Updates in Naturopathic Medicine

A. Updates in OZONE THERAPY

Prior embarking on this updated section of ozone therapy we would like to kindly suggest that you get yourselves familiarize with medical ozone. You may want to check out our PROGRAMME and FAQ sections first.

Introduction to Ozone therapy Update

We have mentioned some of the uses and modes of actions of ozone in our website’s sections of PROGRAMME and FAQ. The following are updates based on clinical trials performed by some of the more reputed authorities in medical ozone today.

a) Ozone in Liver Diseases

i) Viral hepatitis:-

A study performed in Egypt entitled "OZONE THERAPY IN PATIENTS WITH VIRAL HEPATITIS "C", A CLINICAL STUDY" demonstrated the effectiveness of ozone therapy (Major autohaemotherapy + Rectal insufflation) in the treatment of viral Hepatitis C especially of genotype 4. There are currently six known genotypes of HCV with a worldwide prevalence of genotypes 1, 2 & 3.  In Africa, genotype 4 and 5 are more dominant. In Asia, genotype 6 is more dominant. Genotype differences have shown varying susceptibility to antiviral therapy. In Egypt, genotype 4 is prevalent and is known to be relatively resistant to antiviral treatment. The study showed a declination in viral load after 8 weeks of treatment and a further decline after 16 weeks. 95% of patients showed improvement in clinical parameters while the remaining 5% did not demonstrate a decline in the viral load and appeared non-responsive to medical ozone. Possible causes of non-responsiveness were poor nutrition (food with high fats and meat) and the concomitant ingestion of potential hepatotoxic medication for other diseases. Not only did the authors find the use of ozone therapy in viral hepatitis C to be effective but also to be safe and less expensive as well.

Ref- "OZONE THERAPY IN PATIENTS WITH VIRAL HEPATITIS "C", A CLINICAL STUDY” Prof. Dr. Mohamed Nabil Mawsouf, Dr. Taha Tarek Tanbouli & Dr.Wagdy Ibrahim El-Tayar.

VIEWs of NWC's Physicians

We have used ozone therapy in the treatment of viral hepatitis B with impressive results. The use of ozone seemed to work better when there is a demonstrable liver inflammation (Stage 2 of Chronic Hepatitis B) as evident from elevated liver enzymes. Our treatment protocol has been working, as the progression of the disease to Stage 3 of the disease is shortened and uneventful. Nevertheless, just like the study mentioned above, we will continue to come up with the best protocol that will not only be clinically beneficial but one which is economical as well. The days of antiviral therapy especially interferon alpha (which is the mainstay of treatment of both Viral hepatitis B and C) may soon be numbered should the beneficial role of medical ozone in these diseases be applied on a wider scale.

ii) Hepatic Ischaemia:-

The effects of ozone treatment in the injury associated with hepatic ischemia-reperfusion (I/R) were evaluated in the study entitled "Protective effect of ozone treatment on the injury associated with hepatic ischemia-reperfusion: antioxidant-prooxidant balance.” Free Radic Res 1999 Sep; 31(3): 191-6. Ozone treatment via rectal insufflation for 10 days resulted in the preservation (glutathione) or an increase (SOD) in antioxidant defense and maintains H2O2 at levels comparable to those in the control group. The non-declination of these anti-oxidants (Gluthathione, SOD and H2O2) following liver injury demonstrated the protective effect of ozone treatment on the injury associated to hepatic I/R.

VIEWs of NWC's Physicians

In theory and based on the above study, ozone should be able to prevent liver injury associated with ischaemia - reperfusion in conditions like drug overdose and liver trauma. However, the morbidity and mortality associated with these conditions deem such trials in patients afflicted with them as unethical and may thwart the use of ozone in the above settings. Nevertheless, we look forward to further ventures in the clinical trials of this area.

b) Ozone in the Locomotor System

i) Effect of ozone therapy on muscle oxygenation.

Ozone therapy can modify oxygenation in resting muscles, particularly of those that are most hypoxic. Results from the study published in the J Altern Complement Med. 2003 Apr; 9(2): 251-6 suggested that ozone therapy could be used effectively as a complementary treatment of hypoxic and ischemic syndromes. Medical ozone was given via major autohaemotherapy on alternate days for one week and it was found that poorly oxygenated muscles benefited most from the therapy. A significant higher oxygenation in these tissues was observed 48 hours after the second session.

