The Science of How Hyperbaric Therapy Works - Episode 335

Biology is an economy of balance. It's not about how hard can you push it. It's not about being keto all the time, being in a hyperbaric chamber all the time. It's not about anything all the time. What biology likes to do is it likes to cycle. Welcome everybody to this edition of the Gladden Longevity Podcast. I'm your host, Dr. Jeffrey Gladden, and today I'm going to be interviewing Jason Sonners. He's a chiropractic physician who became interested in hyperbaric therapy through an injury that he suffered himself, and he's gone on to become quite an expert in the field, a trainer, and knows a lot about the topic. We're getting ready to add hyperbaric here at Gladden Longevity, and I thought it would be interesting for you to hear from him and hear this conversation about some of the benefits and some of the things that have to be looked out for when using hyperbaric responsibly. So enjoy this podcast.

He went from saving hearts as a cardiologist to rewriting the entire aging playbook. Dr. Jeffrey Gladden believes 100 is the new 30, and he's got the science to back it up. This is the Gladden Longevity Podcast.

Jason, welcome to the Gladden Longevity Podcast. It's good to have you here.

Glad to be here. I'm, uh, I'm excited to share as much as I can with, uh, with you and your audience.

Yeah, so tell us a little bit about how you got interested in hyperbaric therapy. Was this something you wanted to do as a young child, or what happened?

Actually, you know, my, my fourth grade autobiography project was Jacques Cousteau, so maybe there was like, oh, something there that, that connected the dots. But no, I, I had no idea what hyperbaric was even, uh first into practice, but I actually ended up with a pretty serious disc injury and then drop foot in my right foot.

Okay.

And, you know, background in exercise physiology, practicing chiropractor at the time, you know, lots of background in nutrition. You know, I was doing all the things I would have told any other patient to do but wasn't getting any of the result. And so I literally only accidentally came across a hyperbaric chamber and thought it looked interesting. So I wanted to try it, but I didn't I didn't actually think it would do anything for me. And within about— well, I did about a 20-minute session, and about 10 minutes after that session, I started getting pins and needles in my foot, which was the first time I felt my right foot in about 18 months at that point. And I was like, whoa, there's— yeah, there's something here, you know. But long story short, treated, you know, I bought a chamber, treated myself, still never planned on using it in practice. It was just a personal project. But the results were so good for me. And then Ended up treating a few family members with different issues.

It was so profound every time that I just, yeah, had to go into it.

Yeah.

So what was the nature of the injury? What, what happened?

So I herniated a disc in my low back. Um, which one? L5-S1.

Okay.

And, you know, there was, I had herniated other discs in my life. Like this wasn't, I was actually became a chiropractor, uh, because of my history of, of back issues and how much chiropractic I see.

So how is it that you were herniating discs all the time? That's not something everyone—

Yeah, I mean, in high school, I wrestled, and there was a couple neck injuries there. And then also in high school, I had a trampoline accident that led to that. So, you know, I had my fair share of injuries, I suppose.

Okay. But what was the one that actually—

This particular— Yeah, so I ended up with, with drop foot in my right foot.

So like the back from trampoline injury?

No, no, sorry. That was I was putting a roof on my house myself.

You fell off the roof?

No, I was just throwing shingles, you know, one of the, you know, blocks of shingles up and down the ladder, putting them in by hand, you know. So essentially, I threw one of these, you know, blocks of shingles down, and it like, it went, you know. But, you know, the back pain got better pretty quickly. My wife was treating me, I was, you know, but this, the drop foot is really what persisted, which—

which side was that on?

Uh, my right, my right.

Right foot. Okay. So just so people understand drop foot, what he's saying is that, and you may have seen people with this, most people are wearing a brace now, but when you pick your foot up off the ground, the toes just basically drop down towards the ground. You can't really hold your foot level or certainly, you know, what we would call dorsiflexor to pull it up. So it's very cumbersome to walk and you can actually develop issues with the foot because of the way it's hitting the ground all the time. We had a guy that developed drop foot actually after it was discovered he had a tumor, but Tumor growing next to his spinal cord. And then we, we treated it with a BPC-157 and it actually got better in a matter of weeks, which he was grateful for because he was told, you know, it's 50/50. We'll just have to wait a year and see. So anyway, there are different approaches to this, but the interesting thing for you is that you'd had the drop foot for, it sounds like a long time, right? 18 months?

