What Is 10-Pass Ozone Therapy?
10-pass ozone therapy — also known as Ozone High-Dose Therapy (OHT) or hyperbaric ozone therapy — is an advanced form of ozone autohemotherapy that delivers approximately 10 times the ozone dose of a standard major autohemotherapy (MAH) session. Developed by Austrian physician Dr. Johann Lahodny, this technique uses a specialized device to repeatedly draw blood, ozonate it under positive pressure, and reinfuse it — completing 10 full cycles (“passes”) in a single treatment session.
At St. George Hospital (Klinik St. Georg) in Bad Aibling, Germany, 10-pass ozone therapy is a core component of our integrative protocols for chronic infections, immune dysfunction, and inflammatory conditions. Dr. Julian Douwes, Chief Medical Officer, has observed: “The difference between standard ozone therapy and 10-pass is analogous to the difference between a gentle rain and a sustained downpour. Both deliver water, but the volume and impact are fundamentally different.”
How Does 10-Pass Ozone Therapy Differ from Standard Ozone?
To understand the significance of 10-pass, it helps to compare it with standard major autohemotherapy:
Standard Major Autohemotherapy (MAH)
- 100-200 ml of blood drawn once
- Mixed with ozone at a specific concentration (typically 20-70 mcg/ml)
- Reinfused once
- Total ozone dose: approximately 2,000-6,000 mcg
- Duration: 30-45 minutes
10-Pass Ozone Therapy (OHT)
- 200 ml of blood drawn per pass
- Ozonated under hyperbaric pressure (positive pressure within the container), which increases ozone absorption
- Reinfused and the cycle repeated 10 times
- Total ozone dose: approximately 70,000-140,000 mcg (roughly 10-20 times a standard MAH)
- Duration: 60-90 minutes
The hyperbaric pressure element is critical: by ozonating blood under positive pressure, significantly more ozone dissolves into the plasma and interacts with blood components, producing a more potent immunological and antimicrobial response.
Benefits of 10-Pass Ozone Therapy
Enhanced Immune Activation
The higher ozone dose in 10-pass therapy produces a more robust immune response than standard MAH. This includes:
- Greater stimulation of white blood cell cytokine production (interferon-gamma, interleukins)
- More significant activation of natural killer (NK) cells
- Enhanced macrophage phagocytic activity
- Stronger upregulation of endogenous antioxidant systems (SOD, glutathione)
Stronger Antimicrobial Effects
For patients with chronic infections — particularly Lyme disease, bartonella, and other intracellular pathogens — the amplified antimicrobial properties of 10-pass ozone can be clinically significant. The higher dose creates a more hostile environment for pathogens while simultaneously boosting the immune system’s ability to eliminate them.
Improved Oxygenation
10-pass therapy produces a greater increase in 2,3-DPG levels in red blood cells, enhancing oxygen release to tissues. Patients with chronic fatigue, fibromyalgia, and circulatory disorders often report noticeable improvement in energy and tissue healing following 10-pass treatment.
Greater Anti-Inflammatory Impact
The amplified hormetic oxidative stress of 10-pass therapy drives a proportionally stronger antioxidant and anti-inflammatory response. This is particularly valuable in conditions characterized by chronic low-grade inflammation, including post-COVID syndrome, autoimmune conditions, and chronic pain syndromes.
Conditions Treated with 10-Pass Ozone
At St. George Hospital, we use 10-pass ozone therapy in the treatment of:
- Chronic Lyme disease and co-infections: As part of our comprehensive tick-borne disease protocol
- Post-COVID syndrome: Addressing persistent inflammation, fatigue, and immune dysregulation
- Chronic fatigue syndrome (ME/CFS): Supporting mitochondrial function and immune recovery
- Integrative oncology: As an adjunctive immune-supportive therapy alongside conventional oncological treatment
- Chronic viral infections: Including Epstein-Barr virus reactivation, chronic hepatitis, and herpes viruses
- Autoimmune conditions: Where immune modulation is beneficial
- Chronic pain and fibromyalgia: Through anti-inflammatory and oxygen-enhancing mechanisms
- Longevity and anti-aging: As part of proactive cellular health optimization
What Does 10-Pass Ozone Therapy Cost?
10-pass ozone therapy is a specialized treatment that requires dedicated equipment (the Zotzmann or Herrmann devices most commonly used), trained medical staff, and physician supervision. Cost varies by region and clinical setting:
- United States: $800-$2,500 per session, depending on the clinic and geographic area
- Europe: EUR 500-1,500 per session, with some variation between countries and clinical settings
- Treatment series: Most patients require a series of 5-10 sessions, with total costs ranging from $4,000-$15,000
At St. George Hospital, 10-pass ozone is integrated into our comprehensive inpatient treatment programs. Costs are included in the overall treatment plan rather than charged per session, which often represents better value than piecemeal outpatient treatment. We provide transparent cost estimates during the initial consultation.
