Under Construction with much more to come
I agree with the innovative Italian MD and researcher, Velio Bocci that ozone is the cheapest drug in the world, offers valuable health benefits, is only minimally utilized by our medical professionals and is often very antagonistically treated or suppressed by many medical authorities. Ozone falls into the category of what is called oxidative medicine. Oxidative medicine seems to be still on the fringes of mainstream USA medicine, but slowly the truth is coming out from a ocean of hype & misinformation. The FDA's reluctance to approve ozone protocols certainly doesn't help out this situation and, most certainly, their prosecution of some USA practitioners giving ozone intravenously has given the whole genre a black-eye in this country. Shame and our loss! Ozone cannot be patented and it is very easy to produce! Probably two reasons why capitalistic medicine has not embraced it. Oxidative medicine is commonly employed in Europe and here in the Americas only primarily in Cuba--particularly where socialized medicine favors effective cheap alternatives. It has been battle tested since the 1880's and hardly can be considered a new arrival as a healing protocol. Side-effects can occur in ozone therapy as in any therapy which is more a fault of the practitioner not fully understanding the modality well rather than true danger. Side-effects, many lethal, occur in all types of legal medication, but these are rarely heard about in the press. On the other hand, come up with a rare case of a chiropractor giving ozone iv resulting in harm, it is sensational and quackery! Ozone therapy is one modality that we should look and study very closely in trying to produce a better racehorse and certainly utilize in rehabbing an injured one. It will offer unique healing advantages and is cheap to administer. Since we are interested in medicinal ozone in a veterinary context, we will be less bothered by the FDA and other medical authorities which is a plus. I will attempt to cut through the haze of information on this subject and present to you what I deem to be the best truth at this time on the value of ozone therapy particularly as applied to race track medicine.
First off, what is ozone for those of you not very scientifically knowledgeable? It is simply a form of oxygen and we all know how important oxygen is to life and health. One oxygen atom, ( 01 ) is a very unstable atom and does not exist very long in nature in its one atom form. The common form of oxygen and the most stable in our world will be the two-atom configuration which we all know and love and breathe ( 02 ). Occasionally in nature, one will find another prevalent form of oxygen known as ozone. It is simply a three-atom configuration which is still rather unstable, yet it can stick around long enough to be very useful ( 03 ). Ozone makes up the upper gas layer that protects our earth's atmosphere and is produced in nature by the sun's UV radiation on regular oxygen along with the lightening's affect on atmospheric oxygen. As a side note, this is how we can artificially produce ozone in the lab, barn or home. By simulating the effect of lightening strikes in the presence of oxygen, we can produce ozone. I will describe this technique later when considering ozone generators.
What can ozone do for our racehorse's health? Much, but if you are one of those race trainers looking for an easy edge, don't bother! Ozone is not a performance enhancer in the sense you are looking for. I am afraid that short-cut trainers will think ozone will be a performance enhancer and ultimately will give this useful gas a bad name. If you do your research into athletic performance science studies and not fall for hype from people that want to sell you something, you will find out that trying to improve an athlete or racehorse with oxygen before a performance has been done and was deemed of little value. In fact, there are a number of accounts of pro-athletes that pre-treated with oxygen before competition to be adversely effected, exhausted during performance! Performance enhancers can only help recovery after an event, not the performance itself and ozone is no exception! Ozone can aid in equine health and recovery, not hop a horse to win, pre-race. A few brave MDs in this country have pioneered ozone in their human practice and it should likewise be considered in veterinary medicine. I will borrow from these ozone medical men in presenting to you what it can do for the injured racehorse. I think it particularly has great potential in regenerating joint and soft tissue damage in those regions and anatomical structures that often have very poor blood supply, even if one wants to sides-step the controversial IV routes of administration completely.
I think it is important to state up front that there has been recent scientific research that points to our body actually naturally using ozone in fighting infections and regaining health. It has long been known that hydrogen peroxide, another compound used in oxidative medicine was used by the body in this manner, but it was less well known that the same was true for ozone. This in itself should suggest that ozone is not the bogey man that it is often portrayed in this country.
Ozone basically complements healing and is not itself a singular factor in that function. This is an important fact to remember! Some health problems in our horses will not respond to oxidative medicine because that horse is dealing with an injury that is not caused or exasperated by a lack of oxygen. Remember that! If you properly use ozone or oxidative medicine in general for those injuries that are based in the realm of oxygen mechanics then you can generally expect good results from its use. Ozone can also be very helpful in battling many infectious pathogens where our common antibiotics fail. Keep it in your bag of tricks when fighting hard to cure cases! You and your horse will be rewarded.
Ozone acts as an:
1) anti-infective . . . . . . . it is well known that ozone will kill a broad spectrum of pathogens on direct contact (as small of concentrations as 0. 01 ppm) and is why our body uses it to kill such pathogenic organisms. Ozone ruptures the cell walls of bacteria, damages the fatty acids in the cell membrane and oxidizes the cellular macromolecules as proteins and DNA. It is also considered an effective fungicide and virucide with inhibitory action for protozoa. There may be another mechanism to its anti-infective action inside the body. Dr. Bocci MD thinks the benefits of ozone is more of a immune stimulating function which I will explain next.
2) stimulate the immune system . . . . . . .according to Dr. Bocci, MD, ozone infused into the blood will react with the blood's components to produce hydrogen peroxide, ROA (reactive oxygen species), LOP (lipid oxidation products) . The ROS will stimulate the red blood cells to carry more oxygen, the white blood cells to more actively engulf viruses, bacteria, and fungi, and stimulate the blood platelets to release growth factors. The LOPs is important in tissue regeneration and the up-regulation of antioxidant enzymes which in turn can be health stimulating in a contradictory way. LOPs can also stimulate endogenous stem cells needed in tissue repair.
3) stimulate healing . . . . . . . . . of course, a strong immune system is an aid in healing, but ozone goes beyond this. Ozone can put more oxygen where it is needed than nature can on its own. It supercharges the red blood cells to carry more and causes the red blood cells to disassociate oxygen from hemoglobin for better oxygen delivery. Oxygen is a must in most all healing! As stated previously, the ozone stimulation of LOPs stimulate stem cell production, a must in healing.
4) anti-neoplastic & anti-cancer . . . . . . . . . ozone has anti-tumor properties which is what a neoplasm is. Ozone has been shown to inhibit neoplastic cell growth upon injection. It s believed that tumor oxygenation tends to inhibit aggressive varieties of cancer and improve survivability.
5) oxidize toxins . . . . . . . . . ozone is well known for oxidizing all types of toxins which is why it has many applications to purifying municipal water supplies.
