This document discusses the importance of glutathione for the immune system, detoxification, and as a master antioxidant. It notes that glutathione must be abundant and active to serve as a major free radical scavenger, especially in the brain. Several environmental triggers and causes of autoimmunity are outlined that can lead to glutathione deficiency and result in various health conditions like heart disease, neurological disorders, autoimmune diseases, cancer, and more. The document emphasizes taking a thorough patient history and implementing a treatment plan focused on lifestyle modifications, supplements, and follow up to support glutathione levels and detoxification pathways.

1. The Glutathione Key Dr. Nancy Doreo, DC 1

2. The Importance of Glutathione Antioxidant Immune System Detoxification 2

3. Master Antioxidant It needs to be ABUNDANT and ACTIVE Major free radical scavenger in the brain 3

4. Environmental Triggers LOCATION STRESSES DIET (gmo, processed) PAST HISTORY NEURO-ENDOCRINE MEDICAL THERAPIES 4

5. Environment Pathogens, drugs, hormones, and toxins are just a few ways that the environment can trigger autoimmunity 5

6. Causes of Autoimmunity GPx1 6

7. Inflammatory Cytokines Inhibit red blood cell growth Activate Microglia Cause pain Cause stiffness Impair intestinal barrier Impair blood brain barrier Wreak chemical havoc with neurotransmitters, hormones, nitric oxide, glutathione 7

9. Alcohol

10. Smokers

11. Low Immune

12. WBCs low8

13. Critical Management Points History Exam Labs: in office challenges, blood/saliva/urine Working Diagnosis versus Existing Diagnosis Plan of Action Phases of Plan Follow Up Re-evaluate 9

14. AutoImmunity Reality: Celiac Hashimoto’s Fix? Manages Fluctuates MS Psoriasis Rheumatoid 10

16. Amino acid conjugation: cysteine/taurine/glycine/glutamine

17. Methylation: Folate, B12, Choline, Methionine

18. Sulfation: sulfur foods, glutathione, taurine

19. Acetylation: thiamine, pantothenic acid, and vitamin C

20. Glucuronidation: Magnesium11

21. Systems Permit Viscous Cycles Mercury Poisons Methionine Synthase Default in GSH and GSSG permit poor detoxification of haptens Virtually every major organ system 12

22. Genomics Glutathione Peroxidase 1 SNP Metalloproteinase SNPs 5 MTHFR Others… Genova Genelink Labcorp 13

23. Genetic Predisposition GPx1 Polymorphisms GPx-1 polymorphism (rs1050450) contributes to tumor susceptibility J Cancer Res Clin Oncol. 2011 Oct;137(10):1553-61 prostate cancer , breast cancer, ovarian cancer and lung cancer may be modulated by GPX1 polymorphism and that the combination of genetic factors involved in oxidative response with environmental carcinogens may play an important role in carcinogenesis. Glutathione helps defend the body against damage from cigarette smoking, exposure to radiation, cancer chemotherapy, and toxins such as alcohol. As a detoxifier of heavy metals and drugs; it aids in the treatment of depression, schizophrenia, bipolar and chronic fatigue, blood, immune and liver disorders 14

25. Centella Asiatica

26. Silybum Marianum

27. N-Acetyl-Cysteine

28. Alpha Lipoic Acid

29. L-Glutamine

30. SeleniumSupport with Glutathione Recycler in Gluten Sensitivity and Cross Reactive Foods 15 ii

31. Glutathione Support and Delivery Patient Profile: Autoimmune Oxidative Stress Neurodegenerative Leaky Gut/Brain Energy Depletion Sarcopenia Mental/Emotional Scoliosis 16

32. Let’s Do Some Math: Low GSH + Low Vit D + Stress = illness Low GSH + Toxic Metal Exposure = illness Low GSH + Gluten Intolerance= illness Modifying Processes Rather than Curing Diseases environmental factors + susceptibility GSH + 4R Program + Anti-Inflammatory Lifestyle Chapter 23, Textbook of Functional Medicine, page 319 17

34. Gut Barrier

35. Glutathione Stores

36. Anti-Inflammatory Lifestyle

37. Exercise and Rest Habits

38. Treatment and Follow Up18

39. Reference Papers: Prog Neuropsychopharmacol Biol Psychiatry. 2011 Apr 29;35(3):784-94. Epub 2010 Jul 4. An intriguing and hitherto unexplained co-occurrence: Depression and chronic fatigue syndrome are manifestations of shared inflammatory, oxidative and nitrosative (IO&NS) pathways Significance of Low Plasma Homocysteine Richard S. Lord, Ph.D. and Kara Fitzgerald, N.D. Toxicology and Applied PharmacologyVolume 219, Issues 2-3, March 2007, Pages 181-189 Anticholinesterases Organophosphorus insecticides chlorpyrifos and diazinon and oxidative stress in neuronal cells in a genetic model of glutathione deficiency Biological Trace Element ResearchVolume 89, Number 2, 105-110, DOI: 10.1385/BTER:89:2:105 Download this presentation at http://www.slideshare.net/nancydoreo/glutathione-key-in-wellness-care 19 Regulation of Neuronal Glutathione SynthesisJ PharmacolSci 108, 227-238 (2008) Low brain glutathione and ascorbic acid associated with dopamine uptake inhibition during rat’s development induce long-term cognitive deficit: relevance to schizophrenia Neurobiology of Disease 15 (2004) 93-105 Textbook of Functional Medicine, IFM 2005