Yeah, like a year and a half.

A year and a half. Yeah.

And you know, the typical things that I would have done or had a patient do, you know, again, I got a lot of control back over the the lower back issues. It was just this nerve that wouldn't, you know, and this was like 20 years ago. So yeah, I didn't know what BPC-157 was at that time.

Sure, sure. Yeah. Yeah. It wasn't really around 20 years ago, at least in the US. Exactly. Yeah. Well, that's, that's really fascinating. So then you kind of went down the rabbit hole with, with it. So tell us what you've, what you've learned about it.

So, you know, if I could bring it down into like the most basic of content, I would say oxygen is just an ingredient that almost every cell in our body is— requires for normal function, certainly at elevated levels for additional performance or additional healing and recovery. We're limited to how much oxygen we can carry based on the number and the health of the red blood cells that we have and the atmospheric pressure that you and I are being exposed to. So pressure is exactly why we're able to pull oxygen out of the air we're breathing right now. When people go hiking or go up in elevation, they feel like it's harder to breathe. We often say, well, there's less oxygen at elevation. And really, percentage-wise, it's the same amount of oxygen even at the top of Mount Everest. What we're actually losing is pressure. And as we lose pressure, we lose the driving force for pulling oxygen out of the air we're breathing and, and driving it into circulation. And with hyperbarics, we're basically temporarily increasing atmospheric pressure. So it's mimicking like going below sea level. And by increasing pressure, oxygen is, is driven by pressure. As we increase the pressure, we can increase dramatically the amount of oxygen the body's carrying. And the way it does that is by bypassing red blood cell carrying capacity. So even when people have, let's say, low red blood cell count, or they're anemic for a variety of reasons, and therefore the red blood cells can't carry the oxygen well, hyperbaric is dissolving oxygen into the liquid of the blood. And so by, by bypassing red blood cell carrying capacity, we're creating a surplus of oxygen in the body that would be literally impossible any other way.

So it's an important point that he's making here. So most people are familiar with red blood cells carrying oxygen. Hemoglobin is the protein that the oxygen binds to, and there is a percent saturation, right? So not every hemoglobin is saturated with oxygen. Usually if you're breathing you might be somewhere 98, 99% saturated. If there's something going on with your lungs, it might be down around 92, 94%. When people have sleep apnea, they can desaturate even further into the 80s and things, which can be problematic. But what he's talking about is that when you just take the oxygen that's in the air, 21%, let's say, sea level or close to it, and you pressurize it, you'll actually just force it into the plasma, into the liquid portion of the blood, So now you've saturated the hemoglobin, but you also have some extra carrying capacity just because it's dissolved into the blood itself. And so then when it circulates in the body, it has two sources to pull from. One, it can release oxygen from the hemoglobin, but also just sort of pull it out by diffusion out of the blood, right? So you're delivering more oxygen to, to the tissues. And it's an interesting thing. There's an interplay between oxygenation and hypoxia. And part of hypoxia, meaning low oxygen, and part of the therapeutic benefit of hyperbaric, interestingly enough, is this hypoxic effect that occurs with hyperbaric. It's, it's a kind of an interesting thing. So when you basically oversaturate the blood like that with, with oxygen, and then you remove it, you trigger the release of a protein called HIF-1 alpha that basically is in response to hypoxia. So there are other ways to release that. You can do it with blood flow restriction bands. You can do it by exercising at high altitude. Anything that sort of triggers your body to wanna release this protein in response to that stress of low perceived low oxygen tension then has some really interesting benefits. I don't know if you wanna rattle those off or talk about those, but it's, it's pretty interesting.

Yeah. I mean, what I would say in, in hyperbarics 20 years ago, even 10 years ago, none of that was part of the conversation. All we ever talked about was the dose of oxygen and how much can we get in. And with that surplus of oxygen, what are all the hyperoxic pathways that are being elicited? And I'd say it's only in the last 5 years where this relative hypoxia, which is what you were talking about, like never actually becoming hypoxic, however, losing some of the extra oxygen that hyperbaric created, triggers hypoxic pathways without actually creating actual hypoxia.

