Talk:Ozone therapy

Discovery of ozone

The article previously stated that Joseph Lloyd Martin discovered ozone. This is inconsistent with what I have found in other reputable references and what is stated in the Ozone article (i.e. that it was discovered by Christian Friedrich Schönbein). The reference for this (which was not properly linked is here http://www.homeoint.org/history/cleave/m/martinjl.htm) and does not state that he discovered ozone but that he had a patent for "for Ozonized Oxygen Gas and its compounds for inhalation in the treatment of disease as a hygienic agent, and compressing the same in water for internal or medicinal use". This is not the same as having discovered the gas, so I have removed this part of the sentence.--NHSavage (talk) 17:22, 13 July 2011 (UTC)

Bias

A neutral viewpoint would include much better balance, such as the following excerpt: "Despite a lack of direct support of O3 therapy, the current Food and Drug Administration regulations do not restrict the use of it in situations where it has proven its safety and effectiveness. Nonetheless, there has been support for its safety and effectiveness in multi-international studies." As well as the following, from the same published review "Despite the presently compelling evidence, future studies should include more double-blind, randomized clinical trials with greater sample sizes, determination of longevity in benefits produced, as well as methods of measurements and analysis." (Med Gas Res. 2017 Oct 17;7(3):212-219. doi: 10.4103/2045-9912.215752. eCollection 2017 Jul-Sep.) — Preceding unsigned comment added by 65.129.201.220 (talk) 15:42, 26 July 2022 (UTC)

One might also be interested in posting the following diagram recently published by Harvard Medical School researchers, with Ozone gas (O3) at top center: Medical Gas Therapy for Tissue, Organ, and CNS Protection: A Systematic Review of Effects, Mechanisms, and Challenges (PMID: 35243825 PMCID: PMC9069381 DOI: 10.1002/advs.202104136 Free PMC article 65.129.201.220 (talk) 15:59, 26 July 2022 (UTC)

Clearly this is a very biased article written by opponents. There is no suggestion of neutrality in the way it is written. It needs to be tagged. Abstrator (talk) 01:14, 24 December 2011 (UTC)

Not clear at all. --Ronz (talk) 17:02, 24 December 2011 (UTC)

Actually it is clearly not neutral. Please look at version https://secure.wikimedia.org/wikipedia/en/w/index.php?title=Ozone_therapy&oldid=453926959 and notice all the sections about: countries where the therapy is practised as regular medicine, methods of use, journals, etc. I'd go as far as accusing the user WLU of vandalism for the series of edits on 4 October. I'll tag the article as not neutral. Alecsescu (talk) 08:38, 29 December 2011 (UTC)

Please focus on content. If you want to make accusations of vandalism, take them somewhere else and provide plenty of evidence. Otherwise, such accusations are disruptive and incivil.

I agree that it is worth trying to salvage some information on its use if we can agree on the sources and don't confound WP:MEDRS issues with those of marketing and use. --Ronz (talk) 18:52, 29 December 2011 (UTC)

Hi, by no means I'm going to learn Wikipedia "bureaucracy" just to make a vandalism accusation on page that is of no interest to me. Click on the history link I gave; if that is not enough evidence of vandalism, then it's not vandalism. I know a reputable clinic doing ozone injections for disk herniation, claiming to show results and patients are indeed satisfied; it is not subsidised by the state, but it is a legal practice. Before WLU's edits, the article showed the view that this is a legal and established practice in some states, now it says "Some marketers of ozone generators make fantastic promotional claims [...]" (very encyclopedical...). I edited the article in the least biased way I could to represent facts as they are, and now you reverted again to WLU's view of the world. I have no idea what MEDRS is, and I won't edit the article again. — Preceding unsigned comment added by Alecsescu (talk • contribs) 11:01, 30 December 2011 (UTC)

It's not vandalism. Glad we're past that. --Ronz (talk) 17:26, 30 December 2011 (UTC)

I can't believe I'm being bullied on Wikipedia. You took out that fragment which was verifiably accurate, noticed my non-combat, and then you came back to make it clear that you're happy everything worked the way you forced it.Alecsescu (talk) 12:00, 21 January 2012 (UTC)

Please focus on content if you have any interest in changing consensus. --Ronz (talk) 17:33, 21 January 2012 (UTC)

Agreed, the bias in the language choice, article selection, expert selection (Ernst is an expert in nothing but asking others to prove negatives), if you would like a line by line content argument, I will gladly oblige. There are as many Pub Med articles that are pro Ozone as there are the select few that you have chosen. To use quackwatch, Ernst, certain physicians who have written for quackwatch, etc. is the definition of using BIAS in an article. The article needs to be flagged. 50.250.97.5 (talk) 19:12, 31 August 2023 (UTC)

I agree the article is biased, see WP:GOODBIAS. Some alt-med journals exist for the sole reason of bolstering quackery. QuackWatch and Ernst are WP:CITEd because of WP:PARITY, which is a content guideline. tgeorgescu (talk) 00:16, 1 September 2023 (UTC)

Ernst is an expert in nothing but asking others to prove negatives This is just random bullshit. --Hob Gadling (talk) 06:21, 1 September 2023 (UTC)

Dischome (talk) 20:45, 12 September 2013 (UTC)I've attended Ozone conferences in Europe, where they are very accepted. More and more they are being accepted in the US, primarily right now by sports doctors, who can't necessarily get reimbursed by insurance, but nevertheless use ozone therapy to get results that people will pay for. Eventually it will be common place in the US. Because ozone is a natural substance, pharmco will not endorse it as they cannot patent it. I don't have ozone facts immediately handy, but I am giving you the fact of my experience. I guess I am agreeing that the article is biased, as the practice of using ozone it used in many other countries successfully.

