Complementary and alternative medicine Friday Woo Medicine Quackery Skepticism/critical thinking

Your Friday Dose of Woo: If our intestines were lungs we could drink our oxygen!

With all the vaccination “skeptics” who’ve crawled out of the woodwork over the last couple of days in response to my two posts about Dawn Winkler, the Libertarian candidate for the Governor of Colorado who happens to be a rabid antivaccination activist, not to mention totally clueless and nasty about autistic children (and who even showed up to play the faux amusement bit on my blog), I briefly contemplated antivaccination woo as this week’s topic. It would have fit well thematically and flowed naturally from previous posts and dicussion on the matter. After all, there is an incredible amount of woo in the antivaccination movement, including non-evidence-based claims that vaccines cause autism, sudden infant death syndrome, and a variety of other diseases, coupled with the claims that vaccines do not really prevent the diseases they are designed to prevent. Couple with that the addtional woo ranting about “fetal parts” in vaccines and a number of other woo-filled hysterical claims, it would on the surface seem like a ripe target for YFDoW.

There’s just one problem.

Yes, the problem is that YFDoW is supposed to be light-hearted, and I find it very hard to be light-hearted about antivaxers. The reason was stated well by Peter Bowditch, as I alluded to earlier: Antivaxers, through ideology, ignorance, and distortion of the facts, “actively advocate that children should be denied protection against life-threatening and disabling diseases, and the inevitable result of such advocacy, should it be even partially successful, is the death or permanent harm of many children.”

I just can’t seem to stay light-hearted about that.

Fortunately, there is another bit of woo that I’ve been meaning to write about, particularly since there’s a fairly recent study that provides rather compelling evidence that it is indeed woo. (Of course, a simple understanding of basic human physiology would just as convincingly show that it is woo, but it’s nice to have a study.) I’m talking about “oxygenated” water and drinks.

Yes, if you believe the guys selling this stuff, you can get an extra shot of oxygen, leading to an extra “boost” of energy, by drinking water or other sports drinks that are “charged” with extra oxygen. Just look at some of the hype:

Why add oxygen to water?

Because it’s a great idea! Two of the essential nutrients for life are water and oxygen. Water (H20) regulates body temperature, carries nutrients and oxygen to the cells, and flushes toxins and impurities from the body. Oxygen (O2) combines with foods such as starches, sugars and fatty acids to release their stored energy. H20 and O2 – essentials for life!

Hmmm. I never realized that oxygen was a “nutrient.” I always thought it was needed to produce energy through oxidative phosphorylation, but by itself it’s not a nutrient. Generally, nutrients are either substances that provide energy or that support metabolism. Usually they are ingested in the diet. I’ve never heard of a “nutrient” that is, under normal conditions, breathed in. It’s also questionable whether water could be considered a nutrient. True, it’s essential for growth, but that’s because all life exists in an aqueous milieu, with all of the components of our metabolism dissolved or suspended in a salt-water solution.

But, my quibble with the terms above aside, consider the incredible benefits! How do I know? The sellers tell me so:

With our exclusive O2Canada diffusion technology we have developed a new, scientifically formulated sports drink. We are able to increase the oxygen content of our Premium Bottled Water by 700% – the maximum amount of oxygen possible! That’s seven times more oxygen! The result is O2Canada Super Oxygenated Spring Water – the incredibly clean taste and smooth finish of our Premium O’Canada Bottled Water, with the power of added oxygen!

Wow! It increases the oxygen content of the water by 700%! That sounds pretty amazing, doesn’t it? As I’ll explain in a moment, it’s not, really. One thing that I couldn’t help but notice was that this particular company didn’t make any specific claims for its water other than that it’s “super-oxygenated.” It didn’t claim that it would give you more energy, or anything else. That’s very clever, as you’ll see, because there’s absolutely no evidence to support such claims. Unfortunately, other companies aren’t so wise:

XYRICH is clear, smooth, pure water with a refreshing boost of extra Oxygen.

It is the perfect way to replenish the body’s supply of much-needed water and oxygen – perfect for anyone who wants to be truly refreshed!

Oxygen stimulates the growth and efficiency of friendly bacteria the body needs for good health.

Drinking OXYRICH water will help the body release bugs and toxins that can rob the body of oxygen from the blood, thus helping to restore normal oxygen levels in the blood. This helps to reduce fatigue and shortness of breath, Improve mental clarity, Bolster suppressed immune systems.

