If you’re into natural medicines, you might already be familiar with glutathione, or it’s more famous precursor, N-acetyl-cysteine. Or maybe you’ve never heard either of these strange words. Either way, now would be a good time to tune in.
What is glutathione?
- Glutathione is produced in organs throughout your body, like the lungs, liver and kidneys. It is best known for its role as the “master antioxidant.”
Why do we care about antioxidants?
- Antioxidants protect tissues from free radicals, which your body creates as a byproduct of normal metabolism, including detoxification of many substances produced by your body and substances you encounter in your environment.
- The immune system also creates a lot of free radicals while it’s fighting invasions such as viruses or other microbes.
- Without sufficient levels of antioxidants like glutathione, we see a lot of collateral damage to cells, which propagates further inflammation.
Why is glutathione so important?
- Glutathione is key antioxidant itself and it also helps regenerate other antioxidants.
- Glutathione in particular may play a regulatory role in the immune system, and it is suspected that it may have antiviral properties.
- Glutathione inhibits the product of pro-inflammatory cytokines.
- It is suspected that glutathione depletion is associated with increased susceptibility to infections, including influenza, and may contribute to the pathogenesis of inflammatory lung conditions like COPD.
- In animal models of influenza, glutathione deficiency is associated with an increased risk of Acute Respiratory Distress Syndrome (ARDS) and sepsis.
The take home:
- Individuals who are depleted in glutathione are more prone to oxidative stress (aka free radical damage) and immune dysregulation.
So how do we support healthy glutathione levels?
First, be aware of what depletes glutathione.
- Glutathione is depleted by stress, smoking, an extensive list of environmental toxicants like mold exposure, exhaust, smoke (including wildfire smoke) and other smelly chemicals, and many medications, including acetaminophen. Excessive alcohol consumption may also deplete glutathione.
Second, you need the fundamental building blocks for glutathione.
- Glutathione is made from 3 key amino acids, glutamate, glycine and cysteine, which need to come from your diet.
- Glutamate and glycine are abundant in protein containing foods, and most people with adequate intake and good digestion will have sufficient levels of these amino acids. A good gelatinous bone broth and collagen powder both contain these amino acids. Glutamine is also found in raw leafy vegetables, like cabbage. Glutamine and glycine can also be found individually as supplements and are usually vegan.
- Cysteine appears to be more readily depleted amino acid of the three, probably because it is less ubiquitous in the standard American diet. Also, especially in the context of inflammation and infectious conditions, cysteine can be depleted, because it is utilized for some other purposes in the body, like the production of acute-phase reactants. Cysteine is found in sulfur containing foods, which are abundant in allium vegetables like garlic and onions, and brassica family vegetables, such as broccoli and Brussels sprouts.
- Additionally, there are small amounts of glutathione in foods, including asparagus, spinach, green beans, garlic, and avocado.
Third, glutathione requires specific nutrient cofactors for its production and then it needs to be continually regenerated, in order to continue functioning. Here are some key components:
- Most B vitamins, but especially Riboflavin and B6 are important for glutathione production or activity. For the general population with good absorption, a good B Complex or high quality multi probably covers the bases, if not diet alone.
- Magnesium is essential for glutathione production. Because magnesium is used throughout the body in over 300 enzymatic reaction, we have a high need for it, and it is a common nutrient deficiency that I see. Magnesium glycinate contains glycine, one of those amino acids required for glutathione synthesis, and this form tends to be well-absorbed, unlike magnesium oxide or even citrate.
- Zinc is required for glutathione synthesis and selenium is required for glutathione regeneration. If you’re looking beyond foods sources, both of these you can find in a trace mineral blend or in a good a multi. If you’re sticking with food, a couple of brazil nuts/day is about the right amount of selenium. For zinc, oysters are an abundant source. Pumpkin seeds or sesame seeds have a fair amount — you’ll get about 5mg per ½ cup.
In addition to the very important food and nutrient considerations, N-acetyl-cysteine (NAC) is a commonly used precursor. It contains a highly utilizable form of cysteine, that rate-limiting amino acid required for glutathione synthesis. NAC promotes glutathione production, but is also an antioxidant in its own right.
- NAC has a body of research supporting its use and safety for lung, kidney and liver protection. In the lungs, NAC can help reduce airway inflammation (demonstrably in smokers), may reduce exacerbations of COPD and help reduce progression of idiopathic pulmonary fibrosis. NAC is mucolytic agent, which may play a role in helping thin mucus secretions, including in conditions such as pneumonia.
- In the case of influenza, in a small human study of 262 elders, we can see that longer term NAC administration reduced the frequency, severity and duration of influenza. In animal models, NAC was shown to reduce mortality in mice infected with H5N1 influenza A, a highly pathogenic strain. In vitro studies suggest that NAC can reduce pulmonary inflammation and enhance immune responses to influenza. Keep in mind that what might work for influenza doesn’t necessarily translate into being helpful for all types of viruses.
- Although NAC is generally very safe, there have been some case reports of rare adverse events including cough, shortness of breath and anaphylactoid reactions. NAC is typically contraindicated in the case of gastritis or peptic ulcers, and in some people it can cause stomach irritation or sulfurous gas. A side-note, it you don’t tolerate NAC or other sulfur containing foods well, then you might benefit from some extra support by an integrative provider, to get to the bottom of the issue, which is could be gut health related.
- With long-term use of N-acetyl cysteine, watch for zinc and/or copper depletion.
Other important tools for glutathione support:
Because antioxidants work together, Vitamin C, Vitamin E, and alpha-lipoic acid also support glutathione functioning.
When it comes to botanicals, there’s a small amount of evidence that suggests that herbs like turmeric, rosemary, and milk thistle all help regenerate glutathione and have antioxidant properties. These herbs all have pretty established safety records, and all tend to support the liver in one way or another. Remember that the lungs depend on many of the same detoxification mechanisms that the liver does.
And lastly, but most importantly, yoga, meditation, stress reduction and moderate exercise can all increase glutathione levels.
In summary, glutathione is incredibly important antioxidant for supporting cellular health, balancing inflammation, and supporting the immune system by a number of mechanisms. With the barrage of environmental insults like exhaust and other airborne pollutants, on top of the impacts of stress, we are primed to be depleted of glutathione. Supporting glutathione levels is an actionable strategy to enhance your overall health and resilience.
Get individualized support.
If you are looking for customized support for lung and immune health or most other health conditions, check out my telemedicine clinic for California residents. Now through the month of April, I’ll be offering expanded sliding scale services for immune wellness. Go to my website at www.drbridgetsomine.com for more details about my practice, or contact my office at 707-332-9696 for details and scheduling.
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Important Disclaimers: This blog is educational and it does not constitute or replace medical advice. The information contained here has not been evaluated by the FDA. Consult your healthcare provider for any interventions that might be appropriate for your personal needs and circumstances, especially if you have any medical conditions, are taking medications, or are pregnant or nursing, or if you are acutely ill. The use of the terms you, I, our does not imply that this represents any form of advice. Dr. Bridget Somine is an independent naturopathic health care provider at Farmacopia and does not receive any financial compensation for purchases there and has no direct affiliation with any herb or supplement company.