The Crucial Role of Oxygen for Health
Chris D. Meletis, ND
Associate Professor of Natural Pharmacology, National University of Natural Medicine, Portland, OR, USA
Kimberly Wilkesa
15455 NW Greenbrier Parkway Way, Portland, OR 97006, USA
PDF
XML

Keywords

Hypoxia
Oxygenation
Perfusion
Hyperbaric oxygen therapy
PDF
XML

Abstract

The human body is dependent upon oxygen for its survival. Yet, various factors such as aging, psychological stress, obstructive sleep apnea, exposure to cigarette smoke, living at high altitude, high-intensity exercise, or a sedentary lifestyle can all lead to a hypoxic state. Hypoxia may be involved in the pathogenesis of a number of disorders including impaired immunity, hormonal imbalances, fibromyalgia, cardiovascular diseases, type 2 diabetes, depression, and anxiety. Hyperbaric oxygen therapy and massage are two means by which to improve oxygen perfusion. Certain dietary supplements such as Ginkgo biloba, coenzyme Q10, and beetroot juice can increase oxygenation through enhanced blood flow while branched-chain amino acids and omega-3 fatty acids can improve maximum oxygen consumption V̇o2max. Additionally, omega-3 fatty acids and vitamin D may reduce the incidence of sleep apnea while N-acetyl cysteine may protect against hypoxia injury related to sleep apnea.

PDF
XML

References

1.Raichle ME, Gusnard ME. Appraising the brain’s energy budget. Proc Natl Acad Sci USA. 2002;99(16):10237–9.
2. Spinalcord.com. https://www.spinalcord.com/blog/whathappens-after-a-lack-of-oxygen-to-the-brain. Accessed June 5, 2018.
3. Mayo Clinic. https://www.mayoclinic.org/symptoms/hypoxemia/basics/definition/sym-20050930. Accessed June 5, 2018.
4. Pirke KM, Sintermann R, Vogt HJ. Testosterone and testosterone precursors in the spermatic vein and in the testicular tissue of old men. Reduced oxygen supply may explain the relative increase of testicular progesterone and 17 alpha-hydroxyprogesterone content and production in old age. Gerontology. 1980;26:221–30.
5. Gajendrareddy PK, Sen CK, Horan MP, Marucha PT. Hyperbaric oxygen therapy ameliorates stressimpaired dermal wound healing. Brain Behav Immun. 2005;19(3):217–22.
6. Huang S, Lu F, Zhang Z, Yang X, Chen Y. The role of psychologic stress-induced hypoxia-inducible factor-1a in rat experimental periodontitis. J Periodontol. 2011;82(6):934–41.
7. Heiden M, Lyskov E, Djupsjöbacka M, et al. Effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense. Eur J Appl Physiol. 2005;94(1–2):97–106.
8. Kritikou I, Basta M, Vgontzas AN, et al. Sleep apnoea and the hypothalamic-pituitary-adrenal axis in men and women: effects of continuous positive airway pressure. Eur Respir J. 2016;47(2):531–40.
9. American Sleep Apnea Association. www.sleepapnea. org. Accessed June 5, 2018.
10. Fu C, Lu H, Wu X, et al. Chronic intermittent hypoxia decreases pulmonary clearance of 99mTclabelled particulate matter in mice. Am J Transl Res. 2017;9(6):3060–72.
11. Gupta MA, Jarosz P. Obstructive sleep apnea severity is directly related to suicidal ideation in posttraumatic stress disorder. J Clin Sleep Med. 2018;14(3):427–35.
12. Luttmann-Gibson H, Sarnat SE, Suh HH. Short-term effects of air pollution on oxygen saturation in a cohort of senior adults in Steubenville, Ohio. J Occup Environ Med. 2014;56(2):149–54.
13. Guo S, DiPietro LA. Factors affecting wound healing. J Dent Res. 2010;89(3):219–29.
14. Hodson L, Humphreys SM, Karpe F, Frayn KN. Metabolic signatures of human adipose tissue hypoxia in obesity. Diabetes. 2013;62:1417–25.
