Health Longevity Secrets

Hyperbaric Oxygen Secrets

• Robert Lufkin MD • Episode 184

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This week we get to unlock the secrets of rejuvenation with Dr. Amir Hadanny, a pioneering neurosurgeon and advocate for hyperbaric oxygen therapy, as he reveals how this cutting-edge treatment is transforming the landscape of neurological recovery and longevity. You'll gain insights into how hyperbaric medicine optimizes healing by harnessing the power of 100% oxygen, triggering repair mechanisms, fostering stem cell proliferation, and encouraging angiogenesis, all within the confines of a pressurized chamber. Dr. Hadani, who once approached this therapy with skepticism, now champions its potential after witnessing remarkable outcomes in randomized control trials for stroke and traumatic brain injury patients.

Explore the fascinating effects of hyperbaric oxygen therapy on aging, backed by a groundbreaking five-year study involving adults over the age of 64. Discover how this innovative approach can improve cognitive function, enhance physical performance, and influence key biomarkers of aging without altering exercise routines. Dr. Hadani also shares the comprehensive evaluation techniques employed at Aviv Clinics to ensure sustained cognitive and physical improvements, offering listeners a glimpse into a future where healthspan is optimally maintained. Whether you're passionate about cutting-edge medical advancements or simply curious about maintaining your vitality, this episode promises a wealth of valuable knowledge and insights.

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Speaker 1:

Amir Hadani, md, phd, is a neurosurgeon and researcher at Aviv Clinic, specializing in the use of hyperbaric medicine to optimize brain and body performance. He also serves as chief medical officer and head of research at Aviv Scientific. Hey Amir, welcome to the program.

Speaker 2:

Thank you so much for having me. Great to be here.

Speaker 1:

Yeah, I'm so excited about talking about hyperbaric oxygen therapy and also some of the things you're doing about how it ties into longevity. But before we do any of that, maybe just take a moment and tell us a little bit about your story and how you came to be interested in this fascinating area.

Speaker 2:

Wow, that's a good story. It's a good start. So I was a neurosurgery resident. I completed it. I was a neurosurgery resident. I completed it, but in the early stages of it I was in touch with my MD thesis Shai Friday in Israel and he told me about a couple of cases of patients with diabetes that also had a stroke, that were treated in a hyperbaric chamber and they got better.

Speaker 2:

And I was a neurosurgery resident. I had a lot of cases, both stroke and traumatic brain injury patients, and I told them no way forget about it. And he was persistent and good that he did and that led us to conduct randomized control trials on both of them, both stroke and traumatic brain injury, in order to prove that it doesn't work. We want to make sure and somehow it did work. Work and we were pretty surprised and ever since then I got hooked on hyperbaric medicine. I got expertise in hyperbaric medicine and diving. I completed my neurosurgery and ever since then we're doing randomized controlled trials, both preclinical and clinical, obviously in hyperbaric medicine, in neurological indications as well as longevity and yeah, it's a fascinating expertise and field of studies. That is endless.

Speaker 1:

Yeah, I mean, we haven't had a podcast talking about hyperbaric oxygen for a while, for at least over a year so maybe you could just kind of remind everybody what is hyperbaric oxygen therapy, how does it work and why are you so excited about it.

Speaker 2:

We'd love to. So, to keep it simple, hyperbaric oxygen is you breathing in oxygen, pure oxygen, 100% oxygen in a huge metal cylinder. So think about a huge box made of metal, that the door is shut and then we're compressing air and air more and more into that and that elevates the atmospheric pressure. We feel it in the ears sometimes when we're in an airplane. We need to equalize the pressure in our ears and our sinuses during the process and once we reach the therapeutic pressure that we want to treat the patient, we give them oxygen masks that deliver 100% fewer oxygen, and we do it in a very specific protocol, since we discovered that if you do it in a very specific way, you're able to trigger healing.

Speaker 2:

And the you know the history of hyperbaric medicine is wound healing. That's basically how it started. It started a bit earlier for diving, but that's mainly diving medicine. I would say. Hyperbaric medicine was generally used, and still is, for wound healing different non-healing wounds from diabetic feet and other vascular issues, as well as wounds from radiation injuries that do not heal by themselves, and the use of specific protocols of hyperbaric oxygen can heal those wounds by doing regenerative processes to heal those wounds.

