However, as history has shown repeatedly throughout the years, convention is only convention until challenged, proven wrong, and then changed. Such is the case with HBOT and autism. Based on the published studies by Dr. Rossignol, the early work of Dr. Buckley and Dr. Kartzinel, and the tremendous number of children that have been treated by physicians such as Dr. Bradstreet, Dr. Feingold, Dr. Freedenfeld, Dr. Stoller and myself, and a growing number of other physicians who are now using HBOT routinely in their offices, there remains no doubt that HBOT works and that it works well for children with autism. There is also no doubt that it works well at low pressures with varying degrees of oxygen concentrations as well as at varying degrees of high pressures with 100% oxygen.
The reason I recommend HBOT for all my patients is because there is scientific evidence that pressure, independent of the concentration of oxygen, decreases inflammation and that any concentration of oxygen under any increased amount of pressure will allow more oxygen to dissolve into the extracellular fluids of the body: plasma, lymph, cerebrospinal fluid, and interstitial fluid. Because dissolved oxygen is not confined to a hemoglobin molecule, it can go wherever "body water goes" and therefore reach 'deeper tissues' more easily and more consistently than ever before Because no test is able to predict which child may and which child may not respond to extra pressure and/or extra oxygen (in contrast to excessive oxygen), I let nature take its course and prescribe a clinical trial of HBOT for all my children Though I let "nature take its course", I would not consider prescribing or administering HBOT to children with autism unless there was good scientific evidence to support its use. Fortunately such evidence does exist, the body of which continues to accumulate, and the mechanisms of action by which HBOT may work for children with autism, as described below, may already be outdated by the time you read this.
A few of the multiple mechanisms demonstrating how HBOT may work for children with autism was originally and thoroughly researched over many months time by Dr. Rossignol. These mechanisms are shown below along with a couple others that have been suggested They include:
- Angioneogenesis from the addition of oxygen: The growth of new blood vessels has been shown to occur from soft chambers as well as from hard, and is a process that may continue to increase subsequent to discontinuing therapy for a period of time after oxygen loading. Though it has been stated often on the internet boards that angioneogenesis does not occur unless pressures are 1.5 ATA or greater, the South American physician Dr. Efrain Olszewer has pre- and post-angiograms documenting collateral circulation beginning as early as ten to twenty hours after initiating hyperbaric therapy for cerebral vascular disease and peripheral arteriosclerosis at pressures lower than 1.3 ATA It is known that one of the problems children with autism have is decreased blood flow to the brain (cerebral hypoperfusion). Therefore is has been speculated that angioneogenesis is the way that HBOT helps autism However, though angioneogenesis may be one mechanism by which children with autism are helped by HBOT, angioneogenesis may not be the primary mechanism by which HBOT works The amount of cerebral hypoperfusion in autistics compared to controls is about 8%, so a small increase in oxygen delivery may be all that is needed to overcome this deficit and show clinical benefit. The small amount of increased oxygen that is needed by the cells to improve their function does not necessarily require new blood vessel formation to be accomplished because with HBOT free oxygen molecules are dissolved directly into the cerebrospinal fluid Therefore these cells are no longer dependent on increased oxygen delivery from increased blood vessel formation that secondarily delivers a greater oxygen load because it carries more hemoglobin.
- Angioneogenesis from the removal of oxygen: At times it may actually be the sudden removal of higher than normal oxygen concentrations that the body has adapted to rather than the higher levels of oxygen itself that may stimulate angioneogenesis There are reports that the new vessel formation in the retinas of premature infants who were on high doses of oxygen was stimulated by the rapid removal of oxygen and not from the oxygen itself.
- Increases in blood flow independent of new blood vessel formation, not only due to the competing mechanisms of vasodilation and vasoconstriction, but also due to decreasing the inflammation that secondarily constricts blood vessel lumens in a closed spac. Because inflammation is accompanied by swelling, tissue expansion or compression will occur. Therefore, whenever inflammation brings more fluid to a region of the body that is comprised of solid tissue and hollow blood vessels, the first thing to happen is that the hollow blood vessel lumens will be compressed and deliver fewer red cells carrying oxygen to the area. Once inflammation is reduced the secondary vascular narrowing is improved allowing increasing amounts of red blood cells carrying oxygen to reach the hypoxic areas and SPECT scans will once again "light up" turning from blue to yellow. SPECT scans demonstrate the relative amount of blood that is able to reach the different areas in the brain. Color coding allows easy visualization of what is occurring with blue areas representing little blood flow and yellow areas indicating normal blood flow.
