#healingwithhyperbarics

Adi Shabi Shlifer, Gil Suzin, Ran Shorer, Erez Lang, Shachar Finci, Karin Elman-Shina, Keren Doenyas-Barak, Shai Efrati. Hyperbaric oxygen therapy improves post-concussion symptoms in adults with childhood traumatic brain injury: a retrospective cohort study. https://pmc.ncbi.nlm.nih.gov/articles/PMC12440767/

SUMMARY:

Post-concussion syndrome (PCS) following childhood traumatic brain injury (TBI) can result in persistent cognitive impairments that extend into adulthood, yet it remains significantly underdiagnosed and undertreated. This study evaluated the effects of hyperbaric oxygen therapy (HBOT) on chronic neurocognitive symptoms in adults with PCS stemming from pediatric TBI.

Between 2017 and 2024, the Sagol Center for Hyperbaric Medicine and Research studied TBI before age 17, HBOT initiation after age 20, and the availability of computerized cognitive assessments before and after treatment.

Twenty-six adults (mean age 31.7 ± 8.6 years) who sustained TBI in childhood (mean age at injury 7.7 ± 5.8 years) met inclusion criteria. Following HBOT, statistically significant improvements were observed in all cognitive domains.

These improvements were independent of time since injury (mean 23.6 ± 9.3 years) and initial TBI severity. Notably, individuals with a history of mild TBI exhibited similar impairments and treatment response to those with more severe injuries. These findings suggest that HBOT may induce meaningful neurocognitive improvement even decades after pediatric TBI, supporting its potential role in long-term rehabilitation strategies for this underserved population.

SIGNIFICANCE: 

Despite increasing awareness, Post Concussive Syndrome (PCS) in children continues to be overlooked by clinicians and educators. Many children experiencing long-term post-injury symptoms, whether from falls, athletic injuries, assaults, or sickness do not receive a formal diagnosis or appropriate interventions, allowing their difficulties to persist untreated into adulthood.

Traumatic brain injury (TBI), a leading cause of emergency department visits in children, has an estimated annual incidence of 150 to 400 cases per 100,000 in the pediatric population. Although most pediatric TBIs are classified as mild (mTBI), a substantial proportion of affected children—estimated between 10 and 30%—develop persistent post-concussion syndrome (PCS), characterized by long-term cognitive, emotional, somatic and behavioral symptoms. These symptoms may persist for years and interfere with academic and social functioning.

Hyperbaric Oxygen Therapy (HBOT) has recently gained attention as a potential treatment for chronic PCS. By increasing oxygen delivery under elevated pressure, dedicated protocols of HBOT may induce neuroplasticity and recovery of dysfunctional brain regions even at the late chronic phase. Clinical studies have demonstrated improvements in cognitive and behavioral outcomes following HBOT in both pediatric and adult populations with PCS.

The present study addressed longstanding PCS following pediatric TBI, and intervention with HBOT. Positive results were found even decades after the brain wound in six categories: Global Cognitive Function; Memory Function; Executive Function; Attention; Information Processing Speed; and Motor Skills.

This study provides initial evidence that HBOT can elicit significant cognitive improvements in adults with chronic PCS from childhood TBI. This evidence substantiates data already showing significant improvement in adults with TBI, irrespective of their age or the origin of the brain wound.

Given that treatment effects were not dependent on time since injury or injury severity, HBOT may represent a valuable therapeutic option even for those with longstanding symptoms. Future prospective, controlled trials are warranted to confirm these findings, elucidate optimal dosing protocols, and explore adjunctive interventions and assess the long-term durability of treatment effects through extended follow-up.

These results also highlight the need for early recognition, long-term follow-up, and access to rehabilitation for pediatric TBI survivors, especially those with mild injuries who are often misclassified and undertreated.

