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Incredible Benefits Of Hyperbaric Oxygen Therapy For Healing The Body | Dr. Scott Sherr

Mark Hyman, MD1:08:44

Transcription

It's a stress in your body, but it stimulates your body's own regenerative repair and renewal systems. It's all the baseline physiology stuff: decreasing inflammation, reversing low oxygen states, stem cell release. It's an anti-infective.

Can you kind of tell us what hyperbaric oxygen therapy is and why it's such a powerful healing technology?

So, hyperbaric therapy, the definition is relatively simple. It's the increase in atmospheric pressure combined with increased inspired oxygen. I'll take oxygen first because most people know a little bit about it.

Oxygen is something we breathe in the air at 21% at sea level; that's how much oxygen is in the air. The rest of it is mostly nitrogen. At 5,000 feet above sea level, where I live here outside of Boulder, Colorado, we're about 16% oxygen.

So what happens is oxygen comes from the body, and that’s okay, but we have trouble climbing the mountains out there. Yeah, I know, that's why.

So you get this, and this actually comes to why it's so important. We carry oxygen typically on red blood cells. Red blood cells carry this molecule on it called hemoglobin, and hemoglobin binds to oxygen. Then oxygen gets to our tissues, and then it goes all the way through our cells. At the end of that whole process, it helps you make ATP, or your cellular energy currency.

So oxygen is really important. Without it, we don't live for very long. Now, we have a certain amount of oxygen-carrying capacity, and that oxygen-carrying capacity is relegated to how many red blood cells we have in circulation typically.

So you have a certain amount of oxygen that can be carried, and you have a certain amount of oxygen that can get into your tissues. Now, there are a couple of ways to increase the amount of oxygen-carrying capacity that you have. You can increase the number of red blood cells you have in circulation. You can do that by altitude training.

So when you go to altitude, for example, come to Colorado, what happens is that your body stimulates a hormone out of your kidneys called epogen, or EPO for short. EPO increases the number of red blood cells you have in circulation.

Now, you can short circuit this by taking the drug itself. This is like what cyclists like Lance Armstrong and others would do—doping. Exactly. Or what you can do is actually auto-transfuse yourself.

So some of these guys will do this. They'll actually take blood out maybe 90 days before a race, because it takes about 90 days to make new red blood cells, or even more time than that, like 180 days. Then transfuse yourself a unit of blood before you race to have extra red blood cells in circulation, so you have increased oxygen-carrying capacity.

So that's typically what's done in the doping world, right? You have EPO, you have auto-transfusion. But there's another way to increase oxygen-carrying capacity, and that's by increasing pressure.

So we talked about hyperbaric therapy, which is increasing atmospheric oxygen. We can increase that up to 100%. But if you're looking at a pulse oximeter, most pulse oximeters for most people are going to read between 96 and 100%, right?

Which means that your bound amount of oxygen on your red blood cells is about 96 to 100% once they leave the lungs. So there's not a lot left for you to bind any more oxygen there. If you put a face mask of oxygen on your face and you breathe 100% oxygen, there's not going to be a whole lot more oxygen you can carry because there's only about 4% more that could be bound.

So the trucks are already loaded, right? Yes, exactly. So the pulse oximeter is something you guys can check. Everybody knows about a pulse oximeter now from COVID, etc.

So if you add pressure, though, if you increase atmospheric pressure, which means that you simulate the pressure you feel under a certain amount of seawater, that pressure changes your physiology and allows oxygen to drive into the plasma or the liquid of your bloodstream.

The physics law around this is something called Henry's law for people who like physics. The only physics law I'm going to talk about today is Henry's law. So the more pressure you put on a gas, the more of that gas is going to go into liquid form.

As a result of that, you get more oxygen into circulation and drive it into the plasma of the liquid of the bloodstream itself, getting up to 1200% more oxygen in as a result of that liquid O2 combined with that pressure with oxygen together.

So that's how hyperbaric therapy works. Incredible! So what are the benefits? Because it sounds like a great idea. Okay, more oxygen. Oxygen's good, or maybe not always, right? You mentioned oxygen toxicity, so too much is not always good.

But what are the benefits that we're seeing, both from the perspective of diseases that we can treat with hyperbaric medicine as well as health optimization and longevity research? I think there's been a number of studies out there, and I think we're still learning.

But I'd love you to sort of unpack how this is used in traditional medicine and how it's used outside of traditional medicine. Sure. I first learned about it in a trauma center in medical school. They were using it for really bad wounds, carbon monoxide poisoning, and acute infections like necrotizing fasciitis, which is also known as flesh-eating bacteria.

That's a nasty one. That's a nasty one, yeah. So the way I like to think about how hyperbaric therapy works is that you have all this oxygen in circulation, and then something happens acutely, or many things happen acutely, or all of a sudden, as soon as you have all that oxygen in circulation.

What I call more the long-term benefits of a hyperbaric protocol are related more to what's called epigenetics, which I'm sure you've spoken about many times in the podcast. The idea that you can change your expression of genes to help you with healing, optimization, and the various ways of rebuilding the scaffolding, as I like to say, of the tissue itself.

So when you get into a hyperbaric chamber, you acutely infuse 100% more oxygen. What's that going to do? That's going to reverse low oxygen states. So if you have tissue that's at risk of dying, if you can get more oxygen to that tissue faster, it may not die.

This has been studied in strokes, traumatic brain injury, acute heart attacks, and acute spinal cord injuries. If these people get hyperbaric therapy very quickly, they're going to save tissue because you're getting more oxygen infused into the body.

So you have more liquid O2 in; it's going to diffuse out more into the tissue, and you're going to prevent it from potentially dying as a result of getting all that oxygen in.

Just a quick anecdote on that, and then I'll continue on the disease thing. My partner fell off a golf cart and had a concussion, smashed her head, and had real bad post-concussive syndrome.

So I contacted the local hospital that had a hyperbaric chamber, and I convinced them to off-label, we call it off-label, give her hyperbaric oxygen therapy. It was a game changer. She literally came out of there, and her brain woke up. It was really quite stunning to see in person as opposed to in a scientific article that I read.

Yeah, no, I appreciate the anecdote. I mean, it happened to me. I gave myself an acute concussion maybe four or five years ago, and I did my whole protocol, got into the hyperbaric chamber, and I felt like a million bucks after three days.

What's going on when you have an acute injury like that is you have acute inflammation, you could have some swelling, and you have some tissue that's at risk of dying depending on the severity of the injury.

Hyperbaric therapy comes in here, reversing low oxygen states, decreasing inflammation immediately, decreasing swelling, and starting the release of stem cells, which are the baby cells in our body that can make new tissue and help mature the tissue in the various areas so that you can make new cells in the area.

You always have these sort of backup cells in all the tissues that you have in your body that are kind of waiting in case they're needed, and hyperbaric therapy can help stimulate the maturation of those.

So you start getting them to start healing that area at the same time. You have all these things happening along with your immune system cells starting to get involved very quickly too.

So your immune system starts revving up as well, and you have the immune system cells like your neutrophils and your macrophages, which are really important when you're starting to clean up tissue to help be able to do this.

So from an acute perspective, you have an acute issue. What hyperbaric therapy really does is just rev up the whole healing process to make it work better.

Yeah, I actually also had another patient who had a stroke. He was a hemiplegic stroke, meaning he was paralyzed on one side and couldn't move that side of his body. We did a lot of things, a lot of nutritional things. We gave him IV NAD and other things, but I was pushing him to do really aggressive hyperbaric treatment, and he did.

