Thank you for sharing

Dear Dr. Alwazeer,

Thank you for opening this discussion forum. Based on my reading, molecular hydrogen has been studied extensively for reducing oxidative stress and inflammation associated organ injury since the first publication in 2007 in Nature Medicine [1]. Please see a review article by Qiu et al.[2]. The Chinese medical team has recommended use of 66.6% H2 / 33.3% O2 for inhalation for treatment of COVID-19 patients in the 7th edition of new coronavirus pneumonia guideline [3]. Since molecular H2 is safe and can reduce free radicals and inflammatory cytokines [2], the inhalation treatment is expected to significantly improve the condition of cytokine storm.

This treatment is cheep and and effective, as you suggested, physicians in other countries surely can follow Chinese team's lead to apply H2 containing gas to treat in-patients.

[1] Ohsawa I, Ishikawa M, Takahashi K, et al. Hydrogen acts as a therapeutic

antioxidant by selectively reducing cytotoxic oxygen radicals. Nat Med. 2007;

13: 688-94.

[2] Qiu P, Liu Y2, Zhang J. Recent Advances in Studies of Molecular Hydrogen against Sepsis. Int J Biol Sci. 2019 May 11;15(6):1261-1275. doi: 10.7150/ijbs.30741. eCollection 2019.

[3] In Chinese

Hi Xiao,

I am so happy to hear this news. Did the Chinese authorities use hydrogen gas for treating covid-19 infected people? How were results ? Did was effective? Please provide us more information about this issue for helping others people and countries.

Best wishes and health for all

Duried

Dear Xiao,

Can you please share the reference 3 you cited i.e. new coronavirus pneumonia guideline (in Chinese). I will try to translate it to English by Google translate. You also can help us in this issue.

Best wishes

Duried

I think we can discuss the corona mechanism first

That's right Dear Rector Prof Alma Mehmet. It will be a good idea.

Hi Duried,

Yes, the H2/O2 gas inhalation is recommended by Chinese medical authority to treat COVID-19 patients. I heard that they have translated the document to various languages to help other countries. But I do not know where to find the translated versions. Here is the web link to the Chinese document: http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml

Since the document was prepared by an expert committee, I believe there may be some promising results in a pilot study, at least it is based on promising clinical trial results of other studies.

For ref. #3, it may be translated to

[3] New Coronavirus Pneumonia Diagnosis and Treatment Guideline, the 7th Trial Edition, National Health Commission of the People's Republic of China, 2020-03-05 (In Chinese).

Shirley Wu

Thank you very much Dear Xiao Yu (Shirley) Wu

Dear Colleagues,

First of all, I would thank Dr. Xiao Yu (Shirley) Wu to kindly providing us the document original (in the Chinese language) entitled " New Coronavirus Pneumonia Diagnosis and Treatment Guideline" that discuss the Chinese experience in the treatment of the Covid-19 using different methods based on promising clinical trial results.

I tried to translate this valuable document to common languages by using the translate tool of Google. As you know this is not the perfect translation method but some people can use it to have an idea about this program for treating covid-19. We hope as soon as possible to have the official translation version of this document in different languages.

Duried

Medications that increase the body’s immunity and some vitamins that act as antioxidants

This is an improved version translated from the original Chinese document entitled " New Coronavirus Pneumonia Diagnosis and Treatment Guideline".

Hi Xiao Yu (Shirley) Wu

I did not find the rate of oxygen and hydrogen proposed for treating covid-19 patients in the English-translated version of the "New Coronavirus Pneumonia Diagnosis and Treatment Guideline". Is there any research paper published about this rate of gases ( 66.6% H2 / 33.3% O2 )?

I think the rates of 66.6% H2 / 33.3% O2 are very high. According to the literature, I found rates ranged from 2 to 4% H2 in inhalation treatment. I think this low rate is sufficient for the application of hydrogen gas in a biological system due to the potent reducing capacity of this gas (hydrogen) as well as the safety concerns.

what do you think?

I think this viruse is seriously affected by oxygene. Therefore oxygene - rich water could be used effectively.

Hi Duried Alwazeer,

The document indicated 66.6% H2 / 33.3% O2 ratio is the composition of the gas for inhalation. It did not specify the gas pressure or flow rate, which is subject to the standard practice and physician's judgement, I assume.

You are right, the literature reported H2 inhalation therapy is 2 - 4% H2, which may contain some air with O2. For COVID-19 patients, supply of extra O2 is important due to dysfunction of the lungs.

