Interview with Dr. Arkadi Prokopov

The Oxygen Paradox - On Mitochondrial Health, Intermittent Hypoxic Therapy, and Why Elite Athletes' Secret Works for Everyone

When Dr. Arkadi Prokopov tells you he wanted to be a "critic of medicine" rather than practice it, you understand you're talking to someone who sees healthcare differently. I had the privilege of sitting down with him in person to explore his forty-year journey with intermittent hypoxic therapy—a conversation I'm deeply grateful he was willing to have, and any transcription errors here are entirely my own. His path from a disillusioned medical student in 1970s Moscow to a pioneering researcher in mitochondrial medicine reads like an adventure story: diving with commercial crews in hyperbaric chambers, testing stress resistance sixty meters underwater, and discovering that the secret to cellular health might lie not in adding more oxygen, but in strategically taking it away.

What Prokopov discovered through decades of research—from those early experiments with swimming rats in barochambers to treating thousands of patients—is that our mitochondria, the energy factories in every cell, respond remarkably to controlled oxygen oscillations. This isn't about climbing mountains or suffering through altitude sickness. It's about mimicking what nature already does: the rhythmic oxygen pulses in the womb during fetal development, the ebb and flow in our muscles during exercise. By diluting room air from 21% oxygen down to 10%—equivalent to standing at 6,500 meters altitude but without leaving your living room—intermittent hypoxic therapy triggers ancient cellular repair mechanisms. The body, sensing this controlled stress, doesn't just adapt; it rejuvenates, clearing out damaged mitochondria and strengthening the survivors.

Here's yet another important, effective, and remarkably low-cost healing modality that belongs in our collective toolkit—one that costs less than many monthly supplement regimens and can be done at home. At 76, Prokopov maintains the VO2 max of an elite endurance athlete, having never been one himself. His patients have seen reversals in cognitive decline, normalization of blood pressure, improvement in chronic Lyme disease, and even progress with autism spectrum disorders. What makes this interview particularly valuable is Prokopov's willingness to share not just the science but the practical reality: from devices that range from $1,000 to $25,000 (he calls them bicycles versus Mercedes), to simple breathing techniques that cost nothing at all. As he puts it, with characteristic directness, "It's difficult to sell air"—but that hasn't stopped him from dedicating his life to understanding how strategically breathing less of it might help us live longer, healthier lives.

With thanks to Dr. Arkadi Prokopov.

OXYESTA Ltd

1. Can you please share your journey and how your interest in biomedical research, particularly with divers, led you to focus on intermittent hypoxic therapy (IHT)?

This is quite a story. First of all, during my studies at the medical university in the seventies, I actually had no interest in practical medicine. I was somehow disappointed from my experience and from the experience of my relatives—that medicine has little value for maintaining good health. It can save your life, but it can also ruin your life if the intervention is done wrongly or with mistakes. I had such examples in my family.

Therefore, I was interested in experimental medicine and biomedical research, particularly in diving. I was a very big fan of diving. I was watching films of Jacques Cousteau, and that made a great impression.

When I was asked during my studies what field of medicine I'd like to specialize in, I answered, "I'd rather be a critic of medicine." They said there's no such specialty, but I asked, "Why not? If there are literature critics, music critics, and even restaurant critics, why not be a critic of medicine?" Until now, I keep this option and I use it.

After graduating from First Medical Moscow University, I worked for a year in emergency medicine. That was quite useful because any physician should have practical experience in handling common emergency cases. But my aspiration since childhood was undersea biology.

I was lucky to find an institution in Moscow that was engaged in undersea biomedical research. That helped me marry my childhood dream to my medical education. So I enrolled in postgraduate study in the specialty of aviation, space, marine, and undersea medicine.

I conducted research on the use of pharmacological agents, so-called adaptogens, for the enhancement of stress resistance in commercial divers. It was quite a hot topic in the eighties because the marine and undersea oil drilling industry was developing.

For the beginning of the study, all test persons, including myself, had to be certified as commercial divers. We took a full course of training in simulated and natural undersea settings.

