EBOO Ozone Therapy Treatment: Uses, Benefits, Diseases Treated, Training, Protocols, and More

Índice

De un vistazo:

  • EBOO ozone is a high dose of intravenous (in the vein) ozone therapy that treats a large (1.5 - 7 L) volume of blood
  • EBOO treatment has several benefits but is generally reserved for severe infections, hepatitis, long-lasting symptoms of viral infections, and vascular or ischemic diseases.
  • EBOO therapy doesn’t have any good comparative studies over other and less expensive forms of intravenous ozone therapy. However, it appears to perform better for severe infections and ischemic diseases.Otherwise, the less expensive ozone treatments are a better route to get results.
  • EBOO ozone treatment is safe to do under a knowledgeable practitioner and can even be used as a preventative, anti-aging, or optimization measure. 
  • Usually, people diagnosed with blood clotting issues, anemia, or G6PD deficiency should not do ozone therapy unless directed otherwise by a medical practitioner.
  • For severe illness, generally 6 - 10 treatments are prescribed at $1,500 - $3,000 per treatment. If the illness has not progressed to a severe level, many patients see benefit in 2 - 4 treatments. It can be done once or twice yearly as a preventative, optimization, or anti-aging therapy.
  • EBOO ozone therapy is not dialysis or filtration of the blood because the dialysis filter is not utilized. Rather there is an ozone-resistant filter to diffuse ozone into large volumes of blood. In addition, many of the filters utilized by practitioners are not safe for use because the ozone oxidizes them and puts microplastics into the blood. An ozone-safe gas exchange unit must be used to avoid microplastics leaching into the blood.
  • Training and equipment are available for practitioners. Training can be found here.

You can download our comprehensive guide to ozone therapy by clicking here.

What Is Extracorporeal Blood Oxygenation and Ozonation (EBOO) or Recirculatory Hemoperfusion (RHP)?

Extracorporeal blood ozone and oxygenation (EBOO) is a medical procedure that involves:

  • Blood Withdrawal: Blood is withdrawn from the patient’s body using a sterile technique.
  • Ozone-oxygen Infusion: The withdrawn blood is mixed with a controlled amount of ozone-oxygen medical gas mixture through an ozone-resistant membrane. This mixture interacts with various blood components, leading to biochemical changes.
  • Reinfusion: The ozonated blood is then infused back into the patient’s bloodstream.

There are two needles inserted, one in each arm. A pump pulls blood from one arm, mixes it with ozone gas, and reinfuses it into the other arm.

Some people also call it “ozone dialysis” or “recirculatory hemoperfusion” (RHP), including in the published literature. RHP is a fancy term that means you reintroduce the blood after adding gas to it. However, EBOO is NOT dialysis, as we’ll cover why later. 

A primary difference between EBOO and standard IV ozone therapy is the volume of blood being ozonated. Since there is a line in each arm, they can put all the blood in the body through the therapy. A typical session utilizes anywhere from two to seven liters of blood.

What Are the Benefits of EBOO Therapy?

Proven benefits [1, 2] 

  • Stimulates the NrF2 pathway through mild acute oxidative stress. The body responds by stimulating antioxidant production, mitigating chronic inflammation, and eliminating chronic oxidative stress.
  • Improves oxygen efficiency and metabolism
  • Stimulates the release of growth factors
  • Modulates the immune system, enhancing where it’s lacking and normalizing overactivity
  • Inactivates pathogens and toxins in the blood
  • Improves circulation as well as vascular conditions, especially peripheral vascular diseases

Theoretical benefits

  • Elimination of senescent cells. Old cells are supposed to self-destruct and eliminate themselves from the body. However, as you get old, these senescent cells can accumulate and make the body less efficient [3]
  • Production of red blood cells via the bone marrow.It may help to regenerate cells that are needed for carrying oxygen and nutrients throughout the body

Lo que experimenta el paciente

  • Aumento de la energía
  • Increased clarity and memory
  • Sensación de bienestar
  • Disminución del dolor
  • Increased stamina
  • Decreased inflammation and bloating

Click here to download our ozone therapy guide

What Diseases Are Indicated for EBOO Therapy?

EBOO is not specifically indicated for different diseases than a standard ozone therapy IV. However, the scientific committee of ozone therapy indicates it over standard ozone therapy IV in certain cases. 

Common indications where EBOO can be used include [2]:

  • Infections such as:some text
  • Enfermedades autoinmunes such as:some text
    • Enfermedad de Lyme
    • Inmunodeficiencia adquirida
    • Rheumatoid arthritis
    • Systemic lupus erythematous 
  • Chronic inflammatory processes such as:some text
    • Age-related macular degeneration
    • Type 2 diabetes and their complications
    • Enfermedades e infecciones hepáticas
  • Circulatory and cardiac conditions such as:some text
    • Enfermedades isquémicas
    • Arteriopatía periférica grave
    • Isquemia cardiaca
    • Insuficiencia cardiaca crónica
    • Post-stroke care
  • Cancer and patients undergoing chemotherapy
  • Athletic improvement and biohacking
  • Prevención de enfermedades y antienvejecimiento
  • Dislipidemia grave
  • Fascitis necrosante
  • Pre-treatment for patients who are planning to undergo antiviral therapy medication

We have a complete list of diseases treated with ozone therapy here.

