Hydrogen-Rich Water Ingestion Alleviates Downhill Running-Induced Muscle Soreness in Recreationally Active Young Men: A Randomized Controlled Trial

Abstract

Purpose

Although hydrogen-rich water (H₂-water) baths and H₂ gas inhalation may reduce eccentric exercise-induced muscle damage (EIMD), evidence for H₂-water ingestion remains limited. This randomized controlled trial examined whether drinking H₂-water alleviates EIMD symptoms.

Methods

In a double-blind, crossover design, 11 young men consumed 1.74 L/day of H₂-water (0.99 ppm) or a placebo for 14 days. On day 7, they completed a 30-min downhill treadmill run (−15% slope, 65% VO_2peak, ~24 °C, 35% humidity). Delayed-onset muscle soreness (DOMS), one-repetition maximum (1-RM) knee extension strength, serum creatine kinase (CK), and plasma heat shock protein 70 (HSP70) were assessed at baseline and throughout a 168-hour recovery period.

Results

Downhill running increased DOMS and serum CK activity while decreasing 1-RM strength (all P < 0.001). Compared to the placebo, H₂-water ingestion reduced DOMS (P ≤ 0.014, \documentclass[12pt]{minimal}\usepackage{amsmath}\usepackage{wasysym}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{mathrsfs}\usepackage{upgreek}\setlength{\oddsidemargin}{-69pt}\begin{document}$$\:{\eta}_{p}^{2}\:$$\end{document}= 0.47–0.50 for both limbs), serum CK (P = 0.043, \documentclass[12pt]{minimal}\usepackage{amsmath}\usepackage{wasysym}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{mathrsfs}\usepackage{upgreek}\setlength{\oddsidemargin}{-69pt}\begin{document}$$\:{\eta}_{p}^{2}$$\end{document} = 0.35), and plasma HSP70 (P = 0.034, \documentclass[12pt]{minimal}\usepackage{amsmath}\usepackage{wasysym}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{mathrsfs}\usepackage{upgreek}\setlength{\oddsidemargin}{-69pt}\begin{document}$$\:{\eta}_{p}^{2}$$\end{document} = 0.50, n = 8). The 168-hour area under the curve was lower in the H₂-water trial for DOMS (dominant: P = 0.041, d = 0.71; non-dominant: P = 0.052, d = 0.66) and serum CK (P = 0.034, d = 0.74). No treatment effects were observed for other EIMD markers.

Conclusion

Our preliminary findings suggest that H₂-water ingestion may help reduce DOMS and serum CK levels after EIMD in physically active individuals. However, since it does not preserve maximum strength, further research is needed to evaluate its overall effectiveness as an exercise recovery strategy.

Keywords

Molecular hydrogen / Exercise-induced muscle damage / DOMS / Creatine kinase / HSP70

References

[1] Kawamura T, Higashida K, Muraoka I. Application of molecular hydrogen as a novel antioxidant in sports science. Oxid Med Cell Longev. 2020;2328768. https://doi.org/10.1155/2020/2328768.

[2] Ostojic S. Hydrogen gas as an exotic performance-enhancing agent: challenges and opportunities. Curr Pharm Des, 2021, 27(5): 723-30.

[3] Ohsawa I, Ishikawa M, Takahashi K, Watanabe M, Nishimaki K, Yamagata K, Katsura K, Katayama Y, Asoh S, Ohta S. Hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals. Nat Med, 2007, 13(6): 688-94.

[4] Zhang Y, Ying Y, Zu X, Ding L, Shi X, Wang J, Li X, Li C, Zhou Q, Shen H, Li H, Lu H, Cheng J. Mechanism by which hydrogen-rich water mitigates exercise-induced fatigue: activation of the immunoresponsive gene 1-itaconate/nuclear factor erythroid 2-related factor 2/heme oxygenase-1 pathway. Med Gas Res, 2026, 16(1): 26-32.

[5] Zhou K, Liu M, Wang Y, Liu H, Manor B, Bao D, et al.Effects of molecular hydrogen supplementation on fatigue and aerobic capacity in healthy adults: A systematic review and meta-analysis. Front Nutr, 2023, 10: 1094767.

[6] Kawamura T, Gando Y, Takahashi M, Hara R, Suzuki K, Muraoka I. Effects of hydrogen bathing on exercise-induced oxidative stress and delayed-onset muscle soreness. Jpn J Phys Fit Sports Med, 2016, 65(3): 297-305.

[7] Kawamura T, Suzuki K, Takahashi M, Tomari M, Hara R, Gando Y, et al.Involvement of neutrophil dynamics and function in exercise-induced muscle damage and delayed-onset muscle soreness: Effect of hydrogen bath. Antioxidants, 2018, 7(10): 127.

[8] Todorovic N, Javorac D, Stajer V, Ostojic S. The effects of supersaturated hydrogen-rich water bathing on biomarkers of muscular damage and soreness perception in young men subjected to high-intensity eccentric exercise. J Sports Med. 2020;8836070. https://doi.org/10.1155/2020/8836070.

[9] Shibayama Y, Dobashi S, Arisawa T, Fukuoka T, Koyama K. Impact of hydrogen-rich gas mixture inhalation through nasal cannula during post-exercise recovery period on subsequent oxidative stress, muscle damage, and exercise performances in men. Med Gas Res, 2020, 10(4):155-62.

[10] Botek M, Krejči J, McKune A, Valenta M, Sládečková B. Hydrogen rich water consumption positively affects muscle performance, lactate response, and alleviates delayed onset of muscle soreness after resistance training. J Strength Cond Res, 2022, 36(10): 2792-9.

