How Is Ozone Therapy Administered?
Ozone therapy can be administered in a multitude of ways and all of them have their pros and cons: some need a doctor to be present, others can be easily done at home. Additionally, people come up with new ways to use ozone all the time.
Ozone therapy is administered intravenously, intra-arterially, intra-articularly, intramuscularly, subcutaneously, topically, as inhalations after bubbling it through olive oil, or as insufflations. The applications are either performed directly with the ozone gas or with ozonated liquids like ozonated water, saline, or oils.
Here is a (non-exhaustive) list of some of the most common ways to administer ozone therapy:
List of ozone therapy administrations
The following list contains some of the most popular ways how ozone therapy is administered, both professionally by doctors as well as at home by laymen. It is not a complete compilation.
Ozone therapy is administered invasively whenever the skin is punctured or cut with needles or scalpels. This includes any type of “blood ozone” treatments, intravenous or intra-arterial infusions, subcutaneous, intra-peritoneal, intra-mascular, or joint injections.
Intravenous ozone therapy is administered into the vein. This can happen in different ways:
1. Blood is drawn into a container outside of the human body and an anti-coagulant (either heparin or sodium citrate) is included to prevent clotting. Ozone is added into the bag (or bottle or syringe), mixed with the blood, and re-infused into the patient’s arm.
2. A saline solution is ozonated and then infused into the patient’s vein via a drip.
3. The ozone gas is injected directly into the blood stream.
Each method can be performed differently with different accessories, techniques or ozone concentrations.
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The 10 pass method was developed by Dr. Johann Lahodny, an Austrian gynecologist. The original 10 Pass ozone treatment consisted of the following strictly defined protocol:
200 ml of blood were drawn into a vacuum bottle, 20,000 units of heparin were added and 200 ml of ozone/oxygen mix at an ozone concentration of 70 mcg/ml. The bottle with the blood and ozone mix was gently shaken and re-infused under slight pressure of maximum 0.8 bar back into the vein. This process was repeated 10 times within 1 to 2 hours, hence the name: 10 Pass.
This resulted in a total ozone dosage of 140,000 mcg and a total of 2,000 ml of drawn blood.
With time the protocol has undergone some changes. Nowadays less heparin is used, namely 7,500 instead of 20,000 units, and more blood is taken per pass (250 to 300 ml) and shaken with more ozone (250 to 300 ml) per pass.
Another modification is that 20 and 30 Passes are being performed.
10 / 20 / 30 Pass treatments require a hyperbaric ozone generator like the Herrmann comfort or the Zotzmann 2000N.
10 Pass and multi-pass treatments are different types of hyperbaric ozone therapy.
A multi-pass is any treatment which employs more than one but less than 10 passes. Each pass usually consists of 200 ml of drawn blood and 200 ml of ozone/oxygen gas mix. The used ozone concentration typically varies between 40 and 70 mcg/ml.
10 Pass ozone therapy is administered with the help of hyperbaric ozone generators like the Herrmann comfort or the Zotzmann 2000N.
RHP stands for Recirculatory Hemoperfusion, EBOO stands for extracorporeal blood oxygenation and ozonation and both describe roughly the same type of treatment: blood is drawn from one arm, transported into a machine where it’s mixed with ozone and then re-infused into the other arm.
RHP / EBOO are a type of ozone dialysis therapy.
The preferred ozone concentration for EBOO treatments is 0.1 to 40 mcg/ml, the total amount of ozone varies between 10,000 to 1,200,000 mcg, the total volume of drawn blood can be as high as 6,000 ml.
RHP / EBOO can be performed by either mixing the blood directly with the ozone gas or by mixing it with ozonated saline and it can be combined with filtration before the re-infusion. The treatment requires an anticoagulant.
EBOO performed with Prof. Nazarov’s equipment by mixing ozonated saline with blood outside of the patient’s body.
Major Autohemotherapy is the classic intravenous ozone therapy administration. It’s one of the original and most widely used ways to use ozone in medicine.
