Dr. Michael Hamblin, a renowned researcher in photobiomodulation, discusses the slow adoption of PBM therapy as a mainstream treatment, the challenges of conducting expensive clinical trials, and the skepticism among physicians. They also explore the balance between starting low with laser therapy, advancements in light therapy, and the importance of individualized treatment based on patient response.
Historical belief in the magical properties of lasers and the cost of conducting randomized trials have hindered the acceptance of Photobiomodulation as a mainstream medical treatment.
Systemic effects of photobiomodulation, including stem cell mobilization and mitochondrial signaling, suggest the need for deeper understanding and potential individualized treatment approaches.
Deep dives
Why isn't Photobiomodulation a mainstream treatment?
In this podcast episode, Dr. Michael Hamlin discusses the reasons why Photobiomodulation (PBM) hasn't become a mainstream treatment despite numerous studies showcasing its benefits. He explains that the historical belief in the magical properties of lasers without understanding the underlying photobiology led to inconsistent results and negative studies. Additionally, the cost of conducting randomized double-blind placebo-controlled trials, which are required for acceptance by the medical community, poses a financial challenge for smaller companies producing PBM devices. Moreover, PBM has often been associated with alternative and complementary medicine due to a lack of understanding of its molecular mechanisms. However, Dr. Hamlin highlights the potential of PBM in addressing serious diseases like Alzheimer's and age-related macular degeneration, where pharmaceutical treatments are limited. He concludes that while invasive procedures and individualized dosing may play a role, further research is needed to determine the most effective approach.
The Systemic Effect and Internal Dosing in Photobiomodulation
During the podcast, Dr. Hamlin explains the concept of the systemic effect in photobiomodulation and its significance. He notes that when light is applied to tissue, blood, and the elements within it, such as cells or solvents, can carry the light's messages throughout the body. This systemic effect involves various mechanisms, including the mobilization of stem cells and signaling from mitochondrial activity in the blood. The discovery of cell-free mitochondria circulating in the blood further supports the understanding of the potential systemic effects of photobiomodulation. Dr. Hamlin also mentions the effectiveness of low-power intranasal LEDs and wrist devices, highlighting how even low-intensity light can have an impact. While external and internal dosimetry parameters remain relevant, the systemic effects suggest the need to explore deeper understanding and potentially develop individualized treatment approaches.
Individualization and Future Directions in Photobiomodulation
In discussing the best practices for clinicians in photobiomodulation, Dr. Hamlin emphasizes the importance of individualizing treatment parameters based on patient phenotypes and responses. He recommends starting with a relatively low intensity and gradually increasing to avoid overstimulating patients, while recognizing the variations in individual genotype and response to photobiomodulation. Dr. Hamlin suggests that individualized approaches and understanding patient phenotypes can lead to more effective treatment outcomes. He also mentions the potential role of artificial intelligence (AI) and real-time feedback in managing light therapy, such as using on-board AI in devices to consider factors like skin type, melanin content, vessel dilation, blood flow changes, and temperature fluctuations. However, further research is required to fully explore these possibilities and determine the most beneficial approaches for specific patients.
