Antioxidants and Reactive Oxygen Species (ROS)

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Antioxidant supplements may be needed in times of Oxidative Stress, which is defined as a disturbance in the pro-oxidant / antioxidant balance in favor of the pro-oxidants, leading to potential oxidative damage in cells and tissues, and inhibiting genetic expression of RNA. Consuming fresh foods supplies daily antioxidants to add to what your body produces, but in times of physiological stress you may need to add antioxidant supplements, and these chemicals comprise a large family of molecules with diverse effects. Specific antioxidant medicines, taken when needed, not continuously, and a healthier diet and metabolism, may be the most important aspect of healing and preventing many of the most threatening diseases. Professional prescription allows the appropriate antioxidant to be prescribed for a particular type of Oxidative Stress, and only Complementary Medicine physicians, such as Licensed Acupuncturists and Naturopathic Doctors, receive medical school training in nutritional medicine. Over 4000 antioxidant flavonoids in herbs and foods have been studied, as well as a number of vitamin molecules, and the choice of the right combination of antioxidant medicines for specific goals, when needed, is not a simple task.

The term antioxidant describes a diverse array of chemicals that the body uses to break down reactive oxygen species (ROS) of molecules, or oxidant free radicals. Free radicals are small parts of molecules that easily become part of another useful molecule in metabolism, and are created by catabolic processes, or breakdown of chemicals. For this reason they may easily combine with oxygen molecules to form reactive oxygen species, and these ROS are potentially reactive in ways that cause cell or tissue degeneration, or increase the load of cancerous mutations and inflammatory stress. ROS are found to be a significant cause or contributor to many chronic diseases, as well as playing a part in acute inflammatory dysfunctions that cause unnecessary symptoms. Most ROS have a very short life, normally lasting a fraction of a second, but some have a long half-life (time it takes for half of the accumulation to break down), lasting from seconds to days, and others need particular enzymes to control the process of elimination. These enzyme-dependent ROS are called hydrogen peroxide and superoxide anion radicals. The superoxide anion (O2-) radicals require superoxide dismutases (SOD), glutathione, or other potent enzymes to be eliminated.

ROS with a half-life of a number of seconds may be created faster than we can break them down, and these are mainly nitric oxide radicals, peroxyl radicals, and peroxynitrite. Nitrogen in the body is mainly produced from the breakdown of proteins and amino acids, and a diet that is heavily weighted in proteins, such as one with a high meat and wheat consumption, may create excess nitrites (NO2). Nitrites and nitric oxide oxidize the iron atoms in blood hemoglobin, rendering it unable to carry oxygen. Nitric oxide is an important signaling chemical in the body, though, that is involved with both normal physiological processes, such as vasodilation, but also in many pathological processes, reacting with many heavy metal ions, as well as halogens, such as fluoride, chloride, bromide, and iodide. The chemicals created from fluoride and chloride, namely fluorine and chlorine, are perhaps the most powerful oxidizing agents in the body, and are widely used in commercial application because of their intense oxidizing nature, mainly to kill microorganisms in drinking water and swimming pools, or to supposedly decrease tooth decay. Bromide is also now widely used in processed foods, as well as natural pesticides, and added to the drinking water as well, and these three halides not only react heavily with nitric oxide, but compete in the body against the most useful halide, iodide, a component of the essential mineral iodine. We see that not only physiological stress, but environmental and dietary stress may create periods of increased need for specific antioxidants to reduce Oxidative Stress. Added to this is the wide use of nitrate preservatives in processed foods, which are a known trigger of many pathological diseases, such as migraines. Excess nitrites and ROS such as nitric oxide may also be created from these sodium nitrate preservatives. The key point to oxidative stress is the need to maintain a healthy homeostasis of clearing of accumulation of unhealthy reactive oxygen species, and dumbing down this elaborate metabolism and regulation does not help. Maintaining a balance, not targeting a specific ROS with chronic use of one antioxidant, or treating all antioxidants like they are the same, is the intelligent focus, and a combination of acupuncture, herbal and nutrient medicines that are individually tailored to accomplish goals provides great help.

Superoxides are ROS (reactive oxygen species) that are biologically quite toxic, and created by our immune systems to kill invading microorganisms, such as bacterial infections, candida species, etc. that penetrate deep into our tissues and cells. Superoxides, though, may also be created by mitochondrial dysfunction, a subject that is increasingly linked to chronic diseases, especially neurodegenerative disorders and autoimmune diseases. Mitochondria are small organisms in our cells that are believed to be evolved from symbiotic microorganisms that invaded animal cells early in evolution and helped us to adapt to a toxic oxygen metabolism. Mitochondrial dysfunction may produce an excess of superoxides in the cellular respiratory process. To counter the toxicity of superoxides, our cells quickly produce enzymes such as superoxide dismutase (SOD), which can break down the superoxides almost as quickly as they are produced. Other molecules have a weaker SOD-like capacity, including glutathione peroxidase, and even hemoglobin in red blood cells. Humans that lack a great ability to produce SOD are more at risk for developing a number of diseases, including liver cancer, muscle atrophy, cataracts, haemolytic anemia, and immunodeficient syndromes, as well as being at risk for accelerated aging and age-related infertility. We can supplement with SOD, but there is a problem with utilization of this supplement, and a more common course is to promote a better SOD metabolism. This can be accomplished with specific acupuncture stimulations, as well as specific herbal extracts, and the evidence for this is provided in Additional Information at the end of this article. Three forms of SOD exist in humans, SOD1 in the cytoplasm of cells, SOD2 in the mitochondria, and SOD3 in the extracellular fluids and tissues. Since SOD needs to be produced as needed quickly to counter superoxides, supplementation as a slower process has some benefit, but not enough to have created a market for the products. Cofactors that may benefit the SOD metabolism are zinc monomethionine, copper and manganese, as well as an array of essential amino acids, especially cysteine and tyrosine. Studies have shown that N-acetyl cysteine (NAC) induces inceased SOD. One of the overlooked natural sources for SOD is properly prepared dried barleygrass powder, which may be a very healthy addition to your dietary supplementation. To learn more about promoting a better glutathione metabolism, you may refer to the article on this website entilted Glutathione Regulation and the Importance of Maintaining Balance. Both expression of superoxide dismutase and glutathione peroxidase are achieved with acupuncture stimulation, and a more holistic treatment protocol that combines short courses of acupuncture and electroacupuncture with specific herbs and supplements produces the best outcomes.

