Hyperbaric Oxygen Therapy for Brain Injuries with Dr. DeepSea - Dr. Joe Dituri | E32

What happens when a decorated Navy commander and world-record holder for living underwater becomes a traumatic brain injury patient himself? Dr. Joe Dituri's extraordinary journey from elite military diver to pioneering hyperbaric medicine researcher offers groundbreaking insights into brain injury recovery that challenge everything we thought we knew.

Having spent 100 days living at pressure beneath the ocean's surface for Project Neptune 100, Dr. Dituri was already studying the effects of hyperbaric conditions on human physiology. Then life delivered a devastating blow – a car accident that left him with a severe TBI, unable to read, write, or control his emotions. Faced with suicidal thoughts, he tried everything to heal his broken brain. The result? A revolutionary understanding that effective brain recovery requires simultaneous physical, physiological, and psychological intervention.

Now part of a team leading the world's largest hyperbaric oxygen therapy study for veterans with TBI, Dr. Dituri reveals fascinating discoveries about how different pressure levels trigger distinct healing mechanisms. Want to reduce inflammation? Lower pressures around 1.3-1.4 atmospheres work best. Need to inhibit toxin production? Higher pressures up to 3.0 atmospheres are required. This nuanced understanding explains why personalized protocols matter tremendously.

What makes Dr. Dituri's research particularly groundbreaking is its comprehensive approach. His team isn't just measuring one or two outcomes – they're collecting blood, urine, saliva, EEGs, and advanced brain imaging before and after treatment. And unlike most medical studies, they've ensured nearly half the participants are women, acknowledging the importance of including females in brain injury research.

Whether you're struggling with concussion symptoms, supporting someone with TBI, or simply fascinated by cutting-edge neuroscience, this episode offers rare insight from someone who's lived the journey from both sides – as researcher and patient. Subscribe now to hear how underwater pressure might hold the key to healing our most complex organ.

Dr. Dituri:

Email: info@ibum.org

Website: https://drdeepsea.com/

Instagram: @drdeepsea

LinkedIn: Dr. Dituri

Get 20% off your first order of Puori protein with code LIFEAFTERIMPACT by following this link.

Chapters

• 0:00 Hyperbaric Medicine Mechanisms
• 6:00 Dr. Joe's Military Career and TBI
• 12:44 Comprehensive Recovery Approach
• 20:41 Project Neptune 100 and HBOT Science
• 29:39 Pressure Levels and Their Effects
• 37:38 Safe Therapy Stacking with HBOT
• 43:30 Research Challenges and Future Directions

Transcript

Dr. Joe Dituri: 0:00

Right. So I'm trying to bring awareness to the fact that you can pressurize for a long period of time and what the mechanisms of action of hyperbaric medicine are. So we knew a whole bunch of them. So we knew like decreased inflammatory markers, decreased neuroinflammation, you know, increased activity, increased cognitive function, decreased phase lag, that kind of stuff. Those were all known mechanism of action that we knew were going to come out of this. But we wanted to kind of highlight them for the world so that on the world stage we could show them. Hey, look this does work.

Dr. Ayla Wolf: 0:36

Welcome to Life After Impact the concussion recovery podcast. I'm Dr Ayla Wolf and I will be hosting today's episode, where we help you navigate the often confusing, frustrating and overwhelming journey of concussion and brain injury recovery. This podcast is your go-to resource for actionable information, whether you're dealing with a recent concussion, struggling with post-concussion syndrome or just feeling stuck in your healing process. In each episode, we dive deep into the symptoms, testing, treatments and neurological insights that can help you move forward with clarity and confidence. We bring you leading experts in the world of brain health, functional neurology and rehabilitation to share their wisdom and strategies. So if you're feeling lost, hopeless or like no one understands what you're going through, know that you are not alone. This podcast can be your guide and partner in recovery, helping you build a better life after impact.

Dr. Ayla Wolf: 1:37

Today's guest on Life After Impact the Concussion Recovery Podcast is someone who quite literally pushes the boundaries of human potential underwater, in the lab and in the classroom. Dr Joe Dituri is a retired us navy commander with over 28 years of service in special operations, deep submergence and undersea systems engineering. He's a phd in biomedical, a decorated officer and a pioneer in hyperbaric medicine and life support technologies. He also holds a Guinness World Record as the man who lived underwater for 100 days during Project Neptune 100. This was a world record-breaking mission aimed at studying human physiology under prolonged hyperbaric conditions, raising ocean awareness and inspiring thousands of students to pursue science and engineering. With three decades of elite military diving experience, Dr. Dituri has helped develop rescue systems for submariners, designed dry submersibles for Navy SEALs and co-authored the Navy Diving Manual and the Art and Science of Hyperbaric Medicine, a go-to resource for clinicians in this emerging field. Currently, he serves as Assistant Vice President of Veterans Clinical Research at the University of South Florida, where he leads clinical trials focused on treating traumatic brain injury, teaches medical engineering and continues to advance the science of hyperbaric oxygen therapy From the depths of the ocean to the frontiers of neuroscience.

