HBOT & Chronic Fatigue — What the Research Shows · Oceanside, CA
CHRONIC FATIGUE &
SOMETHING IS
WRONG IN THE CELLS.
Chronic fatigue isn't tiredness — it's a condition that research increasingly links to real, measurable dysfunction at the cellular level. Impaired mitochondria, tissue hypoxia, and immune dysregulation all appear to play a role. Researchers are now investigating whether hyperbaric oxygen therapy can address these mechanisms directly. This page explores what the science currently shows.
This page is educational and informational. It does not claim that HBOT treats, cures, or prevents chronic fatigue syndrome or any other condition. HBOT is not an FDA-approved treatment for chronic fatigue. If you are experiencing symptoms, please speak with a qualified healthcare provider.
What the Research Shows
65%
Clinically significant quality of life improvement including fatigue scores in registry study1
800%
Increase in circulating stem cells over a course of HBOT — University of Pennsylvania2
#1
Rated PT Clinic — North County 2025
Understanding Chronic Fatigue
CHRONIC FATIGUE SYNDROME IS A BIOLOGICAL CONDITION, NOT A MINDSET.
Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) affects an estimated 836,000 to 2.5 million Americans. It is characterized by profound, unrelenting fatigue that does not improve with rest — along with post-exertional malaise, cognitive dysfunction, sleep disturbance, and often widespread pain.
For decades, ME/CFS was dismissed or misunderstood as a psychological condition. That has changed. Research now points clearly to measurable biological abnormalities in people with ME/CFS — including mitochondrial dysfunction, impaired oxygen utilization at the cellular level, chronic immune activation, and abnormal energy metabolism that distinguishes it from ordinary tiredness.
The overlap with Long COVID is significant — researchers estimate that up to 50% of Long COVID patients meet the diagnostic criteria for ME/CFS, and the two conditions share many of the same proposed biological mechanisms. This convergence has accelerated research into cellular-level interventions, including hyperbaric oxygen therapy.
"Hyperbaric oxygen therapy led to significant improvements in cognitive function, pain, sleep, fatigue, and quality of life — with changes in brain activity confirmed on imaging."
— Hadanny et al., PLOS ONE, 2022 (Tel Aviv University / Sagol Center — Long COVID/CFS overlap cohort)
Why Treatment Remains Elusive
THERE IS STILL NO APPROVED TREATMENT FOR ME/CFS.
As of today, no pharmaceutical treatment has been FDA-approved specifically for ME/CFS. The standard of care focuses largely on symptom management — pacing strategies, sleep hygiene, and treatment of co-occurring conditions — rather than any intervention that addresses underlying biology.
The NIH has acknowledged ME/CFS as a serious, poorly understood condition and significantly increased research funding in recent years. One of the key questions researchers are pursuing is whether impaired oxygen delivery and mitochondrial dysfunction — rather than psychological factors — are the primary drivers of the fatigue that defines this condition.
Hyperbaric oxygen therapy's ability to dramatically increase oxygen availability at the tissue and cellular level makes it a biologically plausible candidate for investigation. Researchers are exploring whether restoring oxygen delivery can help break the energy deficit cycle that underlies chronic fatigue symptoms.
Mitochondrial dysfunction — impaired energy production in cells drives profound fatigue
Tissue hypoxia — reduced oxygen delivery to cells and organs at rest
Immune dysregulation — chronic low-grade immune activation consuming energy resources
Neuroinflammation — brain imaging shows altered activity in regions linked to fatigue and cognition
Post-exertional malaise — cellular energy systems that crash disproportionately after minimal exertion
Understanding Chronic Fatigue & Brain Fog
YOU USED TO HAVE MORE. MORE ENERGY. MORE DRIVE. MORE CLARITY.
Chronic fatigue isn't laziness and it isn't in your head. It's a real physiological state — one where your cells aren't producing energy the way they should, your brain isn't getting the oxygen it needs, and your body can't recover the way it once did.
Whether your fatigue came on gradually, followed an illness, or has no clear cause at all — the experience is the same: you're exhausted, you can't think clearly, and nothing you've tried has given you your life back. HBOT works at the cellular level to address the oxygen deprivation and inflammation that may be driving your symptoms.