He's fully recovered. It was really quite shocking because you just don't see people recover from strokes like that.

No, you don't. I mean, that's what I always say. Obviously, if you have an acute issue, like go to the hospital. Don't try to find your local hyperbaric facility if you have first aid and your ABCs, we call them.

Yeah, yeah. But truly, as soon as possible, if it's possible for you to get into a hyperbaric chamber, now the data is still controversial, let's call it that. These are off-label indications, right?

We have certain on-label indications for hyperbaric therapy, which are covered by insurance, that would be covered by Medicare and all your private insurances. But the things that we're talking about, you're very limited by the way.

Very limited indications, like wound care, diabetic foot ulcers, radiation injury from cancer treatment—this is delayed radiation injury. So if you have an injury from radiation six months or later after your radiation exposure, you can get hyperbaric therapy covered by your insurance companies.

There is sudden hearing loss, sudden sensorineural hearing loss. This is when you lose hearing; it could be pretty devastating for people. Hyperbaric therapy is covered for that.

Chronic bone infections, a condition called osteomyelitis, if wound care hasn't been helpful, then hyperbaric therapy may be something that you can use.

And then at-risk flaps and grafts—this is in plastic surgery. So if you get plastic surgery, then you can potentially get hyperbaric therapy covered for that reason as well.

Yeah, but it's very limited, very limited compared to actually what it does. It's like, you know, it's such a powerful medicine, and it's only approved for, you know, nosebleeds but nothing else.

I know, I know. And so when it comes to it, it's all the baseline physiology stuff that we're talking about here, like decreasing inflammation, reversing low oxygen states, stem cell release. It's an anti-infective.

If you have an infection that does not like high oxygen environments, like your Lyme infections, like your clostridial infections, like your staph infections, these do not do well in high oxygen environments.

So you have that as another piece. I always go back to the physiology of it and how we're thinking about hyperbaric therapy in that more global context as opposed to just, you know, for a specific indication usually.

So you mentioned the approved indications, which for most insurance companies and Medicare and Medicaid will reimburse. What about all the non-approved indications that there's evidence for?

Kind of give us the landscape of what are the kinds of things people are treating. Sure, and you know I have many anecdotes myself, but you've been in this medicine a long time, and I think it's really quite striking how powerful this medicine is when it's applied for certain conditions.

So can you kind of take us through the off-label indications and where it's most effective? Yeah, sure. So when hyperbaric therapy is typically used, it's in more chronic indications.

These are things that have been going on for long periods of time, and when we're not looking at just that acute infusion of hyperbaric therapy of oxygen to really help, but also the long-term benefit of what I would call an oxygen infusion protocol, where we're shifting on the epigenetic side expression of various genes—at least 8,000 different genes that are responsible for growth, for healing, for decreasing inflammation, and preventing cell death.

There's been a lot of research done in multiple different conditions out there looking at it from this perspective. We mentioned a couple of them as we've been discussing in the podcast so far.

But one of the major ones is stroke, for example. So people with strokes do very, very well if they can get into hyperbaric therapy immediately or very close to it.

But also, there's a study that was done three months to three years post-stroke, where people were getting significantly better even three years after a stroke, which is just—you wouldn't see that.

We also have traumatic brain injury. So we talked about concussion here with your partner, but also with people that have post-concussive syndrome. This is people three months or longer after a concussive episode.

We see people with reversal of symptoms a year later, which is not possible. If you've had a concussion, it's three months after your concussion, the chances that you're going to get completely better if you're not better at that point are very, very low.

And we know that this is the case. We see it in hyperbaric facilities all over the country, all over the world, in the places that I work with and the clients that I work with as well.

So you have stroke, you have concussion, you have dementia. We're talking about vascular Alzheimer's and Parkinson's-associated dementia. There is some evidence that hyperbaric therapy can be effective in these patients as well, especially when used in a functional context.

Of course, we're not—and that's a big thing with a lot of these indications. It's not just about getting into a hyperbaric chamber; it's about what are you doing before, during, and after your hyperbaric environment.

Like much before, right before, what are you doing during hyperbaric therapy, and what are you doing right afterwards? I know that's a big thing for you too, Mark. I mean, it's not just one single therapy, but especially with all these indications, it's much more of a broad swath of integration that we're looking at.

Yeah, I mean, you can't be eating an inflammatory diet and then, you know, not taking care of yourself and then just expect it to fix you. But it's really powerful.

So stroke is really clear, traumatic brain injury is really clear, and these are big problems. Obviously, these are also being used for athletes. A lot of this is for recovery.

Not that we'll get into the performance thing in a minute, but what other health or disease sort of indications do you see this being most effective for?

So we're using it a lot in Lyme disease and co-infections. I think it's something that can be very, very effective, but it's something that has to be done in the context of working with a Lyme expert as well, like a Lyme-literate doctor or a functional doctor that has expertise in Lyme.

Because what I found with Lyme disease, especially, is that for most people, they need to be about 60 to 80% better already before they can significantly benefit from hyperbaric therapy and have long-term benefit after hyperbaric therapy is completed.

That's been my experience there, but that's why the ground game, the foundational stuff, is so important, and working with a provider that has expertise.

So Lyme is one of them. Another one would be complex regional pain syndrome, also known as reflex sympathetic dystrophy. It's a very difficult-to-control, difficult pain syndrome that’s unfortunately not uncommon and very difficult to treat.

Hyperbaric therapy can be fantastically effective at recalibrating the whole tissue bed that was injured. Typically, it's an injury that causes this to happen, and then there's a dysregulation, or the area, the tissue itself becomes disregulated.

The nerves get all confused, and the blood vessels and everything else constrict when they don't constrict. What we think hyperbaric therapy can do is actually help with what's called red blood auto-regulation, basically helping re-regulate how the flow of blood is getting into tissue.

Because we talked about that pressure, it's that squeeze that's happening on the microcirculation, on the very small blood vessels, that the pressure itself from a hyperbaric chamber is helping exercise those blood vessels and helping recalibrate them.

It helps happen in the brain, it happens in the heart, it happens in the genitals. We know that there's anti-aging studies for all those places, including your natural Viagra, maybe hyperbaric therapy, if it's a vascular issue at least.

So we know that hyperbaric therapy has this anti-inflammatory capacity. It actually downregulates or decreases some of these major inflammatory markers that you see in autoimmune disease as well, like some of the interleukins, for example, or TNF-alpha, which are some of these cytokines.

So hyperbaric therapy downregulates or decreases those, so that's another type of condition or group is the autoimmune conditions as well. We know hyperbaric therapy can be very helpful in those on its own, maybe not as much as being in more of a holistic perspective.

Yeah, that's amazing. Well, I think, you know, people are going to want to buy one now that it fixes erectile dysfunction. That's how the Israelis got everybody to sign up, actually. It's kind of funny to mention.

They show all the guys pictures of—it's actually one of my favorite things to show as a lecture slide when I lecture is a functional MRI of the penis before and after hyperbaric oxygen therapy.

That's fun! Okay, I love that. Nobody knows what it is. It just looks like a tube, and there are colors on it, and then there's more colors on the other one. But I just like to tell everybody it's a penis that I'm putting up on my lecture slides, talking about how hyperbaric therapy regenerates blood vessels.

