Can Hyperbaric Oxygen Therapy Cure You?

Miraculous!

Hyperbaric oxygen therapy, a revolutionary new treatment for diabetes, asthma, autism, PTSD, cerebral palsy, AIDS, heart disease, aging, learning disabilities, Alzheimer’s, arthritis, alcoholism, multiple sclerosis, hair loss, impotence, and more, has come to my attention. Apparently, it can even restore sight to a person born blind due to birth injuries (p. 92)! (Please note that this article was written many years ago. The page numbers may be wrong, but the points remain valid.)

The book about this treatment, “The Oxygen Revolution” by Paul Harch, MD, and Virginia McCullough, sounds like it’s presenting miracles for the asking. But is it? No. This book is an excellent example of what I call bunk science. Not because hyperbaric oxygen therapy (HBOT) itself is bunk; it’s not when used in the right circumstances. But because using HBOT (high-pressure oxygen) beyond its proven uses without valid scientific reasoning and before such use has been clinically evaluated in controlled peer-reviewed studies is bunk.

The Book is Bunk

Therefore, the objections to this book are not because, as Harch claims (p. xxiv), I’m letting others do my thinking for me. Instead, this article is based on a combination of 1) an analysis of The Oxygen Revolution using bunk-detecting principles I made up a long time ago (it fails every one), 2) a review of the scientific literature on HBOT and traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) in particular, and 3) the input of various experts.

Bunk-Detection

1. Check if the author claims that something has been proven or declares something to be a fact.

Although the book does not use the words “fact” or “proven,” declaring that “we’ve discovered that’ HBOT ‘permanently changes the body’s tissues” comes uncomfortably close (p. 4), primarily since nothing about this has been published in the peer-reviewed literature.

Another chapter speaks about a single patient with traumatic brain injury (TBI) who, after HBOT, experienced a 40% improvement in his computational abilities (p. 65). This “huge change” was deemed “highly statistically significant” and “unquestionably not a chance event.” That implies statistical tests have been run, and they have shown HBOT to have been what made the difference.

But note that three significant errors are being made. The first two have to do with statistics, and the third with the interpretation of the data. It’s the nature of statistics that they calculate the likelihood of something occurring by chance–that is, the probability of it happening outside of the standard bell-shaped curve. To calculate this, one requires that the “n” or number of trials is greater than “1.” But this report is about one incident in the life of one person only.

Then, there are issues with the understanding of what a statistical test can show. Although a probability may be small (unlikely with n=1), it is never “0.” The words “unquestionably not…chance” imply it is.

Finally, it’s being assumed that, because the patient received HBOT treatments, his improvement was due to the HBOT. But correlation does not mean causation. After all, it’s well documented that people do heal from TBI–and this is entirely because of natural processes.

Moreover, claiming that something is “unquestionable” is not a scientific statement. Scientists are trained to be accurate, be skeptical, and consider the options. Principle 1: FAILED

2. Check if the author makes claims to have accomplished something that is beyond what has actually been done or is even possible to do.

The claim that HBOT permanently changes tissues (p. 4) certainly qualifies here. Since we have not yet scientifically established what is “normal” for all tissues (or any), it is impossible to authoritatively ascertain that all of them have been changed, let alone permanently. Or, for that matter, if they had, whether that would be a good thing.

It’s also highly questionable whether a single type of treatment could bring improvement in the multitude of ailments the book references. In fact, on p. 95, we are told of a study on the use of HBOT in patients with various neurological conditions, including autism and cerebral palsy, where 90% of the patients improved. The implication was that the improvement was due to HBOT—but note, there were no controls. The results of this study could not be found in the peer-reviewed literature.

It is not possible to ascertain the effect of a treatment on every tissue forever. Nor is it possible to establish the efficacy of a treatment without using the standard scientific protocol of controlled trials and peer-reviewed publication. Principle 2: FAILED

3. Check if what is said is scientifically accurate.

Oxygen is not a drug.