6) enhances red blood cell flexibility . . . . . . . red blood cells needs to have a deformability factor to travel through the very small capillaries found in the body. This requires the red blood cells to go single file through these small vessels while at the same time actually bending to allow easier passage. One research project found that slight peroxidation by ozone produced a more flexible red blood cell. However, other studies found no difference. Yet another study found that rectally insufflated low dose ozone caused a favorable increase in flexibility of the red blood cell proportional to duration of treatment. So jury still out on this one, but if there is a chance of RBC enhancement, then we probably should employ ozone until concrete results are discovered.
7) enhances the kreb's cycle . . . . . . . the kreb's cycle, also known as the citric acid cycle is important in that it allows the horse and us to generate cellular energy. Ozone will accelerate this cycle.
8) anti-inflammatory and analgesic . . . . . . . . ozone stimulates the production of interleukins, leukotriene's and prostaglandins which is key in reducing inflammation and pain. Ozone can discourage the production of inflammation mediators, oxidizes pain mediators, and improve blood and oxygen circulation.
9) stimulates an anti-oxidant effect . . . . . . . . . as contradictory as it sounds, an oxidant like ozone can actually stimulate anti-oxidant behavior and this can be very good. What happens is when the body is stimulated by a therapeutic dose of ozone, the body quickly compensates for this by flooding itself with various anti-oxidant enzymes.
Administration Routes of Ozone:
First off, know that ozone gas should not be breathed. It is an irritant to lungs, but lungs are about the only anatomical structure that doesn't benefit from controlled ozone dosage. If you make it on the premises preceding administration to your patient, be careful that you or your patient do not to breath much of it. The more sophisticated medical ozone generators have built in ozone reabsorbers or washers to prevent excess ozone escaping into the air.
1) Soft -tissue and joint capsule injections . . . . . . . . often known as "prolozone" therapy which is derived from the Latin word "proli" which means regeneration by the use of ozone. Intraarticular injection is what I am most interested in and has great potential of treating many racehorse injuries of the joint, primarily the hock and knee. However, soft-tissue local injections may also have much promise in treating hard-to-heal flexor tendon and suspensory ligament injuries. It appears ozone can aid in cartilage regeneration.
2) Rectal enema . . . . . . . . . . . . . . . . . also known as rectal insufflation has been employed since the 1930s and is often considered a very safe and valuable form of ozone administration. A number of veterinary clinics have employed this in their small animal practice as well as equine. It is probably the safest and easiest way to get the benefits similar to ozone IV administration without the possible dangers and complexity. A 2011 British Clinical Pharmacology study seemed to show that ozone rectal insufflation actually improved portal vein oxygenation to the liver as is to be expected. The peyer's patches are found in the intestines and act as the primary lymph tissue in the horse and many other animals.
3) Intravenously . . . . . . . . . . . . . . . . . . commonly practiced in several forms and the most controversial of the many delivery methods here in the USA. There are primarily four forms:
a. ozonated saline drip . . . . . . . I consider this probably one of the simplest and safest methods to supply ozone intravenously. It was pioneered by the Russians who seemed to have had much success using it. The danger of embolism as may be the possibility in the other methods does not factor here. It is generally made by bubbling medical grade ozone into a saline solution and then injecting it into the patient. Another method is to fill a syringe with ozone and then draw your saline solution into the same syringe, shake for several minutes commingling, expel the gas in the upper most part of the syringe barrel and then inject the ozonated saline. The critics of this method suggest that the formation of hypochloric acid by the reaction of ozone with the saline solution could be detrimental. I am not so sure this is true and certainly the Russians seem not to be concerned.
b. direct intravenous injection (DIV) . . . . . this is the most controversial method of the four discussed here with supposed human deaths linked to this method in Italy. On closer examination of the deaths, taking into account the patient and other conditions, I am not so sure that this isn't more of a smear campaign than truth telling. Nevertheless, when in doubt, it may be the best policy to proceed with caution and using this method should be carefully weighed with all risks. I think it may have much value in last ditch attempts to fight infections in animals. It is an easy method to use and administer, but there may be a danger of embolism. Certainly, Janet Shoemaker DVM seems to like this method and has written that she has had success using it on horses and this was the method of choice in curing ebola in Africa.
c. major autohemotherapy (MAH) . . . . . . the removal of a large volume of blood, around 50-100cc using sodium citrate as an anticoagulant into a sterile bottle. Ozone is swirled through this blood at 10-40 µg/ml, then it is dripped back into the patient. This method is considered very safe and favored by most ozone specialists in the field. It is rather complicated to employ and offerers challenges for those not equipped. Ozone will activate red blood cell metabolism and oxygen release, release interferon and interleukins, stimulate the immune system as well as modulate it.
d. minor autohemotherapy . . . . . . this technique may be of value for us and is much simpler to utilize than the MAH. This involves removing 2-5 cc of blood, drawing it into a large 30cc syringe that already contains 10cc of ozone at 10-20 µg/ml. Shake vigorously and re-inject back into the patient. Always fill the syringe first with ozone, then blood! Never the other way around!
4) intramuscular injection . . . . . . . . . . small amounts of ozone injected into the muscle bundles. It is often used for allergic reactions and inflammatory conditions in humans. I think this method would be a superb protocol for upper rear-end muscle soreness often observed in the racehorse and which was treated in the past by internal blisters. I would inject 1-3 cc at a strength around 10 µg/ml in a large number of sites over the rear end muscles, hitting some of the acupuncture points.
5) ozonated waters and oils . . . . . . . . . . . . . this is the process of bubbling ozone through water or an oil with a diffusion device of some type. Ozonated waters are used in the human sector for various infection and inflammatory conditions, i.e. ulcerative colitis, ulcers, gastritis, scours, G-I and genital tract infections, skin infections, etc. Ozone can also be bubbled through oils such as olive oil, sunflower oil, coconut oil, etc for a medical type salve for skin problems/infections. Ozonated oils have also been taken internally for ulcers, gastritis, and other internal infections seen in the G-I tract.
Ozone can be generated for our purposes in basically three ways:
1) corona discharge tube . . . . . . . this is probably the most common method to produce ozone and consists of a tube (cathode charged) surrounded by a metal anode. They tend to have a short life, burn out easily, but are commonly found in most of the ozone generators on the market. They require a cooling fan. Parts are fairly economical to purchase.
2) ultraviolet light . . . . . . . . . . . . . . this generator uses an ultraviolet lamp to produce ozone. UV lamps are prone to burning out plus they produce very low amounts of ozone.
3) cold plasma tube . . . . . . . . . . . . . this method uses glass rods filled with a noble gas and energized with high voltage to create ozone. The original design was developed by Nikola Tesla and later improved upon. These tubes never burn out, produce an ultra pure form of ozone since no metal is involved, and can run 24/7 without any type of cooling. These are the most expensive, found in the better medical grade generators.
