Multiple Causes of Low Oxygen (Hypoxia)

Published on August 16, 2018

Recognition of inadequate oxygen delivery to the cells can be difficult in the early stages because the clinical features are often non-specific. Progressive metabolic acidosis, hyperlactataemia, and falling mixed venous oxygen saturation (SvO2), as well as organ specific features[1] are not noticed usually until its too late and serious disease sets in.

Speaking from the perspective of intensive care, Drs. R M Leach, D F Treacher say, “Prevention, early identification, and correction of tissue hypoxia are therefore necessary skills in managing the critically ill patient and this requires an understanding of oxygen transport, delivery, and consumption.”[2] This holds true for many acute and chronic medical conditions.

Without oxygen, our brain, liver, and other organs can be damaged just minutes after symptoms start. Hypoxemia (low oxygen in your blood) can cause hypoxia (low oxygen in your tissues) when your blood doesn’t carry enough oxygen to your tissues to meet their needs. The word hypoxia is sometimes used to describe both problems.

Researchers found that an increase of 1.2 metabolic units (oxygen consumption) was related to a decreased risk of cancer death, especially in lung and gastrointestinal cancers so it really behooves us to study hypoxia. There are many reasons, common to large segments of populations, that pull oxygen levels down in cells, with one or two or even more of these reasons present in many if not all who are chronically ill.

Mineral deficiencies help create hypoxic conditions, especially when they are needed to neutralized chemical and heavy metal toxins. Also, certain minerals are needed by the red blood cells to do their jobs efficiently. Magnesium deficient diet leads to significant decreases in the concentration of red blood cells (RBC), hemoglobin and eventually a decrease in whole blood Fe.[3]

In fact, we find many ways in which magnesium deficiency leads to problems with oxygen transport and utilization (see below.) Iron of course is at the heart of hemoglobin so any deficiencies there are telling. And because many pharmaceutical drugs drive down magnesium levels they must be considered as major causes of lowered oxygen delivery to the cells. Said in a slightly different way, pharmaceutical drugs are a major cause of disease and death.

Radiation exposure leads to hypoxic conditions because so much oxidative stress is created. Local recurrence and distant metastasis frequently occur after radiation therapy for cancer and can be fatal. Evidence obtained from radiochemical and radiobiological studies has revealed these problems to be caused, at least in part, by a tumor-specific microenvironment hypoxia.[4]

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Any element that threatens the oxygen carrying capacity
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Dealing with issues such as chronic stuffy nasal congestion can lead to poor quality sleep, insomnia, or, in the worst-case scenario, sleep apnea, a chronic disease in which oxygen levels decrease during sleep to the point where your heart and your brain don’t get enough air to function properly.

Professor Lum, in his review "The syndrome of habitual chronic hyperventilation" (published in: Modern trends in psychosomatic medicine"), wrote, "Most authors, with the exception of Rice (1950), have described the clinical presentation of hyperventilation as a manifestation of, and secondary to, an underlying anxiety state" (p.197, Lum 1976).

It has been hypothesized that immobilization stress induces the formation of reactive oxygen species, which weakens the brain antioxidant defenses and induces oxidative damage. High levels of stress can be induced by various disturbances such as pain, cold, sexual violence, death of loved ones, accidents and a host of other things like divorce.

Stress potentially upsets many physiological processes including respiration. We breathe faster when stressed out and that forcibly drives down oxygen delivery to the cells. Low oxygen is caused by a sympathetic or fight or flight system that is in overdrive because this causes shallower breathing.

In all serious disease states we find a concomitant low oxygen state.
Low oxygen in the body tissues is a sure indicator for disease.
Hypoxia, or lack of oxygen in the tissues, is the
fundamental cause for all degenerative disease.
Dr. Stephen Levine – Molecular Biologist

Faster, deeper breathing exhales more carbon dioxide. When we breathe more than the norm (and this is a case for over 90% of people today) cell oxygen level is reduced, and we suffer from cell hypoxia. Dozens of studies have shown that modern "normal subjects" breathe about 12 L/min at rest, while the medical norm is only 6 L/min. As a result, blood CO2 levels are less than normal. Arterial hypocapnia (CO2 deficiency) causes tissue hypoxia that trigger numerous pathological effects. Hypocapnia creates tissue hypoxia (low body-oxygen content), and this suppresses the immune system, deprives the cells of the ATP they need, and eventually leads to cancer.

Another reason cells lose oxygen is high sugar intake. Otto Warburg said that glucose brings down a cell’s ability to use oxygen. One of the principle ways sugar does this is by creating inflammation in the capillaries and other tissues, thus cutting down on oxygen delivery to the cells.