Key Differences between EBOO and Ozone Autohemotherapy

While these are both IV ozone therapies, they differ significantly in their methodologies, applications, and specific treatment processes, including:

1) Treatment process and mechanism

EBOO involves passing the patient’s blood (1.5-3L) through an extracorporeal circuit in a machine where it is mixed with ozone and oxygen before being reinfused into the patient. 

This process treats a large volume of blood in a continuous loop and can process the entire blood volume over the course of the treatment.

Ozone autohemotherapy, on the other hand, involves drawing a smaller amount of blood (typically between 100–200 ml), mixing it with ozone, and then re-infusing it back to the patient. This mixing process can be done in a bag, without requiring a machine.

2) Volume of Blood Processed

EBOO processes a much larger volume of blood compared to ozone autohemotherapy. In a typical EBOO session, your entire blood volume can be treated, cycling through the system multiple times.

Ozone Major Autohemotherapy deals with only 100-300 mL of blood per treatment session, which limits the scope of its immediate biochemical impact but still provides significant systemic benefits.

3) Use of blood thinners

EBOO requires the use of anticoagulants (blood thinners) to prevent clotting as the blood passes through the EBOO machine. This is crucial due to the larger volume and prolonged blood exposure outside the body.

Ozone autohemotherapy usually does not require anticoagulants since only a small amount of blood is outside the body for a short period. However, many of our colleagues’ protocols add heparin to the blood during autohemotherapy. Sensibly, autohemotherapy uses lower doses of blood thinners than EBOO. 

Click here to download our ozone therapy guide

4) Presence or absence of a machine

EBOO needs a large machine to circulate the blood and infuse it with ozone. Some practitioners also add a dialysis process (which is not part of EBOO) to add to the health benefit. Therefore, EBOO can only be done in a medical office.

Whereas, autohemotherapy does not require a large machine beyond an ozone generator, and equipment and supplies for IV therapy. 

5) Clinical applications

EBOO is generally used for more severe or systemic conditions due to its comprehensive blood treatment and detoxification capabilities. It is often employed in cases where a quick and significant modulation of blood properties is necessary, or when autohemotherapy isn’t sufficient.

Ozone Autohemotherapy is commonly used for a wide range of conditions such as

  • Modulación inmunitaria
  • Treatment of viral infections
  • General wellness enhancement 

AHT is an easier and less invasive application making it suitable for routine or preventive care.

6) Duration of treatment

EBOO can take 60 - 90 minutes, whereas autohemotherapy takes 30 - 45 minutes.

How Does EBOO Compare to Other IV Ozone Therapies?

Unfortunately, there are no good comparative studies between EBOO and other ozone therapy IVs, such as major autohemotherapy.

There certainly is a heightened potential of a placebo effect, due to the “more is better” mentality and the intensive experience/visuals. However, because ozone therapy works as a hormesis, more is not necessarily better.

That leaves us with clinical evaluations by doctors on what they see performs better. We have outlined all the different forms of IV ozone therapy here.

EBOO delivers the most ozone, but it’s not better than other IV ozone therapies in all situations. Most importantly, we recommend taking the advice of your practitioner who understands your history and needs. 

Ozone IV Therapy Type Blood Volume Ozone Volume Treatment Duration Ozone Delivered Cost
Major autohemotherapy 100 - 300 mL 10 - 60 μg/ml, same volume as blood 20 - 40 minutes 6000 - 14,000 μg $150 - $300
Hyperbaric ozone single pass 100 - 300 mL 70 μg/ml, same volume as blood 4 - 60 minutes 6000 - 14,000 μg $400 - $700
High-dose hyperbaric ozone (10 pass) 2000 mL, 200 mL at a time Same volume of hyperbaric ozone (2 atmospheric pressure) as blood passed through blood 10 times 45 - 90 minutes 140,000 μg $$700 - $1,500
EBOO 2000 - 1000 mL S30 μg/ml at 0.9 L per minute, up to 1 h 60 minutes 460,000 μg $800 - $1,800

When Is EBOO Justified over Standard IV Ozone Therapies?

