Ozone Therapy Studies

by | Last updated: Apr 17, 2021 | 12 comments

Randomized Controlled Studies (5)


Covid-19, rectal ozone insufflations, Minor Autohemotherapy (MiAH), 60 patients (30 ozone / 30 control)

Safety and efficacy of ozone therapy in mild to moderate COVID-19 patients: A phase 1/11 randomized control trial (SEOT study), Mili Shah et al, 2021. 30 patients were treated with standard of care treatments plus rectal insufflations of 150 ml at 40 mcg/ml twice daily plus Minor Autohemotherapy of 2-3 ml of venous blood mixed with 5 ml of ozone at 25 mcg/ml. The control group received only (unspecified) standard of care treatments.

Results: more patients in the ozone group tested negative, more saw clinical improvements, and less patients required intensive care than in the control group. The control group saw 2 fatalities, the ozone group none.

“The OZ group has shown clinically significant improvement in the mean values of all the parameters tested compared to ST Group. However, statistical significance were only observed in RT-PCR negative reaction (P = 0.01), changes in clinical symptoms (P < 0.05) and requirement for Intensive care (P < 0.05). No adverse events were reported in OZ group, as against 2 deaths reported in ST group.”

Covid-19, Major Autohemotherapy (MAH), 60 patients (23 ozone / 18 control), NOT randomized

Blood ozonization in patients with mild to moderate COVID‑19 pneumonia: a single centre experience“, Carlo Tascini et al, 2020, 23 patients received 3 MAH treatments, 200 ml of blood mixed with 200 ml of ozone at 40 mcg/ml, 2 of the 23 patients received only 2 MAH, in addition to BAT (best available therapy) consisting of standard treatments used such as hydroxychloroquine, azithromycin, antivirals (lopinavir/ritonavir, darunavir/cobicistat) and immunomodulating agents (steroids, tocilizumab). The control group received only the drugs without ozone therapy. The ozone group saw a higher rate of clinical improvement (53% vs 33% in the control group).

Problem: The study claims to have enrolled 60 patients in total, but only 41 seem to have completed it, without a full explanation for what happened to the remaining 19.


Chronic osteomylitis, ozone bagging, intraosseous injections, MAH (40 ml), lavage with ozonated saline, plus antibiotics, 60 patients

The Effectiveness of Ozone Therapy in Chronic Osteomyelitis: A Randomized Controlled Clinical Trial“, Bahram Naderi Nabi et al, 2018: 30 patients with chronic osteomylitis (bone infection) received only antibiotics for 2 months, the other 30 received ozone bagging treatments, intraosseous injections with ozonated saline and lavages with ozonated saline, MAH treatment with 40 ml of blood drawn, plus antiobiotics. The ozone concentration was 30 mcg/ml.

“Results: The recovery rate was 73.33% in the control group versus 86.66% in the ozone group (P = 0.31). No significant difference was found between the groups regarding the recovery rate (P = 0.86). However, considering the erythrocyte sedimentation rate, the results were significantly superior in the ozone group (P = 0.0001).
Conclusions: These findings indicate that ozone therapy, as a promising complementary treatment, can be applied in chronic osteomyelitis management.” 


Arthritis, ozone knee joint injections, 20 mcg/ml, 98 patients (63 ozone / 35 control group)

Comparison between intra-articular ozone and placebo in the treatment of knee osteoarthritis: A randomized, double-blinded, placebo-controlled study” (Carlos César Lopes de Jesus et al) comes to the conclusion that ozone injections are a valuable treatment for osteoarthritic pain in knees, July 2017:

“The study confirms the efficacy of ozone concerning pain relief, functional improvement, and quality of life in patients with knee osteoarthritis.”