Should you or physicians in your country need to know the detailed procedures, you may obtain consultation via WHO and National Health Commission of the People's Republic of China. You may also be able to obtain the Treatment Guideline document in English or other languages via these organizations.

Hi Duried Alwazeer

I have found the latest WHO treatment guidance which provides detailed parameters of clinical operations:

Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected

Interim guidance

13 March 2020 | Publication

https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected

Hope it is helpful.

Thank you a lot dear Xiao for these useful links and documents.

I found the English version of the document entitled " New Coronavirus Pneumonia Diagnosis and Treatment Guideline" at the following link:

https://www.chinalawtranslate.com/en/coronavirus-treatment-plan-7/

 Chinese researchers develop paper strips for COVID-19 detection.

https://youtu.be/DlY9pWP2dJo

Dear Dr. Alwazeer,

As you mentioned the word "cheap", there is a drug come to my mind. Pleaee check this publication:

https://www.researchgate.net/publication/6503810_Indomethacin_has_a_potent_antiviral_activity_against_SARS_coronavirus

This paper was published in 2006 discussing the antiviral activity of Indomethacin on SARS. I'm not sure if there is a strong evidence in this publication to apply it to clincal settings, but is a place to start further research. Also, Indomethacin could be used for fever and pain.

That's right, dear Dr Mohammed Bhia, according to the abstract of this paper it seems to be an interesting drug for treating SARS patients. A study has to be conducted on covid-19.

Thank you very much, Dr. Alwazeer, for finding the English version of New Coronavirus Pneumonia Diagnosis and Treatment Guideline (7th edition)!

Useful document

A useful information about the protection of covid-19 contamination in public places is available in the document entitled "Notice on the Issuance of the Novel Coronavirus Pneumonia Health Protection Guide for Public Spaces" published by the Chinese State Council Novel Coronavirus Pneumonia Epidemic Joint Prevention and Control Response Mechanism.

https://www.chinalawtranslate.com/novel-coronavirus-pneumonia-health-protection-guide-for-public-spaces/

Another useful document about the best mehods for controlling and preventing covid-19 is available in the document entitled "Notice on Further Efforts to do a Good Job of Epidemic Prevention and Control Work in Rural Areas" published by the Chinese State Council Novel Coronavirus Pneumonia Epidemic Joint Prevention and Control Response Mechanism.

https://www.chinalawtranslate.com/rural-coronavirus-protection/

For persons working in medical establishments:

This document entitled "Novel Coronavirus Pneumonia Diagnosis and Treatment Plan (Provisional 6th Edition)" provides useful information about covid-19 after the Chinese experience.

https://www.chinalawtranslate.com/diagnostic-and-treatment-plan-6/

I have found a good summary of therapeutics for COVID-19:

COVID-19 Science Report: Therapeutics

by NUS Saw Swee Hock School of Public Health

as of 12 Mar 20

Thank you very much Dear Dr Xiao. I have already skimmed this document. It is a very interesting and updated review of covid-19.

Thanks, Dr. Alwazeer. It has mentioned a number of repurposing drugs that are inexpensive and have shown promising results.

That's right Dear Dr Xiao. For this reason I recommended the reading of this document especially by the medical staff. It's very interesting.

That's a lot again for sharing it.

Per Ma Yun Foundation's invitation, a group of physicians in the First Affiliated Hospital, Zhejiang University, China, has compiled a Handbook of COVID-19 Prevention and Treatment, according to their clinical experience. They hope this handbook can help hospitals, physicians and nurses in other countries to manage COVID-19. The document can be found from Google search:

Global MediXchange for Combating COVID-19 https://covid-19.alibabacloud.com/

Thank you very much Dear Dr Xiao Yu (Shirley) Wu for sharing this extraordinary Handbook. It is an excellent reference for all medical workers especially doctors and nurses. This high invaluable reference is very useful and helpful for all medical staff and authority.

Best thanks for the editor, doctors, experts, and sponsors who provide this handbook for free to everyone.

I would like to cite this sentence extracted from this handbook. "This pandemic is a common challenge faced by mankind in the age of globalization. At this moment, sharing resources, experiences and lessons, regardless of who you are, is our only chance to win. The real remedy for this pandemic is not isolation, but cooperation. This war has just begun".

