EBOO: Ozone Therapy for the Whole Bloodstream, Why Integrative Doctors Use It, and What to Know

EBOO filters your blood and treats it with oxygen and ozone in a closed circuit, the most intensive form of ozone therapy. Here's how it works, why integrative doctors use it, what the research shows, and what to know before you book.

MK Wellness InsightsFounded by Danielle Cordova, Cypress, TX

EBOO (extracorporeal blood oxygenation and ozonation) is the most intensive form of ozone therapy. Your blood flows out through one IV, through a filter where it's treated with oxygen and ozone, and back in through a second IV, much like dialysis.

It was developed in Italy beginning in 1990 by Dr. Nicola Di Paolo and Professor Velio Bocci's team in Siena, and integrative clinics now offer it for chronic fatigue, lingering infections, inflammation, circulation, and detox. Here's how it works, why doctors use it, what the research shows, and what to know before you book.

What It Is

During EBOO, a clinician places two IV lines. Your blood circulates through a closed circuit with a filter, where it meets a mixture of oxygen and ozone, and then returns to your body. Because blood leaves the body, the circuit uses a blood thinner to keep it from clotting. A session takes about an hour.

EBOO treats far more blood than the standard form of IV ozone, called major autohemotherapy, which treats a single bag of blood. The Siena team reported treating up to about 4.8 liters of blood in an hour, compared with about a quarter liter with autohemotherapy (Redox Report, 2005).

How It's Thought to Work

• A controlled, healthy stress. Ozone reacts with fats and antioxidants in the blood, creating short-lived messenger molecules. Researchers describe this as a mild, controlled stress, a little like exercise, that switches on the body's own antioxidant defenses (the Nrf2 pathway) and shifts the immune system from inflammatory to anti-inflammatory (Frontiers in Microbiology, 2022).
• Circulation and oxygen. Practitioners believe EBOO improves circulation and oxygen delivery to tissues, which is why it's used for poor circulation and recovery.
• Filtration. Practitioners also believe the filter helps remove toxins, part of why EBOO is popular for mold and toxin exposure.

Why Integrative Doctors Use It

• The Siena pioneers. Dr. Nicola Di Paolo and Professor Velio Bocci developed EBOO to amplify the results they saw with ozone autohemotherapy. By 2005, their team had performed more than 1,200 treatments in 82 patients (Redox Report, 2005).
• Dr. Robert Rowen, a longtime ozone therapy educator in California, published research in 2023 showing that ozone dialysis, a form of EBOO, gets at least three times more ozone into the blood than other blood-ozone methods (Medical Gas Research, 2023).
• Dr. Joseph Mercola has championed ozone therapy for years, including interviews with Dr. Rowen about ozone for viral illnesses (Mercola, 2020).

Common reasons people choose it:

• Chronic fatigue, brain fog, and slow recovery
• Lingering infections and post-infection symptoms, like long COVID
• Mold and other toxin exposure
• Poor circulation and inflammation

What the Research Shows

• Circulation: in a randomized trial of 28 people with peripheral artery disease (poor circulation in the legs), EBOO was much more effective than a standard IV drug, prostacyclin, at healing skin lesions. It also improved pain, itching, heavy legs, and well-being, with no side effects or complications in 210 treatments. Blood flow itself didn't change, which the researchers said points to other ways EBOO works (International Journal of Artificial Organs, 2005).
• Clinical experience: the Siena team reported benefits in severe circulation problems, heart disease, high cholesterol, and sudden hearing loss caused by poor blood flow (Redox Report, 2005).
• Toxins: in a 2025 case report, an 88-year-old woman's urine levels of mycotoxins fell 65%, environmental toxins 55%, and heavy metals 26% over two series of EBOO treatments (Cureus, 2025).
• Related blood-ozone therapy: in a randomized trial of 73 people with long COVID, adding major ozone autohemotherapy to standard care cut symptoms at least in half in 25 of 35 people, and improved lung function, walking distance, inflammation, and immune markers more than standard care alone (International Immunopharmacology, 2024). In a randomized trial of 92 people hospitalized with COVID-19 pneumonia, ozone therapy improved a combined clinical score by day 7 but didn't change survival or the need for a ventilator (International Immunopharmacology, 2021).
• Regulation: in the U.S., the FDA hasn't approved ozone for any medical use. Ozone autohemotherapy itself had already been used for four decades by 2000, when the Siena team first reported EBOO in people (International Journal of Artificial Organs, 2000).

What to Know Before You Start

We don't share protocols. An experienced clinician can tell you whether EBOO fits your situation.

How to Find a Practitioner

Look for an integrative or functional medicine clinic where a licensed physician oversees EBOO and the staff runs it often. The Natural Health Network directory can help you find holistic practitioners near you.

Common Questions

How is EBOO different from the HOCATT at MK? The HOCATT delivers ozone through your skin while you relax in a warm sauna cabinet with your head outside. Nothing enters your bloodstream through a needle. EBOO is a medical procedure that treats the blood directly.

Is EBOO the same as IV ozone? Both treat blood with ozone. Standard IV ozone (major autohemotherapy) treats a single bag of blood, while EBOO treats a much larger volume in a continuous circuit.

Is it the same as ozone dialysis? Dr. Rowen uses the term "ozone dialysis" for a technique in which blood flows past ozone gas through a dialysis membrane, one way of doing EBOO.

How This Fits at MK Wellness

• The HOCATT ozone sauna combines transdermal ozone with heat, with your head outside the chamber.
• Mild hyperbaric oxygen and EWOT increase the oxygen your tissues receive.
• The infrared sauna supports a deep, cleansing sweat.

Go Deeper

• Ozone Therapy Explained and the HOCATT, explained
• Ozone Therapy for Coronavirus, Dr. Mercola's interview with Dr. Robert Rowen (2020)
• Holistic Therapies: The Basics, every holistic and alternative guide, and the Cancer Support guide

MK Wellness services are non-medical and not intended to diagnose, treat, cure, or prevent any condition. This article is general education, not medical advice, and deliberately includes no protocols. MK Wellness doesn't offer EBOO. Never inhale ozone.

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