Yeah. Which is, which is interesting because it's a stressor. It's like a hormetic stress on the body. Yeah. Like an exercise would be. Right. And so when you do that, it triggers the development of more red blood cells. It improves mitochondrial function. It can have some epigenetic changes on the DNA. Actually, it can actually release stem cells. Think of it almost like a form of exercise, or when you're exposed to ozone for that matter, let's say you're in an ozone sauna or something, a similar thing. You're stressing the body in one direction. When you remove that stress, the body responds by releasing things that make it heal or make it get stronger, right? A hormetic stress, right? Something that stresses you, but you come back stronger. So it's another form of a hormetic stress really is what we're talking about here. Yeah.

100%. Although two sides of that coin. One is it's actually delivering a fuel source and that there's not as much of a hormetic conversation there. It's literally just, oxygen levels go up, mitochondrial output goes up, as an example. So just, you know, driving further ATP production and mitochondrial performance. But separately, then there's all of these other, you know, hormetic cascades that get stimulated by the wave of increased and decreased oxygen over time.

That's right. And it's probably part of the reason that people don't do hyperbaric typically every day, because they're, they're gonna— just like you wouldn't want to exercise hard every day, right? Your body gets stronger during the recovery phase. So you expose yourself to the stressor, then you take a day off, then you maybe go back, or whatever, right? So it's that kind of a rhythm to it, right?

Which I think is part of the— that's like one of the issues I think you probably see too inside this world, where it's like, I learn a new, you know, longevity tool or strategy, and then I add it to the 7 that I've already been doing every day, and it becomes a non-sustainable attempt at improving quality of life and longevity by essentially doing too many things too often without a real plan. And that's, that's one of the things I've been working so hard recently on, is like All of these strategies are great, but how do we create, you know, a program that allows people to do it, right? You know, in increments and in a sustainable way for, you know, for decades to come, not, not for weeks.

So the way I explain that to people is that biology is an economy of balance. It's not about how hard can you push it. It's not about being keto all the time, being in a hyperbaric chamber all the time, doing endurance training all the time, lifting weights. It's not about anything all the time. What biology likes to do is it likes to cycle. It likes to cycle through different states. It's fed, it's fasted, it's rested, it's exercised, it's stressed, it's hyperbaric exposure. It's now not exposed, right? It's, it's in something cold, it's in something hot. It's, it's back and forth, but your body responds best when you meter, just like you wouldn't want to eat constantly throughout the day. Your body needs food, but it doesn't need food throughout the day, right? So you gotta think about it as, uh, I'm gonna take what I need, but not more than I need. And allow my body to recover from that. And if it's the right amount of stressor, my body will be stronger the next time I see it, just like the next time I pick up the dumbbell or something. Right. So it's a really important concept to keep in mind that you're not trying— that you heard that keto is good or hyperbaric is good. And it's not like more is better. It's, it's really not more is better. It's really what's the rhythm in the cycling that's going to help me to optimize. That's really the question to ask, I think.

Right. It's not more is better, but like more variety over time. Right.

And yeah. And yeah.

Cycling them in and out. 100%.

That's right. That's right. And you want a variety of stressors. So do you want to talk a little bit about the telomere study that was done over in Israel? Looking at how—

Yes. So, you know, I think that was one of the, certainly one of the more famous studies that was done in the longevity space.

Yeah.

And a lot of the studies that those guys have put out have been on long-term improvement, cognitive performance improvements, even physical performance improvements over time. This was really a unique version where, you know, now we're looking at specific markers of longevity, let's say telomeres. So, you know, they found actually, I think it was like a 16% reduction in cellular senescence, and about a 20% increase in telomere length, right? So we know that senescent cells are certainly a concern as we're aging. And we certainly know that any strategy at reducing cellular senescence, by the way, is through hormetic stress. You know, killing off, you know, the weak and the dying and the dysfunctional cells. And then, of course, telomeres, which, you know, I don't know that they're causal from a longevity standpoint, but they're definitely highly correlated. Longer telomeres, which are basically the protective ends on the DNA to protect DNA from being oxidized and broken down— longer telomeres are associated with more youthful cells, and shorter telomeres are associated with you know, more oxidative stress and potentially shorter cellular lifespan. And quite honestly, there's really not much that— that, if anything, we're looking at slowing down the shortening of telomeres. It's incredibly rare to find something that's actually increasing telomere length. So this was really a landmark study, not just for hyperbaric, but I think in the longevity space, seeing a reversal of that, that telomere shortening, which is remarkable.