Liver abscesses, ozone gas injections, 60 patients, 2 groups

The Value of Ozone in CT-Guided Drainage of Multiloculated Pyogenic Liver Abscesses: A Randomized Controlled Study” (Bing Li, Chuan Liu, Lang Wang, Yang Li, Yong Du, Chuan Zhang, Xiao-xue Xu, and Han Feng Yang Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province 637000, China) shows that drainage of pus filled liver abscesses has a higher success rate, lower length of stay in hospital and less post-OP complications when combined with low dose and low volume ozone administration, 10 to 20 ml of ozone/oxygen gas at 25 mcg/ml. Result:

“Catheter drainage combined with ozone is an efective and safe treatment in multiloculated PLA.[pyogenic liver abscess]”


Meta-analyses (1)

Ozone therapy for the treatment of COVID-19 pneumonia: A scoping review“, 2021, Morteza Izadi et al. A scoping review of ozone therapy studies comes to the conclusion:

“Ozone therapy could be a potential resource to modulate the patient immune response against SARS-CoV-2, contributing to contain the cellular oxidative stress of COVID-19 pneumonia and breaking the vicious cycle of cytokine storm observed in severe forms of the disease. Ozone therapy may also be a useful complementary treatment to be considered in patients suffering from early stage COVID-19 pneumonia, to prevent the progression to life-threatening disease. “


Observational Studies (3)

Covid-19 patients, Major Autohemotherapy with ozone, twice daily on 18 patients (9 ozone / 9 control), prospective case-controlled study

Ozone therapy for patients with COVID-19 pneumonia: preliminary report of a prospective case-control study“, Alberto Hernandez et al, 2020: 9 patients received MAH ozone therapy (200 ml of blood drawn mixed with 200 ml of ozone at 40 mcg/ml) twice daily plus standard drug therapy. Control group, also 9 patients, received supplemental oxygen therapy, hydroxychloroquine, lopinavir/ritonavir, corticosteroids, and antibiotics (including azithromycin), intervention group received the same plus ozone therapy twice daily for 5 consecutive days. Mean age was 68 years old, Ozone group showed clinical improvement on average after 7 days, the control group on average after 28 days. Ozone therapy was associated with

“shorter time to a two-fold decrease of C-reactive protein, ferritin, D-dimer and Lactate Dehydrogenase in severe COVID-19 pneumonia patients in this prospective case-control study. “

Hepatitis C, MAH, MiAH, rectal ozone insufflations, 52 patients (40 ozone / 12 control), prospective case-controlled study

“Preliminary results of ozone therapy as a possible treatment for patients with chronic hepatitis C”, Saad Zaky et al, 2011.

Ozone group received Major Autohemotherapy (MAH) with 150 ml of blood drawn and mixed with 125 ml of ozone at unclear ozone concentration (original: “25% and gradually elevated every five sessions by 5% until the maximum concentration of 60%”), although it's assumed that it was meant 25 mcg/ml, not %. The MAH were performed three times a week. Minor Autohemotherapy (MiAH) of 3 to 5 ml of blood with 10 ml of ozone at 20 mg/ml (?? wrong units), only once. Plus, rectal insufflations of 300 ml at 40% (??), also only once at the first session. Ozone group received 30, and 60 sessions, respectively, per patient. The control group received silymarin and/or multivitamins.

Results: Following 30 sessions of ozone therapy, there was significant improvement of most of the presenting symptoms in comparison to those who received conventional therapy ( p < 0.5) as shown in Figures 1 and 2. The levels of ALT and AST normalized in 57.5% and 60%, respectively, following ozone therapy in comparison to 16.7% and 8%, respectively, after conventional therapy with a significant difference (Tables 1 and 2). Following 30 sessions of ozone therapy, 10 of 40 patients (25%) showed negative PCR for HCV RNA with a significant difference ( p ¼ 0.001), while 1 patient (8.3%) in the conventional group became negative PCR for HCV RNA; however, the difference is not statistically significant ( p ¼ 0.331; Tables 3 and 4). On the other hand, among 18 patients who are still positive after 30 sessions of ozone therapy, 8 (44.4%) became negative PCR for HCV RNA while 1 patient in the conventional group is still negative, and the difference is significant ( p ¼ 0.040; Table 5). For confirmation of the safety of ozone therapy, evaluation of the blood count monthly revealed no changes in the various blood elements and no evidence of hemolysis with no significant changes in the bilirubin levels before and after ozone therapy.

Pubmed (only abstract), but read the study in full.