So what are we looking for in a medical grade ozone generator? We need a small size, one that runs cool & silent, capable of producing very pure ozone minus the impurities and at specific concentrations. We need it to attach to an oxygen tank system capable of low flow output settings. Your run-of-the-mill ozone generator will not work for our purposes. Most medical grade generators are rather expensive, easily pushing the $3000+ price tags. For the money, the best bare bones medical unit I have found is the Synergy WPS-400. It uses the preferred cold plasma tubes. It has 42 separate concentration settings from 5.4 µg/ml up to the maximum of 118.5 µg/ml. The list price is US$999.00. The company also sells a lower cost unit, the WPS-100 at US$499.00. This unit has 21 settings ranging from 5.4 µg/ml to 79.9 µg/ml . For most of us, the WPS-100 has quite acceptable output levels for most of the common ozone procedures we will encounter. Attach either unit to an oxygen tank with a pediatric regulator and we are set to go.
Lets review some of the pitfalls of ozone. As you may gather, ozone is not a stable structure and we need to be able to manufacture it on site for immediate veterinary use. It typically has a half-life of 55 minutes in a 60cc disposable syringe. Dr. Frank Shallenberger says ozone deterioration is even greater at 50% in 30 minutes in a plastic syringe. That is not a long time! Ozone also is affected by temperature and air humidity. Those that use ambient air to make ozone soon find out that air with high humidity is very detrimental to ozone production. One needs dry air for best results. One will also find that since ambient air consists of only 20% oxygen, shooting atmospheric air into an ozone tube is not very efficient in making high levels of ozone. One needs pure oxygen for the best ozone production! If you do much research on your own on ozone therapeutics, you will soon discover that many recommended procedures require you to either bubble ozone through water or some similar solution before use. Other procedures require you to use water to "humidify" the ozone before or during use to prevent tissue irritation from "burning" etc. It has been shown that ozone can easily be absorbed by water and accordingly deactivated resulting in very low output levels! A test was performed in the 1990s that showed that when one bubbled ozone at 17.2 µg/ml at a flow rate of .5 liter per minute through 8 ounces of water that the output of ozone was way below the initial 17.2 for as long as 12 minutes afterwards. The water must first be saturated before output can match desired levels because of absorption and deactivation! If you do humidify ozone before use via a humidifier, it may take a number of minutes to achieve proper ozone output. Do not begin treatment immediately! Just be aware that water is an enemy of ozone levels! In addition to humidity, ambient air contains nitrogen which opens the ozone generator up to producing nitrogen oxide byproducts which must be avoided for medical purposes. Also, it is best to know that a ozone generator should be in operation for at least 5 minutes before a stable concentration is being produced. Do not use initial production ozone/oxygen gas.
Just to be clear here on how ozone is produced, one needs an air supply to be pushed past the high voltage tube where ozone is produced in order to get an output of ozone containing gas. Three systems are commonly used for this purpose. One is a simple air pump, similar to an aquarium pump that pumps the outside ambient air into the tube for ozone formation. The second commonly used air source is a medical grade oxygen concentrator which though may produce a high quality oxygen output--,it may still contain some ambient air nitrogen levels. And lastly, the third system is a pure medical grade oxygen cylinder with a flow regulator. True medical grade ozone must be produced with an oxygen tank. Some use an oxygen concentrator, but that won't really do. One needs an oxygen tank and a low flow regulator for true medical grade ozone production. To quote a Viebahn-Hansler article: "...it is not acceptable to use oxygen concentrators or oxygen/air mixtures due to their nitrogen component and the consequent possibility of nitrogen oxides being formed in the discharge tube."
Since we have established that USP grade oxygen is what we must use for our ozone generator, how can we obtain oxygen cheaply and easily? In the past, gas suppliers typically maintained two separate storage facilities for oxygen: welding / industrial and USP medical grade oxygen. Since most gas vendors have decided that it is simply not cost-effective to store separate grades of gas, almost all oxygen sold in the USA is now a USP medical grade. However, there are distinct differences in how the cylinders for each grade are filled and handled. So, the debate as to whether we can exchange a non-USP welding gas or a USP medical grade oxygen for medical procedures is mostly irrelevant since most vendors are now filling all cylinders with USP gas. Tank handling may or may not be of some import. The main "special handling" a medical grade tank undergoes is that it is always evacuated before refilling to be on the safe side in avoiding contamination. This removes all possible outside air that may have seeped in when a tank is emptied and opened to the atmosphere which could contaminate the pure oxygen on filling. No doubt, it may be best to follow procedures by obtaining a prescription and paying premium prices for USP oxygen, but I suspect in a pinch, one could simply use industrial grade oxygen in most instances as a close second. If you have a medical oxygen tank with the proper transfer fitting, one can simply fill from an industrial tank. This is particularly true if you shut the valve when the tank becomes low and never allows it to open to the atmosphere until actually connected to the refill tank. In the end, it is of some debate how much contamination is possible from most properly handled tanks even if medical or industrial? You be the judge.
Note of caution: Be careful of the materials that come into contact with ozone! Many common materials, particularly the plastics will break down in the company of ozone. Latex degrades rapidly upon ozone contact. Ozone can be highly corrosive. All tubes coming out of an ozone generator should be ozone resistant such as Teflon (PTFE), polyethylene (PE), polypropylene (PP) and silicone. When using syringes, make sure the pistons are silicone-coated. Never use blood bags of soft polyvinylchloride (PVC)! Use only glass for long term storage.
Below are photos of my WPS-400 system. The first shows a simple connection via silicone tube to a syringe for a syringe filling protocol. However, the better system is to have a luer lock and cut-off valve tubing system with a ozone destructor attached as pictured further below. One can make this fairly simply and at low cost. It is best to have an ozone destructor attached to this system to allow a steady output of ozone between syringe refills. A luer lock shut-off valve is attached to one end of the feed tube with the ozone destructor to the other. The ozone destructor changes toxic ozone gas into oxygen and can easily be made as well from PCV pipe, silicone tubing, a few fittings, and a catalyst made of manganese dioxide and copper oxide. All of these parts and chemicals can be purchased on eBay. For a DIY ozone destructor:
1) 12" of PVC one inch tubing,
2) two end fittings for the PCV pipe that have threaded caps for easy removal, cleaning and recharging. One cap has the brass barb fitting attached and the opposite cap is drilled with ventilation holes,
3) a brass 1/8" air barb fitting and a three-way 1/8" barb fitting
4) a synthetic cotton type of material or loose weave cloth dusted with Manganese Dioxide (2/3) and Copper Oxide (1/3) and packed in the PCV pipe.
Concentrations & Dosages:
Medical grade ozone generators generally have the capability to produce ozone from 1-100 ug/ml. Dosages and concentrations often use the term, "µg/ml" which is equal to micrograms of ozone per milliliter of solution.
