Hyberbaric Oxygen Treatment for Infections, Brain Health, Stroke Detox and Cancer Issues with Scott Sherr, MD

This week on The Less Stressed Life, we’re diving into the world of Hyperbaric Oxygen Therapy (HBOT) and its incredible ability to accelerate healing, reduce inflammation, and support recovery from chronic conditions. Dr. Scott Sherr, a board-certified internal medicine physician and HBOT specialist, explains how increasing oxygen under pressure stimulates stem cell growth, enhances mitochondrial function, and even aids in neurological recovery.

We break down the medical and emerging applications of HBOT, including its role in cancer care, traumatic brain injury, long COVID, autoimmune diseases, and even performance optimization. Dr. Sherr also shares insights on who should (and shouldn’t) use HBOT, how to get the most out of your sessions, and what to look for when considering at-home chambers.

KEY TAKEAWAYS:

• How HBOT works to increase oxygenation, boost healing, and reduce inflammation
• The 14 FDA-approved uses of HBOT (and why it’s still underutilized in conventional medicine)
• How HBOT can enhance chemotherapy & radiation outcomes in cancer patients
• The connection between oxygen therapy and brain health—including stroke, dementia & neuroplasticity
• What to expect from HBOT sessions (including time commitment & cost)
• How to optimize HBOT with supplements, nutrition & other biohacking strategies
• Who should avoid HBOT due to contraindications like lung conditions or seizure risk 

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ABOUT GUEST:
Dr. Scott Sherr is a Board-Certified Internal Medicine Physician specializing in Hyperbaric Oxygen Therapy (HBOT) and Health Optimization Medicine (HOMe). As the Director of Integrative Hyperbaric Medicine at Hyperbaric Medical Solutions, he develops cutting-edge HBOT protocols to support healing and recovery for conditions like traumatic brain injury, chronic pain, stroke, and radiation damage. He also serves as COO of Troscriptions, focusing on precision-dosed nootropics. Through his clinical telepractice, Dr. Sherr combines HBOT, advanced testing, targeted supplementation, and innovative therapies to create personalized health optimization plans. 

WHERE TO FIND:
HBOT Consulting Website: https://www.hyperbaricmedicalsolutions.com/integrative-hbot/scott-sherr
Instagram: https://www.instagram.com/drscottsherr/
Website: https://onebasehealth.com/
Instagram: https://www.instagram.com/onebasehealth/
Nonprofit: https://homehope.org/

WHERE TO FIND CHRISTA:
Website: https://www.christabiegler.com/
Instagram: @anti.inflammatory.nutritionist
Podcast Instagram: @lessstressedlife
YouTube: https://www.youtube.com/@lessstressedlife
Leave a review, submit a questions for the podcast or take one of my quizzes here: https://www.christabiegler.com/links

SPONSOR:  
Thanks to Jigsaw Health for sponsoring this episode! Try their MagSoothe or MagSRT for better sleep and less stress. Use code LESSSTRESSED10 at JigsawHealth.com for 10% off—unlimited use!

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TRANSCRIPT:

[00:00:00] Scott Sherr, MD: whenever I'm thinking about hyperbaric therapy, I'm also thinking about what are you doing before, during, and after to truly optimize the treatment itself and what other tools, technologies, and practices are you integrating to make sure it's the most effective as it can be.

[00:00:12] Christa Biegler, RD: I'm your host, Christa Biegler, and I'm going to guess we have at least one thing in common that we're both in pursuit of a less stressed life. On this show, I'll be interviewing experts and sharing clinical pearls from my years of practice to support high performing health savvy women in pursuit of abundance and a less stressed life.

[00:00:42] Christa Biegler, RD: One of my beliefs is that we always have options for getting the results we want. So let's see what's out there together.

[00:01:00] Christa Biegler, RD: today on The Less Stressed Life, I have back Dr. Scott Sherr, who is a board certified internal medicine physician, certified to practice health optimization medicine, and he's a specialist in hyperbaric oxygen therapy, which is what our topic is today, otherwise known as HBOT. He's the COO of Troscription which we've interviewed him before about methylene blue and that line.

[00:01:22] Christa Biegler, RD: It's a pharmaceutical grade physician formulated precision dosed troches that have methylene blue and other really unique novel ingredients for energy focus, sleep, stress, immune support, and more. But he let me know that he also does the other half of his professional education really around HBOT.

[00:01:38] Christa Biegler, RD: So that's what we've invited him back to talk about today. So welcome back, Scott. 

[00:01:42] Scott Sherr, MD: It is good to be here, Christa. Thank you for having me. 

[00:01:45] Christa Biegler, RD: Yeah. So I know you make your rounds talking about these topics and I'm really curious, I think HBOT came first for you as like a specialty area and how did that happen?

[00:01:56] Scott Sherr, MD: So I learned about medical in medical school. I learned about hyperbaric therapy and it was in a trauma center in Baltimore where I was training and I went to medical school because I had this kind of high minded idea that I could figure out a way to bridge the gap between my upbringing as the son of a chiropractor and The conventional world that it, as it was at that time, and there really was no in between.

[00:02:20] Scott Sherr, MD: And I was looking for various ways of finding my niche, or niche or whatever. And I didn't know what it was going to be. But I was in medical school. I found out in this trauma center that they're using these chambers for. Amazing healing capacity of people with really bad infections, with burns, with soft tissue issues, with trauma.

[00:02:41] Scott Sherr, MD: And I saw some amazing benefits about it or with it. And I started doing more research on the tools and technology around, up. That hyperbaric therapy was all about and it really got me really interested as a way to bridge the gap between those two worlds. And so I got involved when I finished my internal medicine residency in around 2012 2013 timeframe in the San Francisco area where I became the medical director of a facility out there and basically been creating and Evolving my hyperbaric practice since that time.

[00:03:14] Christa Biegler, RD: Yeah, cool. How long has it's been around a long time, right? Decades and decades, but it's taking sort of a new wave in the integrative and functional space, but it's been around since the sixties, at least, if not 

[00:03:25] Scott Sherr, MD: so much 

[00:03:26] Scott Sherr, MD: earlier. So depending on how you want to define it, the Hyperbaric chambers have been around since the 1660s, so a long, over 400 years, and they didn't know what they were doing at the time, per se, but they knew that if they created a steel chamber that was airtight.

[00:03:44] Scott Sherr, MD: You could either blow air into it using a organ bellow kind of thing, or you could suck air out of it. And if you blew air in it, this is a hyperbaric chamber or extra pressure chamber. And if you sucked air out of it, you were taking air out. This is a hypo, H Y P O baric chamber. And so for the first really 300 years, it was used.

[00:04:07] Scott Sherr, MD: Kind of ad hoc for lots of different things. It was used some medical conditions, but there really wasn't a lot of research associated with it. The major modern history of hyperbaric therapy starts with bridge building back in the 1800s and the 1880s, especially the Brooklyn, the building of the Brooklyn bridge in New York city.

[00:04:25] Scott Sherr, MD: This particular bridge, many people that were building the bridge got severely injured because of building the bridge being sunk under the water when they were building it because of coming up too fast. And when they did, they got this symptom or this syndrome called the bends and the bends was a neurologic syndrome where people would get paralysis or seizures or muscle issues related to coming up from underneath the water too fast.

[00:04:48] Scott Sherr, MD: And. Hyperbaric therapy was really created to help simulate the pressure that these divers or these workers in that case were feeling under that much seawater and to basically as a result of going back into the pressure that caused the damage, being able to reverse that damage and so modern mode.

[00:05:08] Scott Sherr, MD: Hyperbaric therapy really started in the 1920s actually with the ability to concentrate oxygen into tanks and as a treatment for the bends or decompression illness. And from there, the evolution of hyperbaric therapy has many different sort of, trails and things like that. But in essence it became a wound healing technology when they realized it had a lot of potential to heal wounds in 60s before there was bypass machines in ORs for cardiovascular procedures, they would actually have the whole operating room in a hyperbaric chamber, actually, instead, because it would help keep the tissue alive for longer, because there's more oxygen in circulation.

