My HBOT Protocol
Hi friend,
Hyperbaric oxygen therapy (HBOT) ranks as one of the highest value health therapies I've done.
Here's:
- the science behind HBOT
- my protocol
- my biomarkers after 60 sessions
- what to do if you can't do HBOT
The science behind HBOT
HBOT involves breathing pure oxygen (100%) in a pressurized chamber at anything above atmospheric pressure (2 ATA, atmospheres absolute, is equivalent to being 33 feet under seawater).
The increased pressure enhances the lungs' ability to absorb oxygen, boosting oxygen levels throughout the body. The therapy aims to promote rejuvenation by increasing oxygen concentration in tissues, supporting healing, cellular repair, and vascularization (the growth of blood vessels).
HBOT is used for recovery and rehabilitation
HBOT is clinically used for:
- treating carbon monoxide poisoning
- supporting chronic wounds with some success in diabetics
- recovery of radiation injuries
- supporting recovery from sports injuries
HBOT is promising for rejuvenation and longevity
A landmark clinical trial showed evidence of HBOT increasing telomere length in a small cohort of healthy older adults (age >64 years).
Increases in telomere length of 20–38% were demonstrated in multiple types of circulating immune cells. The effect was also sustained 1–2 weeks after ending the HBOT protocol.
The study also found a significant decrease in the fraction of senescent (aged) T-cells at the end of the protocol.
This finding is significant for longevity because telomere length decreases with age and is an important marker of biological age. In two randomized clinical trials, HBOT also improved physical performance in mid-aged elite athletes (age 40–50), as well as in healthy older adults (age >64). In both cases, the observed improvements included an increase in VO2 max, a key marker for health and longevity.
A preclinical and clinical study in an Alzheimer's mouse model and in 6 elderly Alzheimer patients (age >64) showed HBOT improved vascular function and cognitive performance, and reduced amyloid (a protein) burden in the brain.
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My HBOT protocol
- Chamber type: Hard shell
- Pressure: 2 ATA
- Session length: 90 minutes
- Oxygen delivery: 20 min breathing 100% oxygen, 5-min break, repeat
- Frequency: 5 sessions per week, 2 days off
- Course: 60 sessions within 90 days
Inside my chamber, the oxygen level is 21%, which is the same as Earth's atmosphere. Other chambers maintain 100% oxygen inside, creating increased fire risk.
The 100% oxygen is delivered through a mask.
Important: Do not take any electronics into the chamber as it creates a fire risk.
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Results from 60 sessions of HBOT
- wiped out detectable systemic inflammation in my body
- 300% increase in VEGF (formation of new blood vessels)
- telomerase activity of a 12-year-old, associated with biological age
- 250% and 290% increase in short-chain fatty acids and n-butyrate, respectively, important microbiome markers
- complete elimination of metabolic imbalance in my gut
- 28.6% reduction in a dementia marker
- improved muscle oxygenation
- dramatic improvements to whole-body skin health
After achieving elite-level biomarkers over the past 4+ years, my team and I have struggled to find new therapies that meaningfully improve my biomarkers.
HBOT achieved that.
Inflammation
Chronic inflammation is the foundation of disease and all things bad health. Before HBOT, my inflammation markers were in the top 5% of 18–29-year-olds (you get more inflamed as you age).
HBOT lowered my systemic inflammation to below detection limits.
This is wild.
A second test to confirm the inflammation measurement (my CRPm, an epigenetic biomarker proxy for inflammation) is in the lowest 1%.
Vascularization
300% increase in VEGF.
VEGF drives the formation of new blood vessels, improving tissue perfusion and oxygenation, which are essential for improving fitness and physical and cognitive performance. It also has further pro-longevity effects on gene expression.
HBOT improved muscle oxygenation, which reached the same level of exercise power (wattage) at more than double the muscle oxygenation.
Telomeres
I now have the telomerase activity of a 12-year-old (7.7%).
Telomeres keep chromosomes from falling apart. They are essential for healthy cell division, including stem cell renewal. As we age, cells lose their telomerase activity and telomeres get shorter. When telomeres are too short, cells may become senescent (aged) and contribute to accelerated aging.
Microbiome
We saw dramatic improvements in my microbiome.
| Akkermansia muciniphila | Short-chain fatty acids (SCFA) | n-butyrate concentration | Metabolic imbalance in the gut | |
|---|---|---|---|---|
| Pre-HBOT | Not detectable | 22.5 micromol/g (low) | 3.8 micromol/g | imbalance score 7 (high) |
| Post-HBOT | 4.2E4 CFU/g | 55.8 micromol/g (optimal) | 11.1 micromol/g | imbalance score 0 (ideal) |
A high metabolic imbalance score might be indicative of a lack of pre-biotics in the diet (including fiber). Interestingly in my case, HBOT was enough to reverse the metabolic imbalance despite no significant change in my diet.
Brain health
28.6% reduction in the brain damage and dementia marker pTau217.
| pTau217 | |
|---|---|
| Pre-HBOT | 0.14 pg/mL |
| Post-HBOT | 0.1 pg/mL |
The phosphoprotein pTau217 is a specific marker associated with Alzheimer's disease.
Levels higher than 0.18 pg/mL are potentially indicative of plaque accumulation in the brain. Keeping this marker at the lowest end is a great relief and a sign of improved brain health.
Lower pTau217 is associated with lower tau pathology and is linked to better preservation of:
- memory
- processing speed
- executive function
- neuronal stability
Skin
| Facial skin age | UV spots score | |
|---|---|---|
| Pre-HBOT | 39 years old | 55th percentile |
| Post-HBOT | 38 years old | 68th percentile |
This is indicative of significant removal of advanced glycation end-products (AGEs) from the skin, perhaps due to improved vascularization.
Subjectively, I've never seen a more dramatic improvement in my skin quality than from these 60 HBOT sessions.
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Free or low-cost alternatives to HBOT
HBOT can be expensive. Here are some free or low-cost activities you can do to get some of the same effects:
- Sauna: Linked to a reduction in systemic inflammation and pTau217.
- Sleep: Sleep loss is linked to shorter telomeres in men, and it increases tau-related neurodegenerative signaling (bad for long-term brain health).
- Exercise: Linked to reduction in systemic inflammation and increases VEGF.
- Nutrition: The Mediterranean (Blueprint) diet is linked to longer telomeres and higher telomerase activity. It also increases gut microbiota diversity.
- Meditation: Meditation is linked to longer telomeres, especially in women.
- Smart UV exposure: Chronic UV exposure causes 80–90% of visible facial aging.
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Blueprint Quantified
Soon, you will be able to find clinics and health practitioners that are Blueprint Quantified, meaning they follow the same scientific rigor and measurement as my protocol.
We will be launching soon. Stay tuned.
Be well, Bryan
Originally published in Bryan Johnson's Blueprint newsletter (February 20, 2026). This content is for informational purposes only and is not medical advice. Consult your healthcare provider before starting any new wellness protocol.