Q&A: How to boost patients’ glutathione levels safely and effectively

Boosting glutathione levels can help transform a patient’s health, revitalizing their mind and body, according to Nayan Patel, PharmD.

Patel serves as an adjunct faculty member of the University of Southern California School of Pharmacy, where he also received his doctor of pharmacy degree. He’s a member of the International Academy of Compounding Pharmacists as well as an expert, consultant, and lecturer on glutathione. In his latest book, “The Glutathione Revolution,” he dives into the health benefits associated with boosting glutathione levels.

The following is an email interview with Patel about the benefits and controversies surrounding glutathione.

Integrative Practitioner: What is glutathione?

Nayan Patel: Glutathione is a powerful antioxidant that occurs naturally in the body and decreases significantly with age and stress. It’s an important detoxifier and has the power to revitalize the body, transform health, and even aid with weight loss.

The glutathione antioxidant is the second most abundant molecule in the body and the first line of defense against oxidative stress. Our bodies create glutathione using amino acids from our food. From there, it processes toxins out of the body, gobbles up free radicals, boosts cellular function, and encourages cell turnover. This means glutathione not only prevents oxidative stress, but also helps to heal the damage it leaves behind.

While glutathione does a lot of detoxifying on its own, it also supports other antioxidants. After an antioxidant donates electrons to neutralize free radicals, glutathione can donate electrons to that antioxidant so that it can attack another free radical. This helps us make the most of our supply. That’s why glutathione is often called “the mother of all antioxidants.”

Antioxidants are defined by the National Center for Complementary and Integrative Health as “man-made or natural substances that may prevent or delay some types of cell damage,” and they form a central part of our natural detoxification system.

Our cells are constantly at work digesting food, fighting foreign invaders, carrying oxygen to our tissues, and more. This work produces unstable molecules called free radicals. Free radicals steal electrons from other molecules, damaging them in the process. Left unchecked, they can damage cell DNA and disrupt our body’s functions. We call this oxidative stress. While some free radical activity is normal, oxidative stress can be a real health concern. Research has linked it to a variety of problems from acne to chronic fatigue syndrome to Parkinson’s disease. Antioxidants, however, limit oxidative stress by disarming free radicals so they can be safely eliminated.

Integrative Practitioner: How do low glutathione levels affect the body?

Nayan Patel: Low glutathione levels reduce your body’s ability to detoxify your liver and decrease inflammation. This is apparent in spectrum disorder kids when their detox pathways are compromised.

The body has the ability to produce enough glutathione, but as we age, as soon as 30 years old, that production decreases and can show at the onset of metabolic disorders. A great example of this is the body’s inability to neutralize alcohol with low glutathione levels due to age.

Integrative Practitioner: What are the benefits to balancing a patient’s glutathione levels?

Nayan Patel: Glutathione’s health benefits are far ranging, with the primary function being to support detoxification in the body, boost the immune system, and fight free radicals and oxidative stress, all in the name of achieving optimal health.

Our body naturally produces glutathione, however, our demand for glutathione increases when our body can’t produce enough of it to flush out all the toxins we are exposed to.

Glutathione works in your entire body to promote optimal function in areas such as:

• Mind: Healthy levels of glutathione aid in focus and clarity. Low glutathione levels in the brain have been related to the oxidative stress occurring in neurological diseases.
• Body: Antioxidants, especially glutathione, are essential to balance the free radicals that cause oxidative stress and that leads to chronic inflammation. This is crucial to overall health as chronic inflammation is at the core of several disorders in the body and disease.
• Health: Glutathione boosts the liver’s ability to get rid of waste and toxins, increasing energy and vibrance. It’s also integral in the processing of oxygen in the mitochondria, making one less prone to fatigue. 

Integrative Practitioner: How can you raise glutathione levels naturally through diet?

Nayan Patel: You can optimize the natural production of glutathione in the body through diet by including foods that stimulate glutathione production. Bolster your diet with wholesome, nourishing foods and leave out harmful foods with preservatives and chemicals that stress the body. The body will spend fewer “stores” of glutathione on fighting free radicals and heavy metals. You can increase glutathione levels by providing foods that contain glutathione or other substances that promote glutathione.

Eat the right foods and avoid the wrong foods:

• Nix processed foods with preservatives, pesticides, and heavy metals. Your body will spend less glutathione fighting these free radicals.
• Focus on foods that promote glutathione-boosting; some great options are avocado, oranges, spinach, tomatoes, and watermelon.
• Supplement with a strategy. Supplements that boost glutathione levels include coenzyme Q10, vitamin C, magnesium glycinate, and more.