[00:05:48] Scott Sherr, MD: And it became a medical treatment for carbon monoxide poisoning back in the 1960s, and then diabetic wounds and radiation injury And a number of other traumatic indications in the 1970s, 80s and 90s. And in like the newer century now, we know that hyperbaric therapy has a fantastic capacity really to heal wounds, to accelerate healing decrease inflammation, reverse low oxygen states, treat infections, and it does this in a very holistic and very significant way.

[00:06:17] Christa Biegler, RD: Yeah. So a couple things I can understand where they might come up with, let's try to simulate this thing from divers and they start to apply this. 

[00:06:26] Scott Sherr, MD: Yeah. 

[00:06:26] Christa Biegler, RD: Is there still use of hypo, like low pressure chambers as well before I continue on with high pressure chambers? 

[00:06:32] Scott Sherr, MD: Yeah, so hypobaric environments, HYPO have been around as long as hyperbaric chambers, as I was alluding to, and they don't have as many medical indications overall, but they certainly are, there's altitude simulation chambers, so if you're ever in the Navy or in the Air Force, And they'll put you in those to see how it feels when you're at low altitude.

[00:06:50] Scott Sherr, MD: For example, they're also used for altitude acclimatization, so they can be used in that capacity. And they're also being used in the performance world as well, because there is some indication that hypobaric environments will improve mitochondrial function, biogenesis. Increased stem cell release, and it potentially could be very healing or very optimizing at least in that capacity.

[00:07:12] Scott Sherr, MD: So they're not used right now as medically as hyperbaric chambers, but there are a number of facilities around the country. I think the Mayo Clinic is one of them that's been testing some of these hyperbaric chambers for performance for sure. And then for some conditions as well. 

[00:07:26] Christa Biegler, RD: Yeah. So the thing that is interesting about HBOT is that it's been around for a very long time.

[00:07:31] Scott Sherr, MD: Yep. 

[00:07:32] Christa Biegler, RD: And I guess we'll talk about contraindications. I would generally consider it to be safe. And yet, it's very, I would say, it may feel mainstream if you swim in the information around it, but I actually don't find it to be as mainstream as I would expect it to be at this stage. I want to talk a little bit about the actual, so I think that there's two things going on.

[00:07:54] Christa Biegler, RD: I think that there's indications for HBOT in the medical field, and there's maybe approved uses, and when I say that, maybe insurance uses, and that may limit that, and I'm guessing it's also a capacity issue certain medical facilities, and then there's, it's also being used , I would say by biohackers, people who are into longevity medicine, and then also in these other places for recovery, et cetera.

[00:08:17] Christa Biegler, RD: So I want to talk about some of the places that it's being used or approved for use. And I want to share a little story that I became more familiar with. H bought a number of years ago when my now past 100 year old great aunt had a septic ulcer and they wanted to and this was in California, which is more progressive.

[00:08:34] Christa Biegler, RD: They wanted to amputate her leg and her son advocated to a university. Professor MD that he knew and instead they ordered daily hyperbaric oxygen therapy in home four hours a day So then they hired an RN to come and facilitate the oxygen at home. And what do you know her ulcer? It was quite large it healed It was like a very primitive version of hbot like they would use in the field of military ops And so actually before we even go through some of those indications, 

[00:09:02] Christa Biegler, RD: I want to make sure we cover give people a picture of what HBOT looks like, because you just mentioned even creating a room of HBOT, I think of these soft shell things, there's all these hard shell things, and what I'm describing is a disposable plastic bag connected to an oxygen tank so let's actually start there before we talk into those indications, What does it look like most commonly and it looks like several different things.

[00:09:25] Christa Biegler, RD: So how do you create an image in an audio podcast? 

[00:09:29] Scott Sherr, MD: Typically it's going to be an enclosed chamber where your whole body is inside of it. It could be made of different types of material. It could be made of. A soft side of material like a nylon or polyurethane, it can be made up of acrylic glass and sometimes they're made of a fully heavy metal steel kinds of things.

[00:09:46] Scott Sherr, MD: Now, the deeper the pressure that the chamber goes to, the more, significant the material needs to be that it actually is made out of, right? So in a multi place chamber, which are the deep pressure chambers where multiple people can be treated at the same time, those go to very deep pressures because they have to simulate the pressure that would have been at a level of seawater that caused a decompression or diving or the bends injury, as I was alluding to before the milder units that are made of nylon or polyurethane, for example, typically go to about 1.

[00:10:17] Scott Sherr, MD: 5 atmospheres. And that's the equivalent of about 25 feet of seawater, just about. And so everything we think about in hyperbaric therapy is related to oxygen and pressure. And all of our pressure nomenclature, or the way we name everything, is related to diving. We think of, you're going to 1.

[00:10:32] Scott Sherr, MD: 5 ATA, that's the equivalent of 25 feet of seawater, for example. And that's the amount of pressure that we're simulating in the chamber without you actually being under the water overall. And all the different pressures have different indications as well. So like the milder pressures are better for neurocognitive kinds of things.

[00:10:48] Scott Sherr, MD: For day to day operations, general health recovery, where the deeper pressure chambers that are either a single unit chambers, which are called monoplace made of steel or made of acrylic glass or a combination, they're typically going to deeper pressures about three ATA, which is the equivalent of about 66 feet of seawater.

[00:11:04] Scott Sherr, MD: And then the multi place can go as deep as they need to go. Typically many ATA, depending on the situation overall. So the bag that you're describing for your gradient is really not hyperbaric therapy because it has to be, you really have to have your full body enclosed in the chamber for it to be.

[00:11:23] Scott Sherr, MD: Classified because what's happening is that you're pressurizing the lungs themselves and increasing the amount of oxygen that you breathe. And that's the combination that's exerting an effect on your lungs that causes the increased oxygen in circulation overall. 

[00:11:40] Christa Biegler, RD: Let's talk about why it seems.

[00:11:43] Christa Biegler, RD: What do you think is the situation? What is it approved for medically where people are getting access to it? You've alluded to it a little bit But I want to make sure we're hitting hard on the potential benefits and results that people can see So what is h bot very calm because what can happen is you may present to your MD and they?

[00:12:00] Christa Biegler, RD: May say no, we don't use that for this or there may be some access issues. So what is it actually approved? What does insurance reimburse? HBOT for right now. 

[00:12:09] Scott Sherr, MD: So there's 14 indications that are currently approved in the United States that get reimbursement from insurance if you're going into a hyperbaric chamber 10 of those or nine of those are really in acute care situations where it's not something you're going to go into an outpatient clinic and say, Hey, I have.

[00:12:26] Scott Sherr, MD: an air gas embolism. Now these are things that happen just in hospitals. So traumatic things severe infections, severe wounds air embolism is another one that's rare. But overall, the four indications that most people would think about are covered by insurance that can be used outside the hospital are diabetic foot wounds, so people with diabetes that have wounds on their feet.

[00:12:47] Scott Sherr, MD: that won't heal chronic bone infections that do not heal with antibiotics or other kinds of procedures. Those are, it's called osteomyelitis radiation injury from cancer treatment. So this is called delayed radiation injury. So you've had radiation for cancer and then six months or longer after the radiation, you get a wound or an issue.

[00:13:05] Scott Sherr, MD: Typically it's a wound in the area that had the radiation. This could be radiation. Like a prostatic radiation is a very common one, causing bleeding in the urine. You can have breast cancer, radiation to the breast, causing wounds that don't heal. These are very common, unfortunately, although they'll get less, they've gotten less common over the years.

[00:13:21] Scott Sherr, MD: Radiation injury is probably the most underutilized indication for hyperbaric therapy, because it's fantastically effective at treating those particular conditions. What else am I missing? Sudden hearing loss. So there's a neurologic presentation where you can lose your hearing, or lose part of your hearing, and it can be very devastating.

[00:13:38] Scott Sherr, MD: Hyperbaric therapy can help reverse that. And there's also a plastic surgery procedure where you're getting a flap, or a graft. Those are procedures where an extra piece of tissue, or muscle, or something is taken from one location and put into another location, typically it's on the face usually.

[00:13:51] Scott Sherr, MD: Or maybe it's the breast, if it's a breast reconstruction. And as a result of that, You get if the flapper graph isn't looking like it's going to work, a hyperbaric therapy can potentially save that tissue and reverse the low oxygen state and help recover it overall. So that, those are the major ones in the U S in other countries.