That's one thing that we haven't talked about is that, you know, what hyperbaric therapy does immediately is reverse low oxygen states by getting more oxygen in a tissue. But over the long term, it's actually rebuilding and regenerating blood vessels—something called angiogenesis.

So if you have more blood vessels, you're going to get more oxygen to the tissue over the long term, and that's important. We can see functional MRIs of the brain, of the heart, of the genitals here, and you can see how you can rebuild this tissue.

That's where it comes into sort of the anti-aging, reverse aging world. But yeah, the Israelis would have been the main people that have done a lot of this research on the reverse aging side.

So they did studies on the brain, the heart, the genitals, and showed that you could see new vascularization, new blood vessels growing in the brain and the heart. In the heart, it gives you more exercise tolerance, and in the groin, it gives you more sexual tolerance, I guess, or sexual possibilities.

Then they've also done studies looking at senescent cells and telomere length, which are fancy words for things that get bad as we get old, basically.

Yeah, zombie cells, we call them. They're cells that don't die that spew out inflammation, and your telomeres are the little things at the end of your chromosomes that tend to shorten as we age.

In those studies, it seemed to lengthen telomeres more than any other treatment and actually kill zombie cells more than any other treatment, which is important as those are just part of the hallmarks of aging we talked about.

Yeah, the zombie cells are a big one too. I mean, I think of all the research that came out, the senescent cells, the zombie cells, decreased population by about 30% after 30 treatments was pretty impressive.

There's no other treatment out there that we're aware of that can do something like that. But you mentioned chambers at the house, Mark, and I probably should mention a little bit about the different types of chambers out there because I think people get confused.

Before we get into the what chambers, we're going to get into how to use them, how long to be in them, what atmospheres we're going to get into, all getting HT yourself. I just want to linger a little bit more on the treatment side and the things that actually can help.

A colleague of mine, a functional medicine doctor, I'm sure you know David Perut, who was a neurologist, was into hyperbaric medicine 30 years ago and had a whole series of hyperbaric chambers at his clinic.

He found it worked for Alzheimer's and Parkinson's. Can you talk about its role in neurodegenerative disease? Is there any evidence? What do we know? Does it work? Is it helpful? Should I be thinking about this for that?

Yeah, David is one of the pioneers of using hyperbaric therapy for neurologic injury. There are a couple of other clinics that were in Florida doing very similar things. This guy, Dr. Newow, one of the older guys, took hyperbaric therapy from the wound care world and started using it for the brain.

It's always like the happenstance kind of thing, right? You have somebody go into a hyperbaric chamber for the bends, but their stroke symptoms get better, or their diabetic neuropathy improves, or their traumatic brain injury that they've had for a year suddenly improves, or their nightmares from PTSD from Vietnam suddenly disappear and don't come back.

These are the things that happened in the early 1990s. The pioneers of this world were a guy named Dr. Newow and Dr. Paul Harch. Paul's still practicing in Louisiana and has been doing this for a while.

They, along with David, were all looking at how specifically the brain worked under hyperbaric pressure and how hyperbaric therapy could potentially be a modality to help in the ways that we've discussed: decreasing inflammation, improving blood vascularization.

We know that this can happen. We know that brains can start lighting up again even if they've been degenerating because of cognitive impairment. I mean, you and I both know, Mark, that after about the age of 50 or so, if you put somebody under an MRI scanner and you look at their brain, even with just a regular MRI, it's going to show something called microvascular changes of the brain, which just basically means that blood vessels are starting to deteriorate.

We know that if we can get somebody into a hyperbaric chamber and start rebuilding those blood vessels, they're going to have more tissue that's not going to die. Because as the brain gets older, it shrinks because the blood vasculature starts to shrink around it and degenerate.

We think that hyperbaric therapy works in these contexts for cognitive impairment, for Alzheimer's potentially, especially in the early stages, by decreasing inflammation, increasing the vascularization of the brain, helping more stem cells populate that area, and then also helping with flow.

The one thing that we forget in hyperbaric therapy—actually, most of my colleagues forget—is that pressure is actually the main thing that's happening. Of course, oxygen's important, but it's pressure that's driving everything.

Pressure itself is driving flow, and it's driving vascular and lymphatic flow. So it's the pressure itself that's helping with the brain's detoxification systems and helping you actually re-get some of that cerebrospinal fluid to flow out and help rebuild and regenerate after getting all that garbage out too.

So I think it's a garbage-collecting capacity as well that's happening in the chamber.

So if you just scuba dived at 60 feet for an hour a day, would that do the same thing?

It's a lot of work to go scuba dive every day because, I mean, that goes into protocols. We're not usually just talking about just going once.

But there's actually a funny story about that, Mark, because they published a study on these veterans that had traumatic brain injury and PTSD. They took them diving for five days, something like 60 feet a day, and they all said that their TBI symptoms were dramatically better.

Their concussion symptoms, their PTSD—all were better, and they attributed going diving and looking at the fish. How about the pressure, guys? How about the oxygen? But they said, "No, no, it wasn't that; it was just because they got to look at fish."

So, okay, a couple other things on the other end of the age spectrum. I've seen people use it for autism. What are your thoughts on that?

Yeah, so my father, who's a chiropractor, his name's Alan, runs a facility in New York called the Northport Wellness Center. He's actually the guy that got me into hyperbaric therapy in the early 2000s because he was looking at how you could use hyperbaric therapy in the context of the autistic spectrum within the functional context that you're very much in.

Could you optimize blood flow to the brain and help with blood flow regulation? Oftentimes in autistic patients, the way that blood flow is regulated, the way it kind of goes to various areas of the brain, is abnormal.

If hyperbaric therapy could help regulate that, would it help with actually helping the brain work better? The answer is that it seems like it does. There have been some small studies in Canada, in India, in other countries, and even in the US looking at how it does seem to help autistic kids.

But it's not a treatment in and of itself without doing all the other work that is required.

But it's amazing. So, okay, in terms of you, you know the mechanisms of action to recap: it increases blood flow, stimulates angiogenesis, increases stem cell production, increases telomere length, kills zombie cells, helps with wound healing, helps reduce inflammation, and it's an anti-infective. Did I miss anything?

No, you did well. That was a good look. Everything. Wait, maybe I don't have too many microvascular changes yet. I'm going to be 64 this year. Maybe my brain is still working well.

You've done some hyperbaric therapy. You do a couple of other things. Not enough. I'm like desperate to get one, honestly. I'm just waiting until I've been stationary enough long enough to go.

Once you get stationary, I can help you. Yeah, I mean, I think you did a good job with the overview or just the rundown there, Mark.

I think the key for people to know—and it's something that I'm very emphatic about—is that I don't think hyperbaric therapy is right for everybody right now. But I do think that at some point in your life, hyperbaric therapy will very likely be helpful for you.

So it's not an if thing, but it's a when thing. But the when thing is important because what happens a lot in my field is that if you own a hyperbaric facility, everything looks like you need to go in a hyperbaric chamber right now.

Yeah, all you have is a hammer; everything looks like a nail, right? Exactly. So, you know, I got disinvited from a lecture because I said, "Please, my lecture title was 'Please Do Not Put Them in the Chamber.'"

So, and it's provocative, right? But the idea here is that it's not if, but when, ladies and gentlemen. Right? Don't take this pill.

Yes, exactly. So what I often find is if you have a chronic issue, Mark, I need them to see you first. I need them to get optimized first. I need them to start working on their vitamins, their minerals, their nutrients, their gut health.