The International Scientific Committee of Ozone Therapy recommends EBOO over standard IV ozone therapy in some critical conditions where standard treatments may be ineffective or insufficient. These include:

  • Critical, inoperable ischemic limbs (stage III and IV, Leriche-Fontaine) when amputation remains the only option. Medical treatments (iloprost infusion, pentoxifylline, electrical spinal cord stimulation, anticoagulants, platelet anti-aggregation, anti-atherosclerotic drugs, etc.) help but are rarely successful.
  • End-stage ischemic cardiomyopathy previously operated on with no success
  • Acute cerebral ischemia, to be treated with EBOO as soon as possible to reoxygenate the hypo ischaemic (penumbra) and infarctuated areas, thus limiting neuronal death and favoring a more rapid recovery.
  • Chronic Hepatitis C virus (HCV) liver inflammation in patients who are resistant or intolerant to antiviral treatments or because they refuse orthodox therapy
  • Chronic renal failure, which is always accompanied by immunosuppression and chronic oxidative stress continuously aggravates the metabolic disorder. In such a case, the oxygenator may be situated parallel to the dialysis filter and used following the dialysis session after a bolus infusion of antioxidants to reconstitute a sufficient antioxidant capacity depleted during dialysis.
  • Metastatic, chemoresistant cancer 
  • Severe primary or secondary (to HIV-protease inhibitors treatment) lipodystrophies

Clinically, doctors and patients seem to think EBOO therapy is better in cases of considerable infections and burdened immune systems like these:

  • Severe Lyme disease
  • Severe viral and bacterial infections or prolonged symptoms
  • Enfermedades isquémicas
  • Stroke patients

Beyond what is listed above, It is difficult to compare EBOO and MaH — potential placebo and financial motives cloud an unbiased comparison. Standard ozone therapy IV (MaH) seems to have similar success stories and cases.

EBOO provides a more intense experience and visualization because the patient sees dark blood leaving their body and bright red blood (due to oxygenation) returning to their vein. This can contribute to stronger placebo effects.

Click here to download our ozone therapy guide

EBOO Benefits and How it Delivers Them 

EBOO offers distinct advantages and benefits over other forms of ozone therapy, particularly through its comprehensive treatment of the entire blood volume and its integration with other therapeutic modalities such as dialysis-like filtration. Here are the primary biological and physiological mechanisms of action that are unique to EBOO:

1) Comprehensive blood treatment

EBOO treats a larger volume of blood compared to autohemotherapy (AHT) or other localized ozone treatments. This allows for the modulation of biochemical properties throughout the entire circulatory system, enhancing the systemic effects of ozone therapy.

This comprehensive treatment can have a more pronounced systemic impact, improving blood oxygenation and temporarily increasing oxidative stress. With EBOO some of these effects are not achievable with smaller volume treatments.

2) Enhanced detoxification

Ozone breaks down substances and many microorganisms on contact. IV ozone therapy tends to work by ozone reacting with the blood components. Some EBOO practitioners believe that this therapy has some detoxification benefits, as ozone and peroxides break down some toxins and pathogens in the blood [4]

Some EBOO clinics add other treatments that may help with detoxification coupled with EBOO, such as:

  • A dialysis process with membranes that can filter out debris, heavy metals, and pathogens, aiding in the detoxification process 
  •  UV blood irradiation (UVI) or LED light treatment on the blood

3) Improved oxygen utilization and metabolic efficiency

By infusing ozone and oxygen into the blood, EBOO directly increases the amount of oxygen available for cellular metabolism and mitochondrial function. This is why ozone therapy temporarily boosts energy [2]

Both the improved oxygenation and thinner blood can be particularly beneficial for conditions involving impaired circulation or lack of oxygen to tissues, especially for ischemic or circulation disorders. The tissue oxygenation, increased energy production, and activated antioxidant responses are crucial for healing and normal cellular functions.

4) Modulation of the immune system

The immune system relies on oxidative species to communicate. By temporarily increasing oxidative stress in the blood, EBOO can stimulate the immune system by increasing the production of cytokines and activating some immune cells [4]

This activation helps the body to more effectively combat infections, manage autoimmune diseases and can even play a role in cancer therapy by boosting the body's natural defenses. In many cases, cases that don’t heal with other therapies respond or resolve with ozone therapy.

5) Anti-inflammatory effects

The initial hormetic effects of ozone therapy include a temporary increase in oxidative stress, which increases inflammation at first. Subsequently, the immune system and antioxidant response have a reset, finally settling with a net reduction in oxidative stress and inflammation. This means therapies like EBOO tend to help with conditions that don’t heal due to chronic inflammation [2]

This reduction in inflammation and oxidative stress can alleviate symptoms in chronic inflammatory diseases such as arthritis such as reduce pain. It may also contribute to the healing of inflammatory injuries.

6) Antimicrobial action

Ozone has strong oxidizing properties that can destroy bacteria, viruses, and fungi. By treating all the blood passing through the EBOO system, it ensures that these pathogens are exposed to ozone, reducing the microbial load in the body.

This is particularly useful in reducing the number of pathogens in blood-borne infections or systemic infections that are difficult to manage with antibiotics alone.

Click here to download our ozone therapy guide

Studies and Case Reports Using EBOO Treatments (with Protocols) in Humans 

There are very few EBOO clinical studies, especially ones that compare with other types of IV ozone therapy, or even placebo or standard of care. Here are the available clinical studies that report the clinical outcomes, excluding ones that only describe EBOO methodologies.

A review presented a clinical and experimental investigation into EBOO, comparing it with traditional autohemotherapy (AHT). For the study, a high-efficiency apparatus allowing the treatment of up to 4800 ml of heparinized blood with an oxygen-ozone mixture (0.5-1 µg/ml oxygen) at 75 - 85 ml/min of blood flow in one hour of extracorporeal circulation was used. 

