Your Journey With Oxygen Therapy To Unlock Longevity

Amir Hadanny, MD, PhD

Thanks for having me. So what we’re talking about is a medical intervention basically, speaking. We’re talking about a chamber built from metal. People go inside of it close the door completely sealed, and we compress air inside and increase the atmospheric pressure to higher than what we’re living right now. Right now, we’re one atmosphere. Usually, the pressure we’re talking about is anywhere between 1.5 to 2 atmospheres, which is like being almost thirty-three feet underwater. That’s the same pressure that we’re feeling. And once you’re under that pressure, we’re connecting you to a mask and breathing 100% oxygen. So instead of breathing air, which is 21% oxygen, we’re breathing 100% oxygen. And that combination of pressure and oxygen or breathing oxygen under pressure is inducing significant therapy modality.

David Jockers, DNM, DC, MS

Yeah, that’s a great overview. And how did you get into this?

Amir Hadanny, MD, PhD

That’s an awesome question. So I was doing my training as a residency, as a neurosurgeon, and one of my PGI one, one of my biggest issues was seeing my trauma patients. The ones that we treat, we do acute surgery, saving their lives, and then seeing them in follow-up three months, six months, even a year or years after that event, those patients still suffer from significant disabilities, whether it’s cognitive, whether it’s motor emotional, and basically, do not go back to their day to day life. My mentor from Medical School Shai Efrati was just receiving being the director of the hyperbaric chamber by complete chance. And I reached out, we talked about it and he said he had a couple of traumatic brain injury patients that he saw some interesting results. And we said, let’s do a randomized controlled trial. And we did that. You know, we were both very skeptical coming from he’s a nephrologist and I was a neurosurgeon, both of us very skeptical. And we designed this randomized controlled trial to prove that this is just a placebo effect. And we were astounded. We were really astounded, you know, comparing the treated group to the control group, we saw amazing both neurological effects as well as significant cognitive effects really translating to improving day-to-day life or what we called activity of daily life, improving the quality of life of these patients, being able going back to work. Amazing. So that got me hooked. You know, traumatic brain injury is always the biggest thing for me, and why I’m doing this.

David Jockers, DNM, DC, MS

Yeah, absolutely. And I think hyperbaric is most well known for its ability to improve people recovering from traumatic brain injuries, strokes, things like that. But what overall like what conditions can improve as a whole for utilizing hyperbaric oxygen therapy?

Amir Hadanny, MD, PhD

Right. So you have, let’s divide them, you know, even by history. So when you think about how hyperbaric oxygen therapy started, we talking about, first of all, diving accidents. That’s how it started. People got the bends. People still get the bends if you do some mistakes in your diving. So that’s the first and foremost use for that. Then when we talk about therapy for chronic conditions, you have majorly non-healing wounds. So people who have diabetic wounds or other issues in their periphery wounds. It’s really inducing a significant healing of those wounds. Also one of the biggest indications is radiation injury. So we’re talking about people who received radiation therapy for different cancers. And can have skin issues, gastrointestinal, urological issues, and even cognitive issues because of radiotherapy. So hyperbaric oxygen therapy is actually the only therapy for radiation sort of radiation injury. And then we have the whole neurological indication. So and that’s kind of what our group has led over the past two decades in research. Like I said, people can have a severe traumatic brain injury, leading to injuries that require surgery. But also people can suffer from mild traumatic brain injury and then develop post-concussion syndrome, which is emotional symptoms, cognitive symptoms, headaches, and a lot of different symptoms that bother people. So we know that post-concussion syndrome can significantly benefit from hyperbaric oxygen therapy. So that’s TBI-wise. And then the second neurological indication I would like to mention is stroke. People suffer from different types of strokes, whether it’s hemorrhagic strokes or ischemia strokes. So people get the acute intervention in the hospital leading to significant improvement, leading to rehabilitation. But still, people remain very, very disabled now on a different spectrum of injuries. And again, we’ve led significant research showing that we can improve both neurological symptoms, such as motor improvements, as well as cognitive improvements. What people a lot of times forget is that more than 50% of stroke survivors suffer from cognitive issues, whether it’s memory, attention, or processing speed for more than 50% of them suffer from that. And we know we are able to improve that. And again, can bring them back to work and improve quality of life. So those two main indications again of broken TBI. 

