Why You May Be Suffering From Low Oxygen and Not Realize It

Hypoxia can cause problems with the mitochondria and the brain. Read this post to learn why, how to find out, and what to do about it.

Why Does Oxygen Matter?

Your mitochondria need oxygen.

Mitochondrial problems are at the heart of all chronic diseases.

When your mitochondria are working well, you will build up healthy levels of ATP and NAD+ levels, which are important for energy utilization and metabolism.

ATP converts to cyclic AMP, which is a critical messenger molecule for so many cellular processes. cAMP is needed for the regulation of glycogen, sugar, and lipid metabolism.

The following hormones also require adequate cAMP levels to function optimally: FSH, LH, ADH (V2=kidneys), TSH, CRH, hCG, ACTH, MSH, PTH, GHRH, Glucagon, and Calcitonin.

Read why NAD+ is important.

Your body fights infections with the superoxide that’s created from oxygen.

Your health and energy will in part depend on how much oxygen you have and how well your mitochondria utilize it.

Now there’s obviously more to the story, but you want to make sure the fundamentals are right.

How To Measure Your Oxygen Levels

Pulse Oximeter and Hypoxia

A pulse oximeter is the easiest method to measure blood oxygen, but it’s only a part of the story.

People think that oxygen levels can be measured simply with a pulse oximeter.

Pulse oximeters measure what percentage of hemoglobin, the protein in blood that carries oxygen, is loaded with oxygen.

It knows this by measuring the amount of red vs infrared that gets absorbed in the tissue. Oxygenated hemoglobin absorbs more infrared light and allows more red light to pass through.

However, this doesn’t measure the number of red blood cells and hemoglobin.

It also doesn’t measure how much blood you have in a given area, especially your brain, where you need it most.

You should measure 99-100% on the Pulse Oximeter if you want optimal function.

Your Blood Tests and Hypoxia

Red blood cells carry hemoglobin, which carries oxygen. The more red blood cells you have, the more you can carry oxygen.

Hemoglobin actually carries the oxygen. The more hemoglobin you have, the more oxygen you transport.

Hemoglobin comprises about a third of the total red blood cell volume. This protein is responsible for the transport of more than 98% of the oxygen (the remaining oxygen is carried dissolved in the blood plasma).

Hematocrit is a blood test that measures the percentage of the volume of whole blood that is made up of red blood cells. This measurement depends on the number of red blood cells and the size of red blood cells.

Red blood cells and hemoglobin are all the info you need in your Complete Blood Count to determine your levels of hypoxia.

Low iron or iron stores can also cause less oxygen utilization because oxygen binds to iron-containing molecules (heme) in your hemoglobin. However, your RBC and hemoglobin will often reflect an iron deficiency.

A low RBC or hemoglobin count indicates that your EPO may be low, all of which are extremely important to oxygenate the blood.  Hemoglobin holds oxygen and RBCs hold hemoglobin. EPO produces both.

EPO is important for mood and memory independent of its effects on RBCs. (R)

Blood Pressure and Hypoxia

You can have good RBCs, hemoglobin, and oxygen saturation, but if your blood isn’t flowing to your brain, it’s meaningless.

Blood pressure is one measure of blood flow.  Higher blood pressure can indicate that the blood is more viscous and thick, which will require more force and pressure to move it.  It can indicate blood vessels that are hardened and not able to relax easily.  It can indicate lower nitric oxide.

Low blood pressure means that blood is not flowing with a certain force level to reach the brain in optimal concentrations.

Your doctor won’t think anything of a blood pressure of 90/60, but this means that not enough blood is flowing to the brain for optimal function.  Your blood pressure should be 110-120/70-80.

Blood Flow and Hypoxia

If you feel you have cold hands or feet, it can be a symptom that blood isn’t going to your peripheral body areas.  It’s also an indicator of low T3 and/or metabolism.

Having a lower EZ in your cells will also negative affect the pumping of blood throughout your body.

Oxygen Utilization and Hypoxia

Assuming you’ve got everything set up to this point, you still don’t know if you have enough neuronal NOS and endothelial NOS that will diffuse the oxygen from circulation into the cells.

UV increases nitric oxide and the relaxation of blood vessels (R).  UV increase free endothelial NOS or eNOS (in vessels/capillaries) and total neuronal NOS or nNOS (in neurons) (R, R2) 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).

nNOS is also important for gut flow and sexual arousal in males and females (R).

Why You May Be Suffering From Hypoxia

There are a few main reasons why you can have lower oxygen.

