Ozone Therapy

REPORT

DTU 0673

COMPLEMENTARY AND ALTERNATIVE MEDICINE

OZONE THERAPY

PREPARED BY: 1. IBADULLAH MAT DAUD 01200605 1771 2. ALIFF LUKMAN ABD GHAPOR 01200605 1652 3. NIK AHMAD SAFWAN 01200605 1777 4. MOHD SHAKKIR MOHD JAMAL 01200605 1779 5. SITI HASMAH MOHD HUSIN 01200605 1778

PREPARED FOR: MR ACHSANUDDIN KAMALUDDIN

DATE OF SUBMISSION: AUGUST 1ST 2008

SUMMARY

Introduction Ozone is the unstable gas, having powerful oxidizing properties. However, it still had been used as therapy for decades. Nowadays, it is broadly used but yet is still controversial.

Applications First revealed by the German chemist Christian Frederick Schonbein (1840), ozone breaks down to oxygen very quickly. It cannot be bottled so must be freshly generated when it is needed. The usual ways to produce it, are including ultraviolet radiation, corona discharge, cold plasma and electromagnetic.

Currently, there are nine methods of practical ozone therapy namely direct intraarterial and intravenous application, rectal insufflations, intramuscular injections, major and minor autohemotherapy, ozonated water, intra-articular injection, ozone bagging, ozonated oil and inhalation of ozone.

Safety Issues However, there are some reported cases relating with ozone therapy such as air embolism, blood borne infections and bilateral visual field loss after receiving ozone therapy. Normally, these were happened when the treatment is done by unqualified personal and also might be due to the contraindication of using this therapy.

Effectiveness It is stated that this ozone therapy can be used to treat up to 300 diseases and syndromes for example, ischaemia, skin disorders, obstetric and gynaecology problems, and cancers. Though, there are very little evidences to show that patients are having complete resolutions after experiencing ozone therapy.

Advantages Ozone therapy applied relaxing and non-invasive approach to the patient. It also will cleanse the skin, pores and lymphatic system. Besides, the users will take advantage of 2 therapies all at once namely sweat therapy and ozone therapy.

Disadvantages Only the trained physicians can performed this therapy. The concentration of ozone used must be put under the firm eyes as the ozone has potent oxidant properties. If it was handled improperly, it can be toxic to the pulmonary system and causing the side effects such as epiphora and upper respiratory irritation, rhinitis, cough, headache, occasional nausea, and vomiting.

Conclusion The therapeutic use of ozone has an exceptional safety record have been observed from the view of the clinical use. But still, there is not enough evidence to suggest that the usage of ozone therapy as alternative medicine has real advantages over the available conventional treatment.

INTRODUCTION

What is ozone? Ozone is a triatomic allotrope of oxygen formed by recombination of oxygen atoms. It is a colourless gas with characteristic pungent odour and can easily be detected at low level of 0.05 ppm. It is a very strong oxidant and is over 3000 times more powerful disinfectant than chlorine. It disinfects, oxidizes, deodorizes, and decolorizes.

Ozone in nature is being produced through action of the flashes of lighting and the photochemical reaction of the UV light of the sun on atmospheric oxygen. Nature produces ozone for the purpose of purifying the air and to destroy all organic decay upon which disease germ and bacteria thrive.

Background/History Ozone was first revealed by the German chemist Christian Frederick Schonbein in the year 1840 in the University of Basel in Switzerland. Ozone was used for the first time to disinfect operating rooms in 1856 and subsequently for water treatment in 1860 (Foundation for alternative science & Technology). The German Army used ozone to treat battle wounds and other infections during World War I.

However, it was not until 1932 that ozone was seriously studied by the scientific community. Ozonated water was used as a disinfectant by Dr. E.A. Fisch, a German dentist. One of his patients was the surgeon Erwin Payr, who immediately saw the therapeutic possibilities of ozone in medical therapy. Dr. Payr, along with the French physician P. Aubourg, was the first medical doctor to apply ozone gas through rectal insufflations to treat mucous colitis and Fistulae.