The oxygen O2 (diatomic) in Oxyrich has been developed by a natural process that doesn’t use chemicals or their salts, meaning the oxygen is not bound up as Sodium Chlorite (NaClO2).

Well, looky here! Not only does this “oxygenated” water “detoxify” your system, but it reduces fatigue and improves mental clarity too! No doubt it’s because of the detoxification. (Remember how much alties love to do all sorts of bizarre things to remove “toxins,” whether those toxins are actually there or not. (In fact, it’s better for their purposes if they aren’t actually there.) But, above all, it does what nearly all altie products purport to do: It “boosts the immune system.” It sure sounds impressive, doesn’t it? Of course, they never actually explain what “boosting the immune system” means or how oxygenated water accomplish this. Does it activate T cells? Which subset? What about B cells? Or how about natural killer cells? Inquiring minds want to know!

Of course, one thing I always ask people who claim that oxygenated water gives them a “boost” of oxygen is whether or not they have gills. Fish can extract oxygen from water through their gills; it’s how they live. We humans do not have that capability. (Whether that’s fortunate or unfortunate, I’ll leave that to the reader to decide.) In any case, one of the best dismissals of oxygenated water woo is this statement: “Unless you have gills, oxygenated water is just an expensive burp.”

Indeed, depending upon which end it makes its way out of.

The next reason why oxygenated water is totally worthless for increasing your blood’s “oxygen content,” is that your digestive system is not designed to absorb oxygen. Do you breathe using your stomach? Do you breath using your colon? No! You breathe using your lungs, because extracting the oxygen from air (which is 21% oxygen) is what their function is. The function of your digestive system is to extract nutrients and water from your food and expel whatever is left over (which, as any good altie knows, is the source of all sorts of vile toxins that make you sick and that you must expel by “cleansing” your colon). You can’t expect an organ to perform a function that it normally does not do, particularly when it is so different from its normal function.

Unless you’re an altie, I guess.

Here’s the last reason that oxygenated water is utterly useless. Take a look at this equation:


where CaO2 = the Content of Oxygen in Arterial Blood; Hb = Hemoglobin (14 g/dl in a normal individual); SaO2 = Arterial Saturation (98% at sea level in a normal individual); PaO2 = Arterial pO2 (roughly 100 mmHg at sea level).

Now, let’s plug those numbers in:

CaO2 = (1.3 x 14 x 0.98) + (0.003 x 100)

CaO2 = 18.1 ml/dl (ml/dl = vol %; 18.1 vol %)

What this means is that, at 100% Saturation, 1 g of Hb binds 1.3 ml of Oxygen, while only 0.003 ml/mmHg of Oxygen is Dissolved in Plasma. In this case, in one deciliter of plasma, there would be (14 g/dl x 1.3 ml/g = 18.2 ml/dl or vol% O2 bound to hemoglobin, but only 0.3 vol % O2 dissolved in the plasma. In other words, very little of the oxygen delivered to your tissues by your blood is dissolved in the plasma, only about 1.6% of the amount your blood carries. (We normally round it to around 2%.) That’s because hemoglobin carries the vast majority of the oxygen your body needs, and very little, relatively speaking, is dissolved in the plasma. And, because at sea level, most people’s oxygen saturation is between 96-100%, there is no room to increase it by much at all. At most, in 100% oxygen, with a partial pressure of around 760 torr (I’m guessing that they “seven times the oxygen” claim comes from using 100% oxygen to oxygenate the water and somehow keeping it from diffusing out), we could increase this amount to 2.1 vol%, or 10% of the oxygen carried, but you could only do that by forcing someone to breath 100% oxygen on a ventilator. You’re certainly not going to achieve this by drinking some “superoxygenated water.” However, if you really want me to, I could intubate you, hook you up to a ventilator, and I might be able to get the level of dissolved oxygen in your blood up to this level. You wouldn’t like it very much, though. I guarantee it. And, for those who would say that this stuff is useful for people at high altitudes, all I would say is that, even at high altitudes, O2 saturation of hemoglobin in most people does not fall below the 90-95% range.

As Harriet Hall put it in the Skeptical Inquirer:

OXYGEN IS GOOD, so we should put it in our soft drinks and breathe it at oxygen bars. Take an oxygen tank home with you–you might feel better. The oxygen vendor might feel better, too. Dr. Andrew Well, the renowned health guru, tells patients with chronic fatigue to ask their doctors to prescribe oxygen for a home trial. Sure, why not? The money it costs will literally vanish “into thin air,” but who cares? OXYGEN IS GOOD.

