Doctor Explains: Evidence for Hyperbaric Oxygen Therapy in ME/CFS, Long COVID and Fibromyalgia.

Hyperbaric Oxygen Therapy (HBOT) has attracted growing interest among people living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Long COVID, fibromyalgia, and post-viral fatigue. As an ME/CFS specialist, I am often asked whether HBOT is an effective treatment and whether it is worth considering.

The short answer is that HBOT is an interesting area of research, but the evidence is still developing. Some studies have shown promising results, while others highlight the need for larger, better-controlled trials before firm conclusions can be made.

What is Hyperbaric Oxygen Therapy?

Hyperbaric Oxygen Therapy involves sitting or lying in a pressurised chamber while breathing oxygen at higher-than-normal pressure. This allows the body to absorb more oxygen than usual.

HBOT is already used for several established medical conditions, including decompression sickness, carbon monoxide poisoning, and certain wound-healing problems. Researchers are now exploring whether it may help conditions involving inflammation, impaired energy production, or nervous system dysfunction.

Why Might HBOT Help ME/CFS?

ME/CFS research has identified abnormalities involving energy metabolism, circulation, immune function, autonomic nervous system regulation, and brain function. Some researchers believe that increasing oxygen delivery to tissues could potentially improve these processes.

Theories include:

• Improving cellular energy production

• Reducing inflammation

• Supporting brain function

• Enhancing recovery after illness or infection

• Improving blood flow to affected tissues

However, these mechanisms remain theoretical and have not yet been fully proven in ME/CFS patients.

What Does the Research Show?

One of the earliest studies, published in 2013, involved 16 people with ME/CFS who underwent HBOT treatment. Researchers reported improvements in fatigue and quality of life measures after treatment. However, the study did not include a control group, making it impossible to know whether the improvements were due to HBOT itself, placebo effects, or natural symptom fluctuations.

More recently, researchers from Germany published a prospective study involving 30 ME/CFS patients who received 40 HBOT sessions. Participants showed improvements in physical functioning, fatigue, pain, exercise capacity, handgrip strength, and some aspects of cognitive performance. Brain imaging also suggested changes in areas involved in sensory and cognitive processing.

These findings are encouraging. However, there are important limitations.

The study was not randomised and did not include a sham-treatment control group. This means we cannot be certain that HBOT itself caused the improvements observed. The study was also relatively small, and follow-up was limited to a few weeks after treatment.

For this reason, most experts view the current evidence as promising but preliminary.

What About Long COVID?

There has also been growing interest in HBOT for Long COVID. Long COVID fatigue clinic researchers have proposed that some of the biological abnormalities seen in Long COVID overlap with those seen in ME/CFS.

Several reviews suggest there may be a scientific rationale for HBOT in post-COVID syndromes, particularly for fatigue, cognitive symptoms ("brain fog"), and exercise intolerance. However, researchers continue to emphasise the need for high-quality clinical trials before HBOT can be routinely recommended.

Many patients attending a Long COVID fatigue clinic also meet criteria for ME/CFS, highlighting the importance of careful specialist assessment before pursuing any therapy.

What About Fibromyalgia?

Many people with ME/CFS also have fibromyalgia. Research into HBOT for fibromyalgia has been more extensive than in ME/CFS.

Several systematic reviews and meta-analyses have found evidence that HBOT may improve fibromyalgia impact scores and tender point counts in some patients. However, benefits for pain have been less consistent, and side effects can occur.

This means HBOT remains a potential option of interest for some patients, but it is not considered a standard first-line treatment.

Are There Risks?

HBOT is generally considered safe when provided by appropriately trained professionals.

Possible side effects include:

• Ear discomfort or pressure

• Sinus pain

• Temporary visual changes

• Dizziness

• Fatigue after treatment

• Claustrophobia

Rare complications can include oxygen toxicity and lung-related problems. Patients should always undergo appropriate medical screening before treatment.

Should People With ME/CFS Try HBOT?

At present, HBOT should be viewed as an experimental or emerging therapy for ME/CFS rather than an established treatment.

Some patients report meaningful improvements, while others experience little benefit. The current research suggests potential promise, but the evidence is not yet strong enough to recommend HBOT routinely for all patients with ME/CFS.

The most important step is obtaining an accurate diagnosis and assessment. Many symptoms that appear similar to ME/CFS can have other causes, and treatment plans should be tailored to the individual.

An experienced ME/CFS specialist can help determine whether further ME/CFS testing is appropriate, review current ME/CFS research, and discuss evidence-based ME/CFS therapy options that may be relevant to your situation.

Whether you are looking for an online ME/CFS doctor, a post viral fatigue doctor, a fibromyalgia specialist online, or support through a Long COVID fatigue clinic, specialist assessment can help guide treatment decisions based on the latest evidence.

To learn more about our services, visit our consultation page: https://www.ukmecfsspecialist.co.uk/book-online

You can also learn more about the specialist behind the clinic on our website and explore additional information about ME/CFS, Long COVID, post-viral fatigue, and related conditions through our blog.

If you would like specialist assessment, learn more about our online consultations.