Speaker 1:

And so what is the mechanism of this regeneration, or how does the high oxygen pressure stimulate the healing that you're talking about?

Speaker 2:

Awesome, so we're talking about. When you think about wound healing whether it's the brain or whether it's a peripheral wound, like we talked about in diabetic feet we need four major components in order to heal that. The first one is oxygen. Oxygen is the energy source for anything, for our regular processes in our cells, but obviously when we try to repair things, you need much higher level of oxygen. The second one is what we call a trigger. You have to have something that will tell you or your body okay, this is an area that actually needs to be healed, otherwise nothing will happen. Actually needs to be healed, otherwise nothing will happen. The third one is stem cells. You need to have stem cells that will go there and rebuild the tissue. Think about the scar that's being covering up wounds when we heal. That's stem cells that are actually building that tissue. And the fourth one is what we call angiogenesis, or the creation of blood vessels. So any wound that we have, the new tissue has to have new blood supply to support it. So those four components are needed in any wound.

Speaker 2:

And what we discovered with hyperbaric medicine? That we are able to get all those four mechanisms working if you do a specific protocol. The first one, oxygen. Like I said, if you're breathing oxygen under very high pressure, we're able to dissolve much higher level of oxygen inside our tissues. We're utilizing a physics law called Henry's law that says you're able to dissolve it under high pressure. So that's the first one. We're supplying that oxygen every single time you go into the chamber. The second one is the trigger. What we found out? That if you're doing it in a very specific routine and we call these oxygen fluctuations, it in a very specific routine and we call these oxygen fluctuations meaning you're breathing high percent oxygen and then removing the mask, breathing high oxygen and then removing the mask In a very periodic timing you're able to trigger.

Speaker 2:

You're able to cause the body to feel a trigger that tells it to heal itself. Why is that? Because that transition from high level of oxygen to normal level of oxygen is being interpreted as relative hypoxia or low level of oxygen, like being suffocated, but without actually being suffocated. Every time we are feeling the body feel that suffocation, it heals itself. It calls up I need help, I need to repair this area. It sends that trigger to heal that area and then the other two components happen it recruits stem cells to regenerate the wound and it recruits specific type of stem cells to build new blood vessels, to build blood supply for that area. So, again, by doing a specific routine of hyperbaric oxygen therapy, you're able to trigger those four components of wound healing.

Speaker 1:

Oh yeah, it's interesting that cycling. We've had other guests on the program talk a lot about mtor and um, the idea that you know, turning mtor on which oxygen is a signal for mtor as well as nutrients and all that that uh triggers growth. But then turning mtor off which hypoxia would be would trigger autophagy and repair. So essentially, by cycling it, you're triggering mTOR down to simulate autophagy, right? Or you're intentionally doing both, I guess right, correct?

Speaker 2:

Correct. So the whole goal is a process we call hormesis. Right, Hormesis is the process of creating a mildly toxic hormone process over and over and over and over again, to create actual resilience. Okay, Think about it. If you think about caloric restriction, if you're talking about even working out, you know, when you think about working out, we're hammering the muscles, hammering. Hammering. The fibers are being torn apart every time we're working out in order to rebuild much stronger and more muscle fibers. So the same concept is going on here. We're doing relative hypoxia, that suffocation, if you will, over and over again in order to generate their healing processes.

Speaker 1:

So, yeah, so the hormesis, the healing process is it's fundamental to do that the cycling of the mask on the mask off, the mask on the mask off. It's not just sitting in the chamber and increasing the pressure, but actually this cycling that is essential to it. That's, yeah, that's fascinating. We've also had several speakers talking about cancer, like Thomas Seyfried, and talking about Otto Warburg and damaged mitochondria and oxygen utilization, and I wonder what does hyperbaric oxygen do to cancer cells? Is that a risk for a patient who has cancer or a history of cancer, or is it a treatment for cancer?