Our genes also react to oxidative stress, with numerous genetic RNA switches and epigenetic controls reacting to oxidative stress to trigger expression of regulating proteins from our main genes. Nrf2, or transcription factor-E2-related factor 2 is one such important genetic regulator of our cells reaction to oxidative stress. Nrf2 is expressed in all tissues, but the highest levels of expression are seen in the kidneys and liver, sites of detoxification. So far, over 200 genetic expressions have been found to be activated by Nrf2, and almost all of these regulatory genes are triggered to provide protective mechanisms related to oxidative stress, inflammatory mechanisms, clearing of protein peptides, and tumor suppression. Nrf2 is linked to the glutathione metabolism, and thus elucidates how our bodies regulate this important cellular detoxification system. Research is showing us that many medicinal herbal and nutrient chemicals work by enhancing Nrf2 expression and activity. Curcumin, milk thistle, ashwaghanda, bacopa, resveratrol, CoQ10 and lipoic acid have been shown in research to boost the beneficial effects of Nrf2. A 2015 study at Capital Medical University, in Beijing, China, found that acupuncture achieved much of its proven neuroprotective effects via the Nrf2 pathway (PMID: 26546103). Achieving a healthy modulation of such homeostatic mechanisms central to antioxidant and detoxification effects should be the goal in disease prevention, and research is showing us how a healthy diet and use of Complementary Medicine achieves this goal even by aiding the balance of genetic expression.

Making the right choices in antioxidant dietary supplementation

When do you need to supplement with antioxidants? Advertisers would have you believe that you should load up on these nutrients all the time to insure health, and that all antioxidants achieve the same effect. This information is patently false. Antioxidants are a large class of chemicals, either consumed in the diet or created in the body, to help neutralize excess oxidant free radicals, or reactive oxygen species (ROS), when they accumulate faster than they can be broken down. Since free radicals are atoms or molecules that may easily bond with other molecules and are beneficial to many processes in the body, we should take antioxidant supplements when we suspect that there are excesses of free radicals, or unhealthy free radical accumulations in our bodies, creating Oxidative Stress, and not just as a habit. Excess free radical accumulation, called Oxidant Stress, is linked to many diseases, especially degenerative diseases and cancers, but a normal balance of free radicals in the body is essential to maintain optimum health, and a balance of prooxidant and antioxidant chemistry and function is the key to this health (in TCM we would call this a balance of yin and yang).

Unless there is a reason to suspect excess free radicals in the body, a healthy diet of antioxidant foods should supply your needs, along with proper light exercise and attention to overall health. When there is a health condition that may create more reactive oxidant free radicals than your body can handle, specific antioxidants should be taken for specific purposes. When you take one type of antioxidant, this does not mean that your antioxidant needs are met. Excess consumption for a long period of time of a particular antioxidant, such as one of the forms of Vitamin E or A, lipid soluble vitamins, may cause an imbalance in the antioxidant metabolism. A long term study on prostate cancer showed that patients taking a high dose of a particular form of Vitamin E prophylactically for a long time actually had a higher rate of prostate cancer, even though a form of Vitamin E was shown to be a potent aid to the treatment protocol. When selenium was taken with this form of Vitamin E taken at excess levels for years, no increase in prostate cancer rates were seen. Succumbing to advertising and simple strategies in antioxidant therapy is not only a ticket for failure, but in this case, potentially a negative health factor. Of course, this does not mean that all antioxidant supplement strategies are bad, just that the individual should use their intelligence to find the right medical strategy suited to their particular condition. An intelligent analysis of the individual's antioxidant needs will produce good medical results. This usually means that a combination of dietary changes is coupled with specific antioxidant supplementation to achieve specific results. An increase in aerobic exercise or activity also could help. A professional Complementary Medicine Physician, such as a Licensed Acupuncturist or Naturopathic Doctor, may advise and prescribe according to your specific needs, if they are knowledgeable.

