Successful treatment of myalgic encephalomyelitis/chronic fatigue syndrome using hydrogen gas: four case reports
Hirano SI, Ichikawa Y, Sato B, Takefuji Y, Satoh F. · Medical Gas Research. 2024;14(2):84–86.
What kind of evidence is this?
Human
Uncontrolled descriptive report of four cases
Other neurological conditions
Inhaled H₂
Not reported in this record.
Not reported in this record.
Methods at a glance
Four people aged 18–58 years diagnosed with or considered probable ME/CFS after previous unsuccessful treatments.
4 cases: two men and two women.
Case 1: about 20 weeks; cases 2–4: 8–9 weeks.
Inhalation of 6–7% H₂ from an MHG-2000α generator. Case 1 used 3–5 hours/day; cases 2–4 used 5–6 hours/day.
H₂ diluted in an unspecified balance gas — the article does not report Brown's gas or deliberate O₂ co-delivery.
6–7% H₂ at a reported total device flow of 2 L/min; balance-gas composition was not stated.
Approximately 120–140 mL/min H₂, calculated from 6–7% of the reported 2,000 mL/min total flow.
Not reported — the balance gas and absolute O₂ flow were not described.
No control group; symptoms before treatment and during follow-up were compared within each case.
Outcomes and reported result
Self-reported fatigue, post-exertional symptoms, pain, sleep, cognition/brain fog, daily activity and other symptoms; one case used the Canadian Consensus Criteria score.
All four cases reported improvement in selected symptoms. Case 1's self-scored total decreased from 29 to 13 over 20 weeks, with temporary worsening around COVID-19 vaccinations. Cases 2–4 were assessed by interview rather than a common validated scale. No causal effect can be separated from natural fluctuation, concurrent care, expectation or selective reporting.
The complete PMC case report was checked for each case, concentration, total and calculated H₂ flow, timing, outcomes, ethics and author employment; the absence of a reported balance gas is explicit.
A reported association, difference or mechanism is not automatically a clinical benefit. Null findings, outcome type, study design and precision all matter.
Cautions and applicability
Four selected uncontrolled cases based mainly on subjective reports, heterogeneous exposure and no blinded or standardized comparison. Four authors were employees of MiZ, the manufacturer of the inhaler used. The report cannot establish efficacy or replace evidence-based ME/CFS care.
Only the four reported cases; hypothesis-generating evidence.
Not reported in this record.
Not reported in this record.
Not reported in this record.
No single-study GRADE certainty rating is assigned. Certainty is assessed by important outcome across a complete eligible evidence set, not by attaching a final grade to one source.
Sources and record status
PMID: 37929512 · DOI: 10.4103/2045-9912.385441
Free full article on PubMed Central.
PMC full article and PubMed record; full-text and article-status check completed 8 August 2026.
2026-08-10