Commercial divers carry out a lot of physical activities, and when they work deeper than 60 meters, they do it in saturation mode. They enter a hyperbaric habitat chamber and stay under constantly high barometric pressure for several weeks, which is close to the depth of their actual work. This allows working at the bottom for 6 to 8 hours a day, then resting in the habitat for 16 hours. This mode requires only one compression-decompression cycle for the whole project, and is more safe and cost-efficient compared to daily compression-decompression journeys.

Nevertheless, when six divers stay for several weeks in a very small volume hyperbaric habitat, it creates extensive stress for their bodies. It consists of environmental, microbiological, immune, hormonal and psychological components. Collectively, it's quite similar to the conditions on board an orbital station. However, American astronauts who spent several weeks in an undersea habitat emphasized that the space station exposure was much more comfortable.

In both cases, there is a mixture of extreme stress-inducing, pro-aging factors that induce excessive oxidative molecular damage and accelerate the aging process, converging on mitochondria. Today, that's quite certain.

I had been testing in divers a new pharmacological component—let's call it component B (Bemythyl)—that had been found to have some stress-preventive and performance-enhancing effects in athletes. I first conducted animal tests in which mice and rats were swimming in buckets placed in a barochamber. For comparison with treated animals, I gave another group of animals a cocktail of amino acids, minerals, and vitamins that all worked as antioxidants and precursors of endogenous antioxidative enzymes.

Both groups showed much longer swimming time compared to control animals. However, the vitamin cocktail-treated group had twice longer swimming time than the B group. This difference increased even more when swimming tests in the same groups were repeated twice a week. Additionally, the B group showed slower biochemical blood recovery values after hyperbaric swimming stress.

From these tests I realized that the combination of repeated training in hyperbaric conditions with nutritional metabolic support is much more efficient than a pure pharmacological intervention.

So I was looking for further synergistic interventions that could bring more stress resistance and health benefits. One such intervention, known as altitude training, was already discovered and used by athletes since the 1960s. Originally it consisted of exposure to moderate altitude—2,500 to 4,000 meters above sea level—while training, recovering, and sleeping also at altitude or at sea level.

This philosophy is based on the phenomenon of hypoxic preconditioning. Obviously, it's much easier to controllably reduce barometric pressure in an enclosed habitat than travel back and forth to the mountains for the same purpose. Using this approach, many studies were conducted by specialists in sports physiology, aviation, and space medicine.

The consensus was that hypoxic preconditioning can be achieved by reducing oxygen content in breathing air using protocols of controlled hyperbaric exposure. But what happens if we reduce oxygen percentage in the breathing air by just diluting room air with nitrogen? Room air contains about 21% oxygen. We can use more nitrogen to reduce oxygen to, let's say, 10%. And that was the beginning of practical application of this technology—using the well-known and proven technology of altitude training, but engineering it to use normobaric gas mixture, diluting oxygen with nitrogen, which is now produced by hypoxic generators.

2. So if you were to get the oxygen level down to 10% by increasing the nitrogen, that is similar to a 6,500 meter altitude?

Yes, 10% oxygen in normal barometric conditions corresponds to about 6,500 meters. It's much easier than climbing 6,500 meters! And much easier than placing a person in a hypobaric chamber because that requires a lot of engineering and technical equipment.

Using oxygen concentrators in reverse mode is much better —because any oxygen concentrator takes room air and separates it into oxygen-enriched and oxygen-depleted fractions—we can use both. So we have hypoxia and hyperoxia. The question is just how to direct these two flows, in what sequence and with what control.

3. Is the origin of this space program work? Does it go back to the space program and conditioning astronauts to deal with increased radiation in space?

No, I would say rather not. It started more as a practical application for fighter jet pilots. At the end of the forties, when jets started to fly over 15 kilometers and higher, it was clear that you need to train pilots for hypoxia. Of course, they have oxygen masks and all this equipment, but nevertheless they experience hypoxia.

