Autoimmune diseases involve a misdirected immune system that attacks the body’s own tissue, and chronic inflammation is the common thread running through all of them. HBOT has documented anti-inflammatory effects and immune-modulating properties, which has led to interest in whether it might help people with conditions like lupus, rheumatoid arthritis, inflammatory bowel disease, and multiple sclerosis. The honest answer is that the evidence is modest and condition-specific. Here’s what we actually know. It is one of several other chronic conditions where HBOT shows promise that researchers are actively investigating.
How HBOT Interacts with the Immune System
HBOT’s effects on immune function are more complex than simply “suppressing” or “boosting” immunity. At therapeutic pressures, HBOT appears to modulate the immune response in several ways.
Suppression of NF-kB, a central transcription factor driving inflammatory gene expression, reduces production of pro-inflammatory cytokines including TNF-alpha, IL-1, and IL-6. These are the same cytokines targeted by many biologic autoimmune drugs. HBOT also appears to shift the balance between pro- and anti-inflammatory immune cell populations, increasing regulatory T cells in some studies and reducing neutrophil-mediated tissue damage.1
Simultaneously, HBOT supports immune function against actual pathogens by enhancing oxidative killing capacity in neutrophils and macrophages. This dual nature, anti-inflammatory in some respects and pro-immune in others, makes HBOT’s role in autoimmune conditions nuanced.
The broader picture of HBOT’s immune-modulating mechanisms is covered in the immune support and HBOT article.
In collagen-induced arthritis models, HBOT increased splenic regulatory T cell frequencies and decreased Th17 cells, reducing synovial inflammation. In NOD mice (a diabetes model), HBOT delayed diabetes onset and preserved pancreatic beta-cell mass.1
Peer-reviewed research
Multiple Sclerosis
MS has received more HBOT research than any other autoimmune condition, dating back to a 1983 paper in the New England Journal of Medicine that showed significant improvements in disability. Subsequent research has been inconsistent. A Cochrane review of nine randomized trials concluded that there was no significant effect of HBOT on the primary endpoints of MS progression or disability.4 Some individual studies and patient reports note improvements in bladder function, fatigue, and quality of life measures.
Many MS patients in the UK access HBOT through MS therapy centers that operate mild-pressure chambers, and subjective improvement in symptoms is commonly reported. The disconnect between patient experience and trial outcomes may reflect that HBOT helps with specific symptoms (fatigue, bladder) without affecting disease progression, which is what most trials measured. HBOT is not recommended by mainstream neurology guidelines as a disease-modifying therapy for MS.
Rheumatoid Arthritis
The anti-inflammatory properties of HBOT are theoretically relevant to rheumatoid arthritis, where synovial inflammation drives joint destruction. Small studies and case reports have documented reductions in joint pain and inflammation markers after HBOT, but there are no adequately powered clinical trials. HBOT is not standard of care for RA, and given the effectiveness of modern biologics, it is unlikely to replace them. It might have a role as an adjunct for patients with inadequate response to medication, but this is speculative.
Inflammatory Bowel Disease
Crohn’s disease and ulcerative colitis are chronic autoimmune conditions with significant bowel inflammation. Some of the more interesting HBOT and autoimmune research involves IBD. HBOT has been used as an adjunct treatment for refractory Crohn’s fistulas and severe colitis, with some case series reporting improvements. The anti-inflammatory mechanisms and ability to support wound healing in the bowel wall make HBOT theoretically attractive.
A 2017 systematic review found several studies reporting improvements in IBD symptoms and inflammatory markers with HBOT, but all were small and methodologically limited. The therapy is not standard of care for IBD but is sometimes used in refractory or complicated cases at centers with hyperbaric facilities.
