The Underappreciated Role of Carbon Dioxide in Health

Explore the profound impact that carbon dioxide has on mitochondrial energy production and cellular health. Discussion with Georgi Dinkov.

In this interview, repeat guest Georgi Dinkov reviews the role of carbon dioxide (CO₂) in health. CO₂ is typically thought of as nothing more than a harmful waste product of respiration, but it’s actually a driver of mitochondrial energy production, and it improves the delivery of oxygen into your cells.

While this may come as a shock to most people, of all the strategies I know of to increase life extension, CO₂ is one of the most effective longevity interventions available. There really isn’t anything that comes close, other than a low linoleic acid diet and reducing estrogen dominance.

Unfortunately, virtually no doctors understand this. The now deceased Ray Peat, a biologist and physiologist who developed the bioenergetic theory of health,1 was one of the few who understood it inside and out, and actually recommended its clinical use.

I wrote an article about this that featured his lecture on CO₂, which I watched six times as it catalyzed my interest in the topic. At the time I found his video there were fewer than 2,000 views on YouTube. You can find it by going to YouTube and typing in Ray Peat CO₂.

Proper Breathing Is Important for Optimal CO₂ Levels

In a nutshell, “proper” or life-extending breathing involves breathing less and breathing slower. Both of these allow CO₂ to build up, and that appears to be part of why breathwork has such wide-ranging benefits.

“As it turns out, carbon dioxide, even though medically it’s mostly viewed as a waste product of respiration, is actually the thing that protects us from oxygen’s well-known toxicity,” Dinkov explains.

“In fact, if you speak to people who work in trauma or in the intensive care unit, when they have to revive people that are in shock or have suffered some kind of ischemic attack, they will tell you that the premature delivery of oxygen, or delivering too much oxygen … is actually what kills most patients after they come out of the initial shock stage.

The introduction of too much oxygen too quickly creates this massive cytokine storm and inflammatory reaction, and one of the reasons [for that] is that the cells are hypermetabolic — they’re not producing sufficient carbon dioxide, so they’re not able to utilize the oxygen properly.”

Forgotten Truths

The Romans recommended taking baths in naturally carbonated water for all kinds of ailments but especially arthritis, infertility and psychiatric ailments, and this practice extended well into the Middle Ages when monks prescribed it. To this day many visit natural hot springs, and the likely benefit in many of these springs is the CO₂ content of the water.

In the 20th century, Russian scientists did loads of research on CO₂, and to this day, many Russian clinics offer CO₂ baths and other CO₂ treatments. There’s even a suit that can be filled up with CO₂, which then diffuses into your tissues. You’ll start feeling hot very rapidly and this is a sign of vasodilation, which is one of the cardiovascular effects of CO₂.

It’s been shown that CO₂ can, over the long term, even reverse arterial calcification. It can also reverse many other signs of and damage caused by the aging process.

Mitochondrial Dysfunction Inhibits CO₂ Production

When your CO₂ is too low, your body reverts to an “emergency” vasodilator, nitric oxide (NO). There are three types of nitric oxide:2 neuronal nitric oxide synthases (nNOS); endothelial NOS (eNOS); and inducible NOS (iNOS). Low CO₂ triggers iNOS. The problem with that is that now you’re overproducing NO, which is not ideal. Dinkov explains:

“Most of the eNOS … stays in the actual blood vessel. iNOS also spills into the blood. That’s kind of the purpose of iNOS because the primary purpose of nitric oxide in the body is to fight pathogens. It’s a reactive nitrogen species.

It’s produced for only two reasons, either as an emergency vasodilator, or if the immune system senses an invasion from pathogens, specifically bacteria and viruses, in which case iNOS is activated.

The reason iNOS is bad is because the nitric oxide does not stay localized. It’s made available systemically because you want to affect all blood vessels, and that’s what happens when you don’t have sufficient amounts of carbon dioxide production. So, if you don’t have [enough] CO₂, you will have elevated NO.

But with NO, nitric oxide, you have a lot of other bad things happening. It’s a highly reactive molecule. It can form peroxynitrite species. It can damage the polyunsaturated fats (PUFAs) in the cells, no matter where they are.

Nitric oxide itself can form a covalent bond with something called cytochrome c oxidase [Complex 4 in the electron transport chain], which is the rate limiting step of the oxidative phosphorylation …

You want to break that bond because otherwise your oxidative phosphorylation is inhibited. Methylene blue can do it, magnesium can do it, carbon dioxide can do it, near-infrared light and some quinols.”

Another significant problem associated with elevated NO is pseudohypoxia, because you have oxygen in the cells but it cannot be utilized because No impairs Complex IV in the electron transport chain.

CO₂ prevents this by dissociating the covalent bond between NO and Complex IV. Hence, oxygenation is optimized when sufficient CO₂ is present. So, to summarize, CO₂ keeps your blood vessels supple without the drawback of blocking Complex IV.

The Bohr Effect

Basically, the Bohr Effect describes the process in which CO₂ weakens the bond between oxygen and hemoglobin so that the oxygen can separate and enter into the tissues.

As the hemoglobin releases the oxygen, it binds to the CO₂ instead. The CO₂ is then expelled through your outbreath. Without enough CO₂, you will not be able to liberate sufficient amounts of oxygen from hemoglobin.

A Note on Oxygen Saturation

The major factor that determines your tissue oxygenation is how much CO₂ you’re producing. If you’re hypermetabolic, if your mitochondria are not working, then you’re oxidizing mostly fats, which produces less CO₂ per molecule, so you’ll be deficient in CO₂.