After 135 years of usage, medical ozone therapy is a recognized modality in many nations in Europe and the USA, and recently in Malaysia.

Theory The different modes of action of ozone on a living organism are now well understood and involve the production of peroxides. The peroxides are responsible for the remarkable bactericidal and fungicidal effects of ozone. The virus inactivation is enhanced by a peroxide intolerance of weakened infected cells. Normal cells are protected from the effects of ozone by enzymes in the cell wall - glutathione peroxidase, catalase and superoxide dismutase. Ozone stimulates the production of these enzymes, thus enhancing the cell wall resistance to invasion. In addition, ozone has been shown to have a measurable benefit on the uptake and utilization of oxygen through improved glycolysis in red blood cells through the abolition of harmful red blood cell stacking. In addition, ozone stimulates and activates mitochondria respiration and metabolic pathways. All mammalian tissues depend for their survival and health on an adequate oxygen uptake and therefore ozone would benefit every person through optimizing tissue oxygenation. Thus ozone has a preventative as well as remedial role. The application for prevention would include increasing longevity, enhancing performance, rejuvenating seniors, optimizing the healing of wounds, and stimulating immunity

APPLICATIONS

How is it produced? Ozone (O3) is an unstable gas, which breaks down into oxygen very quickly. Because of that, it cannot be bottled, but must be generated fresh when it is needed. The halflife of ozone at 68° F., in approximately 40 minutes, which means that in 40 minutes, half of the ozone will have dissipated.

Ozone is generated mostly in four ways:

1. Ultraviolet radiation Ozone is created naturally when ultraviolet radiation from the sun contacts the oxygen in the earth's atmosphere. In industry an ultraviolet bulb is used, which produces low concentrations compared with other methods. Ultraviolet generation produces about

one third less ozone than plasma generation per watt of power. The bulb also loses its efficacy rather quickly. However, this method has the advantage of producing almost no nitric oxide if the input air is clean and free of pollutants. Ultraviolet radiation from the sun passing through the polluted atmosphere of the urban environment breaks down any of the nitrogen compounds and hydrocarbon exhausts into nitric oxide and various other toxic components, with ozone as a byproduct. The ozone itself is not toxic in these low concentrations, only the gases with which it is combined. Unfortunately, because it is used as an indicator gas of overall pollution, it has been labelled by much of the media as a toxic gas synonymous with smog.

2. Corona discharge Electrical sparks are passed through an oxygen-rich environment for example, lightning or any electrical device, which produces sparks. This method is often misleadingly called, cold spark, as the sparks are far from cold. Many room air purifiers frequently use this method. Sparks are discharged between two metallic electrodes, through which a fan passes air. This method is not suitable for medical ozone generation because first: in ambient air, nitric oxide is formed, and second; minute amounts of metal ions, produced by sparks arcing between the electrodes, are released into the oxygen flow, making it unsuitable for medical purposes. For room air purification, however, these units may be suitable for the nitric oxide breaks down rapidly within several feet and the metal ions dissipate rapidly. To avoid this problem, some units use plasma tubes.

3. Cold plasma It is an electrostatic approach to ozone generation which uses voltage as the energizing medium, rather than current. The cathode is a glass tube with a noble gas, and the anode is a similar glass tube. An electrostatic voltage field is generated between these elements, and the oxygen is passed through this field, with a percentage becoming ozone. No metal of any sort is used in the all-glass tube. This approach was invented by Nikola Tesla over 100 years ago, and results in an ozone generator that does not produce heat, and requires no fan for cooling. This superior design eliminates contamination of the gas stream, and has the longest lifespan of any ozone generation method.