Symptoms We Commonly See
Persistent exhaustion — tired regardless of how much sleep you get
Brain fog — slow thinking, poor memory, difficulty concentrating
Low motivation & drive — things that used to excite you feel like a burden
Physical heaviness — body feels weighed down even after minimal activity
Mood changes — irritability, anxiety, or low mood connected to ongoing exhaustion
Unrefreshing sleep — waking up as tired as when you went to bed
The Research Angle
WHAT HBOT DOES
THAT RESEARCHERS
ARE INVESTIGATING
THAT RESEARCHERS
ARE INVESTIGATING
Hyperbaric oxygen therapy delivers 100% oxygen at increased atmospheric pressure — flooding tissues and cells with far more oxygen than normal breathing provides. For a condition where impaired oxygen utilization and mitochondrial dysfunction are central mechanisms, here are six areas researchers are actively investigating.
⚡
Mitochondrial Energy Recovery
Mitochondrial dysfunction — impaired cellular energy production — is one of the most consistent findings in ME/CFS research. HBOT dramatically increases the oxygen available to mitochondria in every cell. Researchers are investigating whether this oxygen surge can help restore mitochondrial function and break the energy deficit cycle that drives chronic fatigue symptoms.
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Tissue Oxygenation
Studies have found evidence of reduced oxygen delivery to tissues in ME/CFS patients, even at rest. Under hyperbaric pressure, oxygen dissolves directly into plasma — bypassing hemoglobin and reaching cells that may be chronically oxygen-deprived. Researchers are exploring whether restoring cellular oxygen availability can meaningfully reduce fatigue burden.
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Neuroinflammation Reduction
Brain imaging studies in ME/CFS patients have identified areas of neuroinflammation — particularly in regions associated with fatigue signaling and cognitive function. HBOT has been shown to reduce neuroinflammatory markers and improve cerebral blood flow in related conditions, and researchers are exploring whether these effects translate to ME/CFS symptom relief.
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Stem Cell Mobilization
Research at the University of Pennsylvania found that HBOT increased circulating stem cells by 800% — the safest known method of stem cell mobilization. These mobilized cells may support tissue repair and immune regulation — both areas of dysfunction in ME/CFS — and researchers are investigating whether this mobilization effect may contribute to recovery in chronic fatigue patients.
🛡
Immune System Modulation
ME/CFS involves chronic immune activation — a low-grade inflammatory state that consumes energy and perpetuates symptoms. HBOT has documented anti-inflammatory effects, including reductions in pro-inflammatory cytokines and changes in immune cell behavior. Researchers are studying whether these effects can help restore immune balance in patients with chronic fatigue-related immune dysregulation.
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Post-Exertional Recovery
Post-exertional malaise — a disproportionate crash in energy following minimal activity — is the hallmark feature of ME/CFS. Researchers believe this reflects an underlying failure of cellular energy systems to recover after demand. By increasing oxygen availability and supporting mitochondrial function, HBOT is being investigated for its potential to improve the cellular resilience that makes post-exertional crashes so severe.
Important Context
ME/CFS-specific HBOT clinical trials are still in relatively early stages. Much of the most relevant data comes from Long COVID research — which overlaps significantly with ME/CFS biology — and from mechanistic studies on mitochondrial function and tissue oxygenation. HBOT is not an approved treatment for ME/CFS or chronic fatigue syndrome. Results vary between individuals. If you are managing a chronic fatigue diagnosis, please work with your healthcare provider about all available options.
The Clinical Evidence
WHAT THE STUDIES
HAVE FOUND
HAVE FOUND
ME/CFS-specific HBOT trials are emerging. The most relevant current data comes from Long COVID research — which shares the same core biology — and from foundational mechanistic studies. Here are three of the most cited findings.
232-Patient Registry · Scientific Reports 2025
65% ACHIEVED CLINICALLY SIGNIFICANT IMPROVEMENT INCLUDING FATIGUE SCORES
A large registry study published in Scientific Reports (2025) tracked 232 Long COVID patients treated with HBOT — a population that heavily overlaps with ME/CFS, with many participants meeting full diagnostic criteria for chronic fatigue syndrome. The study measured quality of life, fatigue, cognitive function, and overall symptom burden.
65% achieved clinically significant quality of life improvement, with fatigue scores among the most improved metrics. The study authors noted that the biological mechanisms driving improvement were consistent with what researchers have identified in ME/CFS — including mitochondrial recovery and reduced neuroinflammation — suggesting the findings may be directly applicable to ME/CFS patients.
Source: Garcia Estevez et al., Scientific Reports, 2025. DOI: 10.1038/s41598-025-85888-7
Randomized Controlled Trial · PLOS ONE 2022
SIGNIFICANT IMPROVEMENT IN FATIGUE, COGNITION, SLEEP, AND PAIN IN RCT
A randomized, double-blind, sham-controlled trial at the Tel Aviv University Sagol Center studied 73 Long COVID patients — many of whom presented with a clinical picture indistinguishable from ME/CFS — over a 40-session HBOT protocol. Primary and secondary endpoints included fatigue, cognitive performance, sleep quality, and pain.