As the subject of excess free radicals and deficient antioxidant capacity becomes more prominent in modern medical science, pharmaceutical manufacturers are producing allopathic antioxidant chemicals that are not natural to the body. These new drugs should not be confused with normal antioxidant biologics. These drugs are designed to inhibit the production of free radical oxidants, not to modulate and support the oxidant balance in the body. Research has already shown that there are potential health hazards to this approach, as free radical oxidants stimulate a wide variety of healthy chemical processes in the body, and wholesale inhibition of free radical production may alleviate some immediate symptoms, but will result in poor health with chronic use. Already, the pharmaceutical industry is using these research findings to try to discourage use of natural antioxidant supplements (see the NY Times article cited below in additional information). The intelligent patient will understand that our bodies have evolved an elaborate means of clearing tissue debris, and that a holistic homeostatic balance of free radical activity is the key. Most of the antioxidants in our bodies are produced by our cells, not consumed in the diet, and so neither a pharmaceutical blocking agent or antioxidant supplementation is the key to a healthy oxidant metabolism. Antioxidant supplements should be utilized to help your body achieve specific goals when they are needed, and should be part of a comprehensive therapeutic protocol. Recent studies have also proven that chronic use of antioxidant supplements may inhibit the natural production of endogenous antioxidants, which are most important, and in fact, could also affect other metabolic systems, such as insulin production and sensitivity at the receptors. Taking antioxidant supplements and herbs as needed, for specific purposes, and directed by an intelligent health professional, may be a key to utilizing these chemicals optimally.

When is there reason to suspect excess free radical formation of ROS in our bodies? When there is infection, disease, tissue injury, inflammation, or cancer, the immune system responds by producing a large amount of free radicals to help bind to and clean out the mess. Therefore, most diseases and injuries may benefit from intelligent antioxidant prescription. If there is excessive free radical formation, and poor clearance, this also may cause damage to our cells and tissues over time, producing chronic health problems.

Our bodies will naturally produce increased antioxidants to clear out the most harmful of these reactive oxidant free radicals, but we can help our bodies in this process by eating a healthier diet, insuring good circulation, and supplementing with specific antioxidants found in herbs and foods. Our bodies also have an antioxidant capacity that we may go over, both from an unhealthy diet, and from acute or chronic diseases and injuries. Excess free radicals may occur when the diet is unhealthy or unbalanced. For example, when excess amounts of meat fat, especially fried fatty meats, are consumed, unhealthy free oxygen radicals are produced in excess from increased fermentation and breakdown of difficult nutrients, such as saturated fats, that require more oxygen. Unhealthy reactive oxidant free radicals may also be produced in response to radiation exposure, pollutants, smoke or automobile exhaust. Patients exposed to radiation therapy or X-rays may want to supplement with potent antioxidants, as well as boost the glutathione antioxidant capacity. Heavy exercise may also produce a temporary excess of reactive oxidant free radicals due to the heavy use of oxygen in the tissues, although the increased circulation produced by exercise should help clear these reactive free radicals. A shot of antioxidant supplementation may benefit tissue recovery from heavy exercise, but continuous use may not be necessary. High glucose in circulation augments cellular oxidant stress by stressing the polyol pathway, creating advanced glycation endproducts (AGE) formation, and activating protein kinase C (PKC), which is the main cause of diabetic peripheral neuropathy and organ disease. High fructose corn syrup, the most widely used sweetener in processed drinks and foods now, not only increases fatty accumulation and oxidative stress, but also is found to increase vascular superoxide production.

In summary, there are a variety of conditions, both acute and chronic, that may require increased antioxidant capacity. Oxidative stress is an important disease causing mechanism, perhaps the most important in chronic diseases, and occurs when the prooxidant mechanisms excede the antioxidant capacity. Antioxidant balance is important in this situation. You may need to do three things that correct this health problem, improve the diet, take specific antioxidant nutrient supplements, and improve the antioxidant, or detox, metabolism. In some acute cases, you might want to take antioxidant supplements for a short period to help your body clear reactive oxidant free radicals produced from acute infection, injury or even heavy exercise. In chronic cases, you may want to take antioxidant supplements for some time, combined with improved diets, and improved metabolism. Various antioxidants perform different tasks in the body. Some knowledge of this physiology helps the patient take an intelligent proactive approach and work better with their Complementary Medicine physician, such as a Licensed Acupuncturist and herbalist, or a Naturopathic doctor.

The physiology of antioxidants and reactive oxidant free radicals

Free radicals are a broad class of molecules, or parts of molecules, that are common to our physiology, and are freely exchanged between compound molecules, but that are incapable of staying together in a free unattached state. When there are too many chemical exchanges taking place, these free radicals attach to a free oxygen and stay intact instead of breaking down into simple atoms and elements. Oxidant free radicals are also created when water is not properly utilized and broken down in the body into hydrogen and oxygen ions. When our cells need to dissolve unwanted chemicals faster, oxygen is an element that will quickly burn up these unwanted chemicals, and the cells will produce hydrogen peroxide and other oxidants to clean itself up and speed the breakdown of unwanted chemicals. When our bodies need increased circulation, cells may produce the oxidant nitric oxide to dilate the blood vessels. Oxidants are normally useful in the body, but Oxidative Stress, or an imbalance of prooxidants greater than antioxidants, creates accumulations of Reactive Oxygen Species (ROS) that are pathological, especially in degenerative diseases and cancers.

Oddly enough, oxygen and radiation from the sun are perhaps the two most toxic parts of our environment, yet life has adapted on this planet to utilize these potent forces of nature as our chief sources of energy. We do this safely by keeping most of the oxygen in our bodies in the form or air (O2), or water (H2O). Oxygen in other forms, called oxidants, are quickly utilized and broken down to reform water, or become a waste product that we call carbon dioxide (CO2), much of which is eliminated via breathing. As stated, many of the common oxidants (molecules that contain oxygen) have a short life in our bodies normally. Two of these oxidant molecules need enzymes to speed breakdown, hydrogen peroxide (H2O2) and superoxide anion radicals (containing O2 with a negative charge).