But if you have an acute issue, then, you know, do not pass go, do not collect your $200. Find a local hyperbaric facility and start getting treated if it's safe to do so because it's going to help the whole process.

But if you have Lyme disease, if you have a chronic concussion, even if you have a chronic stroke or dementia or chronic pain, these things screw up your cellular metabolism, and they need to be addressed.

If I put something in a hyperbaric chamber, I flood their body with oxygen. That's awesome, except if their body cannot tolerate all that oxygen.

What does that mean? Because if you have a lot of oxygen in circulation, you're also causing something called oxidative stress. This is the buildup of free radicals and reactive oxygen species.

That's okay; that's what exercise does. That's what heat does at a high level—temporarily, right?

But if you're going into a hyperbaric chamber every day, you're not going to be able to potentially neutralize that oxidative stress, and that could be a problem. So it's not like it's a cure-all for everybody right now.

I think I just want to emphasize that too.

Yeah, great. Thanks, Scott. So we covered the diseases and the sort of pathology that maybe benefited from hyperbaric. Let's talk about the flip side, which is health optimization, recovery from sports, longevity.

That's kind of a whole new field. So it's not just like, "If I'm sick, I'm going to go there." If I bang my head or I got a big diabetic foot ulcer, but I want to live a long time, I want to feel good, I want to recover from my workouts.

Tell us about the research around recovery, health optimization, longevity, and who, you know, what are the benefits, and what are we seeing?

So some of the stuff we've been talking about so far, almost all of it to some degree, you know, what is aging but wounds that kind of build up over time that we need to address, right?

But I mean, what it comes down to is that the Israeli group, run by a guy named Dr. Shai Fried, published a number of studies on a healthy population greater than 65 years of age, looking at all these markers we've been discussing: senescent cells, telomere length.

They looked at blood vascularization in the brain, in the heart, in the genitals. This is in a normal population, so this is making a normal population a normal for a 65-year-old healthier.

So, i.e., reversing their age by giving them these markers that give them signs of having a lower age: better cardiac output or heart capacity, better brain function, better genital function, etc.

So we know that from a reverse aging perspective, an anti-aging perspective, that's how hyperbaric therapy is working. There's no doubt about it.

We're getting more and more people that are interested in these kinds of protocols, doing diagnostics before, doing cellular testing before, then doing diagnostics afterward—maybe it's brain imaging, maybe it's neuropsychological testing, maybe it's additional types of blood work, things like that, looking at before and after inflammatory markers.

There are lots of different ways to go about it, and I do various things in my practice depending on the patient and the clinic and things like that.

When it comes to the athlete, there are some really interesting studies that have been done in the regenerative world. So looking at like PRP plus hyperbaric oxygen therapy for recovery, which has been pretty effective.

There are also some studies looking at stem cells and hyperbaric oxygen therapy. Now, we make stem cells mobilize more in a hyperbaric chamber, but using them exogenously or getting injections or putting them in various locations, there may be a benefit from doing that as well.

There's interest in exosomes and V cells and all these other fancy different types of regenerative technologies, although we don't have a lot of data for those quite yet.

So it, through the same mechanisms of reducing inflammation, increasing stem cells in repair, and helping new blood vessel formation, it seems to really be something that is promising for not only health optimization and recovery from injury or exercise but actually for longevity itself, right?

Yeah, and then when it comes down to the recovery piece of it, it's everything that we've discussed before.

For my athletes that use hyperbaric chambers, we talk about it using pre-treatment, like as a pre-workout, as a way to kind of boost your hyperbaric therapy.

An interesting thing about after you get out of a chamber is you have about 30 minutes to an hour where you have more oxygen in circulation. So you're going to have more oxygen-carrying capacity for that 30 minutes to 60 minutes after you get out of the chamber.

You can actually leverage that to do some additional work or increase your oxygen-carrying capacity in the sense of what kind of work you're going to do when you get out of the chamber.

You're going to try to do some more exercise that you wouldn't typically do. I've had lots of patients tell me that they can run for 30 minutes longer after their hyperbaric treatment that day as opposed to when they didn't do it that day, for example.

Amazing! Amazing! Yeah, you can use it on the recovery side. So after you do your hard workout, after you do your exercising, you can use hyperbaric therapy on the other end of it for helping with the recovery.

So it's going to help with decreasing inflammation, increasing blood flow, and helping with lymphatic detoxification. But, I mean, you want the hormetic stress; you want the stress of the exercise.

So you don't want to typically do it right after exercise. You want to wait maybe three to four hours afterward. But the same things apply.

I work with athletes; I work with people with stage four cancer, you know, everyone in between. Because we know hyperbaric therapy, from its base mechanisms, what it's doing, and then it really just depends on how much you need, what kind of pressure you need, what kind of chamber you need, how often, you know, those kinds of metrics and variables that we play with.

Then also not only those, but what are your integrations? What are you doing before hyperbaric therapy? What are you doing during, if it's the type of chamber you can bring something in there? What are you doing afterward?

These are all the things that are very much involved in sort of the ecosystem that I've developed with my company, One Base, and everything. But it's something that I've been using in clinical practice for a decade now.

Yeah, amazing! So now let's get into sort of the nitty-gritty because I'm sure by this point people are like, "I want one! I want to get in one! I need it!"

You know, it's not like, "Oh, here's a—I can get a cold plunge and just, you know, bum bum," or get a little sauna. It's a substantial piece of equipment.

For those listening, there are different kinds of chambers. There are ones that are medical-grade chambers that are used in a hospital where you require a technician.

There are soft chambers, which are things that have been sold for a while at home, which have much lower pressure. So we'll get to talk about what is an atmosphere, what are the atmosphere ratings, and what is the difference between them and how do they apply to our health.

But, you know, there are soft chambers and then there are hard chambers, and then there are now home hard chambers. This is a whole new era of people actually learning about this, wanting to do this at home.

It's not cheap, but the benefits are pretty substantial. So I would encourage you to sort of help us walk through the difference between hard and soft chambers.

Take us through the science of the protocols around different things. For example, like, you know, how many atmospheres should we be using? How long do you stay in the chamber? What is the—you know, what do you use for different problems?

Sort of take us through a little bit, and we'll sort of go deep in this because I think it's an important conversation about how this is applied.

Yeah, thanks, Mark. That was a great overview. So the best way to think about it is that let's forget about the type of chamber for a minute. Let's just talk about pressure.

For the most part, what we're talking about is we have two different types of pressures that we typically use in the chamber. We have what we kind of call neurologic pressures, and we have systemic pressures.

Now, of course, there's going to be crossover, but in general, neurologic pressures are an atmosphere between 1.3 and 2.0. So that means about 15 feet of seawater to about 33 feet of seawater.

If you can imagine if you're 33 feet below the sea, you're looking up—all that water is extremely heavy. You pick up a bucket of water; it's extremely heavy. So we're actually simulating that pressure you feel in the chamber.

So neurologic pressures tend to be about 1.3 atmospheres to about 2.0, and the systemic pressures tend to be about 1.7 to about 2.4.

Now, we can go deeper than that, especially if there's an acute injury, like if there is an acute lack of blood flow to a limb or if there's carbon monoxide poisoning or if there's the bends.

But in general, our therapeutic pressure range is between 1.3 and 2.4.

Okay, and so home chambers or soft chambers—let's talk about soft chambers now. So soft chambers, in general, typically go between 1.3 and 1.5 atmospheres.