I've attended Ozone conferences in Europe, where they are very [well] accepted. By whom? By accredited medical professionals/associations? Please be more concise. --user:ASMB--

Because ozone is a natural substance, pharmco will not endorse it as they cannot patent it. Statement is dubious, salicylic acid is a natural constituent of willow tree bark and that didn't prevent Bayer patenting aspirin. --user:ASMB-- —Preceding undated comment added 17:33, 26 October 2013 (UTC)

This entry appears to be outdated and biased. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312702/ Ktjnwebb (talk) 03:06, 11 January 2019 (UTC)

Moved to talk

Seems to confuse health claims, use, and efficacy. Basically, there are the WP:MEDRS issues with health claims, vs WP:SOAP issues that might be addressed with rewording and better sources: --Ronz (talk) 18:41, 29 December 2011 (UTC)

Mainstream medicine uses

Ozone therapy is a well established alternative and complementary therapy in most mainland European countries where health authorities have tolerated its practice. The European Cooperation of Medical Ozone Societies, founded in 1972, publishes guidelines on medical indications and contraindications of ozone and hosts training seminars. In the early 1980s, a German survey and investigation into ozone therapy by the University Klinikum in Giessen and the Institute for Medical Statistics, published in the Empirical Medical Acts revealed over 5 million ozone treatments had been delivered to some 350,000 patients, by more than 1000 therapists, of this number about half were medical doctors. Although ozone is used in a complementary capacity by a significant number of doctors in Italy, Switzerland, Austria and Germany, it has still not gained popular support with mainstream industry policy makers in those countries, it is not covered by health insurance, nor is it part of the curriculum at most esteemed medical schools. Proposals to include ozone therapy in German health insurance schemes invoked hostile objections from pharmaceutical researchers who question its evidence base. Former Soviet Union Countries seem also to have had less difficulty in accepting ozone as a medicine.

References

Pseudoscience

Should this article be added to Category:Pseudoscience? —Entropy (T/C) 17:19, 13 January 2012 (UTC)

Yes, as in modern medicine, ozone is not used, and the FDA treats it as a pseudoscience. ThePlatypusofDoom (talk) 21:21, 25 April 2016 (UTC)

Very little of this article is about the topic

Very little of this article is about Ozone therapy. If someone wants to read about chemical properties of ozone, we have the article for it. I will be deleting the material that is not about "Ozone therapy" and leave a link for ozone for those interested in its properties. ParkSehJik (talk) 04:12, 25 November 2012 (UTC)

MEDRS source British Medical Source removed and replaced by offtopic random statements about ozone

This edit was made removed WP:MEDRS British Medical Journal sourced content and replaced it with offtopic statements about ozone in the stratosphere and MEDRS violating claims. The edit summary was "Requires more than one paper to change things", which is not a policy or guideline. The edit appears to be vandalism and is being reverted o MEDRS grounds alone. ParkSehJik (talk) 06:22, 25 November 2012 (UTC)

Madrid declaration link

Hi,

I agree with Yobol that this is not a WP:MEDRS document, and as stated in the edit comment, I don't think a consensus statement by ozone therapy societies is important to a discussion about ozone therapy itself. The document contains some practice guidelines, but those guidelines are also unreferenced.

-- UseTheCommandLine (talk) 06:21, 4 December 2012 (UTC)

Hello. I am sorry if I have been a headache, I was just trying to help. I know many medical websites that ta`lk about ozone therapy, but they're all in Spanish, that's the reason that when I found the declaration I thought it could help improving the article. The next time I am going to edit this article or any other related to ozone therapy I will ask first discussing in the respective talk page. Sorry if my English is not good, it is not my first language. I hope that together we can improve this article. --Biol. Cons. (talk) 03:01, 10 December 2012 (UTC)

Discolysis article improvement

Hello. I found two metaanalysis of discolysis. Please discuss in the talk page.--Biol. Cons. (talk) 19:21, 15 December 2012 (UTC)

Is this a fringe theory

Is this theory "mainstream enough" that it can be called "alternative medicine" without being called a "fringe theory?"

If the answer is no, then {{Fringe theories}} should be added to the top of the article.

Since I'm on the fence here and I expect that there won't be universal agreement on whether the existing {{POV}} template is sufficient or if adding "fringe theories" improves the encyclopedia, I'm asking that this template not be added until after discussion has occurred.

Discuss. davidwr/(talk)/(contribs)/(e-mail) 20:44, 11 June 2013 (UTC)

Agree that currently it's fringe. will add tag. -- [ UseTheCommandLine ~/talk ]# ▄ 20:55, 12 September 2013 (UTC)

Safety

The following websites might help to contribute in “Safety” of ozone therapy.

• Why Ozone Therapy?
• Ozone Theraphy_Dentistry with a conscience

These are all pro-ozone therapy articles, which gives undue weight to fringe science. ThePlatypusofDoom (talk) 21:24, 25 April 2016 (UTC)

I've removed the following sentence from the lede:

At least 10 deaths have been related to ozone therapy or its lack of usefulness, in nine cases there had been investigation and in eight it was discovered that the practitioners had used false credentials.

The cited webpage does not say what the sentence says: it lists a different number of cases, in none of which ozone therapy is established as the cause of death, and in most of which the underlying cancer or another therapy is clearly cause of death; it does not mention investigations or false credentials. Nor does the site appear to be a reliable source: it has a polemical tone and its information is very vague and supported by deadlinks. I have searched for the original supporting news articles without luck. It would be useful to have anecdotes of deaths from ozone therapy, if anyone can help locate some more reliable information. Fuzzypeg★ 23:46, 29 March 2020 (UTC)

Reversion of safety discussion

Both articles are included on pubmed. The journal is less mainstream, but the methodology and contentions are clear. Need further elaboration to justify removal. Ies (talk)

Please read WP:MEDRS and WP:FRINGE and don't try and force stuff in sourced to weak sources. You have been warned for edit-warring. Be aware this topic is subject to discretionary sanctions. Alexbrn (talk) 19:05, 25 April 2016 (UTC)

It is fine to contest the strength of the references, but you need to remember respond to talk page discussions before reverting edits without sufficient elaboration. Ies (talk) 19:07, 25 April 2016 (UTC)

Wikipedia editors follow WP:PAGs above all. You were edit warring against them. Alexbrn (talk) 19:09, 25 April 2016 (UTC)