The study involved more than 1200 treatments in 82 patients. The standard therapeutic cycle comprised 14 sessions over seven weeks, each lasting one hour. EBOO was found to alter biochemical markers related to oxidative stress significantly:

  • A four to five-fold increase in thiobarbituric acid reactants – indicative of lipid peroxidation
  • A proportional decrease in plasma protein thiols highlights the oxidative changes induced by the treatment.
  • Maintenance of erythrocyte stability, underscoring its safety for large-volume blood treatment at this dose and concentration of ozone.

EBOO showed promising results in treating severe peripheral arterial disease, coronary disease, cholesterol embolism, severe dyslipidemia, Madelung disease, and sudden deafness of vascular origin.

The study also confirms EBOO's therapeutic potential, highlighting its advantages over traditional AHT in treating larger volumes of blood and integrating seamlessly with hemodialysis [2]

Peripheral arterial disease

A randomized clinical trial evaluated the effectiveness of EBOO in treating skin lesions associated with peripheral artery disease (PAD), comparing its efficacy with intravenous prostacyclin therapy in 28 PAD patients. 

The protocol used involved:

  • Starting the treatment after overnight fasting, with 10,000 IU of heparin as a bolus at the start of treatment
  • A blood flow rate of 75 mL/second
  • Ozone concentration at 0.5 - 10 ug/mL at 0.2 bar and 95 - 98% oxygen. A photometer was used to ensure that the one concentration was correct.
  • In 1 hour, 4500 mL of blood was treated
  • Each patient received 14 treatments in 7 weeks

The primary efficacy measures included the regression of skin lesions, pain reduction, improvement in quality of life, and vascularization. In addition, the blood was collected to test for oxidative stress status before, in the middle, and after the EBOO treatment. All patients also received 0.5 grams per day and 600 mg/day of n-acetylcysteine away from the treatment to ensure optimal antioxidant capacity. 

EBOO-treated patients showed highly significant regression of skin lesions compared to those receiving prostacyclin. Additional benefits observed in the EBOO group included significant improvements in:

  • Dolor
  • Itchiness
  • Heaviness sensation in the legs
  • Overall well-being

Despite these improvements, no significant changes were noted in blood vessel regrowth in lower limbs in either group. This suggests that EBOO might help with PAD by directly oxygenating the tissues rather than regrowing the blood vessels. Importantly, no side effects or complications were reported during the 210 EBOO treatments, underscoring EBOO’s safety [5].

Fascitis necrosante

In a case report, a 67-year-old female dialysis patient developed necrotizing fasciitis skin lesions that tested positive for Streptococcus pyogenes. Traditional therapies including multiple antibiotics, fever-reducing medications, and surgeries to remove infected tissues were ineffective. She also developed a deep bedsore on her sacrum. The patient was pre-comatose and close to death [6]

With the consent of the patient’s relatives and the hospital ethics committee, EBOO was administered for 1 hour twice a week. After the 2nd treatment, the fever reduced and she regained consciousness. Subsequently, the study authors applied ozone water and oil to the skin lesions. 

After the 5th EBOO session and about 10 days of topical treatment, the necrotic sores healed . The patient recovered her appetite and was able to leave the bed. By the 14th session, the lesion had healed almost completely. 

Psoriasis 

An observational study of 253 patients with widespread psoriasis vulgaris investigated the effectiveness of various blood treatments, including ozone therapy.

Ozone therapy led to significantly faster and more pronounced improvements. Plasmapheresis, especially when combined with light treatment or ozone treatment of the returned blood, was found to be the most effective treatment modality.

In conclusion, ozone therapy is a highly beneficial part of the complex treatment regimen for patients with widespread psoriasis vulgaris. These methods not only improve the clinical outcome but also enhance the quality of life by effectively reducing the severity of symptoms [7].

Pregnancy and placental insufficiency

Note: We’re not recommending any type of ozone therapy in pregnant women, only reporting on this Russian study results. If you’re pregnant, any decision on interventions needs to involve you and your doctor. Typically, a perfectly healthy pregnancy doesn’t warrant ozone therapy. 

A clinical trial investigated the efficacy of extracorporeal blood purification with medical ozone treatment in the management of placental insufficiency in 127 pregnant women. 

Traditional treatment significantly decreased placental growth factor (PGF) levels and increased vascular endothelial growth factor (VEGF) levels during pregnancy compared to the study group, suggesting less efficacy in managing placental insufficiency. The patients received either standard treatment or plasmapheresis with ozone therapy at 0.4 mg/L on 400 mL blood volume. The study found that the ozone group had significantly reduced complication rates during labor and the postpartum period, and improved perinatal outcomes, including:

  Group 1 (ozone) BGroup 2 (comparison)
Placenta   Thickening of the placental barrier, increased fetal fibrinoid
Spontaneous birth rates Higher Higher odds of unfavorable situations
Premature birth rates^ 13.8% 30.4%
C-section rate for medical reasons^ 39.7% 55%
APGAR (measure of infant wellness)^   Lower due to higher odds of asphyxia

This approach optimizes therapeutic outcomes and reduces complications during labor and improves perinatal results, highlighting its potential as a high-efficacy treatment option in complex cases of placental insufficiency [8].