15. Medline Plus. Obesity hypoventilation syndrome. http://www.nlm.nih.gov/medlineplus/ency/article/000085.htm. Accessed June 5, 2018.
16. Schmatz R, Mann TR, Spanevello R, et al. Moderate red wine and grape juice consumption modulates the hydrolysis of the adenine nucleotides and decreases platelet aggregation in streptozotocin-induced diabetic rats. Cell Biochem Biophys. 2013;65(2):129–43.
17. Saleem TS, Basha SD. Red wine: a drink to your heart. J Cardiovasc Dis Res. 2010;1(4):171–6.
18. Caris AV, Da Silva ET, Dos Santos SA, et al. Effects of carbohydrate and glutamine supplementation on oral mucosa immunity after strenuous exercise at high altitude: a double-blind randomized trial. Nutrients. 2017;9(7). pii:E692.
19. Conley KE, Amara CE, Bajpeyi S, et al. Higher mitochondrial respiration and uncoupling with reduced electron transport chain content in vivo in muscle of sedentary versus active subjects. J Clin Endocrinol Metab. 2013;98(1):129–36.
20. Wittenberg JB, Wittenberg BA. Myoglobin-enhanced oxygen delivery to isolated cardiac mitochondria. J Exp Biol. 2007;210:2082–90.
21. Waltz PK, Kautza B, Luciano J, et al. Heme oxygenase- 2 localizes to mitochondria and regulates hypoxic responses in hepatocytes. Oxid Med Cell Longev. 2018;2018:2021645.
22. Prabhakar NR, Semenza GL. Gaseous messengers in oxygen sensing. J Mol Med (Berl). 2012;90(3):265–72.
23. Garrabou G, Inoriza JM, Morén C, et al. Mitochondrial injury in human acute carbon monoxide poisoning: the effect of oxygen treatment. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2011;29(1):32–51.
24. Rich PR. The molecular machinery of Keilin’s respiratory chain. Biochem Soc Trans. 2003;31(Pt 6):1095–105.
25. Semple PA, Graham A, Malcolm Y, et al. Hypoxia, depression of testosterone, and impotence in pickwickian syndrome reversed by weight reduction. Br Med J (Clin Res Ed). 1984;289(6448):801–2.
26. Gambineri A, Pelusi C, Pasquali R. Testosterone levels in obese male patients with obstructive sleep apnea syndrome: relation to oxygen desaturation, body weight, fat distribution and the metabolic parameters. J Endocrinol Invest. 2003;26(6):493–8.
27. Semple PD, Beastall GH, Watson WS, Hume R. Serum testosterone depression associated with hypoxia in respiratory failure. Clin Sci (Lond). 1980;58(1):105–6.
28. Maneschi E, Morelli A, Filippi S, et al. Testosterone treatment improves metabolic syndrome-induced adipose tissue derangements. J Endocrinol. 2012;215(3):347–62.
29. Passavanti G, Tanasi P, Brauzzi M, et al. Can hyperbaric oxygenation therapy (HOT) modify the blood testosterone concentration? Urologia. 2010;77(1):52–6.
30. Krzywinska E, Stockmann C. Hypoxia, metabolism and immune cell function. Biomedicines. 2018;6(2). pii:E56.
31. Harch PG, Andrews SR, Fogarty EF, et al. A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder. J Neurotrauma. 2012;29:168–85.
32. Ivanov KS, Liashenko IuI, Kucheriavtsev AA, et al. [Hyperbaric oxygenation in the combined therapy of infectious diseases].[Article in Russian, Abstract in English.] Klin Med (Mosk). 1992;70(1):90–2.
33. Gulmen S, Kurtoglu T, Meteoglu I, et al. Ozone therapy as an adjunct to vancomycin enhances bacterial elimination in methicillin resistant Staphylococcus aureus mediastinitis. J Surg Res. 2013;185(1):64–9.