The exact amount of drawn blood and used ozone can vary widely between practitioners and between single treatments. It can involve anything between 60 and 250 ml of blood mixed with ozone amounts ranging from 60 to 250 ml at concentrations between 20 and 70 mcg/ml. MAH requires an anti-coagulant which can be either heparin or sodium citrate. Some practitioners also add saline to the blood.
Normobaric / hyperbaric MAH
Normobaric describes normal barometric pressure which during ozone therapy usually means 0 bar. When ozone therapy is administered hyperbarically, the applied pressure moves between 0 and 0.8 bar.
Mixing blood with ozone under hyperbaric (positive pressure) conditions is supposed to render additional benefits. It’s alleged that the pressure protects red blood cells from being destroyed and improves ozone saturation.
Hyperbaric MAH treatments are achieved when more ozone is introduced into the container with the blood than there is space for. Example: In a 250 ml bag 200 ml of blood are drawn, which leaves 50 ml of space. If 100 ml of ozone gas are injected into that 50 ml space, then this creates a positive (hyperbaric) pressure inside the bag.
Special hyperbaric ozone generators make it easier to administer ozone therapy hyperbarically but they are not absolutely necessary for that purpose. Hyperbaric treatments can be also performed with normal non-hyperbaric ozone machines. When using a normobaric ozone generator, the practitioner uses gravity to extract the blood (by placing the bag below the patient’s arm) and to re-infuse it (by placing the bag above the patient). They hyperbaric aspect of the treatment is generated by manually injecting more ozone into the bag than there is space.
When performed with a hyperbaric ozone generator the extraction and re-infusion happens with the help of either a vacuum (between -0.8 and less than 0 bar) or positive pressure (between more than 0 and 0.8 bar). The mixing of the blood is also performed under slight positive pressure.
During ozonated saline IVs physiological saline of 0.9% is infused intravenously into the patient. The saline can be ozonated right before the administration or during the administration. Some practitioners also ozonate saline in bulk ahead of time and refrigerate it.
When ozone therapy is administered intravenously through saline solution, it’s called the “Russian Method” since it’s been first developed by the Russian doctor Dr. Sergei Peretyagin.
This video includes footage from my stay in Nizhny Novgorod, Russia, where I learned the “Russian method”, aka ozonated saline IVs.
DIV is the administration of ozone/oxygen gas mix directly into the vein. 10 to 60 ml of ozone gas are injected at an extremely low flow rate of 1cc per 10 seconds to 1 cc per 30 seconds. The recommended ozone concentration is between 20 and 35 mcg/ml (Dr. Robins’ preferred concentration is 55 mcg/ml). Special precautions need to be respected to make sure that only pure ozone/oxygen gas mix free of air contamination is injected.
DIV ozone injections are a perfect tool to treat varicose or spider veins. In which case ozone concentrations between 50 to 70 mcg/ml are used.
An intermittent ozone treatment is a type of a small autohemotherapy: first a syringe is filled with ozone, then the same syringe is used to draw blood from a patient’s vein. The line of the butterfly needle is clamped off, and the syringe is shaken to mix the blood with the ozone. During the whole time the needle remains in the patient’s arm and the syringe is never disconnected from the butterfly needle. Once sufficiently mixed, the ozonated blood is then pushed back into the patient’s vein.
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Ozone can be also injected into an artery, instead of into a vein. This is an obsolete form of ozone which is rarely performed nowadays. It requires a good knowledge of anatomy. A recent and rare example has been demonstrated by Dr. Rowen in the treatment of an injury caused by a hyaluronic acid injection.
During intra-articular injections, ozone is injected into joints. Any joint on the human body can be injected with ozone: knee, shoulders, hips, wrists, etc.
Usually, ozone concentrations of 20 to 40 mcg/ml are used and ozone amounts of a few to around 10 milliliters per injection. Joint injections require a good understanding of human anatomy and are commonly performed by doctors or trained chiropractors.
Dr. Frank Shallenberger has made joint injections in the US popular under the name Prolozone™. They are often combined with a mix of B vitamins, homeopathics, procaine, and followed up with ozone.
A demonstration of ozone injections into the knee.