Therefore, the training program in hypobaric chambers was introduced. The physicians noticed that pilots who had some health problems like hypertension, allergies, headaches—after this simulated altitude training they started to improve. They had normalization of their blood pressure, less inflammation. That was the idea that hypoxic training itself has beneficial health effects.

Nowadays, we know that it has a lot of other benefits. It produces radioprotective effects, and that was the origin of intensive studies of intermittent hypoxia in the Soviet Union in the seventies. It was used for cancer radiotherapy as a protective option. If you reduce oxygen in living tissue, in the living organism, it reduces the radiolysis of water under irradiation. But at the same time, it doesn't influence the tumour itself, because the cancer tumor is already hypoxic. So you can increase doses of irradiation—you put more pressure on the tumor, but simultaneously you protect healthy tissues from excessive radioactive damage.

4. Intermittent hypoxic training has roots in the seventies. How did it evolve from its initial radioprotective applications to the broader medical applications we see today?

Soon after the practical application of intermittent hypoxia as a radioprotective means, studies were done to find out what is going on in organisms. Prof. Alexey Ya. Chizsov originally worked a lot in obstetrics and gynecology. He was interested in how it works on embryonic development, and using oxygen measuring techniques, he found out that there's constantly low oxygen in the uterus—actually it's pretty low, twice lower than in room air. But simultaneously, there are oscillations of this already low oxygen. They continue periodically and repeatedly. That means it has some biological meaning.

He was studying this phenomenon for a long time and found that practically all mammals have the same mechanism. He interpreted it as nature developing a process of slow adaptation from low oxygen to high oxygen in the environment. If you do it in one step, you experience a lot of damage, which we see from clinical experience. For instance, preterm babies, when they are placed in a hundred percent oxygen environment—it was done early—they can become blind. The body is not ready to absorb this high oxygen.

So he decided, why not repeat these cycles in the healthy organism or in the patient and see what happens? This process actually repeats something on the muscular level. During exercise, our muscles contract, blood flow is restricted, and muscles are periodically deprived of oxygen. If we do the same with inhalation of oxygen-depleted air, we simulate the same process in the muscles, and not only in the muscles, but also in extremely important organs—brain, heart, kidneys, liver.

That was a brilliant idea, because it immediately showed a lot of benefits in experimental animals. Of course, he started with animals, and a lot of preliminary work was done on animal models.

5. What makes intermittent hypoxia more beneficial compared to continuous hypoxia in terms of mitochondrial function?

It's a very important difference. We know that all biological mechanisms work in a cycling mode. There's always oscillation between stress and relaxation.

Stress causes molecular damage. If you go to the deepest biological level, you see there's always stress-related molecular damage. But relaxation provides repair and super-compensation that helps to endure future stresses.

Continuous hypoxia means continuous molecular stress and damage. Intermittent hypoxic exposure provides necessary recovery, repair, and regenerative windows. Of course, in both cases, the duration and intensity of hypoxic and normoxic phases are dramatically important.

6. You've emphasized the role of mitochondria in health. Why are they such a central focus for improving overall wellness?

I always try to use an analogy. You can compare a cell with a huge industrial plant. It gets raw material from outside. It has lots of equipment. It has thousands of personnel, tons of instructions on the manufacturing of thousands of products, and it consumes energy 24 hours, 7 days a week.

This simplified model is quite helpful when you imagine what happens when you start reducing and rationing energy. That's exactly what's happening in our body, in our cells, when mitochondria produce less and less ATP. Besides ATP, they have 100-plus functions which mitochondria control. Therefore, the quality of mitochondria underlies our health performance, resistance to infections, overall well-being and our healthy lifespan.

7. How does intermittent hypoxic therapy support mitochondrial rejuvenation and help manage chronic conditions like asthma or hypertension?

Both these conditions have a significant mitochondrial component. For instance, the pathogenesis of asthma includes chronic CO2 deficiency due to overbreathing, or hyperventilation. Practically all asthma patients have CO2 deficiency. It induces bronchial spasm and chronic inflammation, and mitochondrial participation is known in this condition.