These are chambers that can be used at home very easily and very safely. It's a bit of a wild west when it comes to finding chambers out there, which we can talk about.

But when it comes down to it, the mild units, the soft-sided units, typically go between 1.3 and 1.5, and then you'll have different varieties of soft chambers that can do that.

But that's more for neurologic pressures in general. So for neurocognitive optimization, for what I would call your overall day-to-day optimization, chambers are safe to use at the house.

They're easy to use at the house. You can stack them or have protocols where you can find different integrations. This is what my team has been really emphatic about, is how you can make these mild chambers more therapeutic by enhancing blood flow before you go in, for example, doing various types of therapeutics while you're in the chamber itself, and even afterwards.

But in general, the mild units are for neurocognitive optimization, day-to-day wellness, and recovery.

Now, the hard chamber units, as you alluded to, Mark, there are medical-grade units that you can go to a facility for. These are single-occupancy chambers, sometimes multiple-occupancy chambers as well, called monoplace or multiplace.

All the medical indications for hyperbaric therapy at this point right now are either at 2.0 or greater. So if you're going to go to a medical facility, typically that's the pressure they're going to treat you at.

Although there are some hyperbaric facilities that do both on-label and off-label hyperbaric therapy that will allow you to have more of a range of pressures that you can do.

There are facilities that do both insurance work and non-insurance work, so you can get hard chambers for your house as well, although that's a newer area, and it's not as easy logistically.

The chambers are much heavier; they take more work to operate in general, and there's more of a safety component to it. I mean, they're very safe, but at the same time, you have to make sure you're getting it from a good manufacturer, from a company that's going to give you good safety, just kind of overall work with you in a very specific way.

I mean, the challenge that you have with hyperbaric chamber companies in general in the US is that it's kind of just buy-sell. They sell you a chamber, and then you're no longer talked to on your own.

Actually, that's why I got involved in the business side of this, because I was just tired of talking to people after they got a chamber, had a bad experience, or didn't know what they were doing, didn't know how to use it, didn't know what kind of protocol.

But in general, the way I see the soft chambers at least going, Mark, is kind of like the way of the Peloton over time. You're going to have your Peloton, you're going to have your sauna for people that can afford it.

I know these are not inexpensive things, but you're also going to have a hyperbaric chamber because it's going to be your recovery tool, like it is with your cold plunge.

I mean, one of my favorite protocols is 30 minutes in a hyperbaric chamber and then get into your cold plunge afterward. It's called our Optimal Performance or Cognitive Performance protocol on our app, for example, that we use.

So, I mean, there are lots of fun ways you can go.

Yeah, that's amazing! So the higher pressure chambers, the hard chambers, seem to be more effective maybe for longevity, for some things you're talking about: the stem cells, the recruitment, the inflammation issues, the telomere length, the zombie cell-killing effectiveness of them. Is that fair to say?

So right now, that's the data. If anybody tells you that your soft chamber they're trying to sell you does the same thing as what they've shown in these studies, the answer is that they have no clue, and they're not being truthful because we just don't know.

There is some indication, though, that we do know actually that stem cells do get released in these mild units even without oxygen, interestingly.

So typically what we're doing is that you have a hyperbaric chamber, and you're getting oxygen that's usually being piped in via either an oxygen concentrator or, if it's a deeper chamber, maybe through oxygen tanks or liquid oxygen even at deeper pressures.

But we do know that even at 1.3 atmospheres, which is a mild unit hyperbaric protocol or hyperbaric chamber, you're getting about two times or 200% more stem cells in circulation.

So this is not a small amount, even without any oxygen added. This is just hyperbaric air. So that all that means is that you're pressurizing the air in the environment around you, and when you do that, you're getting more stem cells released.

Another argument that I get a lot from the hard chamber people in hyperbaric therapy—and again, I'm not a purist; I use hard chambers, I use soft chambers, I use them both—is that one of the arguments you get from the soft chamber people that do not like soft chambers is that they don't think you can get a huge amount more oxygen in circulation at that level.

If it's from a pure oxygen perspective, it's not a huge amount more, but it's the pressure as well that people forget about because the pressure itself increases energy production directly, even without oxygen being around.

So we do know that absolutely the data shows that stem cells—the more the deeper you go, the more stem cells you're going to release.

The 2.0 pressure is what's been studied for senescent cells, for telomere length, for angiogenesis, for the brain, for the heart, and the genitals we talked about before.

Okay, but a 2.0 is the way to go. But I can say, Mark, clinically using the soft chambers for a long period of time, if you have the ability to optimize before you go in, so you're doing functional medicine, you're doing some sort of foundational testing, and then optimizing vascular flow using various types of technologies—maybe lights, maybe U, maybe cold therapy, maybe even things like supplements to help with vascular flow, which I'll use—this is something that I've developed for many years.

You're looking at this cadence of how you do things to enhance vascular flow. You can potentially, I think, simulate for some indications—not all—in the mild unit by doing this integrative kind of approach.

But simply going into a hyperbaric chamber at mild pressure is not going to do the same thing ever as going in at 2.0. It's just not possible.

Yeah, yeah. So, I think, you know, obviously, imagine the costs will come down for these units over time. I think, you know, it used to be $150,000 to get a hard chamber. Now you can get one for $25,000 to $50,000 or less.

It's still a lot of money, but you know, it's kind of a long-term piece of equipment that I think can have profound benefits for health if you can get it.

Yeah, one of the things I think about is sort of like my hub-and-spoke model for this, which is like I have a soft chamber in my house that I use regularly, and I have a clinic close by that has a hard chamber that I can use in case I need it.

So I think from a day-to-day wellness perspective overall, if you don't have a severe condition, some of the things we talked about before, then I think having a mild unit could be very, very helpful.

But having access to a hard chamber so that you can use it periodically, I think, is very, very helpful for the reasons that we mentioned as well.

I think from an affordability perspective, you know, it's significantly less cost to get a mild unit for the house than it is to get a hard chamber for the house, that's for sure, and logistically.

But then if you have somebody close by, you have a facility close by that you can trust—I work with many facilities, and a lot of them are great. Some of them, you know, you have to be careful, but most of them are great.

Then you have a great place close by to get hard chamber hyperbaric therapy when you need it. I think about these longevity protocols: how do you use a hyperbaric chamber over the long term?

I think having the ability to go to 2.0 for a protocol once every year or two is likely awesome if you can do it. Or you can buy one with 10 friends, and so you're going to your chamber.

I like it! Yeah, yeah, exactly. So let's talk about the protocols. I mean, you know, these longevity protocols were like 60 sessions over three months.

So it's basically, you know, Monday to Friday and skip the weekends. Can you talk about, you know, what do we know about the frequency, the sort of dose duration? In other words, should you be 60 minutes, 90 minutes?

How many days a week? How many times a year? Like, is it something you can do every day, for example? If you have your chamber, would you go in a hard chamber every day for 365 days, or is there danger in doing that?

So talk us through what is—because the thing is, you buy a chamber. If you use it for 60 days, what happens to the other 305 days of the year, right?

So let's talk about that. Unless you're a big family guy or you got like a hyperbaric share, like it's like your time share or something.

Yeah, like a time share, exactly. I think that's a new business idea. I like that.

Yeah, you have your condo; you have your hyperbaric chamber. I dig it. So, yeah, protocols are important.