1 ug/ml = 1 mg/l = 1 g/m3 = 1 gamma
Paracelsus is famed for saying: "What is there that is not poison? All things are poison and nothing is without poison. Solely the dose determines that a thing is not poison." This certainly applies to the use of ozone! Whether ozone is therapeutic or toxic is solely determined by its concentration and dose! Ozone has been medically used for well over 100 years, but it was the Russians that found low dose ozone to be the most efficacious. It is important to note that the slower the output of oxygen to the ozone generator, the more concentrated will be the ozone per ml of oxygen. This is why we need to employ a low-flow oxygen regulator when using a medical grade ozone generator. These low-flow regulators are often used in pediatric systems and may be sold as a pediatric regulator. They have air flows of 4 LPM or lower. We are interested in regulators that can perform at 0.03, 0.06, 0.12, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4 LPM rates. The Drive, Pediatric CGA 540 Oxygen Regulator may be a good economical choice for our needs.
GENERAL EFFECTS OF DIFFERENT OZONE CONCENTRATIONS
1 to 55 ug/ml (< 3.5%) . . . . . . . . At this concentration level the 3 main health restoring properties of ozone are: 1) Oxidative influence on the oxygen metabolism (enhanced ATP production ), 2) Increases antioxidant enzymes in the body, 3) Activation of immuno-competent cells to stimulate the immune system --causing the greatest increase of immune system messengers interferon (50ug/ml gives greatest increase), Tumor Necrosis Factor(TNF) and Interleukin-2 (IL-2), setting off a cascade of positive changes throughout the immune system..
55 to 69 ug/ml range (3.5-5%) . . . . . . . . . . .Exhibits a strong germicidal effect by oxidative destruction, useful for killing bacteria, viruses and fungi, topically and internally, which makes ozone ideal for treating infected wounds, intestinal infections, vaginal infection and topical fungal diseases
> 70 ug/ml (>5%) . . . . . . . . . . . . . .Shown to suppress the immune system and inhibit tissue generation. Only applied the larger concentrations to ozonating water and oils--plus some topical applications.
Closer Examination of some Promising Protocols:
I will tell you up front, unlike most trainers, I am not the least bit interested in pain relief nor too much in antinflammatory medications when it comes to training race horses, but I am vitally interested in joint regeneration! I think this procedure may offer some of the best therapeutical hope for injured racehorse joints than any thing to this date! This procedure is also known as "prolozone" therapy and is currently being used by Dr. Frank Shallenberger MD and Dr. Robert Rowen MD among many others to much success in their human practices. A few vets are doing it as well. Dr. Rowen has many YOUTUBE videos of case studies and I urge you to do a little research on what he has accomplished.
Intra-articular ozone Injections
It is believed that ozone intra-articular injections can regenerate joints while not only relieving pain though there has been no widespread studies to definitively prove this illusive goal in the journals. There are anetodal sets of x-rays that seem to suggest this in a "before" and "after" format showing cartilage regeneration. If these are legit? they are impressive, but I have long been a skeptic of the truth telling of most radiographs. X-rays can be deceiving and are highly dependent on the technical skills of the practitioner to my way of thinking for truthful diagnosis. However, these may be legit. One thing is for sure, human patients treated intra-articularly with ozone seem to be very happy people!
Prolozone therapy in the past seemed to have involved injecting a soup of compounds into the joint of which ozone was only one. Such components may include a formulation of procaine, anti-inflammatory homeopathics,
vitamins, minerals, proliferatives, and the signature ozone/oxygen mixture. I am not in favor of that and feel ozone should be able to stand on its own merits. Dr. Rowen seems to have limited his prolozone injections just to the ozone and procaine with a few exceptions of ozone only. I like that! Procaine was commonly used to numb the sting of ozone in its initial minutes of application to a joint. I don't think this is necessary in the horse, nor really most humans for that matter and may only cloud the issue. Certainly in the racehorse, we don't want procaine floating around in the system as it could easily cause a positive drug result. Ozone will not. So on this page, I only endorse the injection of a ozone/oxygen mixture, nothing else.
What can ozone theoretically do for a joint? It is Dr. Frank Shallenberger's theory that ozone therapy works by oxygenation of impaired joint tissue. Between the area of dead joint tissue and healthy tissue, there is a localized layer of tissue that is trapped in a state of impaired oxygen utilization. This tissue is not dead, but it is non-functional. Restoring oxygen utilization to these cells will often result in significant clinical improvement. Ozone improves oxygen utilization in a localized area of damaged connective tissue allowing it to heal and to restore full function. A similar healing phenomena also occurs in Myocardial hibernation and cerebral infarct. Shallenberger goes on to write: "Ligaments and joints are notoriously known as areas of decreased oxygen tension. The oxygen tension in a healthy ligament is often only one-tenth that of the tissue only several millimeters away from it. The same is true for joints. These areas are setups for developing a situation that involves a localized area of decreased oxygen utilization." So if athletic injury occurs in this joint, trauma stimulates edema & inflammation resulting in a further localized decrease in oxygen utilization. This decrease in oxygen utilization produces a localized increase in lactic acid production, free radical damage, and necrosis which serves as the foundation for further injury. A cascade of injurious processes follow of even more edema, inflammation, and decreased circulation resulting in further oxygen starvation. Even though stem cells and blast cells are present and waiting along with growth factors being released, healing does not occur. None of these natural healing mechanisms can be effective due to a lack of adequate oxygen utilization. It doesn't stop here. Ozone also has been shown to mediate, enhance, and promote growth factors important in tissue repair and regeneration. Lastly, there may be other factors involved that serve a purpose unique to ozone. For instance, because one is injecting a gas and not the usual liquid, gas by its nature can expand and cover all facets of the joint surface unlike a liquid which may pool or be restricted to coverage in the joint. Also, lets not forget that ozone is very anti-microbial and anti-toxin in nature. This action is not to be underestimated in therapeutic importance, particularly in case of infectious pathogens!
The results which can be expected from ozone injection are pain relief, anti-inflammation, healing and regeneration of damaged tissue. Lamberto Re, a soccer team physician in Italy routinely injects his team's injured joints with ozone without procaine resulting in improved healing and pain relief. Chronic areas of degeneration as seen in osteoarthritic knees, hips, and ankles will regenerate.
When injecting ozone/oxygen mixtures, always observe as aseptic technique as possible while also carefully scrubbing injection sites. Generally, 2-20 ug/ml concentrations are used in 1-20cc dosage volumes per joint. Treatment may be 1-2 times a week.
Direct Ozone Intravenous Injection (DIV)
This method has been employed world wide with criticism from many of the medical governing bodies. However, it was the preferred method of choice to deliver ozone to Ebola patients during a visit of Dr. Robert Rowen to Sierra Leone in 2014 where all four subjects had their symptoms dissipated in from 2- 4 days. The most amazing cure you probably never heard of! Read about it in the Journal article: RAPID RESOLUTION OF HEMORRHAGIC FEVER (EBOLA) IN SIERRA LEONE WITH OZONE THERAPY. DIV is cheap, easy to administer and worked out very well in third world countries which would be equal to conditions often found on the farm and other similar places.