34. Baugh MA. HIV: reactive oxygen species, enveloped viruses and hyperbaric oxygen. Med Hypotheses. 2000;55(3):232–8.
35. Reillo MR, Altieri RJ. HIV antiviral effects of hyperbaric oxygen therapy. J Assoc Nurses AIDS Care. 1996;7(1):43–5.
36. Bhattacharya M, Kumar PG, Sahni TK. Hyperbaric oxygen therapy in parenchymal liver disease. J Assoc Physicians India. 1996;44(2):106–8.
37. National Fibromyalgia Association. http://www.fmaware.org/about-fibromyalgia/prevalence/. Accessed June 5, 2018.
38. Shang Y, Gurley K, Symons B, et al. Noninvasive optical characterization of muscle blood flow, oxygenation, and metabolism in women with fibromyalgia. Arthritis Res Ther. 2012;14(6):R236.
39. Morf S, Amann-Vesti B, Forster A, et al. Microcirculation abnormalities in patients with fibromyalgia - measured by capillary microscopy and laser fluxmetry. Arthritis Res Ther. 2005;7(2):R209–16.
40. Klemp P, Staberg B, Korsgård J, et al. Reduced blood flow in fibromyotic muscles during ultrasound therapy. Scand J Rehabil Med. 1983;15(1):21–3.
41. Park JH, Phothimat P, Oates CT, et al. Use of P-31 magnetic resonance spectroscopy to detect metabolic abnormalities in muscles of patients with fibromyalgia. Arthritis Rheum. 1998;41(3):406–13.
42. Elvin A, Siösteen AK, Nilsson A, et al. Decreased muscle blood flow in fibromyalgia patients during standardised muscle exercise: a contrast media enhanced colour Doppler study. Eur J Pain. 2006;10(2):137–44.
43. Dinler M, Kasikcioglu E, Akin A, et al. Exercise capacity and oxygen recovery half times of skeletal muscle in patients with fibromyalgia. Rheumatol Int. 2007;27(3):311–3.
44. Dinler M, Diracoglu D, Kasikcioglu E, et al. Effect of aerobic exercise training on oxygen uptake and kinetics in patients with fibromyalgia. Rheumatol Int. 2009;30(2):281–4.
45. Lund N, Bengtsson A, Thorborg P. Muscle tissue oxygen pressure in primary fibromyalgia. Scand J Rheumatol. 1986;15(2):165–73.
46. Beretta P. [Fibromyalgia and myalgic encephalomyelitis: The oxygen clue]. [Article in Spanish, Abstract in English.] Vertex. 2016;XXVII(128):252–5.
47. Lurie A. Obstructive sleep apnea in adults: epidemiology, clinical presentation, and treatment options. Adv Cardiol. 2011;46:1–42.
48. Kohler M, Craig S, Nicoll D, et al. Endothelial function and arterial stiffness in minimally symptomatic obstructive sleep apnea. Am J Respir Crit Care Med. 2008;178(9):984–8.
49. American Heart Association. Sleep apnea linked to silent strokes, small lesions in brain. ScienceDaily. ScienceDaily, 1 February 2012. http://www.sciencedaily.com/releases/2012/02/120201094323.htm. Accessed June 5, 2018.
50. Guilleminault C, Connolly SJ, Winkle RA. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol. 1983;52:490–4.
51. Harbison J, O’Reilly P, McNicholas WT. Cardiac rhythm disturbances in the obstructive sleep apnea syndrome: effects of nasal continuous positive airway pressure therapy. Chest. 2000;118:591–5.
52. Millman RP, Redline S, Carlisle CC, et al. Daytime hypertension in obstructive sleep apnea. Prevalence and contributing risk factors. Chest. 1991;99(4):861–6.
53. Carlson JT, Hedner JA, Ejnell H, et al. High prevalence of hypertension in sleep apnea patients independent of obesity. Am J Respir Crit Care Med. 1994;150(1):72–7.
54. Frent S, Tudorache V, Ardelean C, et al. [Sleep apnea syndrome – cause of resistance to treatment of arterial hypertension]. [Article in Romanian, Abstract in English.] Pneumologia. 2011;60(4):202–7.
55. Yogaratnam JZ, Laden G, Guvendik L, et al. Hyperbaric oxygen preconditioning improves myocardial function, reduces length of intensive care stay, and limits complications post coronary artery bypass graft surgery. Cardiovasc Revasc Med. 2010;11(1):8–19.