[00:14:08] Scott Sherr, MD: There's only five indications that are covered actually in some countries. There are as many as 60 or 70. If you go to China, Japan, or Russia, there are 60 or 70 indications covered by hyperbaric therapy. And then as far as the ones that are not covered, these are called investigational indications.

[00:14:23] Scott Sherr, MD: And there's at least 50 or 60 of them that have very good data overall. And that's what really got me interested in hyperbaric therapy in the initial stages of me learning about it, because I saw so many things that we couldn't do a whole lot about in the conventional world, that we're seeing significant benefit using hyperbaric therapy.

[00:14:39] Christa Biegler, RD: Okay, so before we go to some of these investiinvestigational indications, I just want to understand, because sometimes I want to refer someone to HBAT, and I will just say, accesses here and there, it just depends on the type of clinic, right? And so it's like a, Easter egg hunt, almost, to try to find what people can access.

[00:14:58] Christa Biegler, RD: What does the, you just told us how HBAT can look a lot of different ways. Where there's a lot of scenarios, where it can be a multi chamber, a single chamber, whatever. What's most common in the medical space, like if someone's got a non healing wound or some of these acute care, like what does it look like in that space where people receive it?

[00:15:15] Scott Sherr, MD: The most common is going 

[00:15:16] Scott Sherr, MD: to be the single occupancy monoplace chamber that goes to 3. 0. And that's what you find in most, almost all wound care clinics. That's what you find a lot of in the independent hyperbaric facilities that are not associated with the hospital, may or may not be treating with insurance, or they may just do a full cash pay kind of investigational thing.

[00:15:35] Scott Sherr, MD: There are the soft bagged. Mild chambers are actually very commonly now in a lot of clinics and they'll find them in a lot of different kind of spas and recovery centers and, biohacking facilities and that's great. I think the real key is just to understand what your goals are for using the chamber and then it becomes more of an understanding from there as to which chambers might be best for that particular reason and how often you need to use it, et cetera.

[00:15:58] Christa Biegler, RD: Okay. Let's unpack that slowly as we talk about some of these invest, to understand what your goal is, you have to know some of the benefits that you can get from HPA. So let's talk about some of these investigative indications. What are some of the ones, now some places I've, we've talked about them on the show, but just like a smidge, I've had some.

[00:16:14] Christa Biegler, RD: Amazing cancer doctors, I think, that just love HBOT and then some other people that work with neurocognitive or autism, pandas, etc. What else? Or, if you want to elaborate on this, in fact, I'd love to know you just shared radiation injury. Are there other indications for cancer, specifically?

[00:16:29] Christa Biegler, RD: Let's start with that one, because that one is Very prevalent. 

[00:16:32] Scott Sherr, MD: Sure. There are about seven or eight different ways to use hyperbaric therapy in cancer. We know that hyperbaric therapy makes radiation and chemotherapy work better, so you can use them in conjunction there. As you're alluding to, you can use it for radiation injury.

[00:16:45] Scott Sherr, MD: There's some indication, hypothetically, that you might be able to use it for prevention of radiation injury in the beginning. If you use hyperbaric therapy after a radiation exposure or directly afterwards. It also be used in combination with other directed therapies that are maybe more alternative, like oxidative therapies, or like the ketogenic diet or IV vitamin C, or in a combination with other kinds of modalities in a more integrative context.

[00:17:09] Scott Sherr, MD: And I work a lot with patients that are seeing integrative oncologists and adding on hyperbaric therapy while they're on the ketogenic diet, while they're doing other oxidative therapies or IVs and, or other. Modalities as well. That's a big one. Also hyperbaric therapy can help with recovery from a surgical procedure, whether it's like from a surgical oncologic procedure, of course, so from a cancer surgery, but from any surgery, it can help you recover faster.

[00:17:32] Scott Sherr, MD: It also can help people recover from chemotherapy exposure, especially something that's called chemo brain. So people's brains feel crappy after getting a bunch of chemo because they just had a huge amount of. It's a great way to reduce the amount of, stress in the system because of the chemotherapy itself.

[00:17:44] Scott Sherr, MD: Hyperbaric therapy can help reverse some of that. It also can be used as a palliative therapy for people that have low blood count. So if they have low HNH and they feel, they're anemic and they feel crappy it's, Because they can't carry enough oxygen around and a hyperbaric therapy can be helpful there.

[00:18:02] Scott Sherr, MD: So that's a lot. And from just from a cancer perspective, from a neurologic perspective, there's tons as well. We can help people with strokes or traumatic brain injury, different types of dementia, vascular Alzheimer's and

[00:18:16] Scott Sherr, MD: I think the key really to think about here for neurologic presentations and also for cancer and others, as well as the, is the acuity of the issue in the sense that if it's a more of an acute issue, hyperbaric therapy on its own is very powerful. It can help rev up the whole healing process.

[00:18:30] Scott Sherr, MD: decreased inflammation, stem cell release, improved lymphatic flow, immune system optimization. But if it's a chronic issue, if it's been going on a long time, oftentimes patients really do benefit from having a more integrative approach and that's what I've developed over the last decade in my own clinical practice and brought to the companies that I work with as well because I found that If there's a lot going on, it's been going on for a while.

[00:18:53] Scott Sherr, MD: The system needs a significant amount of support if it's going to be able to see the benefits from using a chamber most effectively. There's definitely a lot of other indications I can go through if you'd like as well. 

[00:19:02] Christa Biegler, RD: Yeah, that makes sense. Anything that's chronic or more extreme, it's not like there's usually one magic bullet.

[00:19:07] Christa Biegler, RD: Or if there's something that someone feels like made a big difference. I always think there's several actions that's happening in the body. Someone brought up some very specific dietary thing this morning in a context where they didn't know anything about my background and my brain is that's because it's doing this, and this, right?

[00:19:24] Christa Biegler, RD: And so of course it's hitting different angles. Before we talk about some other things, when we talk about and so I'm going to talk a little bit about these acute issues, right? Even post, a stroke or whatnot. I'd like to understand maybe a starting point of how long, because my understanding is with insurance reimbursement, there's some approval for maybe like 40 treatments, but you should, you would normally expect to see results quicker.

[00:19:48] Christa Biegler, RD: So how often and how long should the treatments go? And maybe we don't have to say that so definitively, but maybe. How long have you seen it take? We can just be very anecdotal about this. And then the other question is, right now, you brought up some indications of, okay, someone has breast reconstruction, or maybe you have a stroke.

[00:20:08] Christa Biegler, RD: And then also, what about, you find out about HBOT later into the Alzheimer's process, etc. Of course, it's going to be a little different, because that's where we move to the more chronic. So maybe that's a, put that conversation on pause, where if it's acute or more recent What would be the starting point?

[00:20:23] Christa Biegler, RD: And I think the whole goal of my question is just to help create reasonable expectations. As humans, we can be a little bit unrealistic. And so sometimes we might think one treatment would be enough. And I would say one treatment, if you're a healthy person, might feel great. Maybe. I don't know. So tell us what you think about dosing of HBOT.

[00:20:44] Scott Sherr, MD: Yeah. So if there's an acute issue, you don't need a lot of hyperbaric therapy to see a significant benefit. So if you have acute trauma, acute muscle injury, acute surgery, like the body's under significant amounts of inflammation and what hyperbaric therapy is really going to do is just rev up the whole healing process to happen, have it happen much faster than it would.

[00:21:03] Scott Sherr, MD: So on average, we can see people heal. about 50 percent faster from an injury if they use hyperbaric therapy relatively acutely when there's an injury involved. And so typically it would be done, for 3 to 10 sessions after an acute issue. Sometimes it could just be one session after an acute issue if it's like a mild muscle recovery kind of thing.

[00:21:23] Scott Sherr, MD: But for a surgery, for example, that we also have protocols where We have people go into the chamber a couple of days before they go and get in the surgery and then they do it a couple of days afterwards as well, three to five days afterwards and sometimes longer and see significant benefits as a result of that overall.