Hypertension also has multiple underlying causes and mechanisms depending on mitochondrial energy production—in other words, mitochondrial quality. By normalizing and correcting mitochondrial dysfunction, we can help to recover healthy self-regulatory processes and homeostasis, the whole systemic balance. The hypoxic training helps to correct these processes via mitochondrial quality improvement and multiple hypoxic preconditioning mechanisms.

8. What parallels can be drawn between natural processes, like embryonic development or muscle activity, and the mechanisms of IHT?

Embryogenesis takes place in the constantly hypoxic environment of the uterus. Moreover, germinal line stem cells exist in the most hypoxic niches. During egg cell development, fertilization, and embryo growth, the oxygen content increases gradually, but it also periodically oscillates. It is believed to be the reflection of the evolution of aerobic life on our planet. The ontogenesis repeats the phylogenesis, as evolutionary biology teaches.

The same process of oxygen oscillations is found in muscle contractions. It constitutes a continuous challenge, molecular damage and ongoing molecular and cellular repair. Without constant activity, sarcopenia develops even in the healthiest people. It is shown in numerous experiments, especially with the simulation of space flights.

IHT provides similar or even deeper oxygen oscillations in the tissues, in the cells and mitochondria, so it potentiates and even can simulate natural oxygen oscillations found in aerobic exercising and embryonic development.

9. Could you explain the role of carbon dioxide in IHT and why it's essential for oxygen transport and metabolism?

First of all, carbon dioxide and water are produced in the mitochondria in our body. The only single place where CO2 and water are produced is our mitochondria during oxidative phosphorylation. CO2 is not a waste product. It participates in countless physiological and biochemical processes. This can be insufficient in dysfunctional mitochondria, so cellular CO2 deficiency may develop.

Moreover, a lack of CO2—so-called hypocapnia—disturbs oxygen absorption, transportation and utilization, which ultimately results in tissue hypoxia. You can't start IHT in a hypocapnic patient who is already chronically hypoxic. To correct this, you have to normalize the CO2 first and eliminate hypocapnia. This can be done by controlling CO2 retention. Technically, it's controlled rebreathing of exhaled air, or just voluntary reduction of ventilation, like in many pranayama techniques or in the Buteyko method. We start these patients with increasing retention of CO2, and after that we can apply IHT.

10. How does IHT differ from other therapies like hyperbaric oxygen treatment or conventional aerobic training?

It's a very important question. At the cellular and mitochondrial level, IHT and HBO—hyperbaric oxygenation—cause similar effects. Recent studies of Israeli scientists found the so-called hypoxic-hyperoxic paradox, which explains that the oxygen partial pressure oscillations in mitochondria are the decisive factor. Of course, the amplitude and duration of such oscillations are also important.

Remarkably, such oscillations of partial pressure of oxygen and CO2 have been found in the egg cell and embryonic development in all mammals, as I already said. The same phenomenon underlies aerobic exercising, particularly strength and resistance training.

IHT just simulates these oscillations in an adult organism, thus facilitating mitochondrial DNA repair and regenerative processes in general. HBO in many ways is doing the same, but due to the dramatically increased partial pressure of oxygen, it causes much higher oxidative stress. There are also some technical difficulties, limitations and health risks involved in HBO. Collectively, in my experience, IHT is a magnitude more cost-efficient and safe compared to HBO.

11. Your research mentions the glymphatic system's involvement during hypoxic oscillations. How does this impact brain health and mental clarity?

The glymphatic system in our brain is responsible for brain cleansing, drainage and elimination of metabolic and immune waste. In normal aging, the glymphatic system's functional decline is seen. It declines gradually during our adult life to old age. But it accelerates dramatically in brain infections, head trauma, low-grade inflammation and sleep deficiency.

IHT provides an additional mechanistic pumping effect in the glymphatic system and also supports mitochondrial rejuvenation in brain tissues and structures. This provides a multi-level regenerative and rejuvenative effect on brain functions in all age groups studied. We have many recent studies which show improvement of cognitive function and creativity in senior persons—age 80-plus, even 90-plus—under hypoxic training.