On page 4, the book states that HBOT is a “DNA signaling drug.” Elsewhere, we are informed that HBOT is a neurological repair drug because it stimulates DNA (p. 127). This claim is astonishing in its inaccuracy. Oxygen is not a drug insofar as it is a gas that we all breathe. It also does not signal or stimulate DNA. Certain reactive oxygen species may and do damage DNA, but even these are not “signaling” molecules. It appears very much as if scientific words are being used to snow readers.

Oxygen cannot fix typos.

In the very next paragraph, we read that HBOT can “reverse injury to the DNA.” This claim is re-presented in another fashion on pp. 34 and 173. To understand the depth of the scientific inaccuracy, recall that DNA is roughly equivalent to the ink in which the code of life is written. Essentially, the claim is that the application of oxygen to the typos in the book will cause the ink to reformat itself so that the altered sentences will be rewritten with accurate code. One wonders where the oxygen finds the requisite information to accomplish this remarkable feat! Of interest is an article that shows the opposite of what the book claims to be true: HBOT causes DNA breakage in a type of white blood cell.

Oxygen accepts electrons–only.

On page 8, it is written that oxygen has a “positive effect on the DNA and the structural components of cells in the brain, spinal cord, bones, and skin.” We have established that the first part of this statement is nonsense. About the second part, oxygen has the same function in every cell of the body. It is a final electron acceptor in the mitochondria.

Put simply, to harvest energy from food, cells break down glucose, which contains high-energy electrons. The electrons are “rolled” down a chemical hill that is present on mitochondrial membranes; their energy is harvested as they go. The oxygen is at the bottom of the hill, and the electrons “land” there. The only “positive” effect that oxygen could have is to speed up this process–unless the other reagents needed run out or the excess oxygen levels cause the nutrient-containing vessels to constrict or the oxygen toxicity shuts the cells down. This is why controlled studies are required.

Oxygen is toxic

On p. 9, it is stated that HBOT is a holistic therapy because it introduces oxygen to “every cell in the body.” Note two things. First, how could one determine this scientifically? After all, not every cell of the body is accessible for observation. (Principle 2 violated again.)  Second, why would one assume this is a good thing? Drinking water is good, but drinking too much can cause water intoxication and even death.

The supply of oxygen to our cells is carefully regulated. Oxygen is usually carried on red blood cells attached to hemoglobin; too many or too few red blood cells is a symptom of disease. When one changes altitudes, the body adjusts the number of red blood cells. If the body is so careful with getting oxygen levels right, it is entirely reasonable to suppose that forcing them artificially would be toxic—thus the need for placebo-controlled studies.

Oxygen can’t be metabolized.

On p. 18, we read that extra oxygen is not a problem because “we metabolize it.” Wrong. Wikipedia (not the best source usually, but accurate in this instance) says, “Metabolism is traditionally divided into two categories. Catabolism breaks down organic matter, for example, to harvest energy in cellular respiration. Anabolism uses energy to construct components of cells, such as proteins and nucleic acids.” As explained above, we do not use oxygen as a source of energy, nor do we use it to construct cellular components. We use it as a final electron acceptor. That’s because it is fully oxidized and cannot be metabolized.

Thought Experiment

Now for a thought experiment. Have you ever seen someone hyperventilate—that is, breathe faster and deeper than normal? What happens as a result? The levels of blood carbon dioxide decrease, and the person first becomes lightheaded, experiences numbness and tingling of the extremities, may have chest pain, and eventually may lose consciousness. This is because the body is a carefully balanced system designed for optimum function.

Carbon dioxide in our blood helps regulate our acid balance, allowing our enzymes to function most efficiently. When the acid levels change from the normal 7.4, even by tenths, to 7.0 or 7.8, death may result. In HBOT, patients are exposed to high concentrations of oxygen, which drives out blood carbon dioxide.