56. Punjabi NM, Polotsky VY. Disorders of glucose metabolism in sleep apnea. J Appl Physiol (1985). 2005;99(5):1998–2007.
57. Harsch IA, Hahn EG, Konturek PC. Insulin resistance and other metabolic aspects of the obstructive sleep apnea syndrome. Med Sci Monitor. 2005;11(3):RA70–5.
58. Hassaballa HA, Tulaimat A, Herdegen JJ, et al. The effect of continuous positive airway pressure on glucose control in diabetic patients with severe obstructive sleep apnea. Sleep Breath. 2005;9(4):176–80.
59. Sharafkhaneh A, Giray N, Richardson P, et al. Association of psychiatric disorders and sleep apnea in a large cohort. Sleep. 2005;28(11):1405–11.
60. El-Sherbini AM, Bediwy AS, El-Mitwalli A. Association between obstructive sleep apnea (OSA) and depression and the effect of continuous positive airway pressure (CPAP) treatment. Neuropsychiatr Dis Treat. 2011;7:715–21.
61. Ananthakrishnan AN, Bernstein CN, Iliopoulos D, et al. Environmental triggers in IBD: a review of progress and evidence. Nat Rev Gastroenterol Hepatol. 2018;15(1):39–49.
62. Tian X, Zhang L, Wang J, et al. The protective effect of hyperbaric oxygen and Ginkgo biloba extract on Aß25- 35-induced oxidative stress and neuronal apoptosis in rats. Behav Brain Res. 2013;242:1–8.
63. Zhang T, Yang QW, Wang SN, et al. Hyperbaric oxygen therapy improves neurogenesis and brain blood supply in piriform cortex in rats with vascular dementia. Brain Inj. 2010;24(11):1350–7.
64. Xiao Y, Wang J, Jiang S, et al. Hyperbaric oxygen therapy for vascular dementia. Cochrane Database Syst Rev. 2012;7:CD009425.
65. Bennett MH, French C, Schnabel A, et al. Normobaric and hyperbaric oxygen therapy for migraine and cluster headache. Cochrane Database Syst Rev. 2008;(3):CD005219.
66. Mardirossian G, Schneider RE. Limitations of pulse oximetry. Anesth Prog. 1992;39(6):194–6.
67. Giuliano KK, Liu LM. Knowledge of pulse oximetry among critical care nurses. Dimens Crit Care Nurs. 2006;25(1):44–9.
68. Jubran A. Pulse oximetry. Crit Care. 2015;19(1):272.
69. Howell M. The correct use of pulse oximetry in measuring oxygen status, Nursing Times. Mar 1 2002. https:// www.nursingtimes.net/clinical-archive/assessment-skills/the-correct-use-of-pulse-oximetry-in-measuring-oxygenstatus/199984.article. Accessed December 5, 2018.
70. Perlman AI, Ali A, Njike VY, et al. Massage therapy for osteoarthritis of the knee: a randomized dose-finding trial. PLoS One. 2012;7(2):e30248.
71. Melillo N, Corrado A, Quarta L, et al. [Fibromyalgic syndrome: new perspectives in rehabilitation and management. A review]. [Article in Italian]. Minerva Med. 2005;96(6):417–23.
72. Kumar S, Beaton K, Hughes T. The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews. Int J Gen Med. 2013;6:733–41.
73. Moeini M, Givi M, Ghasempour Z, et al. The effect of massage therapy on blood pressure of women with pre-hypertension. Iran J Nurs Midwifery Res. 2011;16(1):61–70.
74. Quinn C, Chandler C, Moraska A. Massage therapy and frequency of chronic tension headaches. Am J Public Health. 2002;92(10):1657–61.
75. Goncharov OV. [Massage with aromatic oils in complex rehabilitation of children with aftereffects of perinatal hypoxic lesions of the central nervous system]. [Article in Russian] Vopr Kurortol Fizioter Lech Fiz Kult. 2007;(2):18–21.