Thanks for clarifying. My suggestion to you is to please try to remember Wikipedia:Civility, and to respond to editors questions when reverting before starting something that could be perceived as an edit war. Ies (talk) 19:14, 25 April 2016 (UTC)

My advice to you is to get some basic understanding of Wikipedia's WP:PAGs before repeatedly trying to force novel content in. Maybe WP:BRD might help? Alexbrn (talk) 19:18, 25 April 2016 (UTC)

Ok thank you. Incidentally, if by "novel" you are trying to invoke WP:OR, this would not be correct in this instance, and I would request that you review the reference and editorial response if you have concerns. Regardless, as you appear to feel strongly about the issue, I will defer, as I do not think your decision negatively impacts the article. Ies (talk) 19:31, 25 April 2016 (UTC)

No, "novel" in respect of accepted knowledge. I have no "feelings" about this topic and it is inappropriate for you to try for that angle. Alexbrn (talk) 20:07, 25 April 2016 (UTC)

As this is fringe medicine, there is not much "accepted knowledge" about it. There is no angle, simply responding to your criticism. Thanks again. Ies (talk) 20:13, 25 April 2016 (UTC)

Fringe

FYI, I have initiated a discussion about this topic at WP:FT/N. Alexbrn (talk) 20:11, 25 April 2016 (UTC)

Much appreciated. Ies (talk) 20:17, 25 April 2016 (UTC)

Additional References

• Ozone therapy: A clinical review
• Mechanisms of Action Involved in Ozone Therapy
  • "The application of ozone therapy in all public hospitals is still being delayed by prejudice, no fundings, commercial competition by big Pharma and above all by the incomprehensible disinterest, if not plain obstruction, by Health Authorities such as the FDA in USA and the European Medical Association."
  • " As it has happened for other innovative medical approaches, thanks for the efforts of many expert physicians, ozone therapy will be eventually accepted by orthodox medicine." — Preceding unsigned comment added by 76.14.15.93 (talk) 19:30, 8 October 2016 (UTC)

Both of those quotes come from the second link, which was published in a well-known predatory open access journal with a history of faked peer-reviews, rushed publication of bad articles and other trust-eroding issues. The first link does not support the claims. Finally, as a rule of thumb, any source you come across that actually uses the term "big Pharma" in a serious, pejorative sense can be safely dismissed as unreliable. MjolnirPants Tell me all about it. 17:36, 9 October 2016 (UTC)

Moved here

This does not appear to be pubmed indexed "This statement is opposed with the release of a peer-reviewed publication (2016), which performed a systematic review of controlled human trials of two major forms of systemic ozone therapies. Based on the Cochrane Library (1992) evidence classification system, as well as the Oxford Center for Evidence Based-Medicine (2009) criteria, systemic medical ozone therapy is establishing itself as evidence-based medicine."

Doc James (talk · contribs · email) 03:00, 14 August 2016 (UTC)

References

Further sources

I suggest: BMJ Case Rep. 2013 Jan 31;2013. pii: bcr2012008249. doi: 10.1136/bcr-2012-008249. The use of ozone therapy in Buruli ulcer had an excellent outcome. Bertolotti A1, Izzo A, Grigolato PG, Iabichella ML. The British Medical Journal's (BMJ)impact factor (2014) is 16.3; it uses a comprehensive peer review process giving priority to articles that improve clinical decision-making in general medicine. BMJ Case Rep is owned by BMJ. BMJ is one the world top medical journals.

Not a reliable source. Alexbrn (talk) 15:59, 17 December 2016 (UTC)

May I ask why one of the world top medical journals is considered by you "not a reliable source"? — Preceding unsigned comment added by 151.20.233.113 (talk) 16:02, 17 December 2016 (UTC)

Please see WP:MEDRS and maybe WP:WHYMEDRS for further background. Alexbrn (talk) 16:04, 17 December 2016 (UTC)

Thank you very much--151.20.233.113 (talk) 16:07, 17 December 2016 (UTC)

Is this perhaps good? Spine is a top Journal and this is a Review of Literature Fort NM, Aichmair A, Miller AO, Girardi FP. L5-S1 Achromobacter Xylosoxidans Infection Secondary to Oxygen-Ozone Therapy for the Treatment of Lumbosacral Disc Herniation: A Case Report and Review of the Literature. Spine (Phila Pa 1976). 2013 Dec 30. [Epub ahead of print] PMID 24384664--151.20.233.113 (talk) 16:16, 17 December 2016 (UTC)

Case reports are primary sources and so generally not allowed for health claims. The secondary component of primary sources (this promises a review) is sometimes allowed, but is often biased to colour the finding from the primary research. I cannot access the full text of this article so don't know what it says. Alexbrn (talk) 16:26, 17 December 2016 (UTC)

Thank you very much, I will try to search a systematic review in a top journal.--151.20.233.113 (talk) 16:30, 17 December 2016 (UTC)

I suggest following systematic reviews:

J Nat Sci Biol Med. 2011 Jan-Jun; 2(1): 66–70. doi: 10.4103/0976-9668.82319 PMC 3312702 Ozone therapy: A clinical review, authors A. M. Elvis and J. S. Ekta — Preceding unsigned comment added by 151.20.236.169 (talk) 15:50, 24 December 2016 (UTC)

GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JòNIOR, G. M.; GON‚ALVES, J. B. O. & BUCHAIM, R. L. Ozone therapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.- 151.20.232.106 (talk) 02:48, 25 December 2016 (UTC)

Pain Physician. 2012 Mar-Apr;15(2):E115-29, Ozone therapy as a treatment for low back pain secondary to herniated disc: a systematic review and meta-analysis of randomized controlled trials. Magalhaes FN1, Dotta L, Sasse A, Teixera MJ, Fonoff ET.--151.20.232.106 (talk) 02:51, 25 December 2016 (UTC)

Revista Dor Print version ISSN 1806-0013 Rev. dor vol.13 no.3 São Paulo July/Sept. 2012 http://dx.doi.org/10.1590/S1806-00132012000300012. Ozone therapy for lumbosciatic pain* José Oswaldo de Oliveira Junior; Gustavo Veloso Lages --151.20.232.106 (talk) 02:53, 25 December 2016 (UTC)

This Article is STILL biased and must be revised.