Speaker 2:

Great question. So a lot of people are afraid of it and, you know, think, hey, if it does all these things, maybe it can actually cause cancer or promote it. So what we have? We have over 60, even 65 years of patients with radiation injury, cancer. Patients that were radiated for their cancer, that went in hyperbaric chamber in order to treat those wounds or those radiation toxicity implications, and there's no increase in cancer.

Speaker 2:

So we know it's safe. We know that it's not going to lighten up or fire up cancer that has been treated. We don't have any evidence of, you know, creating new cancer or promoting an existing cancer. Having said that, on the safety side, any patient of mine that wants to go in and has an active cancer that needs treatment, I will tell them go get the treatment right, because if you have a disease that we have a well-proven, evidence-based treatment for it, that's what you need to do. So you need to go. Whether it's chemotherapy, whether it's radiotherapy, whether it's biological therapy, you name it. That's the first step we're doing. Hyperbaric oxygen therapy is not anti-cancer treating.

Speaker 1:

Yeah. So just to summarize, we're not saying don't do your radiation therapy or chemotherapy or surgery, whatever you recommended for your cancer, do that. The hyperbaric oxygen is not a substitute for conventional therapy. But having said that, if I understood you correctly, once I've had my cancer treatment I can go ahead and have hyperbaric oxygen without increasing, making it worse, essentially increasing the risk of either that cancer or future cancers. Is that right, correct?

Speaker 2:

Correct and I guess two more pointers on that. So one, yes, you won't be at high risk. Two, if you've developed radiation injury, if you were radiated, we can treat that as well. And three, there's some works about making cancer therapy even more potent by combining with hyperbaric oxygen therapy, meaning getting radiation plus hyperbaric oxygen to make it even stronger. Yes, it will make much more oxidative stress and make much, much more injury to the cancer. The problem is we're not yet able to know what's the actual dosage in order to avoid more radiation injury or more chemotherapy injury because of that combination. So there are some researchers that dealt with this a little bit, of trying to combine it for cancer therapy. Nothing came out of it, that is, this is the way you need to do it, or something like that. So again, we're putting it back to it's safe if it was treated. If you have radiation injury, it can even heal that.

Speaker 1:

So the idea of using it to potentiate radiation therapy is an idea now, but the protocols really haven't been worked out, the studies haven't shown consistent anything that we can hang our hats on. And I guess it makes sense too, if you think about turning mTOR down by this hormesis effect, that mTOR drugs that turn mTOR down, like rapamycin, are FDA approved for certain cancers as anti-cancer agents. So it certainly makes sense there. And the other thing I wanted to talk about, kind of following along that thought with rapamycin, of course, and mTOR, is longevity, and I know you're focusing on healthspan and lifespan, and so how does hyperbaric oxygen therapy affect longevity or the aging process?

Speaker 2:

Great question. So, like I said, if we go back in time, 2015, we did a couple of clinical trials on different neurological indications stroke and TBI and we came to this question of what happens with health span. What happens if we take normal aging, if you will, and put them into a protocol that we use for neurological indication? How does it affect that? So that led us to the reverse aging protocol. Reverse aging protocol and um, it was a five years um research that we did with a randomized controlled trial, and what we found out, um, if, if we will, um, we took first patients that were not patients at all. These were normal adults age 64 and above that did not have any significant brain injury or stroke or a significant cancer or anything. There were just adults that were over the age of 64 and all their chronic medications and chronic conditions were well maintained, very controlled, and their only real problem is the fact that the clock is ticking and they're over 64. And what we found out? That we are able to target that.

Speaker 2:

So the same four concepts that we use for wound healing, whether it's peripheral or brain related indications. It also works on normal aging healing. So we all know that as we age there is constant wounds, if you will call them wounds, in different organs. The different organs are deteriorating because of different mechanism, whether it's the telomere shortening, whether it's epigenetic changes, whether it's atherosclerosis and the occlusion of blood vessels and supplying less and less blood to different organs. And it happens in all of our organs, whether it's the skin, whether it's the muscles, whether it's the brain, whether it's the heart everything it happens in different rates. So what we did there? We wanted to evaluate how does our protocol affect the aging process in all those organs. What we found out is pretty tremendous. We found significant cognitive changes in the brain. That's related to actual changes in both microstructure and blood supply or blood perfusion of the brain. So again, the four concepts of wound healing worked in healthy adults and we saw significant change in their perfusion, in the way the neurons are sheathed, and that led to significant cognitive improvement.