Dr. Ayla Wolf: 3:09

Dr Dituri brings a rare blend of operational grit, scientific rigor and humanitarian purpose, and we are honored to have him on the show today. Dr Joe Dituri, you are one of the most well-accomplished people. I know your background, your bio, your experience is incredible and the reason I wanted to have you on the show today is because, as an expert deep sea diver and somebody who holds a world record for spending 100 days in pressure under the sea for spending 100 days in pressure under the sea. You're the best person to talk to about the effects of oxygen on the brain, and so thank you so much for coming on the show sharing your expertise. You're currently leading the biggest hyperbaric oxygen therapy research study for veterans in the world right now. Welcome to the show.

Dr. Joe Dituri: 4:05

Thank you so much. I really appreciate it. Thank you for having me on and I'm excited.

Dr. Ayla Wolf: 4:10

Wonderful. Well, why don't we start out? Give me your background. You have spent so much time under the ocean doing some probably pretty cool top secret work All right real quick.

Dr. Joe Dituri: 4:22

So I spent 28 years in the United States Navy. I got to hang out with really cool people and do great things. When I finished that, my boss at the time, bill McRaven, asked me what I wanted to do I what I wanted to do when I grew up, basically. And I says, look, I don't want to come work for you, that's for sure. Want to come work for you, that's for sure. So he asked me a favor Would I sit on the preservation of the force and family? And I said, yeah, sure, I will. I did that for a little bit and I came back to him. I said, bill, we're talking to our veterans with TBI, but we're not doing anything. Psychology and psychiatry has a limit. And he looked me dead in the eye and goes permission, granted, aquanaut, fix the problem. And I went fuck, right now. I'm like, what am I going to do now?

Dr. Joe Dituri: 5:12

So I went back to school. I got a PhD in biomedical engineering and I said I'm going to fix brains because I'm smartical, right, no, right. Then I started fixing them this way and then, when I did, you know, the good Lord basically said Joe, take a right. And I said no, no, no, I got it, I'm fixing them with just this. And then he said, no, no, no, take a right. I told you to take a right. And then, finally, he threw a 6,000 pound SUV at my head and gave me a traumatic brain injury. And now I'm like best thing that ever happened to me.

Dr. Ayla Wolf: 5:48

That's amazing how life throws us curve balls and you know crazy that you were on the track to studying TBI one way. Then you get your own TBI and all of a sudden it's like oh, I need to go this direction now.

Dr. Joe Dituri: 5:59

Yeah, it's. It's one of these, like holy mackerel, the universe has got a plan, this has got a plan for you. There is a plan. I don't know what it is, but it unfolds before you. You can worry about it all day long or you can just ride this freaking wave yeah, so tell me about your recovery.

Dr. Ayla Wolf: 6:18

What are some of the things that you did to help recover?

Dr. Joe Dituri: 6:21

it. It was this easy and I'll go back and tell your listeners real quick that the quick story, you know. I came to the point where I was despondent, right, and I felt that, okay, now I am hopeless. Right here, I am a clinical researcher for traumatic brain injury and I have a traumatic brain injury. I can't read, I can't write, I can't think. I'm crying all the time when you say unburdened anger, like I want to rip the steering wheel off the car. All that happened to me. So I was like, okay, I can't do. The one thing that I'm here on this planet for is to help people and I can't do that anymore. I set a date for suicide. Can't do that anymore. I set a date for suicide. So here I am setting the date.

Dr. Joe Dituri: 7:09

It was on my birthday, december 8th, and September 7th is when the car hit me. So I went through this real deep lull and then I was like, okay, but before I do that, I'm Catholic and I'm three daughters. I says I have to, I have to do everything, because when I get to the pearly gates I have to be able to tell him look, man, I did freaking everything. And when I did everything. So you asked me what I did when I did everything in combination in a short period of time, holy mackerel. I started getting better and then better, and then more better and then more better. And then all of a sudden, I'm better than I was before I started and I said there's something to this and I'm steeped in science. Right, science wins over bullshit. So I'm like hold on, which thing works best, right, which? Okay, I have to get rid of all the confounding variables and do that one thing. No, that is the wrong way to approach science and we need to change scientists' mindset.

Dr. Joe Dituri: 8:07

It's not just one thing. If you ask somebody hey, this plant, what does it need? You know, water, sunlight, food. Well, we intuitively know it needs water, sunlight and food. So the human body, the human brain, needs to be fixed physically, physiologically and psychologically simultaneously. If you leave one of those out, you're going to miss the boat on fixing the person and you're not going to do them justice. Absolutely Everything. Red light therapy, b-romant therapy. I faced east and watched the sunrise and got the red light in my eyes. I grounded every morning. I hopped up and down on a peg, I did ice bath, I did saunas, I did when I say, everything if I didn't think it was going to hurt me and I applied a little bit of you know science to it, like hey, that's not going to work or there's nothing to that. You know that. And no drugs.