Animal Studies Using EBOO

Lung function

An animal study evaluated the effects of extracorporeal blood treatment using an ozone-oxygen mixture on various physiological and metabolic processes in dogs, both under normal conditions and in models of experimentally induced shock lung.

Ozone treatment significantly enhanced lung ventilation and improved gas exchange and blood oxygenation in the lungs across both groups. There was a notable activation of glycogenolysis, glycolysis, and overall metabolic processes within the lung tissue. Specifically, the uptake of palmitate from the blood by the lungs increased in intact dogs, and the uptake of lactate and pyruvate was elevated in dogs with shock lungs. Additionally, there was an increase in the blood levels of molecular lipid peroxidation products in both groups of dogs.

Extracorporeal treatment with an ozone-oxygen mixture significantly improves pulmonary function and metabolic processes in both healthy dogs and those with induced shock lung. These enhancements highlight the potential of ozone-oxygen extracorporeal treatment as a therapeutic tool, particularly in critical care settings where pulmonary issues and shock states are prevalent [9].

Sepsis

An in vitro and in vivo model investigated the use of ozone in extracorporeal ozone blood treatment to reduce Escherichia coli (E. coli) concentrations in blood as a potential therapy for sepsis.

In human blood samples, ozone treatment reduced E. coli concentrations by 27%, decreasing from an average of 1941 to 1422 CFU/mL. In the sepsis model using swine, 9 out of 10 animals survived. Ozone treatment did not affect circulatory, respiratory, or metabolic parameters, nor did it impact E. coli concentrations in arterial blood or organs. Treatment increased blood oxygen levels and decreased carbon dioxide levels. Methemoglobin levels, a marker for oxidative stress, were unaffected.

Given the substantial mortality associated with sepsis and increasing antibiotic resistance, ozone therapy could represent a novel and effective treatment option that needs further investigation to determine its efficacy and safety in clinical settings [10].

Who Developed EBOO Therapy?

The earliest evidence of EBOO’s use is by Dr. Paolo in Italy during the 90s.It was then adopted by Dr. Velio Bocci, the father of ozone therapy, and then the International Scientific Committee of Ozone Therapy.

How to prepare for an EBOO therapy session

  • Patient must be well hydrated
  • Patient should not have low blood sugar and should have eaten a light meal
  • If a patient has a burdened immune system (large load of bacteria, virus, fungus), they typically undergo standard ozone therapy IV treatments first.This reduces the likelihood of a severe Herxheimer reaction and prepares their body.

How Many EBOO Ozone Therapy Sessions Are Needed?

The number of sessions needed depends on what you’re trying to accomplish.Someone with a more severe chronic illness may have the following protocol for a total of 11 sessions:

  • Once a week for 4 weeks
  • Once a month for 3 months
  • Once every 3 months for a year

People can often experience benefits in 2–3 sessions but best results are generally seen in 6 - 10 treatments.

A healthy person may use EBOO once or twice a year as a preventative measure, to improve bodily function, or to optimize their performance in an athletic event (increased stamina and more energy).

Long lasting post-viral infections are often assisted in 2 - 6 treatments according to anecdotal reports.

Pros and Cons of EBOO Therapy vs. Normal IV Ozone

Pros of EBOO Cons of EBOO
Greater blood volume is ozonated potentially eliminating infection or pathogens 10 - 20x the price per treatment
Potentially quicker results for the patient No good comparative studies exist
Oxygenation of a large volume of blood Higher likelihood of a Herxheimer reaction
Nuanced therapy that takes a lot of time

EBOO Is Technically Not a Dialysis or “Blood Cleansing” Therapy

Although a setup similar to dialysis is used, it is not a dialysis therapy.

Why does this often get confused?

Four reasons:

  1. The setup is similar to a dialysis setup
  2. The blood turns bright red after going through the EBOO machine
  3. Dialysis filters are often used
  4. Some waste materials from the machine are drained into a bucket

Why does the blood turn bright red?

The reason the blood turns bright red is not because it’s been cleaned. It’s because the oxygen is binding to the red blood cells, turning them bright red.

Medical ozone gas is 99% oxygen and about 1% ozone. So, the blood is also getting exposed to a high level of oxygen which is picked up by hemoglobin in your red blood cells. The change to bright red is not due to the ozone.You could turn the ozone generator off and flow in pure oxygen to get the same color change.

Click here to download our ozone therapy guide

The dialysis filters are not used to filter the blood – they’ve been repurposed

The filter in EBOO is not used in the way that is required for a dialysis treatment. EBOO repurposes dialysis machines with a different filter in order to diffuse ozone gas into the blood.