[00:21:38] Scott Sherr, MD: So in essence, with an acute hyperbaric protocol, you are seeing a sort of acceleration of the body's own healing processes, just them happening faster overall. So you have decrease in inflammation, you have decrease in swelling. You have reversal of low oxygen areas. If there's any low oxygen areas, hyperbaric therapy can re auctionate those areas.

[00:21:59] Scott Sherr, MD: That's why there's great studies actually on acute heart attack, acute stroke traumatic brain injury, spinal cord injury, limb trauma really good because we know hyperbaric therapy can re auctionate those areas and see a significant benefit very quickly. Now, if it's a chronic issue though, if it's something that's been going on for a long period of time

[00:22:20] Scott Sherr, MD: there's different mechanisms of place in place that hyperbaric therapy can leverage, but just takes longer to see the benefit. And that's really with what we call our epigenetics, our shift in how our DNA is expressing various proteins. That takes more time. It's not just one or two sessions or five or 10, most likely that are going to see the benefit.

[00:22:40] Scott Sherr, MD: It usually is going to be 20. 40, 60 sessions to see a shift in physiology with new blood vessels forming in different areas. So angiogenesis the downregulation of inflammatory meteors, like the things that cause inflammation in tissue that take a while to get downregulated. There's also the ability to allow healing of tissue and the maturation of stem cells into the various tissues that are required to make that tissue regenerate, so new bone, new cartilage, new connective tissue, those kinds of things.

[00:23:10] Scott Sherr, MD: And so when we're talking about a longer term issue, we need to be thinking about longer protocols 60 sessions. And then we also have to be thinking about creating a good foundation or building a good foundation or supporting at least while they're going through a hyperbaric protocol so that they don't have so many issues while they're going through a protocol and then they benefit.

[00:23:30] Scott Sherr, MD: Really what the indication I'm talking about here is that if you can't make energy effectively because you don't have the machinery to do it and you're putting a lot more energy in the system, it can not sometimes go as well as you'd like it to go. That kind of 

[00:23:42] Scott Sherr, MD: thing. 

[00:23:42] Christa Biegler, RD: Yeah. In general, what you're saying, and I would tell people this as well, the more compromised you are, usually the lower resources you have in your body, like you have lower nutrient amounts of different things.

[00:23:54] Christa Biegler, RD: And so you really have to just nourish, like that tends to be the first thing you have to put back nutrients. I'll just clarify also, I think that can mean a lot of things to a lot of different people. I think people can be like, I have this perfect.

[00:24:04] Christa Biegler, RD: Plant based whatever, I don't care what, like insert anything there and there can be holes, no matter what. And that usually comes from chronic stress. Chronic stress depletes tons of nutrients and it looks like everything chronic stress looks like emotional, physical, et cetera. So if you have a long term health issue, that is a chronic stress on the body and just further depletes.

[00:24:22] Christa Biegler, RD: It just uses up a lot of resources. And then as you said, in different words, your body can't do much if you're just fed in part of a resource, like you have to fill in all the rest of the pieces and then everything starts to work together again. 

[00:24:34] Scott Sherr, MD: Yeah, absolutely. Yeah. 

[00:24:35] Christa Biegler, RD: So you brought up, three to 10 sessions for more acute issues.

[00:24:39] Christa Biegler, RD: And that makes sense because you're starting from typically a healthier state if it's an acute issue, typically. And then these chronic issues, maybe 20, 40, 60 sessions. How long is the session and duration? And I think I've heard they can be quite long. And so like people will be in a chamber, like doing work, on the computer or whatnot, which usually when we're doing like health things, we don't really think about being able to multitask very well.

[00:25:00] Christa Biegler, RD: Like I'm, you'll never find me in my infrared sauna with my computer. It just would not work. 

[00:25:04] Scott Sherr, MD: You can't do that in the 

[00:25:06] Scott Sherr, MD: sauna. It won't work. It depends on what kind of chamber you're using as to whether you can bring something inside the chamber with you. Typically the mild chambers that go 1.

[00:25:15] Scott Sherr, MD: 3, not much of an issue bringing things in, but deeper than that, it depends on the manufacturer and it depends on what they want. As far from a regulatory perspective, as far as what they say is okay and not depending on what their chambers are made out of and how much options coming in and things like that.

[00:25:29] Scott Sherr, MD: But in essence, when you're looking at a longer protocol, you're usually doing it five days a week. So five days a week for the period of time that's designated 20, 40, 60 sessions, that kind of thing. So it's a significant amount of time. There's no doubt about it. And as far as. The actual time in the chamber that can vary.

[00:25:44] Scott Sherr, MD: It can vary anywhere between, sometimes we do 30 minute sessions for some kind of performance related indications, but oftentimes it's going to be more 60 to 120 minutes. 60 to 90 minutes is the most common pressures that we use. And then we also will add in something called an air break when they're in the chamber.

[00:26:01] Scott Sherr, MD: So an air break is when you're in the chamber and you're breathing oxygen through a mask or a face mask nasal cannula or something. And then every 20 minutes or so we have you give you a break where you actually breathe air instead of breathing the oxygen. This decreases risk. So of oxygen toxicity, which are rare, but they can manifest is as pulmonary issues or neurologic issues.

[00:26:21] Scott Sherr, MD: But again, very rare, but they also have the benefit of increasing the number of stem cells released and increasing the number of mitochondrial that are being made as well as decreasing inflammation. we use those air brakes to decrease. It can increase toxicity and increase the benefits of being in the chamber as well.

[00:26:37] Scott Sherr, MD: So that can sometimes increase the amount of time at pressure. So some people will go the amount of time at pressure at 90 minutes, but then you add air brakes and then you add another 15 minutes of air brakes. So it's 105 minutes or that kind of thing instead. In average, again, 60 to 90 minutes overall.

[00:26:51] Scott Sherr, MD: Protocols are typically daily, five days a week with the weekends off. And even for acute issues, it's usually it's, successive days of hyperbaric therapy when possible. 

[00:27:01] Christa Biegler, RD: Okay, so I want to mention, in different words, it's good things are good, but you can get too much. I think that actually is a pretty common theme for a lot of different things.

[00:27:09] Christa Biegler, RD: There are potential issues. You just mentioned a couple possible complications. Are there any other potential, are there contraindications or other complications that we might want to know about? 

[00:27:19] Scott Sherr, MD: Yeah, so there's only one absolute contraindication, 

[00:27:23] Christa Biegler, RD: So a while back, my college aged daughter shared with me that she was tossing and turning and waking up several times per night after a period of stress. We started her on magnesium and her sleep immediately improved. I personally think magnesium should be your first thing to try if you're having trouble sleeping or staying asleep, especially tossing and turning, and it's a no brainer if you have any restless leg issues.

[00:27:47] Christa Biegler, RD: The thing about magnesium is that there's a lot of types of magnesium that will give you symptomatic relief, but I like to steer my clients and loved ones to a more absorbable form of magnesium, because most big box magnesium is magcitrate, and that will push bowels, but it can be damaging to your teeth if it's used daily and it's not the most Rather, Jigsaw Health makes one of my favorite great tasting magnesium powders called MagSue that has magnesium glycinate, my favorite calming and absorbable type of magnesium. It's available in both a Great Tasting Powder and to go packets, and they also make a product, that's great for slow release, especially if you have restless legs, called MagSRT.

[00:28:29] Christa Biegler, RD: So, if you are not falling asleep easily, or if you have disrupted sleep, you can try at least 200mg of great magnesium, like MagSoothe or MagSRT. Especially if you have restless legs, it works better to take this at least 20 minutes before you go to bed to allow it to kick in and you can get a all of Jigsaw's amazing products including MagSooth at Jigsaw Health with the code LESSSTRESS10.

[00:28:54] Christa Biegler, RD: Now you can use LESSSTRESS10 as many times as you want with every order at Jigsaw Health, which is honestly pretty unheard of with coupon codes. So enjoy the magnesium from Jigsaw with my code LESSSTRESS10. 

[00:29:08] Scott Sherr, MD: and that's if you have what's called a tension pneumothorax, which, in essence, means that you have a lot of air outside of your lung, but inside your chest cavity, and pressuring against your lung, and you should be at a hospital if that's happening, and you have, it's not.