Dr. Ayla Wolf: 9:04

And so talk a little bit. So you didn't just spend 100 days underwater for funsies and to break world records. You actually did this to prove that it is safe to be under pressure in that sense. So talk a little bit about you know, when people think about diving, obviously they envision scuba divers and you're talking about something completely different. So describe the difference between the type of situation you're in versus what people might envision when they think diving.

Dr. Joe Dituri: 9:33

Sure. So when you go scuba diving you're under what we call hyperbaric pressure. Hyper means more than baric means pressure. So if you're in a hyperbaric pressure environment, you're at an elevated pressure.

Dr. Joe Dituri: 9:48

While I was underneath the water for 100 days, I did it for three basic reasons. The first was to do science, technology, engineering and mathematics to kids, to let them know that you can. You know, science is not just about white lab coats and beakers and microscopes and they're on board already right, it's more than that and you can do science in a cool environment. The second thing was I'm a biomedical engineer, so I wanted to do blood, urine, saliva, electrocardiograms, electroencephalograms, pulmonary function tests, all that science-y stuff. And the third thing that I wanted to do was talk to all of the people about reaching out to all the experts in the industry about saving our marine environment. So those are the three main things that we did. But the fourth thing, on a side tangential note, was I stayed underwater at the exact pressure hyperbaric medicine that we treat traumatic brain injury right now 1.7 PO2, 1.7 ATA, 1.7 PO2 if you're using 100% peroxide, right.

Dr. Joe Dituri: 10:52

So I'm trying to bring awareness to the fact that you can pressurize for a long period of time and what the mechanisms of action of hyperbaric medicine are. So we knew a whole bunch of them. So we knew like decreased inflammatory markers, decreased neuroinflammation, uh, you know, in increased activity, increased cognitive function, uh, decreased phase, like that kind of stuff. Those were all known mechanism of action that we knew were going to come out of this. But we wanted to kind of highlight them for the world so that the on the world stage we could show them hey look, this does work. And they're like oh, that newfangled thing called hyperbarics. I'm like, okay, hyperbarics has been around since the 1600s, almost 400 years, you know, 1664, I think it's not right it's not at all right.

Dr. Joe Dituri: 11:43

So, but it fell off because we weren't able to describe the mechanisms of action right. Every single drug that comes out has a mechanism of action a non-steroidal anti-inflammatory and NSAID. It decreases inflammation. That's its mechanism of action, right? Cardiac drugs, everything you know vasoconstriction, vasodilation, all that stuff is stuff that we're looking for as a mechanism of action for the drug. So this is where I go to med school and I'm teaching med school and I'm telling the kids look, you have to focus on the mechanism of action. If you want a powerful anti-inflammatory, you can either A do hyperbarics, or B do a non-steroidal anti-inflammatory, or C do like a medro-dose pack or something like that steroid type thing that can reduce inflammation. All three of those will do the same job. However, comma one is two or a pill and one is a lifestyle change. Do you want to change your patient's lifestyle? That's the difference.

Dr. Ayla Wolf: 13:56

Well, and there are side effects to taking non-steroidal anti-inflammatories and I mean I can't. I've had a number of patients develop diabetes as a result of being put on prednisone for long periods of time.

Dr. Joe Dituri: 14:10

And 15 pounds right on the waistline.

Dr. Ayla Wolf: 14:14

Yeah, that too, that too, yeah. So when it comes to chronic situations, it's like okay, maybe we need to look at this a little bit differently.

Dr. Joe Dituri: 14:24

That's exactly it. And to go back to the veteran side of the house, here we are busting these people up and you know, okay, so it's not even just veterans. So veterans get exposed to TBIs. But, as you know, okay, so it's not even just veterans. So veterans get exposed to TBIs. But, as you see, I was in a motor vehicle accident. I spent 28 years in the Navy, didn't have a knockout. You know, I got hurt but never got knocked out. I got knocked unconscious in my 47 Chevy right, holy mackerel, mbas can do it.

Dr. Joe Dituri: 14:51

Domestic abuse, third leading cause of traumatic brain injury. I was shocked at that. Shocked, right. So we have to start thinking that TBIs can come from a lot of different places, not just the military kit. But when you approach this, the blast and the radius and all that stuff, that seems like it's a compelling factor. But I don't want to leave anybody out of this discussion because there are millions of traumatic brain injuries. Incidentally, you probably already know this I don't know if your listeners do but traumatic brain injury has been on the books since 1600 BC. Mm-hmm, yeah, 1600 BC, 1600 BC.

