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Journal of Inammation Research 2015:8 83–96
Journal of Inflammation Research Dovepress
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HypotHesis
open access to scientific and medical research
Open Access Full Text Article
http://dx.doi.org/10.2147/JIR.S69656
The effects of grounding (earthing) on
inammation, the immune response, wound
healing, and prevention and treatment of chronic
inammatory and autoimmune diseases
James L Oschman1
Gaétan Chevalier2
Richard Brown3
1Nature’s Own Research Association,
Dover, NH, USA; 2Developmental and
Cell Biology Department, University
of California at Irvine, Irvine, CA,
USA; 3Human Physiology Department,
University of Oregon, Eugene, OR,
USA
Correspondence: Gaétan Chevalier
Developmental and Cell Biology
Department, University of California
at Irvine, 2103 McGaugh Hall, Irvine,
CA, 92697-2300, USA
Tel +1 760 815 9271
Fax +1 858 225 3514
Email dlbogc@sbcglobal.net
Abstract: Multi-disciplinary research has revealed that electrically conductive contact of the
human body with the surface of the Earth (grounding or earthing) produces intriguing effects on
physiology and health. Such effects relate to inflammation, immune responses, wound healing,
and prevention and treatment of chronic inflammatory and autoimmune diseases. The purpose
of this report is two-fold: to 1) inform researchers about what appears to be a new perspective to
the study of inflammation, and 2) alert researchers that the length of time and degree (resistance
to ground) of grounding of experimental animals is an important but usually overlooked factor
that can influence outcomes of studies of inflammation, wound healing, and tumorigenesis.
Specifically, grounding an organism produces measurable differences in the concentrations of
white blood cells, cytokines, and other molecules involved in the inflammatory response. We
present several hypotheses to explain observed effects, based on current research results and our
understanding of the electronic aspects of cell and tissue physiology, cell biology, biophysics,
and biochemistry. An experimental injury to muscles, known as delayed onset muscle soreness,
has been used to monitor the immune response under grounded versus ungrounded conditions.
Grounding reduces pain and alters the numbers of circulating neutrophils and lymphocytes, and
also affects various circulating chemical factors related to inflammation.
Keywords: chronic inflammation, immune system, wound repair, white blood cells,
macrophages, autoimmune disorders
Introduction
Grounding or earthing refers to direct skin contact with the surface of the Earth, such
as with bare feet or hands, or with various grounding systems. Subjective reports that
walking barefoot on the Earth enhances health and provides feelings of well-being can
be found in the literature and practices of diverse cultures from around the world.1 For
a variety of reasons, many individuals are reluctant to walk outside barefoot, unless
they are on holiday at the beach. Experience and measurements show that sustained
contact with the Earth yields sustained benefits. Various grounding systems are avail-
able that enable frequent contact with the Earth, such as while sleeping, sitting at a
computer, or walking outdoors. These are simple conductive systems in the form of
sheets, mats, wrist or ankle bands, adhesive patches that can be used inside the home or
office, and footwear. These applications are connected to the Earth via a cord inserted
into a grounded wall outlet or attached to a ground rod placed in the soil outside
below a window. For the footwear applications, a conductive plug is positioned in
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the shoe sole at the ball of the foot, under the metatarsals, at
the acupuncture point known as Kidney 1. From a practical
standpoint, these methods offer a convenient and routine,
user-friendly approach to grounding or earthing. They can
also be used in clinical situations, as will be described in the
section entitled Summary of findings to date.1
Recently, a group of about a dozen researchers (including
the authors of this paper) has been studying the physiologi-
cal effects of grounding from a variety of perspectives. This
research has led to more than a dozen studies published in
peer-reviewed journals. While most of these pilot studies
involved relatively few subjects, taken together, the research
has opened a new and promising frontier in inflammation
research, with broad implications for prevention and public
health. The findings merit consideration by the inflammation
research community, which has the means to verify, refute,
or clarify the interpretations we have made thus far.
Grounding reduces or even prevents the cardinal signs of
inflammation following injury: redness, heat, swelling, pain,
and loss of function (Figures 1 and 2). Rapid resolution of
painful chronic inflammation was confirmed in 20 case stud-
ies using medical infrared imaging (Figure 3).2,3
Our main hypothesis is that connecting the body to the
Earth enables free electrons from the Earth’s surface to spread
over and into the body, where they can have antioxidant effects.
Specifically, we suggest that mobile electrons create an antioxi-
dant microenvironment around the injury repair field, slowing
or preventing reactive oxygen species (ROS) delivered by the
oxidative burst from causing “collateral damage” to healthy tis-
sue, and preventing or reducing the formation of the so-called
“inflammatory barricade”. We also hypothesize that electrons
from the Earth can prevent or resolve so-called “silent” or
“smoldering” inflammation. If verified, these concepts may
help us better understand and research the inflammatory
response and wound healing, and develop new information on
how the immune system functions in health and disease.
Summary of ndings to date
Grounding appears to improve sleep, normalize the day–night
cortisol rhythm, reduce pain, reduce stress, shift the autonomic
nervous system from sympathetic toward parasympathetic
activation, increase heart rate variability, speed wound healing,
and reduce blood viscosity. A summary has been published in
the Journal of Environmental and Public Health.4
Effects on sleep
One of the first published grounding studies examined the
effects of grounding on sleep and circadian cortisol profiles.5
Figure 1 Photographic images documenting accelerated improvement of an 8-month-
old, non-healing open wound suffered by an 84-year-old diabetic woman.
Notes: (A) Shows the open wound and a pale-gray hue to the skin. (B) Taken after
one week of grounding or earthing treatments, shows a marked level of healing and
improvement in circulation, as indicated by the skin color. (C) Taken after 2 weeks
of earthing treatment, shows the wound healed over and the skin color looking
dramatically healthier. Treatment consisted of a daily 30-minute grounding session
with an electrode patch while patient was seated comfortably. The cause of the
wound adjacent to the left ankle was a poorly tted boot. A few hours after wearing
the boot, a blister formed, and then developed into a resistant open wound. The
patient had undergone various treatments at a specialized wound center with no
improvement. Vascular imaging of her lower extremities revealed poor circulation.
When rst seen, she had a mild limp and was in pain. After an initial 30 minutes of
exposure to grounding, the patient reported a noticeable decrease in pain. After 1
week of daily grounding, she said her pain level was about 80% less. At that time, she
showed no evidence of a limp. At the end of 2 weeks, she said she was completely
pain-free.