Inappropriate polyunsaturated fatty acids (PUFAs) into the phospholipids of cell and mitochondrial membranes. Such incorporation causes changes in membrane properties that impair oxygen transmission into the cell. Trans fats, partially oxidized PUFA entities, and inappropriate omega-6: mega-3 ratios are potential sources of unsaturated fatty acids that can disrupt the normal membrane structure.

We find sepsis often leads to death because the defining characteristic of sepsis is progressive blood flow dysfunction in the microvasculature of organs remote to the original site of injury. Previous work has established that microvascular oxygen transport is compromised in sepsis due to a loss of perfused capillaries.[5]

Hypoxia is characteristic for sites of inflammation and lesion, and since most people suffer from some sort of inflammation in one part of the body or other, we need to declare inflammation as a main cause of low oxygen levels.

Magnesium Deficiency and Low Oxygen

The mechanism whereby red cells maintain their biconcave shape has been a subject of numerous studies. One of the critical factors for the maintenance of biconcave shape is the level of red cell adenosine triphosphate (ATP) levels. The interaction of calcium, magnesium and ATP with membrane structural proteins exerts a significant role in the control of shape of human red blood cells.[6] Magnesium enhances the binding of oxygen to haem proteins.[7]

The concentration of Mg2+ in red cells is relatively high but free Mg2+ is much lower in oxygenated red blood cells then in deoxygenated ones. This suggests some kind of magnesium pump where oxygen climbs aboard the red cells and magnesium jumps off only to have to jump right back on the red cells again.

Magnesium is involved with the transport of ions, amino acids, nucleosides, sugars, water and gases across the red blood cell membrane. Magnesium levels drop more slowly in red blood cells than in the serum.[8]

In healthy people, most red blood cells are smooth-surfaced and concave-shaped with a donut-like appearance. These discocytes have extra membranes in the concave area that give them the flexibility needed to move through capillary beds, delivering oxygen, nutrients, and chemical

Abnormal magnesium deprived red blood cells lack flexibility that allow them to enter tiny capillaries. These nondiscocytes are characterized by a variety of irregularities, including surface bumps or ridges, a cup or basin shape, and altered margins instead of the round shape found in discocytes. When people become ill or physically stressed (more magnesium deficient), a higher percentage of discocytes transform into the less flexible nondiscocytes.

Iodine and Oxygen

Though doctors and people do not normally associate iodine with oxygen, we must see that iodine-carrying thyroid hormones are essential for oxygen-based metabolism. First increases of iodine and thyroid hormones increase red blood cell mass and increase the oxygen disassociation from hemoglobin.[9] 

Thyroid hormones have a significant influence on erythropoiesis, which is the process that produces red blood cells (erythrocytes). The most common thyroid dysfunctions, hypothyroidism and hyperthyroidism affect blood cells and cause anemia with different severity. Thyroid dysfunction and iodine deficiency induces other effects on blood cells such as erythrocytosis, leukopenia, thrombocytopenia, and in rare cases causes’ pancytopenia. Iodine also alters RBC indices include MCV, MCH, MCHC and RDW.

Thyroid hormone increases oxygen consumption, increase mitochondrial size, number and key mitochondrial enzymes. Meaning iodine increases plasma membrane Na-K ATPase activity, increases futile thermogenic energy cycles and decreases superoxide dismutase activity.

Sulphur and Oxygen

Sulfur is required for the proper structure and biological activity of enzymes. If you don’t have sufficient amounts of sulfur in your body, the enzymes cannot function properly. This can cascade into a number of health problems since, without biologically-active enzymes, your metabolic processes cannot function properly.

Sulfur enables the transport of oxygen across cell membranes. Because sulfur is directly below oxygen in the periodic table, these elements have similar electron configurations. Sulfur forms many compounds that are analogs of oxygen compounds and it has a unique action on body tissues. It decreases the pressure inside the cell. In removing fluids and toxins, sulfur affects the cell membrane. Sulfur is present in all cells and forms sulfate compounds with sodium, potassium, magnesium, and selenium. Organic sulfur, in addition to eliminating heavy metals, regenerates, repairs and rebuilds all the cells in the body. For all of these reasons sulfur is important in the cells receiving all the oxygen they need.

