Hydrogen-rich water suppresses the reduction in blood total antioxidant capacity induced by 3 consecutive days of severe exercise in physically active males

Hydrogen gas inhalation prior to high-intensity training reduces attenuation of nitric oxide bioavailability in male rugby players

Background

Inhalation of hydrogen gas (H2) as an antioxidant supplement may alleviate exercise-induced oxidative damage and protect post-exercise hydrogen peroxide signaling, which may help mediate beneficial exercise adaptation. The aims of this study were to determine the effects of H2 inhalation on plasma nitric oxide (NO) level and its synthesis precursor in professional athletes.

Methods

A randomized, placebo-controlled, double-blind, crossover trial was conducted with professional male rugby players for 3 weeks. Participants underwent 1 week of H2 supplementation and 1 week of placebo treatment prior to daily sessions of high-intensity exercise training, separated by 1 week of low-intensity training as a washout.

Results

Two-way (supplementation and time) repeated-measures analyses of variance showed that NO, L-arginine, and tetrahydrobiopterin levels in the H2 inhalation group were significantly higher than those in the placebo group after exercise (D6) and remained higher after 24 h of rest (D7). Levels of hydroxydeoxyguanosine and interleukin 6 were lower in the H2 inhalation week than in the placebo week on D6 and D7. In addition, total antioxidant levels were significantly higher with H2 inhalation than with placebo.

Significance

These results suggest that H2 inhalation helps to maintain NO signaling after exercise and to alleviate inflammation and oxidative stress induced by high-intensity exercise training in professional athletes.

Inhalation of Hydrogen-rich Gas before Acute Exercise Alleviates Exercise Fatigue: A Randomized Crossover Study

Hydrogen, as an antioxidant, may have the potential to mitigate fatigue and improve selected oxidative stress markers induced by strenuous exercise. This study focused on a previously unexplored approach involving pre-exercise inhalation of hydrogen-rich gas (HRG). Twenty-four healthy adult men first completed pre-laboratories to determine maximum cycling power (Wmax) and maximum cycling time (Tmax). Then they were subjected to ride Tmax at 80% Wmax and 60-70 rpm on cycle ergometers after inhaled HRG or placebo gas (air) for 60-minute in a double-blind, counterbalanced, randomized, and crossover design. The cycling frequency in the fatigue modeling process and the rating of perceived exertion (RPE) at the beginning and end of the ride were recorded. Before gas inhalation and after fatigue modeling, visual analog scale (VAS) for fatigue and counter-movement jump (CMJ) were tested, and blood samples were obtained. The results showed that compared to a placebo, HRG inhalation induced significant improvement in VAS, RPE, the cycling frequency during the last 30 seconds in the fatigue modeling process, the ability to inhibit hydroxyl radicals, and serum lactate after exercise (p<0.028), but not in CMJ height and glutathione peroxidase activity. The cycling frequency during the last 30 seconds of all other segments in the fatigue modeling process was within the range of 60-70 rpm. In conclusion, HRG inhalation prior to acute exercise can alleviate exercise-induced fatigue, maintain functional performance, and improve hydroxyl radical and lactate levels.

Hydrogen-Rich Alkaline Water Supplementation Restores a Healthy State and Redox Balance in H2O2-Treated Mice

Water is a major requirement for our bodies, and alkaline water has induced an antioxidant response in a model of natural aging. A series of recent reports have shown that aging is related to reduced water intake. Hydrogen-rich water has been suggested to exert a general antioxidant effect in relation to both improving lifestyle and preventing a series of diseases. Here, we wanted to investigate the effect of the daily intake of hydrogen-rich alkaline water (HAW) in counteracting the redox imbalance induced in a model of H2O2-treated mice. Mice were treated with H2O2 for two weeks and either left untreated or supplied with HAW. The results show that HAW induced a reduction in the ROS plasmatic levels that was consistent with the increase in the circulating glutathione. At the same time, the reduction in plasmatic 8-hydroxy-2'-deoxyguanosine was associated with reduced DNA damage in the whole body. Further analysis of the spleen and bone marrow cells showed a reduced ROS content consistent with a significantly reduced mitochondrial membrane potential and superoxide accumulation and an increase in spontaneous proliferation. This study provides evidence for a clear preventive and curative effect of HAW in a condition of systemic toxic condition and redox imbalance.