4. Electromagnetic This method uses quartz glass tubes through which the oxygen flows, with copper wire wound around the inner and outer tubes. A high frequency voltage is passed through the coils, producing a strong electromagnetic field (EMF). A fan or heat sink is needed to dissipate the heat, as heat destroys ozone. Quartz glass is required due to the possible contamination caused by heating regular glass to high temperatures. Possible EMF side effects need to be further investigated

Methods of Application There are nine methods; eight simple methods and one highly complex method of ozone therapy that are used in medical practice.

1. Direct intra-arterial and intravenous application An ozone mixture is slowly injected into an artery or vein with a hypodermic syringe. This method is used primarily for arterial circulatory disorders. According to Gerard V. Sunnen, M.D., due to accidents produced by too rapid introduction of the gas mixture into the circulation, this technique is now rarely used.

2. Rectal insufflations First pioneered by Payr and Aubourg in the 1930’s, a mixture of ozone and oxygen is introduced through the rectum and absorbed into the body through the intestine. Used for a wide variety of health problems, this method is considered one of the safest. In a typical treatment for ulcerative colitis, for example, 75 micrograms of ozone per milliliter of oxygen are used. The treatment begins with 50ml of oxygen which can be increased slowly to 500 ml per treatment. While administered under medical supervision in Germany, Russia and Cuba, a growing number of private individuals in the United States use this method for self-treatment for cancer, HIV-related problems and other diseases.

3. Intramuscular injection A small amount of an ozone and oxygen mixture up to 10 ml is injected into the patient usually in the buttocks like a normal injection would be. This method is usually used to treat allergies and inflammatory diseases. Intramuscular injections are sometimes utilized as an optional to cancer therapies in Europe.

4. Major and minor autohaemotherapy Used since the 1960’s, minor autohaemotherapy involves removing a small amount usually 10 ml of the patient’s blood from a vein with a hypodermic syringe. The blood is then treated with ozone and oxygen, and given back to the patient with an intramuscular injection. Thus, the blood and ozone becomes a type of autovaccine given to the patient that is derived from their own cells, thus forming a unique vaccine that can be very specific and effective in treating the patient’s health problem. Major autohaemotherapy calls for the removal of between 50-100 ml of the patient’s blood. Ozone and oxygen are then bubbled into the blood for several minutes, and then the ozonated blood is re-introduced into a vein. These methods have been used to treat a wide variety of health problems, including herpes, arthritis, cancer, heart disease and HIV-infection.

5. Ozonated water This method calls for ozone gas to be bubbled through water, and the water is used externally to bathe wounds, burns and slow-healing skin infections. It is also used as a disinfectant by dentists who perform dental surgery. In Russia, physicians are using ozonated water to irrigate body cavities during surgery. In both Russia and Cuba, ozonated water is used to treat a wide variety of intestinal and gynecological problems, including ulcerative colitis, duodenal ulcers, gastritis, diarrhea and vulvovaginitis.

6. Intra-articular injection In this method, ozone gas is bubbled through water and the mixture is injected directly between the joints. It is used primarily by physicians in Germany, Russia and Cuba to treat arthritis, rheumatism and other joint diseases.

7. Ozone bagging This non-invasive method uses a specially made plastic bag that is placed around the area to be treated. An ozone and oxygen mixture is pumped into the bag and the mixture is absorbed into the body through the skin. Ozone bagging is primarily recommended for treating leg ulcers, gangrene, fungal infections, burns and slowhealing wounds.

8. Ozonated oil Used primarily to treat skin problems, ozone gas is added to olive oil and applied as a balm or salve for longterm, low-dose exposure.

9. Inhalation of ozone The lungs are the organs which are the most sensitive to ozone. Physicians who use medical ozone notify that inhaling ozone into the lungs can bring about alterations in the density of the lung tissue, can damage delicate lung membranes, irritate the epithelium in the trachea and bronchi, and can lead to emphysema. They caution users that no ozone should escape into the room in which it is being used. Modern medical ozone generators are particularly designed so that the accidental escape of ozone gas cannot take place. Dr. Stephen A. Levine, the co-author of Antioxidant Adaptation, cautions people against using commercial air purifiers which generate small amounts of ozone to clean the air, since ozone should not be inhaled.