So it's interesting, telomere lengths are related to cell divisions, and every time a cell divides, uh, telomeres get clipped off in in the, in the DNA replication process for cell division. And as the telomeres get short enough, when they do get short enough, then they signal the cell that it's old and it actually will become senescent. So it's one of the ways that a cell can become senescent is with short telomeres. It's also known that people that are born with short telomeres and certain medical conditions like progeria, young people with short telomeres age much more quickly and they actually get diseases of aging at a much earlier age, whether it's cancer, heart disease, dementia, or whatever else. So we know that telomeres are important for cellular health. And it's interesting that when telomeres get short, mitochondrial function is turned down also, right? So you make less ATP. So there's this whole interplay of the hallmarks of aging with each other. And the telomeres are, are one of those things. There is an enzyme called telomerase that will actually relengthen telomeres, but it's turned off in most of our cells except for the germ cells like eggs and sperm and, and in some of the stem cells to keep them youthful. But it's, it's interesting. So there are some supplements out there that will trigger telomerase to turn on for 3 or 4 hours before it turns off again. And you can kind of relengthen telomeres that way. But it's interesting to see that this hyperbaric chamber and the stress, and it was a, it was a big protocol. I think it was 90 minutes, 5 days a week for like 6 weeks or something. I mean, these people were—

Yeah, it was like 60 sessions at 90 minutes, like 3 months essentially of Yeah, exactly.

So there was a lot of time spent inside these chambers and they were big chambers that had multiple, multiple people in them simultaneously. But it did show that it improved telomere length. So it was actually a stress that turned on telomerase and was relengthening the telomeres. So that's actually pretty fascinating. And then the question becomes, well, could I get the same effect? Maybe not by having to be in there 90 minutes every day for 6 weeks or whatever it is, but could I do it?, if I did it a couple times a week and maybe added a couple supplements simultaneously and some other things, right? So that's something that we—

I mean, I think that, right, the synergy between other tools, I think, is often in research, it's almost purposefully overlooked, right? Because we're trying to control for the variables. But I also think different pressures, like the research that I did when I was finishing the PhD, we didn't do a direct telomere measurement, but we used like a DNA methylation panel. And they have an algorithm for calculating telomere length there. And we only did, we did 50 hours of treatment. So less than what that protocol was, but even in the lower pressure, which was for us, it was 1.3 atmospheres. That study was done at 2 atmospheres, like doubling atmospheric pressure on 100% oxygen. But even at 1.3, we missed statistical significance by 0.01 at low pressure. So like we saw changes. At low pressure, we saw changes at high pressure. In a lot of ways, I think it is a time game. It's, you know, it's consistency over some period of time that gets us what we're looking for.

Yeah, I think, I think that, I think that's right. I think the way I would think about it is it's actually a stimulus change. It's how it's, it's giving the appropriate, a big enough stimulus that the body will respond to it in a proactive way. Right. And if you're giving a small stimulus, then you're getting only a smaller response. But if you give the right stimulus, Right. You could probably get the optimal— if you give too much of a stimulus, you can go the other direction, right?

So let me share this. Same— in that same research, we measured a lot and we— I don't know how much you want to talk about it, but we measured pre, we measured after 25 hours, we took a month off, we did another 25 hours, we measured post 50 hours, and then we waited another month and tested, you know, 4 weeks after, you know, treatment stopped. But as one example to what you're saying, The low-pressure group had a biological reversal of age in the first 25 hours and then a further reversal of age over the next 25 hours. And it was pretty linear and predictable. The high-pressure group actually had accelerated biological age in the first 25 hours and then caught up to and then exceeded the lower-pressure group in the next 25 hours. But if, if all we did was a 25-hour protocol, we would've had low pressure group reversing biological age statistically significant, and we would've had the high pressure group accelerated biological age, right? So, you know, understanding the different parameters, how strong of a stimulus they are and what period of time is necessary to get the outcome you're looking for. Those are the gaping holes, I think, in a lot of the strategies that we're all talking and using in longevity, but hyperbaric's no exception.

It sort of strikes me that actually a gradual increase, when you hit the body too hard up front, it, it can't absorb, it can't absorb the stress, right? And so it's, it's aging you prematurely. Then the body does adapt to that and then it makes up for time, but it makes you wonder if a protocol where you did low pressure.