As previously stated many years ago, the language and tone of this article is very clearly anti-ozone therapy. Wikipedia should be a place of neutrality to allow readers to form their own opinions.

Please present the pro and cons side by side and let the reader decide his or her view.

Moreover, some the website sources used to promote the writer's skewed point of view are dangerously unqualified and smacks of yellow journalism.

Articles and writers such as this one should be outlawed from wikipedia. It is ridiculous that it has remained this way for so long.

— Preceding unsigned comment added by 47.142.153.211 (talk) 22:30, 5 July 2017 (UTC)

See WP:NPOV, particularly WP:GEVAL, & WP:FRINGE. Alexbrn (talk) 06:32, 6 July 2017 (UTC)

Seconded. Delta13C (talk) 10:33, 6 July 2017 (UTC)

Reference supports opposite claim

The only reference that is actually a clinical review published in a scientific journal is reference 2. It’s cited at the end of the introduction and invalidates every claim made in the introduction regarding ozone being dangerous, pseudoscientific, etc. I can’t even find a scientific journal article saying ozone isn’t effective. This is embarrassing. Chemacb (talk) 22:54, 13 March 2020 (UTC)

Evidence of safety and efficacy

An unreferenced statement mentioning "some evidence for its effectiveness in specific medical applications" was removed from the article's lead paragraph. It seems to me there is actually quite a bit of evidence, so I'm gathering what I can find here, in preparation to add something to that effect to the article. (I'll add these to the below list as I find them.)

• Ozone therapy found effective for pain relief in knee osteoarthritis:
  • https://onlinelibrary.wiley.com/doi/abs/10.1002/pmrj.12088 (Ozone therapy effective in pain relief for osteoarthritis of the knee: review article including 8 studies, 355 patients treated and 363 controls)
  • https://pesquisa.bvsalud.org/portal/resource/pt/mdl-30498370 (review article including 5 studies, 225 patients treated and 203 controls)
  • https://www.sciencedirect.com/science/article/abs/pii/S0965229918307337?via%3Dihub (2019 review article including 10 studies)
• Ozone therapy effective for lumbar pain relief (few and poor-quality studies in support):
  • https://pesquisa.bvsalud.org/portal/resource/pt/mdl-31521383 (2019 review including 6 trials found ozone therapy more effective than steroids or placebo, with low confidence)
  • https://pesquisa.bvsalud.org/portal/resource/pt/mdl-30414366 (2018 review found few and poor-quality studies in support of lumbar pain relief. This review is useful in discussing minor but potentially serious complications)
• Ozone therapy effective treatment for herniated discs in terms of pain, function and complication rate: https://www.jvir.org/article/S1051-0443(09)01668-6/fulltext (metaanalysis of 12 studies covering nearly 8000 patients)
• Ozone therapy effective for treatment of chronic wounds (healing and wound closure): https://onlinelibrary.wiley.com/doi/abs/10.1111/iwj.12907 (2018 review of 9 studies, 453 patients)
• Intralesional ozone injection effective against warts: https://www.ncbi.nlm.nih.gov/pubmed/31584525?dopt=Abstract
• Ozone therapy effective against Hepatitis B:
  • https://ojs.uv.es/index.php/JO3T/article/view/11459/pdf (2018 study: 28 patients all had viral load and biological markers reduce to undetectable levels within 15 days)
  • https://www.ncbi.nlm.nih.gov/pubmed/19544653?dopt=Abstract (2008 Chinese-language study on 20 patients plus 22 control)
• Ozone therapy effective for chronic Hepatitis C:
  • https://www.ncbi.nlm.nih.gov/pubmed/21417811?dopt=Abstract: 2011 preliminary study: symptoms improve and 25-45% of patients test negative for RNA in serum
  • https://www.ncbi.nlm.nih.gov/pubmed/21417811?dopt=Abstract 2009 Russian language study found ozone therapy more effective than standard treatments
  • https://www.tandfonline.com/doi/abs/10.1080/01919512.2012.720161 2012 Review of 3 prior studies, and preliminary results of combined ozone and interferon therapy. Patients treated with ozone therapy have a 40% relapse rate one year after treatment.
• HIV: Ozone in conjunction with antiretroviral treatment:
  • https://ojs.uv.es/index.php/JO3T/article/view/11458/pdf: 2018. Participants were 32 patients already taking Lamivudine 150mg and Zidovudine 300mg daily, with high viral load, low CD4 and CD8 counts and adverse reactions to retrovirals. Viral load became undetectable after 1 month in all 32 patients; CD4 and CD8 cells substantially increased; all side effects of antiretroviral drugs disappeared or improved.
• Herpes zoster: https://www.ncbi.nlm.nih.gov/pubmed/29559601?dopt=Abstract 2018 Chinese study comparing 30 patients treated with ozone therapy vs 30 patients treated with valacyclovir, mupirocin ointment and laser treatment: all the ozone group recovered (vs only 87% of control group), and did so faster and with less pain.
• Multiple sclerosis: https://www.ncbi.nlm.nih.gov/pubmed/28623000?dopt=Abstract 2017 study: Ozone insufflation led to significantly increased antioxidant enzymes and cellular reduced glutathione; decreased oxidation damage; and decreased levels of pro-inflammatory cytokines TNFα and IL-1β. Stimulated CK2 expression and the Nrf2 pathway.

Some of these studies are not double blinded, randomized, controlled studies, and some are not published in ideal peer reviewed conditions. They do not constitute proof, and may be open to dispute, but they are "some evidence". Fuzzypeg★ 06:16, 27 April 2020 (UTC)

COVID-19 section

I'm aware that my edits may raise some questions. I personally have no idea whether ozone therapy is effective for COVID-19 or anything else, and am not affiliated with any ozone proponents; I am simply trying to map out significant evidence around this issue. I don't want to suppress reporting on this subject simply for fear of encouraging the uninformed to try unproven treatments – and WP is not censored. Nor do I want to uncritically promote this therapy by citing only poor, one-sided research. I feel the information in the article is notable (it has certainly made the Italian and Spanish news!), and I'd like to present it clearly, without hiding the limitations of the evidence, but also without descending into pejoratives, WP:OR, WP:WEASEL words or liberal sprinkling of adjectives such as "unproven", "discredited" into every second sentence as scare flags for the reader.