SAFETY ISSUES •

There has been a reported case of death due to air embolism during the use of ozone in the treatment of psoriasis (Marchetti & Monaca, 2000).

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Hepatitis C and HIV infections have also been reported following ozone autohaemotherapy (Daschner, 1997).

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A more recent cross sectional study demonstrated that transmission of HCV infection due to cross contamination occurred amongst 6 out of 31 patients who were exposed to autohaemotherapy or intramuscular injection in an outpatient department of a hospital in Italy (Faustini et al 2005).

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It has been reported that a 45-year-old woman complained of acute bilateral visual loss after intra-discal and peri-ganglionic injection of ozone-oxygen gas mixture for lumbar disk herniation (Lo Giudice, 2004). Corea (2004) also reported a case of vertebrobasilar stroke after treatement with ozone-oxygen for lumbar disc herniation.

EFFECTIVENESS Proven Cases

HIV and Infectious Diseases •

An anonymous report claimed that ozone together with oxygen can inactivate the HIV virus. In 1993, Carpendale et al reported the efficacy of ozone in the treatment of AIDS related diarrhoea. In this treatment, three out of the four patients with diarrhoea of unknown etiology treated with daily insufflations of medical ozone, experienced complete resolution, while the other patient had marked improvement.

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A non-randomized controlled study in patients suffering from Hepatitis A, B or C demonstrated that all 40 patients who received ozone were totally cured of hepatitis, and the rate of healing was faster in this group, but there was no mention of the breakdown of patients infected with hepatitis in the respective groups (Betancourt et al)

Ischaemia •

While there have been a number of reports on the effectiveness of ozone in the treatment of limb ischemia (Sroczynski et al, 1992; Turczynski et al, 1991; Maslennikov et al, 1997; Tylicki et al, 2001; Tylicki et al, 2003; Biedunkiewicz et al, 2004), these were small non-randomized clinical trials, from a few centers mainly in Poland and Russia. Tafil-Klawe et al (2002) study involving 62 patients with lower limb ischaemia, of whom 32 patients were treated with ozone whereas the remainder were treated with traditional balneology, found better results with ozone.

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A study of 85 patients with ischaemic, conducted by Kotov et al, treated with ozone demonstrated a decrease in the intra-cerebral blood circulation asymmetry, increased cerebral circulation reactivity and a functional restoration in the circle of Willis.

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Another cross sectional study of ozone therapy in patients with progressive angina pectoris resulted in elimination of non-stable conditions with significant reduction of coronary insufficiency symptoms (Shaarov et al).

Ophthalmology •

A double blind RCT involving 123 subjects suffering from retinitis pigmentosa demonstrated that ozone treatment was effective, although its action is temporary (Moreno et al). A cross sectional study by Mapolon et al reported diminution of photophobia and phototopsia in all 50 patients with retinitis pigmentosa treated with ozone.

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Likewise, another study by Diaz et al comprising of 180 patients with different ophthalmologic diseases like retinitis pigmentosa, myopia, chronic open angle glaucoma, optic atrophy and diabetic retinopathy were treated with daily rectal ozone therapy, demonstrated improvement ranging from 23%- 63% at followup over one year.

Ortholaryngology •

In a small randomized controlled trial by Basabe it was demonstrated that there was improvement in audiometry, electrophysiological threshold and the latency of the wave V to 90 DB for the same ear, in a great percentage of children that received ozone therapy.

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A cross sectional study of patients with chronic purulent mesotympanitis treated with ozone in Russia, observed inflammation control of mucous membrane, discharge reduction and restoration of auditory tube function (Shakov & Edeleva 1996)

Obstetrics and Gynaecology •

Two unpublished non-randomized controlled trials demonstrated that the patients with caesarian sections treated with ozone had less infectious complications compared to controls (Kovalev & Clemente-Apumayta, Kovalev).