So oftentimes, the way to delineate this is a couple of different ways. So if you have an acute indication, meaning you just got an injury, you just had a trauma, you have an infection, typically you don't need that many hyperbaric sessions to see a massive benefit.

Maybe one, maybe three, maybe five, maybe up to 10. But in general, for an acute indication, this actually includes surgical indications.

So if you just had a surgery, you're going to heal faster if you get into a hyperbaric environment. In the studies, we're talking about anywhere between 30 to 70% faster.

On average, about 50% faster overall. So that's a big deal. If you're an athlete, that's a huge deal. If you're somebody that just had plastic surgery, you don't want to have raccoon eyes for two weeks; you want to have them for 10 days.

That's also nice too, right? So then there are also these shorter protocols, typically, as you were mentioning, Mark, Monday through Friday.

The reason for that is not so much for the shorter-term protocols, although it's important, but for the long-term protocols where we're talking about 20, 40, 60 hyperbaric sessions.

It's the cumulative exposure of the oxygen in your cells that creates this shift in your epigenetics, which we were discussing before.

It's that change in expression of helping you heal, helping mature those stem cells, helping decrease inflammation. All that stuff takes time. It doesn't happen—it starts happening pretty quickly, but it doesn't really start solidifying itself up until about treatment 20 or so.

So if you have more of a long-term goal or a chronic indication, like for example Lyme or dementia or a chronic pain syndrome, you don't necessarily want to stop before at least 20 hyperbaric sessions.

But that's your minimum typically. So the hyperbaric protocol you were discussing before with the Israelis, the reverse aging protocol, that was 60 hyperbaric sessions over three months.

But in general, I find—and if you look at their study itself, their max benefit was around treatment 30 to 40. That was when senescent cells dropped the most, that’s when telomere length increased the most, and that’s when angiogenesis, the rebuilding of blood vessels, was happening.

So in general, what I say is for an anti-aging protocol and for most of the long-term benefit for chronic indications, we're talking about at least 30 hyperbaric sessions, sometimes 40, and sometimes more than that.

It just depends on how people are doing. You have to also think about the pressure. So we were talking about the various types of pressures.

For neurologic conditions, we may not start at 2.0; we may start at 1.3 or 1.5 because the brain is more sensitive to oxygen. As a result of the brain being more sensitive to oxygen, you have more stress on the brain if you go to deeper pressures.

You have to be aware of that. There are some interesting studies that were done where if you looked at a deeper pressure versus a milder pressure, the milder pressure does better.

The deeper pressure actually made people worse initially because the brain was under too much stress. So you want to be thinking about the pressure, the type, the amount of pressure, the amount, and the number of sessions.

You talked about the time, and so typically we have people going into the hyperbaric chamber between 60 and 90 minutes at a time. The milder pressures, the ones that we're going for neurologic pressures, those are usually 60 minutes in length, although sometimes we'll do 90 minutes.

But definitely, the 2.0 pressures we do for 90 minutes. This goes into something called air breaks.

When you're in a hyperbaric environment and you're getting oxygen, usually through a mask or sometimes in the chamber itself, you are every 20 minutes for five minutes. We ask people to breathe just the air in the chamber itself.

What this does is it does two things. The first thing is that it simulates the body being at altitude, which you would think is kind of funny, right? Because you're in this hyperbaric chamber; you're deep underneath the sea equivalent in pressure.

But what we do is we, by changing the amount of oxygen, the body sees that as if your body is all of a sudden at altitude. That stimulates all these things in your body to be released that happen at altitude: new blood vessels, new stem cells, decreasing inflammation.

All these things happen—something called hypoxic inducible factor, or HIF-1 alpha, for people who care. That's the name of—I wrote about it in my book, "Young Forever."

Yeah, yeah, it's really important. And yeah, so HIF-1 alpha gets released, and so that's really important for the therapeutic nature we think of hyperbaric therapy.

But also, this is the reason why you don't want to go into the chamber 365, 24/7.

Hyperbaric therapy is creating oxidative stress in the system. It's increasing the amount of reactive oxygen species.

And so your body has the natural ability to balance that out with antioxidants if you have that capacity. That's why it's important not just to go into the chamber without maybe thinking about these things and working with a clinician that can help you.

But what these air breaks help do is help decrease the risk of oxygen toxicity because there's less oxygen every 20 minutes for that five minutes.

So it prevents the potential toxic buildup of these oxygen radicals. It's very rare to have a problem with oxygen toxicity, but it does happen.

These are people that—the most rare side effect that can happen in a hyperbaric chamber is a seizure. This doesn't typically happen unless you're at very deep pressure for long periods of time without air breaks and also have a pre-existing reason to have a seizure, like you've had a seizure disorder before, like you've had a stroke, a traumatic brain injury, or you have cancer in the brain or something like that.

Now, we can mitigate this with things like exogenous ketones, and I have lots of integrative oncologists that I work with that do deeper pressure protocols using hyperbaric therapy.

We didn't talk about cancer, but that's one of the other ones that we use hyperbaric therapy for.

So you can mitigate oxygen toxicity that way, like by using these air breaks as well. But in general, the treatment time in the chamber is going to be between 60 and 90 minutes, sometimes as long as 120 minutes, sometimes as short as 30 minutes, depending on the protocol.

Interesting! So there is a danger, and you mentioned a word before. I talked about before on the podcast called hormesis, which is this idea of a stress that doesn't kill you but makes you stronger.

That's really what hyperbaric oxygen therapy is. It's a stress in your body, but it stimulates your body's own regenerative repair and renewal systems, which are built in to help you deal with problems.

It's already a built-in—you got a built-in autocorrect system, but most of us trample over it, don't facilitate it, and help it. This is a method that actually allows you to activate these ancient built-in repair and regenerate renewal systems.

It's a beautiful technology because it's not like a drug that has all these side effects. It actually, you know, when used properly with the right protocol, with probably medical supervision to some degree at the beginning, can be a really beautiful adjunct to a health and wellness protocol, longevity protocol.

It's something that people don't realize is out there, and it has the potential to help people who are struggling with many, many issues.

I'm curious about, you know, the effect on the brain and what you've seen in terms of depression. You mentioned PTSD a little bit.

I know when I went in, my brain just was like boom, wide awake, clear, sharp. I mean, I didn't even know I had brain fog. I came out of that thing, you know, so it's kind of fascinating to see how it changes your cognitive function in real time—not like over many treatments, but even just after one session.

That's the acute infusion of oxygen piece. There are some people that are pretty what I call the quick responders, the massive responders.

The people that go in initially after their first couple sessions are like, "Holy crap! This is amazing! My brain hasn't felt this good in forever."

That's usually a good sign that if they do a full protocol, they will maintain at a higher level before they started. Now, that usually means that the body or the brain, in this case, is not getting enough oxygen chronically.

This can happen for a number of different reasons. It can happen from mitochondrial distress; it can happen from vascular degeneration; it can happen from inflammation.

Once you get more oxygen in there, your mitochondria, which are the part of your cell that make energy, are like, "Holy crap! This is awesome! We're making more energy! This is great!"

But then after three to five sessions in, that's when that starts to trail off for most people, and then the brain starts doing the hard work of actually regenerating itself.

That's all that epigenetic stuff we were talking about before. I have people that go in there to take—they go in there for tests.

They did an interesting study in China where they put Chinese students in for five days before they did major exams, and they did amazingly better.

They did MRIs of their brain, and their ability to take short-term memories or take long-term memories and bring them to short-term was massively increased, and their executive function increased as well.