Lupus (SLE)
Systemic lupus erythematosus is one of the more challenging autoimmune conditions, with widespread organ involvement and a highly variable course. HBOT research specifically in lupus is extremely limited. An animal study found that early HBOT attenuated disease severity in lupus-prone mice,3 but human clinical data is absent. There is insufficient evidence to recommend HBOT specifically for lupus management, though patients with lupus-related complications (such as avascular necrosis of bone or non-healing wounds) might qualify for HBOT under other approved indications.
Fibromyalgia
Fibromyalgia is sometimes classified with autoimmune or inflammatory conditions, though its exact mechanisms are disputed. HBOT has been more specifically studied for fibromyalgia than for most autoimmune conditions, with a 2015 randomized controlled trial by Efrati showing significant improvements in pain and quality of life. The fibromyalgia and HBOT article covers this in detail.
Important Caveats for Autoimmune Conditions
Do Not Replace Disease-Modifying Therapy
For serious autoimmune conditions like MS, RA, and lupus, disease-modifying therapies have demonstrated efficacy in preventing organ damage and reducing disability progression. HBOT should never be pursued instead of these therapies but potentially as a complement. Stopping proven treatments to pursue unproven alternatives is a risk no patient should take lightly.
The Immune-Stimulation Concern
Some researchers have raised the theoretical concern that HBOT’s immune-stimulating effects (enhancing innate immune function) could theoretically worsen autoimmune conditions by supporting the immune activity that is already causing harm. Current evidence doesn’t strongly support this concern at typical therapeutic doses, but it’s worth discussing with your rheumatologist or neurologist before starting HBOT.
Review Side Effects and Contraindications Carefully
The side effects and contraindications guide should be reviewed carefully in the context of your specific autoimmune medications.
What a Reasonable Approach Looks Like
If you have an autoimmune condition and are considering HBOT, the most reasonable approach is: keep your standard treatment in place, involve your specialist in the decision, set realistic expectations (symptom improvement is possible; disease reversal is not), and consider a defined trial course (20 to 30 sessions) with formal assessment of response before committing to more. The session guide and cost guide will help you plan practically.
The chronic conditions and HBOT overview may also be useful if your condition has multiple dimensions.
Most clinical studies on HBOT for autoimmune conditions are observational or small. The strongest clinical signal so far is for autoimmune-related skin ulcers and inflammatory bowel disease, not for core autoimmune disease activity.2
Peer-reviewed research
Inflammatory vs. Autoimmune: An Important Distinction
Not all conditions marketed as “autoimmune” involve the same underlying mechanism, and HBOT’s relevance varies accordingly. True autoimmune conditions (lupus, RA, MS) involve misdirected immune attack on self tissue. Inflammatory conditions (fibromyalgia, some forms of chronic pain, certain gut disorders) involve dysregulated inflammation without necessarily a clear autoimmune target. HBOT’s anti-inflammatory properties may be relevant to both categories, but the specificity of benefit differs. For conditions driven primarily by dysregulated inflammation without clear autoimmune attack, HBOT may have more theoretical applicability than for classic autoimmune diseases where disease-modifying therapies are highly targeted.
Tracking Response Objectively
If you pursue HBOT for an autoimmune or inflammatory condition, establishing clear objective measures before starting is essential. Relevant markers might include inflammatory lab values (CRP, ESR, specific cytokine panels), validated disease activity scores (DAS28 for RA, SLEDAI for lupus, MSRS for MS), and patient-reported outcome measures specific to your condition. Without baseline measurements, it’s impossible to know whether any subjective changes during or after HBOT reflect the treatment, natural disease fluctuation, or non-specific effects of intensive clinical attention. Objective tracking protects you from both overstating and understating benefit.
The Role of Diet and Lifestyle in Autoimmune Conditions
For autoimmune conditions, HBOT is at most one small piece of a larger puzzle. Diet (anti-inflammatory approaches, gut microbiome support), stress management (chronic stress drives inflammatory signaling), sleep quality, and avoidance of environmental triggers all have meaningful evidence for modulating autoimmune disease activity. These are worth optimizing alongside any HBOT consideration. The alternatives and complementary approaches article provides context for thinking about HBOT within a broader management strategy.