Dr. Joe Dituri: 15:45

For millennia we have been differentiating this and kind of figuring you got hit in the head. You're bad off right. Only in about 1000 AD did we first make our determination the difference between concussion and traumatic brain injury. I think that was actually 1300, right? So FDA medicine, regular medicine, big pharma, you've had this problem for thousands of years. How you doing, how's it going? Oh, there is no end point. I'm running the largest clinical trial, I'm helping with the largest clinical trial in hyperbaric medicine history ever, ever done in the whole world. Right, and here this thing is doesn't have a satisfactory endpoint because the FDA has no satisfactory endpoint for cured traumatic brain injury after thousands of years. And I said well, I suggest maybe we're doing it wrong If you don't have an answer yet. We're doing it wrong.

Dr. Ayla Wolf: 16:41

Yeah Well, and you know, within medicine we have standardized protocols or standard of care for various disorders, diseases, events. We have a, you know, an emergency standard of care when somebody gets a concussion. But when somebody is a year out and they're still struggling, there's no standard of care, for what do you do with the person who didn't recover in the standard window? And so that's part of the problem as well. Now I'm curious. So your study has over 460 participants. It's a huge study 420, yeah, okay.

Dr. Ayla Wolf: 17:15

And what are your objective markers? What are you measuring before and after the HBOT sessions?

Dr. Joe Dituri: 17:21

So, interestingly enough, the same stuff or similar stuff to what I did while I was underwater blood, urine, saliva, electrocardiograms, electroencephalograms, pulmonary function tests, thesis sampling, diffuse tensor imaging, mris, like the whole gamut of everything. And like we cast a really wide net because there are zero approved biomarkers for long-term traumatic brain injury, zero approved biomarker changes None. So we're just testing everything, every kind of blood. We're doing interleukin testing, all these myokins like crazy amount of blood testing that you would never even suspect. And the diffuse tensor imaging is second to none and we're using all the great places to analyze this, Like our blood is going to Duke to be analyzed because they're blood experts. Our diffuse tensor imaging MRI because they're blood experts. Our diffuse tensor imaging MRI that's being shipped out to Australia because they have an AI component that is reading them and trending the imaging right. So we took all the greatest things in the world and I'm not the leader of that study by any wild stretch, I'm just one of the cats that's helping on it. So but we did get a grade A team together.

Dr. Ayla Wolf: 18:41

It really sounds like it and I will say I don't think I have ever seen a study with 420 people in it where they're doing DTI on every single person before and after the intervention. That's going to be astounding and I'm so excited to see the outcome of that information.

Dr. Joe Dituri: 18:56

You and me both right, but this is the thing Science takes a long time. I got three more years of data collection and then probably a year to write it up. Yeah, took a full more years. Everybody's like we need a cure now and I'm like, look, I get it. I get it because I wanted a cure instantly. And there is no instant cure, right, what do you have to do Everything? How long do you have to do it? For as long as it takes, right, just keep trying. Right, because I guarantee you, if you do nothing, nothing's going to happen, or the same thing is going to happen. But you have to be able to affect change in your body. You have to be able to try and change things.

Dr. Ayla Wolf: 19:37

Yeah, yeah. So a couple of questions I want to ask you. I have heard of people talking about pulsing the oxygen when somebody is in the HBOT, because when you're, when you're in a high pressure oxygen situation, some you know different physiological changes happen. Then when you come out of that high oxygen situation, your body has a reflexive response to the change in oxygen, and some people are saying that that reflexive response is also part of the healing that occurs, and so some people are now kind of pulsing the oxygen throughout an HBOT session. So talk to me a little bit about have you looked into that or you know, what are your thoughts on that?

Dr. Joe Dituri: 20:18

Yeah, that's preclinical research at this point, right, so we're doing a clinical trial, we are staying here at one pressure, right? But in preclinical research, we have found that when you decrease the oxygen concentration and then give the oxygen concentration back and then decrease it again and then give it back again, decreases again, what you do is you upregulate something called HIF-1-alpha or hypoxic inducing factor. They won the Nobel Prize in 2019 for this, so it's not like it's old, right, this is brand new stuff. Nobody's ever had it before, right? So when you upregulate HIF-1-alpha, you upregulate brain derivedderived neurotropic fact.

Dr. Joe Dituri: 20:59

And if you upregulate BDNF, that's similar to the lawn seed for the brain. And then, if I give you more oxygen, oxygen is like watering the lawn seed on the brain, right? So it's like you give it, you give it water. You give it, you give it water, right? So you know sunlight, water, food, right? You're trying to do this all together. But that's preclinical research. It's not there yet. I know that those things happen, but that doesn't mean this, right? Causation, not correlation. Correlation, not causation, you know.

Dr. Ayla Wolf: 21:31

Yeah, yeah. Still a lot of research that needs to be done. Okay, next question. Some people have soft shell HBOT machines in their office. Other people have hard shell. Talk to me about the difference in terms of the devices that currently exist clinically.

Dr. Joe Dituri: 21:47

Yeah, so most of the current research that has been done has been done at 2.0 or higher. So there's a small window range from 2.0 to 3.0. But remember, hyper means more than baric, means pressure. So we have found, and we have done research on this at the lower pressures and we have found that if you just go to 1.3 ATA, it's all about the pressure that you go to. What do you need?

