Hyperbaric oxygen therapy (HBOT)

The evidence for HBOT splits sharply, and the split is the whole story. For its accepted medical indications the clinical evidence is genuine and long-standing. For longevity and healthspan claims it is not. The most-cited human ageing work is a small set of single-arm prospective trials from the same Israeli group (Hachmo et al., Aging 2020 on telomere length and immunosenescence; Hachmo et al., Aging 2021 on skin ageing), plus a widely circulated 2022 Frontiers in Neurology paper that is a single-subject case report (n=1). None of the longevity-outcome studies retrieved were randomised or sham-controlled, which matters acutely here because chamber sessions produce strong expectancy effects and because telomere length in isolated blood cells is a surrogate that can shift with leukocyte population changes rather than cellular rejuvenation. No trial demonstrates an effect on mortality, incident disease, or any hard healthspan endpoint. Separately, the protocols in those studies (60 sessions at ~2 ATA, pure oxygen) are not what soft-shell consumer chambers deliver, so even the weak positive findings do not transfer to most commercially sold sessions. Graded "commercial": HBOT is a real medical technology being marketed for an indication its own evidence base does not yet support.

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