Who Should Not Get EBO2 (EBOO)? Contraindications Compared Across Sources
What an ozone physiologist, an Italian consensus, a trial's exclusions, and eleven EBO2 clinics list as reasons not to treat, compared condition by condition.
Questions to ask your own doctor before you consider EBO2
Check anything that applies to you, then build a list of questions to take to your appointment. Each part says why it comes up and which of our guides it comes from.
This tool only asks. It does not score, rank, or warn, and it does not say whether you can or should have EBO2. That is a conversation for you and your own doctor.
Compiled from our guides and the sources they cite. A human editor has not yet checked it against those sources, and it is not yet clinically reviewed. See our medical review process.
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Your questions
From the EBO2.com list of questions for your doctor, ebo2.com/tools/doctor-questions/.
These are questions to ask, built from EBO2.com guides. They are not medical advice, and they do not say whether EBO2 is right for you.
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Every situation and its questions
The full list the builder draws from: the questions for anyone considering EBO2, then 21 situations in 6 groups, each with why it comes up, the questions to ask, the guide it comes from, and that guide's sources. A part in brackets is for you to fill in.
For anyone considering EBO2
- I am considering EBO2, also called EBOO. Blood is drawn from one arm, passed through a filter where it meets an oxygen and ozone gas mix, and returned through the other arm, for about an hour. Is there anything in my health history you would want me to raise with a clinic first?
- Is there anything in the medicines and supplements I take that a clinic offering EBO2 should know about?
- Some clinics require labs before a first session, such as a complete blood count, a metabolic panel, and a G6PD test. Do my recent results cover those, or would you want new ones?
- EBO2 is not FDA-approved to treat any condition, and the published research on it is small. What does the evidence say about the reason I am considering it?
- If I go ahead, what signs during or after a session should make me call you or get care right away?
Medicines and supplements
A blood thinner, or another medicine that affects bleeding or clotting
Why this comes up: The EBOO circuit is kept from clotting with an anticoagulant, heparin in the published descriptions of EBOO in people, and heparin's FDA-approved label says drugs that interfere with clotting or platelet function may induce bleeding. Clinic pages disagree: one lists patients on anticoagulant therapy among those for whom EBOO is contraindicated, and others say blood thinners need to be discussed first. Our medicines guide found no study of EBO2 in people who take blood thinners.
- I take [name and dose]. What would the anticoagulant the clinic uses in its circuit add to my bleeding risk?
- Which of my medicines and supplements affect bleeding, clotting, or platelets?
- Would any of my medicines need to change around a procedure like this, and who would manage that?
From EBO2 (EBOO) and Blood Thinners: What to Ask. Sources: Extracorporeal blood oxygenation and ozonation: clinical and biological implications of ozone therapy (2005); Heparin Sodium in Sodium Chloride Injection, prescribing information (Hospira), on DailyMed; Enovative Wellness, Phoenix, AZ: EBOO page; Synergistiq Wellness, Clearwater, FL: what to expect from EBOO.
Methotrexate, a biologic, or another medicine that suppresses the immune system
Why this comes up: Our autoimmune guide found no study that looked at how ozone therapy interacts with immunosuppressants or biologics. The 2021 American College of Rheumatology guideline addresses using these drugs in people with a history of serious infections, and the guide suggests asking whether a clinic has checked its session plan against current immunosuppressants, biologics, or infusion schedules.
- I take [medicine] for [condition]. Would a procedure that draws and returns blood need to be timed around my doses or infusions?
- Does my treatment change the risk of infection from repeated IV access?
From EBO2 (EBOO) for Autoimmune Disease: Claims vs. Evidence. Sources: 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis.
A blood pressure medicine called an ACE inhibitor
Why this comes up: An ozone physiologist reports a sudden, marked fall in blood pressure when ozone-treated blood was returned quickly to patients taking ACE inhibitors during autohemotherapy, an unpublished observation by other clinicians that he says he confirmed in two patients, and lists ACE inhibitor treatment among the situations that preclude or limit ozone therapy. No EBOO paper addresses it.
- Is any medicine I take an ACE inhibitor?
- One physician reports sharp drops in blood pressure when ozone-treated blood was returned quickly to people taking ACE inhibitors. Is that relevant to me?
From Who Should Not Get EBO2 (EBOO)? and EBO2 (EBOO) and Blood Thinners: What to Ask. Sources: The Potential Toxicity of Ozone: Side Effects and Contraindications of Ozonetherapy (Bocci, 2011).