I would like to share the note of Prof. Tingbo LIANG the Handbook Editor:

"Faced with an unknown virus, sharing and collaboration are the best remedy.

The publication of this Handbook is one of the best ways to mark the courage and wisdom our healthcare workers have demonstrated over the past two months.

Thanks to all those who have contributed to this Handbook, sharing the invaluable experience with healthcare colleagues around the world while saving the lives of patients.

Thanks to the support from healthcare colleagues in China who have provided experience that inspires and motivates us.

Thanks to Jack Ma Foundation for initiating this program, and to AliHealth for the technical support, making this Handbook possible to support the fight against the epidemic.

The Handbook is available to everyone for free. However, due to the limited time, there might be some errors and defects. Your feedback and advice are highly welcomed".

I selected some Figures of this reference.

International Medical Expert Communication Platform

Connecting medical heroes across the world with DingTalk

In order to combat the coronavirus outbreak head on as a world united, we are connecting medical heroes from around the world with our DingTalk messaging platform. The Medical Expert Communication Platform was launched in DingTalk to help medical experts from all over the world share resources and information as well as their experience and know-how, all of which will empower medical teams on the frontlines of the COVID-19 emergency.

As soon as medical teams join the Communication Platform, they can immediately start to use the instant messaging and video capabilities of DingTalk, receive guidance from world experts already on the platform, and obtain a medical treatment guide compiled by some leading world health experts. The platform allows for instant communication across borders with the added support of AI-powered real-time translation, remote video conferencing capabilities, and several other features designed to help world medical experts implement effective interventions and provide quality treatment.

Alibaba and the First Affiliated Hospital of Zhejiang University jointly established the International Medical Expert Communication Platform. We welcome all medical institutions to join the platform to share and exchange valuable experience in fighting the epidemic, and help medical staff around the world to implement effective prevention and treatment measures during the best treatment period.

https://covid-19.alibabacloud.com/

Dear Dr. Duried Alwazeer ,

Thank you very much indeed for disseminating the useful information!

Hope the users at this platform would further spread the information to their countries to help management of COVID-19.

I agree with you Dear Dr Xiao Yu (Shirley) Wu , our goal is to exchange the knowledge and experiences for fighting this common mankind enemy covid 19. We hope all users will share this information with their colleagues especially with workers in healthcare and medical fields.

This a very useful thread. Thank you Duriel and Shirley.

See also

https://www.researchgate.net/project/Covid-19-Staying-abreast

Click “Project log”.

Dear Geoff Taylor,

Thank you very much for collecting the very useful refs about COVID-19 treatments and trials! Given the rapid spread of the new coronavirus (SARS-CoV-2) globally, near 400,000 confirmed cases, and over 17,000 deaths, hope our effort can be of a bit help.

A useful review published on PubMed website entitled "Features, Evaluation and Treatment Coronavirus (COVID-19)" prepared by Italian medical experts.

https://www.ncbi.nlm.nih.gov/books/NBK554776/

Two useful posters:

* Stop the spread of germs

* Symptoms of Coronavirus 2019

An updated review published by BMC entitled " The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status".

Article The origin, transmission and clinical therapies on coronavir...

Re the March 16 reply by Shirley stating that the document recommended 66% hydrogen mixed with 33% pure oxygen. The lower explosive limit for hydrogen in oxygen is 4% (as it is with air), but the upper explosive limit is 94% with oxygen, versus 75% with air. Either way the mixture is highly explosive, and would need extreme care in its use and the choice of fittings and clothing to reduce static electricity.

I seem to remember reading not so long ago about the intubation equipment of a patient who was on oxygen catching fire.

Hi Geoff Taylor

You are right, the safe limits of hydrogen for mixing with air or oxygen are generally lower than 4% . All the scientific papers concerning the potential application of hydrogen as a therapeutic drug have tested hydrogen levels ranged from 2 to 4%. In the previous answer, Dr Xiao Yu (Shirley) Wu admitted these limits of hydrogen i.e. 2-4% but he recommended a higher level of oxygen because the covid-19 patients suffer dysfunction of lungs. However, I don't know why the National Health Commission of the People's Republic of Chin recommended this high level of hydrogen i.e. 66.6%. I don't find any document concerning this issue. If Dr Xiao Yu (Shirley) Wu can kindly ask the Chinese commission for more information about the inhalation therapy by hydrogen and its effectiveness in covid-19 patient treatment.