Problems: authors mix up the units for the ozone concentration, either give it in % which is unlikely to be accurate, or in mg/ml which is also unlikely to be accurate (it has to be either mcg/ml or mg/l). Study design is nonsensical: why were the patients given MiAH and RI only one time at the beginning of the study? Rating: very low quality study.


Spatial Analysis of Air Pollution and Mortality in Los Angeles“, Michael Jerrett et al.: Ozone is not associated with elevated mortality risks in air pollution:

“Ozone had few elevated risks in any of our analyses and did not confound the relationship between particles and mortality. This finding agrees with earlier ACS studies indicating that ozone is not associated with elevated mortality risk,2,4”


Case Studies (9)

Bisphosphonate induced jaw necrosis, irrigations with ozonated water, 2 patients

Adjuvant aqueous ozone in the treatment of bisphosphonate induced necrosis of the jaws: report of two cases and long-term follow-up“, Brozoskia Mariana et al, 2014: 

Patient 1 rinsed three times daily with ozonated water, which was prepared once a week and then store in the fridge, ozonated at 4 mg/L, plus once a week professional irrigation with 200 ml of ozonated water at 4 mg/L plus 0.12% chlorexidine digluconate, for total of either 7 or 12 months, it's not clear. Two bone debridements were performed to remove necrotic bone. Result: after one year the mucosa was completely recovered, same after 3 year follow-up. 

Patient 2, suffered from local pain, bad breath (halitosis), bone exposure, recurrent purulent drainage, fistula in the mandible first premolar region, necrosis. For three months: three times daily rinsing with ozonated water at 4 mg/L and 0.12% chlorexidine digluconate, bone debridement was also performed. Result: sings of infections resolve, wound heals up completely, at 1.5 year follow-up mucosa is still properly. 

Problems: patients used ozonated water and chlorexidine digluconate. 

Hepatitis C, Major Autohemotherapy (MAH) and rectal ozone insufflations, 50 patients


Patients received combined treatment of MAH and rectal ozone insufflations. MAH 140 ml of blood was drawn and mixed with 140 ml of ozone at 20 mcg/ml, increasing by 5 mcg/ml every two MAHs until 60 mcg/ml were reached. RI was performed of 250 ml at 15 mcg/ml, and increased by 5 mcg/ml every two treatments, until 300 ml at 40 mcg/ml were reached. The treatments were performed “three times per week for twelve weeks followed by twice per week for another twelve weeks. Investigations were repeated after 8 and 24 weeks of treatment. General health and daily activity were observed.”

Results: ” (…) following eight weeks of ozone therapy, the viral load decreased in 63.85% of cases (P value < 0.004) that reached zero reading in 24 % 0f cases (P value <0.001). Following 24 weeks of ozone therapy, there was further decrease of the viral load that reached 71.84% of cases (P value < 0.005) with a zero reading in 36 % 0f cases (P value <0.001). After eight weeks of ozone therapy, the abnormal enzyme levels were back to normal in 58 % of cases ( P value <0.001 ) for the SGPT enzyme, and were back to normal in 52 % of cases (P value <0.001) for the SGOT enzyme (normal levels are ≤ 40 U/L) table 1 figure 1– 4.

After eight weeks of ozone therapy, the abnormal bilirubin levels (normal value ≤ 1 mg%) were back to normal in 28% of cases (P value < 0.001). Following also the same period of therapy, the abnormal albumin parameters (normal value ≥ 3.5 mg %) were back to normal in 18% of cases (P value < 0.032). The prothrombin concentration improved towards the normal level (P value < 0.001) table 2 figure 5-7.”

“Clinical observations and questioning of the patients revealed that in 94 % of cases the general condition improved and some of patients returned to work after they were staying at home.”

Problems: not clear where this has been published or if at all. PCR test was used at unknown number of cycles, some patients used a Chinese herbs which was a confounding factor, 

Ebola cases, DIV ozone injections, drinking ozonated water, rectal ozone insufflations, full recoveries, 5 cases

RAPID RESOLUTION OF HEMORRHAGIC FEVER (EBOLA) IN SIERRA LEONE WITH OZONE THERAPY“, Robert J. Rowen et al. 5 patients with suspected or confirmed Ebola infection are treated with DIV, direct intravenous ozone injections, drinking ozonated water, and other ozone interventions and fully recover.