Oh, and it bugs me when people say there's "no evidence" of something, when what they mean is insufficient or inconclusive evidence. The American Cancer Society was misrepresented as saying there was "no credible scientific basis" for anti-cancer claims, when what they really said was that there were a number of trials showing interesting results but that no rigorous trials on humans have yet shown positive effect and hence it remains unproven.

I have (please note) also substantially improved the safety section, giving a lot more information on negative side-effects of the treatment (I had to translate a lot of German for this info, it took me ages). I may soon be able to add even more regarding negative effects. So I'm not editing with an agenda here, merely trying to achieve accuracy and a neutral point of view. Fuzzypeg★ 15:58, 27 April 2020 (UTC)

People with a vested interested in making positive claims around a treatment's success is not 'evidence.' Anyone can call up a newspaper and claim "XYZ," and that in and of itself does not constitute evidence. You're welcome to note these assorted ozone therapy clinics are making claims about positive outcomes related to some specific treatment, but without peer-reviewed empirical evidence to back up their claims, they shouldn't be treated factual. You're conveniently and purposefully leaving out important details (like the existence of simultaneous treat unrelated to ozone therapy which may have a more of an impact than the ozone treatment. CymHastings (talk) 19:48, 27 April 2020 (UTC)

Please assume good faith. I am not "purposely" leaving out information. Very happy for that to be clarified; it helps the article. I thought it was implied by stating that a number of patients were no longer intubated by end of treatment, and didn't really consider stating it more explicitly.

Many research articles are published with authors disclosing conflicts of interest: that doesn't prevent these articles being considered "evidence". Lack of peer review certainly decreases the reliability of evidence very substantially. These reports mostly constitute expert opinion without critical appraisal, which falls of a very low rung on the scale of medical evidence, but is still evidence. I note that the groups producing these reports are all attempting to begin randomized controlled studies and publish peer-reviewed papers, but to run controlled studies requires ethics approval, which has been difficult to obtain for some of them (though they have had approval to deliver treatment). This, for instance, looks ostensibly like a well-designed trial, but failed to obtain ethics approval. Perhaps the failure to deliver gold-standard research comes down to these researchers' "lack of rigour", as you have insinuated, or perhaps it comes down to institutional reluctance to consider alternate therapies. Who knows? I don't wish to present these reports as anything more than they are, but I also don't want to negatively misrepresent them or leap to conclusions about the competency of the people making them. Fuzzypeg★ 23:47, 27 April 2020 (UTC)

Hi again CymHastings. I prefer the language of the edits you've made this time (still not convinced about the words "claim" and "anecdotal", but won't bother arguing). I agree it's sensible to point out the lack of external validation. I'm dubious about this statement: "as of late April, no hospital outside of the ozone therapy community has enacted such treatments based on these recommendations". What does it mean to be "outside the ozone therapy community"? Not practicing ozone therapy? Then no hospital outside the community can or will ever practice the therapy, by definition. Or do you mean something else? In which case, what is your evidence regarding the 20+ hospitals offering this treatment in Italy, plus others in China, Portugal, Brazil, Romania and Turkey? This sounds very much like original research, and I think it needs clarifying, with supporting citation, or else removing. Fuzzypeg★ 00:00, 28 April 2020 (UTC)

It is very difficult for me to assume good faith when you post the statements of the clinicians as fact. Again, someone claiming something does not demonstrate fact. Further, you (and the clinicians for that matter) are attempting to demonstrate causation through proximity. Just because ozone therapy was applied and there was an improvement in condition does not mean the improvement was directly related to the treatment. By excluding from the statements additional information (from pre-existing conditions of the patients to the additional forms of treatment applied at the same time as the ozone therapy), the paraphrasings you list exclusively work to imply the ozone therapy caused the improvements. Baring the release of empirical evidence to support such, they are, by definition, claims. Further, ‘anecdotal’ exactly communicates that a limited number of claims without empirical evidence have been made. It’s an accurate use of the word. If and when any party produces confirmed physical evidence to show a causal link between the treatment and the outcome, I will more than happily yield to different phrasing. In the interim, you should clearly indicate that the clinicians are reporting whatever improvements they claim without using statements of fact. Again, anyone can report anything... and we should be mindful to list claims as such baring evidence to support said claims. A casual reading of your contributions would make the average viewer believe the patients actually had improvements; instead, clinicians reported improvements but failed to provide actual evidence in support of their reports. Are we to take the words of persons just because they called up a newspaper?

Several of the clinics you’ve listed or are cited are alternative medicine establishments and are not part of the mainstream public health community. While other centers may be using ozone therapy (as you listed off), none are necessarily doing so BECAUSE of the recommendations of Dr. Baeza at the Ibiza institution. I’m more than happy to be corrected (it wouldn’t be the first time).