12. You've highlighted the concept of mitoptosis in your work. How does this natural process help maintain mitochondrial health and combat aging?

The term mitoptosis was coined by the late Professor [Vladimir] Skulachev. He was one of the leading mitochondrial researchers. Actually, it is the initial step of the cellular suicide process, apoptosis. It occurs when all mitochondria in a cell release caspases—cell-digesting enzymes, and cell dies. But when only weakened, dysfunctional, mutated mitochondria expire, the healthy mitochondria become free of unfair competition with damaged mitochondria and the cell remains intact and can start the rejuvenating process because the competition is eliminated. Mitoptosis plays a very important role in this process.

13. Can you elaborate on the synergistic effects of combining IHT with dietary strategies like extended morning fasting or ketogenic diets?

This synergy consists of a potentiation of autophagy and mitophagy, accelerating improvement of mitochondrial quality. Fasting, fasting-mimicking diet, or early morning fasting—there are different options. Some people practice one meal a day, which is extreme, but for healthy people it's possible, at least for a certain time.

It facilitates the metabolic landscape improvement in the body, providing a longer periods for cellular repair and recovery. The ketogenic metabolic shift also favors mitochondrial biogenesis.

14. Your studies mention mitochondrial dysfunction in neurodegenerative diseases like dementia. How does IHT contribute to reversing or mitigating these conditions?

These conditions originate from many underlying causes and triggers, but mitochondrial dysfunction is nearly always present. IHT is targeting and normalizing metabolism and mitochondria in all cells of our brain—in neurons, in astrocytes and microglial cells and vascular endothelial cells, all the multiple components of the human brain.

It helps reset dysfunctional mitochondria, improve energy production in neurons, improve resilience and stress resistance, and reduce low-grade brain inflammation, which are always components of neurodegenerative diseases.

It doesn't mean that it radically helps all neurodegenerative processes. But as a component of multi-component treatment, it significantly helps. It's efficient.

15. From your clinical experience, what are some of the most remarkable health improvements you've observed in patients undergoing IHT?

The most obvious and fast-developing improvements are seen in the cognitive, creative functions, and general brain activity of middle-aged persons. Then we see rapid normalization of metabolism in type 2 diabetes patients—normalization of blood glucose and lipid biochemistry. We see blood pressure normalization in patients suffering from mild hypertension.

We see a reduction of chronic inflammatory conditions, such as arthritis, hormonal improvements, and sleep quality improvements. Mitochondrial rejuvenation, mitochondrial improvement has many individual faces and marks, and it differs between different patients.

16. Are there any risks or contraindications associated with IHT, and how do you mitigate these during treatment?

The contraindications are basically the same as those that prevent a person from going to a gym—such as acute injury, fever, intoxication, blood loss, acute infection, exhaustion, exacerbation of chronic disease, and any conditions in their acute phase.

How do we mitigate this? First of all, we facilitate recovery in the acute state, and then when the patient is stabilized, we can cautiously start hypoxic training. It's always highly individualized, because people are very different in their mitochondrial spectrum and in their fitness level. So individualization is a must.

17. Do you practice IHT yourself?

My personal application of IHT is now nearly 40 years. I tried all existing options of hypoxic training, starting from sleeping in a hypoxic tent and using different variation models of hypoxicators, also doing intermittent hypoxia without any device, using just breathing techniques like the Wim Hof method.

I must say that all these options have their value. You should differentiate between healthy people with healthy, uncompromised mitochondria, and people who have dysfunctional, mutated, compromised mitochondria. For instance, the Wim Hof technique for healthy people who don't have any mitochondrial problem—it's a good option for the beginning. It costs nothing. It requires only discipline and some clever monitoring.

But people with extreme mitochondrial dysfunction and mutations need a highly individualized approach. I do hypoxic training up to 3-5 times a week. It takes about 20-30 minutes, depending on whether I use a hypoxic machine or just breathing techniques. To this, I also sometimes add a combination of strength training, resistance training, and a little bit of aerobic training. Altogether, it takes me no more than half an hour a day, not even every day.