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An unpublished cross sectional study by Kachlina reported that the maximum positive effect of ozone was seen in those patients with intrauterine infections without signs of inflammation compared to those with signs of inflammatory process.

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Similarly, another unpublished non-randomized controlled trial noted benefits in patients with various puerperal diseases in postnatal period treated with ozone compared with the control group (Kachalina et al )

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Two cross sectional studies using ozone therapy in the treatment of female infertility and for endometritis showed improvement. However, these studies had small sample sizes (Mello & ‘Mello;, Gretchkanev et al - unpublished article)

ADVANTAGES •

It is a relaxing and non-invasive approach to ozone therapy

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It cleanses the skin, pores, and lymphatic system

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The user will take advantage of 2 therapies at the same time: sweat therapy and ozone therapy (both individually with their own health benefits)

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Users feel clean, refreshed, and rejuvenated

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The therapeutic use of ozone has an excellent safety record and no toxic effects have been observed from clinical use

DISADVANTAGES •

Ozone therapy should be performed only by physicians after an appropriate training in ozone therapy using a precise ozone generator equipped with a well-calibrated photometer

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Ozone therapy is not a panacea although it looks like it because it is mostly based on the use of ozonated autohemotherapy (O3-AHT) that consists in exposing the patient’s blood to precise concentrations of ozone ex-vivo

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The concentration of ozone should be taken into account seriously as the excessive exposure of the ozone to the patient will result in undesirable conditions.

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The uses of PVC bags for ozone therapy is prohibited by Ministry of Health because ozone can withdraw a huge release of plastic microparticles and phthalates

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Ozone inhalation can be toxic to the pulmonary system and other organs. Known side-effects are epiphora and upper respiratory irritation, rhinitis, cough, headache, occasional nausea, and vomiting. However, complications caused by ozone therapy are infrequent at 0.0007 per application

CONTRAINDICATION Caution against the use of ozone therapy in the following conditions: 1. acute alcohol intoxication 2. recent myocardial infarction 3. hemorrhage from any organ 4. pregnancy 5. hyperthyroidism 6. thrombocytopenia 7. ozone allergy 8. Severe anemia 9. Cramping or spasms 10. After recent heart attack

If at any time during the use of ozone pressure is felt in the chest, indicating the change in hydrostatic pressure in the lungs, treatment should be discontinued instantaneously. The pressure dissipates shortly without harm. Ozone amplifies the effect of drugs and supplements due to increased cellular absorption. Hence, the dosage of other medications may need to be dramatically reduced to avoid overdosage. Moreover, ozone should never be used in the presence of ether, as the combination of these two compounds is explosive.

CONCLUSION Records said that the therapeutic use of ozone has excellent safety to the users from the view of the clinical use. However, it is still cannot be suggested that the ozone therapy has an upper hand compared to the available conventional therapeutic modalities.

REFERENCES 1. Ozone Therapy Clinic, Lot 182, Tingkat 1, PKNS Complex, Shah Alam, Selangor Darul Ehsan 2. http://www.malaysiayellowpages.net/medicalozone/index.htm 3. http://www.creativeozone.com/index.html#whatisozone 4. http://www.silvermedicine.org/ozone-therapy.html 5. http://www.ozontip.com/home.php?do=hekimlericin 6. http://www.ozonetherapy.biz/ 7. http://www.ozone.com.my/ 8. http://www.ozonehospital.net/ 9. http://medical-dictionary.thefreedictionary.com 10. http://www.tuberose.com/Ozone_Therapy.html 11. http://www.garynull.com/Documents/ozone.htm 12. http://www.thejcdp.com/issue040/nogales/03_page.htm 13. http://www.ioniczone.com/ozone-therapy-s/123.htm 14. http://altmed.creighton.edu/O2tx/ozone_therapy.htm