I’m sorry if I come across as overly agressive. I’ve seen far too many uneducated people fall prey to claims by miracle workers, and given the popularity (and misuse) of Wikipedia as a source for truth for the masses, I fear for people who may interpret your contributions as a factual recounting of the events rather than just the reporting of events by parties with vested interests. We can’t assume everyone is thorough enough to click on the source links; we have to ensure the entries themselves clearly differentiate between reports of facts and actual facts. CymHastings (talk) 02:41, 28 April 2020 (UTC)

Please don't add any information about COVID-19 to this article yet. Have you heard about the Wikipedia:Recentism idea before? It can be very tempting for editors to rush forward, even though nothing's really known, to add something about the big news topic. But it's better in these instances to remember that Wikipedia:There is no deadline, and that if we wait, we can put truly solid information in. I'd rather that we got this right, even if that means waiting months until proper medical review articles (NB: not case studies, like "We tried this on these two patients, and they recovered") to get published. WhatamIdoing (talk) 15:52, 28 April 2020 (UTC)

Thank-you. I read the WP:MEDRS that Alexbrn linked in his edit summary, and am much chastened. I may continue to add notes to the talk page, such as the five clinical trials I've found currently underway:

• https://clinicaltrials.gov/ct2/show/NCT04366089 Started 2020-03-26, Rome. Randomized controlled, single-blind on outcomes assessor. ~152 participants. Treatment group receives systemic autohemotherapy with Ozone 30 mcg / ml 250ml 2 times / day for 7 days, plus standard of care. Control group receives standard of care. (Standard of care includes hydroxychloroquine and antibiotics.)
• http://www.chictr.org.cn/showproj.aspx?proj=49947 Started 2020-02-22, Haihe Hospital, Tianjin. Non-random controlled. 15 mild ill and 15 severe or critical ill patients receive conventional treatment plus ozonated autohaemotherapy; 30 controls receive conventional treatment.
• https://clinicaltrials.gov/ct2/show/NCT04359303 Starting April 2020, Valencia, Spain. Randomized controlled double-blind. ~50 participants. Treatment group receive WHO-recommended treatment plus autohaemotherapy: 200 mL at 40 mcg/mL of medical ozone / oxygen in 200 mL of patient’s blood. Controls receive WHO-recommended treatment.
• https://clinicaltrials.gov/ct2/show/NCT04370223 Starting ~2020-05-04, Clinica Nuestra Señora del Rosario, Ibiza. Randomized controlled open-label. ~208 participants, all with COVID-19 pneumonia. Treatment group receive standard hospital treatment plus autohaemotherapy every 12 hours during 5 days (100-200ml of patient’s blood interacted with 200ml gas containing 40 μg/mL ozone). Controls receive standard hospital treatment.
• https://www.irct.ir/trial/47149 Starting ~2020-04-23, Baqiyatallah University of Medical Sciences, Iran. Randomized, controlled, non-blinded. Target of 80 participants. Treatment group receive ozone major autohaemotherapy (100-200cc blood interacted with equal volume of 35μg/mL ozone; volume depending on severity) 1-2 times daily depending on severity of disease, plus conventional treatment. Controls receive conventional treatment.

But I understand WP guidelines on levels of medical evidence better now, and am in no hurry to add any more on this to the article proper.

CymHastings, I was not stating those reports as facts. If you reread my edits you should see liberal use of quotation-marks and words such as "stated", "reported". If you find it hard to assume good faith, please try harder. As I said, I won't bother arguing about the other language, though I still disagree. Fuzzypeg★ 06:39, 4 May 2020 (UTC)

Ozone therapy — OHT

Hello everyone,

An in-depth debate on this topic has been ongoing for several days now. To access its interactive content, simply click on → this hyperlink.

Sincerely, — euphonie ^breviary 20:50, 13 July 2020 (UTC)

Discussion archived at Wikipedia talk:WikiProject Medicine/Archive 138#Johann Lahodny SandyGeorgia (Talk) 05:19, 4 August 2020 (UTC)

Why is the empirical research supporting ozone missing? A simple google pulled up NIH data that supports the efficacy of ozone for health uses

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312702/ 69.94.200.170 (talk) 14:07, 25 September 2022 (UTC)

That is not "NIH data". That is an article from the "Journal of natural science, biology, and medicine" which happens to be included in PubMed Central. We have no reason to think that journal is reliable enough for writing about medical topics. It is not indexed in MEDLINE, for example. XOR'easter (talk) 17:37, 6 March 2023 (UTC)

There is no ozone therapy, there is ozone poisoning. Ozone is a poison. It is very good that there is ozone at high altitudes, but we would not like to breathe ozone. tgeorgescu (talk) 17:32, 24 March 2023 (UTC)

Also Aspirine is a poison, and a medicine. It depends on the dosage and way of administration. Ozone in microdosages 0-60 max 80 micrograms per ml O2) is a medicine, if used correctly by medical doctors, according to guidelines based on the principles of Evidence Based Medicine (EBM).

Inhalation of oxygen: Ozone being a very potent oxidant harms the lungs irritating the mucous membranes of the lungs to result in pulmonary oedema.

Oxygen during inhalation penetrates the capillaries of the alveoli and is not being stopped by the antioxidants at the epithelial surface. At the air-epithelium interface, the alveolar cells are constantly overlaid by a very thin (about 0.1 µm) film composed of water, salts and molecules such as surfactant and phospholipids, the so called Endothelial Lining Fluid (ELF).

Ozone, on the other hand, when inhaled, immediately reacts with biomolecules present in the ELF and is not transferred into the alveolar capillaries. As a result, ozone has a more powerful oxidative action, harms available substances that should protect the alveoli and causes lung oedema. It doesn't get a chance to enhance antioxidant mechanisms as when it comes into contact with blood, water or PUFA.

Bocci, Velio; Borrelli, Emma; Travagli, Valter; Zanardi, Iacopo (07-2009). "The ozone paradox: ozone is a strong oxidant as well as a medical drug". Medicinal research reviews. 29 (4): 646–682. doi:10.1002/med.20150. ISSN 0198-6325 1098-1128 0198-6325. PMID 19260079. {{cite journal}}: Check |issn= value (help); Check date values in: |date= (help)

The conclusion here is in order to be safe Ozone needs to be administered in low dosages avoiding pulmonary inhalation, by different application methods via tissues that have sufficient antioxidants available, including blood.

Administration via different routes than inhalation can encompass immune system activation, vascular and haematological modulation and increase of anti-oxidant activity.

Mechanism of Action

Ozone can be administered either by intramuscular, intra- articular or intra-discal injections, by mixing it with autologous blood and transfusing it back, locally applying it to the skin with bagging and through vaginal or rectal insufflation. Not through inhalation.