Covid-19 in ICU hospitalization, 48 recover, 2 die, Major Autohemotherapy with ozone (MAH), 50 patients

Oxygen-ozone (O2-O3) immunoceutical therapy for patients with COVID-19. Preliminary evidence reported“, 2020, Marianno Franzini et al. A presentation of 50 elderly patients, 96% with at least one co-morbidity, all over 60 years old, undergoing ICU hospitalization for COVID-19, showing ARDS and interstitial pneumonia at chest computer tomography (CT). 48 completed the study, 2 of them died. All of them were not responsive to pharmacological therapy with Axitromicinem, Hydroxychloroquine, Methylprednisolone, and Vitamin C. Later they received Major Autohemotherapy (MAH) ozone therapy with 200 ml of blood drawn, mixed with of 100 to 200 ml of ozone at 45 mcg/ml. This was performed at three to five (median = four) cycles for 5 consecutive days. Results:

“[…] the most encouraging outcome is the ability of O2-O3 treatment to reduce significantly (p = 0.0023) the recovery of normal functional pulmonary parameters in less than 10 days (median 13.45 ± 2.33 days), respect to the expected, estimated values for hospitalization in our structures (22.13 ± 3.44 days). […] Ozone effect on the increase in leukocytes was not significant, whereas two major inflammatory markers, i.e. CRP and IL-6, were markedly reduced, i.e. of about 48.15% (covariance = 9576.177, p = 0.0167), and 86.17% (covariance = 9113.337, p = 0.0275), respectively. Reductions were observed also for bacterial-mediated inflammation markers (pro-calcitonin, PCT) and fasting glucose, despite the hypoglycemic effect of O2-O3 treatment was non-significant (p > 0.05, see Table 1B. Among the observed effects of O2-O3 treatment, it is noteworthy the increase in the percentage of O2 saturation (SatO2%) = + 13,26%, p < 0.001,. This result has been further evaluated considering that Hb values and arterial pressures were almost unchanged during the O2-O3 treatment and that the ratio PaO2/FiO2 increased following the treatment, just irrespective of the modest increase (+4,5%) following noninvasive mechanical ventilation (ANCOVA p = 0.00456), so reporting a possible recovery of normal respiratory functions mainly due to O2-O3 treatment […]”


Covid-19 pneumonia, rectal ozone insufflations, full recoveries, 4 patients

Effect of Rectal Ozone (O3) in Severe COVID-19 Pneumonia: Preliminary Results“, 2020, Marcos Edgar Fernández-Cuadros et al. 4 patients with severe bilateral pneumonia due to COVID-19 were treated with 100 ml of rectal ozone insufflations at 35 mcg/ml, fives times (1x / day). Results:

“The patients improved oxygen saturation, as observed by the lower number of desaturations and the lower supply of O2. Biomarkers of inflammation decreased (fibrinogen, D-dimer, urea, ferritin, LDH, IL-6, and CRP). Finally, the radiological signs of bilateral viral pneumonitis improved between 1 and 2 grades based on Taylor’s radiological scale. Rectal ozone decreases O2 supply and improves O2 saturation, decreases inflammation biomarkers, and improves Taylor’s radiological grade in patients with severe COVID-19 pneumonia. Rectal ozone is a safe, effective, cheap, and simple alternative capable of acting on the SARS-CoV-2 virus, and it is presented as an adjunctive therapeutic option to consider in the management of severe bilateral COVID-19 pneumonia.”


Antibiotic resistant bacterial meningitis, re-injection of ozonated cerebrospinal fluid, full recoveries, 2 babies

Cases Study of the Effectiveness of Ozone Gas Therapy on the Treatment of Resistant Meningitis in Infants with Hydrocephalus“, Mazen KB Dahhan, 2015. Two small children: 2 months old and 3 months old are treated with ozone for meningitis. 50 ml of cerebral spinal fluid is withdrawn, mixed with ozone at 20 mcg/ml, then 40 mcg/ml, and then re-injected into the brain, repeated 5 and 6 times, respectively. Both children recover completely:

A five to six sessions of Ozone gas therapy with dose of 40µg/ ml intrathecaly each other day were able to cure from resistant meningitis in 2 infants with hydrocephalus. (With serious and lifethreatening infections like Pseudomonas and Klebsiella).