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Earthing or grounding reduces inammation
The study involved 12 subjects who were in pain and had
problems sleeping. They slept grounded for 8 weeks using the
system shown in Figure 4. During this period, their diurnal cor-
tisol profiles normalized, and most of the subjects reported that
their sleep improved and their pain and stress levels declined.
The results of the experiment led to these conclusions:
1) grounding the body during sleep yields quantifiable
changes in diurnal or circadian cortisol secretion levels
that, in turn, 2) produce changes in sleep, pain, and stress
(anxiety, depression, and irritability), as measured by
subjective reporting. The cortisol effects described by Ghaly
and Teplitz5 are particularly significant in the light of recent
research showing that prolonged chronic stress results in
glucocorticoid receptor resistance.6 Such resistance results in
failure to downregulate inflammatory responses, which can
thereby increase risks of a variety of chronic diseases. This
effect complements the findings described in the “Effects on
pain and the immune response” section.
Effects on pain and the immune response
A pilot study on the effects of grounding on pain and the
immune response to injury employed delayed-onset muscle
soreness (DOMS).7 DOMS is the muscular pain and stiffness
that takes place hours to days after strenuous and unfamil-
iar exercise. DOMS is widely used as a research model by
exercise and sports physiologists. The soreness of DOMS is
caused by temporary muscle damage produced by eccentric
exercise. The phase of contraction that occurs when a muscle
shortens, as in lifting a dumbbell, is referred to as concentric,
whereas the phase of contraction as a muscle lengthens, as in
lowering a dumbbell, is referred to as eccentric.
Eight healthy subjects performed an unfamiliar, eccentric
exercise that led to pain in their gastrocnemius muscles. This
was done by having them perform two sets of 20 toe raises
with a barbell on their shoulders and the balls of their feet
on a 2-inch × 4-inch wooden board.7
All subjects ate standardized meals at the same time
of day, and adhered to the same sleep cycle for 3 days.
At 5.40 pm on each day, four of the subjects had conductive
grounding patches adhered to their gastrocnemius muscles
and the bottoms of their feet. They rested and slept on ground-
ing systems such as that shown in Figure 4. They remained
on the grounded sheets except for visits to the bathroom and
meals. As controls, four subjects followed the same protocol
except that their patches and sheets were not grounded. The
following measurements were taken before the exercise and
1, 2, and 3 days thereafter: pain levels, magnetic resonance
imaging, spectroscopy, cortisol in serum and saliva, blood
and enzyme chemistry, and blood cell counts.7
Pain was monitored with two techniques. The subjective
method involved morning and afternoon use of a Visual
Analog Scale. In the afternoon, a blood pressure cuff was
positioned on the right gastrocnemius and inflated to the
point of acute discomfort. The pain was documented in
terms of the highest pressures that could be tolerated. The
grounded subjects experienced less pain, as revealed with
Figure 2 Rapid recovery from a serious wound with minimal swelling and redness
expected for such a serious injury.
Notes: Cyclist was injured in Tour de France competition – chain wheel gouged his
leg. (A) Grounding patches were placed above and below wound as soon as possible
after injury. Photo courtesy of Dr Jeff Spencer. (B) Day 1 after injury. (C) Day 2
after injury. There was minimal redness, pain, and swelling, and cyclist was able to
continue the race on the day following the injury. (B and C) Copyright © 2014.
Reprinted with permission from Basic Health Publications, Inc. Ober CA, Sinatra ST,
Zucker M. Earthing: The Most Important Health Discovery Ever? 2nd ed. Laguna Beach:
Basic Health Publications; 2014.1
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Oschman et al
both the analog soreness scale (Figure 5) and by their ability
to tolerate a higher pressure from the blood pressure cuff
(Figure 6).7
The DOMS grounding study report7 contains a summary
of the literature on the changes in blood chemistry and content
of formed elements (erythrocytes, leukocytes, and platelets)
expected after an injury. The immune system detects pathogens
and tissue damage and responds by initiating the inflammation
cascade, sending neutrophils and lymphocytes into the region.8–12
As expected, the white cell counts increased in the ungrounded
or control subjects. White cell counts in the grounded subjects
steadily decreased following the injury (Figure 7).7
Previous research has shown increases in neutrophils
following injury.13–16 This happened in both grounded and
ungrounded subjects (Figure 8), although neutrophil counts
were always lower in the grounded subjects.7
As the number of neutrophils increases, lymphocytes are
expected to decrease.17–19 In the DOMS study, the lympho-
cyte count in the grounded subjects was always below the
ungrounded subjects (Figure 9).7
Normally, neutrophils rapidly invade an injured
region8,20–22 in order to break down damaged cells and send
signals through the cytokine network to regulate the repair
process. Neutrophils’ production of ROS and reactive nitro-
gen species (RNS) is termed the “oxidative burst”.21 While
ROS clear pathogens and cellular debris so that the tissue can
regenerate, ROS can also damage healthy cells adjacent to the
repair field, causing so-called collateral damage. The fact that
the grounded subjects had fewer circulating neutrophils and
lymphocytes could indicate that the original damage resolved
more quickly, collateral damage reduced, and the recovery
process accelerated. This would explain the reduction in the
Figure 3 Reduction in inammation with grounding or earthing documented with medical infrared imaging.
Notes: Thermal imaging cameras record tiny changes in skin temperature to create a color-coded map of hot areas indicative of inammation. Panel A shows reduction in
inammation from sleeping grounded. Medical infrared imaging shows warm and painful areas (arrows in upper part of panel A). Sleeping grounded for 4 nights resolved the
pain, and the hot areas cooled. Note the signicant reduction in inammation and a return toward normal thermal symmetry. Panel B shows infrared images of a 33-year-old
woman who had a gymnastics injury at age 15. The patient had a long history of chronic right knee pain, swelling, and instability, and was unable to stand for long periods.
Simple actions, such as driving, increased the symptoms. She had to sleep with a pillow between her knees to decrease the pain. On-and-off medical treatment and physical
therapy over the years provided minimal relief. She presented on November 17, 2004 with considerable right medial knee tenderness and a mild limp. Top images in Panel B
were taken in walking position to show the inside of both knees. Arrow points to exact location of patient’s pain and shows signicant inammation. Lower images in Panel B
taken 30 minutes after being grounded with an electrode patch. The patient reported a mild reduction in pain. Note signicant reduction of inammation in knee area. After 6
days of grounding, she reported a 50% reduction pain and said that she could now stand for longer periods without pain, and no longer needed to sleep with pillow between
her legs. After 4 weeks of treatment, she felt good enough to play soccer, and for the rst time in 15 years felt no instability and little pain. By 12 weeks, she said her pain
had diminished by nearly 90% and she had no swelling. For the rst time in many years, she was able waterski. The patient contacted the ofce after 6 months of treatment
to report that she had nished a half-marathon, something she never dreamt she would ever be able to do prior to treatment.