So that's a short-term benefit, and there are utilization ways that I use it. I use that in clinical practice. I use that for myself when I know I'm going to have a big week at work or lots of podcasts with people like Dr. Heyman here.

So you want to have—you're cheating! I don't have one! Not yet! Not yet!

No, but the key with it always is that when I work with clients—and I know you do the same thing, Mark—it's about a holistic perspective here.

What wasn't and wasn't available until I started doing this with my team was creating a full educational platform and an application for people to actually see how they can use hyperbaric therapy in real time and how they can get educated on it and how they can integrate it with their other technologies that they might or might not have but maybe want to have in their homes.

I mean, that's the problem with hyperbaric therapy. I found, and I've been doing this now for a decade, is that I thought it was the Wild West like three years ago, and then COVID happened.

Now we know from a post-COVID world too, hyperbaric therapy can be extremely effective in helping with the brain, helping with regeneration of blood vessels, everything we've talked about.

It works in post-COVID syndrome fantastically well, exactly, in so many. Even during the acute COVID part of things, we were using hyperbaric therapy to keep people out of the hospital.

I mean, this is not using—I mean, even hospitals were trying it in the beginning, but like using other protocols and other compounds, and I've had a lot of success with other kinds of things too.

But for post-infectious inflammation, hyperbaric therapy is fantastic as well. So if you have an acute thing, we mentioned, you know, this shorter time frame.

If you want to do it for longevity, it's, you know, 30 to 60 sessions.

And then do you just do it once a year? Is that the idea? Is it kind of a reset?

Or, yeah, thank you for mentioning that. I meant to mention it before. So nobody really knows.

I've developed protocols over the years working with people from all walks of life and very different professional backgrounds.

But what seems to work best from what I can tell—because if you ask the Israelis, you do this hyperbaric protocol, you do 60 hyperbaric sessions, right?

You've done—you got all these amazing changes to the brain, all these amazing changes to your lab work. Then I go, "What happens six months later?" They go, "We don't know."

Nobody knows how long it lasts. You know, nobody knows how long it lasts. That's why such a big part of this is like you just can't go into a chamber and expect that it's going to fix your diet and your supplements and your mitochondrial stress.

It may help a little bit, but in six months to a year, you might start going back to the way you were.

So even in somebody that's pretty well optimized, that's just doing the natural aging of life, I think that re-upping on these kinds of protocols is going to be necessary.

Now, how often? I don't know. So what I typically say is if you're over about 60 years or 65 years of age, depending on how old you are, if you have a hyperbaric chamber available to you, going to do a deep pressure protocol every year to every two years would be probably optimal.

Now, would it have to be as long every single year? I don't know. The way I typically work it is that the people that I work with in their own homes and with the chambers that we have and the protocols that we use is that I think about it in this way.

I think about you're doing a protocol every six months, but one's for systemic optimization, one's for brain optimization, or you're doing one protocol every year for one of an alternating.

In between, you're using pretty much mild hyperbaric chamber pressures just for day-to-day recovery optimization—not using it every day, maybe using it on average two to three times a week, using it more when you're getting off an airplane because you were hypoxic when you were low oxygen on a plane, using it more when you have a mild injury, or if you have family members that are going to use it.

I mean, of course, everybody that goes into a hyperbaric chamber should make sure that they're okay to go into a hyperbaric chamber. It's not just—it's a medical technology; it's not a wellness technology.

So you have to make sure you're screened by a physician and all those kinds of things. But in general, it's important to think about it in two different types of tranches: whether you're doing an everyday protocol or you're doing it sort of intermittently for maintenance and then alternating those things over time.

Yeah, I mean, like if you're working out all the time, you want to use it all the time, but you're saying that's a bad idea to actually get that much hyperbaric treatment.

Yeah, you definitely want to take breaks because of the stress of being under high oxygen environments.

I see this with people with traumatic brain injury, for example, and that they're getting better. Maybe they're treatment 40 in, and they're like, "Oh, we should continue because they're continuing to improve."

Then at treatment 42, some of their symptoms start coming back, like their brain injury symptoms start reverting, and they start having difficulty sleeping, and their sleep had gotten better.

Then that could be a sign that it's too much oxygen; you need to take a break. So it's not just more is better, and that's not the American way in a hyperbaric chamber.

It's really important for people to hear. You know, it's really a medical therapy. You don't take it all the time. It's very much customized to what your particular needs are, and you can overdo it.

So it's all, you know, it's actually this whole field of the decentralization of healthcare, the democratization of healthcare is happening across the board, whether it's, you know, with home hyperbaric oxygen therapy or whether it's with things like, you know, access to lab testing like I'm doing with functional health, where we're giving people access to over 100 different biomarkers that they can order outside their healthcare system and directly get their results and have an optimized plan.

You also are, I see, the bridge between the traditional hyperbaric medicine world in hospitals and sort of the consumer interest in this space, making it safe, effective, training people.

So tell us a little bit more about how you have developed tools and programs and services to help support doctors and also patients or even, you know, health hackers or whatever you want to call them, biohackers who want to do this on their own.

Yeah, I mean, I started off conventionally trained, but I grew up the son of a chiropractor, so I was kind of crazy from the beginning.

Working in the middle of these two things has been fun for me and dovetailing. I mean, most of the time that I spend these days is in the alternative optimization recovery, the things that are off-label when it comes to hyperbaric therapy.

I have a lot of great colleagues that work on the conventional side that I can leverage that also do some of the off-label stuff too. But I think that, you know, for me, when I was looking at this world four or five years ago now, I realized that there was really an opportunity to make hyperbaric therapy better, faster, and safer in so many ways, especially because people were getting chambers in their homes.

They didn't know what to do with them. They had all these other technologies at their house; they didn't know what to do with along with hyperbaric therapy.

So I've been creating protocols and working with patients and clients all over the world for the last decade. I have a remote consulting practice that I consult with people all over the world and help them create their hyperbaric protocols, help liaison with their local facility.

I know many at this point around the US and around the world. I also work with clinics, facilities that use hyperbaric therapy as a part of how they integrate their other modalities, whether it be like a biohacking lab or it might be a neurologic chiropractor, for example, and everything in between.

So with all this in mind, I created a company called One Base Health, which is really the idea behind that was to create an educational platform and a way to access hyperbaric therapy in a more holistic way.

So you have access to protocols, you have access to education, you have access to some new smart technology that's really going to make the chamber faster, better, and safer.

Then looking at those integrations in a way that how can you leverage this technology? That's my thing. I mean, like I'm obviously biased because I'm a hyperbaric guy, but how can I leverage this chamber to work better?

So how can I increase vascular flow before you go in? What supplements can I give you? What technology can I use?

Then how can I help you detox afterwards, or how can we help you boost with that oxygen after you've gotten out to truly leverage the technology and go in a cold plunge?

We have like your optimal focus protocol for that. So it's been fun for me to actually operationalize and actually put down on paper things that I've been doing for a decade with patients and then provide the service as well.

In the sense that I don't want to sell or give somebody something that they don't need, and I've been very clear with my team from that from the beginning.

It was hard because everybody just wants to sell whatever they have, right? And any team, you know, books, supplements, it doesn't matter.

I understand that part, but you and I, like, are first and foremost clinicians. That's why my focus has always been what are we doing right for the person that's on the other side of the phone or that we can help here.

