Molecular hydrogen (dihydrogen, H 2 ) is a novel biotherapeutic gas that appears effective in various health conditions. Hydrogen-rich water (HRW: also known as hydrogen-infused water) emerges as the most common vehicle to deliver dihydrogen in biomedicine, and over 1,500 studies published during the past decade or so confirm the favorable effects of drinking HRW in both animal and human trials (for a detailed review see Yang et al., 2020). Due to its pleiotropic biological activity and ability to easily cross the blood-brain barrier
Acute secondary progressive multiple sclerosis (SPMS) is characterized by escalating neurological disability, with limited disease-modifying therapeutic options. A 48-year-old woman with acute SPMS being treated with interferon beta-1a and oral corticosteroids presented as a clinical outpatient with no disease-modifying effects after treatment. A decision was made to treat her with a combination of guanidinoacetate and creatine for 21 days. She had made clinical progress at follow-up, with the intensity of fatigue dropping from severe to mild. Magnetic resonance spectroscopy revealed increased brain choline, creatine, N-acetylaspartate, and glutathione. Patients with SPMS may benefit from guanidinoacetate–creatine treatment in terms of patient- and clinician-reported outcomes; this requires additional study.
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