Next to led research in different pain syndromes. So central pain syndromes are when our brain causes us to think that we have different pain or causes us to process, touch, and feeling, and they’re painful. One of the classic indications is that fibromyalgia, again, people who feel pain along with sleep issues, and emotional symptoms, again, due to a neurological issue. The problem there is in the brain, we already know that. So again, we led a lot of research in fibromyalgia and saw that this can be significantly improved. That led us to a whole branch of trauma-induced brain injury or what we can call PTSD, eventually post-traumatic stress disorder. We’re now leading the second randomized clinical trial, which the results will soon be published. But again, we’re talking about brain injury that results from a traumatic event and it doesn’t have to be military-related. We all know, unfortunately, can be a motor vehicle accident, but it can also be, you know, emotional assault or sexual abuse that unfortunately are so common and cause people to suffer from significant injury and stress for the rest of their lives. So, again, the right patient that we are able to help with, we do assessments for. And if we are able to help again, PTSD is significantly can be significantly improved with HBOT. 

The next indication I would mention is what we’re doing with aging. Okay. So the 2015 study we led on healthy aging or normal aging. We took patients over the age of 64, which didn’t have a significant event. They did not have TBI, stroke, or a significant cancer or cardiac issue. They were just people over the age of 64 pretty healthy. And we wanted to see what we were able to produce or induce with hyperbaric oxygen therapy, a specific novel regime protocol. And we found we are able to improve the aging process, where able to improve cognitive function as well as physical function along with actual aging biomarkers. So we’re actually changing the way we age with hyperbaric oxygen therapy. So I think those are the main indications. We cover diving through wounds, radiation necrosis, and the new field that we had for the past couple of decades for neurological indications. But what’s unifying everything here, what we’re talking about is injuries that are related to hypoxia or low level of oxygen, different organs that suffer from lack of blood, and lack of oxygen that causes a wound. And this is what we do with hyperbaric oxygen therapy. We heal wounds that do not have enough oxygen from blood. It happens with the trauma, whether it’s traumatic or stress-related. It happens with stroke. But it also happens, like I said, aging while we age different vessels in our brain, in our kidneys. It’s our hearts are being occluded and we have tiny wounds in all of our organs. So, again, the goal of hyperbaric oxygen therapy is to heal wounds, whether they’re in your brain or in your heart.

David Jockers, DNM, DC, MS

Yeah, yeah. Really exciting stuff. At the cellular level, we know that oxygen is helping improve mitochondrial energy production, which allows the cell to function better and then also helps the cell to detox more effectively as well, and just handle overall oxidative stress that it may be encountering. And that’s, you know, a big part of the mechanism. Now, a lot of people are confused on the difference between and the importance of the pressure. So they think, well, if I just have an oxygen tank and I’m breathing in the oxygen, then aren’t I getting oxygen? Why do I need to be in the actual pressurized chamber weight?

Amir Hadanny, MD, PhD

Good question. So we have a simple answer to that. That is physics. So there is a physical law called Henry’s Law that says that you are able to dissolve more gas molecules in a liquid under pressure. And the best way to understand this law is a Coca-Cola can. Again, I’m not a Coca-Cola advocate here but think about that. So you have a lot of CO2 gas dissolved in the can. The moment you open the can you hear that? Because now the pressure is released and all the molecule starts to run away. If you leave that Coca-Cola open for a couple of hours, you’ll have a flat Coca-Cola. And this is exactly what we do with a hyperbaric chamber we’re taking you and making cocaine. What we’re dissolving is oxygen in the liquid of the blood or the plasma. We’re dissolving more and more molecules. The only way you’re able to dissolve more molecules of oxygen is with pressure. So you have to have pressure. You know, if you just breathe oxygen without pressure, you’re not really dissolving significantly more oxygen. So you’re not getting to that therapeutic effect. You’re on the lower, lower end of dissolving that and it’s just not effective.