I am not going to throw this modality out like most all of the ozone health professionals in the human sector, but I am going to save it for only serious veterinary situations which I feel can be life saving. This is the controversial method that involves injecting a volume of an ozone-oxygen mixture from a syringe directly into the vein. Few ozone practitioners will administer this method in preference for what they deem "safer" methods of bubbling ozone first into blood and then injecting that ozonated blood back into the patient or by bubbling a saline solution and injecting it. They primarily reject this method for the fear of possibly creating an embolism in the blood stream which could lead to death. I have searched the literature high and low for medical ozone deaths from emboli and have only come up with a few "bad experiences" occurring or three dubious Italian death cases not well documented. Velio Bocci writes in his classic text, Ozone, The New Drug, that two Italian women were killed by emboli during an ozone treatment for psoriasis. I am unable to find any precise details though one seemed to have had a congenital heart abnormality, but this certainly has turned Bocci off of the method. A 1983 German study on ozone adverse effects only found the direct IV method to show problems--whatever "adverse side effects" means and whatever their procedure was? Dr. Frank Shallenberger, the pioneer of ozone medicine here in the USA won't use it saying he has had some bad experiences with it. A study of dogs being injected was shown to have died from pulmonary emboli, but it was never clear what type of air was injected. And it goes on and on like this. Try to read in detail about specific cases and you will likely come up empty. So be it. I will save this method for a life and death situation of infection in a horse where death seems eminent and employ it gladly. For less dire cases, there are no doubt safer modalities.
The fear that an embolism can easily occur and cause death from an injection of a large volume of air is an idea that is very rampant in the medical field. Some ozone practitioners will disagree and say emboli is a factor of the nitrogen component of air, not oxygen. That the air we breath and work with contains 78% nitrogen and only 21% oxygen. Inject ambient air and you inject 78% nitrogen into the blood stream. Injecting a large volume of either ozone or oxygen into the blood stream from a USP tank will not likely cause death simply because there is no nitrogen present which cannot be absorbed by the blood. Perhaps this is true to some extent? However, blood can only absorb so much gas no matter which kind and it is conceivable to me that one can have the possibility of injecting a large volume of gas no matter if it is oxygen or ozone which cannot go into solution very easily and problems may result. However, all ozone direct iv people are usually very strict on how slow they inject. So how much of a danger this would be is debatable. Thus, I will resort to this method only with caution as a last ditch effort to save a life about to be lost. Check out the below YouTube video of a chap that injects himself directly with an ozone mixture without side-effect. I think you may be impressed, but he may be dealing with fire?
I do think that blood emboli is the white ghost of the medical community. Everyone has heard about it and fears it, but no one has actually seen it. It is rampant in fiction, be it movies, tv or novels, but in real life, it seems a myth. It might be enlightening to look to one group of people that know all too well the lethality of emboli for some shade of the truth on the subject? Scuba divers are very familiar with what was known as the "bends" or more appropriately called decompression sickness. The mechanism is a little different, but the outcome is the same. Bubbles of air form in the blood stream with disastrous results. What do we know about decompression sickness? It was discovered back in the 1880s that the emboli from the bends was 100% nitrogen during its onset. Bubbles are made up of inert gases which can come out of solution quickly. Oxygen and ozone are not inert gases. It is an interesting tidbit that if one pre-breathes 100% oxygen before going up high altitudes then this will reduce the chance of decompression sickness. What is the treatment for decompression treatment? Oxygen! Enough said! Maybe the ozone/oxygen versus nitrogen point is indeed truer than false?
The second consideration to carefully consider with direct IV administration is rate of injection. If you do much research, you will find rates all over the place with each practitioner believing that his rate is slow and safe. Perhaps it is or is not? My view is we need to study this a bit further and maybe come to some safe conclusions. Dr. Bocci writes that oxygen solubility at 98.6°F is only about 0.23 ml per 100 ml of plasmatic water and therefore venous plasma. Lets use this as a guide to how fast we should inject ozone/oxygen into the blood stream safely. There will of course be variables and unique individual anomalies which could upset these suppositions of blood solubility, but it is at least a guideline based on general scientific evidence of a point we should not pass. Thus, we know it takes 100 ml of blood to absorb 0.23 ml of oxygen & ozone. We have to figure out the cardiac output to know how much blood is being pumped past the IV needle which is releasing our gas into the blood stream. The cardiac output of a resting equine is said to be around 75ml/min per Kg of body weight. Therefore, a 1000 pound horse would pump approximately 34,000 ml / minute pass that needle. In theory, at that rate, 78.2 ml of oxygen/ozone could be given per minute with the blood just being able to absorb it. Dr. Shoemaker below in her monograph writes that she does it at 1-3ml per second (60-180ml per minute). A human has cardiac output of approximately 5000ml per minute which means that 11.2 ml per minute of oxygen is the upper rate of solubility for the human blood stream. Dr. Robbins in his below protocol does it in humans at 1ml per 5 -15 seconds depending on the size and resistance of the vein. If we go the fast side for Robbins, that would be 12ml per minute--considerably slower than Shoemaker, but then the horse has a larger jugular than the human and a higher cardiac output. The YouTube video ozone injector below says he does it at 10cc or ml per 5 minutes (2 ml / minute) slowest of the lot! My conclusion is that one would not want to go pass the above injection speeds of maximum blood solubility rates to be on the safe side and probably a lot less! This would mean one would probably not want to inject more than 78cc or ml per minute in the average size horse with 30-40 cc (ml) being on the safe side.
What are the advantages and when should we consider direct ozone iv injection therapy? First, it is a very easy method to administer when compared to the others. Simply fill the syringe up and inject it into the vein. That is a plus in most emergency situations. It would be of use in all systemic life threatening infections where all other methods seemed to have failed. Dr. Janet Shoemaker has found it of value and has written an interesting monograph on the subject which I will copy below:
Ozone Administration in Horses
My method of choice for systemic ozone administration in the horse is direct intravenous infusion of 70 ug/ml ozone in oxygen. Given at a reasonable rate (1-3 ml/sec), no significant side effects are usually encountered. I have administered thousands of ozone treatments in the last ten years with minimal reactions occurring only rarely. The most common reaction is an "itchy" nose if the administration rate is too fast. I usually listen to the heart the first time a horse is given ozone as the hyper-oxygenation of the heart will slow the rate significantly and heart rates below 18 bpm can lead to syncope. In athletic horses, one and two degree heart blocks are common and will be more frequent during ozone administration. I reduce the rate of administration if blocks occur more often than every four beats, as blood pressure drops occur with lowered rate and two-degree blocks.