- Decreasing levels of inflammatory biochemicals: Recent studies have demonstrated that children with autism frequently have neuro-inflammatory and gastrointestinal inflammatory conditions occurring. Multiple studies demonstrate the beneficial effect of hyperbaric oxygen therapy in inflammatory conditions. C-reactive protein and high levels of cytokines have been shown to decrease with HBOT. One study demonstrates that the anti-inflammatory effect from HBOT is probably due to pressure effects and not necessarily increased oxygen tension.
- Up-regulation of key antioxidant enzymes and decreasing oxidative stress: Children with autism have been shown to have increased oxidative stress and less reduced (active) glutathione HBOT, especially when using pressures less than 2.0 atmospheres, can up-regulate these antioxidant enzymes and afford antioxidant protection against oxidative stress.
- Increased oxygenation to functioning mitochondria: Mitochondria are the energy producing organelles of the body. A growing number of studies are focusing on the mitochondria and its relationship to many disorders The possibility exists that some autistic symptoms may occur if these organelles are dysfunctional or fewer in number than the number found in children without autism. HBOT may have the potential to activate dysfunctional mitochondria and/or to activate "dormant/idling cells" thereby allowing more "mitochondrial product" to be appreciated by the body.
- Increased production of new mitochondria from HBOT.
- Bypassing functionally impaired hemoglobin molecules, the result of abnormal porphyrin production, thereby allowing increased delivery of oxygen directly to cells: A recent study documented impaired production and abnormal ratios of porphyrins in children with autism. Because porphyrin is involved in the production of functional heme/hemoglobin, and because this appears to be disordered in autism, the impaired delivery of oxygen to cells will be improved when HBOT bypasses hemoglobin-dependent oxygenation.
- Improvement in immune and autoimmune system disorders: HBOT has been shown to benefit the immune system and multiple studies have shown that autism is frequently associated with various types of immune and autoimmune system biomarkers.
- Decreases in the bacterial/yeast load found systemically and in the gut: Many children with autism have increased amounts of abnormal bacteria and yeast in their gastrointestinal tractsThese same children have shown clinical improvements when this overgrowth phenomenon is treated with antibiotics, either by natural agents or pharmaceuticals. HBOT has been shown to decrease abnormal bacteria/yeast in the gut.
- Decreases in the viral load found systemically and possibly decreases in a viral presence that may exist in the intestinal mucosa: Children with autism have difficulty handling viral infections, most likely due to immune dysfunction. It has been postulated many times that children with autism have a chronic low grade viral gastroenteritis and viral encephalitits. HBOT has been shown to decrease HIV viral loads. I speculate that one of the primary reasons HBOT works so well for so many children whose abnormal stools improve once they start HBOT is because the chronic, low-grade, smoldering live viral load harbored in the intestinal mucosa (Wakefield/Krigsman hypothesis) does poorly when surrounded by higher oxygen concentrations. The literature states that in order to kill viruses 100% oxygen at 2.7 ATA or above is required. However, there is no reason to believe that even mildly increased oxygen tensions may inhibit viral activity and/or make the host less hospitable to chronic viral inhabitation. This explanation is in keeping with the clinical results I see. In my clinic improved bowel function is in the top 20 most commonly seen benefits. I explain to my patients that to get cockroaches out of the kitchen, I can either kill them with my shoe or turn on the light. Interestingly it only takes a little bit of light for them to leave the room. Likewise it is my theory that it only takes a little bit of increased oxygen tension for viruses to leave.
- Increases in the production of stem cells in the bone marrow with transfer to the CNS: Studies have shown that HBOT increases the production of stem cells in the bone marrow and that transfer of stem cells to the central nervous system is possible.
- (Theoretical only) Direct production of stem cells by certain areas in the brain.
- Increased production and utilization of serotonin: Studies have shown abnormities in the autistic brain whereby it does not produce and subsequently does not use serotonin properly. Newer studies have shown that HBOT can work like an anti-depressant by increasing brain serotonin levels.
- (Theoretical only) The possibility that oxidation may help rid the body of petrochemicals.
- (Theoretical only) The possibility that oxidation may help rid the body of mercury and heavy metals.
This blog share very important points regarding hyperbaric therapy and how it help to improve the condition of patient. Thanks for sharing very informative blog.
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