[00:29:21] Scott Sherr, MD: safe and dangerous. The other ones are called relative contraindications, meaning that the risks have to outweigh the benefits in some of these cases. So if your cardiac function isn't optimal, if you have an ejection fraction that's less than 35%, it could be dangerous to go into a chamber. If you're pregnant, You're not supposed to go into hyperbaric chamber unless you have carbon monoxide poisoning.

[00:29:39] Scott Sherr, MD: And then it could be actually it could save the life of you and the baby as well. So it is used in emergency cases in that way. If you have lung issues, if you have pulmonary issues where you cannot get enough oxygen in the system already, you have COPD, you have pulmonary fibrosis, you have severe asthma.

[00:29:55] Scott Sherr, MD: It may not be safe to go into the chamber. If you have pockets in the lungs of air that are not really involved in respiratory physiology, but they're like little balloon areas, they can potentially pop in the chamber, so you don't want to go in the chamber if you have any of those.

[00:30:07] Scott Sherr, MD: Typically you have them if you've been a smoker in the past. If you have un, Stable cardiac rhythms, you don't want to go in. If you're severely claustrophobic, it can be really difficult to go in. If you're on certain medications you have to be careful. The main thing I mentioned on the neurologic side of oxygen toxicity is that can manifest as seizures.

[00:30:25] Scott Sherr, MD: They're very rare to have seizures overall, but it can happen. And so you can mitigate that with the air brakes as well, of course. But if you have an underlying seizure disorder, it may not be safe for you to get into the chamber as a result of that. without some significant support and maybe some additional therapies and integrations and other things.

[00:30:43] Scott Sherr, MD: And by that I mean is that whenever I'm thinking about hyperbaric therapy, I'm also thinking about what are you doing before, during, and after to truly optimize the treatment itself and what other tools, technologies, and practices are you integrating to make sure it's the most effective as it can be.

[00:30:57] Christa Biegler, RD: That would be a fun topic. But before we go there, with some of these complications and contraindications, you've referred to, I'm going to call them home HBOT or soft sided chambers as a more of a mild chamber. 

[00:31:09] Scott Sherr, MD: Yes. 

[00:31:09] Christa Biegler, RD: Would you see more of these issues? Would you be more concerned at these higher, like basically if the input is higher, the risk could be higher.

[00:31:16] Christa Biegler, RD: So then that's usually supervised. That's usually more of a supervised thing typically. 

[00:31:21] Scott Sherr, MD: I'd like everybody to be supervised in chambers overall, in the sense, I don't like anybody to go in without anybody knowing even the soft chambers, although they're very safe and it's very, it's in general the risks, as you just alluded to are much lower compared to being at a deeper pressure, but yes, in essence, the deeper you go, the more potential.

[00:31:39] Scott Sherr, MD: Complications you could have, but overall, it's an extremely safe technology. I probably should mention as well, because there's something in the news recently and people are going to be Googling or researching hyperbaric therapy. There was like a terrible unfortunate accident in a hyperbaric chamber just recently in the last couple of weeks where somebody died.

[00:31:54] Scott Sherr, MD: And this is because. Some of the chambers are filled with 100 percent oxygen. And when that's the case, they can be flammable. There's only been like two accidents in the last 20 years. And so it's very rare even in that case, but unfortunately, one, one just happened a couple weeks ago in, in Michigan.

[00:32:10] Scott Sherr, MD: where a young five year old died, unfortunately. I've been around hyperbaric therapy a long time. The safety record is really impeccable compared to almost any other therapy out there. But that is another risk for, risk of fire. So the idea is to, if you're in a 100 percent oxygen chamber, you don't bring anything in those chambers except for this, you typically get scrubs provided by the clinic as well as what you wear in there.

[00:32:30] Scott Sherr, MD: Otherwise, you don't bring anything else in. 

[00:32:33] Christa Biegler, RD: Otherwise, you could increase the flammability, is what you're saying, and that could have been a case. 

[00:32:37] Scott Sherr, MD: Yeah, 

[00:32:37] Scott Sherr, MD: exactly, you could. Again, these clinics that have 100 percent oxygen in the chamber are using medical facilities that are highly regulated and very good at safety and care, have physicians and physician extenders that are on staff that are next to the chambers or close to them overall.

[00:32:51] Scott Sherr, MD: A lot of other types of facilities will have. Oxygen that's going into the chambers via face mask or typically not nasal cannula, like face mask or like a hood type of system so that when the whole system, when the whole chamber is not pressurized with oxygen and just with air, the fire risk is lower overall significantly.

[00:33:09] Christa Biegler, RD: Interesting. Okay. So I want to ask you I don't think we've really said this. Explicitly. But how long do you usually expect people to start seeing results? Because humans would not normally do something every day for a week if they're not going to start seeing results within a So just again with expectations, how, even though you may want 20, 40, 60 sessions for chronic, when would you maybe start to see changes?

[00:33:34] Christa Biegler, RD: Initially. 

[00:33:35] Scott Sherr, MD: Yeah, 

[00:33:35] Scott Sherr, MD: that's a really good question. So if it's an acute issue, you might see improvements the same day of your first session, especially if you have inflammation, swelling, discoloration. You could see significant benefit immediately when it comes to more of a chronic issue. Say you have post-concussive syndrome or a chronic stroke, or chronic pain or chronic infection, it could take, typically you start seeing improvements around 20.

[00:33:58] Scott Sherr, MD: Or so sessions in 15 to 20 but it's not, it's variable for everybody. So in the beginning, some people will feel good right away. And that's a good indication that if they finish a hyperbaric protocol, they're going to continue to get benefit. But if you don't feel good right away, or if you're even a little bit worse, it doesn't mean that.

[00:34:13] Scott Sherr, MD: You still can't have a good benefit. Many people will still have a good benefit overall. So it's not a negative but it's a positive predictor, if that makes sense. So what we see for the most part is that people started having more of a significant benefit or changes, at least somewhere we were around 15 to 25 sessions in overall.

[00:34:33] Scott Sherr, MD: So it is, it's not. Always immediately gratifying, unfortunately. 

[00:34:36] Christa Biegler, RD: Yeah. I have a couple of clarification questions. You were talking earlier about some pulmonary issues and lung issues, and then you brought up embolism earlier. Is embolism an area that would, past embolism, that was treated with blood thinners or whatever the other standard of care is?

[00:34:53] Christa Biegler, RD: Is that something that Would be something someone wants to do hyperbaric oxygen treatment for. I just wanted to clarify that because in my brain it was sticky. 

[00:35:02] Scott Sherr, MD: Oh yeah, so there's something called a pulmonary embolism. 

[00:35:05] Scott Sherr, MD: There's 

[00:35:05] Scott Sherr, MD: something called an air or gas embolism, they're different. The air or gas embolisms, typically they can go to the lungs, but they can often go to the brain as well and cause neurologic symptoms.

[00:35:14] Scott Sherr, MD: They typically happen from instrumentation overall, or decompression illness can happen, it can happen from that too. Pulmonary embolisms. from a clot are different. Those are the ones that you're describing. Those are the ones that you'd be on blood thinners for. Hyperbaric therapy is very safe in those patients as long as they're on blood thinners and so there's no issues there.

[00:35:32] Christa Biegler, RD: You just brought up discoloration, seeing results after discoloration. Are you talking about from oxygenation or skin discoloration? 

[00:35:39] Scott Sherr, MD: Usually, if you have an injury, so for example, if you have a bruise or an echeomotic area from a, let's call it a plastic surgery on your face, you have raccoon eyes, you can see significant improvements in that faster using hyperbaric therapy.

[00:35:53] Christa Biegler, RD: Got it. Okay, this question is coming in backwards but I did want to start with all of these indications to just try to draw people in with what could we be interested in. So I think in order to talk about the before, during, and after to optimize the treatment, understanding the mechanisms, and you've piecemealed it in here and there, you've mentioned like the overarching things that are improving, where inflammation is being reduced, etc.,

[00:36:13] Christa Biegler, RD: And you talked about it a little bit with the pressurization, but do you want to just highlight a little bit of why, when I think about like red light therapy, it's always good to go back to the mechanism because it's like that could help with almost anything if its job is to increase ATP.