There are four main enzyme classes that speed these breakdowns of ROS, superoxide dismutases, glutathione peroxidases, catalase, and quinone reductases. There are six classes of nonenzymatic antioxidants commonly used in the body, ascorbate (Vitamin C), tocopherols (Vitamin E), flavonoids, carotenoids (e.g. Vitamin A), urate, and the most prolific, glutathione. Glutathione is produced continuously by our cells, but needs a balanced chemical bioavailability of key nutrients. Urate, and uric acid, is produced by our cells from the breakdown, or oxidation, of the amino acids that make up DNA and RNA, called purines. Uric acid is the most prolific antioxidant in blood circulation, and glutathione is the most prolific antioxidant inside of our cells. When we try to boost our antioxidant capacity, we should try to improve the glutathione and urate metabolisms as the most important steps that we can take. We may also need to boost the body's capacity to produce the enzymes that break down superoxide radicals and hydrogen peroxide. Although glutathione is not dependent on enzyme regulation, a couple of enzymes are important in the glutathione mechanisms of detoxification within the cells.

So, we may help our bodies in times of physiological stress, acute or chronic, by boosting the body's antioxidant capacity, both by consuming specific antioxidant supplements, or by improving the health and the capacity to produce antioxidant activity. Commonly, though, we think of helping our antioxidant capacity by consuming more food antioxidants. Of course, meat is especially high in purines, especially organ meats, and excess consumption requires higher amounts of urate metabolism, although purines are found in all foods, and all of our tissues and cells are composed of DNA and RNA. Eating less red meat, and especially organ meats, such as lunchmeat, sausages, and some ground beef and turkey, will decrease the need for urate antioxidant capacity. This fact is the most important factor that led to the World Health Organization putting processed meats as a category 1 cancer causing agent in 2015. Eating more whole grains and fresh vegetables and fruits will thus help achieve a state where our antioxidant capacity is not exceeded. There are a number of conditions that will impede the urate and glutathione metabolism (a separate article on this website is devoted to an explanation of the glutathione metabolism), and these health problems may also need to be addressed. Chronic health problems, including accumulations of toxins and heavy metals in our tissues, may need to be treated and resolved to efficiently decrease our antioxidant needs. Some form of chelation may need to be utilized to help clear heavy metal toxins from our bodies, if accumulation is suspect. Our bodies normally clears heavy metal ion toxins, but once again, the capacity to clear these molecules may be insufficient, especially with increased exposure and consumption, or with aging. We see that the question of antioxidants involves a holistic answer, eating healthier, taking specific supplements when necessary, and improving key aspects of our homeostatic metabolism.

Besides urate and glutathione, the other four classes of non-enzymatic antioxidants are found in foods and herbs. Glutathione and urate are only produced by the body, not taken in as food nutrients. Fresh fruits and vegetables are generally high in common antioxidants, as are beans. Some herbs are especially high in beneficial antioxidants, especially flavonoids, and even some common herbs and spices, such as cinnamon, oregano and cloves are rich in antioxidants. Dill, thyme, rosemary and peppermint are some of most antioxidant-rich common food spices and herbs. Studies show that one tablespoon of fresh oregano contains the same antioxidant activity as a whole apple. Foods that are naturally high in antioxidants include dried beans, berries, green tea, artichoke hearts, carrots, oranges, apples, grapes, dark leafy greens, sprouted beans and seeds, red peppers, beets, shallots, pecans, walnuts and hazelnuts. Creating a diet where these are consumed regularly is sensible. When the antioxidant needs are greater, specific nutrient medicines may be necessary. One source of superoxide dismutase that is effective is dried barleygrass powder, which contains a host of beneficial chemicals and other antioxidants as well. In general, these nutrient antioxidants are found in high concentrations in a variety of herbal medicines, and explain some of the effectiveness of these herbs. Most medicinal herbs have a chemical profile that contains 10-50 known active chemical ingredients, and the benefits from herbal medicine include a host of activities that are associated with these chemicals, including antioxidant capacity.

Prooxidants are chemicals that stimulate excess reactive oxygen species of free radicals. The most significant of these in scientific studies are oxidized fats, or lipids, that may result either from poor quality fats in the diet, or from a poor liver metabolism that is supposed to control and regulate the lipid metabolism. Oxidized lipids are a key part of the dysfunction that creates atherosclerosis and cardiovascular disease. Patients with high triglycerides in circulation, or an imbalance of HDL to LDL, may end up with an excess of these oxidized lipids. Metabolic syndrome and obesity may need to be resolved to decrease oxidative stress, as well as the taking of antioxidants. In the diet, transfats and unsaturated fatty acids produce high levels of oxidized lipids. Consumption of healthy fats, such as cold-pressed olive and walnut oils, fish oils, and fresh nuts and seeds, help maintain a fatty acid balance. Some common antioxidant chemicals found in red wine (grape skins), green tea, and cocoa, have shown a capacity to reduce reactive oxidative lipids after meals.