In fact, HBOT patients are administered pure oxygen in a pressurized room or chamber. What would one expect the side effects to be? Perhaps those described on p.p 37-40 as a result of oxygen toxicity, barotrauma to the ears because of the increased pressure, and blindness due to optic neuritis. In addition, because keeping the oxygen level steady is so essential, all vessels in the body (except in the lungs) constrict in the presence of excess oxygen.

So, the result of HBOT in the brain would quickly be less, not more, blood flow.  This does not even take into account the possible brain damage caused by reactive species resulting from a sudden oxygen burst in hypoxic tissues, which could indeed light up the SPECT.

Count the scientific inaccuracies mentioned above–and this is not an exhaustive list. Principle 3: FAILED

4. Beware of grandiose claims.

The Oxygen Revolution is full of them. Apparently, HBOT has applications for TBI, seizures, genetic disorders, birth injuries, fetal alcohol syndrome, strokes, autism, multiple sclerosis, diabetes, cardiac disease, arthritis, cancer, AIDS, Alzheimer’s disease, alcohol and drug detoxification, chronic fatigue, and transplant rejection, to name a few (p. xxvii, xxix, 5, and 31). It is even alleged that it may prevent all future illnesses (p. 66).

There is an attempt to forestall the objections of thinking people by saying it sounds like snake oil, but it isn’t. Yes, it is. It sounds like snake oil because it is. Note the sleight of hand on p. 5, where the book mentions that a doctor at an unnamed institution submitted a grant to the NIH on equipping ambulances with HBOT equipment. Sounds impressive until one realizes that anyone can submit a grant, and many do. Many fewer grants are funded, and even fewer give positive results.

Grandiosity Exemplified

More grandiose bunk can be detected on page 7. Here we are told that doubting that HBOT can treat “the range of conditions and diseases to which humans and other animals are vulnerable” (what, all of them?) is like doubting that water, which is made of oxygen and hydrogen, can float boats, generate electricity, and be essential to our cells. No, it isn’t. Enough said.

Anecdote from 1918

It is ironic that on p. 12 we are told that HBOT may have fallen into disuse because “it may have been applied indiscriminately and the results exaggerated.” Then, on the same page and the next page, the work of Dr. Orval Cunningham in 1918 is described. Apparently, Cunningham treated a Mrs. Rand for temporary high blood pressure with hyperbaric air. Note first that blood pressure does fluctuate naturally and that forcing a person to lie down in a quiet chamber would, in and of itself, reduce their blood pressure. We are told that “Putting any tendency for ‘hype’ aside, Cunningham’s results provide powerful scientific testimony and can’t be written off as merely anecdotal.”

But clinical science requires peer-reviewed controlled studies of multiple patients. Stories of individuals who got better, but where we have no evidence as to whether they got better due to or despite the treatment, are anecdotal by definition (p. 92). This is not disparaging their experience, as is suggested on p. 227, but simply a scientific viewpoint. Incidentally, many patients got better after blood-letting, but this is not considered good basic medical practice today.

Grandiose claims–HBOT can be effective in a multitude of ailments, including aging. Principle 4: FAILED

5. Check if the claims can be tested scientifically, that is, can they be measured.

Throughout the book, we find claims that the benefits of HBOT have been tested scientifically. Presumably, they can be. But have they been? For example, on p. 96, the work of Dr. Senechal in Montreal is cited. This person allegedly published a 2007 review on HBOT in cerebral palsy. However, there was no sign of this paper in the database PubMed—after a search of Senechal and 2007, Senechal and hyperbaric, Senechal and HBOT, and a search of Senechal and cerebral palsy. Looking up all the other research allegedly performed would require too much time, but perhaps just one infraction is enough.