In a normal dialysis setup, the blood flows through these tiny straws, pulling out the clean elements of the blood and reinfusing them back into the patient.

In EBOO therapy, rather than putting the blood through the straws, they put the ozone through them so it can diffuse through the blood. So, the blood never goes through the filtration process the dialysis filter is designed for.

The reason this is important to understand is because businesses and doctors market EBOO as a “blood purification process” when it is not. If someone is in need of dialysis, they should get a dialysis treatment because EBOO won’t do a filtration of the blood. 

Below is how a normal dialysis treatment works

In EBOO, the blood flows where the dialysate normally would. Then the ozone is infused via the tiny straws, where the blood would normally go. No filtration mechanism is actually happening. Rather, the filter has been repurposed and no longer serves its original function.

Some blood is discarded into a bucket during the treatment. This is usually overoxidized blood cells or heavy parts of the blood that can’t be forced through and back into the body.

If you’re a patient, you don’t really need to understand this portion beyond the fact that it’s not filtering your blood. However, if you’re a practitioner or just interested, you can attend our training for a more detailed explanation.

Is There Something to be Said for the High Oxygenation Levels during EBOO Therapy?

During EBOO therapy, only 1% of the gas is ozone. The other 99% is oxygen. Therefore, a large blood volume is directly oxygenated.

There is potentially a benefit to oxygenating all the blood in the body but it is relatively unknown.

Hyperbaric oxygen done with hard-cased enclosures going up to 3 atmospheres is also a great way to noninvasively oxygenate your system. Hyperbaric oxygen does not have all the same benefits as ozone therapy but will force oxygen into the blood, plasma, joints, and other parts of the body. There is a growing body of literature on the antimicrobial, anti-inflammatory, immunomodulatory, and even anti-aging benefits of hyperbaric oxygen therapy. Some of these might be applicable to EBOO. 

Safety of EBOO Therapy 

EBOO therapy is a safe therapy when done correctly under a knowledgeable practitioner and with the appropriate equipment.

While EBOO and IV ozone therapy in general is very safe, EBOO may be the riskier ozone therapy procedure as it involves a greater blood volume being outside your body. Therefore, it’s crucial to choose the right medical supervision for your treatment. 

The practitioner should be particularly careful about the following:

  1. The filter or gas exchange device must be ozone resistant and not produce microplastics in the blood.
  2. The ozone generator must be specifically designed and calibrated for EBOO therapy. EBOO requires a precise dose of ozone. Too much ozone can cause dangerous blood hemolysis.
  3. Patients should be closely monitored during the EBOO session to detect any warning signs of serious complications.
  4. Emergency procedures should be in place.

Contraindications and Reasons to Avoid EBOO Therapy 

To qualify for EBOO:

  • Some practitioners do a d-dimer test to make sure the blood isn’t clotting too easily. If the blood is clotting easily, it can make completion of the therapy difficult.
  • The patient’s veins must be good, easily punctured for IV, and remain open for the duration of the treatment.
  • Rule out the contraindications below
  • Uncompensated diabetes
  • G6PD deficiency, which results in reduced resilience to oxidative stress
  • Recent acute myocardial infarction
  • Trombocitopenia inferior a 50.000 y trastornos graves de la coagulación
  • Inestabilidad cardiovascular grave
  • Intoxicación alcohólica aguda
  • Massive and acute hemorrhage (uncontrolled bleeding)
  • Bleeding disorders or inability of the blood to clot

EBOO Therapy Side Effects and Potential Complications

While EBOO is a powerful therapeutic technique offering substantial benefits in treating various medical conditions, like all medical treatments, it has potential side effects. Understanding these is crucial for maximizing the therapy’s benefits while minimizing risks. Here are the primary side effects associated with EBOO:

1. Blood clotting and bleeding issues

Because EBOO involves blood circulation outside the body, there's a risk of blood coagulating in the tubing or machine. To prevent this, anticoagulants are used during the procedure. However, the blood can still clot due to aggravation from the pumps.

The use of anticoagulants such as heparin can lead to bleeding complications, especially if not dosed correctly. Patients with bleeding disorders or those on concurrent anticoagulant therapy are particularly at risk.

Some blood components, such as fats, can cause the tubing to clog. In most cases, these can be fixed with regular flicking of the tubes. However, an expert practitioner will need to determine if it’s necessary to replace the tubes.

2. Catheter and vein-related complications

EBOO requires blood vessel access, typically through a catheter that may be inserted into a large vein.

This can lead to:

  • Local infections
  • Thrombosis or clotting at the catheter site
  • Mechanical damage to the blood vessel
  • The vein can close, so the blood stops flowing

Proper sterile techniques and careful monitoring of the catheter site are essential to minimize these risks.

Click here to download our ozone therapy guide

3. Hemolysis

If ozone is administered at over 75 ug/mL, or if the patient’s blood has certain vulnerabilities, red blood cells can burst (hemolysis), releasing hemoglobin into the blood. When there is too much hemoglobin in the blood, it can lead to complications like acute kidney injury.