1. Ozone gas treatment can be a promising method to treat resistant meningitis in infants with hydrocephalus, but it needs further study and support.
2. Its safety makes it preferable in my cases than placing external shunt drainage, or injecting antibiotics into the ventricles, but its 100% safety needs to be well studied on many cases.
3. It is an affordable treatment, quick, and available everywhere and can be done in the clinic”


Ozone saunas of 20 min results in an increase in certain blood markers, 7 volunteers, no pathologies noted

Quasi-total-body exposure to an oxygen-ozone mixture in a sauna cabin“, Velio Bocci et al, 1999. Seven volunteers were subjected to an oxygen only sauna, then 3,5 months later to a 20 min ozone/oxygen sauna. Results:

“Body mass, blood pressure, body temperature changes, electrocardiograms, venous blood gas and haemocytometric analyses, total antioxidant status and plasma levels of protein thiol groups, thiobarbituric acid reactive substances (TBARS), plasma cytokine, hepatic enzymes and creatine were determined before, immediately after the 20-min period in the cabin and then 0.5, 1.0 and 24 h afterwards. We observed statistically significant variations of body temperature, venous partial pressure of O2 values, TBARS and plasma levels of interleukin 8, particularly after O2-O3 exposure.


Different eye conditions, ozone oil drops, 3 humans, 3 animals

Use of Ozone-Based Eye Drops: A Series of Cases in Veterinary and Human Spontaneous Ocular Pathologies” (Spadea L.a · Tonti E.a · Spaterna A.b · Marchegiani A.b , La Sapienza, Rome, University of Camerino, Italy) shows how ozone oil drops help with various eye conditions. A collection of 3 animal and 3 human cases with pictures.


Brain tumors, direct ozone injections into the brain results in prolonged survival rate, 5 patients

Intra‑tumoral treatment with oxygen‑ozone in glioblastoma: A systematic literature search and results of a case series” (RICHARD MEGELE1 , MARKUS J. RIEMENSCHNEIDER , FRANK DODOO-SCHITTKO , MATTHIAS FEYRER and ANDREA KLEINDIENST,), Oncology Letters, 2018. Case study of 5 patients with brain tumors. All patients are treated with chemotherapy, and radiation. In addition they receive a direct injection into the tumor of 5 ml ozone gas at an ozone concentration of 40 mcg/ml. The medium survival rate after start of ozone therapy or recurrence of cancer is 36 months. Average survival rate for glioblastoma patients who undergo only conventional therapy is around 26 months. Study authors regard ozone injections as a viable treatment for brain tumors.


Unclear study design

Psoriasis, ozonated oil, 40 patients in 2 groups, not clear study design

Clinical efficacy of ozonated oil in the treatment of psoriasis vulgaris“, Tan Lina et al, 2018: the effect of ozonated olive oil was compared to the effect of glucocorticoid cream on 40 patients. Results:

“Ozonated oil treatment for stable psoriasis is safe and effective, and its efficacy is equivalent to the effect of glucocorticoid topical preparations.”

Problems: does not seem to be randomized, study design is not clear, since only the abstract is available in English.


Other Interesting Publications

  1. Reliable and effective oxygen-ozone therapy at a crossroads with ozonated saline infusion and ozone rectal insufflations“, Prof. Velio Bocci et al, 2011. Prof. Bocci argues that Major Autohemotherapy (MAH) should be made the preferred and mainstay type of ozone therapy, rather than rectal ozone insufflations or ozonated saline IVs. His conclusion about MAH: optimal treatment for vascular diseases, age related macular degeneration, and possibly diabetes, but more high quality studies need to be performed. His conclusions about RI and ozonated saline IVs: they “do not comply with the pharmacotechnical criteria of consistency and stability required by international health authorities.”