Other Causes of Low Oxygen Levels

  • not enough oxygen in the air
  • inability of the lungs to inhale and send oxygen to all cells and tissues
  • inability of the bloodstream to circulate to the lungs, collect oxygen, and transport it around the body

Several medical conditions and situations can contribute to the above factors, including:

  • asthma
  • heart diseases, including congenital heart disease. The respiratory and circulatory systems work together to ensure that adequate oxygen is transferred from the lungs to the bloodstream and subsequently delivered to the body. Therefore, problems with the circulatory system that interfere with normal blood flow through the lungs can lead to hypoxemia. Tissue hypoxia, as a result of cardiopulmonary dysfunction or reduced oxygen-carrying capacity, is a frequently encountered clinical problem.[10]
  • high altitude
  • anemia: Red blood cells transport oxygen from the lungs to the body organs and tissues via a carrier molecule called hemoglobin. A deficiency of red blood cells, or anemia, limits the oxygen-carrying capacity of the blood, potentially leading to reduced total oxygen content in the bloodstream.
  • chronic obstructive pulmonary disease or COPD: People who have lung pathologies develop severe ventilation-perfusion mismatch that leads to critically low arterial blood oxygen levels. This effect takes place due to the ability of CO2 to dilate airways (bronchi and bronchioles). Greatly reduced blood oxygenation makes cell oxygen level low as well.
  • interstitial lung disease
  • emphysema
  • acute respiratory distress syndrome or ARDS
  • pneumonia
  • obstruction of an artery in the lung, for instance, due to a blood clot
  • pulmonary fibrosis or scarring and damage to the lungs
  • presence of air or gas in the chest that makes the lungs collapse
  • excess fluid in the lungs
  • sleep apnea where breathing is interrupted during sleep
  • certain medications, including some narcotics and painkillers.

A Lack of Sunlight

UV is needed to utilize oxygen in the blood. UV increases nitric oxide and the relaxation of blood vessels. UV increase free endothelial NOS/eNOS (in vessels/capillaries) and total neuronal NOS/nNOS (in neurons) and increases nitric oxide through other means (R), which allows oxygen to diffuse into tissues better. UV also relaxes your blood vessels by mechanisms that might be independent of NO (R).

Lower Blood Pressure and Poor Circulation

Oxygen is transported through the blood and when you have low blood pressure, not enough blood goes to the brain. Remember, you need force to pump blood against gravity and when you stand gravity is against you. You need good blood flow to get enough blood to the brain to deliver oxygen.

The respiratory and circulatory systems work together to ensure that adequate oxygen is transferred from the lungs to the bloodstream and subsequently delivered to the body. Therefore, problems with the circulatory system that interfere with normal blood flow through the lungs can lead to hypoxemia.

Heavy Metals

The structure of hemoglobin is easily compromised by heavy metals like mercury. All carcinogens impair respiration directly or indirectly by deranging capillary circulation, a statement that is proven by the fact that no cancer cell exists without exhibiting impaired respiration. See chapter on heavy metals and oxygen transport. (Coming Soon)

“Tumors cannot grow if the oxygen levels are normal, and oxygen levels are controlled by voltage,” says Dr. Jerry Tennant. He could have said oxygen levels are controlled by pH or oxygen levels control voltage because if there is too little oxygen then the mitochondria cannot create enough ATP to keep cellular energy high.

Conclusion

Red blood cells have been reported to shrink and become stiffer under hypoxic conditions[11] leading to a downward spiral in oxygen transport and delivery. So, “Early detection and correction of tissue hypoxia is essential if progressive organ dysfunction and death are to be avoided. However, hypoxia in individual tissues or organs caused by disordered regional distribution of oxygen delivery or disruption of the processes of cellular oxygen uptake and utilisation cannot be identified from global measurements. Regional oxygen transport and cellular utilisation have an important role in maintaining tissue function. When tissue hypoxia is recognised, treatment must be aimed at the primary cause,” write Drs. R M Leach, D F Treacher.[12]

[1] The pulmonary physician in critical care c 2: Oxygen delivery and consumption in the critically ill R M Leach, D F Treacher. https://www.ucl.ac.uk/anaesthesia/StudentsandTrainees/OxygenDeliveryConsumption.pdf

[2] https://www.ucl.ac.uk/anaesthesia/StudentsandTrainees/OxygenDeliveryConsumption.pdf

[3] Influence of magnesium deficiency on the bioavailability and tissue distribution of iron in the rat. The Journal of Nutritional Biochemistry, Volume 11, Issue 2, Pages 103-108

[4] J. Radiat. Res., 52, 545–556 (2011) How Can We Overcome Tumor Hypoxia in Radiation Therapy?

[5] Impact of early sepsis on oxygen delivery in the microvasculature. Critical Care20059 (Suppl 1): P75

[6] http://bloodjournal.hematologylibrary.org/cgi/reprint/44/4/583.pdf

[7] Terwilliger and Brown, 1993; Takenhiko and Weber; Wood and Dalgleish, 1973

[9] Ann Intern Med. 1971; 74 (4):632-633.

[10] Kidney Int. 2008 Apr; 73(7): 797–799. Low oxygen stimulates the immune system

[11] Int J Hyperthermia. 2010; 26(3): 232–246. Hypoxia-Driven Immunosuppression: A new reason to use thermal therapy in the treatment of cancer?

[12] https://www.ucl.ac.uk/anaesthesia/StudentsandTrainees/OxygenDeliveryConsumption.pdf

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