Not testable

Other claims just can’t be tested. Take p. 149, where it is asserted that, “Without HBOT, she’s likely to have needed a major amputation.” Or p. 179, where we are told that without HBOT, Earl would have “required 24-hour observation” and may have lived out his days imprisoned. Take p. 167, where it is claimed that Terrell Owens would not have been able to play in the 2005 Super Bowl without HBOT, or p. 126, where it says that HBOT slowed the progress of Alzheimer’s in two patients. But, one might ask, how could one possibly know how fast Alzheimer’s would have progressed in the absence of treatment? And how could the current claim be tested? The same type of question could and should be posed about the other claims. Principle 5: FAILED

6. Be careful when an author makes too much of the scientific qualifications of those involved or disparages those who disagree with their views.

The Oxygen Revolution is full of such statements. We are told that the reluctance of the medical establishment to use HBOT is the result of “medical politics” (pp. 59 and 223), a few poorly designed studies (p. xxv), personal jealousies (p. 13), or physicians being uninformed (p. 91). Apparently, HBOT is not used because reviews are suppressed (p. 219), some scientists studying it don’t have the credentials needed and misinterpret or misunderstand all the literature (p. 222), and others write things that are “unscientific and even inaccurate, not to mention negative.” (p. 238)

In comparison, Harch claims to have “reviewed the world’s literature on HBOT” in certain conditions (p. 164). Presumably, he found it compelling since the public is repeatedly and passionately requested (p. 225, 97, 191, xxix) to help move HBOT into mainstream medicine since it is “easy to see” why it is medically valuable (p. 8).

Overblown Resume

Harch, the principal author of The Oxygen Revolution, while putting down others, tends to blow his own trumpet rather too loudly. His publication record is rather dire, so he pumps it up a bit in his online curriculum vitae (CV).   However, in comparing his publication record there with that found on PubMed, the premier database for peer-reviewed publications,  one can see that the CV is vastly overblown.

A quick perusal of the rest of the CV reveals the same tendency. For example, Harch actually lists being educated by a safety course (8/5/08) and a web tutorial 8/21/08. Frankly, everyone in science gets this kind of “training”–some of it is mandatory every year. Virtually no one lists it on their CV (except him). The fact that Harch even cites being asked to review a paper (August 7, 2008) in his CV highlights the problem. After all, most graduate students are asked to do this.

Overblown Preface

The same type of problems are present in The Oxygen Revolution. The Author’s Preface is full of Harch’s alleged successes in the treatment of patients with a vast variety of disorders, but they are anecdotal and the claims are often overblown. For example, in the book, Harch refers to a “published” argument in a Workshop in 1996 (p. 31). What he neglects to point out is that workshops are not peer-reviewed publications. What he submitted would have been an abstract at best. Not a scientific study.

On p. 104, we are told that Dr. Harch recruited Dr. Dietmar Schneider to join him in a stroke project and that the German group has gone on to see positive results. Unfortunately, there is no record of this in the literature, despite the project being initiated in 1998 and the book being published in 2010, which makes the validity of the claim doubtful.

There is no doubt that Dr. Harch overemphasizes his own qualifications and successes, and disparages the views of those who challenge him, even though a review of those criticisms reveals that they are very reasonable in tone and content. Principle 6: FAILED

7. Check that the“satisfied customers,” “experts,” study participants, and promoters of the idea or product do not stand to gain from their testimony or participation. 

If patients seek out Harch for HBOT (he suggests a minimum of 40 treatments, but does not base this on any peer-reviewed publication) at $200 per treatment (p. 134 and 197), he will benefit from the sum of $8000. In addition, Harch does suggest that more HBOT sessions may be better—perhaps his patients will require 80 or more treatment sessions.

This, of course, does not include the cost of the SPECT scans he uses before the first treatment, after the first treatment, after 40 treatments, and thereafter to “prove” the treatments worked (p. 43). The costs for these vary, but $ 3,000 per scan would not be unusual.