In the past (going back 100 years ago or so), the test for seizure susceptibility was hyperventilating. The doctor would instruct you to breathe through your mouth very quickly for 30 seconds, and if seizure symptoms emerged, it was a sign that you have insufficient CO₂, as that’s what’s causes the seizure activity.

How CO₂ Can Combat Cancer

“Because carbon dioxide is a Lewis acid, it’s an electron withdrawing agent, even though it doesn’t directly bind them like a quinol. If you look at the structure, it’s very similar to a quinol. It’s a carbon atom with two carbonyl groups, and the quinol is very similar. They usually have a ring and two or more carbonyl groups.

Lewis acids drop the pH of the cell, which automatically decreases the cell’s affinity for water. Which means you’re going to be excreting some of that extra water of the cell.

It’s not a coincidence that linoleic acid has multiple double bonds. It’s much more hydrophilic than the saturated fats, which lack the double bonds. Any time you have an increase of intracellular pH, you have increased affinity for water. The moment water streams in, that’s a signal for de-differentiation and metosis (division). If this process continues uncontrollably, we basically get cancer.

Conversely, when you excrete water, the cell becomes acidified and a little bit dehydrated, so to speak. Then you’re getting high amounts of differentiation. You’re also increasing the affinity of the intracellular proteins for potassium and magnesium, while decreasing their affinity for sodium and calcium. In fact, when carbon dioxide is produced and streams out of the cell, it draws calcium and sodium with it.

If you’re not producing sufficient amounts of carbon dioxide, you’re also probably not producing sufficient amounts of ATP, because carbon dioxide and ATP go hand in hand; they’re signs of good mitochondrial function. ATP has affinity for magnesium, but if you don’t have sufficient amounts of ATP, you’ll have more ADP, which is the degraded version.

ADP has an affinity for calcium. So low metabolic rate, by definition, means cellular excitotoxicity, cellular alkalinity and cellular division, because of the lack of carbon dioxide and the lack of the ATP. ATP always exists in the body in a complex with magnesium. So, if you’re taking magnesium but not producing sufficient amounts of ATP, it will not become bioavailable. But the production of ATP is tied to the production of carbon dioxide.

Carbon dioxide also increases the uptake of serotonin into the platelets, so producing sufficient amounts of carbon dioxide will lower your extracellular levels of serotonin.

It also increases the uptake of histamine, a very highly inflammatory mediator. Its transport also depends on carbon dioxide and on sodium as well, just like the serotonin … So, almost everything that you do metabolically, in terms of health, depends on the production of CO₂. It’s not a waste product.”

Respiratory Alkalosis and Cancer

As a result, you’ll have excess oxygen circulating in your blood stream, but because the CO₂ production cannot keep up with the amount of CO₂ you exhale, you end up with respiratory alkalosis.

Respiratory alkalosis also increases intracellular water uptake, as just described, and as the pH of the cell increases, it causes overproduction of several inflammatory mediators, including lactate, which is another hallmark of cancer cells.

“Cancer cells are highly alkaline, they’re overproducing a lot of lactate and they have a very high uptake of water,” Dinkov says. “In fact, I think the word tumor is a Latin word which meant swelling.

You can reduce the swelling of the tumor to a tremendous degree simply by either increasing delivery of CO₂ around the tumor, if it’s on the surface, or increasing uptake of CO₂ through a CO₂ bath or drugs that increase the levels of CO₂ in the blood.”

Drugs that increase CO₂ include carbonic and hydrate inhibitors such as acetazolamide, which decrease the degradation of CO₂, allowing more CO₂ to build up in your blood.

CO₂ Benefits Your Entire Body

• Dementia
• Psychiatric disorders like mania
• Dysentery
• Fistulas
• Fibrotic conditions
• Whooping cough
• Tuberculosis
• Rhinitis

“Really, every condition you can think of, both physiological and mental, can be remediated, and in many cases cured, by increasing endogenous CO₂ production and decreasing degradation,” Dinkov says. Migraines, are another common ailment that can be addressed with CO₂. In many cases migraines are due to overbreathing causing a lack of CO₂ that constricts the blood vessels in your brain.

Exogenous CO₂ Delivery Methods

• Breathing into a paper bag
• Drinking carbonated water and other carbonated beverages
• CO₂ baths
• A special suit into which CO₂ is pumped
• Hyperbaric administration
• Taking small amounts of baking soda in your drinking water

A book written in 1905 by Achilles Rose, M.D. discusses delivery by rectal insufflation. It contains dozens of case reports of it being used for asthma, whooping cough, dysentery, colitis, rectal fistulas, rhinitis and ear infections. It is a fascinating read. There are three grades of CO₂ gas:

• Industrial-grade, used for cryo chambers, welding and a variety of other typically commercial applications
• Food grade
• Beverage grade, which is 10 times cleaner and purer than food grade, and it’s the kind used in restaurants

If you are going to use CO₂ therapeutically the grade you will want to use is the beverage grade. Commercially, it’s typically sold or rented in 20-pound cylinders. There’s enough CO₂ gas in one cylinder that if you’re using 1 liter a day therapeutically, it will last you 250 years.

However, there are smaller units like SodaStream that can provide CO₂ gas. The problem is that you need to use those CO₂ cylinders with SodaStream equipment and there is no easy way to put the gas into a container or bag.

I hope to go into greater detail of how you can use CO₂ therapeutically when I interview Anders Olsson, breathing instructor and the founder of Conscious Breathing, soon.