David Jockers, DNM, DC, MS

Yeah, yeah. It’s a good explanation there. Now there is an HBOT or hyperbaric oxygen, hard chambers and then there are also soft chambers, otherwise called mild hyperbaric oxygen therapy. And from my awareness, you can really only access the hard chambers, typically, the average person only has access in various specialty clinics and hospitals. And then there’s a little bit more, you know, somebody can actually purchase and have at their house a mild hyperbaric oxygen chamber. What is the difference in the dosage and the effectiveness of these two?

Amir Hadanny, MD, PhD

Okay. So that’s a big talk here. So the soft shell usually does not pressurize more than 1.2, maybe 1.3 atmospheres, but also a lot of them do not provide 100% oxygen. Some do 94, 95, some do regular air and then 30% oxygen. So we’re talking about different protocols. But I think, you know, we call it mild hyperbaric oxygen therapy, but we’re talking about low dose, a very, very low dose of therapy that has never been proven. Basically, we do not have any clinical study that has been run with that protocol. And to see what it does, we have a couple of physiological studies that show that it’s much milder, much lower efficacy on different biomarkers such as stents. Those it does have some efficacy but very, very, very mild. As for the clinical effect, we simply don’t know. Can it heal wounds? Can it heal the brain? Can it help with traumatic brain injury? We just don’t know cause nobody has done a randomized controlled trial looking at the efficacy on the physiological level and thinking, can it actually do what we do with high pressure, 100% oxygen? Probably not. We’re talking about a very low dose and probably not an effective one. But I also want to talk about so that’s on the efficacy level, but I also want to talk about the safety level.

We’re talking about devices. Those are supposed to be medical devices. Most soft shells are not regulated. And we’re talking about pressure and oxygen. And unfortunately, those things can explode. So exactly like you said, we do it in clinics and in hospitals because we have technicians and we have people that were trained to run those safely. And if you don’t do that safely, you can end up with a significant injury or in most cases actually actual death, because when this explodes in that person there, you know, it’s not going to end well for anyone. And those are the devices that explode and cause issues. So on the safety level, I really do not recommend anyone putting it in their homes, like you wouldn’t put an MRI machine in your home garage because these things are dangerous and can harm you. It’s not, you know, there are, different companies that sell them and tell you everything’s going to be fine, but it’s like selling you an MRI and telling you everything’s going to be fine. It’s safety and efficacy. People should not use those devices.

David Jockers, DNM, DC, MS

Oh, interesting. And so how do people access the hard chambers? Do they have to have a specific diagnosis? What if they’re looking to do it for the aging benefits like you were talking about? What is the accessibility at this point?

Amir Hadanny, MD, PhD

Good question. So there are a lot of different clinics and hospitals running them. Most of them do not do neurological indications, unfortunately, something that we are trying to change. Now, I will say that it’s not for everyone. I think the biggest issue we have with hyperbaric oxygen therapy, that people think that it can cure everything. No, definitely not. We need to have a very specific patient selection mechanism and this is what we do here in Aviv. I’m the chief medical officer of Aviv. And our process starts with assessments. We run the patients for three or four days cognitive assessments, physical assessments, and most importantly, brain imaging. We do MRI imaging, we do SPECT imaging, and we see what’s going on in the brain and can we help it if it’s not something that we can predict any benefit, we shouldn’t treat it if the symptoms or the signs are not correlating with what we see in the brain with those non-healing wound sorry non-healing wounds of the brain. If they do not correlate, we do not treat. We shouldn’t offer it. Yeah, what the heck? Do it. It doesn’t do any harm. No, it’s a medical intervention and we should treat it as that. And we should treat patients that have specific indications and can benefit from that. Like you wouldn’t go for any surgery if you’re not indicated for that, that’s exactly how you should deal with it.