Speaker 2:

On the other side, we saw significant improvement in their physical performance, so their heart perfusion was much higher, their mitochondrial function was higher and they were able to perform at much higher levels. We measured something called VO2 max. I know maybe you had a chance to talk about previous talks what it is the maximal oxygen consumption, about previous talks, what it is the maximal oxygen consumption, and that basically, is a combination of the way our heart, our lungs, our muscles and the mitochondria all work together to consume oxygen as we do aerobic activities. And we showed significant improvement over 15% of VO2 max improvement in older adults, which is pretty, pretty amazing for people who are, you know, haven't changed their working out routine. For instance, an additional part of it we measured biomarkers. So we were able to show different biomarkers of aging that have changed because of the protocol in those healthy adults. We're talking about telomeres lengths, we're talking about senescent cells, immune system markers. All that has significantly improved, showing that healthspan has improved. Whether lifespan has improved, we don't have that data so far.

Speaker 1:

Yeah, yeah, I mean that's a great study. I guess it's really hard to control. I mean, how did you control for people having hyperbaric oxygen, the people who were randomized and didn't get hyperbaric oxygen? They would go sit in the room but you wouldn't change the oxygen levels, or something like that.

Speaker 2:

So it's a great question. So that's what you're talking about the sham control. So, on that specific study, the control group was actually a passive one. They did not participate at all. We saw them in constant follow-ups to make sure they're not changing their nutrition, their lifestyle, their working out, their medication, and nothing changes. But they were not getting a placebo or a sham control study. However, in our current different studies that we're doing right now we just had one of them published the other day on PTSD we are using a sham control study, our arm that indeed, people are going to the same chamber, the pressure is not working and they're breathing regular air, but we're tricking them with different noises and different pressure in order to make sure that they do not know they're not getting the treatment. That's pretty hard to accomplish, but doable.

Speaker 1:

Yeah, yeah and well, and then, for the ones that you showed the lifestyle effect, what kind of regimen of hyperbaric oxygen do they need to do? Is this like once a day, once a week, once a year? What do you think is the ideal pattern for that in order to get those lifestyle benefits?

Speaker 2:

So, the original protocol was 12 weeks, five days a week and every day is a two hours session in the chamber with the oxygen fluctuation. So it's 60 sessions over 12 weeks and we measured it for six months to see how that original 12 weeks continues along the year. Whether or not you will need to do it periodically, after several years probably and the answer is how often is complex because we need to find out how well are you going to be maintaining everything else in your life. Are you going to continue the same working out? Are you going to continue the same medications, same lifestyle that you have when we met you? If you, you know, after you're feeling well, you're going to be sedentary all the time. You're probably going to age once again because you know we are probably slowing down the trajectory, but we're not slowing down to a complete stop. So eventually you will deteriorate and will need to do this routine once again. The question is when depends on your lifestyle yeah, it's fascinating.

Speaker 1:

So many interesting things. Yeah, and, like like always, improving the lifestyle is going to improve everything else around it. So the work you're doing at Aviv down in Florida now and, to be clear, there is no telemedicine aspect of hyperbaric oxygen, right, so people can come to you in Florida and tell us about what they experience there and what sort of patients you see and who you're looking for there.

Speaker 2:

Awesome. So, yes, we are here in Central Florida. We have a clinic that we deployed after finishing up that study that we just talked about reverse aging. What we have here is a unique set of population here and I would separate it into two. One is the healthy adults that care about the way they age and want to take an influence on it. The other is what we will call different neurological indications, and that can be very, very unique. It can be a stroke patient, can be a traumatic brain injury, ptsd patient, long COVID patient.

Speaker 2:

We have different patients, but the common thing about all of them that when they come to Aviv, we always start with assessment. So any client that comes in here, we tell them all right, let's do assessment, and they go through anywhere between three to four days of objective assessments, including cognitive assessments, physical assessments, body weight, body composition, different blood markers and, of course, brain imaging. And only after we get the entire picture and also look at the different brain function, brain anatomy, we determine if we're going to do that protocol of 12 weeks. Will it actually benefit the patient or is he just wasting our time or his time, obviously. So we want to make sure the patient is eligible and will actually benefit his neurological, physical or cognitive condition. If he is, we're prescribing a specific routine for him based on the clinical data we have from our research.

