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The use of ozone in medicine




What is medical ozone? Ozone gas (O3) is the oxygen (O2) we breathe with an extra atom added. It is produced from medical grade oxygen by medical ozone generators. Ozone is unstable; it rapidly degenerates back to oxygen hence it needs to be prepared on site and administered quickly mixed with oxygen (95%-99.95% oxygen and 0.05%-5% ozone).


Which countries regulate ozone therapy? 

Although the first portable ozone generator was invented by Nicola Tesla in 1896, the medical use of ozone was pioneered by German scientists to became normal practice primarily in Germany and the former Soviet Union in the sixties. Before the advent of antibiotics, ozone was the main antimicrobial therapy and had been used in world wars to sterilise infected wounds. According to the International Scientific Committee of Ozone Therapy (Madrid Declaration on Ozone Therapy; 3rd edition; as of 2020, ozone therapy has been regulated by the state in 13 countries. Some of these countries, e.g Spain and Brazil, have ozone therapy offered in the public health facilities. These countries are: Greece (1991 - 2014), Ukraine (2001 - 2014), some regional health authorities in Italy (2003 - 2009), China (2005), Russia (2005 - 2007), Spain (2007 - 2012), Cuba which has the world's only medical ozone research centre (2009 and 2015), Sultanate of Oman (2010), Dubai (2011), Portugal (2013 - 2018), Turkey (2014), Brazil (2015 - 2018) and Mexico (2018). 


Globally, the number of ozone therapists exceeds 30000, with Germany in the first place with over 11000 practicing professionals, followed by China(5000), Russia (3500) and Italy (3000) 1.

How does ozone work? Ozone does not work directly. Once mixed with the blood (autohemotherapy) or introduced inside a body cavity (insufflation), ozone instantaneously interacts with components of the cells to form secondary chemical compounds known collectively as "ozonides". It is those "secondary messengers" that exert the biological effects seen with ozone therapy. These ozonides are relatively stable inside the body and have been shown to last for days to weeks, thus continuing to exert their effect long after treatment sessions. The medical effect of ozone is related to 3 main actions:

  • Increasing the body's antioxidant capacity;

  • Boosting the immune system, a desirable effect in infections and cancers;

  • Increasing a specific enzyme in red blood cells called 2,3-diphosphoglycerate (2,3-DPG) thus allowing the red cells to release more oxygen to tissues.

What conditions can be treated with ozone? Ozone has a wide clinical applications; this is because it works on optimising the body's anti-oxidant system and boosting the immunity. Fault in these two systems is the underlying mechanism in many conditions. Below is a list of some of the medical conditions treatable with ozone with links for further in-depth reading:

  1. Cardiovascular diseases: Studies showed that ozone therapy can help reduce the risk of strokes, heart attacks and peripheral artery diseases 1 & 2.

  2. Arthritis and chronic musculoskeletal pain: Ozone may help with arthritis inflammation and chronic pain such as fibromyalgia when administered through the blood or by direct joint or trigger points injection 3 & 4.

  3. Immune system disorders: Ozone could regulates the immune system and has been shown to improve a variety of autoimmune conditions. 

  4. Infections: Ozone is currently used in water purification because of its powerful anti-microbial effect. Ozone in high concentration is directly toxic to bacteria, including MRSA, fungi and viruses and in low concentrations it may boost the immune system. These two effects are used depending on the clinical situation to treat a variety of illnesses and to strengthen the body's defences. Studies have shown that ozone can reduce viral load in chronic viral infections such as chronic hepatitis and HIV and help reduce recurrence in chronic herpes infection. It is also used in treating other infective illnesses such as Lyme disease, TB, interstitial cystitis and chronic sinusitis 5

  5. Chronic ulcers: Application of ozone over areas affected by diabetic foot ulcers may help to promote healing by destroying the bacteria, including antibiotic resistant MRSA and improving tissue oxygenation.

  6. Neurological disorders: A growing body of research found that ozone therapy can assist brain cells in combating degenerative diseases like multiple sclerosis and Alzheimer’s disease 2.    

  7. Cancer: Ozone therapy is complementary to standard medical therapy. It may help to improve the body's immune system and combat the side-effects of cancer drugs 6.

  8. Chronic fatigue: Ozone may help to replenish the stores of a vital cellular compound called NAD. Restoring the levels of this compound is linked to better oxygen utilisation by cells and improvement in fatigue, including post viral fatigue, and clearing "brain fog". 

  9. Obesity and diabetes: Ozone has been shown to boost the metabolic rate leading to better burning of fat, improvement in obesity and diabetes.  