When the ozone reaches the body cells there are two important reaction chains. Ozone will be reacting with the membrane phospholipids and thus produce the following products: Ozonides, Aldehydes, Peroxide, and Hydrogen peroxide. (Viebahn-Haensler)

Viebahn-Haensler, Renate; León Fernández, Olga Sonia (2021-07-23). "Ozone in Medicine. The Low-Dose Ozone Concept and Its Basic Biochemical Mechanisms of Action in Chronic Inflammatory Diseases". International Journal of Molecular Sciences. 22 (15): 7890. doi:10.3390/ijms22157890. ISSN 1422-0067. PMC 8346137. PMID 34360655.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)

Secondly these products will act as second messengers activating enzymes like Superoxide Dismutase (SOD) causing an increase in intra erythrocytic 2,3 DPG level, enhancement of general metabolism through improved oxygen delivery and upregulation of a number of antioxidant enzymes as well of haeme oxygenase 1 and Heat Shock Protein 70 (HSP-70).

Ozone’s antioxidant capacity.

Ozone is a potent oxidant. High dosages cause high oxidative stress and eventual inflammation and even damage to the tissue.

Low dosages, though, can activate antioxidant pathways. In other words, low dosage of Ozone activates the homeostasis mechanism in the body to prevent oxidation and damage of cells and structure.

Low concentration Ozone comes in contact with H2O and PUFA

In vitro and in vivo studies of the long-term antioxidant capacity of infiltration with O2-O3 gas mixture in the human body show that it binds immediately to water and cell membrane components like Poly Unsaturated Fatty Acids (PUFA).(Noel L.Smith et al)

Smith, Noel L.; Wilson, Anthony L.; Gandhi, Jason; Vatsia, Sohrab; Khan, Sardar Ali (2017-10-17). "Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility". Medical Gas Research. 7 (3): 212–219. doi:10.4103/2045-9912.215752. ISSN 2045-9912. PMC 5674660. PMID 29152215. Retrieved 2017-12-20.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)

Hydrogen Peroxide (OH-) and Lipidoxidation products are formed.

After contact with water (H2O), Hydrogen Peroxide is formed and after contact with the PUFA Lipid Ozonation products are formed.

This activates Nuclear Factor Erythroid 2 related Factor 2

The presence of hydrogen peroxide and the lipid ozonation products increase activation of the Nuclear Factor Erythroid 2-related Factor 2 (Nrf2).

Which results in the expression of Antioxidant Response Elements (ARE)

The activation of Nrf2 causes the expression of the so-called Antioxidant Response Elements (ARE) genes. ARE genes are normally associated with Kelch Like Ech Associated Proten-1 (KEAP-1). Now when mildly activated, they dissociate from KEAP-1 and transcription of Antioxidant Response Elements (ARE) driven genes can be induced.

These genes after being induced will produce antioxidant enzymes as Super Oxide Dismutase (SOD), Glutathione Peroxidase (GPx), Glutathione S-transferase (GST) Catalase (CAT) Heme Oxygenase-1 (HO-1) NADPH HSP-70 that will enhance antioxidant processes. .(Noel L.Smith et al) (citation see above)

The importance of this is that after the immediate oxidative effect, antioxidant mechanisms are stimulated and after repetitive stimulation the antioxidant mechanisms remain active at a higher grade. (Viebahn, Malatesta, Galié)

Galiè, Mirco; Costanzo, Manuela; Nodari, Alice; Boschi, Federico; Calderan, Laura; Mannucci, Silvia; Covi, Viviana; Tabaracci, Gabriele; Malatesta, Manuela (2018-08-20). "Mild ozonisation activates antioxidant cell response by the Keap1/Nrf2 dependent pathway". Free Radical Biology and Medicine. 124: 114–121. doi:10.1016/j.freeradbiomed.2018.05.093. ISSN 0891-5849. Retrieved 2019-11-24.

Vascular and haematological modulation

The presence of O3 causes an increase of efficiency of oxygen delivery to the cells. The mitochondrial respiratory chain is made more efficient.

Secondly low dose ozonised blood enhances blood circulation and oxygen delivery to ischemic tissues as a result of the concerted effect of NO and CO and an increase in intraerythrocytic 2,3 diphosphoglycerate (2,3 DPG). (Bocci)

Bocci, Velio (2012-09). "How a calculated oxidative stress can yield multiple therapeutic effects". Free radical research. 46 (9): 1068–1075. doi:10.3109/10715762.2012.693609. ISSN 1029-2470. PMID 22583557. {{cite journal}}: Check date values in: |date= (help)

Pathogen inactivation of bacteria fungi and viruses.

O2-O3 mixture is known in industry for its strong antibacterial, antifungal and antiviral action in disinfecting water, materials, and spaces. In ozone therapy nevertheless this effect

is mostly of use in direct application of O2-O3 mixture to

infected wounds,

rectal dysbiosis,

vaginal dysbiosis, after which the good bacterial flora has to be re-established with micro biotic supplements.

In the blood, in case of a sepsis (microbial infection of the blood) for example, as ozone binds too fast to water, available proteins and PUFA and because of the small dosage used, ozone will not be sufficient to act as an antipathogen. (Bocci)

Immune system activation

In the research of Galie et al, they provide scientific, histologic and biochemical evidence that treatment with a low concentration of ozone in cultured cells promotes nuclear translocation of Nrf2 at the chromatin sites of active transcription and increases the expression of antioxidant response element (ARE) driven genes.

Also, it is now proven that cytokines are directly stimulated by Ozone in fibroblasts and leucocytes. (Malatesta)

“Nrf2 is able to modulate inflammation through multiple mechanisms, such as the regulation of redox homeostasis and the suppression of pro-inflammatory genes. -- Inflammation increases local and systemic ROS level while ROS enhance inflammation. --The Nrf2-KEAP1 mediated ROS-homeostatic control can break this vicious cycle.” (Galié et al.)