High doses of vitamin K
Why this comes up: A Dallas clinic lists high-dose vitamin K among the reasons a person is not eligible for EBO2, without giving a reason. It is on one of the eleven clinic lists our contraindications guide compared.
- I take vitamin K at [dose]. Is that a high dose, and does it matter for a procedure like this?
From EBO2 (EBOO) and Blood Thinners: What to Ask and Who Should Not Get EBO2 (EBOO)? Sources: Alive and Well, Dallas, TX: EBO2 page.
Blood, bleeding, and clotting
G6PD deficiency or favism
Why this comes up: G6PD helps red blood cells handle oxidation, and ozone is an oxidant. A 1977 model of breathing polluted air predicted that people with the deficiency may develop hemolysis, the breakdown of red blood cells, and an ozone physiologist says patients should be checked for it. Our contraindications guide found no published case of hemolysis after EBO2 in someone with the deficiency.
- Do my records show a G6PD test? If I have the deficiency, how severe is it?
- Many clinic lists include G6PD deficiency as a reason not to treat. What does that mean for me?
From Who Should Not Get EBO2 (EBOO)? Sources: Ozone: a possible cause of hemolytic anemia in glucose-6-phosphate dehydrogenase deficient individuals (1977); The Potential Toxicity of Ozone: Side Effects and Contraindications of Ozonetherapy (Bocci, 2011).
A bleeding or clotting disorder, a low platelet count, or a stomach or intestinal ulcer
Why this comes up: Every one of the eleven clinic lists our contraindications guide compared includes bleeding or clotting problems in some form, and a 2022 autohemotherapy trial excluded people with coagulation problems. EBO2 adds two needle sites and an anticoagulated circuit, and heparin's FDA-approved label lists low platelet counts, hemophilia, and stomach or intestinal ulcers among conditions with a higher risk of bleeding.
- With my [condition] and my latest platelet count, what would you want a clinic to know before it places two IV lines for about an hour?
- Would a clinic need recent clotting test results before treating me?
From Who Should Not Get EBO2 (EBOO)? and EBO2 (EBOO) and Blood Thinners: What to Ask. Sources: Combining Ozonated Autohemotherapy with Pharmacological Therapy for Comorbid Insomnia and Myofascial Pain Syndrome: A Prospective Randomized Controlled Study (2022); Heparin Sodium in Sodium Chloride Injection, prescribing information (Hospira), on DailyMed; in2GREAT, Overland Park, KS: EBOO therapy page.
Anemia, especially if it is severe or not controlled
Why this comes up: Four of the eleven clinic lists our contraindications guide compared include severe or uncontrolled anemia. A 2025 case report of EBOO in an 88-year-old woman with chronic anemia records her hemoglobin falling after a first series of treatments and rising after a second, and her feeling more tired after the second; the paper has no adverse-events section and does not attribute either change to EBOO.
- What was my most recent blood count, and how is my anemia being managed?
- Would you want my blood count checked again before a procedure that circulates blood outside my body?
From Who Should Not Get EBO2 (EBOO)? Sources: BionwoRx, Carmel, IN: EBO2 page; Avena Natural Health, Solana Beach, CA: EBOO page; Renew Specialty Group, Cornelius, NC: EBO2 page; Omni Life Med + Wellness, Tampa, FL: EBO2 page; Observed Reduction in Urinary Toxin Excretion With Extracorporeal Blood Oxygenation and Ozonation (EBOO) Treatment in an 88-Year-Old With Chronic Anemia: A Case Report (2025).
Iron infusions, or iron overload
Why this comes up: One of the eleven clinic lists our contraindications guide compared includes iron overload or iron infusions. The clinic gives no reason, and our guide could not verify one.
- One clinic lists iron infusions and iron overload as reasons not to treat. Does my iron treatment or iron level matter for a procedure like this?
From Who Should Not Get EBO2 (EBOO)? Sources: in2GREAT, Overland Park, KS: EBOO therapy page.
Heart, circulation, and blood pressure
Heart failure, an unstable heart condition, a recent heart attack, or a stroke
Why this comes up: An ozone physiologist lists serious cardiovascular instability, an Italian consensus lists cardiovascular decompensation, and a 2022 trial excluded heart failure. Most of the clinic lists our contraindications guide compared include an unstable heart or a recent heart attack, one saying such patients cannot handle systemic fluid shifts, and three list a stroke. The book and the consensus do not explain their reasoning.
