EBO2 (EBOO) vs 10-Pass Ozone: A Side-by-Side From the Primary Sources

EBO2 (also called EBOO) and 10-pass ozone are the two methods US clinics market as the highest-dose ways of ozonating blood. In 10-pass, 200 mL of blood is drawn into a vacuum flask, mixed with ozone gas under pressure and returned, ten times in about an hour [1]. In EBOO, blood is pumped continuously from one arm, through a gas exchanger or dialysis filter where it meets the gas, and back into the other arm, for about an hour [2][3]. Ozone therapy is not FDA-approved for any condition [4].

This page sets the two side by side from the papers that describe them, then takes apart the dose comparison that several clinic pages quote, which says EBOO delivers “three or more times” the ozone of 10-pass [2]. The short version: the two move similar amounts of blood, the dose comparison mixes calculated and theoretical figures, and no study has compared what either does for patients.

The two procedures side by side

Figures are as each source states them; where we combined them, we say so.

Two things stand out. First, the blood volumes are close. Ten passes of 200 mL come to 2 liters, and the California EBOO pump speeds move 1.8 to 2.4 liters in an hour; only the Siena description, at about 80 mL a minute, reaches 4.8 liters [1][2][5]. Second, the ozone concentrations run the other way from what volume pitches imply: 10-pass uses the highest concentration of the three, and the Siena version of EBOO the lowest.

Each liter of blood also meets ozone differently. In 10-pass, a batch of blood is mixed with an equal volume of gas in a bottle and shaken [1]. In EBOO, flowing blood takes up ozone across a membrane, and the California group found that how much it took up rose with pump speed, by up to 30 percent at 40 mL a minute compared with 30 [2]. Why US EBOO uses a dialysis filter, and how that compares with hemodialysis, is in EBO2 vs dialysis; the heparin in both methods is covered in blood thinners and other medicines.

The dose comparison: what was measured and what was assumed

The “three or more times” figure comes from the title and conclusion of the 2023 California paper [2]. The paper is careful about its own method, but the comparison it draws mixes figures of different kinds.

The paper’s own wording marks the difference: for the other methods it gives the “maximum theoretical delivery of ozone”, and for 10-pass “a total of up to 140,000 μg” [2]. The 10-pass paper uses the same arithmetic and says each pass “delivers 14,000 μg” [1]; neither paper measured how much ozone 10-pass blood actually took up.

So the EBOO figure counts only the ozone that did not come back out in the exhaust, while the 10-pass figure counts all the ozone put into the flask. The two numbers answer different questions, and the ratio between them is not a measured difference. The California authors also note limits of their own: they did not check whether unabsorbed ozone was destroyed after leaving the chamber, they do not know whether other dialysis chambers lose ozone the same way, and they did not study clinical benefits or risks [2]. Whether more ozone is better is a separate question the paper does not address, and its authors note that “little is reported on the efficacy of higher doses of ozone vs. lower dose” [2].

The one 10-pass study

The only peer-reviewed study of 10-pass in our library is König and Lahodny’s 2022 pilot [1]. Its parameters, as the full text gives them:

• Patients. Six consecutive patients aged 55 to 74 who came to Dr. Lahodny’s private practice in St. Pölten, Austria, for preventive treatment; four had no current disease, and none took medication.
• Treatment. Two sessions of ten passes within one week, on a Hyper Medozon comfort device. Each pass drew 200 mL of blood into a vacuum flask holding 7,500 units of heparin, added 200 mL of gas at 70 µg/mL under pressure, and returned the blood using positive pressure of 0.9 atmosphere. Ten passes took about an hour. The paper does not say whether the heparin is added once or with every pass.
• What was measured. A bioenergetic health index, a laboratory measure of energy use in white blood cells, before treatment, after the first session and after the second.
• What it found. The index rose by the second session, driven by maximum respiration and reserve capacity. Against the starting value, the change was statistically significant after the second session (p = 0.045) but not after the first (p = 0.198).
• Limits. Six patients, no comparison group, one week of follow-up, and a laboratory marker rather than any symptom or illness. The authors write that more patients should be included in further studies.
• Interests. Lahodny “has pioneered the 10-pass OHT method” and uses it at his private clinic; the paper says he does not hold a patent on it.