76. Durkin JL, Harvey A, Hughson RL, et al. The effects of lumbar massage on muscle fatigue, muscle oxygenation, low back discomfort, and driver performance during prolonged driving. Ergonomics. 2006;49(1):28–44.
77. Mitchell UH. Nondrug-related aspect of treating Ekbom disease, formerly known as restless legs syndrome. Neuropsychiatr Dis Treat. 2011;7:251–7.
78. Franklin NC, Ali MM, Robinson AT, et al. Massage therapy restores peripheral vascular function after exertion. Arch Phys Med Rehabil. 2014;95(6):1127–34.
79. Yen DH, Chan JY, Huang CI, et al. Coenzyme Q10 confers cardiovascular protection against acute mevinphos intoxication by ameliorating bioenergetic failure and hypoxia in the rostral ventrolateral medulla of the rat. Shock. 2005;23(4):353–9.
80. Park J, Park HH, Choi H, et al. Coenzyme Q10 protects neural stem cells against hypoxia by enhancing survival signals. Brain Res. 2012;1478:64–73.
81. Holy R, Prazenica P, Stolarikova E, et al. Hyperbaric oxygen therapy in tinnitus with normal hearing in association with combined treatment. Undersea Hyperb Med. 2016;43(3):201–5.
82. Han L, Li M. Protection of vascular endothelial cells injured by angiotensin II and hypoxia in vitro by Ginkgo biloba (Ginaton). Vasc Endovascular Surg. 2013;47(7):546–50.
83. Oh JH, Oh J, Togloom A, et al. Effects of Ginkgo biloba extract on cultured human retinal pigment epithelial cells under chemical hypoxia. Curr Eye Res. 2013;38(10):1072–82.
84. Kang JM, Lin S. Ginkgo biloba and its potential role in glaucoma. Curr Opin Ophthalmol. 2018;29(2):116–20.
85. Költringer P, Eber O, Klima G, et al. [Microcirculation in parenteral Ginkgo biloba extract therapy]. [Article in German, Abstract in English.] Wien Klin Wochenschr. 1989;101(6):198–200.
86. Zhang SJ, Xue ZY. Effect of Western medicine therapy assisted by Ginkgo biloba tablet on vascular cognitive impairment of none dementia. Asian Pac J Trop Med. 2012;5(8):661–4.
87. Xu L, Hu Z, Shen J, et al. Effects of Ginkgo biloba extract on cerebral oxygen and glucose metabolism in elderly patients with pre-existing cerebral ischemia. Complement Ther Med. 2015;23(2):220–5.
88. Domínguez R, Cuenca E, Maté-Muñoz JL, et al. Effects of beetroot juice supplementation on cardiorespiratory endurance in athletes. A systematic review. Nutrients. 2017;9(1). pii: E43.
89. Astorino TA, Robergs RA. Effect of hyperoxia on maximal oxygen uptake, blood acid-base balance, and limitations to exercise tolerance. J Exercise Physiol. 2003;6(2):8–20.
90. Haghravan S, Keshavarz SA, Mazaheri R, et al. Effect of omega-3 PUFAs supplementation with lifestyle modification on anthropometric indices and Vo2max in overweight women. Arch Iran Med. 2016;19(5):342–7.
91. Matsumoto K, Koba T, Hamada K, et al. Branchedchain amino acid supplementation increases the lactate threshold during an incremental exercise test in trained individuals. J Nutr Sci Vitaminol (Tokyo). 2009;55(1):52–8.
92. Archontogeorgis K, Nena E, Papanas N, et al. The role of vitamin D in obstructive sleep apnoea syndrome. Breathe (Sheff). 2018;14(3):206–15.
93. Ladesich JB, Pottala JV, Romaker A, et al. Membrane level of omega-3 docosahexaenoic acid is associated with severity of obstructive sleep apnea. J Clin Sleep Med. 2011;7(4):391–6.
94. Jouett NP, Moralez G, White DW, et al. N-Acetylcysteine reduces hyperacute intermittent hypoxia-induced sympathoexcitation in human subjects. Exp Physiol. 2016;101(3):387–96.
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.