The 10-Pass Treatment Experience
Here is what patients can expect during a 10-pass ozone session at St. George Hospital:
- Preparation: An intravenous line is established. The Zotzmann or equivalent device is connected
- Pass 1: Approximately 200 ml of blood is drawn into the ozone-resistant container under vacuum. Medical-grade ozone is injected under positive pressure. The blood-ozone mixture is allowed to react, then reinfused
- Passes 2-10: The cycle repeats. Each pass takes approximately 6-9 minutes
- Total duration: 60-90 minutes for the complete 10-pass protocol
- Monitoring: Vital signs are monitored throughout. Patients remain comfortably seated or reclined
- Post-treatment: Most patients can resume normal activities. Hydration is encouraged
Side Effects and Safety
10-pass ozone therapy has a strong safety profile when performed by trained physicians using appropriate equipment. Potential side effects include:
- Fatigue: Common after the first 1-2 sessions as the body processes the increased immune stimulation
- Herxheimer-like reaction: In patients with active infections, bacterial die-off can temporarily worsen symptoms. This is managed with supportive measures and, at St. George Hospital, with therapeutic apheresis
- Mild headache: Occasionally reported, usually transient
- Vein irritation: The repeated draw-infuse cycles may cause mild discomfort at the IV site
- Temporary changes in blood pressure: Usually mild and self-correcting
Contraindications are the same as for standard ozone therapy: G6PD deficiency (absolute contraindication), severe cardiovascular instability, untreated hyperthyroidism, and active hemorrhage. A comprehensive review of ozone therapy safety has been published in the Archives of Medical Research.
10-Pass Ozone as Part of a Multimodal Protocol
At St. George Hospital, 10-pass ozone therapy is rarely used in isolation. Its greatest clinical impact comes when combined with complementary modalities:
- Whole-body hyperthermia: Hyperthermia + ozone creates synergistic antimicrobial and immune-activating effects. Hyperthermia weakens pathogens and makes them more vulnerable to the immune stimulation triggered by ozone
- Therapeutic apheresis: Blood filtration manages the inflammatory response from bacterial die-off, allowing patients to tolerate more aggressive treatment
- NAD+ IV therapy: Supports mitochondrial recovery and cellular energy production alongside ozone’s oxygen-enhancing effects
- Targeted antimicrobial therapy: Pharmaceutical agents combined with ozone for comprehensive infection management
This integrative approach reflects the clinical philosophy of Dr. Julian Douwes and the St. George Hospital medical team: “No single therapy is sufficient for complex chronic disease. The art of integrative medicine lies in combining the right tools in the right sequence for each individual patient.”
Frequently Asked Questions
Is 10-pass ozone better than regular ozone therapy?
10-pass delivers a significantly higher ozone dose, producing more potent immune stimulation and antimicrobial effects. For patients with chronic infections, severe immune dysfunction, or complex inflammatory conditions, 10-pass is generally preferred. For milder conditions or maintenance therapy, standard MAH may be sufficient. Your physician will recommend the appropriate approach based on your clinical needs.
How many 10-pass sessions do I need?
Most treatment protocols involve 5-10 sessions, typically administered 2-3 times per week during an inpatient stay. The exact number depends on your diagnosis, severity of illness, and clinical response. Patients with chronic Lyme disease, for example, may receive 10-pass ozone as part of a 2-3 week intensive treatment program.
Can I get 10-pass ozone therapy near me?
10-pass ozone requires specialized equipment and trained practitioners, which limits its availability. In the United States, a growing number of integrative medicine clinics offer the treatment. In Europe, Germany and Austria have the longest clinical tradition. St. George Hospital in Bad Aibling, Germany, is one of Europe’s leading centers for ozone therapy and welcomes patients internationally.
Does 10-pass ozone therapy hurt?
The treatment involves standard IV access — the needle insertion is the same as any blood draw. During the treatment, most patients feel little to no discomfort. Some experience a mild warmth, slight chest tightness, or pressure sensation during certain passes, which resolves quickly. Most patients find the treatment comfortable and some read or rest during the session.
Begin Your Treatment
If you are considering 10-pass ozone therapy for chronic infection, immune support, or as part of a comprehensive treatment plan, the physicians at St. George Hospital can evaluate your case and recommend the most effective approach.
Contact us:
- Phone: +49 (0)8061 398-0
- Email: info@clinicum-stgeorg.de
- Visit: Contact page
St. George Hospital (Klinik St. Georg) — Rosenheimer Str. 6-8, 83043 Bad Aibling, Germany