Speaker 2:

But the difference is, since they're not coming into a randomized controlled trial, I'm able to add ancillary treatments, meaning exactly what we finished up on their last question. We finished up on their last question in addition to the hyperbaric oxygen session, exactly like in the trial, we'll also do physical training. We'll also do physical therapy in case they need it, we'll do nutritional coaching if he needs them and we'll do cognitive training if he needs them. Because this is not a randomized controlled trial, we will do everything to put the lifestyle to their best as it. So the HBOT will be on top of it. So, and also it will be maintained for much longer time exactly what we talked about.

Speaker 1:

Yeah, and I wanted to point out, when I toured your center down there, I saw something that I hadn't seen in other hyperbaric oxygen facilities and that is your specific room, your treatment rooms, that you know. Many hyperbaric oxygen things are just a single, you know almost coffin shape thing that you have to get into but you have, like it's, it's like a whole room with what? 15 people or 17? I can't remember 14. Yeah, room with what? 15 people or 17? I can't remember 14. It's almost like you're going into an airline, you know, with a flight attendant there and everything, and you know. It's a great approach and I urge people to check out the website and they can see it there. But it's pretty. It's unusual, especially if anybody has any issues of claustrophobia or something they. If anybody has any issues of claustrophobia or something, this would be definitely the place to go.

Speaker 2:

So yeah, definitely. I think that's a valid point there. The difference with all the randomized controlled trials we ever did were always in that big hole you would call an airline, we call it the multi-place. Compared to those tubes or a monoplace, there are many, many differences, both on the safety side and the efficacy side, but also on the data itself that we present. We're all done in a multi-place and you know, a lot of people are thinking all right, I can do it at home with the different companies that provide sacks. And that's not that, and I really encourage people to read exactly what they're getting if they're thinking about it. Home use I think it's unsafe and very not recommended.

Speaker 2:

But we definitely do it in a multiple place for different reasons. Like I said, claustrophobia is one of them, but also the entire ability to have a nurse inside the chamber to monitor everything, to have monitors. Each patient has a tablet on their own so they're able to do cognitive therapy if they need to run through that. The social interaction between the different patients is very, very critical for some patients, like PTSD patients that need this kind of interaction to you know, to support the whole process. And one other thing that I wanted to mention at the end of this, at the end of those 12 weeks, that it's hard work, definitely. You know, when people come here to Central Florida, they're thinking, all right, I'm going to a Disney cruise. No, no, this is not a Disney cruise, for sure. This is hard work.

Speaker 2:

12 uh, 12 weeks of going in and out the chamber doing other therapies. If you need to um to get the actual results, you would like um. At the end of it, we measure everything back and I think that's the critical part. Everything that we do in the assessment in the beginning, we repeat it at the end. So cognitive tests, physical tests and the brain imaging, because we want to monitor exactly what happened, not just the subjective improvement oh wow, I feel great. Oh wow, I'm that or not. We actually want to quantify everything in numbers how the cognitive performance, how the physical performance and how the brain actually changed, how brain metabolism actually improved. And we do it periodically, every six months, to make sure everything is maintained exactly as it did at the end of the treatment, and I think that's a really, really important point.

Speaker 1:

Yeah, this is so fascinating. Well, maybe, amir, you could. You could, if you don't mind, share with the audience your website and how they can go there. I urge you to take a look at the facility and see this the, the, the, the setup there. It's very, it's very beautiful there. Where can they find you on the web?

Speaker 2:

So we're Aviv Clinics. You can just Google Aviv Clinics, but the website itself is aviv-clinicscom. We're also in all the social media platforms and obviously, if you Google me, Amir Hadani, you want to email me. I'm pretty available on email and please feel free. If you have any questions, We'd love to answer anything.

Speaker 1:

Well, thanks again, Amir, for spending time with us and telling us about the great work you're doing. We really appreciate it.

Speaker 2:

My pleasure. This was fun.