Can molecular hydrogen supplementation enhance physical performance in healthy adults? A systematic review and meta-analysis

Background

Physical exertion during exercise often leads to increased oxidative stress and inflammatory responses, significantly affecting physical performance. Current strategies to mitigate these effects are limited by their effectiveness and potential side effects. Molecular hydrogen (H₂) has gained attention for its antioxidant and anti-inflammatory properties. Studies have suggested that H2 supplementation contributes to antioxidant potential and anti-fatigue during exercise, but the variance in the observations and study protocols is presented across those studies.

Objective

This systematic review and meta-analysis aimed to comprehensively characterize the effects of H₂ supplementation on physical performance (i.e., endurance, muscular strength, and explosive power), providing knowledge that can inform strategies using H2 for enhancing physical performance.

Methods

We conducted a literature search of six databases (PubMed, Web of Science, Medline, Sport-Discus, Embase, and PsycINFO) according to the PRISMA guidelines. The data were extracted from the included studies and converted into the standardized mean difference (SMD). After that, we performed random-effects meta-analyses and used the I 2 statistic to evaluate heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the quality of the evidence obtained from this meta-analysis.

Results

In total, 27 publications consisting of 597 participants were included. The search finally included aerobic endurance, anaerobic endurance, muscular strength, lower limb explosive power, rating of perceived exertion (RPE), blood lactate (BLA), and average heart rate (HRavg) in the effect size (ES) synthesis. The ES of H2 on aerobic endurance, including V̇O2max (SMD = 0.09, p = 0.394; I 2 = 0%) and aerobic endurance exercise (SMD = 0.04, p = 0.687; I 2 = 0%), were not significant and trivial; the ES of H2 on 30 s maximal anaerobic endurance (SMD = 0.19, p = 0.239; I 2 = 0%) was not significant and trivial; the ES of H2 on muscular strength (SMD = 0.19, p = 0.265; I 2 = 0%) was not significant and trivial; but the ES of H2 on lower limb explosive power (SMD = 0.30, p = 0.018; I 2 = 0%) was significant and small. In addition, H2 reduces RPE (SMD = -0.37, p = 0.009; I 2 = 58.0%) and BLA (SMD = -0.37, p = 0.001; I 2 = 22.0%) during exercise, but not HRavg (SMD = -0.27, p = 0.094; I 2 = 0%).

Conclusion

These findings suggest that H2 supplementation is favorable in healthy adults to improve lower limb explosive power, alleviate fatigue, and boost BLA clearance, but may not be effectively improving aerobic and anaerobic endurance and muscular strength. Future studies with more rigorous designs are thus needed to examine and confirm the effects of H2 on these important functionalities in humans.

Systematic review registration

http://www.crd.york.ac.uk/PROSPERO.

Can molecular hydrogen supplementation reduce exercise-induced oxidative stress in healthy adults? A systematic review and meta-analysis

Objective

Exercise-induced oxidative stress affects multiple neurophysiological processes, diminishing the exercise performance. Hydrogen (H2) can selectively reduce excessive free radicals, but studies observed its "dual effects" on exercise-induced oxidative stress, that is, increasing or decreasing the oxidative stress. Therefore, we here conducted a systematic review and meta-analysis to quantitatively assess the influence of H2 on exercise-induced oxidative stress in healthy adults.

Methods

We conducted a systematic review of publications across five databases. The following keywords were used for search strategy: ["hydrogen"[Mesh] or "molecular hydrogen" or "hydrogen rich water" or "hydrogen-rich water" or "hydrogen rich saline"] and ["Oxidative Stress"[Mesh] or "Antioxidative Stress" or "Oxidative Damage" or "Oxidative Injury" or "Oxidative Cleavage"] and ["randomized controlled trial"[Mesh] or "randomized" or "RCT"]. We included trials reporting the effects of H2 on exercise-induced oxidative stress and potential antioxidant capacity post-exercise in healthy adults. Additionally, subgroup analyses were conducted to explore how various elements of the intervention design affected those outcomes.

Results

Six studies, encompassing seven experiments with a total of 76 participants, were included in our analysis. Among these studies, hydrogen-rich water, hydrogen bathing, and hydrogen-rich gas were three forms used in H2 administration. The H2 was applied in different timing, including before, during, or after exercise only, both before and after exercise, and repeatedly over days. Single-dose, multi-dose within 1 day and/or multiple-dose over days were implemented. It was observed that compared to placebo, the effects of H2 on oxidative stress (diacron-reactive oxygen metabolites, d-ROMs) was not significant (SMD = -0.01, 95%CI-0.42 to 0.39, p = 0.94). However, H2 induced greater improvement in antioxidant potential capacity (Biological Antioxidant Potential, BAP) (SMD = 0.29, 95% CI 0.04 to 0.54, p = 0.03) as compared to placebo. Subgroup analyses revealed that H2 supplementation showed greater improvement (SMD = 0.52, 95%CI 0.16 to 0.87, p = 0.02) in the antioxidant potential capacity of intermittent exercises than continuous exercise.