Figure 4 Grounded sleep system.
Notes: Grounded sleep system consists of a cotton sheet with conductive carbon
or silver threads woven into it. The threads connect to a wire that leads out the
bedroom window or through the wall to a metal rod inserted into the Earth near
a healthy plant. Alternatively, it can be connected to the ground terminal of an
electrical outlet. Sleeping on this system connects the body to the Earth. A frequent
report from people using this system is that sleeping grounded improves the quality
of sleep and reduces aches and pains from a variety of causes.
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Earthing or grounding reduces inammation
0.00
Day 1
0.00 113.79 172.41 127.59
0.00 28.26
Days
89.13 41.30
Placebo
Grounded
Day 2 Day 3 Day 4
Placebo
Grounded
20.00
40.00
60.00
80.00
100.00
% change
120.00
140.00
160.00
180.00
200.00
PM pain scale
Figure 5 Changes in afternoon (PM) visual analog pain scale reports.
Days
Placebo
Grounded
Placebo
Grounded
% change
Blood pressure cuff
–30.00
–20.00
–10.00
0.00
10.00
20.00
30.00
40.00
Day 1
0.00 –18.41 –13.04 –15.46
29.9116.148.390.00
Day 2 Day 3 Day 4
Figure 6 Changes in afternoon (PM) pain levels using a blood pressure cuff.
Days
Placebo
Grounded
Placebo
Grounded
% change
White blood cells
–10.00
–5.00
0.00
5.00
10.00
15.00
20.00
Day 1
0.00
–0.45 –1.35 –4.05
9.66 15.97 13.87
0.00
Day 2 Day 3 Day 4
Figure 7 Comparisons of white blood cell counts, comparing pretest versus post-test for each group.
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Oschman et al
cardinal signs of inflammation (redness, heat, swelling, pain,
and loss of function) following acute injury, as documented,
for example, in Figures 1 and 2, and the rapid reduction of
chronic inflammation documented in Figure 3.
Our working hypothesis features this scenario: mobile
electrons from the Earth enter the body and act as natural
antioxidants;3 they are semi-conducted through the connective
tissue matrix, including through the inflammatory barricade
if one is present;23 they neutralize ROS and other oxidants in
the repair field; and they protect healthy tissue from damage.
The fact that there are fewer circulating neutrophils and
lymphocytes in the grounded subjects may be advantageous
because of the harmful role these cells are thought to play
in prolonging inflammation.24 We also raise the possibil-
ity that the inflammatory barricade is actually formed in
ungrounded subjects by collateral damage to healthy tissue,
as was suggested by Selye in the first and subsequent editions
of his book The Stress of Life (Figure 10).25
While there may be other explanations, we suggest that
rapid resolution of inflammation takes place because the
Earth’s surface is an abundant source of excited and mobile
electrons, as described in our other work.1 We further propose
that skin contact with the surface of the Earth allows Earth’s
electrons to spread over the skin surface and into the body.
One route to the body interior could be via acupuncture points
and meridians. The meridians are known to be low resistance
pathways for the flow of electrical currents.26–28 Another
pathway is via mucous membranes of the respiratory and
digestive tracts, which are continuous with the skin surface.
Sokal and Sokal29 found that the electrical potential on the
Days
Placebo
Grounded
Placebo
Grounded
% change
Lymphocytes
Day 1
0.00
0.00
–9.22
–12.30
–18.00
–16.00
–14.00
–12.00
–10.00
–8.00
–6.00
–4.00
–2.00
0.00
2.00
–12.12
–0.58 –2.45
–16.84
Day 2 Day 3 Day 4
Figure 9 Comparisons of lymphocyte counts, pretest versus post-test for each group.
Placebo
Grounded
Placebo
Grounded
Days
% change
Neutrophils
0.00
0.00
0.00
Day 1
28.24
20.11
Day 2
30.83
17.86
Day 3
30.49
19.05
Day 4
5.00
10.00
15.00
20.00
25.00
30.00
35.00
Figure 8 Comparisons of neutrophil counts, pretest versus post-test for each group.
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Earthing or grounding reduces inammation
body, on the mucosal membrane of the tongue, and in the
venous blood rapidly drop to approximately –200 mV. When
the body is disconnected from the Earth, the potential is
quickly restored. These effects reveal changes in the internal
electrical environment within the body.29
Selye30 studied the histology of the wall of the inflamma-
tory pouch or barricade (Figure 10). It is composed of fibrin
and connective tissue. Our hypothesis is that electrons can
be semi-conducted across the barrier, and can then neutralize
reactive oxygen species (free radicals).30 A semiconducting
collagen pathway or corridor may explain how electrons from
the Earth quickly attenuate chronic inflammation not resolved
by dietary antioxidants or by standard medical care, including
physical therapy (Figure 3). The barricade probably restricts
diffusion of circulating antioxidants into the repair.
Taken together, these observations indicate that grounding
or earthing the human body significantly alters the inflam-
matory response to an injury.
ABCD
Irritant
Connective-tissue cell
Connective-tissue fibres
Red blood cell
White blood cell
Figure 10 Formation of the inammatory barricade.
Notes: Copyright © 1984, Selye H. Reproduced from Selye H. The Stress of Life. Revised ed. New York: McGraw-Hill Com panies, Inc.; 1984.25 (A) Normal connective tissue
territory. (B) Same tissue after injury or exposure to irritant. Vessel dilates, blood cells migrate toward irritant, connective tissue cells and bers form a thick impenetrable
barricade that prevents the spread of the irritant into the blood, but that also inhibits entry of regenerative cells that could repair the tissue and slow the entry of antioxidants
into the repair eld. The result can be a long-lasting pocket of incompletely resolved inammation that can eventually leak toxins into the system and disturb functioning of
an organ or tissue. This is referred to as “silent” or “smoldering” inammation. (C) The inammatory, Selye, or granuloma pouch as originally described by Selye,30 is widely
used in studies of inammation.