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The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can end suicidal ideation, help end symptoms of PTSD, get patients off most of their drugs, and heal brain wounds to end the effects of Concussion, BLAST injury, mild TBI, Persistent Post Concussive Syndrome, and polytrauma from Operator Syndrome, AHI, and Burn Pits. No Veteran or civilian has ever been killed or hurt while undergoing HBOT treatment for TBI/PTSD.

PRESS RELEASE

Wednesday, 1 July 2026

SOAA: Special Operations Association of America

Hyperbaric Oxygen Therapy Access for Veterans

Beth Bailey

A stalwart group of advocates has made it their mission to raise awareness about the safety and efficacy of hyperbaric oxygen therapy (HBOT) for helping veterans alleviate post traumatic stress disorder (PTSD) and traumatic brain injury (TBI). Retired U.S. Navy SEAL John ‘Sandy’ Pidgeon, Vietnam-era tanker pilot Dr. Robert Beckman, Co-founder of TreatNOW, and U.S. Air Force C-141 Flight Engineer and National Director of TreatNOW State Legislative Efforts Eric Koleda spoke with the Special Operations Association of America (SOAA) about their mission to bring HBOT to the population of veterans with brain wounds related to their military service in order to fight back against the veteran suicide epidemic, which has claimed more than 140,000 lives since 2001.

TreatNOW is a coalition of veterans, academics, researchers, civilians, and veteran service organizations working together to advocate for veterans’ access to HBOT. The group says it has successfully supported 33,000 citizens, service members, and veterans, including over 12,500 veterans and 800 special operations forces (SOF) personnel, with HBOT access.

Advocates believe this number is not enough. 

Beckman says that TreatNOW wants the population of roughly 18 million veterans “to hear, to understand, to educate themselves” about how they can assist with brain wounds and traumatic brain injury that “can lead to depression, suicide, and significant loss of quality of life.”

Accessing HBOT for Veterans

During HBOT, patients enter a chamber in which they breathe 100 percent oxygen delivered at higher than normal air pressure.

HBOT is FDA-approved for 14 indications, including carbon monoxide poisoning, necrotizing infections, wound healing, burns, and radiation injury. It has not been approved for PTSD or any other conditions conventionally thought to be linked with mental health. 

However, according to Beckman, there are “28 clinical studies showing efficacy” since 2008.

Among these is a 2023 study published in Frontiers in Neuroscience. Following an exhaustive review of the mechanisms in HBOT thought to support brain repair, researchers stated that “pre-clinical and clinical trials have shown that HBOT can induce neuroplasticity and improve clinical outcomes of veterans with treatment-resistant PTSD.” Of ten clinical trials, including six controlled trials, cited in the article “all…studies indicated positive effects on PTSD symptoms.”  

SOAA asked the Department of Veterans Affairs (VA) whether it would provide veterans experiencing PTSD or TBI with HBOT. A spokesperson told SOAA that the “FDA has neither approved nor cleared the use of HBOT to treat traumatic brain injury or PTSD. VA continues to review emerging research and incorporate new findings into clinical practice guidelines to deliver Veterans safe, proven, and patient-centered treatment options.”

HBOT to Treat Brain Wounds

Advocates who spoke to SOAA emphasized that they believe that while PTSD is often considered a mental health diagnosis, it typically results from TBI, which they refer to as a “brain wound.” Concussive forces from heavy weapons overpressure, artillery and rocket back-blasts, improvised explosive devices, close-quarters small arms fire, breaching explosives, accidents, and injuries can radiate, Beckman explained, creating a conglomerate of physiological, behavioral, psychological, and moral impacts, “any one of which, when neglected, leads to dysfunctions that negatively affect all the others.”

Though a variety of treatments are emerging which can assist with PTSD and TBI, Beckman says that it is best “to diagnose and heal the brain first.” On this score, Beckman says HBOT “has worked for decades,” including at over 183 TreatNOW Coalition clinics and hospitals nationwide.