Conclusion

H2 supplementation can help enhance antioxidant potential capacity in healthy adults, especially in intermittent exercise, but not directly diminish the levels of exercise-induced oxidative stress. Future studies with more rigorous design are needed to examine and confirm these findings.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=364123, Identifier CRD42022364123.

Acute effect of hydrogen-rich water on physical, perceptual and cardiac responses during aerobic and anaerobic exercises: a randomized, placebo-controlled, double-blinded cross-over trial

Molecular hydrogen (H2 gas) dissolved in water to produce Hydrogen-Rich Water. Hydrogen-Rich Water (HRW) is considered as ergogenic aid in different exercise modes. However, acute pre-exercise HRW ingestion effect is unclear regarding athlete performance. This study aimed at investigating acute effect of HRW ingestion on aerobic and anaerobic exercise performance. Twenty-two male amateur middle-distance runners volunteered to participate in this study. In a randomized, double-blind study design, all players ingested 500 mL of HRW or placebo (PLA) supplement 30 min before the start of the tests. Over 4 days, maximal aerobic speed of Vameval test (MAS), time to exhaustion at MAS (Tlim), squat jump (SJ), counter-movement jump (CMJ) and five jump test (5JT) were evaluated. Also, rate of perceived exertion (RPE) and peak heart rate (HRpeak) were measured during the aerobic tests. For Vameval test, HRW ingestion improved MAS, HRpeak and RPE compared with the placebo condition. For Tlim test, HRW ingestion demonstrated improvements in time to exhaustion, RPE and HRpeak. However, no significant change was observed between HW and placebo conditions in SJ, CMJ, 5JT. 500 mL of HRW can significantly improve HRpeak, time to exhaustion, RPE, with no significant effect on MAS, jumping performance in amateur endurance athletes.

Molecular Hydrogen Therapy-A Review on Clinical Studies and Outcomes

With its antioxidant properties, hydrogen gas (H2) has been evaluated in vitro, in animal studies and in human studies for a broad range of therapeutic indications. A simple search of "hydrogen gas" in various medical databases resulted in more than 2000 publications related to hydrogen gas as a potential new drug substance. A parallel search in clinical trial registers also generated many hits, reflecting the diversity in ongoing clinical trials involving hydrogen therapy. This review aims to assess and discuss the current findings about hydrogen therapy in the 81 identified clinical trials and 64 scientific publications on human studies. Positive indications have been found in major disease areas including cardiovascular diseases, cancer, respiratory diseases, central nervous system disorders, infections and many more. The available administration methods, which can pose challenges due to hydrogens' explosive hazards and low solubility, as well as possible future innovative technologies to mitigate these challenges, have been reviewed. Finally, an elaboration to discuss the findings is included with the aim of addressing the following questions: will hydrogen gas be a new drug substance in future clinical practice? If so, what might be the administration form and the clinical indications?

Effects of molecular hydrogen supplementation on fatigue and aerobic capacity in healthy adults: A systematic review and meta-analysis

Background

Fatigue is oftentimes induced by high-intensity exercise potentially via the exceeded amount of reactive oxygen species, leading to diminished functions (e.g., aerobic capacity) and increased risk of injuries. Studies indicate that molecular hydrogen (H₂), with antioxidant and anti-inflammatory properties, may be a promising strategy to alleviate fatigue and improve aerobic capacity. However, such effects have not been comprehensively characterized.

Objective

To systematically assess the effects of in taking H₂ on fatigue and aerobic capacity in healthy adults.

Methods

The search was conducted in August 2022 in five databases. Studies with randomized controlled or crossover designs that investigated the rating of perceived exertion (RPE), maximal oxygen uptake (VO_2max), peak oxygen uptake (VO_2peak), and endurance performance were selected. The data (mean ± standard deviation and sample size) were extracted from the included studies and were converted into the standardized mean difference (SMD). Random-effects meta-analyses were performed. Subgroup analysis was used to analyze potential sources of heterogeneity due to intervention period, training status, and type of exercise.