How Long Does It Take to Know If HBOT Is Helping an Autoimmune Condition?
Autoimmune disease activity fluctuates naturally, making it difficult to attribute short-term changes to any single intervention. To give HBOT a fair assessment, most practitioners suggest evaluating formal outcomes at the completion of a defined course (20 to 40 sessions) rather than during treatment, and again at 30 to 60 days post-treatment. Changes in inflammatory markers (CRP, ESR), validated disease activity scores, and patient-reported quality of life measures at these time points give a more reliable signal than day-to-day symptom observation.
Patients who complete a course and show no measurable improvement on objective measures at 60-day follow-up should discuss with their physician whether additional sessions are justified. Open-ended continuation of expensive off-label treatment without objective response evidence is not a sound approach for any chronic condition, autoimmune or otherwise.
Frequently Asked Questions
Can HBOT put autoimmune disease into remission?
There is no clinical evidence that HBOT induces remission in any autoimmune disease. It may reduce inflammation and improve symptoms, but it does not address the underlying immunological dysfunction that drives autoimmune conditions.
Is HBOT safe while on immunosuppressant medications?
Most immunosuppressants don’t directly interact with HBOT, but some medications require review (certain chemotherapy agents used in autoimmune conditions have known HBOT interactions). Your hyperbaric physician should review your full medication list before treatment begins.
How many HBOT sessions would be needed for autoimmune conditions?
There are no established protocols. Most small studies have used 20 to 40 sessions. A trial course with formal symptom assessment before and after is a reasonable approach to determine individual response.
Will my rheumatologist support me doing HBOT?
This varies. Some specialists are open to adjunctive approaches when standard treatment is already in place. Others are skeptical due to limited evidence. Bringing published research to the conversation and framing HBOT as adjunctive (not alternative) care tends to go over better than presenting it as a standalone treatment.
Sources
- Mei S, et al. Hyperbaric oxygen therapy modulates immune effector responses and reshapes peripheral immune tolerance: a narrative review. Frontiers in Immunology. 2026. PMC12992055.
- Fang J, et al. Clinical efficacy and mechanisms of hyperbaric oxygen therapy in the treatment of rheumatic and immune diseases. Front Med. 2025. DOI: 10.3389/fmed.2025.1706637
- Chen SY, et al. Attenuation of murine lupus nephritis by hyperbaric oxygen. Clin Immunol. 2003. DOI: 10.1016/S1521-6616(03)00091-3
- Bennett MH, Heard R. Hyperbaric oxygen therapy for multiple sclerosis. Cochrane Database Syst Rev. 2004. PMID: 15171524. PubMed
- Efrati S, et al. Hyperbaric oxygen therapy can diminish fibromyalgia syndrome. PLoS ONE. 2015. PMID 26010952
- Undersea and Hyperbaric Medical Society. HBO Therapy Indications. UHMS
Medical Disclaimer
The content on BaricBoost.com is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Author
Seph Fontane Pennock is the founder of BaricBoost.com and Regenerated.com, a clinic directory for regenerative medicine serving 10,000+ providers across the United States. He previously built and sold PositivePsychology.com, which grew to 19 million users and became the largest evidence-based positive psychology resource on the web. Seph brings direct experience as an HBOT patient, having completed protocols at clinics across three continents while navigating mold illness, systemic inflammation, and autoimmune conditions. His treatment journey includes hyperbaric oxygen therapy, peptide protocols, NAD+ therapy, and consultations with specialists from Dubai to Cape Town to Mexico. This combination of entrepreneurial track record and lived patient experience shapes everything published on BaricBoost.com. Every article is grounded in peer-reviewed research, informed by real clinical encounters, and written for patients making high-stakes treatment decisions. Seph's focus is on bringing transparency, scientific rigor, and practical guidance to the hyperbaric oxygen therapy space.