Congressional Support for HBOT

SOAA spoke to Rep. Greg Murphy, MD, (R-NC) about the Veterans National Traumatic Brain Injury Treatment Act, H.R.1336, legislation he sponsored which passed the House of Representatives’ Veterans Affairs Committee in May 2025. If the legislation is passed, it will require the VA to conduct a five-year pilot program to provide veterans who experience TBI or PTSD with access to HBOT.

Murphy explained that he has “spent the better part of a decade” looking into HBOT, and that he is “as a scientist, convinced, especially after talking with so many veterans who’ve had such a good response for this, that this is a treatment that is there for veterans when nothing else is working.”

In addition to looking at the science, Murphy says that he has “visited HBOT centers, spoken with advocates,” and concludes that HBOT “is something I truly believe as a physician that our VA should be offering.” Unfortunately, Murphy noted, “I think those who are controlling some of the things at the VA are scientists who are stuck in data from either the ‘60s, ‘70s, or even ‘80s that did not at the time show a benefit, but so many different protocols, new protocols are being done, new treatments modalities are being done, where I really believe this moves the needle.” 

For the Veterans National Traumatic Brain Injury Treatment Act to come to fruition, Murphy said that it must get onto the House floor and acquire more co-sponsors. Murphy urges interested parties “to call their member of Congress, and ask them to get on this bill, because it’s a notification to leadership. If there are a lot more co-sponsors, that means there’s a lot more interest in it.”

Murphy noted that there is a companion bill on the Senate side sponsored by Sen. Tommy Tuberville (R-AL) “who believes in this.” 

“Truth be told, I don’t think the VA needs to do a study, it just needs to read the most recent literature and understand that the preponderance and overwhelming amount of evidence shows the efficacy of HBOT for PTSD and TBI,” Murphy said. “They just need to do their job.”

Getting the HBOT legislation passed is “one of the things that I would like to have done,” Murphy explained. “I truly believe it helps those who have literally nothing else to turn to… We can’t accept the numbers that we still have every day for veteran suicide.”

State-Level Support for HBOT 

One impediment to helping veterans access HBOT is its expense. Advocates note that it costs between $230 and $450 per hour for the therapy, and that a typical treatment requires 60 to 100 hours in a hyperbaric chamber. They also believe that costs will decline as HBOT infrastructure expands.

Koleda noted that he has worked extensively at the state level to help veterans access HBOT. One state where he has had great success is Kentucky, where veterans with PTSD can have their HBOT covered through $1.5 million in state funding through 2028. Koleda says that in Kentucky, 64 percent of veterans he has treated “are either back to full-time or part-time school or work.”

In the 14 states that have enacted laws, Koleda said that about “1,955 state lawmakers voted ‘yes’ to five ‘no’s.’” Koleda says that another 10 states are working on HBOT legislation. Seven of the 14 states that have passed legislation have assembled over $33 million in HBOT funding, but Koleda emphasized that “the fiduciary responsibility for the treatment of veterans should lie with the U.S. government and the VA.” Koleda said that “Congress is not standing up and doing what they need to do to provide the best care for” veterans with PTSD and TBI. 

“Despite the VA, we’re having success. We’re winning, just not fast enough,” Beckman reports. Beckman wants veterans to understand that they “do not have to live a diminished life,” and that “legislators will start to pay attention to the extent that veterans make their voices heard.”

Sandy Pidgeon is a 20-year Navy SEAL Officer, who qualified as a diving supervisor in open circuit, O2, mixed gas, and SEAL Delivery Vehicles (Mk-8 and MK-9). He was also a hyperbaric chamber operator/co-pilot of the Advanced SEAL Delivery System.

Our knowledge of brain wounds and how to heal them has “exploded” in the last decade. The medical universe is mired in old notions about the brain and how to heal brain wounds. We can help in their education by allowing and funding State hospitals and clinics to use HBOT to heal TBI/PTSD while Congress and the VA and DoD catch up.