- Given my heart condition or stroke and how I have recovered, how might a procedure that circulates blood outside my body for about an hour affect my heart and circulation?
- Are there results of mine, such as heart tests, that a clinic should see first?
From Who Should Not Get EBO2 (EBOO)? Sources: The Potential Toxicity of Ozone: Side Effects and Contraindications of Ozonetherapy (Bocci, 2011); Italian national consensus on oxygen-ozone paravertebral injection (Istituto Superiore di Sanità, Rapporti ISTISAN 08/9); Combining Ozonated Autohemotherapy with Pharmacological Therapy for Comorbid Insomnia and Myofascial Pain Syndrome: A Prospective Randomized Controlled Study (2022); BionwoRx, Carmel, IN: EBO2 page.
Very low blood pressure, or high blood pressure that is not controlled
Why this comes up: One of the eleven clinic lists our contraindications guide compared includes severe low blood pressure and another uncontrolled high blood pressure, and heparin's FDA-approved label lists severe high blood pressure among conditions with a higher risk of bleeding.
- How is my blood pressure right now, and does it matter for a procedure that moves blood out of my body and back for about an hour?
From Who Should Not Get EBO2 (EBOO)? Sources: Avena Natural Health, Solana Beach, CA: EBOO page; Roots Integrative Medicine, Marble Falls, TX: EBOO page; Heparin Sodium in Sodium Chloride Injection, prescribing information (Hospira), on DailyMed.
Pregnancy and breastfeeding
Pregnancy, a chance of pregnancy, or breastfeeding
Why this comes up: Ten of the eleven clinic lists our contraindications guide compared include pregnancy, and a 2022 trial excluded pregnant and breastfeeding women. An ozone physiologist lists early pregnancy to exclude any mutagenic risk, which he calls unlikely. Our guide found no study of EBO2 in pregnancy.
- I am pregnant, may be pregnant, or am breastfeeding. What do you know about ozone-based therapies at this time?
From Who Should Not Get EBO2 (EBOO)? Sources: The Potential Toxicity of Ozone: Side Effects and Contraindications of Ozonetherapy (Bocci, 2011); Combining Ozonated Autohemotherapy with Pharmacological Therapy for Comorbid Insomnia and Myofascial Pain Syndrome: A Prospective Randomized Controlled Study (2022).
Other health conditions
An overactive thyroid, such as Graves disease, especially if it is not controlled
Why this comes up: An ozone physiologist lists hyperthyroidism among the situations that preclude or limit ozone therapy, an Italian consensus excludes clinically evident hyperthyroidism, and five of the eleven clinic lists our contraindications guide compared include it, as active, uncontrolled, or Graves disease. Neither the book nor the consensus explains why.
- Is my thyroid well controlled right now, and what were my latest thyroid results?
From Who Should Not Get EBO2 (EBOO)? Sources: The Potential Toxicity of Ozone: Side Effects and Contraindications of Ozonetherapy (Bocci, 2011); Italian national consensus on oxygen-ozone paravertebral injection (Istituto Superiore di Sanità, Rapporti ISTISAN 08/9).
Diabetes, or a tendency to low blood sugar
Why this comes up: One clinic tells patients to eat a proper meal before treatment because, it says, ozone and ultraviolet blood treatment affect blood sugar, and cites no source. Our guide to a session found clinic pages telling patients to eat beforehand, giving blood sugar as the reason, and one that checks blood glucose at the start to avoid a low.
- How well controlled is my blood sugar right now?
- Is there anything about meals or my diabetes medicines to plan for on the day of a procedure like this?
From Who Should Not Get EBO2 (EBOO)? and What to Expect at an EBO2 (EBOO) Session: A Timeline. Sources: in2GREAT, Overland Park, KS: EBOO therapy page; Synergistiq Wellness, Clearwater, FL: what to expect from EBOO; Mitch Marder DDS, Seattle, WA: EBOO page.
Kidney or liver disease, or a high potassium level
Why this comes up: A 2022 autohemotherapy trial excluded people with kidney injury or liver dysfunction, and one of the eleven clinic lists our contraindications guide compared includes kidney or liver failure. A 2017 case report describes a woman with chronic kidney disease whose heart rhythm stopped (sinus arrest) from high potassium after nine days of autohemotherapy, which its authors hypothesize was linked to the therapy. Heparin's label advises measuring potassium before heparin in people at risk of high potassium, and lists liver disease with impaired clotting among conditions with a higher risk of bleeding.