I have just read the ventilation section of the handbook in English version but can find no mention of the use of hydrogen.

Dear Geoff Taylor I found the citation of hydrogen treatment in the handbook of

Novel Coronavirus Pneumonia Diagnosis and Treatment Plan (Provisional 7th Edition). You can see it in the attached image.

Duried

Thanks for that Duried

Hi, thought I'd pop in on this discussion as I am looking into this topic presently. I have also received a communication from a colleague that states on March 14th H2 treatment was certified by the Peoples Republic of China as an important supplement to O2 therapy. H2 was listed as one of the basic treatment methods for COVID 19. The letter also alleges that engineers have resolved the issue of flammability in H2/O2 mixtures.

Hi Grace Russell have you the document or any reference about this information to share it here in this forum?

Best regards

Duried

Sure, it seems to be a personal communication, so I have added the full Trial (Version 7) that states the ratio 66%:33% H2/O2

Dear Grace Russell Thank you very much for sharing this useful document. According to this document, the clinical results of the application of H2/O2 for treating covid-19 patients are very promising. One issue is still unclear in this treatment. According to the scientific reports, the recommended hydrogen levels range from 2 to 4% balanced with air or oxygen; however, in the handbook of the National Health Commission Office of National Administration of Traditional Chinese Medicine, the H2/O2 levels are 66.3/33.3 (%, v/v). If it is possible, can you please communicate with Xin-Yong Lin for giving more information about this issue?

Best regards

Duried

Dear Grace Russell ,

Thank you for joining the discussion and obtaining more information about the H2/O2 gas mixture for treating COVID-19.

Duried

Can you please give me the URL for the edition of the FAHZU guide you are looking at? Thank you

Dear Duried Alwazeer thank you for bringing up the discussion of the potential use of molecular hydrogen. Typically we use 2-3% H2 since it is below the flammability level (Article A New Approach for the Prevention and Treatment of Cardiovas...

Article Molecular hydrogen increases resilience to stress in mice

Article Molecular hydrogen suppresses glioblastoma growth via induci...

However, this can be difficult because 1) we are required to either purchase mixed medical gas air containing the desired percentage of each gas, which from experience can be expensive and difficult, and/or 2) we need to have all the approvals to bring in tanks of pressurized (and explosive gas) into the lab/facility/clinic, etc., and the appropriate knowledge and use ofgas regulators to ensure that the percentage of H2 gas is correct in conjunction with the rate of respiration, etc. In contrast, using the machines that simply use electrolysis of water to make the gas has several advantages i) easy to ship/transport, re-locate, maneuver, ii) produces H2 on demand with little set up, iii) ensures a sufficiently high enough H2 concentration to the patient, iv) possible additional benefit of the increased oxygen levels, and v) these machines have been donated by the company for this research. --I imagine that the recommendation to use 66.7%H2/33.3%O2 is because this is the combination produced from the machines used, and so to be congruent with what was used, the recommendation reflecting that was made. It is not clear that an electrolysis machine was used in the report. The letter to posted by Grace is from the CEO of the company to professor Sun about the work that they have done.--

Nevertheless, there is still the issue of flammability,and I am not convinced that the additional oxygen is always beneficial (in some cases it may be, and in other cases it could be harmful). However, since H2 gas diffuses very quickly (thus diluting below the flammability level) the explosive area is confined to the cannula and the top part of the unit where the gas first mixes. The machine adds humidity to the mixture, thus preventing static electricity from forming/discharging, and making it rather difficult to ignite the gas inside the cannula. If, however, this still occurs, a relatively small (likely not significantly dangerous) explosion ensues. This has been tested by the company manufacturing these devices, and they sent me videos before we used their machine in some of the animal research cited above. In short, the concern may not be as great as it initially appears on the surface, but safety and precaution are still warranted because it is still a very flammable gas. The company has a good reputation amongst many researchers because of their support to researchers in donating machines, following Chinese regulatory approvals, and supporting academic/medical symposia. You can read about the company here: http://www.asclepiusmeditec.com

We still don't know the optimal administration method, concentration, frequency, or duration. We reported that inhalation of only ≈ 1.3% H2 (10 min; twice daily) was not effective in Parkinson's disease Article Inhalation of hydrogen gas elevates urinary 8-hydroxy-2′-deo...

Article Drinking hydrogen water and intermittent hydrogen gas exposu...

