Hyperbaric oxygen therapy (HBOT)
(This article was written by Jackie Scoones, a mercury poisoned sufferer who has seen clinical benefit from HBOT. Edited by Craig Robinson)
What is HBOT?
HBOT involves breathing pure oxygen in a purpose built chamber for periods of an hour. This pure supply of oxygen is delivered at 1.5 to 2.5 times normal atmospheric pressure ATA. (Please see Hyperbaric Oxygen Treatment Trust HBOTT and click on the ‘FAQ’ tab for further details.). For those who are interested, ATM is a unit of pressure equivalent to the weight of the earth's atmosphere at sea level. Absolute pressure (ATA) is the total ambient pressure on the system being calculated or measured. In essence, the crucial point is that the oxygen is delivered at a pressure in excess of that which you would experience in ‘normal everyday life’.
How does HBOT work?
Under normal ‘everyday’ circumstances oxygen is transported throughout the body only by the red blood cells. With HBOT, the pressure effect increases the oxygen carrying capacity of the blood stream. So, oxygen levels increase in all of the body's fluids, including the blood plasma and lymph.
There are many benefits which arise from this increased level of oxygen availability:
- The extra oxygen can reach damaged tissue and areas where circulation is diminished or blocked. This is of proven benefit in conditions where blood supply is impaired such as acute stroke  or myocardial infarction . Please also refer to the ‘Research and Guidance’ section of the website Hyperbaric Oxygen Treatment Trust HBOTT for further details of these benefits and also for all up to date studies with regard to HBOT.
- The white blood cells’ ability to kill infection(s) is enhanced because oxygen is itself both an effective anti-biotic and anti-viral.
- Swelling and inflammation are reduced. This is because the delivery of extra oxygen allows the rapid growth of new blood vessels into the affected areas and these are then available for healing and repair purposes.
- Recent studies are now suggesting that increased oxygen levels trigger the release of stem cells from the bone marrow. These stem cells have the potential to transform into any cell of the body and so there is the possibility that damaged tissues could be renewed .
Through this therapy, and depending upon the pressure level, the body is provided with between a ten and twenty fold increase in normal oxygen delivery. HBOT is a simple, non-invasive and painless treatment.
Which conditions benefit from HBOT?
HBOT is of proven benefit in carbon monoxide poisoning, multiple sclerosis, cerebral palsy, cognitive disorders in the elderly, myocardial infarction (heart attack), stroke, burns, leg ulcers, coronary artery stents, radiation damage and (problem) wounds that are failing to heal. A comprehensive list of conditions that have been found to benefit from HBOT can be seen at Hyperbaric Oxygen Treatment Trust HBOTT - Research, where you will find links to the references supporting these many benefits of HBOT.
HBOT protects against infection and inflammation during surgery and accelerates healing. It may also relieve the pain and inflammation of arthritis. Please see here for more detail regarding the benefits of HBOT during surgery and also healing more generally - Hyperbaric oxygen and wound healing.
Where can I obtain HBOT?
We are fortunate in the UK to have 2 organisations providing this therapy for the public. First, there is The British Hyperbaric Association, which has 13 Diving Chambers across the UK.
Secondly, for ME/CFS sufferers the Multiple Sclerosis National Therapy Centres are more affordable, and also more likely to help. This is a self-help charity with a network of 50 Independent Centres across the UK. The history of one such Centre in Cornwall is movingly described at The Merlin Centre - How it all began. To access information about oxygen therapy on the website of the MS National Therapy Centres, navigate to MS Therapies Overview and select ‘Oxygen Therapy’. Please note that as of April 2021, no MS National Therapy HBOT centres within the Greater London area are accepting ME/CFS patients.
Once you have had a look around the website, and if you decide that this is a therapy that you would like to investigate further, you can telephone 0845 367 0977 for more information and help of a general nature. Or if you feel that you have definitely decided to check out this therapy in more detail, you can simply call your nearest Centre and arrange a visit - it will normally be the case that someone will be pleased to show you around and let you sit inside the HBOT chamber and explain how things work. Please note that these Centres are very used to dealing with severely disabled people and so there will not be a problem if you are a wheelchair user. For example, you can actually get into the Chamber whilst remaining in a wheelchair.
You can find your nearest Centre by going to Find your nearest Centre and entering your postcode in the search box or by browsing the Directory of Centres. Although this charity primarily treats people with MS, it is the case that, given the wide range of conditions that benefit from HBOT, you will most likely find other CFS sufferers and people being treated for a wide range of varying conditions including, for example, sports injuries, autism and (post chemotherapy) cancer. It should also be noted that the Centres are all staffed by volunteers and the atmosphere is friendly and informal and there is no need to be apprehensive.
In addition, and although there are regional variations with NHS funding, I am advised that the HBOT Unit in Whipps Cross, East London London Hyperbaric Medicine, the DDRC Healthcare in Plymouth and the HBOT Unit in Hull North of England Medical Hyperbaric Services Ltd all have many patients funded by the NHS.
What will the treatment be like and how much will it cost?
If you decide that you do want to go ahead with the treatment, you will be asked to become a member of the Centre. Each Centre is independent and so costs will vary. However, as a guide, membership is normally around £20 a year. The cost of each treatment varies but is approximately £12 - £15 a session. You will need your GP to fill in a form saying that you don't suffer from any ear/sinus problems.
The Centre Manager will usually seek advice from their own medical expert on your treatment programme. This is usually a block of 20 daily sessions. There are 3 different levels of atmospheric pressure - 1.5, 1.75 and 2.00 ATA, also called 16, 24 and 33 feet (indicating the ‘diving depth’ equivalent). You will start at the gentlest level and gradually proceed to the next level, until you find the pressure that suits you best. Once you have completed your block of 20 sessions, you can then decide how often to continue with your treatment, normally once or twice a week. The oxygen will continue to have benefits for about 3 days after each treatment.