VIEWs of NWC's Physicians

We do not have any objective means of measuring hypoxia in muscles but have numerous patients with muscular complaints. Most of the clinic's (>95%) patients with some form of muscle complaints (e.g. lethargy, aches and pains) do very well (i.e. complete relieve of symptoms that brought the patient to clinic in the first place) after ozone is given via either major autohaemotherapy or extra-corporeal blood oxygenation and ozonation (EBOO). As the response vary from individuals, we do not have a rigid protocol for muscular symptoms but will usually stop after giving three doses on alternate days.

ii) Ozone therapy in lumbar disc herniation

In the AJNR Am J Neuroradiol. 2003 May; 24(5): 996-1000, the authors compared the outcome of administering medical ozone alone with the outcome of medical ozone followed by injection of a corticosteroid and an anesthetic at the same session. All subjects presented with clinical signs of lumbar disk nerve root compression and with CT and/or MR evidence of contained disk herniation. Three hundred patients (group A) received an intradiscal (4 mL) and periganglionic (8 mL) injection of an oxygen-ozone mixture at an ozone concentration of 27 micro g/mL. The other 300 patients (group B) received, in addition, a periganglionic injection of corticosteroid and anesthetic. Therapeutic outcome was assessed 6 months after treatment by using a modified MacNab method. Results were evaluated by two observers blinded to patient distribution within the two groups. It was found that combined intradiscal and periganglionic injection of medical ozone and periganglionic injection of steroids has a cumulative effect that enhances the overall outcome of treatment for pain caused by disk herniation. Oxygen-ozone therapy is a useful treatment for lumbar disk herniation that has failed to respond to conservative management.

VIEWs of NWC's Physicians

Ozone therapy alone can cause an alleviation in the pain as observed in the study published in Radiol Med (Torino) 1998 Jan-Feb; 95(1-2): 21-4. Although steroids appear to have an augmentive effect in the alleviation of pain, we will only resort to this combination therapy in resistant cases.

c) Ozone in Infectious Diseases

i) Efficacy of ozonized sunflower oil in the treatment of tinea pedis- Mycoses. 2002 Oct; 45(8): 329-32.

Ozonized sunflower oil, Oleozon, has a remarkable germicidal action. In this study, the efficacy of Oleozon in the treatment of tinea pedis was demonstrated in a controlled randomized phase III assay, comparing topical Oleozon with ketoconazole cream 2% (Nizoral) in 200 patients (100 in each group). The treatment administered was twice per day for a period of 6 weeks. The efficacy was evaluated clinically (disappearance of all lesions, with or without negative mycological results) and mycologically (negative culture results). A complete clinical and mycological cure was obtained in 75 and 81% for Oleozon and ketoconazole, respectively, with no significant differences between both groups. No side effects or bacterial super-infections were observed. Patients were evaluated 6 months after the end of the treatment and no recurrence was observed in the Oleozon group. Oleozon can be an effective alternative low-cost antimycotic drug.

VIEWs of NWC's Physicians

NWC has been using ozonized olive oil in many skin conditions with good results. In addition to skin infection, the use has been extended to cases of apthous mouth ulcers, superficial skin burns and eczema rather successfully. It would be interesting to note the successful use of ozonized olive/sunflower of the above-mentioned conditions in clinical trials.  

ii) Necrotizing fasciitis successfully treated with extracorporeal blood oxygenation and ozonization (EBOO)- Int J Artif Organs. 2002 Dec; 25(12): 1194-8.

A case of necrotizing fasciitis in a dialysis patient is described. Since conventional therapies were unsuccessful, extracorporeal blood oxygenation and ozonation (EBOO) was tried. Patient condition improved radically after EBOO.

VIEWs of NWC's Physicians

It has been almost impossible to prevent the spread of this streptococcal infection even with the advent of mankind's superbacterial-busting antimicrobials. The common occurrence of resistant nosocomial infection and the emergence of mutant bacterial strains have caused pharmaceutical companies to be hard pressed to come up with antidotes.  Could the simple ozone be the elixir to mankind's self-inflicted woes?  It would be interesting to watch this epic struggle against Mother Nature and be witness to who will emerge as the winner. We have been successful in using medical ozone in bacterial infections but in a clinic set-up. However, we do rarely combine ozone therapy with antibiotics and only as a last resort.