Results showed significant improvements across all measured domains compared to the sham group. Brain SPECT imaging confirmed changes in cerebral blood flow in regions associated with fatigue and cognitive function — providing objective neurological evidence for the improvements patients reported. One-year follow-up data showed gains were maintained.
Source: Hadanny et al., PLOS ONE, 2022. DOI: 10.1371/journal.pone.0261405
Mechanistic Research · American Journal of Physiology 2006
800% STEM CELL INCREASE — THE SAFEST KNOWN MOBILIZATION METHOD
A foundational study at the University of Pennsylvania found that a course of HBOT treatments increased circulating CD34+ stem cells by 800%. The lead researcher, Dr. Stephen Thom, described this as the safest known method of stem cell mobilization — far safer than any pharmaceutical alternative.
In the context of chronic fatigue, stem cell mobilization is relevant because these cells play a role in tissue repair, immune regulation, and the restoration of damaged cellular systems. Researchers studying ME/CFS biology are investigating whether this mobilization effect may support recovery in patients whose cellular repair systems appear to be operating below capacity.
Source: Thom et al., American Journal of Physiology, 2006. DOI: 10.1152/ajpheart.00306.2006
The Broader Research Context
ME/CFS research has accelerated significantly in recent years, driven partly by the Long COVID crisis — which has created a large, well-documented patient population with overlapping biology and an urgent need for effective interventions. The NIH's RECOVER initiative and dedicated ME/CFS research programs at Stanford, Cornell, and Columbia are producing new mechanistic insights at a pace not seen before. HBOT is one of several interventions being investigated in this context.
At Land and Sea PT, we take chronic fatigue seriously — and we present this research without oversimplification. We offer HBOT as a wellness service and are glad to have a detailed, honest conversation about what the science shows and where the gaps still are. We are not a medical clinic and do not diagnose or treat ME/CFS. If you are managing a chronic fatigue diagnosis, please work closely with your healthcare team.
WANT TO KNOW IF HBOT IS RIGHT FOR YOU?
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OTHER CONDITIONS
PEOPLE ARE EXPLORING WITH HBOT
PEOPLE ARE EXPLORING WITH HBOT
HBOT is being studied across a wide range of conditions. Explore what the research shows for other areas at Land and Sea PT in Oceanside.
🔥 Inflammation & Recovery
🫚
Long COVID
Fatigue, brain fog, breathlessness
🛡
Autoimmune
Immune dysregulation, inflammation
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Chronic Fatigue
Low energy, brain fog, exhaustion
Current Page
🔥
Chronic Inflammation
Systemic inflammatory response
⚡
Chronic Pain
Persistent pain, neuropathy, fibromyalgia
🌡
Fibromyalgia
Widespread pain, fatigue, sensitivity
🦠
Lyme Disease
Chronic symptoms, fatigue, joint pain
🩹
Tissue Recovery
Wound healing, diabetic tissue health
🧬
Neuropathy
Nerve pain, tingling, numbness
🏥
Post-Surgical Recovery
Healing, swelling, tissue repair
🧠 Brain & Nervous System
Ready to Learn More?
LET'S HAVE A
CONVERSATION.
CONVERSATION.
If you're dealing with chronic fatigue that hasn't responded to conventional approaches, we're here to walk you through what HBOT is, what the research shows, and whether it might be worth adding to your recovery plan.
This page is educational only. HBOT is not an approved treatment for ME/CFS, chronic fatigue syndrome, or any other condition. Results vary between individuals. Please work with your healthcare provider for diagnosis and care. HBOT at Land and Sea PT is offered as a wellness service.
📍 821 S Tremont St, Oceanside, CA
Serving Carlsbad · Vista · San Marcos · North County San Diego
Serving Carlsbad · Vista · San Marcos · North County San Diego
References
- Garcia Estevez et al. "Hyperbaric oxygen therapy in long COVID: a prospective observational multicenter registry study." Scientific Reports, 2025. DOI: 10.1038/s41598-025-85888-7
- Thom et al. "Stem cell mobilization by hyperbaric oxygen." American Journal of Physiology, 2006. DOI: 10.1152/ajpheart.00306.2006
- Hadanny et al. "Hyperbaric oxygen therapy for cognitive and functional improvement in post-COVID-19 condition." PLOS ONE, 2022. DOI: 10.1371/journal.pone.0261405