The paper also dates the method’s use at that practice to 2015 [1]. The California paper reports a survey of 10-pass therapists, presented at a professional meeting, that found no significant toxicity in more than 4,000 treatments apart from rust-colored urine in a small minority of patients; we have not read that survey [2].

The EBOO studies, briefly

EBOO has more papers, but not better ones for this question. As of October 2, 2026, our library lists six studies of EBOO as given to people, the California paper among them, shown with their procedures in the table under “From our data”. The only randomized trial compared EBOO with intravenous prostacyclin in 28 patients with peripheral artery disease and found greater regression of skin lesions with EBOO, with no change in leg circulation in either group [6]. The California paper measured gas and reports no outcomes [2]. Its authors write that patients who had received both methods showed a “near universal preference” for EBOO, an observation, not a measured result [2]. For the batch method that both grew from, a controlled crossover study in 12 hemodialysis patients found that nine sessions of ozonated autohemotherapy, 250 mL of blood at 50 µg/mL, did not change two inflammation markers compared with nine oxygen-only sessions [9]. More on all of these is in does EBO2 work? and what EBO2 is.

What clinic pages say about the two

As of October 4, 2026, we could read the EBO2 pages of 174 of the 177 clinics in our directory. Of those 174:

• Thirty-six mention 10-pass ozone.
• Eleven repeat the three-times comparison or the figures behind it. None says that the 10-pass and MAH figures are theoretical maximums.
• Five carry nearly the same sentence, saying traditional or 10-pass ozone “treats only a small portion” of the blood while EBO2 “treats the majority”, at 4 to 6 or 5 to 7 liters.

A few pages come closer to the papers. One sets out 10-pass as 200 mL “drawn, ozonated, and returned 10 times” and puts its blood volume at 1.5 to 2 liters [10]. Another clinic that offers EBOO says ozone dosing is “measured as mcg/ml, not volume of blood treated or filtered” [11].

Prices for the two are not comparable from our data, which records EBO2 prices only; see the price report and the cost guide.

What a fair comparison would need

We found none of these in the published record:

1. The same measurement for both: ozone taken up by blood, measured the same way in 10-pass and in EBOO, instead of a calculation for one and a maximum for the other.
2. A head-to-head trial in people with a defined condition, with a comparison group that gets neither, and outcomes that matter to patients.
3. Safety recorded the same way for both, with adverse events counted by people other than the practitioners.
4. Both versions of EBOO, the Siena gas exchanger and the US dialysis filter, since their settings differ many times over.

What we could not verify

• The survey of 10-pass therapists that the California paper cites. It was presented at a meeting, and we have not found it published.
• When 10-pass began. The 2022 paper dates its use at the pioneer’s practice to 2015; other accounts of the method’s origin are not peer-reviewed.
• Whether the heparin in the 10-pass flask is given once or with each pass.
• How much ozone 10-pass blood actually takes up. No paper we found measured it.
• Whether the dialysis chambers used in US EBOO behave like the one in the California paper.
• Anything about 10-pass prices or session counts from our data, which covers EBO2 only.

How this guide was made

This guide draws on 11 sources: the 2022 10-pass paper and the 2023 California paper read in full on PubMed Central, Siena papers read as abstracts and one in full, a federal regulation, and clinic pages saved by our research pass. Where we combined published figures, such as liters of blood per session, we say “our arithmetic”. The clinic counts come from our dataset of 177 clinics, read between September 28, 2026 and October 4, 2026, and were counted from the saved pages. Drafting used AI tools. A human editor has not yet checked this guide claim by claim against its sources, and no clinical reviewer has signed off yet.