The protocols are all based on my understanding of those things, but at the same time, always keeping in mind, you know, making sure it's really appropriate for the person to be really, you know, accessing our ecosystem right now or if it's something that they need to access later as well.

So big time on service. That was the other piece in the hyperbaric world that I saw was missing, is that there was really not a great amount of service and long-term ambulatory care—like actually working with people over a long period of time and seeing how they do and working with them.

That's the ecosystem that we're creating, and I'm really excited about it.

That's amazing! And I think, you know, your website, onebasehealth.com, has many articles, chambers that you actually have helped develop that are safe and easy to use, and they're for home use that are both soft and hard chambers.

I think it's a really wonderful resource, and it fills a huge gap in the marketplace that I've seen because, you know, I have access to you. I just call you when I need you. Most people don't, and they can't.

I got this person who needs this; what do you think? So I think this is a huge, huge help in the marketplace, and I think it's really important.

I think, you know, can you talk maybe a little bit about some of the challenges? You know, some of the machines out there are not FDA approved; they come from other countries. Some are FDA approved in America; some use pumping oxygen; some have masks.

Can you talk about the safety and efficacy of these different ones and what you've learned?

Yeah, thanks for mentioning that. So there are certain types of chambers that are called FDA cleared. These are chambers that have certain sort of FDA monitor that's similar to FDA approval but different.

Those are the chambers that I really do think are important for people to use in a clinic setting most likely because if you're seeing patients and you're getting people in there, it just has a little bit of regulatory support that may be beneficial.

We don't know really at this point, but there's a lot of other chambers that are coming from other countries and other developers and other companies, you know, my company included, that don't quite have that FDA certification yet but are very safe to use.

I think that the challenge is to navigate this field and find people that you trust in it to work with you, no matter what chamber you decide to get, is what it comes down to.

All the soft chambers should not have—you shouldn't be getting a chamber that has oxygen around you in the chamber itself. That's not the safe thing for you to do at the house.

The only kind of chamber that you should get at the house is one that has a mask on that you can breathe in, either that's getting like an oxygen concentrator or, if it's a hard chamber, maybe something more like bottled oxygen or liquid O2 if you're at a medical facility.

But waiting is not easy because the safety of the chambers, whether it's non-FDA or FDA, it's unclear if there's really any major difference.

I have one of my chambers at the house; it's a non-FDA chamber. It's a One Base Health chamber, and it works well, and there's no problems with it. It's got a long track record outside the United States.

So it's difficult to wade through this information, I know, for people as you're thinking about it. But if you're looking for like a hard chamber for your house that's FDA cleared, it's going to cost $175,000.

But if you get one from outside the US, it's going to cost between $30,000 and $50,000. Is the safety a problem? The answer is, you know, probably not.

But it really depends on your relationship with the company, how you feel about it, and how you are going to sort of access them over the long term. Most of these companies, as I said, will not do much more than just sell you a chamber and sell you the deepest chamber they can for no particular reason other than they're going to charge you more for it.

Are the chambers from One Base Health FDA cleared or no?

Not currently yet, no, they're not manufactured in the US. No, they're not manufactured in the US either. They're manufactured outside the US.

But that's okay because most of the chambers in the US now that are being used are not manufactured here, actually. Like everything else, even the ones that say they're manufactured in the USA are not really manufactured here.

They might be assembled in the United States, but all the parts are coming from other countries. So, you know, my feel here is that as a clinician, it's important that people are very astute at looking at what's out there and doing the best that they can.

I know cost can be an issue, and certainly, the FDA chambers are more expensive. But if you feel more comfortable with that and you feel more comfortable that that's giving you some additional safety, then, you know, by all means, go that way and get those chambers.

I work with everybody. It doesn't matter what kind of chamber they have. I have just found, as a sort of risk tolerance thing for me personally, working and doing this work, knowing that there are a lot of great manufacturers outside the United States that are doing great work, that I can get less, that I can get more chambers out there to more people.

That's been my thing. I just want—my thing is access and safety. So safety first, access second.

But the other reason why I started this company was I wanted there to be more access for people, and to be more access, there needed to be less—there needed to be more affordability for it.

It's been frustrating because, you know, there are chambers everywhere in every hospital, but you can't get them because they won't let you use them for off-label indications.

There are other off-label centers, but they're far and few between, and it's really a problem for many patients who I've tried to refer to hyperbaric medicine.

I want to loop back to something, and then we'll close out with, you know, where can people find a chamber? How do they get one?

You mentioned cancer. Can you drill down on that for a sec? Because I think people might have heard and go, "What was that? Cancer hyperbaric for treatment recovery? What? How does it work? What's happening in that field?"

Yeah, it's a big topic, and I'm glad you mentioned it because I was remiss from mentioning it earlier.

So in hyperbaric therapy, it can be used in about six or seven different ways. We know what hyperbaric therapy does: it regenerates blood vessels, it regenerates tissue, it rebuilds scaffolding.

So the way it's FDA approved, so insurance covered, is with radiation injury. Radiation affects the tissue beds; it depletes them of stem cells; it kills blood vasculature.

Hyperbaric therapy can rebuild all that, and so it's used as a treatment for radiation injury. These are in patients that have had radiation, and then six months to many years later, they get an injury or a wound in the radiated field, and then they have a hard time healing that.

A common one is people that have had head and neck cancer, and they have a tooth that's decaying or dying. You can do a hyperbaric protocol where you go in before the surgical excision and then afterwards to prevent the actual bone, the jaw itself, from causing necrosis or dying.

So that's called the Marx protocol. That's been around forever. That's the only FDA insurance-covered indication.

Now, there's been studies that can potentially help in chemotherapy sensitization, so help chemotherapy work better.

If it's a chemo that's not going to work as well as you'd like it to, hyperbaric therapy may help it work better.

If it's radiation, hyperbaric therapy can make radiation work better because radiation is oxygen-requiring.

Radiation cannot penetrate tissue where there's no oxygen. This is why something like brain cancer or glioblastoma is so hard to treat because it's a low-oxygen tumor and why hyperbaric therapy might be helpful.

Hyperbaric therapy is also being used in combination with other oxidative therapies for cancer. This is something like IV vitamin C, for example, or mistletoe or other types of oxidative therapies, especially in combination with the ketogenic diet.

This is the work of Dominic D'Agostino and Tom Seyfried and Dr. Nisha Winters—all the people that you know and I know that are using it in something called the Press-Pulse technique, where the press is ketogenic diet, the pulse is hyperbaric oxygen therapy, as a way to truly start killing more cancer cells, especially deeper pressures.

Hyperbaric therapy is also being used in surgical oncology to help with recovery from surgical procedures, just like we talked about with an athlete or, you know, somebody else that has any kind of injury.

Hyperbaric therapy is going to help you heal faster. Same thing in a hyperbaric environment.

Also, if you're anemic, if you have low oxygen, if you have low amounts of red blood cells, you have less oxygen you can carry. Hyperbaric therapy is going to make you feel better because you get more oxygen circulation for, you know, three to five hours afterward.

You're going to feel better. So, and the last thing to say about cancer is that there's no indication that hyperbaric therapy makes cancer grow.

This is something that some conventional oncologists still think, but there's no evidence in any reviews that have ever been done that hyperbaric therapy can make cancer grow.

That's something just for people to be aware of as well.

That's good! Yeah, so basically as an adjunct to improve the efficacy of therapy and also recovery from the treatments itself.

So that's great! I guess I could have said that too. If you loved