Another prooxidant that is being studied in relation to disease are aldehydes, which are simple carbohydrates that usually contain a free radical attached to a single carbon atom. Excess aldehydes are created from overconsumption of alcohol, candida overgrowth, and various other common unhealthy conditions. The word aldehyde refers to alcohol dehydrogenation, and aldehyde is a byproduct of the breakdown of acetaldehyde to ethanol or vice versa. Since alcohol is a common molecule in nature, produced by fermentation, for instance, aldehydes are common organic molecules, with many uses in the chemical industry as well. Many fragrances used in commercial production are aromatic aldehydes, and it is surmised that aldehyde excess in the body stimulate immune responses that explain the growing hypersensitivity to fragrance chemicals in the population, or that various synthesized aromatic aldehydes may create toxicity in the body. Aldehyde accumulation in the cells and tissues leads to reactive oxidative aldehyde molecules, called malondialdehydes, also requiring enzymatic activity to reduce them in the cells. The term mal- means harmful. Current studies show that reactive aldehydes play an important role in the etiology of cardiovascular disease as well as neurodegenerative disorders and cancer. A lack of aldehyde dehydrogenase enzymes in the body is linked to cardiovascular disease. This is a family of enzymes rather than a single protein enzyme, though. With excess intercellular aldehyde stress, metabolic changes occur that stimulates a requirement for increased glutathione clearing and detox. Patient concerns include excess alcohol consumption, poor liver health, systemic candidiasis, and a poor glutathione metabolism. Separate articles on this website about the glutathione metabolism and balance, and the subject of detoxification can be referenced for more information.

One particular aldehyde that has been implicated in a number of tissue diseases, as well as cancer, is malondialdehyde (MDA). This simple molecule would seem inocuous, yet it has been well studied in the last 15 years and found to be implicated in cancerous cell mutations and carcinogenicity, as well as a number of tissue diseases, including pathologies of the eye (keratinosis) and even tissue lesions in the lung associated with spontaneous pneumothorax, as well as atherosclerosis. In recent years studies with more accurate measurement of MDA stress and toxicity have discovered a strong association between subclinical hypothyroidism and malondialdehyde toxicity as well (PMID: 18727709). Molandialdehyde is a naturally occurring byproduct of fat breakdown in our cells, or lipid peroxidation, as well as inflammatory processes such as prostaglandin synthesis, and is implicated in fatty liver disease and metabolic syndrome. Chronic inflammatory states, systemic or localized, may create a high level of malondialdehydes. Scientific study has been trying to unlock the pathological mechanism of malondialdehyde for some time, and we have discovered that low grade deep bacterial infections may be linked to malondialdehyde mutagenicity, or cancer cause. Malondialdehyde may react with DNA to form chemical adducts, the major one called M1G. M1G has been found to be mutagenic in bacteria as well. M1G has been found in various pathological tissues in the body, in the blood cells, liver, pancreas, and breast, and may contribute heavily to these cancers.

This type of potential damage and cancer cause associated with malondialdehydes is also linked to oxidant reactivity to polyunsaturated fatty acid residues in phosopholipid membranes. A related subject is advanced glycation endproducts (AGEs), which are difficult protein sugar fat combinations that we eat (mainly fast food and snacks) and that our bodies may produce in excess (see a separate article on this website concerning AGEs or advanced glycation endproducts). Some experts have termed the complex lipoprotein adduct byproducts of malondialdehyde toxicity advanced lipoxidation endproducts (ALE). We see from such study the ill effects of a variety of seemingly inocuous factors, including the high consumption of poor quality fats in the diet, poorly controlled chronic inflammation, and an immune system that is not properly handling deep low grade infections. The way to correct these health threats from malondialdehydes is to eat a healthier diet, get sufficient exercise, and help the immune and antioxidant processes in our bodies, which can be accomplished with the help of a knowledgeable Complementary Medicine physician, such as a Licensed Acupuncturist and herbalist. In fact, studies in recent years show that specific acupuncture stimulations achieve significant reduction of malondialdehydes in circulation as well, and study links on this and other articles on this website are provided to show scientific proof of this benefit from acupuncture stimulation.

Age is also an important consideration in antioxidant use. Numerous studies have shown that the metabolic capacity of the glutathione and cysteine metabolism decrease significantly with age. As we age, we need to spend more energy on health maintenance if we want to avoid the common diseases associated with aging, especially cardiovascular disease and cancer. Increasing the intake of a variety of supplemental antioxidants as needed is a smart move, and many herbal extracts and formulas provide a host of synergistic flavonoid antioxidants, as well as nutritional supplements. Since these supplements are expensive, you might want to take short courses of a variety of antioxidant supplements periodically, or obtain specific supplements from a professional CIM/TCM physician or Naturopath. It is obvious that treatment with almost any Chinese herbal formula also supplies antioxidants, and this is just one of the beneficial side effects of TCM therapy. Of course, improving the diet is most important as we age. Unfortunately, the general diet of the aging population in the United States has decreased in quality, rather than improved, due to a number of factors, including changes in the appetite, decreased income and mobility to purchase healthy foods, and advertising that urges the aging population to buy processed foods from large corporate grocery chains. The smart patient, as they age, will overcome these tendencies and explore healthier options.

The types of antioxidants and antioxidant therapies and what they do

Not only antioxidant herbs and dietary supplements are useful in clearing of excess reactive oxygen species to treat or prevent disease, but acupuncture, electroacupuncture, and even physiotherapies and increased physical activity is proven useful in scientific study. For example, a 2008 study (cited below) at Beijing University of Traditional Chinese Medicine, in China, measured antioxidant effects of a single acupuncture point with electrical stimulation. The study animals were randomly divided and hyperlipidemia was achieved with diet. Electroacupuncture at a single point, ST40, significantly increased the super oxide dismutase (SOD) activities, an important cellular detox and ROS (reactive oxygen species) clearing enzyme group. The measurements of SOD and MDA (malondialdehyde) activity in various organs showed that this point stimulation affected primarily the spleen and lung oxidant free radical and aldehyde levels, with lesser affect on the liver as well, but no effect on the pancreas. These findings are consistent with the traditional use of the point Fenglong. Such studies show how various point stimulations achieve specific effects to aid antioxidant activity in the body. By combining expert acupuncture stimulation with herbal and nutrient antioxidants, and improving lifestyle and dietary protocols, the antioxidant effects will be much more dramatic than taking a single antioxidant alone. Quality and choice of the herbal and nutrient antioxidants is very important as well, and a professional Licensed Acupuncturist and herbalist is able to supply the right antioxidant therapies with professional products that assure quality.

