Successful treatment of myalgic encephalomyelitis/chronic fatigue syndrome using hydrogen gas: four case reports

Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized by unexplained fatigue and malaise that persist for more than 6 months with neuropsychiatric symptoms, including slight fever, headache, weakness, impaired thinking, and depression. The onset and severity of these symptoms vary and reduce the quality of life as well as social, occupational, and personal activities of those affected, with some becoming bedridden. The number of ME/CFS patients in the United States is estimated to be between 836,000 and 2.5 million. Although it currently remains unclear whether there are objective and biological abnormalities in ME/CFS, recent neuroimaging, blood marker analyses, and energy metabolism and mitochondrial studies detected these abnormalities in ME/CFS patients. ME/CFS may be caused by the activation of the immune system, both within and outside the brain, which induces the release of inflammatory cytokines. ME/CFS is presumed to cause abnormalities in the central and autonomic nervous systems, systemic energy metabolism, and immune system and also involve oxidative and nitrosative stress. Dysfunctions in systemic energy metabolism may be related to abnormalities in the structure and function of mitochondria. Molecular hydrogen (H2) is a gaseous molecule that selectively scavenges reactive oxygen and nitrogen species with strong oxidizing power, namely, hydroxyl radicals (·OH) and peroxynitrite, respectively. H2 easily crosses the blood-brain barrier and biological membranes, reaches mitochondria, and protects cells from ·OH-induced cell damage. A recent literature review revealed that H2 attenuated acute or chronic fatigue in animals and healthy subjects. We also reported that the anti-fatigue effects of H2 involved the protection of mitochondria, which may also ameliorate the pathogenesis of ME/CFS. Therefore, we conducted this case study to test this hypothesis by examining the efficacy of H2 gas inhalation in four patients with ME/CFS. The results obtained suggest the potential of H2 gas as a therapeutic gas for ME/CFS. Further large-scale clinical studies are needed to evaluate the efficacy of H2 gas as a therapeutic agent for ME/CFS and the underlying mechanism of action.

Study details

Article type

Case Report

Disease / injury model

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Outcome

Positive

Findings

This series of case studies are based on self-assessments by a small number of patients. Nevertheless, the results obtained suggest the potential of H2 gas as a therapeutic gas for ME/CFS.