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Important Information on DIV and generators
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The AAO position on DIV (Direct I.V. injection of ozone/oxygen)


The AAO is committed to holding our members to the highest of standards.  There are two basic reasons that our members practice the use of medical ozone therapy with their patients.  One, and perhaps most importantly, is that when ozone therapy is used according to AAO and international guidelines and standards it is one of the safest therapies in all of medicine.  All of our doctors are absolutely committed to therapies that will not hurt our patients, and this is clearly one of the reasons that we embrace ozone therapy.  Ozone therapy will often eliminate the need for other medical therapies that are inherently unsafe such as surgery and pharmaceuticals, and in this way simply because of its safety profile ozone therapy can save lives. 

            Second, ozone therapy not only works extremely well as an alternative to drugs and surgery, but it is also effective for many conditions for which there is no known effective treatment.  This includes many cases of chronic and acute infections, interstitial cystitis, dry macular degeneration, certain cardiovascular disorders, and many pain and degenerative disorders. 

            DIV ozone therapy is used by a minority of doctors around the world.  Doctors using this form of ozone therapy insist it is safe and effective.  However, without exception, the international ozone community has denounced DIV as being unproven and potentially unsafe.  Therefore the AAO has issued this position statement on DIV therapy.  It clarifies why we believe that DIV should not be used in any human applications.


1.     DIV is offered as an alternative to MAH (major-auto hemotherapy).  MAH has been the mainstay of intravenous ozone therapy for the past fifty years.  Literally thousands of papers have been presented proving its efficacy and safety.  On the other hand there is absolutely no published support for DIV.  This is also in contrast to every other methodology for ozone therapy such as sauna, rectal, intravesical, ozonated saline, and soft tissue and joint injection.  To sum, there is no evidence that DIV is either a safe or effective alternative to MAH.

2.     There is also a side effect issue with DIV.  DIV can cause respiratory failure in patients with reactive airway as well as the very common side effect of phlebitis.  None of these side effects occur with MAH.  At least one documented case of acute respiratory failure which required emergency management in order to save the patient's life and one death have recently occurred from DIV.  In both cases there was documented evidence of gas embolism.  So while MAH is inherently safe there are distinct dangers with the DIV method.  These dangers are not acceptable to AAO members.

3.     Another disadvantage of DIV therapy is that high doses over 10mg cannot be achieved.  These doses are often needed for autoimmune and other conditions, and they can easily be achieved by MAH. 

4.     The position of the AAO is that DIV is dangerous where as MAH is not, and  there is no known benefit for DIV over MAH.

5.     Therefore in recognition of the seriousness of this issue, and of the importance for our academy to maintain the very highest of standards, it is the opinion of this president and our advisory board that all members of the AAO avoid using DIV therapy in human subjects.  We understand that treating animals using the MAH method cannot be practically performed and so we make an exception for the use of DIV in animals.   All AAO members will be required to acknowledge either by mail or email that they will not engage in the use of DIV ozone therapy unless it is done to animals or to humans under the auspices of an IRB approved research study.


AAO position on ozone generators

It is critical that all our members understand that we must all be sure that we are introducing nothing but pure ozone/oxygen mixtures at the right concentrations into our patients.  Improperly designed generators will produce impure, contaminated gases at unreliable concentrations.  You will not believe some of the generators that some practitioners are using or prescribing to their patients because they believe the equipment is reliable.  Therefore, I can't overestimate how important it is that all our members adhere to our AAO official position on ozone generators.  The entire position and it's scientific justification is stated on the web site, but in brief this is it:

·         This applies to all generators used in direct human or animal medical applications.  This includes sauna, rectal, injectable, topical, and all other applications used in humans. It does not apply to generators solely used for decontaminating surfaces, food, medical instruments, or air, etc.  The AAO believes that only the purest forms of ozone/oxygen mixtures can be safely used for medical applications of any kind on human subjects.

·         All ozone generators for human or animal (in office or at home) use must bear a safety approval sticker such as ETL, CSA, UL, or QAI for the assembled unit, not it's components separately.

·         No generator for human or animal use (in office or at home) must be constructed of any substances that come into contact with ozone other than quartz glass, kynar, Teflon, or silicone.  This includes all other materials such as ceramic, other plastics, aluminum, and steel.


   AAO neither endorses nor condones the use of generators that do not meet these safety guidelines.  As an academy of professionals we must set ourselves apart from all other ozone practitioners who do not meet the highest of standards.

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