Ozone Therapy

What is Major Autohemotherapy (MAH)?


In MAH, a certain amount of the patient's blood is drawn into a sterilized container. This blood is then mixed with a precise concentration of medical-grade ozone-oxygen gas. The ozonated blood is then re-infused back into the patient's bloodstream intravenously (through an IV).

Proposed mechanisms of action by proponents include:

  • Improved Oxygen Delivery: Ozone is thought to stimulate red blood cells to release more oxygen to tissues.

 

  • Immune System Modulation: It may activate the immune system to fight infections and cancer, or calm it down in cases of autoimmune disease.

 

  • Antioxidant Boost: It triggers the body to produce its own antioxidants.

 

  • Inactivation of Pathogens: Ozone can damage the membranes of bacteria, viruses, and fungi.

Conditions Proponents Claim Can Be Treated with MAH

The following list categorizes conditions for which intravenous ozone therapy is used or studied, primarily in integrative, complementary, or alternative medicine settings.

1. Infectious Diseases

The direct antimicrobial effect of ozone is a primary reason for its use here.

Chronic Viral Infections:

Herpes Simplex (HSV) and Herpes Zoster (Shingles): Used to reduce outbreak frequency and severity.

Epstein-Barr Virus (EBV) / Chronic Mono: Aimed at reducing viral load and associated chronic fatigue.

Hepatitis B and C: Some studies, particularly from Cuba and Europe, have shown a reduction in viral load.

HIV/AIDS: Used as a complementary therapy to reduce viral activity and support the immune system (though antiretrovirals are the standard of care).

Bacterial Infections:

Lyme Disease and Co-infections: This is one of the most common uses in alternative medicine clinics, especially for chronic, persistent cases that have not responded fully to antibiotics.

Chronic Bacterial Prostatitis: Used when antibiotics fail.

Fungal Infections:

Chronic Candidiasis: For systemic fungal overgrowth that is resistant to conventional treatment.

2. Autoimmune and Inflammatory Conditions

The proposed mechanism is the modulation of the immune system, shifting it from a pro-inflammatory to a more regulated state.

Rheumatoid Arthritis: To reduce joint pain, swelling, and inflammation.

Multiple Sclerosis (MS): Used to reduce the frequency and severity of flares.

Inflammatory Bowel Disease (Crohn's Disease and Ulcerative Colitis): Aimed at reducing gut inflammation.

Lupus (SLE): To manage systemic inflammation and fatigue.

Chronic Fatigue Syndrome/Myalgia Encephalomyelitis (CFS/ME): Often linked to viral triggers and immune dysfunction.

3. Circulatory and Vascular Disorders

The proposed effect is improving blood flow and oxygen delivery to ischemic tissues.

Peripheral Artery Disease (PAD): To reduce leg pain (claudication) and improve wound healing.

Diabetic Foot Ulcers and Poor Wound Healing: Used topically and systemically to improve circulation and fight infection.

Age-Related Macular Degeneration (AMD): The goal is to improve oxygen supply to the retina.

Vertigo and Tinnitus: Sometimes used when these are linked to poor circulation.

4. Neurological Disorders

The focus is on neuroprotection and improving cerebral oxygenation.

Dementia and Alzheimer's Disease: Some studies suggest it may help slow cognitive decline by improving brain metabolism.

Parkinson's Disease: Used to support neuronal health and reduce inflammation.

Stroke Recovery: To support recovery of brain tissue in the subacute and chronic phases.

5. Musculoskeletal and Pain Conditions

The anti-inflammatory and oxygenating effects are the primary rationale.

Chronic Pain Syndromes: Including fibromyalgia.

Degenerative Joint Disease (Osteoarthritis): Injected directly into the joint (not MAH) or used systemically to reduce pain.

Back Pain (from herniated discs): Often administered as an intradiscal or paravertebral injection, not MAH.


Important Disclaimer


Ozone therapy for diabetic ulcers is considered an alternative or complementary treatment and is not the standard of care in most countries. It should never replace conventional treatments like debridement, off-loading, infection control, and vascular assessment. Always consult with a podiatrist, wound care specialist, or endocrinologist for the management of a diabetic ulcer.

The Problem with Diabetic Ulcers

Diabetic ulcers are notoriously difficult to heal due to a "perfect storm" of underlying issues:

1. Poor Circulation (Ischemia): Diabetes damages blood vessels, reducing blood flow and oxygen delivery to the extremities.
2. Neuropathy: Nerve damage leads to a loss of sensation, so injuries go unnoticed and pressure points aren't relieved.
3. High Risk of Infection: Hyperglycemia impairs white blood cell function, making it hard to fight bacteria.
4. Chronic Inflammation: The wound often remains stuck in a prolonged inflammatory state, preventing progression to the healing phases.

