Hyperbaric oxygen therapy (HBOT) is a medical treatment where patients breathe pure oxygen inside a pressurised chamber. The higher-than-normal pressure forces more oxygen into the lungs and bloodstream, allowing it to be delivered to damaged or oxygen-deprived tissues to accelerate healing.
Whilst HBOT is an established and effective treatment for conditions such as diabetic foot ulcers and carbon monoxide poisoning, its efficacy for conditions like ME/CFS remains a subject of ongoing debate.
Revisiting Our 2023 Update
We previously reported that for ME/CFS alone – we cannot draw any conclusions about the effectiveness of HBOT as the research in this area was lacking and conflicting. We also reported potential benefits for long COVID. However, a recent randomised, placebo-controlled, double-blind trial has challenged this. The trial evaluated whether ten sessions of HBOT could improve short- and long-term health-related quality of life, symptoms, and physical performance. It ultimately found that individuals with long COVID showed no greater improvement in physical function than those who received a placebo (measured using the RAND-36 scale). Also at the time, it was noted that whilst HBOT showed promise for fibromyalgia, the study methodologies lacked robustness.
New Findings in ME/CFS
Conversely, a recent small-scale study exploring HBOT for ME/CFS has yielded positive results. The observational study involved 30 individuals with ME/CFS and 30 age- and sex-matched controls who underwent 40 HBOT sessions.
Clinical outcomes were assessed at baseline, during treatment, and four weeks post-treatment. The results demonstrated significant improvements in physical functioning (measured by the SF-36 scale), exercise capacity, muscle strength, and information processing speed.
Furthermore, post-treatment brain imaging (MRI) revealed a shift toward healthy control patterns within the thalamus, correlating with the positive clinical responses observed. The researchers stated that this supports the hypothesis that “functional thalamic dysregulation contributes to ME/CFS pathophysiology and may be modulated by HBOT,” providing a clear rationale for future controlled trials to confirm therapeutic efficacy.
Study Limitations and Future Research
The researchers acknowledged limitations, this included: small sample size, observational, non-controlled design limiting generalisability and causal interpretation of findings. Furthermore, very severely affected individuals were not included in the study, and the cohort consisted predominantly of individuals with post-COVID ME/CFS (Canadian Consensus Criteria), which could affect the application of findings to the full spectrum of severities and ME/CFS resulting from other infectious or non-infectious triggers. Their methods did not allow full contextualisation of brain networks which limits interpretation of results. The research group currently has ongoing research underway using improved methodology.