[11] Sládečková B, Botek M, Krejčí J, Valenta M, McKune A, Neuls F, Klimešová I. Hydrogen-rich water supplementation promotes muscle recovery after two strenuous training sessions performed on the same day in elite fin swimmers: randomized, double-blind, placebo-controlled, crossover trial. Front Physiol, 2024, 15: 1321160.

[12] Byrnes WC, Clarkson PM, White JS, Hsieh SS, Frykman PN, Maughan RJ. Delayed onset muscle soreness following repeated bouts of downhill running. J Appl Physiol, 1985, 59(3): 710-5.

[13] Maeo S, Ochi Y, Yamamoto M, Kanehisa H, Nosaka K. Effect of a prior bout of preconditioning exercise on muscle damage from downhill walking. Appl Physiol Nutr Metab, 2015, 40: 274-9.

[14] Ikewaki N, Sonoda T, Yamao H. Analysis of the serum levels of heat shock protein 70 (HSP70) after inhalation of a steam-gas mixture containing hydrogen gas. J Kyushu Univ Health Welf, 2021, 22: 89-93.

[15] Febbraio MA, Ott P, Nielsen HB, Steensberg A, Keller C, Krustrup P, et al.Exercise induces hepatosplanchnic release of heat shock protein 72 in humans. J Physiol, 2002, 544(3): 957-62.

[16] Peake JM, Suzuki K, Hordern M, Wilson G, Nosaka K, Coombes JS. Plasma cytokine changes in relation to exercise intensity and muscle damage. Eur J Appl Physiol, 2005, 95: 514-21.

[17] Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods, 2007, 39(2): 175-91.

[18] Kelly A. The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J, 2001, 18(3): 205-7.

[19] Ooi CH, Ng SK, Omar EA. Acute ingestion of hydrogen-rich water does not improve incremental treadmill running performance in endurance-trained athletes. Appl Physiol Nutr Metab, 2020, 45(5): 513-9.

[20] Mizumura K, Taguchi T. Delayed onset muscle soreness: Involvement of neurotrophic factors. J Physiol Sci, 2016, 66(1): 43-52.

[21] Ge Y, Wu F, Sun X, Xiang Z, Yang L, Huang S, et al.Intrathecal infusion of hydrogen-rich normal saline attenuates neuropathic pain via inhibition of activation of spinal astrocytes and microglia in rats. PLoS ONE, 2014, 9(5): e97436.

[22] Kawaguchi M, Satoh Y, Otsubo Y, Kazama T. Molecular hydrogen attenuates neuropathic pain in mice. PLoS ONE, 2014, 9(6):e100352.

[23] Matsumoto S, Ueda T, Kakizaki H. Effect of supplementation with hydrogen-rich water in patients with interstitial cystitis/painful bladder syndrome. Urology, 2013, 81(2):226-30.

[24] Aoki K, Nakao A, Adachi T, Matsui Y, Miyakawa S. Pilot study: Effects of drinking hydrogen-rich water on muscle fatigue caused by acute exercise in elite athletes. Med Gas Res, 2012, 2: 12.

[25] Javorac D, Stajer V, Ratgeber L, Betlehem J, Ostojic S. Short-term H₂ inhalation improves running performance and torso strength in healthy adults. Biol Sport, 2019, 36(4): 333-9.

[26] Yamazaki M, Kusano K, Ishibashi T, Kiuchi M, Koyama K. Intravenous infusion of H₂-saline suppresses oxidative stress and elevates antioxidant potential in Thoroughbred horses after racing exercise. Sci Rep, 2015, 5: 15514.

[27] Sobue S, Inoue C, Hori F, Qiao S, Murate T, Ichihara M. Molecular hydrogen modulates gene expression via histone modification and induces the mitochondrial unfolded protein response. Biochem Biophys Res Commun, 2017, 493(1): 318-24.

[28] Nishiwaki H, Ito M, Negishi S, Sobue S, Ichihara M, Ohno K. Molecular hydrogen upregulates heat shock response and collagen biosynthesis and downregulates cell cycles: Meta-analyses of gene expression profiles. Free Radic Res, 2018, 52(4): 434-45.

[29] Kamimura N, Nishimaki K, Ohsawa I, Ohta S. Molecular hydrogen improves obesity and diabetes by inducing hepatic FGF21 and stimulating energy metabolism in db/db mice. Obesity, 2011, 19(7): 1396-403.

[30] Febbraio MA, Steensberg A, Walsh R, Koukoulas I, van Hall G, Saltin B, et al.Reduced glycogen availability is associated with an elevation in HSP72 in contracting human skeletal muscle. J Physiol, 2002, 538(3): 911-7.

[31] Febbraio MA, Mesa JL, Chung J, Steensberg A, Keller C, Nielsen HB, et al.Glucose ingestion attenuates the exercise-induced increase in circulating heat shock protein 72 and heat shock protein 60 in humans. Cell Stress Chaperones, 2004, 9(4): 390-6.

[32] Jin Z, Zhao P, Gong W, Ding W, He Q. Fe-porphyrin: A redox-related biosensor of hydrogen molecule. Nano Res, 2023, 16: 2020-5.

[33] Enns DL, Tiidus PM. The influence of estrogen on skeletal muscle: sex matters. Sports Med, 2010, 40(1): 41-58.

[34] Clarkson PM, Hubal MJ. Exercise-induced muscle damage in humans. Am J Phys Med Rehabil, 2002, 81(11 Suppl): S52-69.

Funding

Sterling Circle Sdn Bhd(PRO-S-1031-U721)

Universiti Sains Malaysia(#2015/0592/P4580)

Rights & permissions

Beijing Sport University