A quick calculation shows that a course of treatment will cost $17,000 to $28,000/patient in 2010. Now, it would be more. Principle 7: FAILED

8. Be skeptical.

Do not be quick to believe people, especially when it involves your health and/or your money! In this case, both will be involved. We have mentioned the cost, but is the therapy as innocuous as suggested (p. 28, 91, etc.)? Probably not. After all, oxygen is known to be cytotoxic, so that administration may lead to an inflammatory reaction, which would show on a SPECT scan.

In addition, when oxygen levels rise in the brain, the brain responds by vasoconstriction, so that less oxygen reaches the brain. The possible damage to the neurons may cause erratic electrical discharges or mini seizures, which would result in increased metabolic activity and a change in the SPECT scan results.

What about the risks of the SPECT that is used to “prove” the HBOT is working? SPECT itself is not a very dangerous procedure. Still, it does require an injection of a radioactive tracer that contains about the same level of radioactivity that one would typically be exposed to over a year. Four scans would be equivalent to four extra years of radiation—all radiation is calculated as cumulative exposure, and it does not wear off. If the medical test is necessary for diagnostic purposes, then this would be acceptable.

Just so you know, this test, which is extremely nonspecific since it only tests for uptake of a particular chemical and has a notoriously low level of resolution, is repeatedly administered only to convince the patient to continue to receive HBOT treatment sessions. Harch himself says, “When a patient can actually see a picture that displays the injury, the experience can have a profound effect, and lead to greater insight about the disability involved” (p. 51).

It would also lead to a greater willingness to open the wallet. Principle 8: FAILED

9. Check if the consensus in the peer-reviewed literature supports the scientific claim.

According to the scientific literature, HBOT may be helpful in the treatment of carbon monoxide (CO) poisoning, diving-related decompression illness, and chronic ulcers or wounds (as referenced on pp. 46-47). Logically, excess oxygen would be helpful in the first condition because CO is bound to the hemoglobin, preventing the tissues from gaining access to oxygen. Increasing the partial pressure of oxygen would help stabilize the tissues.

However, Buckley et al. 2011 report that a review of the existing literature does not show a definitive advantage of using HBOT in CO poisoning. In the second, the divers have increased the amount of nitrogen in their blood. The high-pressure oxygen would drive out the nitrogen bubbles, although oxygen toxicity can and does result. In the third, some wounds are infected with anaerobic bacteria, which find oxygen toxic and would therefore die in its presence. Others are formed as a result of restricted blood flow, where the tissues do not have the oxygen needed to repair themselves (eg, crush injuries, diabetes). Oxygen supplementation may therefore be beneficial.

However, there is no scientific consensus regarding the benefits of HBOT in TBI or many of the other ailments referenced. Therefore, the use of HBOT in these conditions should be viewed with extreme caution, and is not recommended as essential (p. 5). The statement deriding the “current fashion” of evidence-based analyses may reveal much about the author (p. 133).

The consensus is not always right, nor is it always wrong. But it is more likely to be right than wrong. And that is why I say: Principle 9: FAILED.

10. Be sure that the scientific claim does not contain invalid assumptions or extrapolation.

No control group

There are many of these, but one example will have to suffice. In deciding not to include a control group in his TBI (or any) study, Harch is making several invalid assumptions. First, he is assuming that no injury is resulting from the treatment. Second, he is assuming that any changes are the result of the HBOT, not any other therapy the patient is receiving or even the natural healing process. Finally, he is assuming that the changes in the SPECT results are not due to patient thought patterns, ischemia-mediated mini-seizures, or inflammation.

Invalid extrapolation

The assertion that, because HBOT is useful in certain conditions, it must be useful in many is an excellent example of invalid extrapolation. And about as logical as noting that because Band-Aids are useful for the treatment of burns, cuts, and scrapes, they would also be suitable for the treatment of diarrhea and brain tumors. The conditions where HBOT appears useful (and even though there is little conclusive data) are all due to acute oxygen deprivation. Conditions where there is no acute deprivation of oxygen (PTSD, fetal alcohol syndrome, birth damage, etc.) are extremely unlikely to respond to the replacement of oxygen.