This is why it’s crucial to use machines that accurately measure ozone volume, especially for EBOO therapy. 

4. Excess oxidative stress

While the controlled oxidative stress induced by ozone is therapeutic, excessive or improperly managed ozone exposure can overwhelm the body's antioxidant defenses.This can lead to cellular damage and exacerbation of oxidative stress-related conditions, potentially affecting cellular function and integrity across various tissues.

5. Air embolism

Improper handling of the ozone gas or errors in the extracorporeal circuit could introduce air into the bloodstream (embolism).

Air embolisms can be serious, leading to blockages in blood vessels which can cause:

  • Dolor
  • Serious neurological symptoms
  • Organ damage
  • Death if critical regions like the brain or heart are affected

6. Infection risk

Any procedure involving extracorporeal circulation and repeated vascular access inherently carries a risk of introducing pathogens into the bloodstream.

Infections can range from local site infections to systemic infections, depending on the extent and nature of the contamination.

7. Adverse reactions to heparin or ozone

Rarely, individuals might have allergic or other types of negative reactions to the ozone itself, heparin, or other substances used during the procedure.

These reactions can range from mild itching and rash to severe anaphylaxis, requiring immediate medical intervention.

To minimize these side effects, it is best to start with smaller-scale IV ozone therapy, such as autohemotherapy first, if possible. This will uncover any possible allergic or immune reactions to materials used in both procedures.

In addition, EBOO must be performed under strict medical supervision with adequate patient assessment and preparation. Monitoring during and after the procedure is essential to quickly identify and manage any adverse events. 

Additionally, the practitioner should take careful note of symptoms, history, and individual risk factors such as pre-existing conditions, medication use, and overall health status to ensure the safety and effectiveness of the therapy.

Click here to download our ozone therapy guide

8. Herxheimer reactions

Herxheimer reactions refer to adverse reactions to debris from microbes that die from ozone’s antimicrobial effects. It can lead to flu-like symptoms, fatigue, or temporary worsening of the original symptoms before improvement.

To minimize Herxheimer reactions, it’s best to:

  • Start slow, such as with autohemotherapy at a low dose of ozone, and work your way up to EBOO. 
  • Support the detoxification process, such as by taking binders and drinking more water
  • Limit toxic exposure from other sources
  • Rest and plan to take it easy, especially when starting out with ozone therapy

9) Complications from the wrong EBOO filters

Dr. Velio Bocci, the father of ozone therapy, expressed concern in his book about the use of dialysis filters in EBOO [11]

“This [use of ozone resistant materials] is essential to prevent leakage of toxic compounds into the blood and this can happen with dialysis filters” 

Another study by Dr. Paolo, the inventor of EBOO, evaluated dialysis filters that are often used in EBOO [12],

“In fact, dialysis filters… are not ozone-resistant and therefore they react with ozone, and they release unwanted chemicals potentially harmful for the patient … On the basis of the present findings, it is hoped that anyone incautiously using dialysis filters for blood extravascular ozonation should correctly use the appropriate device.” 

The picture above shows a microscopic look at an EBOO filter after an ozone therapy session. The authors speculated that the dark spots are due to oxidation from the ozone gas and the release of the plastics into the blood.
This same concern has been verified in multiple studies.

What does this mean for you?

Plastic and toxic compounds are going into your blood if the wrong EBOO filter is used.

Here’s an example of a filter similar to what was observed in the studies.

So, what are the appropriate materials to be used during EBOO?

“They are hydrophobic, permeable only to gasses and, unlike dialysis filters, do not form any ultrafiltrate. The exchange of oxygen, ozone and carbon dioxide occurs through the membrane without any bubble formation” - New medical drug

Polypropylene hydrophobic fibers coated in phosphorylcholine 

EBOO Therapy Near Me

You can look up EBOO clinics on https://aaot.us/.  Here are some US-based clinics that offer EBOO therapy.

  1. Brio Medical Integrative Oncology Program - Located in Scottsdale, Arizona, this center offers EBOO as part of its holistic medical treatments. For more details, you can contact them at 480-613-8807 or visit their website.
  2. LifeWorks Wellness Center - Based in Florida, LifeWorks has been providing ozone therapy since 2010 and offers EBOO among other services. You can schedule an appointment by calling (727) 466-6789.
  3. Whole Health Houston - This clinic provides a comprehensive range of treatments including EBOO, emphasizing its potency in delivering ozone to the blood. Further information can be found by visiting their site or contacting them directly.
  4. The AIM Clinic in Exeter, NH - Known for its strong focus on immune and detoxification treatments, The AIM Clinic offers EBOO therapy as a major service.
  5. Detox for Life in Scottsdale, Arizona offers a wide variety of ozone therapy including ozone sauna, EBOO and ozone colonics. 
  6. EBOO Clinic Houston is part of Houston Wellness Clinics which provide ozone therapy along with other holistic health services
  7. Interactive Health Clinic in Lynnwood, WA is a naturopathic clinic that also provides EBOO therapy.
  8. James Clinic based in Ellisville, MO is a holistic clinic that provides EBOO along with other cutting-edge therapies
  9. American Regen Clinic in Bingham Farms, MI is a regenerative medicine clinic that provides EBOO therapy
  10. Envista Medical in Bakersfield, CA provides integrative and regenerative care, including EBOO therapy.