"HBOT Heals Brains, Stops Suicides, Restores Lives." TreatNOW

PRESS RELEASE

Monday, 15 June 2026, TreatNOW.org, Washington, DC

The TreatNOW Coalition today released a Report to coincide with PTSD Awareness Month. The Case for HBOT (Hyperbaric Oxygen Therapy) as a VA Standard of Care Indication for TBI and PTSD, together with a companion piece on VA/DOD Interventions for TBI/PTSD, lay out specifics about the two decade medical doldrums in the VA/DOD.

The FDA last approved a drug for PTSD in 2001 — the same year as 9/11. None have been approved for TBI. In the 24 years since, while the VA has treated over 500,000 veterans with TBI and millions with PTSD, not a single new pharmacological treatment has been approved for the condition. Every drug the VA prescribes beyond sertraline and paroxetine is off-label. Both approved drugs carry FDA black box warnings for suicidal ideation and work only modestly better than placebo — and not at all reliably in combat veterans.

The VA's Booklet on PTSD continues the illusion that PTSD is a Mental Health problem alone, with no mention of the physical damage that may underlie PTSD symptoms. Thus, the Clinical Practice Guidelines (CPGs) in place for co-occurring Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD) emphasize better screening, careful medication management, and the use of trauma-focused psychotherapies. On the issue of a brain wound, the CPGs are silent.

As of June 2026, the VA library contains more than 30 active CPGs spanning mental health, rehabilitation, pain management, and chronic disease — none of which mention brain wounding, none include HBOT as a standard-of-care recommendation for TBI or PTSD, and none identify any FDA-approved pharmacological treatment for TBI; there aren't any. And, characteristically, both DoD and the VA hang on to woeful formularies and practices that cost more and fail to dent the suicide rate's upward trend. Something has to change.

Here is a quick Summary of what the TreatNOW Coalition recommends in this 12th year recognition of PTSD Awareness Month, a period that saw total suicides increase from 88,229 to over 160,000, an average of over 6,387 Veteran suicides every year.

Every day, between 17 and 22 American veterans die by suicide. That number has barely moved in twenty years — despite billions spent on VA mental health programming. We are here today to tell you why, and to tell you what will change it.

TBI and PTSD are not primarily psychiatric conditions. They can be and generally are brain wounds — physical injuries to living tissue that can be seen on MRI, measured on PET scan, and, critically, healed. The VA's current treatment model — pharmaceuticals, psychotherapy, coping strategies — cannot heal a physical wound. No antidepressant restores a shredded axon. No benzodiazepine rebuilds a hypoperfused hippocampus. The suicide rate will probably not move until we treat the wound itself.

Hyperbaric Oxygen Therapy does exactly that. Under pressure, oxygen dissolves directly into plasma and reaches metabolically starved neurons that red blood cells can no longer reach. It triggers angiogenesis — the growth of new blood vessels into damaged tissue — documented in human brains on perfusion MRI. It regenerates white matter fiber tracts, confirmed by DTI imaging. It mobilizes stem cells from bone marrow. It reduces neuroinflammation. These are not theories. They are peer-reviewed findings, in randomized controlled trials, in veterans — published in the Journal of Clinical Psychiatry, PLOS ONE, and Frontiers in Neuroscience.

The Israeli government — whose military sees the same blast injuries, the same PTSD, the same suicide risk — has recognized this evidence. Israel's Ministry of Defense now funds HBOT for veterans. The Sagol Center in Be'er Ya'akov treats 350 patients daily, with documented 68% significant improvement rates and PTSD remission lasting two years and beyond. Congressman Greg Murphy, himself a physician, asked the obvious question when he saw these results: "Why the hell are we not doing this in the United States? . . . . I believe it is medical malpractice not to offer this to our Veterans."

The VA's answer has been inertia. But here is the cost of that inertia — in numbers this Congress controls.

