I am always ready to follow the evidence wherever it leads, but it has to be good evidence. Good scientists do experiments to find out “if” a treatment is effective; but a lot of poor science and pseudoscience is done by people who already “know” the treatment they are using is effective and are looking for evidence that will prove to others that they are right. I frequently write about the claims for dietary supplements, devices, and other questionable treatments. The satisfied users and true believers can’t understand why I don’t recommend their favorite treatment. They send me emails with links to studies. They seem to think that if only I would look at their “evidence”, I would change my mind and become a believer. They can’t understand why the evidence they found so convincing would fail to convince me.
A rebuttal of my article
Last year I wrote about hydrogen water. I reviewed the evidence and concluded that it hadn’t established that hydrogen water was any healthier than regular water. Alex Tarnava disagreed with what I wrote. He published this rebuttal. He called my piece “incredibly poorly written”. He accused me of incompetent research. He thought I had just read his ads, regurgitated a FOX News article, failed to review the literature, and hadn’t even looked at Wikipedia. Those accusations are all false. It’s easy enough to compare my article to the FOX article: there’s no “regurgitation” to be found.
As for the Wikipedia article, it pretty much agrees with what I wrote. It concludes:
There is so far a lack of scientific consensus concerning the evidence that hydrogen has health benefits in humans. A few articles have been published on the topic, but the clinical literature is sparse and what has been published covers many conditions, but not multiple trials of any one condition. Hydrogen water proponents claim that it has health benefits such being an antioxidant, reducing inflammation, reducing risk of metabolic syndrome, providing neuroprotection for various diseases, and reducing side effects associated with cancer radiation treatment. But none of the published articles concerning these claims are systematic reviews or meta-analyses and very little work has been done in animals.
Tarnava is not content to just criticize me; he goes on to criticize the Science-Based Medicine blog, Skeptics Guide to the Universe, and skeptics in general. And he goes on to provide a data dump of human studies. A few of them are labeled as having studied OUR TABLETS, but a lot of them were studies where hydrogen was inhaled, infused, or applied to the skin, so they are not really relevant. And many of the studies lacked an appropriate control group. The great majority of the human studies looked at biomarkers rather than at POEMS (Patient-Oriented Evidence that Matters). I don’t want to know whether hydrogen water makes the blood tests look prettier; I want to know if it produces any clinically significant health benefits.
His list includes two studies of rheumatoid arthritis (RA); there have only been two human studies of RA. The first is a study of infused hydrogen, so it doesn’t tell us anything about drinking hydrogen water. The second was an open-label pilot study of patients with RA. There were only 20 subjects, no control group, and no blinding. Subjects were given high H2 water (4-5 PPM of hydrogen), and were aware of what they were drinking. They found statistically significant reductions in measures of oxidative stress; and amazingly, all five of the patients who had early RA without antibodies against cyclic citrullinated peptides achieved remission, and four of them became symptom-free. The authors concluded, “The results suggest [emphasis added] that the hydroxyl radical scavenger H2 effectively reduces oxidative stress in patients with this condition. The symptoms of RA were significantly improved with high H2 water”.
Anything that produces remissions in 100% of RA patients and relieves all symptoms in 80% would be front-page headlines for rheumatologists and they would all be recommending it; but I find it hard to believe. My crystal ball predicts that future researchers will fail to get such great results.
Tarnava and his claims
Who is Tarnava? He has no medical or scientific background. He runs the spiffy DRINK HRW website and sells Drink HRW Rejuvenation tablets. You are supposed to dissolve the tablets in a glass of water, wait 1-2 minutes, and then drink the water immediately. It ain’t cheap: the tablets cost around a dollar each. He claims that his product supplies more hydrogen than any other product, with a peak concentration of 7.4 PPM. The benefits claimed include:
- Improving athletic performance and recovery
- Supporting a healthy redox, the harmony between our natural antioxidant defense and beneficial oxidative species
- Supporting a healthy inflammatory response
- Supporting our body’s resilience to a wide array of stresses
- Delivering 80mg of highly bioavailable magnesium per tablet
He also sells other products such as Hydrogen Beauty Tablets, a Rejuvenation + Essentials bundle, fish oil, vitamin D, and caffeine and creatine supplements.
Two new studies
An email correspondent wrote me about a friend of hers who bought an expensive machine to make his own hydrogen water at home and sent her this updated information. It was a link to an article in Scientific Reports, an online open-access journal from the publishers of Nature. The study was randomized, double-blind, and placebo-controlled. It compared two groups of healthy Korean adults: 20 who drank hydrogen water for four weeks and 18 who drank plain water. They measured several biomarkers. Biological antioxidant potential (BAP) was not significantly different in the two groups, but subgroup analysis detected an increased BAP in the hydrogen water group for subjects under the age of 30. They found less apoptosis, fewer CD14+ cells, and more down-regulation of transcriptional networks in the hydrogen water group. Will those changes result in significantly improved clinical outcomes? We have no way of knowing. They concluded, “These finding suggest [emphasis added] HW increases antioxidant capacity thereby reducing inflammatory responses in healthy adults”.
The believer in hydrogen water followed up with a second new study. It was a randomized controlled trial of 60 people in India who met at least 3 out of the 5 criteria for metabolic syndrome. It found that supplementing with high-concentration hydrogen water for 24 weeks resulted in significantly reduced blood cholesterol and glucose levels, attenuated serum hemoglobin A1c, and improved biomarkers of inflammation and redox homeostasis as compared to placebo (P < 0.05). Furthermore, H2 tended to promote a mild reduction in body mass index and waist-to-hip ratio. The authors noted that their results were consistent with the results of some animal studies but differed from the results of some other human studies. They said, “a larger prospective clinical trial is warranted”. It’s hard to know what to make of their results, but I think it would be unwise to make too much of it unless the results can be corroborated by other researchers and in other populations.
Biomarkers can be misleading. Homocysteine is a prime example. Elevated homocysteine is thought to be a risk factor for cardiovascular disease, so it seemed logical that lowering it would reduce the risk. Treatment with B vitamins effectively lowered homocysteine blood levels, but it didn’t reduce risk. A Cochrane systematic review concluded that lowering homocysteine did not prevent heart attacks or reduce death rates.
Conclusion: the evidence is not convincing
Researchers are continuing to evaluate the possible health advantages of drinking hydrogen water, and some of their preliminary results look promising. I will keep an open mind and stay tuned, but we know that promising small preliminary studies tend not to pan out. Meanwhile, I am not convinced by the evidence. I see no reason to buy expensive tablets or invest in a machine to produce hydrogen at home.