[00:36:26] Christa Biegler, RD: So similarly with HBOT, can you talk about some of those big picture mechanisms that happen? You did already highlight them a little bit, but just can we go over some of that? 

[00:36:35] Scott Sherr, MD: Yeah, so the quick story with hyperbaric therapy is that we're combining increased inspired oxygen with increased atmospheric pressure, and we've alluded to these already a little bit, but oxygen is extremely important.

[00:36:46] Scott Sherr, MD: We need it to have our cells make energy. And so it's typically carried on red blood cells, Have a molecule called hemoglobin on them. Hemoglobin binds for oxygen molecules. You have 250 million hemoglobin molecules per red blood cell. So you have 1 billion oxygen molecules per red blood cell getting carried all over your system to get to all your tissues, to all your cells.

[00:37:04] Scott Sherr, MD: So you can continue to make energy. And that is in the form of ATP. We make about 165 pounds of ATP every single day. It gets recycled very quickly. So it's not all there at the same time. But we need this oxygen to be carried to our tissues to be able to do that. So the way you can increase the amount of oxygen in circulation is by increasing the number of red blood cells in circulation.

[00:37:25] Scott Sherr, MD: That's by giving yourself a hormone called epigen or coming to altitude in Colorado and. Getting it naturally secreted because when you're at low oxygen levels, this EPO will be secreted. So if you were a cyclist in the early two thousands, like named Lance Armstrong, you were taking EPO as a drug. You can also transfuse yourself red blood cells and increase your oxygen carrying capacity in a hyperbaric chamber.

[00:37:47] Scott Sherr, MD: We simulate the pressure you feel under a certain amount of seawater, which we were talking about before seawater is very heavy. And that heaviness we simulate in the chamber. And it's that heaviness that drives oxygen, not only on those red blood cells, if there's any sites available. There's not that many for most of us are if you get a pulse ox machine and measure your pulse ox, that's measuring how many sites in your blood cell have oxygen attached typically between 96 and 100%.

[00:38:10] Scott Sherr, MD: So pressure is going to drive oxygen on any of those sites. It's not already bound, but it's going to mostly work by driving oxygen into the liquid of the bloodstream. And that's where the power of hyperbaric therapy comes. You have 1200 percent or more oxygen free floating in the liquid of your bloodstream.

[00:38:27] Scott Sherr, MD: As a result of that, you have these sort of catalytic things that can happen both the long term, and I've mentioned many of these already, including reversing of low oxygen states inflammation and swelling decreases stem cell release, killing bugs that do not like high oxygen environments, immune system activation flow, lymphatic flow and blood flow.

[00:38:46] Scott Sherr, MD: That's all happening immediately, and over the long term, you have those epigenetic shifts that I was describing over 20, 40, 60 sessions. you get new blood vessels and tissue, you get decreased inflammatory markers and down regulation of inflammatory pathways. You have these stem cells that are being matured into various types of new cells in the body.

[00:39:02] Scott Sherr, MD: That new blood, new connective tissue, new heart, new cartilage, new brain cells, new neurons, new connect, et cetera. And so as a result of these. epigenetic shifts, you have basically a healing environment, a wound healing optimization environment overall, where hyperbaric therapy is helping short term and helping long term as well.

[00:39:23] Christa Biegler, RD: You answered why pressure instead of just oxygen because you were driving that oxygen in and so that way we have oxygen in the plasma. So now we have this fizzy, fizzy liquid running through our body, like hyper oxygenating our system. How long do those benefits tend to last after a session?

[00:39:42] Christa Biegler, RD: Do they dissipate after a day or, a couple days? You're getting it every day, so I'm guessing maybe it lasts about a day, but how long does that kind of last? 

[00:39:50] Scott Sherr, MD: So protocol of hyperbaric therapy, they've done some studies. It looks like the improved utilization of oxygen typically lasts about 24 hours after your last session.

[00:39:58] Scott Sherr, MD: And so if you're just doing a one off session, that's what you can expect. If you just do one session in a chamber, you might see some benefit for about 24 hours and that's going to be it. But if you're looking for more of a healing, more long term benefit, then it takes that. Five day a week, at least four days a week, we think to see the benefits of this more long term epigenetic shift where you're seeing all that, those benefits happen.

[00:40:21] Scott Sherr, MD: New, new blood vessels down, regulation of inflammation stem cell maturation. There's also mitochondrial biogenesis and other kinds of things that are happening too. 

[00:40:30] Christa Biegler, RD: I want to talk more about optimization and really getting the most out of your HBOT session, but I am stuck on something in my brain.

[00:40:39] Christa Biegler, RD: You were, you brought up epigen and it made me flash back to my partial decade in a dialysis unit. And I just can't help but think that, why don't we bring HBOT into some of these other vascular issues a little bit more proactively? I know we're not very, we're not a huge proactive society, so maybe that's the issue, maybe it's staffing issue.

[00:40:58] Christa Biegler, RD: I'm just like curious, why don't you think it's a little more prevalent in some of these settings? I would assume that we would see benefits potentially, vascular that's part of what it's doing, right? Doesn't it healing that tissue? And so that's literally, the problem with, Kidney disease, for example, and maybe it's too far gone, but why aren't we using it?

[00:41:17] Christa Biegler, RD: Kidney disease is one of the most, like I knew the numbers. It was like, I don't remember if it was like every week, it was like a half a million or something that our government spent on that clinic. I can't remember the numbers, it was so long ago. But I used to know them and it was like, man, you'd think we'd want to do something about this.

[00:41:32] Scott Sherr, MD: Yeah, I think the challenge with hyperbaric therapy is it requires a chamber, right? It requires a facility, it requires multiple hyperbaric sessions. It's not like you go in once and you're done. It's a round of 20, 30, 40 hyperbaric sessions, five days a week. So it's a lot of time, effort, facilities.

[00:41:48] Scott Sherr, MD: costs that the system would save, potentially, but that's not how the system is operating, as you said. 

[00:41:54] Christa Biegler, RD: Yeah. Compliance would 

[00:41:55] Christa Biegler, RD: be an issue potentially also for that. 

[00:41:57] Scott Sherr, MD: Yes, for sure. 

[00:41:58] Christa Biegler, RD: I could see that. 

[00:41:58] Scott Sherr, MD: I have seen some patients over the years that have had early kidney disease, reversed their kidney disease or significantly improve it with hyperbaric therapy, especially if it was a more of a vascular issue, like a diabetic kind of thing where they had.

[00:42:11] Scott Sherr, MD: Diabetic nephropathy and that was, related to small vessel disease because of their diabetes. So definitely something to think about if you have the wherewithal because it's not going to be covered by any insurance. so I have seen significant improvements in vascular issues overall.

[00:42:25] Scott Sherr, MD: They did some studies using the chamber, saw revascularization of the brain, revascularization of the heart, revascularization of the genital tissue, improving erections. And so you can, one of my favorite slides to show in talks is an MRI of the penis before and after hyperbaric therapy, a functional MRI.

[00:42:43] Scott Sherr, MD: So you see the blood flow before you see the blood flow afterwards and a significant benefit after 40 hyperbaric sessions, for example. Yeah. Yeah. So nobody knows what it is and you say, what is this? And you get to say penis a whole bunch on stage. So that's always good. Always good. And so I think that a lot of it has to do as you were alluding to with just the incentives in the system overall.

[00:43:01] Scott Sherr, MD: And there hasn't been a lot of great studies on hyperbaric therapy for kidney disease, but at least anecdotally I've seen some improvements in some patients. 

[00:43:09] Christa Biegler, RD: Yeah. There's already a lot of medical interventions happening. It's too bad we can't like utilize that time well at the same time or something, but 

[00:43:16] Scott Sherr, MD: Yeah.

[00:43:16] Christa Biegler, RD: Okay. So one thing before we talk more about this optimization, getting the most out of your treatment, and I think this is a loaded question that can be very variable, but I'm sure it has come up already in people's thoughts. Cause we've mentioned what's covered by insurance. And then there's also lots of people that are just doing this at their will, cause they understand the benefit of it.

[00:43:34] Christa Biegler, RD: What do you think the range of the cost of doing a hyperbaric oxygen treatment session? I understand that it's like. Not even really part of your wheelhouse, but because you've been in the industry a long time and I think you do a lot of coaching, like what does that range typically just so people can have an expectation again.

