fasciitis is a medical emergency that requires immediate treatment with antibiotics and often surgical debridement of affected tissues. HBOT is being used as an adjunctive therapy in some cases to improve outcomes and potentially reduce the extent of surgical intervention needed.
How HBOT Helps
How HBOT may help:
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Reduces inflammation
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Improves tissue oxygenation
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Enhances mitochondrial function
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Promotes neuroplasticity
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Modulates immune response
What’s happening in the body: HBOT increases oxygen levels in the blood and tissues, which may help address the underlying hypoxia (low oxygen levels) that some researchers believe contributes to long COVID symptoms. The anti-inflammatory effects of HBOT may help reduce the chronic inflammation associated with long COVID. Improved mitochondrial function can help address fatigue symptoms, while the promotion of neuroplasticity may help with cognitive issues.
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Additional Information: Long COVID is a significant public health concern, affecting millions worldwide. While research is ongoing, early studies suggest that HBOT could be a promising treatment option for some long COVID patients, particularly those experiencing fatigue, cognitive issues, and shortness of breath.
Post/Long Covid
Description:
Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), refers to a range of symptoms that can last weeks or months after the initial infection with the SARS-CoV-2 virus. It can affect people who had mild, moderate, or severe COVID-19.
How it occurs:
The exact mechanisms of long COVID are not fully understood, but it’s believed to involve persistent inflammation, immune system dysregulation, and possibly ongoing viral activity. Long COVID can affect multiple organ systems, including the respiratory, cardiovascular, and neurological systems.
Common symptoms include:
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Fatigue
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Cognitive dysfunction (“brain fog”)
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Shortness of breath
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Headaches
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Loss of taste or smell
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Joint and muscle pain
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Herpes Zoster (Shingles)
Description:
Herpes Zoster, commonly known as shingles, is a viral infection that causes a painful rash. It is caused by the varicella-zoster virus, the same virus that causes chickenpox.
How it occurs:
After a person recovers from chickenpox, the virus stays dormant in the nervous system. Years later, the virus may reactivate as shingles, often due to stress, aging, or a weakened immune system. The reactivated virus travels along nerve fibers to the skin, causing the characteristic painful rash.
Symptoms include:
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Pain, burning, or tingling sensation in the affected area
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Sensitivity to touch
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A red rash that begins a few days after the pain
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Fluid-filled blisters that break open and crust over
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Itching
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Fever, headache, fatigue, and sensitivity to light
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How HBOT Helps
How HBOT may help:
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Reduces inflammation and pain
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Enhances immune response
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Promotes faster healing of skin lesions
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May help prevent post-herpetic neuralgia
What’s happening in the body: HBOT increases oxygen levels in the affected tissues, which can help reduce inflammation and promote faster healing of the skin lesions. The increased oxygen levels may also enhance the immune system’s ability to fight the virus. HBOT’s anti-inflammatory effects can help reduce pain and may potentially lower the risk of developing post-herpetic neuralgia, a common complication of shingles where pain persists long after the rash has healed.
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Additional Information: While antiviral medications are the primary treatment for shingles, HBOT is being explored as a complementary therapy to help manage symptoms and potentially speed up recovery. A randomized controlled trial by Peng et al. (2012) found that HBOT combined with standard medication had a higher therapeutic efficacy (97.2%) compared to medication alone (81.3%) after a 3-week treatment period.
How HBOT Helps
How HBOT may help:
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Reduces inflammation
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Improves tissue oxygenation
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Enhances mitochondrial function
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Modulates immune response
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Promotes neuroplasticity
What’s happening in the body: HBOT may help address some of the underlying issues in CFS/ME. The increased oxygen levels could improve mitochondrial function, potentially addressing the severe fatigue experienced by patients. HBOT’s anti-inflammatory effects may help reduce systemic inflammation, which is thought to play a role in CFS/ME symptoms. The therapy’s ability to modulate the immune response could also be beneficial, as immune dysfunction is a suspected factor in CFS/ME.
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Additional Information: Research on HBOT for CFS/ME is still in its early stages, but some studies have shown promising results. A case series by Akarsu et al. (2013) reported improvements in fatigue and quality of life in CFS patients treated with HBOT. Another study by Efrati et al. (2015), while focused on fibromyalgia, showed improvements in symptoms that overlap with CFS/ME, such as fatigue and cognitive function. However, larger randomized controlled trials are needed to establish the efficacy and optimal treatment protocols for HBOT in CFS/ME.
Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis (ME)
Description:
Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex, long-term illness characterized by extreme fatigue that can’t be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity but doesn’t improve with rest.
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How it occurs:
The exact cause of CFS/ME is unknown, but several theories exist. These include:
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Viral infections (such as Epstein-Barr virus or human herpesvirus 6)
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Immune system dysfunction
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Hormonal imbalances
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Physical or emotional trauma
Symptoms include:
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Severe fatigue that doesn’t improve with rest
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Post-exertional malaise (PEM)
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Sleep problems
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Cognitive difficulties (“brain fog”)
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Muscle or joint pain
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Headaches
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Sore throat
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Tender lymph nodes
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References
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Huang CY, et al. (2014). Hyperbaric oxygen therapy as an effective adjunctive treatment for chronic Lyme disease. J Chin Med Assoc, 77(5):269-71.
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Fife WP, Freeman DM. (2000). Treatment of Lyme disease with hyperbaric oxygen therapy. Undersea Hyperb Med, 27(Suppl):33-4.
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Savvidou OD, et al. (2018). Efficacy of hyperbaric oxygen in the management of chronic osteomyelitis: A systematic review of the literature. Orthopedics, 41(4):193-199.
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Wilkinson D, Doolette D. (2004). Hyperbaric oxygen treatment and survival from necrotizing soft tissue infection. Arch Surg, 139(12):1339-45.
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Robbins T, Gonevski M, Clark C, et al. Hyperbaric oxygen therapy for the treatment of long COVID: early evaluation of a highly promising intervention. Clin Med (Lond). 2021;21(6):e629-e632. doi:10.7861/clinmed.2021-0462
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Zilberman-Itskovich S, Catalogna M, Sasson E, et al. Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial. Sci Rep. 2022;12(1):11252. doi:10.1038/s41598-022-15565-0
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Harch PG. Hyperbaric oxygen in chronic traumatic brain injury: oxygen, pressure, and gene therapy. Med Gas Res. 2015;5:9. doi:10.1186/s13618-015-0030-6
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Löndahl M, Katzman P, Nilsson A, Hammarlund C. Hyperbaric oxygen therapy facilitates healing of chronic foot ulcers in patients with diabetes. Diabetes Care. 2010;33(5):998-1003. doi:10.2337/dc09-1754
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Peng Z, Wang S, Huang X, Xiao P. Effect of hyperbaric oxygen therapy on patients with herpes zoster. Undersea Hyperb Med. 2012;39(6):1083-7.
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Huang L, Obenaus A. Hyperbaric oxygen therapy for traumatic brain injury. Med Gas Res. 2011;1(1):21. doi:10.1186/2045-9912-1-21