Mar 30, 2022
Disclaimer
Our Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By following this protocol, you understand and accept that the recommendations in the protocol are for initial guidance and need to seek medical professional advise.
Antioxidant Support
The biomarkers of oxidative stress have been strongly linked to aging. (26)(29) Oxidative stress biomarkers, such as lipoprotein phospholipase A2 (Lp-PLA2), isoprostanes, malondialdehyde (MDA), 8-hydroxy-2-deoxyguanosine (8-Oxo-dG), derivatives of reactive oxygen metabolites, oxidized glutathione/glutathione, 4-hydroxy-2, 3-nonenal (4-HNE), and protein carbonylation, have all been linked with increased risk of frailty and pre-frailty. (29) In addition, cardiovascular mortality has been associated with increased serum markers of oxidative stress, such as derivatives of reactive oxygen metabolites (D-ROM) and total thiol levels (TTL). (26)
Antioxidants may help to mitigate the potential negative effects of prolonged oxidative stress. Additionally, ingredients with antioxidant function have shown potential for reducing oxidative damage caused by exercise when taken by healthy individuals.
The protocol below is intended to support healthy aging through ingredients focused on attenuating damage caused by oxidative stress.
Coenzyme Q10
200 mg, once per day, minimum 2 weeks (25)
CoQ10 is a lipid-soluble antioxidant found in every cell in the body. CoQ10 is abundant in the mitochondrial membrane and plays an important role in the synthesis of adenosine triphosphate (ATP), a molecule of chemical energy upon which all cellular functions depend. The synthesis of ATP within the mitochondria is a multi-step series of biochemical reactions called the electron transport chain. As a coenzyme, CoQ10 is required for several enzymatic reactions required to produce cellular energy and to protect the body against free radicals produced during this process. To maintain energy production, mitochondrial CoQ10 is continuously recycled from ubiquinone, its ATP production state, to ubiquinol, its antioxidant state. After the age of 35 to 40 years, endogenous synthesis of CoQ10 begins to decline.
CoQ10, an essential component of cellular energy production, has been shown to extend cell life and benefit high-energy systems, namely the cardiovascular, neurological and immune systems.
Superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were increased, and malondialdehyde (MDA) and diene levels were decreased after CoQ10 supplementation (33, 15, 12)
- CoQ10 supplementation has been shown to decrease the level of age-related cardiovascular fibrosis through its antioxidant and anti-inflammatory actions (7, 8)
- Systematic review and meta-analysis of 19 studies found CoQ10 supplementation to improve markers for oxidative stress demonstrated by and increase in total antioxidant capacity (TAC), glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT), and decrease in malondialdehyde (MDA) (23)
- Two systematic reviews have shown improvements in antioxidant systems as demonstrated by increases in SOD, CAT, and TAC activity, and decreases in MDA and diene levels (1, 12)
- When given 200 mg of ubiquinol before strenuous exercise, healthy adults were found to have decreased oxidative stress and increased antioxidant status as demonstrated by improved levels of isoprostanes, 8-OHdG, oxidized LDL, hydroperoxides and CAT activity (25)
Curcumin
600-2000 mg, once per day, minimum 12 weeks (24)
- Curcumin (in a Longvida® proprietary preparation) supplementation has been shown to increase vascular nitric oxide bioavailability, reduce oxidative stress, and, therefore, improve artery endothelial resistance (24)
- Meta-analysis of 8 clinical studies found curcumin supplementation improved oxidative stress demonstrated by decreases in MDA when given curcuminoids at a dose of 600 mg per day; additionally, when piperine was used in combination, the effect was greater (20)
- Systematic review of 11 articles found curcumin effective in decreasing inflammation, oxidative stress, pain, and muscle damage while improving muscle performance and recovery (30)