Ozone therapy is proposed to address each of these core problems simultaneously.

Proposed Benefits and Mechanisms of Action


Medical ozone works through several key mechanisms to break the cycle of non-healing:

1. Powerful Antimicrobial and Antibiofilm Action

Direct Destruction: Ozone is a potent oxidizing agent. It can puncture the cell walls of bacteria, viruses, and fungi, effectively killing them on contact. This is crucial for diabetic ulcers, which are often colonized or infected by multiple types of bacteria.
Disrupting Biofilms: Biofilms are slimy, protective communities of bacteria that form on chronic wounds. They are highly resistant to antibiotics and the immune system. Ozone's oxidizing power can break down the biofilm matrix, exposing the embedded bacteria and allowing other antimicrobial agents (like topical antibiotics) to work more effectively.

2. Enhanced Oxygen Delivery and Improved Circulation

Stimulating Oxygen Release: Ozone interacts with red blood cells, making them more flexible and improving their ability to release oxygen (the Bohr effect) to hypoxic (oxygen-starved) tissues. A wound cannot heal without adequate oxygen.
Vasodilation: Ozone is thought to stimulate the release of nitric oxide (NO), a potent vasodilator. This helps to open up blood vessels around the wound, improving local blood flow and delivering more oxygen, nutrients, and immune cells to the area.

3. Modulation of the Immune System and Inflammation

Controlling Inflammation: Diabetic ulcers are often stuck in a chronic inflammatory state. Ozone acts as a modulator—it can "calm down" an overactive immune response by reducing pro-inflammatory cytokines while simultaneously stimulating the immune system to fight infection. This shifts the wound from a stagnant inflammatory phase to the proliferative (healing) phase.
Activating Immune Cells: It stimulates the production and activity of immune cells like macrophages, which are essential for cleaning up dead tissue and pathogens in the wound bed.

4. Stimulation of the Antioxidant System and Cellular Repair

Preconditioning Effect: This is a key concept. When ozone is administered at controlled, therapeutic doses, it creates a mild, transient oxidative stress. In response, the body upregulates its own powerful antioxidant enzyme systems (like superoxide dismutase, glutathione peroxidase). This "prepares" the body to handle oxidative stress more effectively, protecting healthy cells and promoting a healthier healing environment.
Promoting Growth Factors: Ozone therapy has been shown in some studies to increase the release of growth factors like Platelet-Derived Growth Factor (PDGF) and Transforming Growth Factor-beta (TGF-β). These are critical for triggering cell proliferation, collagen synthesis, and the formation of new tissue.

5. Direct Activation of Wound Healing Processes

Fibroblast Activation: Fibroblasts are the cells that build new tissue and collagen. Studies suggest ozone can stimulate fibroblast proliferation and migration into the wound bed, accelerating the formation of granulation tissue (the pink, bumpy tissue that fills a wound).

How is it Administered for Diabetic Ulcers?


Ozone can be applied in two main ways, often in combination:

1. Topical Application (Ozone Bagging): The most common method. The limb with the ulcer is placed in a sealed, airtight bag filled with medical-grade ozone gas, allowing it to diffuse directly into the wound tissue.
2. Systemic Administration (Major Autohemotherapy - MAH): As described previously, drawing blood, ozonating it, and reinfusing it. This is used to address the systemic issues of diabetes, like overall poor circulation and immune dysfunction, while topical treatment handles the local wound.

Clinical Evidence and Conclusion

While the mechanistic rationale is strong, the clinical evidence is still evolving.

Positive Studies: Several small-scale clinical trials and meta-analyses have concluded that ozone therapy, as an adjunct to standard care, can significantly increase the healing rate, reduce the size of the ulcer, decrease the incidence of infection, and shorten the time to complete healing compared to standard care alone.
Need for More Research: The main criticism is the lack of large, multi-center, randomized controlled trials (RCTs) that are the gold standard in medicine.

In summary, from the perspective of its proponents, ozone therapy offers a multi-targeted approach that directly addresses the core pathological factors preventing a diabetic ulcer from healing: infection, ischemia, and chronic inflammation. It is seen not as a magic bullet, but as a powerful adjunct that can help shift a stagnant, chronic wound back into an active healing state when used by trained professionals alongside conventional wound care protocols.