Results

Seventeen publications (19 studies) consisting of 402 participants were included. The pooled effect sizes of H₂ on RPE (SMD_pooled = -0.38, 95%CI -0.65 to -0.11, p = 0.006, I ² = 33.6%, p = 0.149) and blood lactate (SMD_pooled = -0.42, 95% CI -0.72 to -0.12, p = 0.006, I ² = 35.6%, p = 0.114) were small yet significant with low heterogeneity. The pooled effect sizes of H₂ on VO_2max and VO_2peak (SMD_pooled = 0.09, 95% CI -0.10 to 0.29, p = 0.333, I ² = 0%, p = 0.998) and endurance performance (SMD_pooled = 0.01, 95% CI -0.23 to 0.25, p = 0.946, I ² = 0%, p > 0.999) were not significant and trivial without heterogeneity. Subgroup analysis revealed that the effects of H₂ on fatigue were impacted significantly by the training status (i.e., untrained and trained), period of H₂ implementation, and exercise types (i.e., continuous and intermittent exercises).

Conclusions

This meta-analysis provides moderate evidence that H₂ supplementation alleviates fatigue but does not enhance aerobic capacity in healthy adults.

Systematic review registration

www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022351559.

Effects of pre-exercise H2 inhalation on physical fatigue and related prefrontal cortex activation during and after high-intensity exercise

Objective: In this study, we examined the effects of pre-exercise H₂ gas inhalation on physical fatigue (PF) and prefrontal cortex (PFC) activation during and after high-intensity cycling exercise.

Methods: Twenty-four young men completed four study visits. On the first two visits, the maximum workload (W_max) of cycling exercise of each participant was determined. On each of the other two visits, participants inhaled 20 min of either H₂ gas or placebo gas after a baseline test of maximal voluntary isometric contraction (MVIC) of thigh. Then participants performed cycling exercise under their maximum workload. Ratings of perceived exertion (RPE), heart rate (HR) and the PFC activation by using functional near-infrared spectroscopy (fNIRS) was measured throughout cycling exercise. The MVIC was measured again after the cycling.

Results: It was observed that compared to control, after inhaling H₂ gas, participants had significantly lower RPE at each workload phase (p < 0.032) and lower HR at 50% W_max, 75% W_max, and 100% W_max during cycling exercise (p < 0.037); the PFC activation was also significantly increased at 75 and 100% W_max (p < 0.011). Moreover, the H₂-induced changes in PF were significantly associated with that in PFC activation, that is, those who had higher PFC activation had lower RPE at 75% W_max (p = 0.010) and lower HR at 100% W_max (p = 0.016), respectively.

Conclusion: This study demonstrated that pre-exercise inhalation of H₂ gas can alleviate PF, potentially by maintaining high PFC activation during high-intensity exercise in healthy young adults.

Effects of Alkaline-Reduced Water on Exercise-Induced Oxidative Stress and Fatigue in Young Male Healthy Adults

Regular physical activity confers health benefits and improves the general quality of life. Recently, alkaline-reduced water (ARW) consumption has garnered increasing attention in the field of sports. ARW effectively inhibits the oxidative stress generated in cells during high-intensity exercises; however, whether it exerts similar effects during exhaustive exercises remains unknown. This study was designed as a randomized, controlled, crossover, double-blind clinical trial with a single intervention of ARW intake (pH 9.5, 10 mL/kg body weight) after intense exercise. The participants were divided into two groups, wherein they consumed either purified water (PW group) or ARW (ARW group). Blood samples were collected before exercise, immediately after exercise, and 15 min after drinking water. The serum levels of oxidative stress markers and fatigue markers were determined. The results showed that ROS (p < 0.01) and NO levels (p < 0.001) were significantly decreased after ARW intake, and the reduction was more pronounced than that in the PW group. Interestingly, the increase in GPx and MDA levels was mediated by ARW intake (both p < 0.05) after exercise. The levels of fatigue markers, such as lactate (p < 0.001), lactate dehydrogenase (p < 0.001), and phosphate (p < 0.001), were significantly reduced in both groups, with ARW intervention showing more decreased markers. The correlation analysis results showed that ARW may help maintain homeostatic conditions for ROS, antioxidant systems, and fatigue markers. These findings indicate that ARW consumption is effective in reducing oxidative stress and fatigue following exhaustive exercise and that ARW could be used as an antioxidant and anti-fatigue supplement after exhaustive physical exercise.