2. “Treatment by Octozone”, Oscar Parkes, C.H. Buckley, The Lancet, Oct 17, 1931, pages 849, 850. Ozone is reported to help with arthritis, sciatica, varicose ulcers, skin conditions, wounds, and the elimination of “waste products”.

3. Italian newspaper reports about a hospital where 36 Covid-19 patients were successfully treated with Major Autohemotherapy (MAH) ozone therapy.


In Vitro Studies

Mechanism and Kinetics of the Reaction of Ozone with Sodium Chloride in Aqueous Solutions“, Razumovskiia et al, shows that ozonating a saline solution does not create hypochlorites.


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About the author:

PaolaI’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.

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  1. barbarapdx

    Hello Paula, I noticed that Graves disease was mentioned briefly as a contraindication for ozone on your site. I couldn't find any supportive information, or discussion on this. Could you please let me know as I've found ozone to be quite helpful, but also deal with intermittent Graves as well. THANK YOU for all your detailed and thorough work on ozone!!!

  2. Vital

    Hello Paola,

    I would appreciate it very much, if you could publish some concise info about the scientific findings, what the different ozone treatments actually cause in the body.
    E.g. I suppose that ozone turns quite quickly into oxigen (?), once it comes into contact with the body – and then, is it absorbed into the blood, and if so, in what amounts, and then are the cells, mitochondria etc. supplied with higher amounts of oxigen?
    Also e.g. I can hardly imagine that ozone in a sauna passes the skin blood barrier or whatever – I would guess that it just has an effect on the bacteria etc. on the skin(?).

    Many thanks in advance!


    • Paola Dziwetzki

      Hi Vital,

      this is a big job, and I might write something like this sometime in the future.


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  4. Courtney Humphrey

    My 4 yr old has an autism diagnosis and is on seizures Med for abnormal brain waves on an EEG but doesn't have visible seizures. On a biomed FB group some parents did a trial with ozone water . With the inexpensive machines on Amazon. They noted significant gains. However, I'm struggling to find much info on how ozone water would interact with oral low frequent side chelation . So far I've pieced together that since ALA chelator is an antioxidant that I can't do ozone while on a chelation round . His chelation round is 3 days on chelators 4 days off. BUT on the off days he takes magnesium, zinc and VITAMIN C three times a day . So I've heard some say you could space them out with 2 hours between vitamin c and ozone . My two concerns are making sure it's been studied and proven that you can do ozone and chelation just not at the same time and you can space out vitamin C and ozone water and both still be affective . Also, I'm concerned with increasing oxidative stress because chelation already causes oxidative stress , so would doing something everyday that causes oxidative stress be too much of a burden on the body over time ? Should I give more antioxidants than just vitamin C to help balance the burden .

    • paola d

      Hi Courtney,
      I saw you also had posted this in the Ozone groups, so I hope your questions have been answered already?

  5. Michael Schmok

    Hi Paola,

    I love your blog site. I'm also an Ozone junky. I've been to Malaysia for EBOO and own a Longevity generator for home use.
    I have an aluminum E cylinder (24 cf) with a CGA870 regulator. However, it's very difficult to find a place to fill it with oxygen (places require a contract and prescription). I was thinking of switching to a 21 cf steel welding cylinder and get a CGA540 reg. What type of oxygen cylinder do you use? Do you have any advise on this?

    • paola d

      Hi Michael,
      oxygen cylinders seem to be a tricky subject, since gas companies also make problems with the industrial ones. They usually do not want to accept clients' own tanks but either sell their own or rent them out.
      I was in the lucky position that I found a sympathetic doctor (ozone dentist actually) who refilled my medical CGA 870 tank for me. It lasted me several years. That might be a route to explore … Or join our Facebook group “Ozone to Health”. We have over 3,000 members there. You might find someone in your area to give you a tip where to get your tank filled and which one to get …

    • Fiona

      facebook page ‘ozone to health' i was not able to find that is it still up?

    • Paola Dziwetzki

      Hi Fiona,
      we changed the name to “The Ozone Group”.


    • Craig Waterman

      If you live near the sea, you should be able to have your tanks filled at a Dive Shop.

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