Judith M. Shoemaker, DVM
The hyper-oxygenation of the gut can cause increased peristalsis and some horses show a very transient gas pain reaction. This usually occurs within 20 minutes of administration and lasts for, at most, 10-15 minutes. We usually give Rescue Remedy and Nux Vomica homeopathic and entertain them, and the discomfort resolves quickly. Severely toxic horses may have skin detoxification signs in a few days. Continued treatment creates phenomenal hair, mane, tail and hoof growth (up to 1⁄2" or more per month). All animals we have treated have benefited, and many have been "miracle cures".
I have treated cases of laminitis, septic arthritis and tenosynovitis, lymphosarcoma, endocarditis, myocarditis, C.O.P.D., allergies, colic, lymphangitis, abscesses, osteomyelitis, fistulas (poll and wither), candidiasis, periodic opthalmia, melanoma, Rocky Mountain Spotted Fever, Lyme disease, Babesiosis, West Nile, EPM, herpes myelitis, sinusitis, tooth abscesses, soft tissue infections, bladder and kidney infections and chronic liver and kidney disease all with successful outcomes. Many completely resolved very rapidly, even long standing cases that had been treated unsuccessfully with the best of conventional medicine.
The procedure is simple. Making the ozone with Genesis' SST machine at 1/8 lpm flow of oxygen produces 70 ug/ml concentration ozone. Fill six 60cc syringes with the gas. Do not let them sit around, as the ozone will disintegrate the rubber of the syringe. One can use glass or non-reactive syringes; I just replace mine frequently. A 25-gauge needle (so bubbles are small) inserted in the jugular with a 24 inch IV extension set taped with duct tape is all that's needed to administer the treatment.
Give 1-3 ml/sec. and "strip" the jugular periodically during the treatment as the gas can accumulate in the empty vein as you proceed. It is almost impossible to create an embolism in a horse with this treatment, even if the vein fills completely, as the ozone and oxygen dissolve and are absorbed very rapidly.
Most often horses will look very content during and after the treatment. They soon look forward to it - especially if the first treatment is given at the rate described above and not faster. If an animal says his nose is very itchy or he seems uncomfortable after four 60cc syringes, we may reduce the dose to four syringes for 1-2 treatments. They usually tolerate all six after two treatments.
I usually recommend 8 treatments at 1-3 day intervals. I have treated animals with as many as 300 treatments over months with no side effects. Severe cases can be treated daily, but much older horses may want 2-3 days between treatments.
Even a few treatments will benefit, making other treatments more effective and accelerating healing. I often give a single ozone treatment after an adjustment and acupuncture session as the effects of other modalities of therapy are enhanced and any muscle soreness from reorganization and remodeling from joint reorientation are resolved and healed more rapidly. Ozone's effects are enhanced by Procaine and pain control is profound in some cases. The concurrent use of anti-inflammatories is contraindicated but is usually not needed, especially with homeopathic and/or neutraceuticals. One can use Palosein (orgotein) with ozone therapies.
Discussion: One can't knock success or years of experience, but its interesting that she uses a concentration of 70 ug/ml in six 60cc syringes or a total of 360 mls of ozone per treatment for what I presume is a typical 1000 lb horse. In the past, 70 ug/ml would have been the upper reaches of acceptability. Probably not so much any more with the lower concentration guidelines. According to the Viebahn-Hansler article, Ozone in Medicine (2012), the low dose concept (Hormesis) has become the proven dosage platform of choice for ozone with any dosage over 69 ug/ml considered in the toxic region. If that be the case, she is using a rather high concentration for the animal's needs and may be better off with a range around 20 ug/ml with maximum of 40 ug/ml which matches the article's MAH guidelines. Her total dosage volume is close to the recommended volume used in humans for MAH. She has a good idea about using a small gauge needle (25g) to reduce bubble size in the jugular along with a IV extension and monitoring the heart rate. Any change in the heart rate should be carefully acknowledged and treatment rate adjusted. Perhaps the commonly available equine heart rate monitors would be a very useful device to utilize when treating a horse with ozone? Lastly, it is interesting that she equated "nose itching" with a too quick administration of ozone. This might be a very useful tip and should be monitored closely. I will discuss below the concept of giving too much ozone and what can happen. However, lets look at her injection rate of 1-3ml per second (60-180ml per minute). According to my calculations above, she may be injecting a bit too fast since I feel anything over 78ml per minute in the equine blood stream may have a hard time with solubility. Her slower rates are within that range, not her faster ones. However, saying this, we do not live in a standardized world. Her horses may not have a cardiac output equal to a resting rate. As we know, vets can easily get horses' hearts racing resulting in increased blood flows able to take care of larger injection rates. It all depends.
At Dr. Howard Robins' New York Clinic, direct ozone intravenous therapy has been performed over 160,000 times in 18 years in his human practice, and he writes of no serious difficulties to this controversial method.
The Robins' Protocol (human):
A Tomco Ozone Generator is used at a 55 mcg/ml setting for all the patients in the study.
A Terumo 27 gauge winged infusion set (scalp vein set) and a Terumo 60cc syringe are used for administration.
The largest superficial veins in the forearm or hand are used along with PICC (peripherally inserted central catheter) lines at times. PICC lines require pushing some sterile saline or water through first before the gas. After pushing 5cc of oxygen/ozone gas through the infusion set to sterilize and prevent any air that might be in the tubing from entering the body, the needle is inserted into a vein. The intravenous push is performed at a flow rate from 1cc per 5 -15 seconds depending on the size and resistance of the vein. Most treatments last from 1 to 8 minutes depending upon the volume of gas delivered to a maximum of 12 minutes for 180 -240ml treatments. Smaller veins require a slower push than larger veins.
All adult patients are given 20cc at the first treatment increasing 10cc per treatment until 55cc are achieved. This volume is held until at least 10 to 12 treatments are completed. Additional volumes are given then in 10cc increments until an additional 60cc's are achieved. In some cases a total of 180-240cc are given each treatment. The amount given depends on vein tolerance, patient reaction to "kill-off", and the presenting medical problem(s) being treated. Infusion frequency is at a minimum of three treatments per week to a maximum of 12 (the Robins Fast-Trac method or RFT). RFT can be performed at a maximum of 2 treatments per day with a minimum three-hour window between treatments for no more than 6 days in a row or in any combination of consecutive or non-consecutive days. One day a week with no therapy is necessary for the body to have an opportunity to clean out the waste created by the kill off from the treatments more completely.