Molecular Hydrogen as a Medical Gas for the Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Possible Efficacy Based on a Literature Review

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disorder that is characterized by fatigue that persists for more than 6 months, weakness, sleep disturbances, and cognitive dysfunction. There are multiple possible etiologies for ME/CFS, among which mitochondrial dysfunction plays a major role in abnormal energy metabolism. The potential of many substances for the treatment of ME/CFS has been examined; however, satisfactory outcomes have not yet been achieved. The development of new substances for curative, not symptomatic, treatments is desired. Molecular hydrogen (H2) ameliorates mitochondrial dysfunction by scavenging hydroxyl radicals, the most potent oxidant among reactive oxygen species. Animal experiments and clinical trials reported that H2 exerted ameliorative effects on acute and chronic fatigue. Therefore, we conducted a literature review on the mechanism by which H2 improves acute and chronic fatigue in animals and healthy people and showed that the attenuation of mitochondrial dysfunction by H2 may be involved in the ameliorative effects. Although further clinical trials are needed to determine the efficacy and mechanism of H2 gas in ME/CFS, our literature review suggested that H2 gas may be an effective medical gas for the treatment of ME/CFS.

Effects of carbohydrate-electrolyte dissolved alkaline electrolyzed water on physiological responses during exercise under heat stress in physically active men

Purpose

This study investigated the effects of 1400 mL intake of alkaline electrolyzed water (AEW) or purified water (PW) into which carbohydrate-electrolyte (CE) was dissolved on improving physiological responses during exercise under heat stress.

Methods

This double-blinded, crossover randomized controlled trial included 10 male participants who completed two exercise trials in a hot environment (35 °C, ambient temperature, and 50% relative humidity) after consuming CE-dissolved PW (P-CE) or CE-dissolved AEW (A-CE). The exercise trial consisted of running for 30 min on a treadmill (at an intensity corresponding to 65% of heart rate reserve adjusted for heat stress conditions) and repeated sprint cycling (10 × 7-s maximal sprint cycling), with a 35-min rest interval between the two exercises, followed by a 30-min post-exercise recovery period. Before and after running, and after cycling, the participants drank P-CE (hydrogen concentration of 0 ppm, pH 3.8) or A-CE (0.3 ppm, pH 4.1). Blood samples were obtained before, during (rest interval between running and cycling), and post-exercise.

Results

Repeated sprint performance and oxidative stress response did not differ between the P-CE and A-CE trials. A-CE consumption significantly attenuated the increase in blood lactate concentration during the running exercise but not during repeated sprint cycling under heat stress conditions.

Conclusion

Our findings suggested that A-CE did not significantly affect repeated sprint performance; however, the attenuated elevation in blood lactate by A-CE ingestion implies a partial enhancement of endurance performance during submaximal exercise under heat stress.

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A-CE did not enhance repeated sprint performance in a hot environment.

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A-CE failed to decrease oxidative damage induced by exercise in a hot environment.

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Blood lactate response during submaximal running was attenuated by drinking A-CE.

Molecular hydrogen downregulates acute exhaustive exercise-induced skeletal muscle damage

Physical exercise-induced skeletal muscle damage may be characterized by increased oxidative stress, inflammation, and apoptosis which may be beneficial when exercise is regular, but it is rather harmful when exercise is exhaustive and performed acutely by unaccustomed individuals. Molecular hydrogen (H2) has emerged as a potent antioxidant, anti-inflammatory, and anti-apoptotic agent, but its action on the deleterious effects of acute exhaustive exercise in muscle damage remain unknown. Therefore, we tested the hypothesis that H2 decreases acute exhaustive exercise-induced skeletal muscle damage of sedentary rats. Rats ran to exhaustion on a sealed treadmill inhaling an H2-containing mixture or the control gas. We measured oxidative stress (SOD, GSH, and TBARS), inflammatory (TNF-α, IL-1β, IL-6, IL-10, and NF-κB phosphorylation), and apoptotic (expression of caspase-3, Bcl-2, and HSP70) markers. Exercise caused no changes in SOD activity but increased TBARS levels. H2 caused increases in exercise-induced SOD activity and blunted exercise-induced increased TBARS levels. We observed exercise-induced TNF-α and IL-6 surges as well as NF-κB phosphorylation, which were blunted by H2. Exercise increased cleaved caspase-3 expression, and H2 reduced this response. In conclusion, H2 effectively downregulates muscle damage, reducing oxidative stress, inflammation, and apoptosis after acute exhaustive exercise performed by an unaccustomed organism.