Integrative Practitioner: Under what conditions would you recommend glutathione?

Nayan Patel: Anyone that has a known deficiency of glutathione levels. Patients that are exposed to heavy metals, toxic chemicals, pollutants, solvents, and organic chemicals will often have low glutathione levels. Patients with chronic viral infections, bacterial infections, and stress have also shown to have low glutathione levels. Additionally, I know age is not a condition, but as we age our ability to produce glutathione decreases, and our need, in fact, increases as our exposure to toxins have not reduced and inflammation has increased. Therefore, depending on one’s healthy/unhealthy habits, anyone over the age of 30 should consider evaluating their glutathione needs.

Integrative Practitioner: The U.S. Food and Drug Administration (FDA) recently recommended that the Pharmacy Compounding Advisory Committee ban compounded glutathione. Why do you think the FDA suggested this and what are the risks involved in compounded glutathione?

Nayan Patel: In June 2022, the Pharmacy Compounding Advisory Committee recommended to allow glutathione for compounding, and we just have to wait for the FDA to give us the final decision.

The FDA could have suggested this as there is no USP monograph [standards for identity, quality, purity, packaging etc.] for glutathione. Even though glutathione has a GRAS (generally recognized as safe) status by FDA when consumed orally, the safety studies have not been conducted on any forms besides oral administration. 

I do not see any current risks for using glutathione in compounding situations and I’m waiting to hear what the FDA’s concerns are. There have been a handful of adverse reactions with the use of glutathione intravenously which are more likely due to compounding error than glutathione itself.

Integrative Practitioner: What would the impact on patients be if compounded glutathione was banned?

Nayan Patel: It would be devastating for patients that rely on their glutathione regimens for their health concerns. There are commercially available glutathione products that are available but that will not meet the targeted needs for all patients. For example, patients that need to inhale glutathione for their lungs to help them breathe will not have access to it and there are no over-the-counter products for that purpose.

Integrative Practitioner: What is the safest, most effective form of glutathione supplementation?

Nayan Patel: As glutathione declines in our body naturally with age, we need it even more. Glutathione has a unique ability to combat all the symptoms of stress and works with the body on a cellular level. So glutathione supplements become important for optimal health. It’s important to know the difference between supplements and what’s best for the patient.

My advice is to always to determine the strength, efficacy, and safety of glutathione, and other supplements. Once this is ascertained, you can confidently explore your patient’s options and decide where and how to get the supplements.

In my opinion, the best form of glutathione supplement is transdermal, but it is important to note that not all transdermal supplements are the same. In order for glutathione molecules to pass through the skin’s protective barrier, they must be the right size. This is where patented sub-nanotechnology can help, where a reduced glutathione molecule ensures the intact delivery of glutathione through the skin barrier for maximum bioavailability. The patented transdermal delivery method is more effective and longer lasting, as it ensures the highest level of efficacy and is highly potent.

It’s also important to establish how strong a supplement is. The patient may absorb a product just fine, but it won’t do much good if there’s not a high enough concentration of glutathione.

One easy way to estimate potency is to check how the product smells. Strong glutathione has a distinct sulfur-like smell which tells you it’s still active and ready to go to work. Once applied, the scent should dissipate in a few minutes. Lastly, longevity: you should also know how long a supplemental glutathione will be active. With IVs and injections, the body uses up glutathione very quickly. This can mean repeated clinic visits for long-term results.

We don’t yet know how oral or injected glutathione can alter glutathione levels over time. Transdermal supplements are a better bet since it takes the body longer to process glutathione provided this way.

Overall, besides diet and supplementation, remember the following to maximize a patient’s glutathione stock:

• Exercise
  • Exercise boosts the production of glutathione and creates a more efficient release from the tissues. There is also some evidence that if you exercise throughout your life, you will maintain higher glutathione levels as you age.
• Avoid toxins as much as possible
  • Be an alert consumer and avoid products that contain substances we know are not suitable for us. Top offenders include bisphenol-A found in plastics and food packaging, phthalates found in plastics, solvents, personal care products, parabens found in cosmetics, body care products, and more.
  • Avoid the Dirty Dozen, a list of twelve fruits and vegetables that the Environmental Working Group found to contain the highest levels of pesticide residues.
  • Buy the Clean Fifteen, a list of fruits and vegetables that you can feel safe and good about eating, as advised by the Environmental Working Group.
• Address stress
  • Keeping stress levels low daily can help conserve antioxidants, including glutathione. Try meditation for three to seven minutes, two times daily, to free your mind of clutter. Take a walk outside in nature or a long bath.

Editor’s note: This Q&A was edited and condensed.