Our Brain Drain analysis quantifies the annual burden of untreated TBI and PTSD veterans at $118 billion per year — across disability compensation, VA healthcare, pharmaceutical costs, lost productivity, homelessness, incarceration, suicide, and ten other categories. There are 877,450 Iraq and Afghanistan veterans languishing in this condition right now.

The one-time cost to treat every one of them with a full HBOT course: $19.7 billion — less than one-half of one percent of the forty-year lifetime burden of doing nothing. The VA recoups that investment in under seven years at even the most conservative outcome assumptions. Dr. Paul Harch's clinical data shows 50% reduction in psychoactive medication use following treatment. Ten of twelve veterans with active suicidal ideation in his trial resolved that ideation entirely.

Here is the legal absurdity the Congress should understand: the VA already reimburses HBOT — for carbon monoxide poisoning (and 14 other conditions). The mechanism is identical. CO poisoning starves neurons of oxygen by blocking hemoglobin and mitochondrial enzyme function. Blast TBI does the same thing through different means. We treat one. We deny the other. That distinction is not medicine. It is policy inertia with a body count.

The TreatNOW Coalition has already returned more than 33,000 patients to work, school, and active duty — pro bono — using this therapy. Among them: over 12,500 veterans, including more than 700 Special Operations Warriors. We know it works. The peer-reviewed science shows it works. The only institution that has not acted is the U.S. Government.

The ask is straightforward: Pay for HBOT treatments in TreatNOW Coalition clinics and hospitals. Authorize pilot programs at Innovative Therapies Centers of Excellence under the PATH Caucus framework. Amend CMS NCD 20.29 to include chronic TBI with documented metabolic dysfunction. Mandate neuroimaging-based outcome tracking. The evidence is there. The precedent is there. The fiscal case is unambiguous.

Too many veterans will die by suicide today. The question before this Congress is whether the number will be different tomorrow.

The answer, of course, is to do the right thing: TreatNOW

Our knowledge of brain wounds and how to heal them has “exploded” in the last decade. The medical universe is mired in old notions about the brain and how to heal brain wounds. We can help in their education by allowing and funding State hospitals and clinics to use HBOT to heal TBI/PTSD while Congress and the VA and DoD catch up.

HBOT Heals Brains, Stops Suicides, Restores Lives. TreatNOW

September 30, 2025 Birmingham, Alabama

Col James Wright, MD (USAF, ret) testified before the Senate Alabama Field Hearing on Hyperbaric Oxygenation for TBI and PTSD (HBOT).  In his testimony he referenced a recent clinical study on Traumatic Brain Injury and Suicidal Thoughts and Behaviors among Post-9/11 Veterans.

That study states: "TBI appears to compound suicide risk in veterans: those who experience TBI are 1.5 times more likely to die by suicide than veterans without TBI . . . . This is particularly concerning given the prevalence of TBI in post-9/11 veterans . . . . Identifying who is most at risk of developing through examining associations between TBI and suicide related outcomes has the potential to inform more effective prevention strategies, improve the delivery of evidence-based care, and save veteran lives."

Dr. Wright is not the first to draw attention to a serious mismatch between DOD's and the VA's spending and their inability to bring down the increasing trend in suicides. The daily number is somewhere between 16 and 22 a day, depending on who is counting. VA's own numbers show over 157,000 Veteran suicides since 9/11. The "reverberating effects" of war that have led to at least 4.5-4.7 million deaths and counting, have seen over 6,000 Veteran deaths per year for over 20 years, now more than 22 times the number (7,053) of US service members killed in the war.

So much money has been thrown at "suicide prevention" strategies that it's hard to pin anyone down on "return on investment" or the apparent willingness to throw good money after bad. Put simply, the USG approach to Veteran suicides is to broaden outreach to Veterans and the 66,000 Veteran Service and community Organizations and enable them to pay better attention: "If you see something, say something."

The net effects of all the spending (over $5.375 Billion over the last decade) is to avoid a central truth: when you do not heal the brain wounds of combat Veterans, they are at higher risk for suicide.