Intramuscular injections are performed by injecting an ozone/oxygen mix into the ventrogluteal or the dorsogluteal muscle (buttocks).
A syringe is filled with 10 to 20 ml of ozone at an ozone concentration of 20 to 40 mcg/ml and then injected into the desired muscle. Care needs to be taken to prevent the injection of the gas into a blood vessel.
Minor Autohemotherapy (MiAH) is also a type of intramuscular ozone injection where a mix of ozone and blood is injected instead of direct gas.
A 60 cc ozone syringe and a 40 mm needle is used to inject only 20 cc of ozone/oxygen gas. Not a good call. It’s better to use a smaller syringe.
During minor autohemotherapy a syringe is first filled with 40 to 50 ml of ozone gas at an ozone concentration of 20 to 40 mcg/ml. The same syringe is then used to draw 10 to 20 ml of blood. The syringe is then shaken several times and the ozonated blood is injected into the muscle (usually the dorsogluteal or ventrogluteal). MiAH is a type of ozone therapy which is administered intramuscularly, but the treatment involves an intravenous component.
Ozone can be injected superficially under the skin into nearly every part of the body. For this, usually a syringe of 10 to 20 ml and a small needle (30 g, 13mm) is used. The ozone concentration varies between 5 to 40 mcg/ml, depending which body area is injected for what purpose. Per injection, usually not more than a few milliliters of gas (1 to 5 ml) are introduced.
Ozone therapy administered subcutaneously is a very versatile treatment: it can be injected in the face, around joints, into painfully tight shoulders or necks, or paravertebrally along the spine. Subcutaneous ozone injections can be also administered around or into a tumor, a cyst, or fibroids. Ozone can be also injected into so called “bioactive points”. I have also witnessed Russian doctors injecting ozone all around the head to successfully treat headaches.
In some parts of the world (Russia, Italy, Spain), subcutaneous ozone injections are administered for cosmetic reasons, hoping to stimulate collagen production and treat wrinkles, saggy skin, cellulite, or to improve hair growth (personally, I have not seen any convincing evidence that this helps).
Joint pain can be treated with subcutaneous ozone injections which do not go as deep as true joint injections.
This procedure is also called ozone discectomy and it involves the injection of ozone into bulging discs. The ozone shrinks the disc and makes it retreat from the spinal canal, relieving impingements on the spinal cord.
To administer ozone therapy intra-discally requires image guiding technology to ensure utmost precision when placing the needle.
Video of intradiscal ozone injection to shrink a patient’s disc.
The peritoneum is a membrane which surrounds the intestines. Ozone can be introduced into the body cavity surrounded by the membrane, and is then absorbed by the tissue. Intra-peritoneal ozone insufflations are performed under surgical settings. They require a small incision into the patient’s abdomen. Dr. Perez Olmedo is a pioneer in this area.
Ozone gas can be also injected directly into tumors. Usually, just a few milliliters of the gas are injected at an ozone concentration of 20 to 40 mcg/ml. In order to administer the ozone therapy as precisely as possible and depending on the accessibility of the growth, the procedure may require image guiding technology.
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Whenever ozone therapy is administered in a way which does not require the skin to be punctured, it’s called a non-invasive ozone treatment.
This includes insufflations of various body orifices like the rectum, vagina, ears, mouth, or the stomach, but also topical applications or the ingestion of ozonated liquids.
Ozone insufflations (also called instillations) are ozone therapy administrations during which ozone gas is introduced into a body cavity to be absorbed by the body tissue. Ozone insufflations are low risk, non-invasive, easy to perform with simple supplies and do not require a doctor’s presence.
Anecdotal evidence as well as clinical studies have shown the effectiveness of ozone insufflations for a wide range of ailments.
During ear insufflations ozone gas is infused into the ears. This can be done either with the direct or the indirect method.
During the direct method, a modified stethoscope (earscope) which allows to be hooked up to the ozone generator, transports the gas in a continuous fashion from the machine into the ears. The direct method requires an empty trap between ozone generator and the earscope to muzzle the noise of the machine.
The direct method calls for an intermediary container like a syringe or a bag to be filled with ozone gas first. It is then connected to the earscope and the gas is gently pressed from the bag or syringe into the ears.