Other conditions

Well, what about all the other conditions where The Oxygen Revolution touts the benefits of HBOT? Unfortunately, to address them all would require writing a book, but here are some debunked.

On page 139, we are informed that HBOT enhances the function of white blood cells. On pp. 142 and 148, we are told that HBOT inhibits the inflammatory response, which is, of course, mediated by white blood cells. Now, there is some evidence that the use of HBOT may be beneficial in the treatment of chronic wounds (there is as yet no consensus), but it is very obvious that it cannot be through both improving the function of and inhibiting white blood cells.  Note that the paper by A. Adibia, cited on p. 141, allegedly showing that HBOT improves the overall health of diabetic patients only refers to ulcers, not overall health.

Neurology

The Oxygen Revolution dedicates numerous pages to demonstrating the efficacy of HBOT in treating neurological diseases. We are told of the work of Fischer, who showed that HBOT had a temporary positive effect on patients with multiple sclerosis, but the benefit was not sustained. However, since the normal course of the disease is that it progresses by attacks and remissions, this result means very little.

We are also treated to discussions of the potential benefits of HBOT in autism (p. 112)  where the literature does not support what is claimed, in ALS (p. 134)  where the literature does not support its use, in Alzheimer’s (p. 126) where nothing has been published in the literature, and even in increasing intelligence (p. 105) which is clearly an unsubstantiated assertion.

The use of HBOT in stroke yielded indefinite results—indeed, the book says that there are no promising results in the USA. This makes the statement that Harch recommends it to the stroke victims he sees in the ER (p. 104) all the more astonishing. An extremely questionable practice!

Invalid assumptions and assertions? How about that HBOT may be able to rejuvenate and rebuild brain tissue (p. 165)? Principle 10: FAILED

Survey of the Literature on HBOT and TBI

On pp. 58 and 95, Harch writes about his current project, where he is targeting veterans with TBI in an uncontrolled study. Having observed how The Oxygen Revolution fails to meet all ten principles, it would be expedient to specifically review the literature regarding HBOT and TBI.

Defective work

A quick check of what Harch himself has published in this area revealed one peer-reviewed paper on preliminary results from a clinical trial (2012).  Harch’s other publications over the last six years include a case report (on one person), two animal studies, and two letters defending the methodology and conclusions of the very flawed clinical trial.

The 2012 paper reports on a Phase I uncontrolled (according to p. 58 of the book) study of HBOT for blast-induced post-concussion syndrome and post-traumatic stress disorder (PTSD). Phase I. That means that the treatment is being evaluated in a small group of people for safety and efficacy. One may ask how either can be accomplished without a control (sham-treated) group. Conducting a Phase I trial without a control group is either the mark of an extremely inexperienced scientist or, at worst, a scam.

The preliminary results are intriguing. After all, it is claimed that in the 15 patients who completed the trial, HBOT significantly improved IQ, memory, PTSD, depression, anxiety, and more. But again, the study was uncontrolled; there was no placebo group. There is no way of knowing whether the treatment helped, whether the patients would have improved anyway, or if they improved as a result of other therapies, or even if the experimental protocol damaged them.

Safety Profile

So, let’s first look at the safety of HBOT. As reported by Harch, a third of the people suffered “reversible middle ear barotrauma,” four got worse for a while, and one had an asthma attack. He does not mention oxygen toxicity, which can be a real problem with HBOT–according to the book itself, where it talks about adjusting the dose when it occurs.

That seizures occur is just accepted by Domachevsky et al. as a preexisting fact; whether the seizures cause damage is questioned. Or look at this article where it is also assumed that HOBT-caused oxygen toxicity and seizures occur. And since seizures cause increased metabolism and thus increased glucose uptake, this is what could be observed in the SPECT: not improved health, but brain damage.