Start low and build. Exactly.

I mean, exactly. Start low and then build up, right? That might be.

At my clinic, we've, we've always done it that way out of mostly out of just making sure patients tolerate it well.

Right.

Like the more I look at this research, I'm like, you know what? That's actually using exercise as an example, using fasting as an example. You, you don't just jump into a 5-day fast.

That's right.

You start shrinking the eating windows, then you do it 24 hours, right? You, you, you don't just run a marathon. You train for months to run that marathon.

That's right. That's right.

I, I would look at this the exact same way.

Yes. 100%.

You mod—

that's right. You modulate the stress. Yeah. Is the way to think about it. The stimulus. And I think, yeah, I think sort of easing into it, maybe starting at 1.3, going to 1.5, 1.7.

Yeah.

You know, you know, you get it. And then, you know, there are some risks to hyperbaric also. Do you wanna speak to those? Because people should understand. That there are some risks potentially.

So, you know, there's— well, first of all, if you can't equalize your ears, you can't go in. That's, that's sort of step one. So a pneumothorax, untreated pneumothorax, a popped lung, or the inability to equalize your ears, you just— it's no-go, 100%.

It'll collapse your lung further, it's a problem, right?

You get a tension pneumothorax. And exactly, there's some medications, certain chemo drugs, certain conditions like advanced heart disease, advanced emphysema.

Yeah, you could blow up a bleb in a lung if you had advanced emphysema.

But quite honestly, even a lot of those people can tolerate at least lower pressures. The other risks really come— there's, you know, as important as oxygen is, there's a thing called oxygen toxicity. So too much of a good thing is still a bad thing.

So that's a really important point. You know, um, when we were taking care of people in the ICUs and the coronary care units back when I was doing the interventional cardiology work and training, you know, when somebody would be intubated in an ICU and on 100% oxygen, The first thing we would do is try to get them down on that percentage because we knew that the longer they were exposed, the more damage it was going to do to their lung tissue. And so you would do all the other adjunctive therapies to try to improve lung function to the point where you could start to wean that down as quickly as possible.

Now, I mean, the biggest difference is though, you know, that's essentially once you're on it, they're like, that's a 24-hour cycle.

Right. That's right.

So pulmonary oxygen toxicity risk keeps growing. You know, hyperbaric, we're doing it for 60 minutes, 90 minutes, maybe 2 hours.

Yeah, right.

And so that's one way we reduce the risk by not doing really long extended exposures. There's also central nervous system oxygen toxicity, which is— it's different. It's not a cumulative threat to lung tissue over time. It's just an absolute too much oxygen in a moment that really can short circuit the nervous system.

Have you seen that happen?

Quite honestly, no. In my office, I've never seen it, but we always start low. We build people tolerance, you know, we, we go through the steps, and then we don't treat everybody at 2 to 2.5 atmospheres. We treat different tissues at different pressures. Like a lot of neurological treatments, we do it like 1.5, even 1.3, because we know that the brain is going to be the most fragile, even though it's one of the most metabolically active and needs a lot of oxygen. It's also the most susceptible to, to over-oxidation. So, you know, like you were saying earlier, there's a, there's a balance point that, that needs to be found, right? If you're practicing it responsibly and you learn the things you need to learn to use hyperbaric, you'd see that oxygen toxicity is— both pulmonary and central nervous system oxygen toxicity are very easy to avoid, but you just have to know where the goalposts are and how to keep people, you know, away from the edges.

Yeah, exactly. Yeah, I think that's important. Is there anything that you do to prevent oxygen toxicity? Like you haven't drank molecular hydrogen or, you know, some of the other things that are kind of decrease oxidative stress.

Somebody who has metabolic issues that we know that they're not going to metabolize the oxygen as efficiently as, let's say, a healthier person, or so maybe metabolic syndrome, maybe on some version of a diabetic spectrum, maybe brain injury, brain trauma where their brain can't metabolize the oxygen as well. Or somebody with multiple autoimmune disease, like where they're just very sensitive to oxidative stress, we might— well, sometimes we'll use glutathione. Usually we'll use hydrogen inhalation or hydrogen water pre or post, but just doing air breaks. So to your point earlier about the increase and decrease of oxygen, the, the HIF-1 stimulation, you can get HIF-1 stimulation by once you're in the chamber, getting out of the chamber, going back to normal oxygen. That triggers HIF-1, but just being on oxygen and taking the oxygen off a number of times during each session, that does two things. One, it massively reduces the risk of central nervous system oxygen toxicity, but it also increases that wave of HIF-1 stimulation. So it's actually reducing risk and increasing effectiveness, you know, simultaneously.