These centers are renowned for their expertise in ozone therapy and offer state-of-the-art treatment options for a variety of health conditions. It's advisable to contact them directly to inquire about specific treatments, availability, and any prerequisites for scheduling a session.

What Is the Cost of EBOO Ozone Therapy?

A typical EBOO ozone therapy session ranges from $1,500 - $3,000, depending on location and type of clinic. Clinics will venture outside of these ranges depending on their business, additions or subtractions to the therapy, and protocol being used.

EBOO Therapy Equipment for Sale

Generally, it’s advised for medical practitioners to go through formal ozone therapy training prior to getting started with EBOO therapy.

Link to video demonstrating the equipment

List of equipment required for EBOO therapy, most of which will need to be sterile:

  • EBOO therapy machine and ozone generator
  • Gas exchange unit (sometimes referred to as “dialyser” or “filter”)
  • Bucket for collecting debris in blood
  • 2 catheters
  • Oxygen tank with regulator
  • Heparin
  • Saline

Should UBI (Ultraviolet Blood Irradiation or Light Therapy) be Added to EBOO Therapy?

There is no research indicating that UBI should be used in EBOO therapy. However, given their overlapping benefits, UBI may synergize with EBOO. 

There were studies done by Vasogen that displayed the use of light therapy during a standard dose of ozone in the form of an intramuscular injection – minor autohemotherapy. It was not an IV.

Nonetheless, some practitioners feel that adding light therapeutics is beneficial despite no specific research of combining EBOO and light therapy.

There doesn’t appear to be any safety concern with adding light therapy to ozone therapy.

Click here to download our ozone therapy guide

Referencias

Bocci, V. and Valacchi, G. (2015) Nrf2 activation as target to implement therapeutic treatments. Front Chem 3, 4

Di Paolo, N., Gaggiotti, E. and Galli, F. (2005) Extracorporeal blood oxygenation and ozonation: clinical and biological implications of ozone therapy. Redox Rep. 10, 121–130

Yıldırım, M., Erkişi, S., Yılmaz, H., Ünsal, N., İnaç, E., Tanrıver, Y., et al. (2022) The apoptotic effect of ozone therapy on mitochondrial activity of highly metastatic breast cancer cell line MDA-MB-231 using in vitro approaches. J Interv Med 5, 64–71

Bocci, V., Valacchi, G., Corradeschi, F., Aldinucci, C., Silvestri, S., Paccagnini, E., et al. (1998) Studies on the biological effects of ozone: 7. Generation of reactive oxygen species (ROS) after exposure of human blood to ozone. J. Biol. Regul. Homeost. Agents 12, 67–75

Di Paolo, N., Bocci, V., Salvo, D. P., Palasciano, G., Biagioli, M., Meini, S., et al. (2005) Extracorporeal blood oxygenation and ozonation (EBOO): a controlled trial in patients with peripheral artery disease. Int. J. Artif. Organs 28, 1039–1050

Di Paolo, N., Bocci, V., Cappelletti, F., Petrini, G. and Gaggiotti, E. (2002) Necrotizing fasciitis successfully treated with extracorporeal blood oxygenation and ozonization (EBOO). Int. J. Artif. Organs 25, 1194–1198

Gazkhanovna, M. A., Makhmatovich, A. K. and Utkirovich, D. U. (2022) Clinical efficacy of extracorporeal and intravascular hemocorrection methods in psoriasis. ACADEMICIA: An International Multidisciplinary Research Journal, South Asian Academic Research Journals 12, 313–318

Efficiency of using extracorporeal blood purification techniques and medical ozone in placental insufficiency treatment https://en.aig-journal.ru/articles/Effektivnost-primeneniya-efferentnyh-metodov-i-ozonoterapii-v-komleksnom-lechenii-placentarnoi-nedostatochnosti.html

Yakovleva, E. I., Peretyagin, S. P., Kontorshchikova, K. N., Seroglazova, G. S., Andreeva, N. N. and Dergunova, T. V. (1995) Effect of extracorporeal blood treatment with an ozone-oxygen mixture on pulmonary functions in healthy dogs and dogs with shock lungs. Bull. Exp. Biol. Med. 119, 256–259

10  Skorup, P., Fransson, A., Gustavsson, J., Sjöholm, J., Rundgren, H., Özenci, V., et al. (2022) Evaluation of an extracorporeal ozone-based bactericide system for the treatment of Escherichia coli sepsis. Intensive Care Med Exp 10, 14

11  Bocci, V. OZONE A New Medical Drug, Springer Netherlands

12  Travagli, V., Zanardi, I., Gabbrielli, A., Paccagnini, E. and Bocci, V. (2010) Are dialysis devices usable as ozone gas exchangers? Artif. Organs 34, 170–175

 

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