Volume, concentration and frequency is dependent upon: body size with smaller people being fully perfused with less gas than larger people; medical problem with more serious problems requiring more gas; ability of the individual to tolerate the waste created and not develop Herksheimer/Jarrisch reactions following treatment; lung reactions including bronchospasm or a feeling of tightness developing in the upper chest (what this effect is will be discussed later). Volume, concentration, frequency and rate of administration are adjusted to each patient's individual needs and reactions as necessary at each treatment. Over the years we have learned how to push the limits of concentration, volume, frequency and rate without causing undo vein damage or other adverse reactions. Not a single patient has ever been harmed in anyway. Every patient inducted into this protocol was fully informed of the risks and benefits and all consented to become part of our ongoing research studies.
The Robins Method uses 27 gauge needles which makes it possible to treat almost any patient easily including children. The use of this gauge needle also puts a stream of extremely small gas bubbles into the vein facilitating the safe dissolving of the gas in the blood and its attachment onto the red blood cells
Intramuscular / Tendon / ligament Ozone Injections:
Racehorses are often plagued with deep muscle soreness along with ligament & tendon injuries. In the past, an internal counterirritant such as 2% Iodine in sweet almond oil was often used to treat such injuries with excellent t results. Some suggested trigger-points can be seen to the right. Ozone could perhaps be substituted for this long used 2% iodine internal blister with even better healing results! So how might ozone work in an intramuscular application? Probably the pain relieving part is due to the production of the before mentioned ROS and LOPs when ozone is injected into the muscle fibers which inhibits the amyelinic fibres (C-nociceptors) resulting in pain relief. Also as mentioned above, the ROS and LOPs mechanism does much to set sore fiber injured muscle bundles up to regeneration and healing. Another mechanism that is not generally appreciated was formulated by Dr John Sarno and is known as "Tension Myositis Syndrome" (TMS). TMS is caused by an cellular oxygen deprivation resulting in pain in affected muscles, nerves, and joints. Oxygen deprivation at the cellular level may be helped by ozone intramuscular injections.
Generally, one would not want to inject more than a 10-20 ug/ml ozone concentration with not much more than 500 total mcg of ozone dosage per treatment. As an example, if one is injecting a 20 ug/ml concentration of ozone at a total dosage of 500 mcg per treatment---one would inject 25cc divided into 2cc individual doses. In other words, take 25 cc and inject approximately 2 cc per site along the affected muscle bundles on each side of the rear end, if one is doing both sides of the rump. This would result in approximately 12 injection sites being employed per treatment session on each side. In the end, play it by how the horse reacts.
A study published in 2009, SPINE, on ozone treatment for low back-pain in human subjects may be of interest here:
Treatment of low back pain and sciatica is a major concern. Although the natural history of acute low back pain is often self-limiting, conservative therapies are not always effective; in such cases, O2 / O3 intramuscular lumbar paravertebral injections, which are minimally invasive, seem to safely and effectively relieve pain, as well as reduce both disability and the intake of analgesic drugs.
Specific site injections around injured tendon or ligament is another possibility for ozone application. Of course, injecting into a tendon or ligament would not be practical due the dense fibrous tissue, but injecting small amounts of ozone at 10-20 ug/ml concentrations in 1-2 cc increments may be of therapeutic value around the tendon or ligament.
Ozonated Platelet-rich plasma (PRP)
The injection of platelet-rich plasma (PRP) is a known regenerative tendon and ligament protocol that can also be enhanced with the addition of ozone to release many of the growth factors that occurs in ozonated blood treatments, similarly in PRP. In the past, it took two centrifugal spins to process PRP, an initial "hard " spin to separate the red blood cells from the plasma and then the "soft" spin which separates the platelets & white blood cells from the plasma for the final product. Now perhaps just a simple one stage spin to process PRP is all that is necessary, and I suggest you study the: "Simple tube centrifugation for processing platelet-rich plasma in the horse", Can Vet J. 2012 Dec; 53(12): 1266-1272 for more in-depth knowledge for on premise processing. Pick the method you would like to use to process PRP from your patient, then mix ozone with it for an enhanced version. The platelets need to be activated once processed which is either done with thrombin or calcium to release the growth factors we are after. I want to suggest here that the application of ozone gas to PRP may be a much better way to activate PRP and should be considered.
One can use a commercial PRP centrifuge tube system or what I suggest may be the best, do it yourself with a simple sterile 50 ml tube in your machine. The above study suggests very useful PRP can be achieved on site using instruments on hand versus employing the more expensive procedures and instrumentation.
1) Using aseptic technique, withdraw 50cc of whole blood from the jugular in one 60cc syringe, heparin (calcium salt, 30 IU/mL blood) anticoagulant is present in the syringe. Mix by gently rocking.
2) We next harvest the platelets using the 50ml conical centrifuge method in the study. We place 30 cc of whole blood into a 50ml conical sterile centrifuge tube for two tubes. The tubes are spun for 15 minutes at 720g. You will need to find out how RPMs on your centrifuge translate to "g" which requires you measuring your rotor radius. The platelet poor plasma in the finished spun tube, (PPP) will be removed using a sterile 14-gauge pipetting needle and a 20-mL syringe, leaving a standardized 3 mL volume of PRP which is what we want. The remaining plasma, buffy coat, and top 1 mm of the packed RBCs were collected for a total of 3 mL of PRP.
3) Next, we will borrow from Minor Ozone Autohaemotherapy to activate the PRP. Never bubble ozone through blood, but gently rock blood in a syringe containing the ozone. Collect approximately 3 ml of the PRP in syringe from each tube and then add an equal amount of Ozone at 40-80 ug/ml in the same syringe from the ozone generator and gently rock, mixing the gas in the PRP avoiding foaming.
"It has been demonstrated that ozone (O3) can promote platelet aggregation particularly when heparin is used as an anticoagulant. Platelet-rich plasma (PRP) treated with O3 significantly increases the amount of platelet-derived growth factor (PDGF), transforming growth factor b1 (TGF-b 1) and interleukin-8 (IL-8). These factors are released in a dose-dependent manner after ozonation of heparinised PRP samples." International Journal of Ozone Therapy 9: 55-58, 2010, "Role of Ozone/Oxygen in Fibroblast Growth Factor Activation."
A Note of Caution and Warning:
Certainly Ozone therapy can be very helpful, if not life-saving, but be warned here that it is not the total answer. The physiological body of the horse or any mammal is much more complex than one key element. Here is an example brought to the forefront by Dr. Peter Jovanovic who recently wrote:
"About ten or so years ago we had noticed that when using high dose ozone and introducing it into blood with our RHP Medical Ozone Therapy method we would have fantastic results with any sort of cardiovascular issues, even three vessel disease with left main involvement. In essence, anything presented to us but it did take a while to correct, perhaps as much as 35 sessions. In any case we started to concentrate on these issues and the results were fantastic but there was a draw-back and that was that we saw some cancer patients getting worse. When we looked at it in detail we found that the ozone was creating collaterals and angiogenesis at a rapid pace. It was at that time that we decided to not use ozone in those patients past second stage and most definitely after stage three. If we did, there was a format that we would follow. We warned the industry of our findings but were mostly ignored as cancer and ozone became big business, I guess due to the always used quotes from Otto Warburg, which by the way are erroneously advertised and taken out of context but that is another topic. In any case, this article and report confirms what we are saying but only talks about HBOT (hyperbaric oxygen therapy), so, just try to imagine what ozone will do. Angiogenesis is not what we want when working with tumors or cancer, I think you can all relate to that."
