• #5-1. Glutathione and Lipoic Acid


     In this article, we will discuss two of the key antioxidant ingredients of IVNT; glutathione and lipoic acid. They are used very commonly in private practices under fancy nicknames such as “white jade injection” and “Cinderella injection.” I recommend using these two ingredients in separate therapies rather than combining them to cocktails that I have mentioned in previous articles. It is desirable to categorize them as series rather than added ingredients.



     Glutathione is known to have a wide range of antioxidant actions. It is used in the “white jade” injection due to its known whitening effects but in reality less than 10% is absorbed in the skin. Its benefits on the nerves, lungs, and liver as well as detoxifying effects are known to be more important.    


    Glutathione consists of three amino acids; glutamate, cysteine and glycine. These three amino acids are not essential but cysteine is created from degradation of methionine, an essential amino acid, so should be treated as an essential amino acid. Oral supplementation of cysteine(NAC, N-acetyl-cysteine) helps increase the bioavailability of glutathione. NAC is contained in Muteran, Flumucil Capsule, and Moktin Capsule, etc. which are commonly used antitussive, mucolytic and expectorant agents(Figure 1).


    Figure 1. Glutathione synthesis and basic actions.


     Glutathione interacts with glutathione peroxidase(GSHPx) and converts hydrogen peroxide(H2O2) found across our body into water(H2O). Without glutathione, hydrogen peroxide is converted by iron(Fe2+) into hydroxyl group(HO•) which is a more potent oxygen free radical.


    This hydroxyl group induces oxidative damage strong enough to cause genetic mutation. Many cytotoxic anti-cancer treatments generate hydroxyl group to directly destroy cancer cell DNA. However, this damages normal cells as well due to the potent oxidative damage from hydroxyl group(Figure 2). Antioxidants that counter the effects of hydroxyl group include vitamins C, E and lipoic acid, which we will talk about in this article.


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     Hydrogen peroxide is continuously released in the human body and antioxidant actions that counter the damage from hydrogen peroxide occur throughout the body; from head to toe, including in the extra- and intracellular fluids, and cell membranes. This is why glutathione is called a wide-range antioxidant.


    Figure 2. Oxygen free radicals and antioxidant enzymes.


     Moreover, glutathione is involved in glutathione conjugation reaction which is the second detoxification stage in the drug metabolism of the liver. Glutathione helps make toxic materials water-soluble and induces renal or biliary excretion. Glutathione-S-transferase is the enzyme involved in this process.


    -To be continued

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