- When were my kidney and liver function last checked?
- A 2017 case report describes high potassium and a heart rhythm stop during ozone autohemotherapy in a woman with chronic kidney disease. Does anything in that case apply to me?
From Who Should Not Get EBO2 (EBOO)? and EBO2 (EBOO) and Blood Thinners: What to Ask. Sources: Combining Ozonated Autohemotherapy with Pharmacological Therapy for Comorbid Insomnia and Myofascial Pain Syndrome: A Prospective Randomized Controlled Study (2022); Ozone therapy induced sinus arrest in a hypertensive patient with chronic kidney disease: a case report (2017); Omni Life Med + Wellness, Tampa, FL: EBO2 page; Heparin Sodium in Sodium Chloride Injection, prescribing information (Hospira), on DailyMed.
Recent or upcoming surgery, or a recent spinal tap
Why this comes up: Heparin's FDA-approved label counts the period during and right after a spinal tap or major surgery among conditions with a higher risk of bleeding, and an Italian consensus on spinal ozone injections excludes patients who need surgery that cannot wait.
- I had, or am due for, [surgery or procedure] on [date]. Does that matter for the timing of a procedure that uses a blood thinner in its circuit?
From EBO2 (EBOO) and Blood Thinners: What to Ask and Who Should Not Get EBO2 (EBOO)? Sources: Heparin Sodium in Sodium Chloride Injection, prescribing information (Hospira), on DailyMed; Italian national consensus on oxygen-ozone paravertebral injection (Istituto Superiore di Sanità, Rapporti ISTISAN 08/9).
An active infection, especially one in the blood
Why this comes up: One of the eleven clinic lists our contraindications guide compared excludes active, severe blood-borne infections.
- If I have an infection around the time of a booked session, what would you want me to do?
From Who Should Not Get EBO2 (EBOO)? Sources: BionwoRx, Carmel, IN: EBO2 page.
Cancer, or treatment for cancer
Why this comes up: Five of the eleven clinic lists our contraindications guide compared include cancer or leukemia: one excludes people in active cancer treatment, another lists cancer without qualification, and three list leukemia. Another clinic says chemotherapy agents need additional assessment.
- Several clinics list cancer or cancer treatment among their reasons not to offer EBO2. Should my oncologist know before I consider it?
- Could a procedure that circulates my blood outside my body affect my cancer treatment or its timing?
From Who Should Not Get EBO2 (EBOO)? Sources: BionwoRx, Carmel, IN: EBO2 page; Alive and Well, Dallas, TX: EBO2 page; Bliss MD, Hanover Park, IL: EBOO page.
Seizures, porphyria, sensitivity to light, sulfa drugs, or a past episode of hemolytic anemia
Why this comes up: Each of these is on one of the eleven clinic lists our contraindications guide compared. For sulfa drugs, light sensitivity, and porphyria, the guide notes that the pages list them without explanation.
- One clinic lists [the item that applies to me] as a reason not to treat. Is it relevant to me?
From Who Should Not Get EBO2 (EBOO)? Sources: in2GREAT, Overland Park, KS: EBOO therapy page; Roots Integrative Medicine, Marble Falls, TX: EBOO page; Mitch Marder DDS, Seattle, WA: EBOO page.
IV lines, allergies, and past reactions
Veins that are hard to find, or IVs and blood draws that have been difficult before
Why this comes up: EBO2 needs a working line in each arm for the whole session. One clinic requires two compliant veins, one in each arm; another places its own lines and does not use an existing PICC line or port; and the authors of an ozone dialysis paper chose smaller catheters out of concern that larger ones would damage veins over repeated treatments.
- IVs and blood draws have been difficult for me. Is there anything about my veins a clinic should know before it places a line in each arm?
From Who Should Not Get EBO2 (EBOO)? Sources: Mitch Marder DDS, Seattle, WA: EBOO page; IV Elements, Hoboken, NJ: EBOO page; Ozone dialysis delivers three or more times the ozone than other forms of ozone blood treatment (2023).
An allergy or a bad reaction to heparin, or to pork products
Why this comes up: Four of the eleven clinic lists our contraindications guide compared include a heparin allergy or intolerance. Heparin's FDA-approved label lists a known hypersensitivity to heparin or pork products, and a history of heparin-induced thrombocytopenia, a serious immune reaction to heparin, among the reasons not to use it; the drug is derived from pig intestinal mucosa.
