HyperBaric Oxygen Therapy (HBOT)
This involves laying in a small pressurised tube, and breathing in higher pressure Oxygen, sessions last 1-2 hours. In the UK sessions they are priced at £80-150. Most sources suggest 10-40 sessions. So this treatment will set you back £800-£6000. If you are getting towards the top end of that you might want to buy your own system, they start at £8400.
Between 15% and 37% of people worldwide are affected by claustrophobia, with 5–7% affected by severe claustrophobia, also remember you cannot just get out and go to the loo. So this is definitely not for everyone.
HBOT for Mild Traumatic Brain Injury
This is what fairly convincing data looks like. Instead of subjective measurements they actually did verbal and non verbal tests on the patients instead of just asking them their own subjective opinion. So much lower bias.
56 patience in a cross over study, so there is a baseline, which is probably a good alternative to blinding, since blinding a HBOT is very difficult.
Notice how the treatment bars are clearly above the baseline and controls groups.
This the data from a study of HBOT to treat Long Covid. The bars with a star above them apparently show a statistically significant improvement.
However, except the first one on Chader faigue scale they clearly look the same. Maybe the Information processing speed has gone up, but that could easily be explained by people just getting better at one specific test.
I don’t understand how they got statisical significant data when the bars are the same. But even if they are really statisitcally significant, the actually change is barely noticeable.
The reduction is the Chader fatigue score is impressive, 27.4 down to 9.7. However, this is very subjective measurement and it would drop considerably if you feel less fatigued. Like after resting for 105minuues for 10days out of 12. As this is what the patience are doing in this study.
It seems the patience in the study were paying for this therapy. So you can’t really add controls/placebo group and deny paying customers the treament they paid for. Paying for the treatment could mean that people bais thier responses
Concerns were also rasised that the authorus only abtained approaval for a retrospective analysis. There is no attmept at measuering a background, and not follwo to see if the reducing in fatigue lasted after the two weeks of treatment.
Placebo effects are likely as HBOT facilities are highly technical. Patients are locked in a hyperbaric chamber and usually wear a mask or hood. They experience pressure sensations in their ears and temperature alterations as ambient pressure in the chamber changes. So like acuputure, this could just be another elaborate placebo.
A study on HBO2 For CFS
Cronic Fatigue Syndrome is a good comparison as it is so similar to LC, and it has been around for longer (although the science is still tragically lacking)
Again a small study of only 16 people, no blinding, no long term assessment. 15 treatment sessions of HBO2 therapy over a period of three consecutive weeks (five days per week). 90-minute therapy sessions with HBO2 at 2.4 atmospheres. That’s 22.5 hours in a tiny space.
The improvements were very good, but these are subjective measurement and no indication that they work in the long term. If someone had invested that much time, effort and expense in those therapy session they would be primed to give positive results.
The lack of objective measurements, and no follow up is a concern for me. The results could be mostly or possibly even all reporting bias.
They are at least aware of these flaws “Limitations of the present study include the lack of a control group, the lack of a long-term follow-up and the small sample size with female predominance.”
HBOT vs MS
Multiple sclerosis (MS) and myalgic encephalomyelitis (ME), or chronic fatigue syndrome (CFS), are two conditions that share several overlapping symptoms and might even coexist, including fatigue, cognitive difficulties, and pain.
Those individuals with ME or CFS reported significantly more functional limitations and significantly more severe symptoms than those with MS. Ref
Here the data between HBOT and MS is even more reliable, as there are mutlpul studies, hence we can combine in a concrain review, to reduce bias, which concluded “there is little need for further research.” becasue it doesn’t work. “
“We found no consistent evidence to confirm a beneficial effect of [HBOT} for the treatment of [MS] and do not believe routine use is justified.
Notice here the first study, the top horizontal line, shows a clear favour for treatment. While later studies clearly overlap with zero difference. The diamonds show the subtotals, with the lower being the total of all the studies.
While it is slight to the left, it is consistent with no effect, and slight deviation from zero can be ascribe to residue of reporting bias/placebo effect.
This is why I am still very skeptical of the inital results for HBOT and LC. Since we frequently get postive results from inital, weak and poorly blinded studies. When further better studues are done, the effect sizes reduces, until we end up with nothing. I suspect HBOT will go the same way, but I will keep and eye on the data in case I am wrong.
I am still concerned that a well blinded study will show that it doesn't work. That the only effect comes from sitting and resting in a small chamber for an extented period of time. So lets keep an eye on this to see if better evidence comes along, maybe get onto a study if you can, or a free session(s) if possible. However, I wil definitely be saving my money, it is too expensive for what at best seems a short term gain.