# Consumption of water containing a high concentration of molecular hydrogen reduces oxidative stress and disease activity in patients with rheumatoid arthritis: an open-label pilot study.
> 高濃度水素水の摂取が関節リウマチ患者の酸化ストレスおよび疾患活動性に与える影響：オープンラベルパイロット試験


## Abstract

Twenty patients with rheumatoid arthritis (RA) consumed 530 ml of hydrogen-rich water at 4–5 ppm daily over a 4-week period, followed by a 4-week washout and a second 4-week intake phase. Urinary 8-hydroxydeoxyguanosine (8-OHdG), a marker of oxidative DNA damage, declined by an average of 14.3% (p<0.01), while the DAS28 disease activity score fell from 3.83 to 3.02 (p<0.01) during the first drinking period. In the second drinking phase, DAS28 further decreased from 2.83 to 2.26 (p<0.01). Notably, all 5 patients with early-stage RA (disease duration under 12 months) who were negative for anti-citrullinated peptide antibodies (ACPAs) achieved clinical remission, with 4 becoming symptom-free by study end. These findings indicate that molecular hydrogen, acting as a selective hydroxyl radical scavenger, may reduce systemic oxidative stress and improve clinical outcomes in RA patients.

### Mechanism

Molecular hydrogen acts as a selective scavenger of hydroxyl radicals, reducing oxidative DNA damage as measured by urinary 8-OHdG, which is proposed to attenuate the inflammatory processes underlying rheumatoid arthritis and lower disease activity scores.

## Bibliographic

- **Authors**: Ishibashi T, Sato B, Rikitake M, Seo T, Kurokawa R, Hara Y, et al.
- **Journal**: Med Gas Res
- **Year**: 2012 (2012-10-02)
- **PMID**: [23031079](https://pubmed.ncbi.nlm.nih.gov/23031079/)
- **DOI**: [10.1186/2045-9912-2-27](https://doi.org/10.1186/2045-9912-2-27)
- **PMC**: [PMC3563451](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3563451/)
- **Study type**: human observational study
- **Delivery route**: hydrogen-rich water
- **Effect reported**: positive

## Delivery context

Hydrogen-rich water is a low-risk delivery route, but the achievable systemic hydrogen dose is bounded. For clinical applications, inhalation is the most efficient route; inhalation, however, carries explosion risk, and concentration matters (empirical LFL of 10% applies to inhalation environments; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).

## Safety notes

Hydrogen-rich water is a low-risk delivery route, but the achievable systemic hydrogen dose is bounded. For clinical applications, inhalation is the most efficient route; inhalation, however, carries explosion risk, and concentration matters (empirical LFL of 10% applies to inhalation environments; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).

See also:
- [Inhalation concentration and LFL / UFL](https://h2-papers.org/en/safety-notes/inhalation-concentration)
- [Consumer Affairs Agency accident cases](https://h2-papers.org/en/safety-notes/accident-cases)
- [Inhalation safety threshold lineage](https://h2-papers.org/en/safety-notes/lineage)

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> **Cite as**: H2 Papers — PMID 23031079. https://h2-papers.org/en/papers/23031079
> **Source**: PubMed PMID [23031079](https://pubmed.ncbi.nlm.nih.gov/23031079/)