- Meta-analysis of 8 clinical studies found curcumin supplementation improved oxidative stress demonstrated by a decrease in MDA and increase in SOD when supplemented for four weeks; effects improved when combined with peperine (20)
- Systematic review and meta-analysis of 15 randomized controlled found curcumin improved inflammation and antioxidant status as demonstrated by decreases in interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and MDA (31)
Polyphenols
300-745 mg, once per day, minimum 5 weeks (10)(22)
- Polyphenol supplementation in normal dose (299 mg/d) or high dose (745 mg/d) decreased 8-hydroxy-2′-deoxyguanosine (8-Oxo-dG), 8-iso-prostaglandin F2α (8-iso-PGF2α), erythrocyte catalase, and glutathione reductase (GR) activity in obese and overweight non-smoking adults; additionally, waist circumference, BMI, and leptin were decreased (22)
- In different age groups, resveratrol provided protection against protein carbonylation and lipid peroxidation, and cellular levels of glutathione (GSH) and sulfhydryl (-SH) were restored during oxidative injury in erythrocytes; additionally, resveratrol has been shown to up-regulate plasma membrane redox system (PMRS) and ascorbate free radical reductase activity (19)
- Systematic review and meta-analysis of 14 studies found improved antioxidant status and subsequent performance improvements as demonstrated by a 1.9% increase in exercise performance in athletes when supplemented for a minimum of 7 days (28)
Lycopene
10-30 mg, once or twice per day, for 8-24 weeks (14, 16, 6, 34, 17)
- Improved endothelial function was correlated with improvements in antioxidative enzymatic activity and in the oxidative and inflammatory profile (14)
- 5 mg and 15 mg doses of lycopene decreased oxidative stress as shown by decreased lymphocyte DNA comet tail lengths and increased SOD activity; 15 mg doses additionally decreased hs-CRP, systolic blood pressure, sICAM-1 and sVCAM-1 and increased β-carotene, LDL-particle size, and reactive hyperemia peripheral arterial tonometry (RH-PAT) (14)
- Lycopene supplementation at a dose of 30 mg per day decreased oxidative damage to DNA and urinary 8-hydroxy deoxoguanosine (8-OHdG) in healthy volunteers (6)
- Postmenopausal women experienced a decrease in endogenous DNA damage when given 12 mg of single carotenoid (beta-carotene, lutein, or lycopene) of 4 mg of mixed carotenoids (34)
NAC
NAC (N-Acetyl-Cysteine)
600-1800 mg per day for minimum of 1-3 months to adults and older adults (3, 2, 11, 9)
- N-acetyl cysteine (NAC) is an amino acid that boosts antioxidant function and is a source of the conditionally essential amino acid L-cysteine. It has also been found to raise glutathione levels. Glutathione is an important antioxidant used in many different metabolic processes within the body. Maintaining adequate levels is important to maintaining the health of the respiratory, hepatic, and immune systems. It is also important in supporting antioxidant protection of lipids and proteins and supporting the normal response to inflammation. NAC is commonly used as an agent to help clear sinus and airway congestion caused by mucus overproduction. It also supports antioxidant and cellular detoxification pathways in the body.
- Older individuals have lower glutathione levels, lower glutathione synthesis, higher oxidative stress and F(2)-isoprostanes but can be improved with supplementation of glutathione precursors including NAC and glycine (27)
- Increased blood catalase, GSH, GSH/GSSG, glutathione peroxidase, neutrophil capacity, and total thiol groups (TTG), and reduced GSSG, oxidized homocysteine (Hcy) and free Hcy:oxidized Hcy ratio, superoxide anions, MDA, NO, VCAM-1, improving antioxidant status and possibly slowing progression of vascular damage (18, 3, 21, 32, 9, 5)
- Reduced total peroxide and oxidative stress indices, malondialdehyde (MDA), sperm DNA damage and increased total antioxidant capacity (2, 11)
- Reduced oxidative stress indices, malondialdehyde (MDA), sperm DNA fragmentation and increased total antioxidant capacity in infertile men with asthenoteratozoospermia (11)
- Reduced protein carbonyl groups, serum lead content, and increased glutamate dehydrogenase activity indicating improved oxidative stress in workers with lead exposure (13)
Attachments
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