One of the more useful studies in the hydrogen literature is also one of the least promotional, because its headline result is negative. Two trials, published together in 2011, gave hydrogen-enriched water to patients with muscular dystrophy, inflammatory myopathy and mitochondrial myopathy. In both trials, no objective clinical improvement was observed[1].
What did change was the bloodwork. Several biochemical markers moved significantly while the symptoms did not, and the gap between those two things is genuinely worth understanding, because it recurs throughout supplement research.
What these conditions are
Three different diseases were studied and they are not variations on one theme.
Progressive muscular dystrophy is a genetic disorder in which muscle fibres progressively break down. Polymyositis and dermatomyositis are inflammatory myopathies, where the immune system attacks muscle tissue. Mitochondrial myopathies are disorders of the mitochondria, the structures that generate cellular energy, and muscle is affected because it is energy-hungry.
Mitochondrial and inflammatory myopathies were among only six human diseases studied with hydrogen as of a 2012 review[2], so this was one of the earliest human hydrogen trials rather than a late addition.
The rationale is that all three involve oxidative stress, and hydrogen reacts selectively with hydroxyl radical while leaving normal signalling molecules alone[3]. In mitochondrial disease specifically there is a further reason: the mitochondria are both the main source of reactive oxygen species and the thing that is malfunctioning.
The two trials
The paper reports an open-label trial and a randomized, double-blind, placebo-controlled crossover trial, and the difference between them is the most instructive part[1].
The open-label trial gave 1.0 litre per day of hydrogen-enriched water for 12 weeks to 5 patients with progressive muscular dystrophy, 4 with polymyositis or dermatomyositis, and 5 with mitochondrial myopathies. 18 serum parameters plus urinary 8-isoprostane were measured every 4 weeks.
The crossover trial gave 0.5 litres per day of hydrogen-enriched water or placebo water for 8 weeks to 10 patients with dermatomyositis and 12 with mitochondrial myopathies, measuring 18 serum parameters every 4 weeks[1].
Note the two changes between them: the dose halved, from 1.0 litre to 0.5 litres per day, and the duration dropped from 12 weeks to 8. That matters for interpreting the results.
What was found, starting with the part that did not work
In the open-label trial, no objective improvement or worsening of clinical symptoms was observed[1]. In the double-blind trial, no objective clinical effects were observed either.
That is the finding that matters most to a patient. Neither trial made anyone measurably better at the thing the disease actually does to them.
The biochemical results are a different picture. In the open-label trial there were significant effects in lactate-to-pyruvate ratios in the muscular dystrophy and mitochondrial myopathy groups, in fasting blood glucose in muscular dystrophy, in serum matrix metalloproteinase-3 in the inflammatory myopathy group, and in serum triglycerides in that same group[1].
The lactate-to-pyruvate ratio is the most meaningful of those. It is a standard indicator of how well cells are producing energy aerobically, and it is elevated in mitochondrial disease. A change in that ratio is a plausible mitochondrial signal rather than an incidental blood result. Matrix metalloproteinase-3 is a marker associated with inflammatory tissue activity, which fits the inflammatory myopathy group.
In the double-blind trial, a significant improvement was detected in lactate in the mitochondrial myopathy group[1]. The lactate-to-pyruvate ratio in that group and matrix metalloproteinase-3 in the dermatomyositis group both showed favourable responses but without statistical significance.
The dose-response question
The authors attribute the weaker double-blind results to the lower amount of hydrogen administered and the shorter observation period, and describe this as implying a threshold effect or a dose-response effect[1].
That is their interpretation, and it is a reasonable one, but it should be labelled as interpretation rather than a finding. There is a competing explanation that fits the same data: the open-label trial was unblinded and uncontrolled, so some of its results may reflect that rather than the dose.
The tell is which results survived. The findings that persisted into the blinded, placebo-controlled trial were the objective laboratory measures, particularly lactate. Blood lactate does not know whether a patient believes in the treatment. So the biochemical signal in mitochondrial myopathy is the most credible thing in the paper, precisely because it survived blinding.
It is also worth noting that this dose-response reading sits awkwardly with the broader hydrogen literature. A 2012 review flagged as an unresolved puzzle that no dose-response effect is observed with hydrogen generally, and that small quantities produce marked effects even though intestinal bacteria already generate far larger amounts[2]. The field has not settled this.
Why bloodwork can improve while symptoms do not
This pattern is common enough to be worth naming, because it appears constantly in supplement marketing.
A blood marker is a proxy. It is chosen because it tends to track a disease process and because it is cheap and precise to measure. But a proxy improving does not guarantee the underlying disease has changed, and it certainly does not guarantee the patient feels different.
In these conditions the reason is fairly concrete. Muscular dystrophy involves structural loss of muscle fibres. Shifting a metabolic ratio does not rebuild lost tissue. In mitochondrial myopathy, better aerobic energy handling could in principle translate to less fatigue, but 8 to 12 weeks in a group of 12 to 14 people is not enough to detect it if the effect is small.
Both readings are consistent with the data, and the honest position is that this study cannot distinguish them.
The safety finding worth carrying away
No adverse effect was observed in either trial, with one exception, and that exception is the most practically useful sentence in the paper[1].
An insulin-treated patient with MELAS, a mitochondrial disorder, experienced hypoglycaemic episodes, which subsided when the insulin dose was reduced[1].
This is a concrete, documented interaction rather than a theoretical caution. Hydrogen water was also associated with a significant change in fasting blood glucose in the muscular dystrophy group in the same paper, which makes the hypoglycaemia observation coherent rather than anomalous.
The practical implication is narrow but real: anyone using insulin or other glucose-lowering medication who starts drinking hydrogen water should be monitoring blood glucose and should tell their prescriber. The event here resolved by adjusting the insulin dose, not by stopping the water, but it required someone noticing.
If you have one of these conditions
Muscular dystrophy, inflammatory myopathy and mitochondrial disease are serious diagnoses managed by specialists, often with immunosuppressive treatment in the inflammatory cases. This trial gave hydrogen water alongside existing care and there is nothing in it that supports replacing anything.
The most defensible summary for a patient is that hydrogen water did not improve symptoms in either trial, produced a reproducible laboratory change in mitochondrial myopathy, and carries a documented glucose-related interaction for anyone on insulin.
The bottom line
Two trials, one open-label at 1.0 litre per day for 12 weeks and one double-blind placebo-controlled crossover at 0.5 litres per day for 8 weeks, found no objective clinical improvement in muscular dystrophy, inflammatory myopathy or mitochondrial myopathy[1].
Laboratory markers did move, and the lactate finding in mitochondrial myopathy survived blinding, which makes it the most credible result in the paper. Whether that translates into anything a patient would notice was not shown, and the trials were too small and too short to find out.
References
- Open-label trial and randomized, double-blind, placebo-controlled, crossover trial of hydrogen-enriched water for mitochondrial and inflammatory myopathies. Medical Gas Research, 2011
- Molecular hydrogen as an emerging therapeutic medical gas for neurodegenerative and other diseases. Oxidative Medicine and Cellular Longevity, 2012
- Hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals. Nature Medicine, 2007
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease. Content is for informational purposes only and is not medical advice; consult a qualified healthcare provider before starting any supplement. As an Amazon Associate we earn from qualifying purchases.