Effects of 7-day intake of hydrogen-rich water on physical performance of trained and untrained subjects

Hydrogen-rich water (HRW) is used as a supplement to improve performance and reduce fatigue in athletes. However, the potentially beneficial effects of HRW intake could be mediated by the training status of athletes. The purpose of the study was to analyse the ergogenic effect of intake of HRW for one week on aerobic and anaerobic performance, both in trained and untrained individuals. Thirty-seven volunteers participated in the study and were divided into two experimental groups: trained cyclists and untrained subjects. A double-blind crossover design was performed in which all subjects took a placebo (PW) and nano-bubble HRW (pH: 7.5; hydrogen concentration: 1.9 ppm; oxidation-reduction potential (ORP): -600 mV). At the end of 7-day intake, performance was assessed by an incremental VO₂max test and by a maximum anaerobic test. After HRW intake, only trained cyclists improved their performance in the anaerobic test with an increase in peak power (from 766.2 ± 125.6 to 826.5 ± 143.4 W; d = .51) and mean power (from 350.0 ± 53.5 to 380.2 ± 71.3 W; d = .51), and a decrease in the fatigue index (from 77.6 ± 5.8 to 75.1 ± 5.9%; d = .45). The findings demonstrate that the ergogenic effect of HRW is mediated by the training status, and that 7-day intake of HRW would be an effective strategy for improving anaerobic performance in trained cyclists.

Synergistic Effects of Regular Walking and Alkaline Electrolyzed Water on Decreasing Inflammation and Oxidative Stress, and Increasing Quality of Life in Individuals with Type 2 Diabetes: A Community Based Randomized Controlled Trial

Alkaline electrolyzed water (AEW) and walking are strongly recommended for ameliorating oxidative stress and inflammation. Nevertheless, there is a lack of information on the combination of both on alleviating inflammation, oxidative stress, and improving the quality of life (QoL). We investigated the synergistic effects of drinking AEW and walking on advanced glycation end products (AGEs), advanced oxidation protein products (AOPPs), malondialdehyde (MDA), white blood cells (WBCs), neutrophil-lymphocyte ratio (NLR) and QoL. In total, 81 eligible patients with type 2 diabetes (T2DM) were randomly allocated via single blind to four groups: consumed 2 L/day of AEW (n = 20), instructed to walk for 150 min/week (n = 20), received a combination of AEW and walking (n = 20), and continue their habitual diet and activity (n = 21). Data were collected and analyzed before and after 8 weeks of intervention. Our results showed a significant interaction between the group and time, with both AEW and walking independently and synergistically ameliorating AGEs, AOPPs, MDA, NLR and WBCs levels. Moreover, the AEW group had a higher physical and total QoL score. The walking group and the combined group had higher scores in physical, mental and total QoL compared to the control group. The synergistic effect of AEW and regular walking are an advisable treatment for patients with T2DM.

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

Molecular hydrogen has been suggested to have a cytoprotective effect on the whole body and to enhance exercise performances. However, the effect of hydrogen-rich gas mixture (HG) inhalation on physiological responses has been poorly investigated. We examined the impact of acute HG inhalation on subsequent oxidative stress, muscle damage, and exercise performances during the recovery period after a strenuous exercise. This is a two-trial, double-blind, crossover, repeated measures study. Eight physically active male volunteers inhaled HG (estimated fraction of inspired oxygen and hydrogen were 21.57 and 4.08% at most, respectively) or normal gas (placebo, ambient air 400 m above sea level) during a 60-minute recovery phase after oxidative stress-inducing exercise) completion comprising 30-minute treadmill running at an intensity corresponding to 75% of maximal oxygen uptake and squat jumps (5 sets × 10 repetitions). Before oxidative stress-inducing exercise and 10 minutes after the post-exercise gas inhalation, blood and urine samples were obtained and exercise performances (jumping ability; pedaling power output; muscle strength) were evaluated. Post-exercise HG inhalation attenuated the increase in urinary 8-hydroxydeoxyguanosine excretion rate (P < 0.05), a DNA oxidation marker, and the reduction in the countermovement jump height (P < 0.05), compared with Placebo inhalation. Other exercise performances and blood oxidative stress and muscle damage markers did not differ between HG and Placebo inhalation. Moreover, the increase in urinary 8-hydroxydeoxyguanosine excretion rate was significantly associated with countermovement jump performance reduction (r = -0.78, P < 0.01). These findings suggested that HG inhalation during post-exercise recovery period might improve exercise performance via reducing systemic oxidative damage. The study was approved by the Human Research Ethics Committee of the University of Yamanashi (approval No. H29-006) on June 28, 2017.