[00:43:50] Scott Sherr, MD: Yeah, usually soft sided chambers that go to 1. 3, 1. 5, they can range anywhere between 75 to 125 a session. If it's more than that, it's highway robbery, as far as I'm concerned. And then the deeper pressure chambers usually range anywhere between 150 and 350 per session, depending on the type of chamber, depending on how much oxygen you're getting, or how the oxygen is being delivered.

[00:44:14] Scott Sherr, MD: Yeah. And the time overall. So that's the range. And depending on where you live in the country, the ranges will change, of course. 

[00:44:21] Christa Biegler, RD: And as an aside, some providers maybe rent out chambers for home use. I've seen her, I have no idea what that looks like. And then of course you can buy what we call mild HBOT.

[00:44:33] Christa Biegler, RD: As well. And so maybe later. 

[00:44:34] Scott Sherr, MD: You can buy a heart 

[00:44:35] Scott Sherr, MD: chamber, too. You can buy a chamber that goes to 2. 0 for the house now, too. And that's more of our medical grade treatment pressure. But since the pandemic, there's been a huge influx of companies bringing chambers into the country. And that's overall okay, but the problem is And we'll talk about it now, I think, is just on how you're designing protocols and how you're thinking about your goals.

[00:44:56] Scott Sherr, MD: It's really important you get the chamber that you need, not the chamber that the company thinks that you need overall. And and the expenses that are associated with that. And I got pretty frustrated even before the pandemic around 2019 ish, because I just saw all these companies coming in and bringing in chambers, not giving really any guidance and they can't as companies, they just can't, they shouldn't give any medical advice, but then I would. Talk to somebody six months or a year or longer after they've had the chamber and they've been using it completely wrong and haven't had the benefits that they want. And maybe some detrimental effects overall because of using it.

[00:45:27] Scott Sherr, MD: So I got really frustrated and decided, do more education, doing more podcasts, creating my own company. That does a lot of work in the hyperbaric space. And it also looks how to integrate other technologies associated or alongside hyperbaric therapy, because that's my wheelhouse, which is, how do you conduct an integrative plan for people that, utilizes the tools and technologies that have at their service and are not just using hyperbaric therapy on its own most of 

[00:45:53] Scott Sherr, MD: the time.

[00:45:53] Christa Biegler, RD: I think that's noble because I think that Some kind of facility can offer a lot of modalities. If people aren't sure how to weave those together to use them well, then they may not really get benefit. And I actually, I go to a place and jump in some kind of machine that's got all these therapies built in.

[00:46:09] Christa Biegler, RD: But I see that issue for them because they don't really have anything to tie it all together for people. And if you don't tie it together, then you're not really seeing. You're leaving people up to their own devices and we're not realistic humans. So you have to be shared. You have to understand, what should you expect and what are the goals?

[00:46:25] Christa Biegler, RD: Those should always be questions. 

[00:46:26] Scott Sherr, MD: Yeah, and that's a big deal when it comes to places that have hyperbaric facilities. Most of them you're like what do you want to do? What kind of, what's your protocol? What do you want to do? And that's not really how it should go. It should be like, what are your goals?

[00:46:37] Scott Sherr, MD: What are your options as far as timing what do you want to integrate it with? What other tools, technologies are you doing at home? What supplements are you taking? How are you going to monitor your progress as you go through this? Those are the questions that I ask everybody. And that's very rare.

[00:46:51] Scott Sherr, MD: And that's why created a whole like ecosystem at my company to start having people be able to track those various things, integrate those various things, and then see how they do over time. That kind of thing. 

[00:47:03] Christa Biegler, RD: Yeah. And I do think, I don't think everyone is blessed with a lot of awareness.

[00:47:09] Christa Biegler, RD: And I think awareness is something you cultivate. And I think awareness is the first step that comes before results. If you don't really know what you were looking for or how to even measure. Yeah. Yeah. That's just like the main issue I see is like, how can you even understand what results to see if you don't understand those initial things or have awareness around those.

[00:47:24] Christa Biegler, RD: You brought up something that made me wanna revisit a topic really quick. You said that there are some medication contraindications and so since you use the word supplement, are there any other supplemental contraindications? What are the meds and are there any supplement contraindications? 

[00:47:38] Scott Sherr, MD: So 

[00:47:38] Scott Sherr, MD: medication indications.

[00:47:39] Scott Sherr, MD: There's a couple of chemotherapy medications that affect the heart and the lungs, you just have to be aware of overall if you're taking certain medications that you a higher risk of having a seizure in the chamber, you have to be mindful if you're going to deeper pressures in the chamber so there's a particular.

[00:47:54] Scott Sherr, MD: antidepressant called Welbutrin or Bupropion that has that potential risk. There's also high dose narcotics that also give you a higher risk of having seizures. And so I don't have people take their Adderall before they go into the chamber, for example if at all possible. So those are the major ones from a supplement.

[00:48:10] Scott Sherr, MD: It's a bit of more of a nuanced discussion, but I try to have people mostly avoid taking antioxidants before they go into the chamber and that's because hyperbaric therapy works by creating more of a stress on the system and antioxidants would potentially mitigate that stress without it actually being able to happen.

[00:48:27] Scott Sherr, MD: That's not always the case. It depends on the reason you're using hyperbaric therapy, but usually I don't like to give a huge amount of. antioxidants ahead of time. I will give some like low dose methylene blue. I know we spoke about that last time, but I use low dose methylene blue as a way to support mitochondrial function and also with detox, but super low doses before hyperbaric therapy, or maybe depending on the indication, maybe a couple hours afterwards.

[00:48:48] Scott Sherr, MD: But other supplementation that I can think of. Yeah, I don't like people on any sort of, major sort of hypoglycemics overall. So like you can, unless they're used to their blood sugar already dropping, like they're already in ketosis on a regular basis overall, because you can drop your blood sugar in the chamber a little bit too.

[00:49:05] Christa Biegler, RD: Yeah. Okay. So when we're thinking about optimizing HBOT, what would you want to say about before, during and after? 

[00:49:12] Scott Sherr, MD: So the big things before is, and I was alluding to this just earlier, is that you really want to think about how well the system is going to tolerate being in a hyperbaric chamber.

[00:49:20] Scott Sherr, MD: And what I mean by that is like, how well is a whole bunch of oxygen going to be utilized when it comes in and where this. Is going is how well can you make energy overall? Do you have the machinery and the capacity to make energy effectively? Do you have the optimized levels of macro nutrients to make energy like your fats and your carbohydrates specifically, do you have the levels of vitamins, minerals, nutrients, cofactors, intermediates that are all involved in the process of making energy.

[00:49:50] Scott Sherr, MD: And so a big piece for me is to do all the testing and look at somebody's. foundational biology and say, do they have the machinery they have and have capacity to do all that? And on the other end of it, do they have the capacity to decrease the oxidative load that happens after making energy? So when you make energy, you make waste products of making energy, including carbon dioxide and water, and you also make reactive oxygen species and the body.

[00:50:13] Scott Sherr, MD: Needs to be able to neutralize those with antioxidants and the body's own natural antioxidants and but if you don't have those available, you might have a huge amount of oxygen and you make a whole bunch of energy and you feel crappy because you don't have the capacity to neutralize that oxidative stress.

[00:50:29] Scott Sherr, MD: And so for me, a big piece when there's time is to really focus on that foundation, optimizing their vitamins, their minerals, their nutrients, their cofactors, their detoxification pathways, antioxidant status, et cetera. So that's a big piece. The other piece that I think about is we want to make sure we're getting the oxygen to where we want it to go overall.

[00:50:47] Scott Sherr, MD: And so another big thing for me is what tools, technologies, other supplements might be helpful. So like nitric oxide boosters might be helpful in this case, or using low level light therapy might be helpful or. Heat therapy might be helpful as well. Just opening up the blood vessels in a particular area.

[00:51:01] Scott Sherr, MD: So you have more of the capacity to get the oxygen to the area that you want to. So you can start stacking technologies, personal practices, get out in the sunlight real quick, and then get into the chamber, for example, because then you're going to dilate blood vessels and you're going to get more oxygen flowing to those particular areas.