So when I've been in a hyperbaric chamber, you're laying in a chamber. We have one coming here where you're going to be seated in it, which is kind of, I think, nice. But so you're laying in a chamber and you're just breathing the ambient air and not wearing a mask per se. But you're saying that you're— are you giving the oxygen through the mask as well as in the air of the hyperbaric chamber? Or describe that for us.

Right, there's two ways to do it. Some people pressurize with oxygen, so the gas surrounding you is 100% oxygen. Now that chamber should still have a mask in it, but that mask would then deliver air, right? So an air break would be in that— in that chamber, an air break would be given by going on, going on your mask.

Got it.

The way I run chambers, the chambers are pressurized with air. And so the oxygen is delivered through a mask.

Ah, okay. Got it.

And then you, you take the mask off for the air break and you put it on for the oxygen side.

Gotcha.

So same concept, just opposite tool.

Yeah. Right. Okay. Perfect.

Which one are you, are you pressurizing with air or pressurizing with oxygen?

Oxygen.

Okay.

Yeah. It'll, we'll be pressurizing with oxygen when it comes in. And then, um, yeah, we'll do the air break the other way. I was gonna say, what, what kind of chamber slash what kind of pressures are you using for neurological things? Like when you fixed your. Foot drop, you're fixing a peripheral neuropathy, so to speak. What did you actually use?

So, I mean, that, that was, that was just over 20 years ago, and I used a soft chamber, air only. So that was 1.3 air only, which is the lowest theoretical therapeutic dose you could even access. And that's all, that's all it took. Now, I didn't know anything at the time, and if I could do it again, I probably would have treated it at 1.5. 1.5 seems to be a dose that's really targeting the nervous system without over— ever overexposing it.

So, and that's true for both the peripheral nervous system and the central nervous system.

I would say so. Yeah. You know, oxygen's a vasoconstrictor, and there's an enormous amount of vasoconstriction of the central nervous system in hyperbarics because it's protecting, you know, the CPU from being overexposed, right? The higher the pressure you go, the more vasoconstriction there is. To me, if there's a defense mechanism that my body is, is trying to tap into to protect itself, well, I want the highest dose that I can give before the alarm starts going off and the body has to react to— sure, to defend itself. And that seems to be somewhere between like that 1.5 to 1.7 range for, for the nerve.

That's right. So the way to think about that as an analogy, if you're listening to this, is, you know, you would lift— if you're trying to build strength, you might lift the heaviest weight you can, but you can still comfortably move it up and down. It's not, you know, causing undue pain or, you know, your ligaments don't feel like they're gonna fall off. Your joints don't feel tortured. You know, the muscle doesn't feel like it's gonna snap, but yet it's a stress, right? And so you could even go a bit less than that and still be getting something valuable. So when in doubt, quite honestly, in a situation like this, you wanna start low because the danger point is high and there isn't much danger to low. And so you want to kind of ease into it, allow your body to adapt. Just back to the marathon training example. Right.

You're also like, to me, we should all be, and this is true, I think, at least for me in my practice, I'm always looking for the minimum effective dose. Like, what's the, what's the lowest amount of something that I can use that still creates a very strong upside result? I'm not looking for the highest somebody could tolerate before the wheels start falling off, right?

That's right.

Especially like if, if you're anything like I am, where we're combining numerous therapies simultaneously, like the synergy is going to have such a magnifying effect, of which a lot of which hasn't been studied yet per se. And so, you know, using a lower dose of each one, knowing that there's synergy once we combine them, you know, that's proven over and over again in clinical practice to be, you know, a safe way to get the output we're looking for.