Thank you very much Dr Tyler LeBaron for this detailed information about the recommended practices and properties of hydrogen when medical applications are envisaged. Dr Tyler LeBaron is the Founder and Executive Director of the Molecular Hydrogen Institute, and he is the author and co-authors of many publications about the potential applications of hydrogen in the health field.

I would ask Dr LeBaron about the possibility of the application of hydrogen gas combined with oxygen for treating covid-19 patients. According to the clinical results reported in the letter of Xin-Yong Lin, the director of Shanghai Asclepius Meditech Co., it seems this method is promising in this issue. Have you, Dr LeBaron, more information about this issue? Can we use both the inhalation and the hydrogen water together in the treatment administration of covid-19 patients? Can we recommend hydrogen water as a preventative method against covid-19 contamination?

Best Regards

Duried

There are many types of hydrogen-enriched water in the literature i.e. hydrogen-rich water (HRW) produced by bubbling method, electrolyzed reduced alkaline water (ERAW) and magnesium stick water (MSW). The property of each hydrogen-enriched water differs according to the technique used in the preparation with a common characteristic of molecular hydrogen content. All these different hydrogen-enriched waters were evaluated in scientific research for their potential healthy benefits. However in the case of covid-19, which type of them could be more advantageous for prevention or treatment concerns?

Hi Geoff Taylor

You can find the URL for the edition of the FAHZU guide below.

https://covid-19.alibabacloud.com/

Duried

Thanks Duried

Duried

The ventilation instructions in the current manual which come up in your link do not include hydrogen therapy.

The machine adds humidity to the mixture, thus preventing static electricity from forming/discharging, and making it rather difficult to ignite the gas inside the cannula. If, however, this still occurs, a relatively small (likely not significantly dangerous) explosion ensues. This has been tested by the company manufacturing these devices, and they sent me videos before we used their machine in some of the animal research cited above.

Very useful information concerning the Chinese experience in the evaluation of the covid-19 and the different treatments performed by the Chinese medical teams are found in the presentation entitled "Perspectives of the management of COVID-19 infection in China" Prof. Dr. Nanshan ZHONG, Academician of Chinese Academy of Engineering, Director, National Clinical Research Center for Respiratory Disease, Professor of Respiratory Medicine , Guangzhou Medical University.

You will find the H2/O2 treatment of covid-19 patients at the 34 minutes 48 seconds of the presentation.

https://vimeo.com/395657458?fbclid=IwAR2GstldW0myU6h2yoCV9qVYkJh_OtCbQp9h6_YuJxH0oJ5DUUKWCNr_tsg&_ke=eyJrbF9lbWFpbCI6ICJzY2lfdHk3QHlhaG9vLmNvbSIsICJrbF9jb21wYW55X2lkIjogIkg5aHh3VCJ9

A clinical trial investigating the use of hydrogen in covid-19 patients is found in the report entitled "COVID-19 trials registered up to 8 March 2020—an analysis of 382 studies" prepared by Jeffrey K Aronson, Robin E Ferner, Nicholas DeVito, Carl Heneghan and published by Oxford covid-19 evidence service. This report describes the medicines that are currently undergoing clinical trials or have trials planned in the management of COVID-19, due to the single-stranded RNA virus 2109-nCoV (SARS-CoV-2). The mechanism of action of each medicine was also provided. From these medicines, Hydrogen was listed under Inhaled gases category and it was proposed to have an anti-inflammatory effect.

https://www.cebm.net/oxford-covid-19__trashed/covid-19-registered-trials-and-analysis/?fbclid=IwAR2TnDJspDYcrF-yeq3cv2wtLTfd7vbgIo4VIT340tjz9-AN5BiRJJnp-z0

Human plasma of recovered patients

I suspect few hospitals would allow use of 66% H2 gas however, 2-4% sounds reasonable as does its provision by electrolysis vs tanks. However, electrolysis makers need to provide metering to mix the H2-O2 product with the inhalation gas the patient is to receive. I've used H2 gas in anaerobic microbial incubations and it's a bit tricky and scary. Remember the Hindenburg. Low levels of H2 exposure via inhalation at 2-4% or in water/saline at 1 mM, sounds like it could have many clinical applications, especially where inflammation/cytokine storms could be involved. Easier, safer delivery methods are needed.

Dr. Duried Alwazeer ,

Thank you very much for finding very useful information and sharing with others about COVID-19 treatment!

