Doping that is not doping - effects of ozone therapy in sport

Background: ozone as a natural approach to athletic performance

Some practitioners have explored major ozone autohaemotherapy - in which a small amount of blood is withdrawn, mixed with an oxygen-ozone gas mixture and reinfused - as a way of supporting athletes' aerobic capacity and recovery. The phrase "doping that is not doping" captures the author's argument: that ozone might aid performance as a natural approach rather than a banned pharmaceutical. That framing needs important caveats, both about the strength of the evidence and about anti-doping rules, which are set out below.

Study design: a randomised controlled trial in 30 young footballers

This was a small randomised controlled trial in 30 male footballers from the Turkish National League (U19 squads, mean age about 18.5). Baseline aerobic performance was measured with the Astrand treadmill test. Fifteen players were randomly assigned to receive major ozone autohaemotherapy (20-30 micrograms per millilitre, twice a week for five weeks) while the other fifteen served as a control group. All players followed the same training programme, and the treadmill test was repeated after the treatment period to compare the two groups on VO2 max (a measure of aerobic capacity) and maximum running time.

Findings: larger gains in aerobic capacity and running time in the ozone group

In the ozone group, average VO2 max rose from about 51 to 61 mL/kg/min (around a 20% increase), compared with a rise from about 51 to 55 (around 8%) in the control group. Maximum running time increased from about 25 to 32 minutes (around 28%) in the ozone group, versus about 25 to 28 minutes (around 12%) in controls. The author reported the difference in improvement between the treated and untreated players as significant.

What the author concluded

The author concluded that ozone therapy could be effective for increasing athletic performance ahead of a season or tournament. He also argued that ozone therapy represents a natural perturbation distinct from prohibited blood doping, noting that requests for clarification had been submitted to the World Anti-Doping Agency (WADA) without a definitive answer at the time of writing. That is a strong performance claim resting on one small study, and it should be read as a preliminary signal rather than an established finding.

Limitations of this study

This is a small trial - 30 young male footballers from a single setting, reported by a single author in a specialist ozone-therapy journal - so the results need independent replication in larger, more diverse groups before firm conclusions can be drawn. There is also a crucial practical point for competitive athletes: anti-doping rules restrict the manipulation, withdrawal and reinfusion of blood, so a method such as major autohaemotherapy may fall foul of those rules regardless of the "not doping" label, and the author's own queries to WADA were unresolved. Any athlete considering ozone therapy must check their current status with their sport's anti-doping authority first, and discuss it with their medical team.