Ignore the fact that you could find out whether you need oxygen by testing your blood oxygen saturation with that little-clip-thingy-they-stick-on-your-finger-in-the-ER (aka pulse oximeter). Who cares if your blood is fully saturated with oxygen already? OXYGEN IS GOOD. If your oxygen saturation is a little less than 100 percent, there is no evidence that raising it will help with anything. If it is a lot less, and you do need oxygen, any competent doctor should be able to figure that out. But try an oxygen tank anyway: OXYGEN IS GOOD. Is this starting to sound like a mantra? It should. This is religious belief I am talking about, not science.

It’s even more of a religious belief that a healthy person with normally functioning lungs can appreciably raise his or her oxygen delivery to where it really matters–to the tissues–by drinking oxygenated sports drinks! Heck, even a person with lung disease won’t be able to raise his or her oxygen delivery, mainly because the stomach and intestines absorb food, not oxygen. Scientists have even investigated whether oxygenated drinks improve blood oxygenation and atheletic performance. I read the study a few months ago and have been meaning to write about it, but, given that this is YFDoW, I don’t really see the need to describe it in detail other than that they found absolutely no benefit from oxygenated water over tap water. None. Not only that, but they don’t even contain that much more oxygen than tap water:

Researchers found that drinking super oxygenated water had no measurable effect on the subjects’ resting heart rate, blood pressure or blood lactate values. Similarly, there was no effect on heart rate, blood pressure or blood lactate values during either the sub-maximal or maximal exercise tests.

A second maximal test was conducted immediately following the first test to investigate the effects of super oxygenated water on exercise recovery. If additional oxygen had, in fact, been absorbed in the blood stream and delivered to the tissues, there should have been measurable reductions in sub-maximal exercise heart rates and blood lactate values, and increases in maximal oxygen consumption during the second test. Apparently, the blood oxygenation levels were either not elevated at all or not elevated sufficiently to affect oxygen delivery to the tissues or tissue metabolism.

Researchers also conducted a dissolved oxygen analysis on three bottles of Aqua Rush and three bottles of SerVenRich. Results revealed that both types of super oxygenated water contained less than three times the amount of oxygen found in normal tap water.


In addition, Porcari notes that the super oxygenated water must first be ingested and absorbed in the gut. Even if the oxygen is absorbed, he explained, it would have to be absorbed into venous blood. As soon as it passes through the lungs for the first time, the blood would either release the oxygen at the alveolar membrane or, more likely, not pick up as much additional oxygen.

Surprise, surprise! Personally, I’m waiting for some altie to make the claim that, because the venous circulation from the gut goes to the liver first, that the extra oxygen “absorbed” is beneficial to the liver and that’s why you don’t observe any increases in blood oxygen. If it hasn’t been made already, that claim is coming. In any case, I also like the way the utter ludicrousness of oxygenated water woo is described here:

All water that has been exposed to the air is “oxygenated” to a small extent– about 8 milligrams of O2 per liter of water at room temperature– and this can be increased by pressurizing the water with oxygen gas; each additional atmosphere of oxygen pressure pumps an additional 40 mg into each liter. But what happens when you open the bottle? That’s right, the extra oxygen goes right back out– but not immediately, so by drinking oxygenated water, you can still take in a bit more oxygen. But can any oxygen molecules that don’t get burped back out actually find their way into your bloodstream through absorption in the stomach or intestine? I don’t pretend to know, but I very much doubt it; the lungs are exquisitely adapted to this function, while your digestive system is specialized for absorbing other nutrients. Suppose, instead, that you simply breathe in an extra liter of air (much easier to do than drinking a liter of water!) It’s an easy chemistry students’ calculation to show that you will be inhaling about 146 mg of oxygen in this way. Not all of it will enter your bloodstream, but you can always take an extra breath; it’s free!

Which is, of course, why purveyors of “superoxygenated water” don’t recommend it in preference to their drinks.

Here’s another question. Given all the altie fascination and dread of “free radicals,” one would wonder why anyone without lung or heart disease that might decrease the amount of oxygen in their blood (or people with sickle cell disease, who need to maintain a high oxygen tension to keep their red blood cells from sickling and causing them intense pain and other nasty complications) would even want to pump up his or her oxygen so much. After all, what contributes the most to forming oxygen free radicals?

A high partial pressure of oxygen, of course.

Logical consistency has never been a strong point in woo, has it?

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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