Hello Duried, thank you for initiating the discussion on the benefits of hydrogen in these unusual times. I am a Partner and CTO at H2 UNIVERSE, LLC., www.h2universe.com, where our goal is to advance the public knowledge of Hydrogen Therapy. Our current product--True Hano H2 - a capsule format, is a dietary supplement that boosts the immune system; it is an anti-oxidant, -anti-inflammatory, and provides all the benefits that you listed in your piece.

Driving the knowledge to fellow human beings is still a challenge, but people who are aware that the secret to fighting viral diseases is to boost the immune system have been using our capsule daily. We believe that 2 pills daily may boost your immune system to fight viral infections. We are launching another product - a pain-relieving hydrogen-generating patch in the coming weeks.

Our goal is to develop novel and therapeutic products on the platform of hydrogen, and we have several products in the pipeline.

Hi Christian S Yorgure,

Thank you for sharing this useful information. Was the True Nano H2 product approved by the FDA?

That's true, there are many products/processes to produce hydrogen gas and all these products possess beneficial effects for health.

True Nano H2 is a dietary supplement and did not go through the FDA. However, we are currently seeking investors for two other products under development and shall require FDA approval.

Do we know how much H2 is present in a capsule. A ml of H2 saturated water at room temp would have 4 micrograms of H2. A quick look at some of the literature indicated people were drinking at least 500 ml of H-water and would be consuming 2 mg of H2.

Sorry, its 2 ug/ml not 4 ug/ml.

Robert Bryant ,

There would not be much H2 in water as the water solubility of H2 at 20 C is 0.00016 g/100 g of water, as compared to O2 (0.0043 g/100 g of water) according to the following reference:

Reference: G.W.C. Kaye and T.H. Laby, "Tables of Physical and Chemical Constants," 15th ed., Longman, NY, 1986, p. 219.

A very useful and interesting video demonstrating the measures SAHZU has taken to manage its patients, protect its medical staff and apply information technology to cope with the outbreak of COVID-19.

The presentation entitled " Hospital Strategies to Prevent and Control COVID-19 " was presented by Professor Jian'an Wang President of SAHZU, Chief Physician, direct and oversee all COVID-19 affairs at SAHZU; Chair SAHZU COVID-19 Prevention and Control Steering Committee.

@Robert Bryant - 1 mg of H2 as an active ingredient. You can find this information on the box when you purchase it. - www.h2universe.com

What does anyone think this means from the China National Health Commission 3.3.20 guidance:

” lopinavir or ritonavir (200 mg/adult 50 mg/grain, every time 2 grain, 2 times daily, ”

What do they mean by “grain”, do you think?

Hi Geoff Taylor ,

This English translation may not be accurate. Here is the description quoted from

the Handbook of COVID-19 Prevention and Treatment by Liang et al., p24

"Antiviral Treatment

At FAHZU, lopinavir/ritonavir (2 capsules, po q12h) combined with arbidol (200 mg po q12h) were applied as the basic regimen. From the treatment experience of 49 patients in our hospital, the average time to achieve negative viral nucleic acid test for the first time was 12 days (95% CI: 8-15 days). The duration of negative nucleic acid test result (negative for more than 2 times consecutively with interval ≥ 24h) was 13.5 days (95% CI: 9.5 - 17.5 days).

If the basic regimen is not effective, chloroquine phosphate can be used on adults

between 18-65 years old (weight ≥ 50 kg: 500 mg bid; weight ≤50 kg: 500 mg bid for first two days, 500 mg qd for following five days).

Interferon nebulization is recommended in Protocols for Diagnosis and Treatment of COVID-19. We recommend that it should be performed in negative-pressure wards rather than general wards due to the possibility of aerosol transmission.

Darunavir/cobicistat has some degree of antiviral activity in viral suppression test in vitro, based on the treatment experience of AIDS patients, and the adverse events are relatively mild. For patients who are intolerant to lopinavir/ritonavir, darunavir/ cobicistat (1 tablet qd) or favipiravir (starting dose of 1600 mg followed by 600 mg tid) is an alternative option after the ethical review. Simultaneous use of three or more antiviral drugs is not recommended."

Christian, Thank you so 1 mg would make about 500 ml of H2 sat'd water.

The FAHZU quote doesn’t mention the amount of active ingredient per capsule, Shirley.

Going back to the NHC document, I think it means 50mg per tablet, 2 tablets each time, two times daily, giving a total daily dose of 200mg. FAHZU is probably also saying that.