1) Nasal Problems or Mucus

Do you have a problem breathing through your nose?  Perhaps a deviated septum or you’ve constantly got mucous?

It doesn’t matter what’s blocking your nose, but if you’re not breathing easily through your nose, you’ve got a problem that you have to fix.

2) Obstructive Sleep Apnea or Low Oxygen During Sleep

You either have sleep apnea or you don’t.  True, but there’s a continuum of how well you breathe while you’re sleeping.  You can do a sleep study to see what your oxygen concentrations drop to while you’re sleeping.

3) Living in an Elevated Area

Living in an elevated location like Colorado or Utah can contribute to hypoxia. People who live in elevated locations often have higher RBCs and hemoglobin to make up for lower blood saturation.

4) Chronic Inflammation

Low oxygen can be caused in part by cytokines, which prevent oxygen from reaching the tissues from capillaries.

If you’ve got chronic inflammation, you will have hypoxia to some degree.

5) Psychological Stress

Low oxygen is also caused by a sympathetic or fight or flight system that is in overdrive because this causes more shallow breaths.

Check your number of breaths per a minute and cortisol levels.You should have 5-6 breaths per a minute.

Blood pressure and heart rate should be normal (115/75 and 55-70).

Heart rate variability should be high, which is an indicator of vagus nerve function.

These are quick and dirty indicators a normal stress response.

6) 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.

Why is blood pressure reduced in chronic illness?  Here’s one reason:

Inflammation and cytokines increase iNOS, which produces large quantities of Nitric Oxide (as opposed to eNOS and nNOS) (R).

iNOS usually occurs when you have high levels of oxidative stress, and thus high levels of NO have the opportunity to react with superoxide leading to peroxynitrite formation and cell toxicity (R).

Very high levels of uncontrolled nitric oxide through increased iNOS decreases smooth muscle contractions by the heart and lead to lower blood pressure (R).

Nitric oxide from iNOS is more systemic rather than localized where you need increased blood, which is how eNOS and nNOS work.

Having a lower EZ in your cells will also negative affect the pumping of blood throughout your body.

Hypoxia locally in the brain is what contributes to cognitive problems.

7) A Lack of Sunlight

As discussed UV is needed to utilize oxygen in the blood.

UV increases nitric oxide and the relaxation of blood vessels (R).  UV increase free endothelial NOS/eNOS (in vessels/capillaries) and total neuronal NOS/nNOS (in neurons) (R, R2) 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).

How to Increase Oxygen

My top natural ways to increase EPO are:

  • Interval exercise,
  • Breath holding,
  • Astragalus (R).
  • Rhodiola/Salidroside (R),
  • Rehmannia/Catalpol (R),
  • Kidney glandular – the kidneys make EPO, so they presumably have it, and given my experiments with it, it wouldn’t be surprising.
Major mitochondrial changes in hypoxia. Hypoxia could decrease electron-transport rate, increase reactive oxygen species (ROS) production, and enhance nitric oxide synthase (NOS). Source: http://www.sciencedirect.com/science/article/pii/S0005272810000575
Major mitochondrial changes in hypoxia. Hypoxia could decrease electron-transport rate, increase reactive oxygen species (ROS) production, and enhance nitric oxide synthase (NOS). Source: http://www.sciencedirect.com/science/article/pii/S0005272810000575


  1. Rje

    Hi – So if hemotocrit and red blood cell counts are high, can one conclude insufficient O2 will cause this the body to generate more red blood to supply needed O2?

    It might be possible that a congenital heart defect such as bicuspid valve or defect would limit O2. Would this also limit Nitric Oxide availability as described? In such a case would these therapies and NOS for example help provide oxygen delivery?

  2. Hi Joe,
    I am the founder of the training virtual center for the adoptive community in Israel. I would like to understand the correct way to describe how (and if) oxygen can reduce the high level of cortisol that adoptive children suffer from.

    I consult with Brain Dr. and understood that the concept of breathing and having more oxygen in our brain body would reduce the amount of cortisol. Can you write shortly the correct way to describe the connection between them.

    Many thanks

  3. Hi
    Joe ,
    Great site It’s great to see a former Longecity member turn his life around.

    – What are your thoughts on the similarities between chlorophyll and heme can you increase oxygen by consuming a diet in high in chlorophyll ?
    I know you said you steer clear of plants.
    – What are your thoughts on hyperbaric oxygen ?