How will the treatment help me and are there any side effects?
To begin with a quote from Petra Kliempt Medical Advisor to the Multiple Sclerosis National Therapy Centres - " Oxygen is our body's antibiotic dealing with inflammation and infection,moreover,it controls over 8000 genes and a course of 20 sessions increases our own stem cells eightfold."
Normal effects are an increase in energy and an increase in mental clarity and a sense of optimism and well-being.
The main side effect is that you may feel a little light-headed after the treatment for the first few sessions. It is therefore wise to sit down for about 10-15 minutes when you come out of the chamber and have a drink, until you are used to the treatment and know how it affects you. We are all individuals and will react differently to HBOT. You may also feel you want to rest for an hour or two afterwards. Overall the increased oxygen levels create a feeling of relaxation and optimism. It’s a pleasant experience. In order to write this article I did some research on the London and Midland Diving Chambers, www.oxygenhealing.co.uk . This organisation is associated with the British Hyperbaric Association. There is a big difference in prices - they quote £50-£300 a session, but I think the average is more like £150. They can "dive" deeper, each client has a consultation with a doctor before being treated and a doctor goes into the chamber with the client. So, this represents a different level of service than that being offered via the Multiple Sclerosis National Therapy Centres and the cost clearly reflects this!
A course of treatment can obviously cost thousands of pounds, but HBOT treats some very serious conditions, including people who would otherwise lose limbs through amputation. The only reason I mention this organisation is that I am aware of individual cases of ME/CFS sufferers having had a course of 10-12 HBOT sessions at the deepest concentration and this treatment was the difference between them being bed ridden and becoming mobile. It wasn't a cure but it did create a big improvement in their condition and subsequently they were able to go to an MS therapy Centre for weekly HBOT.
However, I advise people not to start off at the ‘deeper levels’, although the idea of having a block of treatments at the deeper level might appeal to some people because they may want to see a ‘quick improvement’. It is wiser to go gently, and pace yourself, by starting at the lightest level and gradually building up to a level that is right for you. In addition, not everyone can tolerate the deeper levels, especially those with neurological conditions. Finally, and as noted, ‘going deeper’ also costs more money and so by pacing yourself, you will save your wallet as well as (potentially) your health!
I offer this information in the knowledge that HBOT offers an improvement for many chronic conditions. To my knowledge its hallmark characteristics are increased energy levels, reduced pain and inflammation and increased mental clarity and optimism.
I think it’s an ideal therapy for CFS... until a cure is found.
Article written by Jackie Scoones March 2014
Facebook Oxygen therapy group
If you are interested in joining a Facebook group which discusses these issues and has members who can help with their experiences and expertise, please consider sending a request to:-
‘HDOT (High Dosage Oxygen Therapy) For M.E, M.S, & Many Other Conditions’
If you wish to join, please visit Facebook Group weblink - HDOT (High Dosage Oxygen Therapy) For M.E, M.S, & Many Other Conditions
This is a closed Facebook group and so only members of this group can see your posts – this affords a level of privacy.
Comment by Dr Myhill
The cardinal symptom in CFS is fatigue. The commonest rate limiting step is poor mitochondrial function caused either by a deficiency of substrate (eg magnesium, co-enzyme Q 10, vitamins B3, vitamin B12 , carnitine etc) or by blocking caused by substances from the ‘outside world’ (eg pesticides, toxic metals, VOCs) or by blocking caused by substances from the ‘inside world’ (eg such as products of the fermenting gut).
Of course, lack of oxygen would severely impair mitochondria, but the causes of such a lack of oxygen, such as severe anaemia or respiratory failure, are usually clinically obvious.
Less obvious causes of poor oxygen delivery would include hyperventilation or allergy. In hyperventilation the acidity of the blood is changed in such a way that oxygen binds so avidly to haemoglobin that it cannot escape to get to the mitochondria, where it is needed! Blood vessels and tissues can react allergically with oedema (an excessive build-up of fluid in the body's tissues), which may impair oxygen delivery.
The second major problem in CFS is inflammation which may be as a result of infectious, allergic or autoimmune problems. There are many interventions to tackle this, and for some, HBOT may be a helpful additional therapy for the reasons given above.
A further possible explanation has to do with the fermenting gut - many of the ferments such as alcohol, esters and aldehydes have a general anaesthetic like effect on the brain. The effects of general anaesthetics can be reversed by high pressure. So a response to hyperbaric oxygen could point to fermenting gut or toxic stress being an issue. See Theories of general anaesthetic action
Here are 2 useful links from HARCH HBOT:
- Intermittent Supplemental Normobaric Oxygen Therapy for Acute, Subacute, or Chronic Brain Injury
- Hyperbaric Oxygen Therapy – Off-Label or Alternative Therapy
- Hyperbaric Oxygen Treatment Trust HBOTT - this is clearly a website worth exploring in detail. "Research and Guidance" and "FAQs" tabs are a tremendous resource giving a wealth of information about the treatment, offering links to recent articles supporting the efficacy of the treatment in various conditions. You will also be able to find a hyperbaric centre close to where you live.
- Subsequent to the first writing of this page, a patient of mine has pointed out the website of the Sussex MS Centre to me. This centre offers HBOT and the website, in itself, is a useful resource. The prices are very reasonable - for people with neurological conditions there is a suggested donation of £12.00 per treatment, for those with other non- neurological conditions who wish to use the chamber there is a suggested payment of £18.00 per session and for those who have sports injuries the price is £25.00. Please see also Oxygen Therapy at Sussex MS Centre. Prices are as at May 2015.
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