Rectal insufflations are one of the most popular type of home ozone applications due to the widely promoted belief that their effectiveness is equivalent to intravenous ozone treatments.
Just like other insufflations, rectal ozone can be performed either directly or indirectly, with the indirect method via a bag being the most popular. There, a bag is first filled with 100 to 750 ml of ozone, and then connected to a catheter which has been inserted into the rectum. By manually squeezing the bag, the contents of the bag are introduced into the colon.
Same can be done with a syringe instead of a bag.
Alternatively, ozone can be infused in a direct and continuous fashion by connecting the inserted catheter with the ozone generator through a silicone tube. The procedure should be timed to make sure that a recommended total volume of ozone gas is not exceeded.
When ozone therapy is administered rectally, the gas volume usually ranges from 100 ml to 750 ml at ozone concentrations from 8 to 100 mcg/ml depending on what is being treated and on the response of the patient.
Dr. Lahodny is known to slowly introduce up to 2,000 ml rectally in 10 ml increments at an ozone concentration of 80 mcg/ml, a treatment which can take around one hour.
Is ozone therapy administered vaginally, then either a catheter or a special spiral device is inserted and connected with the output of the ozone generator. They are a type of gas rinse: the ozone is poured in continuously for a certain amount of time. Some of the gas is absorbed, and the rest escapes the way it came in. It does not need to be retained.
Vaginal insufflations can also be performed indirectly, meaning with the use of a bag or a syringe, just like ear or rectal insufflations.
When done directly, VIs are performed for 5 to 30 minutes. The ozone concentration typically lies between 20 to 60 mcg/ml.
Sublingual ozone (or as I call them “mouth insufflations”) are done by placing a small volume of ozone gas under the tongue and allowing it to be absorbed.
A syringe is filled with 10 to 20 ml of ozone at an ozone concentration of 5 to 20 mcg/ml. A small piece of silicone tubing connected to the syringe serves as the “applicator”. The patient then places the piece of silicone tubing under the tongue, closes his mouth and keeps pressing the tongue against the palate. Breathing takes place through the nose only. The ozone is then squeezed out in increments of 1 to 2 ml. After a few moments, the gas is exhaled, and the procedure is repeated until the whole syringe has been emptied.
It’s important to only breathe through the nose during sublingual ozone insufflations.
During nasal or sinus ozone insufflations, ozone is injected through a syringe into the nose. The patient first takes a deep breath, then inserts the ozone filled syringe into one nostril, empties its contents, removes it, then pinches the nose for a few seconds to prevent ozone from pouring out. After a few seconds, the ozone is exhaled and the same procedure is repeated for the other side.
The used ozone volume is 10 to 20 ml per nostril at an ozone concentration of 5 mcg/ml to 20 mcg/ml.
During nasal insufflations it’s important to keep holding one’s breath to prevent accidental inhalation of ozone.
Bladder insufflations are an ozone therapy administration during which ozone gas is introduced via a catheter into the bladder.
First, a syringe is filled with ozone gas. Then, the catheter is introduced, remaining urine is drained, and the syringe is screwed onto the catheter and emptied into the bladder.
The used ozone volume ranges from 60 ml to 120 ml at an ozone concentration of 20 to 40 mcg/ml.
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Ozone therapy can be also absorbed through the skin. The human body is able to take in various oxidative substances through its outer membrane and generate beneficial by-products.
There are several ways to administer ozone therapy transdermally: with the help of a sauna, a bag, or a suit which covers the entirety of the body, or just single limbs. Soaking baths in ozonated water, applying ozonated oils topically, or cupping also work through the skin.
An ozone sauna consists of two separate parts: a heating element (steam, or infrared) and ozone. The heat opens the pores of the skin and makes it moistt, rendering it penetrable for the ozone.
An ozone sauna has to be designed in a way to allow for the head to stick out to prevent the person from inhaling ozone gas.
Ozone saunas ideally last for 30 minutes, and are performed at an oxygen flow of 1/2 LPM at ozone concentrations ranging from 10 to 30 mcg/ml.