Myofascia
Ligament
Bone
Periosteum
Pericardium
Heart
tendons
Tendon Cartilage
DNA
Nuclear matrix
Nuclear envelope
Cytoskeleton
Integrin
Superficial
fascia Perineurium
Figure 11 The living matrix, ground regulation system, or tissue tensegrity matrix is a continuous brous web-work or network that extends into every part of the body.
The extracellular components of this network consist primarily of collagen and ground substance. It is the largest system in the body, as it is the only system that touches
all of the other systems.
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Oschman et al
Anatomical and biophysical aspects
The concept that the inflammatory barricade forms from col-
lateral damage to healthy tissue surrounding an injury site is
supported by Selye’s classic studies published along with his
description of the granuloma or Selye pouch (Figure 10).25,30
Moreover, research in cell biology and biophysics reveals the
human body is equipped with a system-wide collagenous,
liquid–crystalline semiconductor network known as the living
matrix,31 or in other terms, a ground regulation system32,33
or tissue tensegrity matrix system (Figure 11).34 This body-
wide network can deliver mobile electrons to any part of
the body and thereby routinely protect all cells, tissues, and
organs from oxidative stress or in the event of injury.23,31 The
living matrix includes the extracellular and connective tissue
matrices as well as the cytoskeletons of all cells.31 Integrins
at cell surfaces are thought to allow for semi-conduction of
electrons to the cell interior, and links across the nuclear
envelope enable the nuclear matrix and genetic material to be
part of the circuitry.23 Our hypothesis is that this body-wide
electronic circuit represents a primary antioxidant defense
system. This hypothesis is the central point of this report.
The extracellular part of the matrix system is composed
mainly of collagen and ground substances (Figures 11 and 12).
The cytoskeleton is composed of microtubules, microfila-
ments, and other fibrous proteins. The nuclear matrix contains
another protein fabric composed of histones and related
materials.
It is not widely appreciated that collagen and other
structural proteins are semiconductors. This concept was
introduced by Albert Szent-Györgyi in the Korányi memorial
lecture in Budapest, Hungary in 1941. His talk was published
in both Science (Towards a New Biochemistry?)35 and Nature
(The Study of Energy Levels in Biochemistry).36 The idea that
proteins might be semiconductors was immediately and firmly
rejected by biochemists. Many modern scientists continue to
reject semi-conduction in proteins, because living systems
only have trace amounts of silicone, germanium, and com-
pounds of gallium that are the most widely used materials in
electronic semiconductor devices. However, there are many
ways of making organic semiconductors without using metals.
One of the sources of confusion was the widely held belief that
water was a mere filler material. We now know that water plays
crucial roles in enzymatic activities and semi-conduction.
Hydrated proteins actually are semiconductors, and have
become important components in the global microelectronics
industry. Organic microcircuits are preferred for some appli-
cations, because they can be made very small, self-assemble,
are robust, and have low energy consumption.37,38
One of the leaders in the field of molecular electron-
ics, NS Hush, has recognized Albert Szent-Györgyi and
Electron
Hydration shell
AB
Helical protein
Proton
Hyaluronan
Link protein
Keratin sulfate
Electrons
H2O
(b)
Field of
negative
charge
Core protein
Chondroitin
sulfate
Figure 12 Collagen and ground substance.
Notes: (A) Collagen, the principal protein of the extracellular connective tissue matrix, is a triple helix with a hydration shell surrounding each polypeptide strand. The protein
can transfer electrons by semiconduction, and protons (H+) and hydroxyls (OH−) migrate through the hydration shell. These charge movements can be very rapid and are vital
to life. (B) Copyright © 2005. R Paul Lee Reproduced with permission from Lee RP. Interface. Mechanisms of Spirit in Osteopathy. Portland, OR: Stillness Press; 2005.67 The
ground substance is a highly charged polyelectrolyte gel, a vast reservoir of electrons. Note the collagen bril embedded in ground substance units known as matrisomes (a term
coined by Heine).33 Detail of a matrisome to the right (b) reveals vast stores of electrons. Electrons from the ground substance can migrate through the collagen network to any
point in the body. We suggest that they can maintain an anti-oxidant microenvironment around an injury repair eld, slowing or preventing reactive oxygen species delivered
by the oxidative burst from causing collateral damage to healthy tissue, and preventing or reducing the formation of the so-called “inammatory barricade”.
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Earthing or grounding reduces inammation
–45.00
–40.00
–35.00
–30.00
–25.00
–20.00
–15.00
–10.00
–5.00
0.00
% change
Placebo
Grounded
Placebo
Grounded
Day 1
0.00
0.00
–36.84 –39.47 –39.47
–9.43 –3.77 –13.21
Day 2 Day 3 Day 4
Days
Bilirubin
Figure 13 Comparisons of bilirubin levels, pretest versus post-test for each group.
Robert S Mulliken for providing two concepts fundamental
to the industrial applications: theories of biological semi-
conduction, and molecular orbital theory, respectively.39
In recent studies, given awards by the Materials Research
Society in both Europe and the USA, scientists from Israel
made flexible biodegradable semiconductor systems using
proteins from human blood, milk, and mucus.40 Silicon, the
most widely used semiconducting material, is expensive in
the pure form needed for semiconductors, and is inflexible
and environmentally problematic. Organic semiconductors
are predicted to lead to a new range of flexible and biode-
gradable computer screens, cell phones, tablets, biosensors,
and microprocessor chips. We have come a long way since
the early days when semi-conduction in proteins was so
thoroughly rejected.41,42,43
Ground substance polyelectrolyte molecules associated
with the collagenous connective tissue matrix are charge
reservoirs (Figure 12). The matrix is therefore a vast
whole-body redox system. The glycosaminoglycans have
a high density of negative charges due to the sulfate and
carboxylate groups on the uronic acid residues. The matrix
is therefore a body-wide system capable of absorbing and
donating electrons wherever they are needed to support
immune functioning.44 The interiors of cells including the
nuclear matrix and DNA are all parts of this biophysical
electrical storage and delivery system. The time-course of
the effects of grounding on injury repair can be estimated in
various ways. First, we know from medical infrared imag-
ing that inflammation begins to subside within 30 minutes
of connecting with the earth via a conductive patch placed
on the skin.2,3 Secondly, metabolic activity increases during
this same period. Specifically, there is an increase in oxygen
consumption, pulse rate, and respiratory rate and a decrease
in blood oxygenation during 40 minutes of grounding.45 We
suspect that the “filling” of the charge reservoirs is a gradual
process, possibly because of the enormous number of
charged residues on the polyelectrolytes, and because they
are located throughout the body. When charge reservoirs are
saturated, the body is in a state we refer to as “inflamma-
tory preparedness”. This means that the ground substance,
which pervades every part of the body, is ready to quickly
deliver antioxidant electrons to any site of injury via the
semiconducting collagenous matrix (see Figure 16B).
