Effect of Ozone Therapy on Muscle Oxygenation: Direct Measurements in 26 People (2003)

Background

By the early 2000s ozone therapy was being used in several countries for conditions caused by poor blood supply, but - as the authors of this study put it - the mechanisms behind its reported success were unknown and it had not been accepted within conventional medicine. One proposed explanation was that ozone improves the delivery of oxygen to tissues. That had been inferred from blood tests, but not measured in the tissue itself.

Dr Bernardino Clavo and colleagues at the Dr Negrín University Hospital in the Canary Islands, Spain, were well placed to check. As a radiation oncology department they already used polarographic needle electrodes - fine probes that read oxygen pressure directly inside tissue - because tumour oxygen levels affect how well radiotherapy works.

Study design

This was a prospective study of 26 people: 23 patients and 3 volunteers. Systemic ozone therapy was given by autohaemotransfusion - a quantity of the person's own blood exposed to ozone and returned - on three alternate days over one week.

Oxygen pressure, in mmHg, was measured directly in the tibialis anterior muscle at the front of the shin, at rest, before and after the first session and before and after the third. Because the third session's "before" reading was taken two days after the second session, it also showed whether any change had lasted.

There was no control group or sham procedure.

Findings

Overall, no significant change. Taking all participants and all readings together, the differences in muscle oxygenation before and after ozone were not statistically significant.

Fewer severely low readings. The percentage of readings in the severely low range - below 5 mmHg - fell significantly after ozone sessions.

The lowest benefited most. The size of the change was inversely related to the starting value: the more poorly oxygenated the muscle was at the outset, the more it gained. This was the strongest relationship in the study. Older participants tended to gain less.

It lasted at least two days. In the poorly oxygenated tissues, oxygenation was still significantly higher 48 hours after the second session.

What the authors concluded

The authors conclude that ozone therapy can modify oxygenation in resting muscle, particularly in muscle that is most short of oxygen. They suggest it could be used as a complementary treatment in conditions of poor oxygen supply, and that it warrants further investigation.

Limitations of this study

The headline result was not significant: across the whole group, muscle oxygenation did not change. The positive findings come from looking at the low-oxygen readings and at the relationship with starting values. That is a reasonable thing to examine - a treatment that improves oxygen supply would not be expected to raise levels that are already normal - but results found this way need confirming in a study designed to test them.

A pattern in which the lowest starting values rise the most can also arise by chance alone, because unusually low readings tend to be followed by more typical ones whatever is done. Without a control group given a sham procedure, the study cannot rule this out.

Twenty-six people is a small sample, and readings from a needle probe vary with exactly where in the muscle it sits. The study measured oxygen in resting muscle, not symptoms or function, over one week.

Ozone was given by autohaemotherapy in a hospital. The study does not show that other routes produce the same effect. We have worked from the published abstract; the full paper is behind a paywall.

Related reading

Ozonised Autohaemotherapy, Blood Viscosity and Red Cell Flexibility in Peripheral Arterial Disease - what ozone does to the blood's ability to deliver oxygen.

Modulation by Ozone Therapy of Oxidative Stress in Chemotherapy-Induced Peripheral Neuropathy - later work from Dr Clavo's group.

How Ozone Therapy Works: The Science in Plain Words

Clavo B, Pérez JL, López L, Suárez G, Lloret M, Rodríguez V, Macías D, Santana M, Morera J, Fiuza D, Robaina F, Günderoth M. Effect of ozone therapy on muscle oxygenation. Journal of Alternative and Complementary Medicine. 2003;9(2):251-256. doi:10.1089/10755530360623365