IMO, oxygenation is the biggest reason to need a protein skimmer when carbon dosing. Plus it removes a lot of the bacteria that build up. I have carbon dosed for years. A couple of months ago, I unplugged the protein skimmer while feeding and forgot to plug it back in. After about 2-3 hours I had my first fish loss. Luckly, when he died he splashed and I was in the room to hear it. Everything was extremely lethargic, even the coral. I quickly turned it back on and tested everything I could in the water. No other perameters were off. within another hour, everything appeared to be fine.