Galiè, Mirco; Covi, Viviana; Tabaracci, Gabriele; Malatesta, Manuela (2019-08). "The Role of Nrf2 in the Antioxidant Cellular Response to Medical Ozone Exposure". International journal of molecular sciences. 20 (16). doi:10.3390/ijms20164009. ISSN 1422-0067. PMC 6720777. PMID 31426459. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)

This is a finding that is falling in place with the publication of Cuadrado in Nature Reviews, where ozone is not yet mentioned. Cuadrado states: “a functional NRF2–KEAP1 axis is essential for protection against a plethora of diseases that have oxidative stress and inflammation as underlying pathological features. 

“(Cuadrado) Cuadrado, Antonio; Rojo, Ana I.; Wells, Geoffrey; Hayes, John D.; Cousin, Sharon P.; Rumsey, William L.; Attucks, Otis C.; Franklin, Stephen; Levonen, Anna-Liisa; Kensler, Thomas W.; Dinkova-Kostova, Albena T. (2019-04). "Therapeutic targeting of the NRF2 and KEAP1 partnership in chronic diseases". Nature reviews. Drug discovery. 18 (4): 295–317. doi:10.1038/s41573-018-0008-x. ISSN 1474-1776 1474-1784 1474-1776. PMID 30610225. {{cite journal}}: Check |issn= value (help); Check date values in: |date= (help)(Lamberto Re)

Smith, Noel L.; Wilson, Anthony L.; Gandhi, Jason; Vatsia, Sohrab; Khan, Sardar Ali (2017-10-17). "Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility". Medical Gas Research. 7 (3): 212–219. doi:10.4103/2045-9912.215752. ISSN 2045-9912. PMC 5674660. PMID 29152215. Retrieved 2017-12-20.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) Hermelyn Meinardi (talk) 17:36, 9 April 2023 (UTC)

Not very helpful I'm afraid, and nobody will be making any changes to the article based on this TL;DR screed. Which, if any, of the refs you have wedged in meet our sourcing requirements WP:MEDRS? - Roxy the dog 20:04, 9 April 2023 (UTC)

@Roxy the dog: Hermelyn Meinardi was warned that her next edit to Ozone therapy will take her to WP:AE. tgeorgescu (talk) 20:27, 9 April 2023 (UTC)

OK, THanks t. - Roxy the dog 20:55, 9 April 2023 (UTC)

Could you please be more specific? Did you read any of the references? You seem only to react directly without reading. I studied a year at the university of Verona in Italy to grasp it. And I have no intentions to send lies into the world. I will go and check which of the refs I have wedged in, meet the sourcing requirements WP: MEDRS. That will take some time.

Therapeutic Indications

The following table 1 shows the therapeutic indications for ozone therapy.

The grade of evidence according to the standard of Evidence Based Medicine (EBM) are

A= Shown statistically relevant evidence in Systematic Reviews (SR) of Randomised Controlled Trials (RCT).

B =Systemic Reviews of Case Control (Individual or Cohort) studies.

C = Expert opinion without explicit critical appraisal or based on physiology bench research. ( OCEBM)

TABLE 1 THERAPEUTIC INDICATIONS (Burns, Smith 2017, Linee Guida e Buone Pratiche in Ossigeno Ozono terapia art. 6-L. 8 marzo 2017 n.24, Zambello, Bonetti et al)

SPINE

Grade of evidence EBM

Bulging disc of the cervical, dorsal and lumbar spine

A

Herniated disc of the cervical, dorsal and lumbar spine

A

Osteoarthritis of the cervical, dorsal and lumbar spine

A

Pain after back surgery FBSS of the cervical, dorsal and lumbar spine

B

Spinal canal Stenosis of the cervical, dorsal and lumbar spine

B

NERVE ENTRAPMENT SYNDROMES

Nerve Entrapment Syndrome (Carpal Tunnel Syndrome)

B

Ulnar Nerve Entrapment Syndrome (Guyon’s Canal Syndrome)

B

Ulnar Nerve Entrapment Syndrome (Cubital Canal Syndrome)

B

Posterior Tibial Nerve Entrapment Syndrome

B

(Medial Tarsal Tunnel Syndrome)

B

Sural Nerve Entrapment Syndrome

B

Deep Peroneal Nerve Entrapment Syndrome (Anterior Tarsal Tunnel Syndrome)

B

Superficial Peroneal Nerve Entrapment Syndrome

B

External popliteal sciatic nerve or common peroneal nerve entrapment syndrome

B

Entrapment syndrome of the lateral cutaneous nerve of the thigh (Bernhardt-Roth Syndrome)

B

Interdigital nerve entrapment syndrome (Civinini-Morton neuroma)

B

ARTHROSIS AND SYNOVITIS

Trapeziometacarpal Arthrosis (Rizarthrosis)

B

Knee, Hip, Shoulder or Elbow Arthrosis (GRADE A for the knee (Raeissadat), GRADE B)

A/B

Knee, Hip, Shoulder or Elbow Synovitis

B

Retropatellar chondropathy

A

VARIOUS GENERALIZED DEGENERATIVE DISEASES

Therapeutic Indications GRADE C

Peripheral Vasculopathies

C

Dry maculopathy

C

Ulcers due to Vasculopathies

C

Pressure sores Decubitus

C

Diabetic foot ulcers (Anupunpisit) GRADE A

A

Herpes Simplex

C

Herpes Zoster

C

M.Dupuytren

Vascular Headaches

C

Multiple Sclerosis

C

ALS Amyotrophic Lateral Sclerosis

Parkinsons Disease

C

Fibromyalgia

C

Acne

C

Rheumatoid Arthritis

C

Ulcerative recto colitis

C

Bronchial Asthma

C

Allergies

C

Liver diseases

C Hermelyn Meinardi (talk) 20:53, 9 April 2023 (UTC)

WP:MEDRS sets forth two conditions:

1. systematic reviews, and
2. indexed for MEDLINE.

While technically some systematic reviews which aren't indexed for MEDLINE could be accepted (if published in very reputable journals), in light of WP:ECREE it is not such a good idea.

Do mind that higher quality sources are allowed, specifically rendering the EBM consensus in sources published e.g. by AMA or WHO. tgeorgescu (talk) 21:48, 9 April 2023 (UTC)