A home ozone sauna treatment with a foldable steam sauna tent.
HOCATT stands for hyperthermic ozone carbonic acid transdermal technology and is a form of ozone sauna. The HOCATT treatment promises to enhance “standard” ozone saunas by stimulating blood circulation.
In the meantime, HOCATT saunas have been endowed with PEMF, microcurrent, far infrared, and UV irradiation technology and far infrared heaters. The saunas also allow for the inhalation of pure oxygen or the addition of essential oils during the sauna sessions.
A HOCATT ozone sauna is a type of a pod which allows for the head of the patient to stick out.
An ozone body bag is an alternative to ozone saunas, especially for people who are heat intolerant. A bag or suit made of ozone resistant material which covers the whole body (except for the head) is used to trap the body heat which opens the pores and moistens the skin. An inlet allows for the simultaneous infusion of ozone from the ozone generator. It’s recommended to use the full body bag right after taking a shower or in combination with an electric blanket for extra heat.
An ozone body bag encloses the entire body except for the head. It’s a minor alternative to ozone saunas.
Transdermal ozone therapy can be administered on single extremities, in which case it’s called ozone limb bagging. The skin of a hand, arm, leg, or foot is first moistened with warm water and then inserted into a bag which is tightened around the skin. Ozone is then infused inside which exposes the skin of the limb to the gas and allows wound, eczema, or sores to heal.
The ozone concentration can be as high as 100 mcg/ml. Ideally, the used ozone generator should have a vacuum function to siphon off the ozone, or the bag should be opened where there is plenty of ventilation to prevent the accidental inhalation of ozone.
Limb bagging with ozone can be used to treat diabetic ulcers.
The topical application of ozonated oils (in most cases it’s ozonated olive oil) is yet another ozone skin treatment. Ozonated oils can be produced at home or be easily acquired online. They come either as a liquid or a thick paste and can be applied around painful joints, rashes, or as cosmetics.
During cupping, a cup is placed on a single spot on the skin and exposed to ozone. This concentrates the ozone stream towards that one spot. The skin needs to be first moistened with warm water to open up the pores. Usually, ozone cups have a destructor attached to them to stop ozone from escaping into the room. Cups with a vacuum function are another way to perform ozone cupping.
Ozone baths consist of ozone being continuously bubbled through bath tub water with the person being wholly or partially submerged in it. They can be performed as a type of soaking bath or as a jacuzzi. Single limbs can be also treated this way. It’s important to protect oneself from accidentally breathing in the excess gas.
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Ozonating water means bubbling ozone gas through water. This causes the ozone to be temporarily suspended in the liquid. After water has been infused with ozone, it can be ingested. This should happen on an empty stomach or at least 3 hours after the last meal. After the ingestion of ozonated water, one should wait 15 to 20 minutes before eating again to prevent the food from reacting with ozone and causing gas, cramps, and bloating.
Given that only around 1/4 of the ozone ends up in the water, relatively high ozone concentrations can be used of up to 100 to 120 mcg/ml. Water reaches its ozone saturation after around 10 minutes, longer times are necessary for bigger amounts.
The colder and the less minerals water contains, the more ozone it can absorb for a longer time. It should be consumed within minutes after the ozonation before the gas dissipates.
Drinking ozonated water is a mild systemic but often a very effective way to administer ozone therapy.
Ozonated water looks just like regular water, but it smells differently since it keeps losing ozone. The gas then collects on the surface. It’s important not to breathe it in during drinking. One should 1. keep the glass away and take a deep breath, and then 2. drink the water while holding one’s breath to prevent the accidental inhalation of the gas.
When ozone is bubbled through oils, it bonds with them and creates so called ozonides. Those are molecules which largely retain the therapeutical properties of ozone without irritating the lungs.
BOOO, or Breathing Ozonated Olive Oil, is the name of the resulting treatment. It allows to administer ozone therapy into the lungs safely and effectively.
The recommended ozone concentration is around 10 to 30 mcg/ml at the oxygen flow at 1/2 LPM.
