ALA, Glutathione, CoQ10: Three Major Endogenous Antioxidants from Perspective of Functional Medicine

Introduction

In functional medicine, oxidative stress is never something that can be solved simply by "taking more vitamin C".

The human body has a complex endogenous antioxidant network that works together, supporting and regenerating each other, to maintain mitochondrial, endothelial, liver detoxification and immune balance.

Focus on three key endogenous antioxidant substances:

Alpha-lipoic acid (ALA): The "all-purpose antioxidant" that is water-soluble and fat-soluble

Glutathione (GSH): The "general commander" for antioxidant, detoxification and immunity

Coenzyme Q10: The "dual player" for mitochondrial energy and heart health

Understanding them makes it easier to understand why functional medicine emphasizes: Antioxidation is not a single-point supplementation, but a network support.

Alpha-lipoic acid (ALA): "all-purpose antioxidant" that dissolves in both water and fat

Identity Card

ALA is an enzyme present in mitochondria.

The original text classifies it as a type of compound belonging to vitamin B.

The most notable feature of ALA is that it possesses both lipid solubility and water solubility.

This means that ALA can freely travel throughout the body and reach different cell sites.

It can not only eliminate free radicals in hydrophilic structures but also those in lipophilic structures.

Therefore, it is called the "universal antioxidant".

Alpha-lipoic acid Core function

1. Comprehensive Antioxidation

After entering the tissues, it can exist both inside and outside the cells, including within the mitochondria.

As a coenzyme, it participates in the oxidation of pyruvate, ketoglutarate, and branched-chain amino acids.

It is particularly significant for people with high oxidative stress.

2. Preservation and Regeneration of Other Antioxidants

It can help regenerate major antioxidant substances such as vitamin C, vitamin E, and coenzyme Q10.

3. Supporting Glutathione Synthesis

It helps the body synthesize its main detoxification substance - glutathione.

It increases the level of glutathione in the tissues and maintains the appropriate ratio of reduced and oxidized glutathione in the mitochondria.

4. Balancing Blood Sugar Concentration

The ALA is mentioned to have the effect of balancing blood sugar concentration in the text.

5. Auxiliary Factor Function

It is a growth factor for some microorganisms and plays an auxiliary factor role in certain multi-enzyme systems.

6. Helping to Remove Heavy Metals

The ALA also helps the body remove heavy metals.

Functional Medicine Highlights: Endothelium and Nitric Oxide

Healthy endothelium-mediated vasodilation is an important marker of cardiovascular health.

Nitric oxide (NO) is an important vasodilator substance produced by endothelial cells.

However, oxidative stress increases and counteracts the effect of NO.

Due to its antioxidant properties, safety and effectiveness, ALA is regarded as one of the preferred choices for supporting healthy endothelial function.

Source and supplementation of reality

ALA can only be synthesized in the liver and other tissues in very small amounts.

After oral intake, it is absorbed by the intestines into cells, can pass through the blood-brain barrier, enter the portal vein, and be distributed through the circulatory system.

The amount of ALA in the human body is very small and decreases with age, so it needs to be obtained from outside the body.

ALA in food is often found together with vitamin B₁.

Potatoes, spinach, broccoli, tomatoes, carrots, liver, etc. contain it, but the amount is very low: 30g of spinach contains only about 0.005mg of ALA.

The emergence of nutritional supplements has its practical reasons.

The Ministry of Health, Labour and Welfare of Japan once classified lipoic acid as a medicine, and in June 2004, it was reclassified from medicine to food.

Remember ALA in one sentence:

Water-soluble and fat-soluble, antioxidant throughout the body;

Regenerates other antioxidants;

Supports glutathione and endothelium.

Glutathione (GSH): "command center" for antioxidation, detoxification and immunity.

Identity Card

Reduced glutathione, commonly known as glutathione, is a tripeptide containing sulfhydryl groups, composed of glutamic acid, cysteine, and glycine.

Reduced glutathione plays a wide range of roles in various tissues and organs throughout the body.

three major pathways by which reduced glutathione protects cells

1. Strong antioxidant function

Reduced glutathione is the most important antioxidant in the body.

The sulfhydryl group on cysteine is reductive and can be reduced again after oxidation, making it an effective scavenger of free radicals in the body.

S-acetylglutathione has been proven to be able to pass through the mitochondrial membrane, increase mitochondrial activity, and reduce reactive oxygen species (ROS).

The reduction of ROS is related to maintaining the integrity and function of mitochondria.

Healthy mitochondria are the prerequisite for supporting the overall health and energy of the body.

2. Detoxification Function

Glutathione, especially the glutathione present in liver cells, can participate in the process of biotransformation.