These considerations also imply anti-aging effects of
earthing or grounding, since the dominant theory of aging
emphasizes cumulative damage caused by ROS produced
during normal metabolism or produced in response to pol-
lutants, poisons, or injury.46 We hypothesize an anti-aging
effect of grounding that is based on a living matrix reaching
every part of the body and that is capable of delivering anti-
oxidant electrons to sites where tissue integrity might be
compromised by reactive oxidants from any source.47,48
Molecules generated during the immune response
were also followed in the DOMS study.7 Parameters that
differed consistently by 10% or more between grounded
and ungrounded subjects, normalized to baseline, included
creatine kinase, phosphocreatine/inorganic phosphate ratios,
bilirubin, phosphorylcholine, and glycerolphosphorylcho-
line. Bilirubin is a natural antioxidant that helps control
ROS.49–53 While bilirubin levels decreased in both grounded
and ungrounded groups, the margin between the subjects
was large (Figure 13).7
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The inflammatory markers changed at the same time that
the pain indicators were changing. This was revealed by both
the visual analog pain scale and by the pressure measurements
on the right gastrocnemius (Figures 5 and 6). The authors
of the DOMS study suggested that bilirubin may have been
used as a source of electrons in the ungrounded subjects.7 It
is possible that the lower decline in circulating bilirubin in
the grounded subjects was due to the availability in the repair
field of free electrons from the Earth.
Other markers encourage the hypothesis that the grounded
subjects more efficiently resolved tissue damage: the pain
measures, inorganic phosphate-phosphocreatine ratios (Pi/
PCr), and creatine kinase (CK). Muscle damage has been
widely correlated with CK.54–56 As Figure 14 shows, CK
values in the ungrounded subjects were consistently above
those in the grounded subjects.7 Differences between Pi/PCr
of the two groups were monitored by magnetic resonance
spectroscopy. These ratios are indicative of metabolic rate
and cellular damage.57–60 Inorganic phosphate levels are
indicative of hydrolysis of PCr and adenosine triphosphate.
The ungrounded subjects had higher levels of Pi, while the
grounded subjects showed higher levels of PCr. These findings
indicate that mitochondria in the grounded subjects are not
producing as much metabolic energy, probably because there
is less demand due to more rapid achievement of homeostasis.
The differences between the groups are shown in Figure 15.
The pilot study7 on the effects of earthing in speeding
recovery from the pain of DOMS provides a good basis for
a larger study. The concepts presented here are summarized
in Figure 16 as a comparison between “Mr Shoes”
Placebo
Grounded
Placebo
Grounded
Days
Creatine kinase
% change
–20.00
–40.00
–0.51
–1.20
–21.94 59.69
146.22
Day 4Day 3Day 2Day 1
0.00
0.00
26.29
0.00
20.00
40.00
60.00
80.00
100.00
120.00
140.00
160.00
Figure 14 Creatine kinase levels, pretest versus post-test for each group.
Day 1 Day 2 Day 3 Day 4
5.84
4.74
2.170.00
Placebo
Grounded 0.00 –12.06
–20.00
–15.00
–10.00
–5.00
0.00
5.00
10.00
–14.97
Days
Pi/PCr ratio
Placebo
Grounded
% change
–10.39
Figure 15 Inorganic phosphate/phosphocreatine ratios (Pi/PCr) pretest versus post-test for each group.
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93
Earthing or grounding reduces inammation
Ungrounded from wearing shoes Ground substance
depleted of electrons
Grounded from
going barefoot
Mr Barefoot
Mr Shoes
Ground substance
filled with electrons
INJURY INJURY
Neurophils
attracted to
site of injury Neutophils
attracted to
site of injury Electrons
from ground
substance are
semi-conducted
through the
collagen matrix and
neutralize free
radicals that would
otherwise damage
nearby healthy
tissues. No
inflammatory
barricade, no
inflammation
Oxidative burst
delivers free radicals
to injury site to break
down damaged cells
and bacteria
Inflammatory
barricade caused by
unnecessary damage
to neaby healthy
tissues – can lead to
chronic inflammation
and chronic disease
AB
Figure 16 Summary of central hypothesis of this report: comparison of immune response in ungrounded versus grounded person.
Notes: (A) After an injury, the ungrounded person (Mr Shoes) will form an inammatory barricade around the injury site. (B) After an injury, the grounded person
(Mr Barefoot) will not form an inammatory barricade, because reactive oxygen species that could damage nearby healthy tissue (collateral damage) are immediately
neutralized by electrons semiconducted from the electron-saturated ground substance via the collagen network.
(an ungrounded individual) and “Mr Barefoot” (a grounded
individual).
Discussion
Voluminous current research correlates inflammation with a
wide range of chronic diseases. A search for “inflammation” in
the National Library of Medicine database (PubMed) reveals
over 400,000 studies, with more than 34,000 published in
2013 alone. The most common cause of death and disability
in the United States is chronic disease. Seventy-five percent
of the nation’s health care spending, which surpassed US$2.3
trillion in 2008, is for treating chronic disease. Heart disease,
cancer, stroke, chronic obstructive pulmonary disease, osteo-
porosis, and diabetes are the most common and costly chronic
diseases.61 Others include asthma, Alzheimer’s disease, bowel
disorders, cirrhosis of the liver, cystic fibrosis, multiple scle-
rosis, arthritis, lupus, meningitis, and psoriasis. Ten percent
of all health care dollars are spent treating diabetes. Osteopo-
rosis affects about 28 million aging Americans.61,62 However,
there are few theories on the mechanisms connecting chronic
inflammation with chronic disease. The research on grounding
or earthing summarized here provides a logical and testable
theory based on a variety of evidence.
The textbook description of the immune response describes
how large or small injuries cause neutrophils and other white
blood cells to deliver highly ROS and RNS to break down
pathogens and damaged cells and tissues. Classical textbook
descriptions also refer to an “inflammatory barricade” that
isolates injured tissues to hinder the movement of pathogens
and debris from the damaged region into adjacent, healthy
tissues. Selye described how the debris coagulates to form
the inflammatory barricade (Figure 10). This barrier also
hinders the movements of antioxidants and regenerative cells
into the blocked-off area. Repair can be incomplete, and this
incomplete repair can set up a vicious inflammatory cycle
that can persist for a long period of time, leading to so-called
silent or smoldering inflammation that in turn, over time, can
promote the development of chronic disease.