    Self Hacker

  4. I recently was diagnosed with severe deviated septum, and suspect that I may have been suffering from low oxygen levels now for a while because of it. It all started when I decided I was gonna better myself and start exercising more, except it didn’t take long for me to feel like I was like a fish gasping for air. only about 15 mins in I’d have to stop as i just couldn’t breath and it was causing me severe panic attacks. I also suffer with depression, chronic fatigue, and brain fog as well, on top of an auto immune disease. Thankfully I am going in for a septoplasty to fix the deviated septum by the end of this month. Hopefully it will at least help with the breathing.

    • Abhimanyu

      hy, found no better place to ask, so, here we go, i am also suffering from the same problems as you are, relating to Daviated Nasal Septum and related problems, now if you have under gone the septoplasty (in my case septorinoplasty) what is your feedback and benefits from it.
      Hope for your great health and wellbeing.

  5. Jerb Derb

    Hey Joseph, I’ve heard you say that acute doses of inflammation are good for the brain. What’s the mechanism behind this? Hormesis? And are you referring maybe to LLLT? Thanks.

  6. Before I saw post I already decided I need to fix my nose. It’s true, I can’t breathe easily through nose.

    Quite problematic, I don’t wake up refreshed (sleep sucks) and I sleep for 9-11 hours easily.

    It seems like I function minimum of everything.

  7. Thomas

    I think their explanation of the mechanism is accurate.

    “Breathing pure oxygen lowers the oxygen content of tissues; breathing rarefied air, or air with carbon dioxide, oxygenates and energizes the tissues; if this seems upside down, it’s because medical physiology has been taught upside down. And respiratory physiology holds the key to the special functions of all the organs, and to many of their basic pathological changes.” Ray Peat, Ph.D.

    “…I have claims to one thing: I have discovered the cause of the most frequent illnesses. It is Deep Respiration. No one ever spoke about it before. This is the gist of my discovery.“. Ref, From the record of K.P.Buteykoís speech at the 5-th All-Union Seminar on Buteyko Method. Moscow, 1990 Vladimir Buteyko

        • Joseph M. Cohen

          I agree, CO2 is also important…

          I’m a fan of more oxygen+CO2

          “The available data indicate that residency at higher altitudes are associated with lower mortality from cardiovascular diseases, stroke and certain types of cancer. In contrast mortality from COPD and probably also from lower respiratory tract infections is rather elevated. It may be argued that moderate altitudes are more protective than high or even very high altitudes. Whereas living at higher elevations may frequently protect from development of diseases, it could adversely affect mortality when diseases progress.”


          I’m not on board with Kruse and high altitudes:
          “Statistically significant decreases in mortality, with very large effect sizes, were observed in high land elevation for three of the four outcomes, including cancer. One possible explanation for the decreased mortality in high elevation jurisdictions is radiation hormesis. Another possible explanation, at least in the case of heart disease mortality, is the physiologic responses that accompany higher elevations regarding decreased oxygen levels.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057635/

          “In fully adjusted analysis, those residing in the highest altitude strata (≥ 6000 ft) had a lower all-cause mortality risk in fully adjusted analyses: death hazard ratio: 0.92 (95% confidence interval, 0.86-0.99), as compared with patients in the reference group (<250 ft). Residential altitude is inversely associated in all-cause mortality risk in maintenance dialysis patients notwithstanding the unknown and unmeasured confounders." http://www.ncbi.nlm.nih.gov/pubmed/24422763

  8. Hello Joseph,

    Have you ever looked into Buteyko breathing exercises? Basically they are about reducing the breathing volume consciously and thereby improving one’s health. I think that their science might be off when it comes to explaining the exact mechanisms, but the exercises definitely work (though I doubt they are a cure-all as claimed.) Before I tried them, I used to have huge problems with breathing, I felt like I could never breathe enough. My sinuses often closed up completely, especially when I had colds (which was frequently) and generally at night. After practicing for some time, however, I almost never mouth-breathe at night (basically only when lying on my back, which is rare) and can even nose-breathe during vigorous exercise quite comfortably.


  9. Thomas

    Do you know about the control pause measurement in the Buteyko method? If you do it let me know what you get. I’m in the upper 20’s when I’m relaxed. It goes up to 31/32 seconds after I do breathing exercises but because I can’t avoid my allergens I have no way to get to 40 seconds (just goes back down in my sleep) :/

    The Buteyko method is super important… you can bypass the need for a lot of self hacking by just reducing your breathing rate a little bit.

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