So you should go to a clinic that does assessments that include brain imaging and make sure that you would benefit from that. If you don’t do that process, don’t do it. Yeah. So the clinics that we’re running is what we’re doing right now here in central Florida. We do the assessments and then we decide which type of treatment, which protocol you’re going to get that we have shown in the randomized controlled trial based on your brain imaging that we should benefit from.

David Jockers, DNM, DC, MS

Very interesting. And how many of clinics do you guys have at this point?

Amir Hadanny, MD, PhD

So right now we have three clinics. We have the Central Florida one, the Asia one in Dubai, in the United Emirates, and in Israel.

David Jockers, DNM, DC, MS

Okay, excellent. So you guys can look up. It’s just Aviv clinics and check out the assessment and what are the treatment protocols look like. Like how often is somebody using it? What is the time length typically where they’re in the chamber?

Amir Hadanny, MD, PhD

Good question. So definitely it depends on which indication we’re talking about. We didn’t have time to talk about it. Sometimes there are acute indications such as carbon monoxide or compromised flap that people can suffer from the can plastic surgeries. So it really depends. But if we’re talking about the neurological implications, such as a stroke or TBI, a pain syndrome, or an aging process, we usually talk about three months of therapy, 12 weeks on each week. We’re talking about daily sessions. So five sessions a week and each time each day we’re talking about 2 hours in the chamber. We use multiples. We do not use a hardshell chamber, like you mentioned, which is a model place that is only for one person we talk about a very big chamber that looks like an airplane. From the inside, we talk about 14 people sitting together at once, up to 14. So obviously each person has their own chair, their own tablet, and they sit there and time. So usually 60 sessions for 12 weeks, five days a week, 2 hours, and a specific protocol that we do here.

David Jockers, DNM, DC, MS

Well, that’s really interesting. So you got 14 people in there. They’re just kind of sitting there on their tablets so they don’t have to kind of lie, you know? And, you know, they can sleep if they want, but they’re able to obviously do their kind of daily activities or just they have Internet access, things like that. So yeah, really. Right.

Amir Hadanny, MD, PhD

Yeah. But I also want to mention one of the key things that we do here with Aviv, we also combine for specific patients cognitive training so patients can actually do different exercise, cognitive exercises while they’re in the chamber. And the reason for that is the synergistic effect. We know cognitive training has some benefits from it. We know our hyperbaric protocol has a benefit. So we combine the two for specific patients and we give specific exercises or specific indications. Of course, specific cognitive domains are personalized to that patient to do while he’s in the chamber. He doesn’t do it for the entire time of the 2 hours. But for this specific amount of time, we want him to do it every day or every other day.

David Jockers, DNM, DC, MS

I love that you’re stacking those different therapies and going to obviously get better benefits that way. So really, really great stuff Amir. And people can reach out to Aviv clinics to learn more about this. And where do you see hyperbaric medicine? Obviously, you’re at the forefront of this, seeing patients and also doing research. Where do you see this going in the future? Are there any other, you know, promising conditions that hyperbaric oxygen will be approved for that you foresee in the future?

Amir Hadanny, MD, PhD

Yeah, so definitely that’s our goal. That’s our life goal. First of all, I want to have bold indication that we’ve discussed FDA-approved. Yeah. So we are working on significant trials to get them approved and to be much more available everywhere for survivors of those conditions. But also, we are working on cognitive decline due to other pathologies. And obviously, the biggest one is Alzheimer’s. We have a couple of Alzheimer’s disease studies running currently. We don’t know the results yet, but that’s definitely the direction we’re talking about. We are exploring different indications. We haven’t even talked about led performance, but we are also utilizing oxygen to improve the physical performance of athletes. So definitely I think in this decade we’ll see hyperbaric oxygen therapy being more and more utilized for different indications, much more available. And again, if used smartly and correctly on the right, people, this will be a significant portion of a lot of people.

David Jockers, DNM, DC, MS

Wonderful. Well, thanks so much for your time and the great research and work that you’re doing. Amir, really, really exciting to hear about the results that you guys are getting and how people are utilizing this sort of therapy. And again, thanks so much for your time and your great work, and guys will see you on a future interview. Be blessed, everybody.