What results do I have? I am at the moment 76 years old, and my VO2 max—which is an integrative parameter of mitochondrial efficiency, mitochondrial capacity, ability to metabolize oxygen, an extremely important marker of general health and even health expectancy—my VO2 max at the moment is 39. For my age it's quite high. Usually, only elite athletes who trained all their life for endurance like marathon, triathlon, and cycling have that high level. I never was an athlete in my life. I used only hypoxic training and a bit of other aerobic exercise in combination.

For me, it's proof—I am living proof that hypoxic training influences this highly integrative parameter of health and longevity, healthy longevity. It doesn't guarantee that I will live to 120, absolutely not. But in any case, I will continue to use this, because I want to stay as healthy as possible till the end of my life, and I would like to die young at the age of 100-plus!

18. What about the cost and accessibility of IHT? There are clinics that offer it, but they seem pretty expensive. What can you tell people about accessing this modality?

There is actually a big range of devices on the market. The most sophisticated, expensive devices can cost up to €25,000. We have such devices in Europe. I always compare it with cars—this is a Mercedes, the highest range, or Rolls Royce.

But on the other end of this scale, you see scooters, bicycles. Both of these vehicles can bring you from point A to point B. Point A is your bad health, and point B is your better health. So you can use both. With a scooter and with a bicycle, you will need more discipline, more self-activity, self-involvement, and understanding. But you will reach the same goal, maybe in a bit longer time.

At the moment, there's a huge choice of such devices. Even rebreathers are now gaining more interest and efficiency. I'm working with all kinds of these devices. People can get more information on my website. I have a Bulgarian company, Oxyesta—like "oxy" for oxygen and "esta" like in fiesta. The name is oxyesta.com.

19. You've done quite a bit of work with Lyme disease. Can you tell us about that?

At the moment it's the highest priority in my activity. I've been working with Lyme disease patients since 2006. When I came back from the US to Germany, a lot of borreliosis patients came to my practice and asked if it could help with their problem. At that time I didn't even know what borreliosis was.

But when I started to apply hypoxic training to them, I've seen practically in each case a definite improvement of symptoms in a pretty short time—in weeks, or at least in one month. But as soon as they stopped using IHT, symptoms returned again. So there was always some improvement, and then a rebound effect.

I didn't understand for a long time why it was happening and how it could be overcome. But then I understood that borreliosis is a unique problem, absolutely a unique infection. It has a lot of very specific features, and our body has quite a specific reaction to this disease.

Actually, I published a book which is available on Amazon. It's called "Undoing Lyme Disease." Anyone can purchase it online. It's not expensive. Now I've developed a protocol which is very efficient against all kinds of types of chronic Lyme disease and post-Lyme disease, so-called post-treatment Lyme syndrome. It's also related to chronic fatigue syndrome and myalgic encephalomyelitis, which belong to the same entity.

Now we are organizing clinical trials with such patients. We're in the process of organizing this study. Anyone can get more information on my Facebook group, which is called "Mitoproxy Fights Lyme Disease"—Mitoproxy because it's mitochondria modulation with oxygen. Anyone can get more information in my Facebook group, and if they're interested, they can join and take part in this prospective clinical study.

20. Have you had any experience with autism and autistic kids? Is there any pathway to helping autistic kids with IHT?

Definitely, yes. We're working in this direction also. I have a collaboration with a clinic in Moscow, which has concentrated on this topic for the last seven years. We've been working together since 2017, and they now have experience with more than 5,000 autistic kids. They work on a very high level. They do all clinical lab tests and everything in the framework of mitochondrial medicine.

First of all, autism is definitely a neurodevelopmental disorder that is based on mitochondrial dysfunction. This mitochondrial dysfunction can be inborn, inherited from the mother. Of course, it also has other inherited components. Not only mitochondrial DNA is involved, also nuclear DNA, many components, and they all converge in specific phases of neurodevelopmental disturbances. Therefore, autism manifests in kids usually at the age of over one and a half to two years old.