- My records show a reaction to heparin or to pork products. What happened, and what should a clinic that uses heparin in its circuit be told?
From Who Should Not Get EBO2 (EBOO)? and EBO2 (EBOO) and Blood Thinners: What to Ask. Sources: Heparin Sodium in Sodium Chloride Injection, prescribing information (Hospira), on DailyMed; in2GREAT, Overland Park, KS: EBOO therapy page.
A bad reaction to ozone therapy in the past
Why this comes up: One of the eleven clinic lists our contraindications guide compared includes a known sensitivity to ozone. An ozone physiologist questions what an allergy to ozone would be, and our guide suggests describing a past reaction to any ozone treatment to both the clinic and one's own doctor.
- I had [describe the reaction] after ozone therapy. What do you make of it, and what should a clinic be told?
From Who Should Not Get EBO2 (EBOO)? Sources: The Potential Toxicity of Ozone: Side Effects and Contraindications of Ozonetherapy (Bocci, 2011); Renew Specialty Group, Cornelius, NC: EBO2 page.
Bring to the appointment
- A list of every medicine and supplement you take, with the doses, including anything you take only now and then.
- Recent lab results, if you have them, such as a complete blood count, a metabolic panel, and any G6PD test.
- Results of any heart tests or imaging you have had.
- The clinic's name, the address of its EBO2 page, and any intake form or screening list it gave you.
- This list of questions, with room to write down the answers.
What this tool does
It turns what you check into a list of questions for your own doctor: 5 questions for anyone considering EBO2, then the questions for each situation you checked, grouped, with the reason each one comes up and the guide behind it. It adds a short list of what to bring to the appointment. You can print the list or copy it as text.
It produces questions only. It never scores your answers, ranks situations, warns you off, or says whether you can or should have EBO2, and checking a box does not mean a clinic will or will not treat you.
How the list is made
We read our guides on safety, screening, and the session itself, and took every situation they name as a reason to talk with a clinician first and tie to a cited source. The list draws on EBO2 (EBOO) and Blood Thinners: What to Ask, EBO2 (EBOO) for Autoimmune Disease: Claims vs. Evidence, Who Should Not Get EBO2 (EBOO)?, and What to Expect at an EBO2 (EBOO) Session: A Timeline. A unit test checks that every section link points to a heading in that guide, and that every source a situation lists is cited in the section it links.
For each situation, "why this comes up" says what the guide and its source report, attributed to them: practitioner sources, one clinic's published screening or eligibility list, or a case report. The questions are ours, written to ask rather than to answer. The order of the list is fixed, whatever order you check the boxes in.
We left out situations a reader might expect that the guides do not state with a cited source:
- Heart rhythm problems. None of the lists the guides compare names them; the one case report of a heart rhythm stop appears under kidney disease.
- Lung disease and asthma. The guides mention asthma in explaining claims of an ozone allergy and in FDA reports about ozone devices, not as a reason for caution before EBO2.
- An allergy to contrast dye. None of the guides names it; heparin and pork allergies are included.
- Dialysis. The guides compare EBO2 with dialysis, but none of the lists they compare names being on dialysis; kidney disease is included.
- Thyroid conditions other than an overactive thyroid. The guides name only an overactive thyroid.
- Drinking alcohol before a session. Three clinic lists name alcohol intoxication; that is for the clinic on the day of a session rather than a question about your health history.
The list is built in your browser from the questions built into this page.
The data behind it
21 situations in 6 groups and 37 questions in all, drawn from 4 of our guides, which cite 22 sources for them: research papers, a book chapter by an ozone physiologist, an Italian national consensus, a medical society's guideline, an FDA-approved drug label, and clinics' own pages, which the guides label clinic-stated. The guides were last updated on October 3, 2026. Every situation above lists its sources.
Something wrong, or a situation our guides support that is missing? Tell us.
What it cannot tell you
- Whether EBO2 is right for you, safe for you, or likely to help. It asks questions; your doctor answers them.
- Whether a clinic will treat you. Clinics set their own screening and eligibility rules, and the lists the guides cite are a few clinics' published policies, not a standard.
- Everything that could matter. A situation that is not on this list can still matter, and the reasons come from practitioner sources and clinic policies rather than an FDA-reviewed standard: ozone therapy is not FDA-approved for any condition.
- It has not yet been clinically reviewed, and it is not medical advice.