You know, I was seeing some interesting things with the brain also about improving detoxification in the brain through the glymphatic pathway. Most people are familiar with the lymphatic pathway, right? That, you know, the lymph, it's kind of like a, a venous pathway. It's a vascular pathway that kind of parallels the veins, but it's draining fluid out of the interstitial tissues, right? The tissues that are in your legs, your arms, and things like that. And if you've ever seen anybody with lymph damage, they can get a lot of swelling. The most obvious would be if a woman has had breast cancer with a radical mastectomy and lymph node excision from under the arm, then the lymph system is damaged, so many times that arm will tend to wanna swell. And so lymphatic drainage is important. Glymphatic drainage, it turns out, was discovered in the brain a few years ago. I maybe about 7 or 8 years ago now as being very important for draining toxins outta the brain. And it occurs at night while we're sleeping in slow wave sleep. And in particular when our right cheek is on the pillow, interestingly enough. But it turns out that hyperbaric therapy has been shown to actually increase glymphatic drainage, which is kind of a cool thing. And sometimes the accumulation of those toxins in the brain can— what shall we say— they can facilitate, accelerate neurodegenerative disorders, whether it's dementia or Parkinson's or something else. So there's a role for this also in sort of not only treating somebody, let's say, with a concussion or something like that, but also a role for it in preventative therapy for people that might be predisposed to some sort of neurological, you know, dysregulation down the line, right? So I don't know if that's something you guys do, if you're looking at it prophylactically as well as therapeutically, but it seems like there may be a role there.

Yeah, I mean, I would say that unfortunately a lot of people are very motivated to seek outside-of-the-box therapies when they've already been diagnosed and now they're suffering and not responding to, let's say, the standard of care. And so we might see somebody with mild to moderate dementia and they're just trying everything they can to slow it down or potentially reverse it. Parkinson's, slow it down, potentially reverse it. And in a lot of those cases, these people are— respond very well to hyperbaric and other components put together, right? At the same time, you know, whatever ingredient is being used, let's say oxygen in that case, is helping to reduce the symptoms or even potentially reverse some of those consequences, could be used, you know, years, decades earlier. Like dementia runs in my family actually pretty strong. And a lot of the things that I do, which we've already mentioned, but exercise, a lot of extended fasts, hyperbaric oxygen, carbon dioxide therapy, hydrogen therapy. Like, I do everything I can today because I know what a lot of my family goes through in their older years. And, you know, I'm, I'm literally just trying to prevent it for me and then educating patient at a time, you know, to, to get more preventative in that, in that way. Because of course, if it could actually help the condition, it would have helped even quicker if we got to it, you know, years prior to diagnosis.

So yeah, it's the idea of being preemptive as opposed to even preventative. It's, uh, you know, if you, let's say you do some genetics and you figure out, oh, I'm carrying some genes for this, that, or the other thing, you can start to take a preemptive kind of approach. So yeah, very cool. So talk to us a little bit about wound healing, because I know this is a big area for hyperbaric. Are you using it in that regard for wound healing?

Yeah, I mean, so I do a lot of things. I, I run my clinic, I teach hyperbaric medicine, certify people, help people with their business, you know, consulting, a lot of different roles. In my particular office, we don't do any of the, quote, like, on-label conditions. So wound healing, you know, flaps and grafts that aren't taking properly, severe burns, gangrene, like, in my office, we don't do that because there are plenty of offices that do do that. And quite honestly, if you can get insurance coverage for some of those things, Sure. I would just assume have them do that. And when they get cut off prematurely, you know, we help them on the back end finish, you know, finish out their therapy. We do a lot of wound healing from the standpoint of pre and post-surgical or even in some of the more severe cases that they're just not severe enough to get, let's say, a small amount of necrotic tissue after a breast augmentation or post-surgical scar that just isn't healing properly. But we do a ton of like pre and post-surgical, pre and post stem cell. To me, a lot of it's the same. We're just triggering this certain healing response. But when it works for, you know, severe non-healing ulcerative wounds, those are the same mechanisms that would be at work, let's say, pre and post-surgical. I tore my shoulder a couple of years ago and I did a whole, like, as I'm sure you would put together, you know, a routine of hyperbaric, a routine of shockwave therapy, a whole routine of peptides mixed with like exercise, nutrition, fasting. And, you know, I spent 3 months essentially rebuilding my shoulder without surgery. It was time-consuming and it was expensive, but I wanted to do everything I could to try to avoid it. And, you know, these things work, you know?