Dr. Joe Dituri: 22:16

Different pressures affect different mechanisms of action. One mechanism of action for hyperbaric medicine is toxin inhibition. Toxin inhibition needs to be up here, needs to be up at the 2.8, 3.0 level. That's where we see the toxin inhibition working its best. Does it work down here? Sure it does. It works down here to lower pressure. It just works less right. Inflammation decrease in inflammation, like a decrease in interleukin-6, increase in interleukin-23, pro-inflammatory, anti-inflammatory cytokines. That works best at about 1.3, 1.4. That's the lower pressure. When you go higher, does it still decrease inflammation? Yes, just not as well. But the range is from about 1.0, that you're trying to treat Doctors. You need to know all these mechanisms of action and where they're best portrayed in the figure and match the person with that and then practice medicine while you're doing it, by evaluating your patient and looking for objective quality measure changes, just like we were talking about before we started.

Dr. Ayla Wolf: 23:45

Okay, so when you're talking about toxin inhibition, then you're immediately thinking what somebody that has say like Lyme disease, or somebody that has these infections that their body's trying to combat.

Dr. Joe Dituri: 23:53

Yeah. So toxin inhibition, like mold, is a toxin, right? So we use it for gaseous gangrene. Gaseous gangrene, you know, we want to inhibit those toxins. We want to get your body to stop allowing toxins to reproduce, right? Or to get the toxins out of your body in some way, shape or form. We realize, and we see through lots of objective testing and measurement, that if you get the oxygen concentration right here, right? So this is 35 millimeters of mercury. You know, when you put that stupid little light on your finger, that's about 35 millimeters of mercury, of oxygen. Well, we're at 760 millimeters of mercury pressure right now and you're only getting 35 in your finger. What we have found is that toxin production stops at 450 millimeters of mercury. Give or take Stops, it cannot reproduce. You know alpha toxins, you know gaseous gangrene, all of those C proteins, all of that kind of stuff stops reproducing at 450 millimeters of mercury. So if you get the oxygen to here, to 450 millimeters of mercury, you can stop oxygen production or you can stop toxin production, right. But that's a slippery slope because when you get up to 3.0, that's human tolerance. Humans cannot tolerate any higher than 3.0, right. So you really don't have much of a band to work with, right, you get to hear minimum effective dose, and that's the problem.

Dr. Joe Dituri: 25:30

Who funds hyperbaric oxygen research? Well, the drug companies do. Oh, there are no drug companies. Who are the drug companies when it comes to hyperbaric oxygen therapy? In my opinion, it is the hyperbaric chamber manufacturers. Right, Because they're kind of peddling the drug, if you will, whatever. But otherwise nobody's making money off this. There's no like oh, we're going to make a billion dollars off this. Trust me, anybody in the hyperbaric business is not making a million dollars, they're not making a billion dollars. Nobody's getting rich here. But it's basically compressing the oxygen that we have on the planet, naturally produced, by the way, uh, by trees, and you know plants and stuff. So you know, we compress that down and then we use a hall to hold that pressure in, and we've been doing this for, you know, 42 forevers, you know.

Dr. Ayla Wolf: 26:23

Yeah, yeah, okay. So different pressures have different mechanistic effects on the body and so, based on kind of what somebody is coming in for, that would determine what the best pressure is for that person. Or maybe they need multiple pressures If there's different things happening at different pressure.

Dr. Joe Dituri: 26:41

Yep, this is why the doctors need to take a class, right? Like? Doctors are smart people, I get it, but but you have to know the mechanism of action and where you want to put them on this number line, from, you know, 1.0 to 3.0. When you put them here, it does something different than when you put them here. Right, it's wonky, but that's the way it is.

Dr. Ayla Wolf: 27:02

Yeah, yeah, and so you teach this class. It sounds.

Dr. Joe Dituri: 27:05

Well, I teach that class at med school. But find an instructor from, like, the International Board of Undersea Medicine or something like that. Right, this is one of these like go find a good instructor near you and get them to teach you. It'll be good.

Dr. Ayla Wolf: 27:20

Yeah, excellent. And then my next question some people are combining we talked about, I mean, with research. You have to look at one thing HBOT by itself, same pressure whole time. But in clinical practice, in real world, we like to stack different therapies, and so I know some people when they're using HBOT, they're also encouraging the person to be doing cognitive exercises or different things to stimulate their brain while they're in the HBOT or immediately after. So what are your thoughts on, you know, and even maybe your personal experience on trying to like stack therapies with HBOT clinically?