Some antioxidants are more potent in certain circumstances than others. A little knowledge of the types of antioxidants is very important to your choice of supplementation. Dietary antioxidants include vitamins A, C, E, beta-carotene, and the mineral selenium. The mineral iodine is also a potent antioxidant that has affinity for the thyroid, breast tissues, ovaries and uterus. Melatonin is an important antioxidant in the brain, as well as being an important neurotransmitter and hormone. Certain antioxidants may be 100 times as potent as these more common antioxidants, and are more useful in specific states of oxidative stress. The body produces antioxidant enzymes in response to need, and improving homeostatic metabolism may be needed to restore this antioxidant enzymatic metabolism. Healthy liver function is especially helpful in efficient production of enzymes. The four most studied of these super antioxidant enzymes are super-oxide dismutase (SOD), methionine reductase, catalase and glutathione peroxidase. Go to my article on this website entitled glutathione balance to understand this most important aspect of antioxidant health. Various antioxidants and antioxidant strategies will make your holistic healthcare much more effective. A knowledgable Complementary Physician can help you utilize these enzymes and nutrient antioxidants more efficiently by both supplementation and treatment. Acupuncture, herbal medicine, and nutrient medicine may work synergistically to create a more effective treatment protocol. The choice in effective holistic medicine is not which type will work, but which combination will produce the best results. Below is a partial list of some of the most beneficial antioxidants.