Yeah, they do. It's interesting. I like the idea of, and we do it all the time, of basically stacking different technologies that complement each other. And, you know, one of the things we do here is plasmapheresis also to kind of clear out all the trash from the blood, which then all of a sudden regenerative medicine works better, of course. But less garbage. Yeah. It's interesting that hyperbaric also will stimulate stem cell release from the bone marrow. And things like pulse shockwave therapy, which is putting energy into a tissue, a couple of different mechanisms, ways to do that. But when you do that, you release endogenous peptides and you also then stimulate and attract endogenous, uh, the person's own stem cell release to come in and help heal. So, uh, there's lots of ways, and then peptides and everything else will complement that. So there's lots of really cool ways. So if you think about hyperbaric oxygen, you can think of it as a standalone, but you can also think of it as a piece of a system, if you will, that helps people heal better. So if you have a question of would hyperbaric be the right thing for me, I would be asking the bigger question. How does hyperbaric potentially fit into an actual system that would be the best for me? That would be one way to think about it.

One of the ways I look at that is to say, if you broke down the mechanisms of action into like 4 categories, mechanical from like a vasoconstrictive swelling edema management. Immunological, from killing anaerobic infections through upregulating the immune system's ability to fight infection, and then metabolic, the whole like energy production side of all the mitochondrial benefits, and then regenerative, all the, all the healing mechanisms, the, the VEGF, the BDNF, right? All these growth factors that stimulate tissue healing and repair and then stem cell mobilization, collagen formation, all of those things. So whatever it is you're trying to solve for fits into one of those 4 categories. It's like, okay, mitochondrial. Okay, so here's the hyperbaric program for that. But what else can we do? Well, fasting is good for the mitochondria. NAD could be good for the mitochondria. CoQ10 could be good for them. You know, red light's good for the mitochondria. So you can create a stack based on a goal, right? Tissue repair. Well, okay, you know, which peptides could we use for, you know, GHK-Cu and you know, and shockwave therapy mixed with hyperbaric. So we pick a goal, like what role does hyperbaric play in it, and then what are the targeted therapies that we can add to it to, you know, create that synergy. That's, that's usually how I kind of take a patient through the thought process.

Yeah, yeah, we do the same thing. And I think the reason for that is you actually get somebody where they want to go sooner than if you're just depending on one technology to try to get there. So what's, uh, what's on the horizon for you? What are you excited about in the world of hyperbaric?

Anything you're thinking about that Yeah, I mean, we're going through some challenges, you know, with all the growth. 20 years ago, hyperbaric wasn't on the radar, you know, it's only in the last 10 years, maybe more in the last 5, even more in the last 2. So the growth is there, the awareness is there, but what that brings is growth that might be going faster than, than the regulations and things can keep up in some cases, or growth in a way where education isn't being met. Matched to applying this thing safely and effectively. So there's a challenge there of trying to keep up with that growth and make sure that those who choose to access it as a patient or those who choose to use it from a clinical standpoint have all the information that they need to make the best decision that they can. So I'm playing a huge role, I hope, in trying to move the, you know, the needle in the industry from that standpoint. And then at the same time, there's a lot of rules and regulations coming down, you know, state by state, some of which are really very— could be very great and helpful for the industry, and some of them could be really hurtful. And so I'm playing another role legislatively, helping, you know, draft and review and revise a lot of these regulation changes, essentially trying to protect the industry and make sure that we're not cutting any corners. We're still offering it as safely as possible. We're really— we're training people to be effective. At the same time, we're not over-restricting it and making it impossible for people to either practice or get it as a patient. So those are probably the two biggest areas of my attention right now, just wanting to make sure that this thing is, you know, around far longer than I'll be around and that we're offering it in the most appropriate way possible.

Yeah, exactly. No, I think that's true. In this space, people can see a shiny object and then think they're just going to, you know, it's the magic bullet for everything, and it's not. It's a tool.

It's a tool.

Just like a hammer can hurt you, it can also help you build a house, but you gotta be care— you gotta be careful. And just so the audience understands, anybody that's doing hyperbaric, the clinicians are going through training. We're going through our own training here as this unit comes in, right? We, well, we are because it's, well, because it's important because, you know, you can hurt people with a hammer if you don't know how to wield it properly. And so super, super important.

Yeah.

Cool. Well, Jason, I appreciate you taking the time to chat with us. It's been a pleasure.

Thank you so much.

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