Dr. Joe Dituri: 27:58

Stacking therapies is always a better concept, right, because the whole is better than the sum of its parts, right? I mean, you know it's not going to work. The onesies, twosies, are no longer going to work as effectively as multiple therapies. However, caution, warning, warning, warning, right? Please, don't stack things that don't go together in the hyperbaric chamber. I'll give you a perfect, for instance, red light therapy. Wonderful on its own. However, red light therapy requires, in my estimation, a varying wavelength, requiring at least 110 volts, if not 220, right, with a varying intensity and magnification and a heat generating source. And we already know that heat and power do not go well inside a hyperbaric chamber. So, please, please, please, please, please, don't stack those modalities, right? Like, don't? You know?

Dr. Joe Dituri: 28:57

I see people wanting to work out in a hyperbaric chamber. You can absolutely exercise in a hyperbaric chamber. Exercise lowers your oxygen toxicity threshold. It used to be 3.0 when you're laying there doing nothing, but if you're in there working out, do you think 2.0 is safe? We don't know, nobody knows, right? So here you are working out. Maybe 1.3 is safe enough. No, no, no, it's fine, right? I'm on my rowing machine, it's fine? Wait, wait, wait. Rowing machines have metal wheels on metal rails which create friction. Friction rubs together, friction creates heat, heat and oxygen account to be stopped, right. So, like, don't stack the modalities.

Dr. Joe Dituri: 29:41

Or if you're going to get somebody smart to make sure that whatever you're doing is correct, right, is it good to do breathing exercises while you're in a hyperbaric chamber? I do them all the time. Right, I do a quad, you know, four count, four count, four count. You know, four count, four count, four count. Uh, you know, we've done that in the military for years to reduce our parasympathetic relax, calm down a little bit, right? So that's the kind of thing that's great. Can you do eye exercises? Oh boy, yes, those are great, like those functioning visual things. Can you, um, you know, can you listen to meditation? Absolutely, if you have an approved device that's inside that's giving you sound. Yeah, sure, why not do a meditation? Right? Should I do a hallucinogenic inside a hyperbaric oxygen chamber? Oh, my God, I'm a little bit afraid, right, like? You know what I'm saying. So, uh, you know what I'm saying.

Dr. Ayla Wolf: 30:41

So you got it. I was thinking more along the lines of like eye exercises or cognitive exercises.

Dr. Joe Dituri: 30:47

You just opened a whole nother level of like no, I'm sorry but like you see all this craziness happening on the internet, I literally saw a video of a girl inside a hyperbaric chamber with her red light mask on and an oxygen mask over the red light mask, pushing the oxygen through the red light mask. Oh, please, don't do that. Oh, please stop, please, stop, right. So this is the kind of thing that we're dealing with, right? You know, people like I can't get away from my cell phone. I have to have my cell phone on me 24-7. It needs to be in the chamber.

Dr. Joe Dituri: 31:22

No, first of all, you, me, everybody we need a break from this damn cell phone. Mine sits over here on the charger over there. It doesn't sit in my pocket. I try and get away from it. I try, I'm addicted, just like everybody else, but we got to try and get away from that. So don't bring the cell phone in there. But, yeah, if you have a way to do eye exercises and breathing techniques and you can listen to a meditation, sure, that's great stacking of modalities at this point. But yeah, any of the craziness, yeah, let's not do that.

Dr. Ayla Wolf: 31:52

Yeah, yeah. No, I wasn't even thinking of the craziness, but honestly, you're right, people are doing crazy things. So it probably absolutely needs to be said Like these are the things that you cannot do when you're in the HBOT.

Dr. Joe Dituri: 32:27

So people are kind of not maybe stacking at the same time, but stacking right after they're doing this. So I've done ice bath before and ice bath after I've done sauna before. I've done sauna after. I can't see much of a measurable distance. I am freezing after I do my ice bath so it's really uncomfortable. So it's better for me after and the sauna is better before. But I don't know that kind of stuff. Yeah, I get it, you know, ewot training, stuff like that afterwards is always, you know, it's always beneficial. But yeah, that kind of stuff.

Dr. Joe Dituri: 32:59

We're actually getting to a point where I just ordered a new type of hyperbaric chamber. It's called a hypo, goes to altitude, like it goes to the top of Mount Everest and then pressurizes all the way down to 3.0. So it's a hypo hyperbaric chamber. It can do both. And what we're going to do is a study on increasing brain-derived neurotropic factor by going all the way up to altitude and giving you hypoxia and then coming back down and watering it on a severe jump up down. So we're going to see how that works. Crazy, it's fun, it's science, right. This is what keeps me awake at night.

Dr. Ayla Wolf: 33:40

Yeah, absolutely. The other thing that I think is one of the biggest barriers to HBOT is the amount of sessions people have to do. So talk about minimum, effective dose, ideal dose and how this is structured for people who may not be familiar.

Dr. Joe Dituri: 33:56

I'll give you a very sad answer and the truth right up front we don't know, right, minimum effective dose. We have no idea, right? I can tell you that if you want to decrease inflammatory markers, I have had really good results with 10 to 12 treatments reduces the interleukin-6 enough in 10 to 12 treatments. However, if you're treating traumatic brain injury, it seems to be more like 25 to 40. Nobody really knows and that's because there is no drug company funding these studies.

