Ozone Doses Explained: The "10 passes" and "EBOO"

You can get ozone into your body in two ways:

1- The Extracorporeal (outside the body) method involves extracting blood and mixing it with ozone externally. It includes three main techniques: a) Major Autohaemotherapy (MAHT), the preferred European method using vacuum bottles; b) multi-passes system, where around 10 volumes are ozonated and returned to the body; c) EBOO (Extracorporeal Blood Oxygenation and Ozonation), similar to haemodialysis, adding ozone to blood in low concentrations.

2- The Intracorporeal method involves injecting ozone directly into the veins to mix with the blood. There are two ways: a) Direct gas injection, which is dangerous and prohibited; b) Ozonated Saline, the only safe method, involves passing ozone gas through the infusion solution before administration.

Despite the publicity of EBOO and the 10-passes, these methods are not endorsed by reputable ozone societies in countries that pioneered ozone therapy, such as European countries and Russia. These societies recommend calculating blood volume and ozone dose based on body weight and tolerance to maximise benefits without toxicity. High-dose ozone practices, however, are common in private clinics offering ozone therapy..

It is asserted that the 10 passes or EBOO yield superior results due to the greater volume of ozonated blood. This is certainly false; in fact, raising the ozone dose beyond the recommended levels results in the opposite of the intended effect, namely inducing oxidative stress. Additionally, the quantity of anticoagulant required for the 10 passes is ten times that needed for Major AHT, significantly heightening the risk of internal bleeding, particularly in the hours immediately following the therapy. Technically, you can administer a higher concentration of ozone using any method by increasing the concentration and/or the volume of ozone mixed with blood, without needing to repeatedly extract new volumes.

Although ozone in high concentrations is indeed toxic to micro-organisms, it is equally true that such concentrations are also harmful to human cells. The figure below (from the German Ozone Society Handbook, 2020) illustrates this point by showing the changes in antioxidant levels induced by ozone therapy at different concentrations. It demonstrates that the therapeutic effect is achieved between 10 and 40 mcg/ml, with an optimal level around 30 mcg/ml. Other European guidelines concur with this finding.

For more information about the "low ozone concept" please visit the German Ozone society website.

Therapeutic Efficacy of Ozone by Concentration: A chart from the German Society for Ozone Therapy showing safe and effective ozone concentrations between 10 and 40 µg/ml, with peak efficacy at 20, 30, and 40 µg/ml. Concentrations outside this range fall into the ineffective or toxic categories.

At Leicester Ozone Clinic, we use ozone doses within the range advised by scientific societies, disregarding any commercial incentives to offer more expensive methods. We start at the lower end of the therapeutic spectrum (10 mcg/ml) and aim to gradually reach 30 mcg/ml, based on the individual's tolerance and medical conditions. We utilise either Major AHT or the Russian method of ozonated saline to accomplish this, although the calculations for the Russian method are more complex but adhere to the same general principles. 

In summary, ozone functions like a drug, where an increased dose does not necessarily lead to an improved response. Studies have clearly defined the correct dosage and blood volume. Recent progress in our comprehension of ozone therapy at the cellular level has prompted a shift in practices towards the idea of using low ozone.

More about the 10 passes/EBOO

Q- Why don't people die or get serious side effects from excessive ozone exposure during the 10 passes?

Given the previous discussion, one could expect serious side effects, including possible fatalities, when undergoing 10 passes with high ozone doses. However, these occurrences are uncommon due to the particular method used during the 10 passes. The Major Autohaemotherapy (MAHT) technique, which is equivalent to a single pass, takes 20 to 30 minutes to complete according to the standards established by the International Scientific Committee of Ozone Therapy, available from this link. Thus, 10 passes should take 200 to 300 minutes (3.5 to 5 hours). However, automated machines complete 10 passes in about an hour, mixing ozone with blood for only a few seconds and returning it under pressure, contrary to recommendations against pressurised re-infusion to avoid risks. Rapid mixing leaves most ozone in the container, not interacting with blood. Dr. Bocci, an expert in ozone therapy, argues in his book "Ozone: A New Medical Drug" that MAHT should take 40 minutes, with manual, gentle mixing for effective ozone-blood interaction.

In light of the above discussion, it can be concluded that the 10 passes (and the 20 or 30 passes currently promoted by some clinics) would indeed deliver a toxic or potentially lethal ozone dose if performed correctly. However, because it is rushed, the patient is highly unlikely to receive the intended ozone dose they paid for, which ironically can be seen as a positive outcome. The total dose delivered in a multi-pass system can be achieved in a single pass without the added expenses and risks associated with high anticoagulant doses for each pass. The spectacle of blood moving up and down 10 times or more may be visually appealing but is scientifically incorrect and risky.

Q- OK, what about the assertion of "stem cell activation" mentioned on websites advocating for the use of multi-passes?

Many websites promote the 10 passes as a superior method for administering ozone therapy, claiming that high ozone doses "activate the bone marrow" to release stem cells into the bloodstream, which, according to these clinics, aids in the "healing" process. To examine this assertion, we should begin with a fundamental understanding of physiology: Blood cells are generated in the bone marrow from stem cells. These cell lines progress into mature cells before being released into the bloodstream. Having an abundance of immature cells or even stem cells in the bloodstream is not indicative of good health. The body releases these cells prematurely when there is severe blood loss or destruction in an attempt to "fill the gap" and maintain circulation. This phenomenon is well-recognised in medicine, for example, in cases of sudden hemolysis (the breakdown of red blood cells) or significant bleeding. In such situations, the bloodstream will be filled with immature forms of blood cells, detectable under microscopic examination. These cells do not migrate to other organs and initiate a "healing process." Instead, they are simply undeveloped cells mobilised to replace those that have been destroyed as a consequence of excessive ozone exposure. Another situation where plenty of immature cells and stem cells are found in the blood stream in abundance is in blood cancers such as leukaemia, however this is unrelated to our discussion. 

In summary, the assertion that high doses of ozone "stimulate" stem cells is a misrepresentation of scientific facts. Stem cell therapy is completely different. The immature cells that may be observed following the 10 passes are indications that the body has suffered a substantial destruction of blood cells due to interaction with high doses of ozone. As a coping mechanism to maintain blood volume and oxygen delivery, the body releases immature cells into the bloodstream.