No Gas No Gain: Flatulence is Hydrogen and is most likely has anti-inflammatory effects: Colonic fiber fermentation produces large amounts of H2 gas constantly for most of the day following consumption of high fiber foods. Similarly Acarbose, an alphaglucidase inhibitor increases expired H2 excretion throughout the day as well. Just published study on the mechanisms of anti-inflammatory effect of H2 in allergic airway disease:

Article Hydrogen Attenuates Allergic Inflammation by Reversing Energ...

Article Are the effects of α-glucosidase inhibitors on cardiovascula...

More rationale and references for intestinal generated hydrogen: https://www.lonjevity-foods.com/post/no-gas-no-gain-hydrogen-is-medicine

Double anti-inflammatory benefit from microbial accessible carbohydrate fermentation are the Short Chain Fatty Acids produced along with hydrogen. Butyrate is a powerful HDAC inhibitor and signaling molecule with widespread anti-inflammatory effects including Treg stimulation and IL10 production in Bregs.

https://www.lonjevity-foods.com/post/coronavirus-action-plan

I'm reading a small volume of hydrogen gas is needed at a given time, if used in ventilation. If so, would something such as an "H-cube" work? It is used by chemists to generate hydrogen as needed for hydrogenation reactions from water, instead of using a tank.

Hi Jack Silver

The source of hydrogen or the process producing it is not important in the case of the health application of hydrogen. The amount of molecular hydrogen available in the product as the case of HRW (hydrogen rich-water) at the time of use and its stability are the key factors in this issue. In the case of inhalation, the hydrogen level besides the oxygen is the key factor.

Duried Alwazeer I agree with everything you say. Making hydrogen as needed alleviates the fear of the "Hindenburg syndrome", and eliminates the need for a large tank when only a small amount of gas is needed. However, if the volume needed is small enough, a simple "classroom" cylinder is fine, too.

Jack Silver I agree with you.

Hi Gerry Davies ,

Thank you for sharing the useful information and papers about anti-inflammatory effect of H2 administered in water or saline. Given the oral administration of low concentration of H2, the amount of H2 absorbed through the GI tract may be minimal. It is possible its effect is more on the modulation of immune environment in the gut, leading to systemic effect ?

Exhaled H2 concentrations after prebiotics are quite high, proving absorption into bloodstream is high as well. In fact much higher and longer than with drinking hydrogen water

Hi Gerry Davies

Few studies were performed for comparing between the exogenous and indigenous hydrogen for its potential effects on different diseases. The study of Kajiya et al. (2009) may be the only report treating this issue. According to the results of this study, although the amount of hydrogen taken by water or gas is much less than that produced by intestinal bacteria, the exogenous hydrogen demonstrates a more prominent effect.

What do you think?

Article Hydrogen from intestinal bacteria is protective for Concanav...

The amount of H2 systemically available from exogenous or endogenous (gut derived) can be directly measured in exhaled breath. Endogenous H2 is always much higher than drinking H2 water, just measure exhaled breath H2 levels.

Funny that milk acts as a prebiotic in those who have lactose intolerance i.e. it is fermented rather than digested.

Hi Gerry Davies I agree with the results you provided. However, some reports indicate that the bioavailability and biological effects of exogenous hydrogen are more potent than the endogenous one produced by gut bacteria (see for example Kajiya et al., 2009; Slezák et al., 2016). What do you think about this point?

Gerry Davies and Duried Alwazeer this is a great discussion. This is one of the enigmas that we see with molecular hydrogen research. The normal healthy intestinal bacteria may produce over 10 liters of H2 per day, yet ingestion of HRW only provides less than 0.1% of that amount of molecular hydrogen. Nevertheless, as I mentioned earlier HRW may be more effective than inhalation (especially if inhalation is continues) (Article Article Drinking hydrogen water and intermittent hydrogen gas exposu...

There are a few observations that may help us to understand the ostensible discrepancy. 1) The cited article (as well as other non-published data from several research groups) have observed that when H2 is administered continuously the therapeutic benefits seem to initially occur and then slow decrease and then are eliminated. It appears that the rapid intermittent/pulse type exposure of H2 is important. Ingestion of HRW can double the cellular H2 concentration within a couple minutes (e.g. 10 uM to 20 uM) whereas inhalation of say 3% H2 would take nearly 20-30 minutes to reach the 20 uM level according to Henry's law (and published animal data, which we discussed here: Article Inhalation of hydrogen gas elevates urinary 8-hydroxy-2′-deo...

btw re the graph of the H2 production of the milk. Consider that the graph is going out many hours. We are most interested in zooming in to say the first 20 minutes. Now compare breath H2 exhalation following ingestion of 0.8 mM H2 and that of prebiotic-milk in this 20 min window, and the peak rise in of HRW (≈2-15 min) and the area under the curve (in this window) is significantly greater. Hope that helps!