Dr. Joe Dituri: 34:28

The study that I'm doing right now at the University of South Florida right, usf is doing this study because the governor of the state of Florida and the speaker of the house said listen, we want to help our veterans and we want to figure out the science behind hyperbaric medicine, so we're going to fund this. So he funded us. That's the only funding that people get in hyperbaric medicine. There is no like $20 million to go do this study, or $50 million or $100 million to go do a phase two clinical trial. There's none of that kind of money rolling around. So unfortunately we don't have those answers of minimum effective dose just yet. But there's people that are funding it out of their own pocket, right? So the International Bank of Joe is looking to do some more research.

Dr. Ayla Wolf: 35:15

Excellent, excellent. And how many women are in your study? Half.

Dr. Joe Dituri: 35:21

No, and this is the thing, and female veterans are hard to come by. But I'm like girls, get in here, get in here. I'm done having this like it's only guys. So about half it's a 40 something percent right now, but about half of the people are coming in are female, which is great, right, because we are like we were talking about earlier. We are woefully inadequate in doing research on females because, man, you're so different.

Dr. Ayla Wolf: 35:51

Well, and I think one of the problems, too, is that even when females are included in the study, that doesn't necessarily mean that, when all the data is being sifted through and all the statistics are being run, that people are even asking the question like okay, we now have 420 before and after DTIs. Is there a difference in the female brains versus the male brains? That's the question that I would want to know. But do you know? Is that one of the aims of your study?

Dr. Joe Dituri: 36:17

Absolutely it's one of the sub aims, right, Cause you have to have a primary and a secondary and then you have to have subs. So yeah, it's one of the sub aims. But yes, absolutely the the stratification of female to male and how their blood biomarkers differ, how their theses differ, how the urine differs, everything right, Like how their EEG scores differ, Cause y'all, y'all brains work totally differently than ours do. I mean, that's just the way that it is, and if a guy you don't believe that, trust me, that's the way it is. I do a lot of EEGs on people, and women are just wired differently.

Dr. Ayla Wolf: 36:51

Absolutely. Yeah, well, that makes me so happy that that is actually part of your study. I mean, this is going to be so exciting when all this data comes out and, like you said, it's probably going to take you a year to sift through it all.

Dr. Joe Dituri: 37:04

Three and a half more years or so we'll have something.

Dr. Ayla Wolf: 37:06

Yeah, incredible, Amazing. So right now you're also writing a book on your personal journey. So talk a little bit about the book you're writing.

Dr. Joe Dituri: 37:16

So it's why my Traumatic Brain Injury is the Best best Thing that Ever Happened to Me. Is the working title Right? And I'll give you just a real quick. For instance, I was engaged to a beautiful, you know, 40 year old Bulgarian fitness model. Like she was just fabulous. But when I got hit by the car she couldn't find her way to the hospital. But two of the seven days that I was in the hospital I was like this is not cool, right. So that's just one of the things that happened to me where it was like okay, that made me realize that that support system wasn't there, that person wasn't the right person for me. And after a couple of months we were like okay, we're done, right. And the changes that I had.

Dr. Joe Dituri: 37:58

Also here, I am a person from the military 28 years of active duty service and then I didn't really have a lot of empathy. Now, being a traumatic brain injury survivor, I have more empathy. So when that kid was in my chamber with a traumatic brain injury and reached up and ripped the speakers off the wall because he had to go to the bathroom so badly, he's like I have to shit, I have to shit. And that was literally the tone that he took and he ripped the speakers off the wall. I was totally empathetic to him and his mom when his mom was pulling him out and trying to clean him up and then get him to the bathroom.

Dr. Joe Dituri: 38:39

And then she looks at me and goes, what's that going to cost me to repair? And I said, come here you. I said, mom, you're doing a great job. I didn't have that empathy before. God gave that empathy to me through my traumatic brain injury right. So I needed this to be able to help people. This is I mean that among you know a hopeful cure for traumatic brain injury and many, many, many other modalities and just giving people hope when it comes to fixing traumatic brain injury. It's going to be great. Like I said, that's the working title. We'll see how it goes.

Dr. Ayla Wolf: 39:13

Yeah Well, I can't wait to read it and I'm so excited that you, you know, you share your story with everybody, because people do need to hear, and I think especially from doctors, from people that are in positions of power, to also say and I have empathy and I have lived through this and I'm now devoting my entire life to researching it to help you. I mean, that is so powerful.

Dr. Joe Dituri: 39:36

Yeah, and this is where I kind of talk about you finding your purpose in life. You know now that I have a purpose, you know I, I did the military thing, I did the teaching, I did this. I did that. Now it's like I want to help. Right now I just want to give back, I want, and that's my, that's my currency. So when you have that kind of currency, you get to do the things that you want to do and everything else falls away. It's like all those little things fall away. How are we going to get the money? We'll figure it out. I don't know. We'll figure it out.