The oil should be fresh, otherwise the patient runs the risk of inhaling pure ozone gas instead of ozonides.
Sinus irrigations or flushes can be performed either with ozonated saline or water with the help of either a neti pot or a dropper bottle. The liquid is first ozonated at an ozone concentration of 10 to 40 mcg/ml for at least 10 minutes, and then either used as a sinus rinse or sniffed from the dropper bottle.
Dr. Kondrot explains how to use ozonated saline to treat eye problems.
Rectal enemas with ozonated water are an alternative to rectal ozone insufflations. Water is ozonated at an ozone concentration of 40 to 100 mcg/ml and then inserted via a catheter and syringe or catheter and enema kit into the rectum.
Although the colder the water is the more ozone it can be absorbed, it’s recommended to use room temperature water when administering this type of ozone therapy to prevent uncomfortable contractions and cramping.
Injecting ozonated water instead of the gas into the bladder is gentler and is accompanied by less burning sensations.
First, a catheter is inserted into the bladder, the remaining urine is drained, a syringe filled with ozonated water is then connected to the catheter and injected into the bladder. After holding the ozonated water in the bladder for a few minutes, it is then expelled.
The recommended volume of liquid ranges from 60 to 200 ml. The recommended ozone concentration used to prepare the water can vary from 50 to 100 mcg/ml.
The use of ozonated oils is one of the oldest forms of how ozone therapy can be administered. Ozonated oils contain beneficial ozonides or lipid oxidation products. They can be ingested, applied topically, or inserted into various body cavities.
Ozonated oils are produced by bubbling ozone gas through them: it’s a process which can take several days depending on the type of oil, its amount, and the used ozone concentration. During the ozonation, the oil gradually loses its color and becomes viscous or paste-like. Once oil has been ozonated it will retain the gas for years.
The generation of ozonated oils is not without risks, with most professional ozone oil makers reporting having encountered at least one fire incident. Ozonated oils can be bought on amazon and many other online retailers.
Home made ozonated olive oil: it’s a messy and long process. Not something I’d like to do again. Unless as a by-product of BOOO. Best is to outsource the procedure and buy it online.
Ozone therapy has been administered in dentistry for decades and it’s gaining in popularity. It can be applied in a multitude of ways, from injections, to ozonated water rinses, or trays. Dental ozone treatments can help with infections and are used as a staple during cavitation surgery.
Promolife offers different solutions for dentists and home users alike.
Dr. Nischwitz is among many dental surgeons who use ozone during cavitation treatments.
The Ultimate Guide to Buying an Ozone Generator for Ozone Therapy at Home
“The Ozone Miracle”, Frank Shallenberger, MD
“Ozone in Medicine”, Renate Viebahn-Hänsler, Olga Sonia Leon Fernandez
“Ozone: The Miracle Therapy”, David Brownstein, MD
About the author:
I’m Paola the Crazy Old Ozone Lady behind The Power of Ozone. I’m a licensed naturopathic practitioner, natural health consultant, ozone therapy enthusiast, researcher, and ozone therapy analyst. I hold certificates in ozone therapy, hyperbaric ozone applications, Oxyvenierung, and the Andrew Cutler chelation. I own several ozone generators including a German hyperbaric 10 Pass machine. I have been using ozone for over 13 years, I’ve chelated with the ACC program for close to 5 years and I’ve been carnivore for nearly 1.5 years. This website serves as a resource for those who are interested in ozone therapy and other approaches to successfully manage chronic conditions.
Information provided is for informational purposes only and is not a substitute for professional medical advice. No health claims for these products or treatments have been evaluated by the United States Food and Drug Administration (FDA), nor has the FDA nor any other medical authority approved these treatments or products to diagnose, cure, or prevent disease. Neither The Power of Ozone nor the manufacturers of these items are responsible for the misuse of this equipment or the information on this page. It is highly advised to receive professional council from a licensed doctor before using ozone therapy or any of the mentioned products or tests on yourself.
This website contains links to vendors of products I endorse, including amazon.com. If you decide to make a purchase through one of my links, they will pay me a commission. This does not influence my opinion about the products, as you can see from my reviews.