Where there’s smoke, there’s fire. And where there’s one breach of experimental protocol, there are often more. Indeed, within months of Harch’s paper being released, at least two groups of scientists wrote thoughtful pieces pointing out many serious mistakes in the work. They concluded that “the study results leave little meaningful behavioral data to support the effectiveness of the examined treatment,” and “the current investigation is incapable of supporting many of the assertions made by the authors.”  The other group wrote, “The degree and clinical importance of the symptomatic changes experienced by participants in this study are also doubtful.”

Criticism of the paper

This is not surprising given that, according to Armistead-Jehle and Lee, the study suffered from several errors in statistical methodology, making the analyses invalid. In addition, there were several study design mistakes, including the use of an inappropriate intelligence test and failure to report individual scores, the omission of a pre-test post-treatment comparison, and the making of unsubstantiated and false assertions about memory function.

There were even issues with test subject selection. This small group included mild TBI patients (who are known to usually recover spontaneously), two individuals with moderate TBI (who require their own group for effective evaluation), and two patients with mild, complicated TBI; however, there was no control group.

Wortzel et al. point out that all of the study subjects had co-morbid PTSD, were clinically depressed, and nearly all had generalized anxiety and were receiving psychotropic medications. Therefore, it is likely that their symptoms originated from these conditions, rather than their mild TBI. Consequently, it is entirely possible that their “recovery” came from the placebo effect, resulting from “extensive pre-and post-treatment clinical and neuroimaging assessments, interaction with study personnel during treatments with the awe-inspiring HBOT equipment, and, of course, the psychoactive drugs. If the study was “designed” to evaluate the effect of HBOT on TBI, it did not do a good job, and the “results” are unconvincing. In fact, even according to the definition of an observational study, which does not require controls, this work falls short.

Overblown claims

What is also incredibly troubling is Harch’s tendency to overblow his results—a tendency that we have observed before. He claims “dramatic improvements across somatic, cognitive, and psychological outcomes.” For example, he reports a 14.8-point improvement in IQ after treatment, but it is well-established that people with mild TBI do not suffer from cognitive impairment, making improvement unlikely.

Harch claims that “Significant improvements occurred in symptoms, abnormal physical exam findings, cognitive testing, and quality-of-life measurements…” But he neglected even to show that TBI caused the symptoms the patients were experiencing in the first place.

So does HBOT help with TBI? Unknown. Some of the literature suggests it may prevent death after TBI, but does not improve cognitive outcome; other papers say that it doesn’t even do that.  This is why a properly designed study, such as that by Weaver et al., is essential.

According to Wortzel et al., “remaining circumspect on these matters is essential when treatment entails more than minimal risks, assessments and treatments are costly, and their development is intertwined with commercial interests.” This is particularly vital because we are dealing with a “vulnerable” population who could, in fact, be very tempted by the “allure of promising but unproven results.” And false hope is not better than realism.

Conclusion

The Oxygen Revolution is riddled with a mixture of three things. 1. Simplified explanations of real science, which lull the reader into thinking that the other parts of the book are also scientifically valid. 2. Expositions of heart-rending problems, such as autism, birth injury, neurologic illnesses, etc., which engage the reader’s emotions. 3. Numerous anecdotal accounts of seemingly miraculous cures tempt the reader with the hope being offered.

There is no good clinical data to support Harch’s claims, but ultimately, what he is selling is hope (p. 21). “I can’t emphasize enough the possibility that hyperbaric oxygen therapy can promote healing in the vast number of conditions that afflict humankind.” (p. 155) It may be false hope, and it definitely comes with a huge price tag, but when people are desperate, it seems better than nothing.

A highly-experienced and ethical neurologist told me, “Hyperbaric oxygen does have established uses in treating certain wounds, for example, in burn patients, and in pressurized chambers in the treatment of decompression sickness in scuba divers. But I am skeptical based on what I know of hyperbaric oxygen in other applications where quacks have notoriously misused it.”

The Oxygen Revolution violates every one of my Bunk-Detecting principles. Need I say more?