Remarkable as it may seem, our findings suggest that
this classical picture of the inflammatory barricade may be a
consequence of lack of grounding, and of a resultant “electron
deficiency”. Wounds heal very differently when the body is
grounded (Figures 1 and 2). Healing is much faster, and the
cardinal signs of inflammation are reduced or eliminated.
The profiles of various inflammatory markers over time are
very different in grounded individuals.
Those who research inflammation and wound healing need
to be aware of the ways grounding can alter the time-course
of inflammatory responses. They also need to be aware that
the experimental animals they use for their studies may have
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94
Oschman et al
very different immune systems and responses, depending on
whether or not they were reared in grounded or ungrounded
cages. It is standard research practice for investigators to
carefully describe their methods and the strain of the animals
they use so that others can repeat the studies if they wish. An
assumption is that all Wistar rats, for example, will be geneti-
cally and physio logically similar. However, a comparison of
neoplasms in Sprague–Dawley rats (originally outbred from
the Wistar rat) from different sources revealed highly signifi-
cant differences in the incidences of endocrine and mammary
tumors. The frequency of adrenal medulla tumors also varied
in rats from the same suppliers raised in different laboratories.
The authors “stressed the need for extreme caution in evaluation
of carcinogenicity studies conducted at different laboratories
and/or on rats from different sources.”63
From our perspective, these variations are not at all
surprising. Animals will differ widely in the degree to which
their charge reservoirs are saturated with electrons. Are their
cages made of metal, and if they are, is that metal grounded?
How close are their cages to wires or conduits carrying 60/50
Hz electricity? From our research, those factors will have
measurable impacts on immune responses. In fact, they repre-
sent a “hidden variable” that could have affected the outcomes
of countless studies, and also could affect the ability of other
investigators to reproduce a particular study.
Dominant lifestyle factors such as insulating footwear,
high-rise buildings, and elevated beds separate most humans
from direct skin connection with the Earth’s surface. An earth
connection was an everyday reality in past cultures that used
animal skins for footwear and to sleep on. We suggest that
the process of killing pathogens and clearing debris from
injury sites with ROS and RNS evolved to take advantage of
the body’s constant access to the virtually limitless source of
mobile electrons the Earth provides when we are in contact
with it. Antioxidants are electron donors, and the best electron
donor, we strongly believe, is right under our feet: the surface
of the Earth, with its virtually unlimited storehouse of acces-
sible electrons. Electrons from the Earth may in fact be the best
antioxidants, with zero negative secondary effects, because
our body evolved to use them over eons of physical contact
with the ground. Our immune systems work beautifully as
long as electrons are available to balance the ROS and reac-
tive nitrogen species (RNS) used when dealing with infection
and tissue injury. Our modern lifestyle has taken the body
and the immune system by surprise by suddenly depriving it
of its primordial electron source. This planetary separation
began accelerating in the early 1950s with the advent of shoes
made with insulating soles instead of the traditional leather.
Lifestyle challenges to our immune systems proceeded faster
than evolution could accommodate.
The disconnection from the Earth may be an important,
insidious, and overlooked contribution to physiological
dysfunction and to the alarming global rise in non-commu-
nicable, inflammatory-related chronic diseases. A lack of
electrons can also de-saturate the electron transport chains
in mitochondria, leading to chronic fatigue and slowing
the cellular migrations and other essential activities of the
cells of the immune system.64 At this point, even a minor
injury can lead to a long-term health issue. When mobile
electrons are not available, the inflammatory process takes
an abnormal course. Areas that are electron deficient are
vulnerable to further injury – they become positively charged
and will have difficulty warding off infections. The result
is an immune system constantly activated and eventually
exhausted. Cells of the immune system may fail to distin-
guish between the body’s diverse chemical structures (called
“self ”) and the molecules of parasites, bacteria, fungi, and
cancer cells (called “non-self ”). This loss of immunologic
memory can lead to attacks by some immune cells on the
body’s own tissues and organs. An example is the destruction
of insulin-producing beta cells of the islets of Langerhans
in the diabetic patient. Another example is the immune
system attacking cartilage in joints, producing rheumatoid
arthritis. Lupus erythematosus is an extreme example of an
auto-immune condition caused by the body’s immune system
attacking host tissues and organs. Lupus, for example, can
affect many different body systems, including skin, kidneys,
blood cells, joints, heart, and lungs. With time, the immune
system becomes weaker and the individual more vulnerable
to inflammation or infections that may not heal, as often seen
with the wounds of diabetic patients. Specifically, which part
or parts of the body the weakened immune system will attack
first depends on many factors such as genetics, habits (sleep,
food, drinks, exercise, etc), and toxins in the body and in the
environment.65,66 A repeated observation is that grounding,
or earthing, reduces the pain in patients with lupus and other
autoimmune disorders.1
Conclusion
Accumulating experiences and research on earthing, or
grounding, point to the emergence of a simple, natural, and
accessible health strategy against chronic inflammation, war-
ranting the serious attention of clinicians and researchers. The
living matrix (or ground regulation or tissue tensegrity-matrix
system), the very fabric of the body, appears to serve as one
of our primary antioxidant defense systems. As this report
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95
Earthing or grounding reduces inammation
explains, it is a system requiring occasional recharging by
conductive contact with the Earth’s surface – the “battery”
for all planetary life – to be optimally effective.
Acknowledgments
The authors are indebted to Martin Zucker for very valuable
comments on the manuscript. A Clinton Ober of EarthFx Inc.
has provided continuous support and encouragement for the
research that has been done to explore the science of earthing,
with particular focus on the immune system.
Disclosure
G Chevalier and JL Oschman are independent contractors for
EarthFx Inc., the company sponsoring earthing research, and
own a small percentage of shares in the company. Richard
Brown is an independent contractor for EarthFx Inc., the
company sponsoring earthing research. The authors report
no other conflicts of interest.
References
1. Ober CA, Sinatra ST, Zucker M. Earthing: The Most Important Health
Discovery Ever? 2nd ed. Laguna Beach: Basic Health Publications;
2014.