The idea that a short burst of H2 is the most beneficial is tenuous at best. is it even plausible? Much more work needed

Hi Gerry Davies, we would have to define what you mean by “short burst” since obviously a 1 sec exposure is unlikely to provide any effect. I am only reporting what has been demonstrated in the literature. As mentioned in my above comment, in at least the Parkinson’s disease model, neither a continues exposure of H2 nor H2 produced from intestinal bacteria was effective. However, intermittent exposure such as from intermittent inhalation or better from ingestion of HRW was effective. Also consider this article: Article Consumption of hydrogen water prevents atherosclerosis in ap...

There appear to be different mechanisms at work, signaling and free radical neutralizing. Not much work on gut derived H2. But H2 might be one of the reasons for the beneficial effects of high fibre diets. All speculative but the cheapest and most convenient source of H2 is fibre fermentation.

The discussion with Dr. Shigeo Ohta, Professor at the Department of Neurology, Junendo University, is really very interesting and provides a huge amount of information about hydrogen properties and its biological effects according to the 40-years experience of Dr. @shigeo Ohta. At 38 minutes 04 seconds of the video, Dr. Ohta discusses the difference between hydrogen produced by intestinal bacteria and that taken by exogenous source i.e. hydrogen rich water or inhalation. The youtube link was given above in the comment of Tyler LeBaron .

I give it here again:

https://www.youtube.com/watch?v=1Up2i35MLdw

Dr. Duried Alwazeer , Thank you very much for sharing this very interesting interview video of Tyler LeBaron with Dr. Ohta!

Dr. Ohta mentioned that drinking H2 water was more effective than inhaling H2 gas in his animal studies. Is it possible the gut bacteria processed H2 and generated cascade effects?

You sell H2 water and I sell Fiberflour https://www.lonjevity-foods.com/

Therefore, Hope constant high levels are beneficial.

Gerry Davies As mentioned, H2 from intestinal bacteria has also been demonstrated to be therapeutic. BTW, neither Dr. Ohta, nor myself "sell H2 water" (maybe you were referring to someone else? Anyways, we shouldn't dismiss the potential of H2 from bacteria...it seems that different methods of administration gives a different effect. For example: https://pubmed.ncbi.nlm.nih.gov/25707580/

Xiao Yu (Shirley) Wu Yes, it appears that mode of action of molecular hydrogen is via its influence on signal transduction and gene expression. So H2 produced via bacteria will still work though this mechanism, but as mentioned, the different methods of H2 exposure may results in different effects.

Duried Alwazeer, Gerry Davies Xiao Yu (Shirley) Wu, this discussion promoted me to make a short video about COVID-19 Pathophysiology & the Rationale for why Molecular Hydrogen is being clinically investigated. Please see video here: https://www.youtube.com/watch?v=-oh9Ztgjm4A

Tyler LeBaron thank you very much for sharing this video. It is a very good explanation about the possible mechanism of molecular hydrogen action on the covid-19.

Tyler LeBaron , Thank you for making the very informative video. Also thank you for promoting the science and technology of molecular H2 therapy that may help patients with COVID-19. I also believe that locoregional treatment by inhalation of H2-containing gas would generate greater therapeutic effect on conoravirus pneumonia, as I indicated in my early communication with Duried Alwazeer .

In your video, patients treated by Zhong Nanshan with inhalation of H2-O2 mixture felt significant improvement in chest pain and breathing. Given the lack and availability of effective drugs for COVID-19 and viral infection induced ROS, inflammation, cytokine storm and multi-organ failures, broader application of H2-O2 gas inhalation may save many lives. Hope the company making that equipment, shown in your video, can increase production and more patients can use it.

Hi Tyler, Enjoyed your podcast, didn't realize your link with the H2 Foundation. I will be following all this research activity with great interest. Meanwhile I am one of those people out there eating 50-70g fibre a day and producing vast amounts of intestinal H2.