[00:51:17] Scott Sherr, MD: And so I think about. Laboratory testing. I think about dietary changes. I think about other technologies that might be helpful. Like I mentioned a couple there already. Personal practices. I mentioned sunlight just now. Maybe cold therapy could be helpful, especially after hyperbaric therapy.

[00:51:32] Scott Sherr, MD: And I also think about other practitioners that might be helpful. If you need to go see a chiropractor or a massage therapist or a craniosacral therapist or a speech therapist or whatever it might be, as a way to prepare you more for hyperbaric therapy. And then, during the hyperbaric session itself.

[00:51:47] Scott Sherr, MD: Oftentimes you don't have a lot you can do, but you can potentially do brain games in your mind or work with your hand. If you're having issues with your hand and you've had a stroke or something, you can work with your fingers and coordination, or you can, do serial sevens, which is my least favorite test ever, subtracting seven from a hundred and as far as you can go from a concentration perspective.

[00:52:06] Scott Sherr, MD: And then after you get out of the chamber, you can think about. Leveraging the oxygen that was just in there, so you have about 15 to 30 minutes where you have more oxygen floating around, so you can do more work, physical work, cardiovascular work, exercise in general, or you can do it the other way, which is work on recovery, which is mostly what we do, and recovery would include things like sauna, or ice, or massage, or like a pulse electromagnetic field technology and things like that, so It's a full scale way I think about it.

[00:52:32] Scott Sherr, MD: And then the other piece of it is just how are you monitoring things over time? Like are you monitoring things in your ring? Are you if you have an aura ring, if you're measuring your sleep and with a Garmin or are you measuring your heart rate other ways? And just being able to monitor things, these things over time can be very helpful so that you can see you're getting the right outcomes for the the therapies and practices that you're doing.

[00:52:51] Christa Biegler, RD: Totally. Did you mention NAD? As a pre 

[00:52:54] Scott Sherr, MD: I sometimes use NAD with hyperbaric therapy. I'm a little bit more careful with NAD than most people. I think, because my sense of it is that you have to be really careful with NAD supplementation over the longterm because it can cause some.

[00:53:06] Scott Sherr, MD: upregulation of enzymes that are responsible for potentially cardiovascular and oncologic processes. And so I have a good friend of mine. Her name is Dr. Elizabeth Ureth, who talks a lot about this. So people that are interested, they can look up some of her stuff and talk about the potential downsides of taking too much NAD over time.

[00:53:22] Scott Sherr, MD: But. In essence, I'm looking for anything that's going to enhance energy production. So in the short term, I may use NAD, I may use methylene blue. I may use nitric oxide boosters. I use B vitamins and minerals and other things to help leverage the energy production cycles as well. 

[00:53:38] Christa Biegler, RD: Yeah. I would assume also lymph drainage before or after it makes sense to 

[00:53:41] Christa Biegler, RD: me.

[00:53:41] Scott Sherr, MD: Yeah, totally. Yeah, a lot of lymphatic drainage that's a great tool. 

[00:53:44] Christa Biegler, RD: Okay. I'm almost reaching the end here of some of my questions, but since we talked about the mechanisms, I just want to rapid fire on some other things that make sense that could be helped by HPOT, and you can just say yes, no, maybe.

[00:53:56] Christa Biegler, RD: Like eye issues or skin issues. I would assume 100 percent long COVID, hair loss, thyroid issues. These are things that are important to people of course, that I feel like this makes maybe some sense for also. 

[00:54:08] Scott Sherr, MD: Yeah, so when it comes to the eyes, there's some studies on RP or retinitis pigmentosa, which is a pretty nasty one glaucoma potentially, although it may not be a permanent kind of fix, in essence, with everything you just mentioned, if there's an inflammatory component.

[00:54:23] Scott Sherr, MD: Hyperbaric therapy can help the question is just whether it's the right thing to help right now, or if it's something that you need to really work on, foundational biometrics biology before going ahead and 

[00:54:34] Christa Biegler, RD: it makes a lot of sense 

[00:54:34] Scott Sherr, MD: into 

[00:54:34] Scott Sherr, MD: a chamber. 

[00:54:35] Christa Biegler, RD: Yeah, 

[00:54:35] Christa Biegler, RD: that's cool. Okay. So on that note, there's some really significant indications where HBOT could be useful.

[00:54:41] Christa Biegler, RD: And then at the same time, you offered some contraindications for some of those same things like cancer, for example. So what if someone wanted to use HBOT, but they wanted an expert to run things through, let's pretend they want to. use HPOT, but their own MD doesn't really know anything. Where would you recommend that they get some support?

[00:54:57] Scott Sherr, MD: Yeah, so to be clear, you can use hyperbaric therapy in cancer. Hyperbaric therapy does not have a pro growth effect on cancer. There's been no indications of that. So we use it a lot in the context we described earlier For chemo radiation sensitivity for healing for palliation and things like that, just to be clear there.

[00:55:12] Scott Sherr, MD: But if you're looking for somebody that can help you with hyperbaric therapy, the best things to do, if you're looking at somebody locally, you can find a facility that has a physician on staff that. Does consults and can help you understand indications protocols for hyperbaric therapy. If you are interested, people that are listening, I do remote consultation with people all over the world and helping them understand how hyperbaric therapy might be effective, what kind of protocols would be best for them in their particular situation, what integrations might be helpful overall as well.

[00:55:41] Scott Sherr, MD: So I do that. So as a local facility or, if you're interested in remote consulting, I can certainly be of assistance usually as well. 

[00:55:50] Christa Biegler, RD: Any last thoughts on, A lot of these therapies were like many sessions, right? And so is there anything you want to tell someone? I think you already covered this a little bit.

[00:55:58] Christa Biegler, RD: It depends on your goals, but is there anything you want to tell people about if they wanted to buy an HPOT chamber? Is there any kind of words of caution or wisdom? Because you mentioned that the actual sales, facility isn't really supposed to be educating exactly. So that makes it, there's a little bit of a gap there, unfortunately.

[00:56:16] Scott Sherr, MD: Yeah, so when you're looking to purchase a chamber, if you're looking to buy one, you're going to work with a company that's going to be able to give you good service and then help you with troubleshooting and then, pretend to give you access to a practitioner like, me like my company does if you end up purchasing a chamber so you can have somebody to talk to, to go through protocols and kind of dial in your protocols.

[00:56:34] Scott Sherr, MD: So that's what I do at my company, our company, OneBaseHealth. We have that kind of full service suite and, We were a big piece on education as well. So we're looking at some really cool new technology where we're basically now Bluetooth connecting your lights, your sauna, your cold plunge, your hyperbaric chamber, at least with our technology our our equipment right now, and you can actually.

[00:56:55] Scott Sherr, MD: Monitor all of these devices and use them all from your phone, operate them on off, watch their timing, and then eventually we're gonna have environmental centers as well. So you know what's happening with the chambers and then it's connected to or with all the technologies. And then you also have connections to your wearables.

[00:57:11] Scott Sherr, MD: So you can integrate a bi directional flow of information coming from your equipment, your wearables, and then also from the equipment itself. So I think that you could go to any company to buy a chamber, but you have to be careful because you don't know where the chambers. Coming from number one, nor you really do know what kind of protocols that are going to be best for you and what kind of service you're going to have over the long term.

[00:57:29] Scott Sherr, MD: My company is, top notch with all that stuff. That's why I created it with the overall goal of being able to give people the education on how to use them most effectively over the long term. Looking at the data coming from their technology along with their goals and then the data that's coming from their equipment and being able to modify iterate and optimize using all that.

[00:57:49] Christa Biegler, RD: Yeah. Super cool. Where can people find you online? 

[00:57:52] Scott Sherr, MD: So you can find me, my personal consulting for hyperbaric therapy is at integrativehbot. com. My hyperbaric company is onebasehealth. com. If you're interested in the socials and things, I'm at drscottsherr, D R S C O T S H E R, and we have onebasehealth on Instagram as well.

[00:58:14] Christa Biegler, RD: Cool. Thanks so much for coming on today and for talking to us all about HBOT.

[00:58:18] Scott Sherr, MD: My pleasure, Christa. Thank you for having me.