2. Amalu W. Medical thermography case studies. Clinical earthing applica-
tion in 20 case studies [undated article on the Internet]. Available from:
http://74.63.154.231/here/wp-content/uploads/2013/06/Amalu_thermo-
graphic_case_studies_2004.pdf. Accessed July 5, 2008.
3. Oschman JL. Can Electrons act as antioxidants? A review and com-
mentary. J Altern Complement Med. 2007;13:955–967.
4. Chevalier G, Sinatra ST, Oschman JL, Sokal K, Sokal P. Review
article: Earthing: health implications of reconnecting the human body
to the Earth’s surface electrons. J Environ Public Health; 2012;2012:
291541.
5. Ghaly M, Teplitz, D. The biologic effects of grounding the human body
during sleep as measured by cortisol levels and subjective reporting
of sleep, pain, and stress. J Altern Complement Med. 2004;10(5):
767–776.
6. Cohen S, Janicki-Deverts D, Doyle WJ, et al. Chronic stress,
glucocorticoid receptor resistance, inflammation, and disease risk.
Proc Natl Acad Sci U S A. 2012;109(16):5995–5999.
7. Brown D, Chevalier G, Hill M. Pilot study on the effect of grounding on
delayed-onset muscle soreness. J Altern Complement Med. 2010;16(3):
265–273.
8. Butterfield TA, Best TM, Merrick MA. The dual roles of neutrophils
and macrophages in inflammation: a critical balance between tissue
damage and repair. J Athl Train. 2006;41(4):457–465.
9. Takmakidis SP, Kokkinidis EA, Similios I, Douda H. The effects of
ibuprofen on delayed onset muscle soreness and muscular performance
after eccentric exercise. J Strength Cond Res. 2003;17(1):53–59.
10. Close GL, Ashton T, Cable T, Doran D, MacLaren DP. Eccentric exercise,
isokinetic muscle torque and delayed onset muscle soreness: the role of
reactive oxygen species. Eur J Appl Physiol. 2004;91(5–6): 615–621.
11. MacIntyre DL, Reid WD, Lyster DM, Szasz IJ, McKenzie DC. Presence
of WBC, decreased strength, and delayed soreness in muscle after
eccentric exercise. J Appl Physiol (1985). 1996;80(3):1006–1013.
12. Franklin ME, Currier D, Franklin RC. The effect of one session of
muscle soreness inducing weight lifting exercise on WBC count,
serum creatine kinase, and plasma volume. J Orthop Sports Phys Ther.
1991;13(6):316–321.
13. Peake J, Nosaka K, Suzuki K. Characterization of inflammatory
responses to eccentric exercise in humans. Exerc Immunol Rev. 2005;11:
64–85.
14. MacIntyre DL, Reid WD, McKenzie DC. Delayed muscle soreness: the
inflammatory response to muscle injury and its clinical implications.
Sports Med. 1995;20(1):24–40.
15. Smith LL, Bond JA, Holbert D, et al. Differential white cell count after
two bouts of downhill running. Int J Sports Med. 1998;19(6): 432–437.
16. Smith LL. Cytokine hypothesis of overtraining: a physiological adaptation
to excessive stress? Med Sci Sports Exerc. 2000;32(2):317–331.
17. Ascensão A, Rebello A, Oliveira E, Marques F, Pereira L, Magalhães J.
Biochemical impact of a soccer match: analysis of oxidative stress and
muscle damage throughout recovery. Clin Biochem. 2008;41(10–11):
841–851.
18. Smith LL, McCammon M, Smith S, Chamness M, Israel RG, O’Brien KF.
White blood cell response to uphill walking and downhill jogging at
similar metabolic loads. Eur J Appl Physiol. 1989;58(8):833–837.
19. Broadbent S, Rousseau JJ, Thorp RM, Choate SL, Jackson FS,
Rowlands DS. Vibration therapy reduces plasma IL6 and muscle
soreness after downhill running. Br J Sports Med. 2010;44(12):
888–894.
20. Gleeson M, Almey J, Brooks S, Cave R, Lewis A, Griffiths H.
Haematological and acute-phase responses associated with delayed-onset
muscle soreness. Eur J Appl Physiol Occup Physiol. 1995;71(2–3):
137–142.
21. Tidball JG. Inflammatory processes in muscle injury and repair. Am J
Physiol Regul Integr Comp Physiol. 2005;288(2):R345–R353.
22. Zhang J, Clement D, Taunton J. The efficacy of Farabloc, an electro-
magnetic shield, in attenuating delayed-onset muscle soreness. Clin J
Sport Med. 2000;10(1):15–21.
23. Oschman JL. Charge transfer in the living matrix. J Bodyw Mov Ther.
2009;13(3):215–228.
24. Best TM, Hunter KD. Muscle injury and repair. Phys Med Rehabil Clin
North Am. 2000;11(2):251–266.
25. Selye H. The Stress of Life. Revised ed. New York: McGraw-Hill Com-
panies, Inc.; 1984.
26. Motoyama H. Measurements of Ki energy: Diagnoses and Treatments.
Tokyo: Human Science Press, 1997.
27. Colbert AP, Yun J, Larsen A, Edinger T, Gregory WL, Thong T. Skin
impedance measurements for acupuncture research: development of
a continuous recording system. Evid Based Complement Altern Med.
2008;5(4):443–450.
28. Reichmanis M, Marino AA, Becker RO. Electrical correlates of acu-
puncture points. IEEETrans Biomed Eng. 1975;22(6):533–535.
29. Sokal K, Sokal P. Earthing the human organism influences bioelectrical
processes. J Altern Complement Med. 2012;18(3):229–234.
30. Selye H. On the mechanism through which hydrocortisone affects the
resistance of tissues to injury; an experimental study with the granuloma
pouch technique. JAMA. 1953;152(13):1207–1213.
31. Oschman JL, Oschman NH. Matter, energy, and the living matrix. Rolf
Lines. 1993;21(3):55–64.
32. Pischinger A. The Extracellular Matrix and Ground Regulation: Basis
for a Holistic Biological Medicine. Berkeley: North Atlantic Books;
2007.
33. Heine H. Lehrbuch der biologischen Medizin. Grundregulation und
Extrazellulare Matrix. [Handbook of Biological Medicine. The extra-
cellular matrix and ground regulation]. Stuttgart: Hippokrates Verlag;
2007. German.
34. Pienta KJ, Coffey DS. Cellular harmonic information transfer through a
tissue tensegrity-matrix system. Med Hypotheses. 1991;34(1): 88–95.