  10. Macular degeneration: good response was reported with ozone in this condition. 

  11. Anti-aging and rejuvenation: Ozone is commonly used in anti-aging clinics to vitalise the body and help reduce the external and internal deterioration associated with ageing. Ozone does this by stabilising many mechanisms involved in aging such as reduced oxygen utilisation, reduced oxygen delivery to tissues, reduced metabolic rate, impaired circulation and reduced cell energy production. 


How is ozone administered?

Ozone can delivered by different methods including: 

  • Blood infusion (known as Auto-haemotherapy): This is the most popular method where a small amount of blood is extracted then with ozone/oxygen gas before injecting the blood back. This process is known as "Major Auto-haemotherapy". Minor Auto-haemotherapy involves a similar process but instead of injecting the blood back through the same vein, the blood is injected in the muscle. We do not use direct ozone intravenous therapy (DIV) or the "multi-pass" method because of safety concerns. The video below shows how major aut-haemtherapy is done at Leicester Ozone Clinic.

  • Ozonized Saline Solution: Ozonized Saline Solution (O3SS) is the traditional practice in Russia and its practice is mainly confined to this country. 

  • Insufflation: This method involves injecting ozone in to a body cavity, such as the colon (rectal insufflation) or vagina (vaginal insufflation). Rectal insufflation is mainly used for home self-treatment or when auto-haemotherapy is not possible.

  • Joint and soft tissue injection: Ozone may be injected directly in to a joint in arthritis or in to a trigger point in the case of fibromyalgia.

  • Topical skin applications: In diabetic foot, chronic ulcers or other skin problems, the affected area is enclosed in a sealed pouch, which is flooded with ozone gas at a specific concentration. Application of ozonated water or ozonated oils is another method for delivering the anti-microbial and tissue healing effects of ozone to a localised area. 

  • Drinking ozonated water: Drinking freshly prepared ozonated water is a simple method of delivering ozone to the entire body. Ozone physically dissolves in water and is released in the stomach. Ozonated water, however, has a strong smell and may cause stomach irritation or nausea that may limit the dose that can be comfortably delivered. In addition, ozonated water needs to be prepared on site and consumed within a short period, another impractical aspect for using it routinely in therapy. 

frequency of ozone sessions

The number of treatment sessions and the ozone dosage administered will depend on the general condition of the patient, the sensitivity of the tissues to the effects of ozone and the condition being treated. As a general rule, every 5 sessions the dose of ozone is increased and it is given in cycles that vary between 10 to 20 sessions. A clinical improvement usually occurs between 5-10 sessions. Ozone sessions are usually given two to three times a week.


side effects of ozone

In general, aside from occasional irritation associated with the method of delivery, there are no reported lingering effects and recovery is rapid. The most commonly reported side-effects are skin irritation, bruising, and/or pain at the site of the injection. As with any blood-letting procedure or injection, infection is a possibility. When ozone is administered by rectal insufflation, it can cause bloating and constipation. 

Some people feel flu-like symptoms after each session, these side effects are transient and should be followed by the desired effect.


contraindication to ozone

Ozone therapy (especially auto-haemotherapy)is not suitable in the following situations:


  1. People with glucose-6-phosphate dehydrogenase deficiency (one of the causes of haemolytic anaemia).

  2. Hyperthyroidism (over-active thyroid) if not controlled.

  3. Pregnancy especially in the first 3 months.

  4. Leukaemia (major auto-haemotherapy).

  5. Low platelet counts and serious bleeding disorders. 

  6. Severe cardiovascular instability. 

  7. People with wet (not the dry) Age Related Macular Degeneration (ARMD).

  8. Hemochromatosis (a condition of iron overload)or receiving treatment of iron by i.v.

  9. Patients being treated with some blood pressure medication (ACEi)can experience slight blood pressure reduction which cane mitigated by slow re-infusion.

  10. Ozone may modify the coagulation pathway. People on warfarin (an anticoagulant) need more frequent INR checks. The newer anticoagulants are compatible with ozone and do not require extra checks.

  11. People on high doses oral or i.v vitamins or antioxidants: The presence of these compounds in high concentrations in the blood interferes with the ozone’s action and there is a possibility that Ozone oxidize and inactivate them or generate toxic compounds. It is recommended that intravenous antioxidant therapy, such as vitamin C or glutathione, neither be administered before nor during, but only after ozone therapy. Small amounts of oral antioxidants such as vitamin C or E are probably ok if taken 1-2 days before or 1-2 days after the ozone session.

  12. In the past, very rare reports of allergy have been noted, most likely related to the use of PVC and plastic materials during ozone therapy. These materials are now totally avoided with the use of ozone-resistant materials and glass vacuum bottles.