How the assessment is built.
A wellness assessment is only useful if it tells you something true. This is how ours works: four scoring dimensions, one routing question, three safety questions — each grounded in published research. The science underneath, in plain language.
Four rules we designed around.
- 01
Self-rated, not diagnostic.
This is a wellness assessment, not a medical diagnosis. We're sizing your candidacy and giving you context — your consultation is where any clinical determination happens.
- 02
Short and honest.
Nine questions, four real scoring inputs. Where two variables almost always move together (diet + alcohol + sleep), we ask one question. We don't pad to look thorough.
- 03
Safety questions never affect your score.
G6PD, pregnancy, and anticoagulant questions don't change your toxic load score. They only change whether your result page recommends booking treatment directly or booking a screening call first.
- 04
Tracks are routing, not ranking.
Recovery / Performance / Longevity isn't a quality ladder. They're three different operating modes for the same protocol — chosen by what you're optimising for.
Four dimensions. One score.
The Toxic Load Score (0–100) is a weighted composite of four independent inputs. Each dimension is normalised against its theoretical maximum, then multiplied by its weight. The weights reflect how strongly each axis drives the literature on oxidative stress, inflammation, and accumulated load.
- — 01
Environment · 40%
Where you live is the strongest external load factor we can measure. Major cities concentrate particulate matter, traffic exhaust, water contaminants, and heavy metals at orders of magnitude above rural baselines.
What we ask: We don't ask. HSW operates from London and our launch audience is reached via ads in London and Glasgow only — so urban environmental load is the baseline for everyone taking this assessment. The 40% environment weight is applied automatically and is not user-toggleable for the launch cohort.
40/ 100 - — 02
Lifestyle · 25%
Diet quality, alcohol load, and sleep are the three most-cited modifiable inputs to oxidative stress and inflammation in modern adults. We collapse them into a single self-rated read because they almost always move together.
What we ask: One question with four lifestyle archetypes — hectic, busy, steady, disciplined — each scored by the typical sum of food, alcohol, and sleep behaviours that cluster at that level.
25/ 100 - — 03
Symptoms · 25%
Symptoms are the body's downstream signal of the upstream load. We don't diagnose — we look for the pattern that ozone-responsive conditions tend to present with: fatigue, brain fog, recovery debt, low-grade inflammation.
What we ask: Multi-select. Each symptom is weighted by how strongly it correlates with conditions that have responded to EBOO in the literature.
25/ 100 - — 04
Time · 10%
Accumulated load is partly time-dependent. Older adults carry more environmental residue, more glycation products, and more NRF2 dysregulation — independent of lifestyle.
What we ask: Age bracket. Worth 10% of the score because it modifies but doesn't drive the recommendation.
10/ 100
After the score, your goal.
After the score is computed, your goal determines the protocol. The science doesn't change — but the dosing, cadence, and surrounding support do.
- Recovery
Higher-intensity dosing patterns follow the ozone autohaemotherapy regimens used in fibromyalgia, long-COVID, and chronic fatigue trials — frequent enough to drive sustained NRF2 activation, sustained enough to reset. Specific cadence is set by the consulting physician.
- Performance
Lower-frequency dosing mirrors the maintenance approach used for healthy-but-stressed cohorts. Targets oxidative stress recovery without over-shooting hormesis. The cadence depends on training load, recovery markers, and individual response — all reviewed with your physician.
- Longevity
Foundation-plus-maintenance pattern: establish first, then maintain at a cadence the physician calibrates to your other longevity protocols. Stacks well with NAD+, peptides, and HBOT in the preventative-medicine literature.
Why we screen for three things.
These questions don't affect your score. They route the result page — if any flag is raised, you're directed to a screening call with a doctor rather than straight to booking.
- — 01
- — 02
Pregnancy / trying to conceive
Ozone therapy isn't established as safe in pregnancy — not because it has been shown harmful, but because it hasn't been adequately studied. Standard precaution applies.
Sources[1] - — 03
Anticoagulant therapy / bleeding disorders
EBOO involves IV access and extracorporeal blood handling. Active anticoagulation or bleeding disorders need physician review before any procedure. Not an automatic exclusion — needs a doctor's call.
Sources[11]
The newest published EBOO research.
