On a recent podcast, the host asked actor and commercial wellness mogul Gwyneth Paltrow, “What’s the weirdest wellness thing you’ve done?” Paltrow shared that she has received something called ozone therapy, administered rectally, and had found it “very helpful.” She told host Will Cole, “It’s pretty weird.”
The problem with rectal ozone therapy, of course, isn’t that it’s weird. Medicine is full of so-called weird but clinically effective and demonstrably safe things, including other rectal treatments, like taking donated feces and transplanting it into the colon of another person to fight Clostridium difficile bacterial infection.
The rationale behind using ozone as a health aid derives from the fallacy that if something is good for you, more must be even better.
Ozone, however, isn’t one of these things.
The oxygen we breathe is a couplet of oxygen molecules (O₂); ozone is a triplet (O₃). If two is good, three must be amazing, right? The rationale behind using ozone as a health aid derives from the fallacy that if something is good for you, more must be even better.
Unfortunately, ozone stinks, both literally (its name is derived from the Greek word for “to smell,” for its pungent odor) and qualitatively as a broadly applied therapy. Though it has a positive impact in the upper atmosphere, protecting us from harmful UV radiation, it is a pollutant at the Earth’s surface where we live, a byproduct of cars and industrial activity.
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♬ Aesthetic – Tollan Kim
According to the Food and Drug Administration: “Ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy. In order for ozone to be effective as a germicide, it must be present in a concentration far greater than that which can be safely tolerated by man and animals.” In densely populated urban areas and during hot weather, ozone can rise to harmful levels, exacerbating breathing problems and even leading to death, especially among those who work outside or live in neighborhoods where improving air quality hasn’t been prioritized.
But in America, where inequities are so vast, an inescapable toxin to those who are systematically disadvantaged is bottled and taken electively in delicate aliquots by those who are rich.
The health claims for ozone are tremendously broad, including that it fights infection and inflammation, improves the circulation and bolsters the immune system. Yet it is hard to find a published scientific study about the positive health uses of ozone that a) occurred in human subjects and b) isn’t from a predatory or defunct journal. Numerous recent articles have debunked the legitimacy of ozone as therapy.
There is an aspect of Paltrow’s confession that hits hard, and it highlights why her public journey might be so attractive to many of those who follow it. She is a self-acknowledged Covid long-hauler who has been suffering from fatigue and brain fog since the first year of the pandemic. Even a purveyor of woo-woo can succumb to the same desperation experienced by many people with long Covid. Indeed, while it is appropriate to wait for validated and safe treatments for long Covid, research into this area has progressed far too slowly. The gap between medical need and available evidence-based treatments creates vulnerability and an opportunity for both innovation and serious harm. But Covid has further lowered my tolerance for people with endless means who take potential risks with their health and present X or Y new treatments with only wide-eyed marvel over their purported benefit for any host of maladies. They rarely mention side effects or the fact they have the financial wherewithal and privileged access to offset any harms. People like Paltrow don’t have to choose between a voluminous menu of woo-woo du jour and traditional preventive or medical care. Paltrow experiments in a bubble of abundance and safety, one inaccessible to the vast majority of people she reaches. The line between traditional and “complementary” health care is not as black and white as one might think. Within the National Institutes of Health is a 25-year-old institute dedicated to studying treatments that don’t fit within conventional medicine. Another institute, the National Institute on Drug Abuse, funds my current research examining health modalities such as massage and acupuncture. In the course of our work, my team and I are often surprised by how little is known among medical professionals about the role such approaches can play in promoting health, healing and function. Within “Western” medicine, there is so much room for openness to evidence and practices that fall outside standard mainstream therapies. But medical science is bound by rules and integrity in the way that speculative wellness isn’t. We can’t, as Paltrow does in the podcast, state that only feedback given with love and kindness will be listened to. All scientists have yearned for the freedom to ignore comments in peer reviews that wounded their feelings or to dismiss harsh criticisms as problems with the reviewers and not their work. The fact we can’t means something; it forces us to confront uncomfortable flaws in methodology or interpretation, blind spots that might lead to erroneous judgment and harmful recommendations. “Tried stuff, feels right” is a lucrative formula but not a reliable or, ultimately, a caring one. It takes more to be truly about wellness, no matter how big a chunk of the commercial wellness industry one occupies.
Dr. Esther Choo
Esther Choo, M.D. M.P.H., is an emergency medicine physician, health policy researcher and founding member of Equity Quotient, a company that advises organizations on building cultures of equity. She has provided commentary on the pandemic and other health care topics through appearances on MSNBC, CNN, the BBC and Yahoo! Finance and editorials published in The Lancet, the British Medical Journal, The Washington Post, NBC Think and USA Today. 