  • Super-oxide dismutase (SOD): this enzyme neutralizes perhaps the most dangerous of free radicals, superoxide. It also aids in maintaining cellular health and the utilization of zinc, copper and manganese. Dried barleygrass powder is perhaps the best source of SOD, although pill supplementation with either copper/zinc SOD or manganese SOD is also available. Copper/zinc SOD protects the cytoplasm of the cell, whereas manganese SOD protects the mitochondria. The pills must be enterically coated to insure that they pass the stomach acid without being destroyed. The manganese SOD is perhaps best in neurodegenerative disorders, while the copper/zinc SOD is best utilized in cancer prevention. Supplementation with SOD may have limited effects, though, as the body needs to constantly generate these superoxide dismutase enzymes as needed. Research shows that a combination of specific acupuncture stimulations and herbal and nutrient chemicals will greatly aid this SOD metabolism, and may be one of the key biological activities that explain the success of acupuncture and herbal medicine in treatment of various difficult diseases. Hormonal balance and health is shown to aid the SOD metabolism as well, and the common relative deficiency of progesterone to estrogens is implicated. A 2015 study at Wenzhou Univesity in China showed that a natural metabolite of progesterone, allopregnanalone, also derived from pregnenelone, the steroidal precursor to progesterone, enhances SOD activity and reduces lipid peroxidation. Synthetic progestins would not achieve this generaton of allopregnanalone. To see this study, just click here: http://www.ncbi.nlm.nih.gov/pubmed/26550302 . Use of bioidentical hormone therapy to achieve normal balance and homeostasis, with acupuncture stimulation and herbal and nutrient medicine combined in TCM care could provide an amazing antioxidant effect that would help prevent or treat serious disease.
  • Glutathione peroxidase: this enzyme contains four selenium cofactors and is a very efficient scavenger of hydrogen peroxides in the cells and tissues. It is very useful when there is tissue repair or injury, and is also useful in detoxification and central nervous system pathology. Selenium supplementation (methylselenocysteine), or herbs rich in selenium may help this process, as well as increased liver function. Vitamin B2 riboflavin, alpha-lipoic acid (ALA), the amino acids L-cysteine, L-glutamate, and glycine, as well as Schisandra berry and milk thistle, may all aid the formation of glutathioine peroxidase. Direct supplementation with glutathione is problematic, as it is not well absorbed across GI membranes. Since your gut flora and fauna may produce glutathione, probiotics may help you to achieve better antioxidant production. Prolonged viral illnesses may use up too much selenium in the body and lead to glutathione deficiency.
  • Bioflavonoids: rose hips, passionfruit, grape, artichoke, St. Johnswort, Gingko Biloba, passionflower, huangbai, and many other Chinese herbs are rich in flavonoids. Gingko Biloba also is proven to enhance microcirculation, leading to its reknown for aiding memory, mental function, pain relief, inhibiting blood clotting and lowering blood pressure.
  • Oligomeric Proanthocyanidins (OPCs): these are a class of flavonoids; whole grape extract is the most well known source of OPCs, and are especially useful in tissue injuries, cardiovascular repair and allergic and inflammatory responses. Whole pomegranate extract is also a very potent source. Green tea has been proven to decrease breast cancer risk and benefit many health conditions due to its concentrated OPCs, and bilberry, black currant, cranberry, blueberry, elderberry and tart apples are also good sources. The Granny Smith apple is now famous for its concentrated OPCs. The black chokeberry (aronia melanocarpa or photinia melancarpa) is found to have the highest concentration of OPCs in many current studies, and is a medicinal plant native to the United States. Analoguous medicinal plants in China are used, from the Rosacea family, and a number of Chinese herbal pharmaceutical companies are already marketing this product (Xian lei hua qiu, or hong guo xian lei hua qiu). A more common, but related, berry in China is the wolfberry, or Goji or gou qi zi. Other fruits high in OPCs have become very popular, including Acai, Noni and Mangosteen.
  • Beta-carotene and other carotenoids: walnuts, carrot juice, spinach, barley, barleygrass, papaya, spirulina, alfalfa sprouts, bok choy, mustard greens, beets, bell peppers, sweet potatoes, and watercress are rich in beta-carotene, the precursor to a type of Vitamin A. These antioxidants are especially good for maintenance of the membranes and skin, and are thus preventative against frequent sinus infections and allergies, skin outbreaks and rashes, skin cancer and eye diseases. They are also well-known as scavengers of carcinogens and guard against heart disease and stroke for those that are at risk. Herbs such as comfrey, gotu kola, chrysanthemum, wormwood, gouqizi berry, and hibiscus are also good sources. Other carotenoids that have been found to be potent antioxidants include lycopene, which is a common food pigment, but does not form Vitamin A molecules. Lycopene has been found to be the principal carotenoid antioxidant in blood and various tissues, and has been found effective in studies treating or preventing prostate cancer, atherosclerosis, breast and ovarian cancers, and metabolic syndrome.
  • Quercetin: speaking of quercetin, a very valuable nutrient, tasty shallots are very high in this beneficial substance, as is evening primrose oil and steel cut whole oats. Quercetin helps with allergies, pain, viral infection, cancer, PMS, aging, asthma, autoimmune disorder, diabetes, prostate hypertrophy, candidiasis, poor liver function, birth defects, and neurological disorders. It is also a strong antioxidant, anti-inflammatory, and MAO-A-inhibitor in depression. Other plants rich in quercetin include okra, garlic, beet, tea, escarole, endive, cilantro, parsley, buckwheat, sour cherry, black currant, rose hips, cranberry, ginger, spinach, valerian and milk thistle. A number of Chinese herbs are very rich in quercetin, which is one reason they were chosen as medicinals.
  • Resveratrol: resveratrol is a chemical that has been isolated and highly studied in China, abundant in the Chinese herb Polygonum cuspidatum (Hu zhang), sometimes referred to as Bushy knotweed. Resveratrol studies showed dramatic benefits as a potent antioxidant, aid to vascular health, anti-cancer agent, neuroprotective agent, a stimulator of lypolysis and modulator of fatty acid metabolism, and an anti-angiogenesis agent. This dramatic set of benefits spurred the American pharmaceutical industry to try to synthesize a version of resveratrol that could be patented and widely used in standard medicine, but also led to a huge propaganda campaign insisting that resveratrol was merely a component of red wine. The amount of resveratrol in grape skin, though, was minimal, and studies showed that a consumption of gallons of red wine per day would be needed to achieve effective dose. Nevertheless, as resveratrol gained popularity in prescription by medical doctors, all advertising and advice suggested that resveratrol was derived from red wine, whereas the actual source in supplements was the Chinese herb Polygonum cuspidatum. Resveratrol, a phytoalexin, was found to affect chemical messengers called sirtuins dramatically, but scientific study found a wide range of metabolic effects, and synergy with a number of cellular messengers. Combinations with various other herbal and nutrient chemicals showed greatly enhanced beneficial effects, especially with combination of resveratrol with quercetin and genistein, as well as other antioxidant chemicals in medicinal berries. Today, these combinations of resveratrol with other chemicals provide significant potential for resveratrol as a medicine. More and more studies demonstrate that resveratrol is able to reverse cellular oxidative stress affecting superoxides and reductions of endothelial nitric oxide synthase, and a number of studies have shown that resveratrol and quercetin offer promise of positive effect on exercise-induced oxidative stress and muscle damage as well, especially when combined with other herbal and nutrient polyphenols and catechins.