35. Szent-Györgyi A. Towards a new biochemistry? Science. 1941;93:
609–611.
36. Szent-Györgyi A. The study of energy levels in biochemistry. Nature.
1941;148(3745):157–159.
37. Tokita Y. Proteins as semiconductor devices [article on the Internet].
Available from: http://www.jsst.jp/e/JSST2012/extended_abstract/
pdf/16.pdf. Accessed May 23, 2014.
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Dovepress
Dovepress
Dovepress
96
Oschman et al
38. Sarpeshkar R. Ultra Low Power Bioelectronics. Fundamentals,
Biomedical Applications, and Bio-inspired Systems. Cambridge:
Cambridge University Press; 2010.
39. Hush NS. An overview of the first half-century of molecular electronics.
Ann N Y Acad Sci. 2003;1006:1–20.
40. Mentovich E, Belgorodsky B, Gozin M, Richter S, Cohen H. Doped
biomolecules in miniaturized electric junctions. J Am Chem Soc.
2012;134(20):8468–8473.
41. Cuevas JC, Scheer E. Molecular Electronics: An Introduction to Theory
and Experiment. Singapore; World Scientific Series in Nanoscience and
Nanotechnology, Volume 1; World Scientific Publishing Co. Singapore.
2010.
42. Reimers JR, United Engineering Foundation (US); et al. Molecular
electronics III. New York, NY; Annals of the New York Academy of
Sciences; 1006; 2003.
43. Joachim C, Ratner MA. Molecular electronics: Some views on trans-
port junctions and beyond. Proc Natl Acad Sci. USA. 2005;102(25):
8801–8808.
44. Heine H. Homotoxicology and Ground Regulation System (GRS).
Baden-Baden: Aurelia-Verlag; 2000.
45. Chevalier G. Changes in pulse rate, respiratory rate, blood oxygenation,
perfusion index, skin conductance, and their variability induced during
and after grounding human subjects for 40 minutes. J Altern Comple-
ment Med. 2010;16(1): 81–87.
46. Miwa S, Beckman KB, Muller FL, editors. Oxidative Stress in Aging:
From Model Systems to Human Diseases. Totowa: Humana Press; 2008.
47. Oschman JL. 2008. Mitochondria and cellular aging. In: Klatz R,
Goldman R, editors. Anti-Aging Therapeutics. Volume XI. Chicago:
American Academy of Anti-Aging Medicine; 2009:275–287.
48. Kessler WD, Oschman JL. Counteracting aging with basic physics. In:
Klatz R, Goldman R, editors. Anti-Aging Therapeutics. Volume XI.
Chicago: American Academy of Anti-Aging Medicine; 2009:185–194.
49. Stocker R. Antioxidant activities of bile pigments. Antioxid Redox
Signal. 2004;6(5):841–849.
50. Paschalis V, Nikolaidis MG, Fatouros IG, et al. Uniform and prolonged
changes in blood oxidative stress after muscle-damaging exercise.
In Vivo. 2007;21(5):877–883.
51. Nikolaidis MG, Paschalis V, Giakas G, et al. Decreased blood oxidative
stress after repeated muscle damaging exercise. Med Sci Sports Exerc.
2007;39(7):1080–1089.
52. Florczyk UM, Jozkowicz A, Dulak J. Biliverdin reductase: new features
of an old enzyme and its potential therapeutic significance. Pharmacol
Rep. 2008;60(1):38–48.
53. Sedlak TW, Salehb M, Higginson DS, Paul BD, Juluri KR, Snyder SH.
Bilirubin and glutathione have complementary antioxidant and cyto-
protective roles. Proc Natl Acad Sci U S A. 2009;106(13):5171–5176.
54. Close GL, Ashton T, McArdle A, MacLaren DP. The emerging role
of free radicals in delayed onset muscle soreness and contraction-
induced muscle injury. Comp Biochem Physiol A Mol Integr Physiol.
2005;142(3):257–266.
55. Hirose L, Nosaka K, Newton M, et al. Changes in inflammatory media-
tors following eccentric exercise of the elbow flexors. Exerc Immunol
Rev. 2004;10:75–90.
56. Hartmann U, Mester J. Training and overtraining markers in selected
sport events. Med Sci Sports Exerc. 2000;32(1):209–215.
57. McCully KK, Argov Z, Boden BP, Brown RL, Bank WJ, Chance B.
Detection of muscle injury in humans with 31-P magnetic resonance
spectroscopy. Muscle Nerve. 1988;11(3):212–216.
58. McCully KK, Posner J. Measuring exercise-induced adaptations
and injury with magnetic resonance spectroscopy. Int J Sports Med.
1992;13(S1):S147–S149.
59. McCully KK, Shellock FG, Bank WJ, Posner JD. The use of nuclear
magnetic resonance to evaluate muscle injury. Med Sci Sports Exerc.
1992;24(5):537–542.
60. Zehnder M, Muelli M, Buchli R, Kuehne G, Boutellier U. Further gly-
cogen decrease during early recovery after eccentric exercise despite a
high carbohydrate intake. Eur J Nutr. 2004;43(3):148–159.
61. Swartz K. Projected Costs of Chronic Diseases. Health Care Cost
Monitor. The Hastings Center; 2011. Available from: http://healthcare-
costmonitor.thehastingscenter.org/kimberly Swartz/projected-costs-of-
chronic-diseases/. Accessed January18, 2011.
62. Partnership to Fight Chronic Disease. Available from: http://www.fight-
chronicdisease.org/issues/about.cfm. Accessed January 18, 2011.
63. Mac Kenzie WF, Garner FM. Comparison of neoplasms in six sources
of rats. J Natl Cancer Inst. 1973;50(5):1243–1257.
64. Oschman JL. Mitochondria and cellular aging. Anti-Aging Therapeutics
Volume XI, Klatz R Goldman R. eds; Chicago IL; in American Academy
of Anti-Aging Medicine, 2008;285–287.
65. Biagi E, Candela M, Fairweather-Tait S, Franceschi C, Brigidi P. Aging
of the human metaorganism: the microbial counterpart. Age (Dordr).
2012;34(1):247–267.
66. Franceschi C, Bonafè M, Valensin S, et al. Inflamm-aging. An evo-
lutionary perspective on immunosenescence. Ann N Y Acad Sci.
2000;908:244–254.
67. Lee RP. Interface. Mechanisms of Spirit in Osteopathy. Portland, OR:
Stillness Press; 2005.