I have experience with some patients—not that much, about 10 patients came to my clinic before the COVID pandemic. Now I consult such patients only online because I don't accept patients anymore in Mallorca.

But in any way, intermittent hypoxic training in combination with diet—it's absolutely a must for autistic kids. The diet should be adjusted, and we add some supplements, introduce individualized supplementation program. It has a dramatic effect on autistic spectrum disorders. We're working intensively in this direction.

21. Are there any other interesting directions of your work that we haven't touched on?

I think that most of these problems, these mitochondrially related pathologies, they can be alleviated or even eradicated if we focus on prevention and specifically on preparation for healthy pregnancy.

If we organize preventive treatment for prospective mothers and fathers—when they want to have a healthy child, they should concentrate on this. They should do a complex of interventions, including intermittent hypoxic training, dietary change and a bit of supplementation. This can help provide the highest quality egg cells for fertilization.

The problem is that a lot of not quite healthy egg cells come to fertilization, then they are fertilized and all the consequent mitochodrial quality problems appear. But when we reduce this pressure, when we put the mitochondrial selection phase much earlier—not when the egg cell is already ripe, but when we put selection pressure on the early phases when egg cells are only starting to develop—then we can support development of highest quality egg cells, and that reduces or eliminates a lot of consequent problems.

This intervention is absolutely not expensive. It can be done as a home-based preventative treatment. And this is my highest goal, which I hope to achieve in the next years.

22. What tips would you give to people looking for an IHT therapist or practitioner if they can't do it themselves?

Ideally, they should have a hypoxic device at home. It should belong in a bedroom. Today it's not that difficult and not expensive, because there are devices which cost less than $1,000.

Of course, to use them properly, you need to learn. It's like buying a violin—you should invest time to learn how to play it. It's exactly like this.

But if a person has an acute problem, like asthma or high blood pressure, or even the acute phase of Lyme disease, of course, they should try to find a qualified practitioner. There are practitioners also in Australia. In Europe, I actually work on the education of physicians in Germany and in German-speaking countries. We've educated more than 1,000 physicians already. There's some movement starting in the US.

All this develops in parallel. I want to emphasise that one needs to educate oneself. It's great to have a simple hypoxic machine, or even no machine, but only knowledge of how to use affordable hypoxic interventions at home. This will be the most powerful tool, the most efficient intervention, which can radically improve health.

23. Is there resistance to this from the medical establishment or Big Pharma?

I would say there is no obvious direct resistance against this method. Moreover, a lot of research was performed on this phenomenon of hypoxic preconditioning. If you type "hypoxic preconditioning" in the browser, you will get tons of research.

Most of this research was financed by Big Pharma because they had hope to find out what molecules can be used, synthesized and patented to simulate these effects just by taking medication. But so far as I know, for today, there's no more financing of this project, because they understood that too many components are involved in hypoxic preconditioning.

Also, in 2019 a group of scientists received the Nobel Prize for research explaining molecular mechanisms of hypoxic adaptation. So all this is obvious. But to make the transfer of this technology which already exists and tested for more than 2,000 years, if you count yogic Pranayama breathing. Today, many clinics in the US try to use it for neuro-rehabilitation, for spinal injuries, and for brain damage. But they do it mostly “flying below the radar screen”.

There is no investment in this field, because it's difficult to sell air. We sell oxygen-depleted air, actually, because you cannot pack it so nicely as medication. But nevertheless, interest is growing, especially interest from end users, from patients who want to have this technology for treatment, prevention, and rehabilitation. This is our hope. We try to bring this technology directly to end users. And of course we observe all necessary regulations and restrictions, if any exist.

24. Finally, what are you currently focused on in your research and practice, and how can readers stay connected with your work?

They can take a look at my website, oxyesta.com. They can also find information on my YouTube channel—just type "Arkadi Prokopov YouTube" and a lot of my videos and channels appear. Also, in my Facebook group, "Mitoproxy Fights Lyme Disease." Just type my name in the browser and a lot of contacts will appear.

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