Congress is once again awakening to the need to do things differently. Legislation calling for the use of HBOT for TBI/PTSD/Suicide Prevention under consideration in the House and Senate includes:

S.2737 - Veterans National Traumatic Brain Injury Treatment Act. Senator Tuberville (R-AL) Introduced in Senate (09/09/2025)  It would require the Secretary of Veterans Affairs to implement a pilot program to furnish hyperbaric oxygen therapy to certain veterans through community care providers, and for other purposes.

S.862 - HBOT Access Act of 2025. Senator Tuberville (R-AL) Introduced in Senate (03/05/2025) It would amend title 38, United States Code, to direct the Secretary of Veterans Affairs to furnish hyperbaric oxygen therapy to certain veterans with traumatic brain injury or post-traumatic stress disorder.

H. R. 1336 - Veterans National Traumatic Brain Injury Treatment Act. Rep. Greg Murphy (R-NC) (for himself, Mr. Davis of North Carolina, Mrs. Kiggans of Virginia, Ms. Strickland, Mr. Wittman, Ms. Malliotakis, Ms. Ross, Mr. Van Orden, and Mr. Biggs of Arizona)  introduced February 13, 2025. It was voted out of the full Veterans Affairs Committee and is awaiting a full House vote. It directs the Secretary of Veterans Affairs to establish a pilot program to furnish hyperbaric oxygen therapy to a veteran who has a traumatic brain injury or post-traumatic stress disorder. The language was incorporated in S.2737 by SEN Tuberville.

H. R. 72 - TBI and PTSD Treatment Act. Mr. Biggs of Arizona (for himself, Mr. Crane, and Mr. Gosar) introduced the following bill; which was referred to the Committee on Veterans' Affairs. The Bill would amend title 38, United States Code, to direct the Secretary of Veterans Affairs to furnish hyperbaric oxygen therapy to veterans with traumatic brain injury or post-traumatic stress disorder. It has gone nowhere.

TreatNOW is calling for the following revisions and additions in all Bills that would call for revision of safety provisions and establish immediate funding of treatments of eligible Veterans while conducting research. We also call for "informed consent," instructing the VA to tell every affected Veteran that HBOT is safe, effective and available to them.

1.   Incorporation of the recommendations in CBO Cost Estimate Report, June 11, 2025. CBO estimates that roughly 6,000 veterans would participate in the program at an average cost of $27,000 for a course of 40 treatments. The bill would establish a fund to accept donations for the program; however, CBO anticipates that contributions would be minimal and would not significantly offset the costs of the program. In total, CBO estimates that the temporary program would cost $158 million over the three-year period, and that funds are available to pay those costs using already appropriated funds.

2.   We are in general support of other amendments proposed by other organizations.

a.   Refine HBO2 Definition: Amend Section 4(e) to clarify eligible devices -- monoplace or multiplace chambers -- meeting ASME PVHO-1 and NFPA 99 standards, capable of delivering up to 3 ATA with 100% oxygen.

b.   Support compliance with ASME, NFPA, and FDA standards for all hyperbaric equipment.

c.   Support Ethical Research: Ensure studies are independent, IRB-approved, transparent, and designed to produce publishable, peer-reviewed data.

3.   Ensure the VA informs Veterans about the availability of HBOT for TBI/PTSD as one of the treatments available to them. Lack of informed consent prevents Veterans from knowing about HBOT as a safe and effective treatment.

HBOT. Heal Brains. Stop Suicides. Restore Lives. TreatNOW.

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The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can end suicidal ideation, help end symptoms of PTSD, get patients off most of their drugs, and heal brain wounds to end the effects of Concussion, BLAST injury, mild TBI, Persistent Post Concussive Syndrome, and polytrauma from AHI, Burn Pits, and COVID. No Veteran or civilian has ever been killed while undergoing HBOT treatment for TBI/PTSD. For a video Summary, see: https://www.youtube.com/@treatnowdotorg/videos