Dr. Ayla Wolf: 40:06

We'll keep trying. Yeah, amazing, well, and you got the money. Yeah.

Dr. Joe Dituri: 40:12

They ain't paying me that money. I'm just a researcher and a college professor.

Dr. Ayla Wolf: 40:23

So you know I don't have a pot to pee in. Yeah, the money's going to the AI lab in Australia. It sounds like Wow, wow. Well, you know, one time I had somebody on my podcast and I said you know, if there was future research you would want to see. I go, what type of research would you want? He goes. Honestly, it's the kitchen sink studies that I think are the most fabulous, the ones where you can just like throw all these different things at people and then see, did they get better? And sadly, those kitchen sink studies aren't really what we consider the gold standard, which is why we're left with having to do one thing by itself, in isolation at a time, first to say here's how this thing works and then go from there. But whose model is that?

Dr. Joe Dituri: 41:04

That's the drug company model.

Dr. Ayla Wolf: 41:06

Yeah.

Dr. Joe Dituri: 41:07

Yeah, that's the drug company model, because they want to just see the red pill, the blue pill, the red pill, the blue pill and that's it. And they have the ability to do that. All things remain the same. I just give you a pill. That's not real life. That is not real life.

Dr. Joe Dituri: 41:24

Now, you and I were talking before we even started. Is it beneficial for you to go to the gym to spell gym with a G right? Is it beneficial for you to drink a lot of water? Is it beneficial for you to have breath work and believe in some kind of faith in some way, shape or form, that this is all going to work out? All those things we know are beneficial? Now, is there a double-blind, randomized, placebo-controlled study that proves that? No, but I'll give you a little piece of information. There is no double-blind, randomized, placebo-controlled study that cigarettes cause cancer. It's not ethical to do that kind of a study. So there is no proof. So that bar of randomized, controlled clinical trials, it's a drug company thing. It really is.

Dr. Joe Dituri: 42:17

There are things that are ethical and unethical to do. So when you give somebody advice like hey, have a better diet than fricking Cheetos, hey, drink a lot of water. And it has to be the right kind of water that's going to nourish you and get out in the sun a little bit and catch that early morning red light. Good, none of that's bad and that's the Hippocratic oath right do no harm. So that's where I push people. I'm like, look, come on, this is not going to do you any harm and it might just help. So, yeah, try that too yeah, yeah, absolutely.

Dr. Ayla Wolf: 42:52

I mean, I've been in practice for 20 years and I still say on a regular basis are you drinking enough water, like I mean. I mean it's like for 20 years I still have to come back to are you drinking enough water here?

Dr. Joe Dituri: 43:06

A hundred percent. See, people think that I drink coffee all day long. This is a cup of refillable water that I take my water bottle and I refill the water up and I drink water all day long. Absolutely, you need it.

Dr. Ayla Wolf: 43:20

Yeah, yeah, absolutely Well. Thank you so much for coming on the show and I, like I said, I'm excited about your book. I'm excited about the outcomes of all this research. Thank you for all the hard work you're doing for this community. Thank you for including women in your study.

Dr. Joe Dituri: 43:37

No, it's important, it really is, you know? Yeah, no, it's important, it really is. Look, they're over half the people on the planet. For Christ's sake, can we figure these people out, please?

Dr. Ayla Wolf: 43:52

Plus, I got a personal desire to figure them out too, because I still am not good at it. Well, I don't know if you're ever going to figure us out, but you can try, yeah.

Dr. Joe Dituri: 43:59

That's the plan. That's the plan. So, yeah, no, really exciting work and thank you. Thank you for having me, thank you for the listeners. If you want to get in touch with me or look at, follow what we're doing, it's Dr Deepsea. Look up Dr Deepsea, google it. That's usually the handle on most of the things, but you know.

Dr. Ayla Wolf: 44:16

Excellent. I will share all that in the show notes and then, when your book comes out, maybe we'll have you back on the show. That'd be fun, you can I would love that.

Dr. Joe Dituri: 44:24

I would love that, yes, please, thank you, thank you. I appreciate you having me on it's. It's great, and I love the the compatibility of what you're doing too. Look, we got to do this differently.

Dr. Ayla Wolf: 44:48

The drug company model is not working. Let's figure out a different way to help people. Yeah, yep, absolutely, absolutely Well, thank you for your service.

Dr. Ayla Wolf: 44:51

Thank you for everything you're doing and we'll definitely have you back on Hoorah Thanks. Medical disclaimer. This video or podcast is for general informational purposes only and does not constitute the practice of medicine or other professional healthcare services, including the giving of medical advice. No doctor patient relationship is formed. The use of this information and materials included is at the user's own risk. The content of this video or podcast is not intended to be a substitute for medical advice, diagnosis or treatment, and consumers of this information should seek the advice of a medical professional for any and all health-related issues. A link to our full medical disclaimer is available in the notes.