Wednesday, October 21, 2015

Misconceptions about oxygen by alternative medicine practitioners

An article called “Simple ‘4-7-8′ breathing trick can induce sleep in 60 seconds” claims that this trick can get you to go to sleep within 60 seconds. All you have to do is the following:

♦ Exhale completely through your mouth, making a whoosh sound.
♦ Close your mouth and inhale quietly through your nose to a mental count of four.
♦ Hold your breath for a count of seven.
♦ Exhale completely through your mouth, making a whoosh sound to a count of eight.
♦ This is one breath. Now inhale again and repeat the cycle three more times for a total of four breaths

An integrative medicine expert, Dr. Andrew Weil, said it works because it allows the lungs to become fully charged with air, allowing more oxygen into the body, which promotes a state of calm.

“Promotes a state of calm” is nonsense. Let’s concentrate on the science. Does it allow more oxygen into the body? Ich don't think so.

The air we breathe contains about 21% oxygen. Nearly all oxygen in the blood is carried by hemoglobin. No matter how many deep breaths you take, you cannot get the oxygen saturation of hemoglobin (normally > 92%, closer to 98% in healthy people) above 100%. This is explained in more detail in a previous post of mine about why athletes don’t benefit from breathing pure oxygen after exertion.

This simple trick would be hard to remember but might work through the power of suggestion. It doesn’t cost anything, and unless you hyperventilate and pass out (but you'll be in bed anyway), it is harmless.

The next misconception about oxygen is neither inexpensive nor harmless.

Two naturopathic “doctors” have been accused of injecting a woman with oxygen or perhaps purified water that had been taken from an Octozone machine. The oxygen was supposed to destroy any pathogens in the woman’s blood. In the process of trying to kill the pathogens, the injection killed the patient who paid $500 for the treatment.

The naturopathic duo left town and were at large for several months before eventually being caught and charged with homicide.

An autopsy found her death was due to an air embolism.

According to a recent review of the subject, “Traditionally, it has been estimated that more than 5 mL/kg of air displaced into the intravenous space is required for significant injury (shock or cardiac arrest) to occur. However, complications have been reported with as little as 20 mL of air (the length of an unprimed IV infusion tubing) that was injected intravenously.”

Pure water should never be injected IV either because it causes blood cells to die from hemolysis.

How about we just take our oxygen the old-fashioned way—normal breaths and never intravenously?


Katherine McNeese said...

However, it is an effective quick meditiation technique; or at least for me, it is better than counting to 10!

William Reichert said...

Dr Weil has a video on this technique. He states that there has been
"no research" done on this and it may take "months or years to work".
He had a patient who used this technique religiously for panic attacks and the panic attacks improved " after two years". He thought this
was a notable response.
When I was in medical school there was physician who used to say
that when there was no effective treatment for such and such a condition that he would treat the patient with "tincture of time".
Isn't that what Dr. Weil is actually doing? Doing nothing but
using the breathing technique as a way of biding time while waiting for things to improve on their own?
Is not this the function of prayer ?

Skeptical Scalpel said...

Tincture of time is the basis for a lot of "integrative medicine." Like prayer, deep breathing cannot hurt.

Les said...

Please explain why anyone would go to someone's apartment for a medical procedure.

Skeptical Scalpel said...

I can't explain it. I can only guess that the woman was desperate, the naturopaths were smooth talkers, and possibly were less expensive that a real doctor.

Libby said...

My naturopath's office is in his house-not unlike Dr. Welby. BTW I'm skeptical but he did appear to help with a couple of things. Because the cream was topical I was willing to try with the massive bruising I had from a sprain/fracture ankle. My massage therapist laughed at the "oxygen" ingredient in the cream. I figured it was just from mixing that put the oxygen in it.
Being in Canada, he was almost expensive because he isn't covered by even our extended health care insurance. I'm also skeptical with chiropractors but still use them...unless my 'spidey senses' say otherwise.

Skeptical Scalpel said...

Oxygen in skin cream? Ich don't think so. Bruises occur beneath the skin. Even if there was some magic extra oxygen in a topical cream, how would the oxygen get to the bruise. And how would oxygen alleviate a bruise?

PGYx said...

I'm a regular doctor but do share with my patients a variety of non-pharmacologic sleep strategies (I hate the sedative-hypnotics!). I tried the 4-7-8 breath many years ago and found it made me feel very relaxed and put me to sleep after 3-5 breaths. However, I typically fall asleep easily. I recall Dr. Weil writing something like it "calms the nervous system (i.e. reduces sympathetic tone)," but don't recall any comments about oxygen and it doesn't sound like his style.

In any case, I have since recommended this particular breathing exercise to patients with insomnia, anxiety, and panic attacks. I have them do it with me in the office or hospital room. Have had some folks tell me it stops a panic attack before they reach for the Xanax. Some of them are very motivated to pursue non-pharmacologic approaches (and hence likely more prone to the placebo effect), but not all of them. I have also found it to work well for folks with anxiety following traumatic spinal cord injury and other negative life-changing events. One inner city kid GSW victim told me it felt like he was "high [on marijuana]."

I don't know how it works, but it seems to be more effective than just taking slow deep breaths. I still use it myself on occasion if I find myself thinking too much about tomorrow's tasks after I lay my head on the pillow -- the focus on keeping count takes my mind off the tasks and I'm asleep within 3-5 breaths vs. the ~10-15 minutes or so it might otherwise take when I'm in day-planning mode.

Anonymous said...

Off topic but the email doesn't work for me (little on a computer does). Are you planning a comment on the Boston Globe story about surgeons doing two cases in two ORs at the same time? I know Mass General is good but?

Skeptical Scalpel said...

PGYx, Thanks for commenting. The first sentence under the headline of the article I linked to in my first sentence is "Dr Andrew Weil says it works because it allows the lungs to become fully charged with air, allowing more oxygen into the body, which promotes a state of calm." As I said in the post, at least it is harmless and doesn't cost anything.

If it works for you, that's great, but it's not about oxygen.

Anon, I am planning to comment about the Boston Globe article. If I do, it may appear in my blog on the website Physician's Weekly.

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