AUTO-UPDATED WEEKLY · NCBI E-UTILITIES- 2025
Observed Reduction in Urinary Toxin Excretion With Extracorporeal Blood Oxygenation and Ozonation (EBOO) Treatment in an 88-Year-Old With Chronic Anemia: A Case Report
Bennett SJ, Kuo J, Wang S, et al. · Cureus
- 2025
Oxidative analysis, clinical-laboratory parameters, and quality of life in treatment associated with ozone therapy in female dogs with mammary tumors
Oliveira VAP, Pinto MPR, Larangeira DF, et al. · Research in veterinary science
- 2025
Major Ozonated Autoheamotherapy Alleviates Skeletal Muscle Ischemia/Reperfusion Injury by Regulating Nrf2/HO-1 Pathway
Guo HZ, Yu SL, Chen HW · The Kaohsiung journal of medical sciences
- 2025
A clinical study on ozone autohemotherapy for the treatment of acute ischemic stroke
Cheng H, Lu R, Du J, et al. · Frontiers in medicine
- 2024
Major ozonated autohemotherapy promoted functional recovery following spinal cord injury in adult rats via the inhibition of oxidative stress and inflammation
Xia L, Sun Y, Zhou Y, et al. · Open life sciences
- 2024
Efficacy of ozonated autohemotherapy for improvement of myocardial injury following traumatic brain injury
Wang C, Zhu Y, Liu W, et al. · BMC anesthesiology
Every claim, sourced.
- [1]
Bocci V. Scientific and medical aspects of ozone therapy. State of the art. Archives of Medical Research · 2006
The foundational pharmacology paper for ozone therapy: defines therapeutic dose ranges, signalling pathways activated, and the controlled-oxidative-stress hypothesis.
PubMed · 16785045 - [2]
Re L, Mawsouf MN, Menéndez S, et al. Ozone therapy: clinical and basic evidence of its therapeutic potential. Archives of Medical Research · 2008
Reviews clinical applications of ozone across vascular, autoimmune, and chronic infection conditions — supports the multi-target therapeutic profile.
PubMed · 18164952 - [3]
Pecorelli A, Bocci V, Acquaviva A, et al. NRF2 activation is involved in ozonated human serum upregulation of HO-1 in endothelial cells. Toxicology and Applied Pharmacology · 2013
Mechanistic evidence: ozonated blood activates NRF2 — the master antioxidant transcription factor — and induces HO-1, a key cytoprotective enzyme.
PubMed · 23583632 - [4]
Galiè M, Costanzo M, Nodari A, et al. Mild ozonisation activates antioxidant cell response by the Keap1/Nrf2 dysregulation reversal. Redox Biology · 2019
Confirms NRF2 activation as the dominant signalling pathway behind ozone therapy's anti-inflammatory effects.
PubMed · 30769287 - [5]
Leslie HA, van Velzen MJM, Brandsma SH, et al. Discovery and quantification of plastic particle pollution in human blood. Environment International · 2022
First identification of microplastic particles circulating in human blood. Direct evidence of the modern environmental load every adult carries.
PubMed · 35367073 - [6]
Sharifi-Rad M, Anil Kumar NV, Zucca P, et al. Lifestyle, oxidative stress, and antioxidants: back and forth in the pathophysiology of chronic diseases. Frontiers in Physiology · 2020
Establishes the lifestyle → oxidative stress → chronic disease pathway. Justifies weighting diet, sleep, and stress as scoring inputs.
PubMed · 32848873 - [7]
Tirelli U, Cirrito C, Pavanello M, et al. Ozone therapy in 65 patients with fibromyalgia: an effective therapy. European Review for Medical and Pharmacological Sciences · 2019
Clinical evidence: 70% of fibromyalgia patients reported significant improvement after a course of ozone autohaemotherapy.
PubMed · 30993633 - [8]
Tirelli U, Franzini M, Valdenassi L, et al. Fatigue in post-acute sequelae of SARS-CoV-2 (PASC) treated with oxygen-ozone autohemotherapy. European Review for Medical and Pharmacological Sciences · 2021
Long-COVID cohort: significant fatigue reduction following a 7-session ozone autohaemotherapy protocol.
PubMed · 34755362 - [9]
Beutler E. Glucose-6-phosphate dehydrogenase deficiency: a historical perspective. Blood · 2008
Defines G6PD deficiency as a contraindication to oxidative therapies — red blood cells lack the protection needed to safely handle controlled oxidative stress.
PubMed · 18063748 - [10]
Bocci V, Borrelli E, Travagli V, Zanardi I. The ozone paradox: ozone is a strong oxidant as well as a medical drug. Medicinal Research Reviews · 2011
Reviews the dose-response curve: low controlled doses activate adaptive antioxidant pathways; high doses are damaging. Defines the therapeutic window.
PubMed · 20186705 - [11]
Smith NL, Wilson AL, Gandhi J, et al. Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility. Medical Gas Research · 2017
Modern overview of ozone therapy mechanisms, clinical evidence, and safety. Useful as a single-source primer for non-specialists.
PubMed · 29023736 - [12]
Schmidt TS, et al. The human gut microbiome and chronic systemic inflammation. Cell · 2018
Gut microbiome composition is causally linked to systemic inflammation markers — justifies including gut symptoms as a scoring input.
PubMed · 29622236