The sulfhydryl group on cysteine is the active group of glutathione and is prone to combine with certain drugs (such as paracetamol), toxins (such as free radicals, iodobutyric acid, mustard gas, lead, mercury, arsenic and other heavy metals).

This converts harmful substances in the body into harmless substances and eliminates them from the body.

The binding action of glutathione is an essential part of the body's process of metabolizing drugs and foreign substances.

3. Support normal immune system function

Glutathione can help maintain the normal function of the immune system.

Numerous studies have shown that the level of glutathione in antigen-presenting cells affects the response patterns of Th1/Th2 cytokines and promotes a balanced immune response.

The content of reduced glutathione is a very meaningful biomarker for measuring the health status of the body.

Synthesis and oral absorption problems

The biosynthesis of glutathione is influenced by both the body and dietary factors.

Substances that can serve as precursors of glutathione and increase the level of glutathione in the body include: whey protein, vitamin C, and glutamine.

The conversion ability of glutathione varies greatly among different biological individuals.

In the past, since most of the glutathione was oxidized in the intestine before being absorbed and utilized by cells, and thus lost its effect, intravenous administration was generally recommended.

Now, research has proved that S-acetylcysteine is the S-acetylated form of glutathione.

The acetyl group is located on the thiol group and can act as an antioxidant, allowing the molecule to diffuse into cells after intestinal absorption.

After entering the cells, the acetyl group is removed.

Acetylation can prevent the degradation of glutathione, and S-acetylcysteine is stable when passing through the intestine and plasma.

Oral administration of S-acetylcysteine can increase the total content of glutathione and reduced glutathione.

In one sentence, remember glutathione: the core of antioxidant, the core of detoxification, the core of immune balance, and also an important health biomarker.

Coenzyme Q10: Mitochondrial Energy and "Antioxidant Pump" of Heart

Identity Card

Coenzyme Q10 plays a crucial role in the production of energy and antioxidant functions in the body.

It is an activator of cellular metabolism and cellular respiration, which can improve mitochondrial respiratory function and promote oxidative phosphorylation reactions.

It is also a natural antioxidant produced by cells itself, which can inhibit mitochondrial peroxidation and has the function of protecting the integrity of biological membranes.

It also has a non-specific enhancing effect on immunity:

it can increase the phagocytic rate of phagocytes, increase antibody production, and improve the function of T cells.

Which factors can affect level of coenzyme Q10?

Coenzyme Q10 is rarely present in the diet.

The serum level decreases with age.

Nutritional deficiencies caused by drugs can also reduce its level.

The synthesis of coenzyme Q10 in the body is regulated by HMG-CoA reductase.

Many factors can inhibit the activity of HMG-CoA reductase, thereby inhibiting the production and utilization of coenzyme Q10, leading to increased potential oxidative stress and reduced energy.

Supplementation of coenzyme Q10 can improve quality of life, energy levels, neural health, exercise tolerance and muscle comfort.

Why are cardiovascular systems particularly dependent on coenzyme Q10?

Because cardiac muscle cells have a higher energy requirement.

The support of coenzyme Q10 for cardiovascular health has been confirmed by human studies:

A randomized double-blind placebo-controlled study involving 49 people found that supplementing with 100mg/d of coenzyme Q10 could increase its plasma level by 127%.

A randomized double-blind placebo-controlled study of 420 patients was divided into two groups:

one group took coenzyme Q10 orally three times a day, 100mg each time; the other group took a placebo.

After three months, the NT-proBNP (N-terminal pro-brain natriuretic peptide) level in the group taking coenzyme Q10 decreased, which is an important indicator of heart health.

Two years later, patients taking coenzyme Q10 showed significant and meaningful improvements in cardiovascular function.

In a nutshell:

coenzyme Q10 is involved in mitochondrial respiration, energy production, and antioxidant protection, and the heart muscle is particularly dependent on it.

three do not operate independently: an antioxidant network

When ALA, glutathione, and coenzyme Q10 are considered together, it becomes clear that they do not work independently:

ALA: Soluble in both water and fat, provides comprehensive antioxidant protection, can regenerate vitamin C, vitamin E, and coenzyme Q10, and helps in the synthesis of glutathione.

Glutathione: One of the most important antioxidants in the body, it also plays a role in detoxification and immune balance.

Coenzyme Q10: Supports mitochondrial respiration and energy production, while protecting mitochondria and biological membranes.

This chain can be simplified as:

Mitochondrial health → Energy production → Antioxidant defense → Detoxification ability → Immune balance → Endothelial and cardiovascular health

From a functional medicine perspective, antioxidant protection is not about "the higher the better for any single nutrient", but rather about whether the entire network is functioning in synergy.