B. PROBIOTICS-Update on Usage and mechanism of action

Probiotic is defined as  "a viable microbial dietary supplement which beneficially affects the host through its effects on the intestinal tract" - Gibson and Roberfroid 1995. They are immunomodulating bacteria that have very low virulence compared with the more pathogenic gut flora such as Escherichia coli and clostridia. Some of the effective uses of probiotics, which have been demonstrated in clinical trials, are mentioned below;

a)   Prevention of anti-microbial associated diarrhea- Antibiotics are known to cause diarrhea but clinical trials have shown the effectiveness of probiotics in preventing the occurrence of diarrhoea when used prior the initiating of any antibiotic treatment.  Some of the bacteria used in theses trials are Lactobacillus acidophilus, Bifidobacterium longum and Enterococcus faecium.

b)   To decrease the recurrences of Clostridium difficle-associated disease.

c)   Other diarrhoeal illnesses-Traveler's diarrhea, Acute infantile diarrhea, acute diarrhea in adults

d)   Vaginal infections including bacterial vaginosis.

e)   Urinary tract infections-Lactobacillus spp. has been used successfully.

f)    Helicobacter pylori gastroenteritis-Lactobacillus has been shown to be antagonistic to H.pylori both in vitro and in a gnotobiotic murine model. The results published in the Int J Antimicrob Agents. 2003 Oct; 22(4): 360-6 suggested that probiotics might have a place as adjunctive treatment in H. pylori infections and possibly in prophylaxis.

g)   Inflammatory bowel disease. Intestinal microflora play an important role in the pathogenesis of inflammatory bowel diseases (IBD) and a review article in the Curr Drug Targets Inflamm Allergy. 2003 Jun; 2(2): 145-54 demonstrated that certain probiotic bacteria provide beneficial effects for human health and intervention of Inflammatory Bowel Disease. Possible mechanisms underlying these effects are diverse and include many aspects of the interaction of the host with its commensal microflora, with immunological and non-immunological effects.

h)   Irritable bowel syndrome- Individuals receiving L.planatarum have experienced a decreased in the severity of abdominal pain.

i)    Possibility in reducing the incidence of gastro-intestinal cancer. Although a myriad of health-promoting effects have been attributed to the probiotic lactic acid bacteria, perhaps the most interesting and controversial is that of anticancer activity, the vast majority of studies in this area dealing with protective effects against colon cancer. There is no direct experimental evidence for cancer suppression in humans as a result of the consumption of probiotic cultures in fermented or unfermented dairy products, but there is a wealth of indirect evidence, based largely on laboratory studies. Reports in the literature regarding the anticancer effects of lactic acid bacteria fall into the categories of in vitro studies, animal studies, epidemiological studies and human dietary intervention studies. Examples of these reports were published in the Best Pract Res Clin Gastroenterol. 2003 Oct; 17(5): 849-59.  

        j)    Preventing atopy (eczema, rhinitis, conjunctivitis and asthma) in children.

k)   Treatment of oral apthous ulcerations has been successfully demonstrated in a local study at University Malaya's Faculty of Dentistry in September 1999.

l)    A study involving the Department of Biological Resources Chemistry of Japan and Okayama University demonstrated the effectiveness of probiotic against methicillin –resistant Stapylococcus aureus.(MRSA). MRSA is a notorious bacterial infection that is a relatively common nosocomial (hospital) infection and is difficult to treat.

Mechanism of action

By and large, the mechanisms by which probiotic bacteria may exert its beneficial effects are still poorly understood, but several potential mechanisms are mentioned in the following excerpt;

a)   Productions of pathogen-inhibitory substances-probiotics produce a variety of substances that are inhibitory to both gram positive and gram-negative bacteria. These include organic acids, hydrogen peroxide and bacteriocins.

b)   Inhibition of pathogen attachment-competetive inhibition for bacterial adhesion sites on intestinal epithelial surfaces.

c)   Competition for nutrients.

d)   Inhibition of action of microbial toxins and degradation of toxin receptors.

e)   Stimulation of immunity (esp. immunoglobulin A).

f)    May prevent atopy by supporting faecal flora and strengthening the T helper 1 cell response (and in so doing decreasing the allergic response mediated by T helper 2 cells).

The potential advantages of probiotics over conventional therapy includes its relatively low cost, they are unlikely to increase the incidence of antibiotic resistance and the multiple mechanisms by which they inhibit pathogens.

Ref-Journal of Nutrition 130:396S-402S, 2000  -   British Medical Journal 2002; 324:1364(8 June)

View of NWC's Physicians

We have been using probiotics widely and successfully in most of the conditions mentioned above. Some conditions are difficult to be assessed objectively (e.g. Irritable Bowel Syndrome) but all of the clinic's successfully treated patients have displayed a remarkable improvement of symptoms. However, the physicians in NWC ensure that where possible, objective improvement of disease process is obtained in conditions where improvement can be demonstrated by clinical investigations and parameters. (E.G Performing serological tests to determine part of the success criteria in Helicobacter pylori related diseases.)
 

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