Dear Dr. Roach: I’m 36 and have had Crohn’s disease for years. I’m having a mild Crohn’s flare. My specialist is leaning toward biologicals (Remicade, Humira, etc.), but I’m not game for that. I’ve been hearing more and more about ozone therapy, pioneered in Germany. Do you have any experience with that?


Dear P.G.: I don’t have any experience with ozone, and when I looked it up, I found many treatment centers with impressive testimonials. However, when I looked it up in the scientific literature, I found nothing. It took further research to try to identify why.

Ozone was indeed studied in Germany in the 1930s, but the effectiveness of using ozone topically (on wounds) was not impressive, and it was much less effective than other, safer treatments. Research was mostly abandoned. Ozone is irritating to mucus membranes and to the lungs. The Food and Drug Administration has stated that “ozone is a toxic gas with no known useful medical application in specific, adjunctive or preventive therapy.” The Natural Medicines Comprehensive Database has reviewed the evidence and concluded that ozone treatment is “likely unsafe.” From the standpoint of medical science, the question is answered, and ozone is neither safe nor effective. I recommend strongly against it.

However, people clearly are using it, and I read reports of people saying it worked for them. One study looked at people who, like you, had had Crohn’s disease for many years. The longer people have had inflammatory bowel disease, the more likely they are to try alternative treatments. These may include herbal therapies, such as wheatgrass, curcumin and Boswellia; traditional Chinese medicines; probiotics; and acupuncture. People naturally will try alternative treatments when standard treatments are less effective or more toxic than desired. Some alternative treatments I mentioned have shown promise, and although none has been studied well enough to be definitive, there is enough information to suggest that they may be useful and deserve further study.

I suspect that most of the practitioners offering ozone treatment are doing so in good faith, believing it will be helpful, despite the evidence. That can lead people to believe it is working: There is a robust history of people claiming that ineffective, dangerous treatments are effective, probably due to placebo effect. Unfortunately, there also are some people who prey on the desperately sick while knowing that their treatments are ineffective and toxic.

Dear Dr. Roach: My total cholesterol has been above 200 for as long as I can remember. A recent test showed a total cholesterol of 215, with an HDL of 112 and an LDL of 89. My cholesterol/HDL ratio is 1.9. My doctor seems unconcerned about the total cholesterol because my HDL is so high, which he feels is a good thing. I am a 67-year-old female who has exercised for 30 to 45 minutes, six days a week, for about 40 years. If I exercise more than that, my HDL and total cholesterol levels go even higher. Should I be concerned?


Dear K.J.: Doctors prefer looking at LDL cholesterol or non-HDL cholesterol (not total cholesterol) to help stratify risk for heart disease. HDL has a protective effect. You are in an unusual and enviable position, having an HDL cholesterol higher than your LDL cholesterol, and this puts you at substantially lower-than-average risk for heart disease for your age. Exercise routinely raises HDL and also reduces risk for heart disease, so exercise as much as you want, and don’t worry about your cholesterol.

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