This was quite an interesting observation for me as I have of late became an ardent student of Otto Warburg and Johanna Budwig, both becoming famous for establishing revolutionary insights into the cellular respiratory process. My view here seems to be a first in connecting what Dr. Jovanovic observed with ozone to Dr. Budwig's theories. It is known that hypoxia promotes vessel growth (angiogenesis) in the before mentioned late stage cancer cases. So how could ozone IV possibly cause hypoxia and thus, increased angiogenesis? Could it be that one is setting up what Johanna Budwig called an "oxygen bomb"? She wrote:
". . . . Von Helmholtz had attempted to get more oxygen into the cell. He showed that when we treat doves who have become asphyctic (i.e. doves that have been fed in such a manner that oxygen absorption is blocked), with increased ozone or oxygen, they then die more quickly - and this is still the case today. If the "oxygen bomb" is set up in the hospital for a person with oxygen deficiency, then the sick person dies more quickly. If animals can be made asphyctic through a certain diet, e.g. bleached rice, then they suffocate and neither increased introduction of oxygen nor activation with any other possible substance will help. At this time we already knew vitamin A, B, C, D, and E, but this did not help. Prof. Linus Pauling for example had been involved with animal experiments and knew precisely that it had been published in 1951 that all vitamins had been investigated in searching for the respiratory activator for Warburg's respiratory enzyme, but this had produced absolutely nothing, not even vitamin C."
In short, Budwig found that Flax-seed oil provided the necessary respiratory activator, linoleic-linolenic fatty acids when combined with the sulfhydryl proteins which are so necessary for proper oxygen assimilation of the cell. For more information on this aspect of cellular metabolism, go to my page on Budwig. The key to this matter is activating the cells before ozone is administered and afterwards via the Budwig Protocol. The Budwig will allow ozone to be much more efficiently utilized and in cases of cancer where the patient is deficient in the linoleic-linolenic fatty acids complex, it is a must!
This is a photo Dr. Frank Shallenberger using a Longevity EXT-120 ozone unit made in Canada to fill a hypodermic syringe with the proper concentration of ozone gas and oxygen. Longevity was also the brand of ozone generator Dr. Rowen and Robbins took to Sierra Leone to treat Ebola. I own a used Longevity EX-120 and it is a very robustly constructed unit.
The above YouTube videos brings up the subject of chest, brochiospams, lung reaction to too much ozone. One reason for this side-effect is that he may be injecting the ozone/oxygen mixture too fast! Cardiac output for a 154 lb man at rest is 5000ml/minute. Dr. Bocci writes that oxygen solubility is approximately 0.23ml/100ml of venous plasma. A 154 lb man at rest in theory could absorb 11.5ml of DIV ozone/oxygen per minute. Seems slow, eh, but slow is probably the safe way to go! Lung reaction to ozone is important to note and to monitor. He speaks of "tightness of the chest" as the sign to quit. There may be others. Certainly in any animal, we will have to be very perceptive to possible body changes looking for respiratory discomfort, etc. Dr. Shoemaker above watches out for a nose itch. What is the mechanism behind this? There are a number of theories, one is put forth by Ed McCabe:
"I have always used the analogy of filling up the gas tank in your car. You pump the gas in and when it's full, if you keep pumping it in the gas runs down the side of the car. The lungs are the oxygen overflow mechanism for the blood. When the bloodstream is full, the blood out-gasses into the lungs, and the oxygen-ozone sub species 'run down' the inside of the lungs, causing rapid lung pollution detoxification, heat, and possible slight temporary edema. All the patient knows is that he or she can't stop coughing if you do not quickly stop the procedure at the first sign of this."
Dr. Robins view:
"I believe that the ozone and its analogs are reacting with harmful free radical gases such as carbon monoxide (as much as 3% or more of the gases found in blood), creating larger than normal amounts of carbon dioxide and other gases that can be eliminated from the blood through respiration. The buildup of these gases around the lung tissue causes the feeling of pressure, tightness or discomforting the upper chest. This also causes the lungs to try and expel these gases through coughing."
To go back to the subject of exactly how ozone works in blood which seemed to have been partially suggested in the above YouTube video to be some type of an antibiotic which reacts directly with blood pathogens, lets look at what Velio Bocci writes on the subject. Basically, he has come to the conclusion that ozone stresses blood to produce compounds that aids in healing. This is really not too much different on how counter-irritation works which I discuss on another webpage. Like counterirritation, ozone stresses tissue that results in a healing process. When Ozone & oxygen is injected into blood, the blood undergoes a temporary oxidative stress which stimulates physiological mechanisms. Like counter-irritation, one wants just the right amount! Too little will not stimulate a reaction and too much would overwhelm the antioxidant system causing damage. Ozone does several things when it hits the blood. First, ozone reacts instantaneously with the blood's antioxidants, proteins, carbohydrates and the polyunsaturated fatty acids--producing an initial reaction stimulating ROS (reactive oxygen species) which is neutralized by the antioxidant system in seconds. The second reaction is lipid peroxidation which produces hydrogen peroxide and aldehydes (LOPs) using up the total dose of ozone. After this point, ozone is no longer a factor and its by-products of ROS (mostly hydrogen peroxide) and LOPs take over and is responsible for the therapeutic effects one sees. All of these therapeutic by-products can be easily toxic to the system in large enough volumes, but are neutralized very quickly when just the right dosages of ozone are utilized, not too little, nor too much.
ROS is produced in the first seconds of blood contact yielding the initial biological effects. Hydrogen peroxide is one of the critical ozone messengers from ROS which stimulates powerful antioxidant enzymes. Ozone concentrations from 20-80 ug/ml is a must to achieve adequate hydrogen peroxide levels. Any less and it won't happen and any more and it will become toxic. Later, LOPs which are also produced result in a much longer life reaching the vascular system and most organs in the body.
Ozone in the Plasma produces:
ROS . . . . . improves oxygen delivery in the red blood cells, activates white blood cells, and releases autacoids and growth factors in the platelets.
LOPs . . . . increases the release of nitric oxide in he endothelium, generates super-gifted red blood cells and stem cells in the bone marrow, and up regulates the OSP and antioxidant enzymes in various other organs.
In short, ROS is responsible for immediate biological effects while the LOPs are later effectors.