  • Coenzyme Q10: highly praised and utilized in Japanese medicine, CoQ10 was first discovered at the University of Wisconsin in 1957, and since has been the subject of much study. The use of certain pharmaceutical drugs, such as statins, may deplete CoQ10, requiring some supplementation. Also, the chronically ill and infirm may suffer from a deficiency. Migraine sufferers benefitted significantly in 2 randomized controlled trials. Patients suffering a heart attack increase survivability from a second attack by using CoQ10, according to a randomized controlled study, and meta-analysis reveals that it is helpful in reducing high blood pressure significantly. The amino acid L-tyrosine and the Vitamin B5 pantothenic acid are necessary parts of its synthesis in the body, and may be utilized. It is a lipid-based antioxidant like Vitamin E, and may be found in herring and mackerel, or taken as a pill. It benefits mitochondrial health, and thus may be beneficial in neurodegenerative conditions. CoQ10-H2 is a newer patented form of a more active CoQ10 metabolite, able to provide cells more CoQ10 with a lower dosage, and stimulates more CoQ10 in circulation. CoQ10 enhanced with mixed tocopherols (Vitamin E) also are proven to supply a profound benefit to the liver, and aid regeneration of Vitamin E tocopherols in cell membranes. This form of enhanced CoQ10 is also found to be more bioavailable and naturally solubilized for greater absorption, with such added ingredients as d-limonene oil, glycerin, medium chain triglycerides, turmeric extract and zinc oxide added in a patented process to benefit the liver cells and reduce oxidized lipids. Clinical trials have demonstrated that a combination of CoQ10, vitamin B2, and Magnesium provide relief and prevention of migraine headaches comparable to standard pharmaceutical medication.
  • Melatonin: this hormone and neurotransmitter may be the most efficient free radical scavenger identified to date. Unfortunately, it is highly regulated in the body, and excessive supplementation may have effects that the patient doesn't like. It is good to correct any hormonal and neurotransmitter or CNS imbalances in order to insure efficient production and use of melatonin in the body. It also stimulates increases glutathione peroxidase activity in the body, and produces this indirect antioxidant benefit.
  • Glutathione-enriched yeast and rice embryo/soybean extract (GEY/RES): this new product is being researched to reduce the effects of hangovers and alcohol toxicity, and is found to modulate alcohol-metabolizing enzymes and exert significant antioxidant effects, reducing blood acetaldehyde and alcohol concentrations while also reducing related reactive oxidative free radicals. While not readily available on the market yet, such novel nutrient medicines are being explored for the future.
  • Selenium: selenium is an essential mineral nutrient and strong antioxidant, as well as an active component of glutathione peroxidase enzyme. It is found in pecans, Brazilnuts, milk thistle, sorrel, and wheatgrass in high concentrations, and in smaller amounts in pumpkin seed, thyme, raspberry and black walnut. It is also found in a number of Chinese and native herbs, including He shou wu, Sheng ma, Ginseng, crampbark, nettle, echinacea, buchu, lemongrass, and barberry. Supplementation is often used in cases of hypothyroidism and immune dysfunction. The supplement methylselenocysteine supplies a more usable selenium with a key amino acid, cysteine, in the antioxidant enzyme pathways.
  • R-Lipoic Acid: lipoic acid is a thioctic acid that is naturally occurring in the body and R-Lipoic Acid is the isomer that is endogenously synthesized in the mitochondria of cells, particularly CNS, or brain cells. R-Lipoic acid is an essential cofactor for several mitochondrial enzyme complexes related to energy production and to enzyme dependant antioxidant activity. R-Lipoic acid may be reduced in the cell to DHLA, which is shown to effectively reduce ROS (reactive oxygen species) and RNS (reactive nitrogen species), although this antioxidant activity is of short duration. The greatest benefit of DHLA is that it is able to oxidize glutathione, ascorbic acid and CoQ10, which in effect recycles, or regenerates, these potent antioxidants. Concurrant use with CoQ10 or supplements that increase glutathione metabolism will perhaps increase its effect. R-Lipoic acid and DHLA are also able to chelate iron and copper accumulation in the tissues, preventing these metal ions from generating free radicals, and providing significant neuroprotection.
  • Iodine and Iodide / Iodoral: iodine is an essential mineral that is a key component of thyroid hormones, and iodine deficiency is a prevalent problem in modern industrialized countries due to depletion of iodine from the soil due to modern farming methods, as well as the halide competition from chlorine, fluoride, and bromides, which are much used in commercial products and added to the water supply. Much of the iodine in the body is derived from iodide, which is a potent antioxidant in the thyroid gland and breast tissue (90% of the iodine and iodide in the body is stored in the thyroid and breast tissues). Iodine deficient states are proven to create significant oxidative stress through overuse of available iodide in tissues, reducing antioxidant protection, and conversely, lack of iodide in oxidative stress is shown to create a lack of available iodine and results in hypothyroid states and excess TSH production. In states of oxidative stress, such as goiter, nodular thyroid disease, or breast cancer, the cytotoxic effects of iodide are greater when there is selenium deficiency and a lack of antioxidative enzyme activity. In these diseases, we want the iodide to exert a cytotoxic effect against cancer cells and abnormal tissue growths. Health data has long found that populations that are not iodine deficient, such as Japan, with a routine diet of iodine rich seaweed, have much lower incidence of breast cancer. In the mid-twentieth century, the association of iodine deficiency in the U.S. with goiter and toxic nodular thyroid disease prompted public health experts to demand an addition of iodine to table salt and drinking water, and a dramatic decrease in these diseases resulted. Since then, table salt manufacturers have adopted poor quality iodine additive, bromides have been substituted in drinking water, commercial bakery products, and even pesticides, competing with normal iodine absorption and assimilation. Fluorine and chlorine, also negative competers with iodine, have also been increased in our water, and toothpastes. Iodine and selenium deficiency combined is also found to be related to thyroid cancers and benign growths. Measurement of iodine via challenge with urinary testing (24 hour collection), or professional assessment of health profile, has been needed to predict true iodine deficient states. Recently, though, ZRT laboratories have completed their refinement of complex testing and assessment of iodine levels utilizing a simple urine dipstick test. Supplementation should always be guided by a health professional, as there is a possibility that long term high dose supplementation could decrease antioxidant protection overall. Iodoral is a product with balanced iodide and iodine, available in low to high dose. Concurrent use of selenium, methylselenium, and/or supplements to increase glutathione metabolism are recommended to enhance the antioxidant effect. SOD may also be a potent antioxidant to take concurrently. If iodine deficiency is suspected, concurrent use of dried barleygrass powder and methylselenocysteine may potentiate the antioxidant effects. To guard against adverse reactions and antioxidant stress, gradual increase in Iodoral dosage to desired leveles, and gradual decrease when finishing the course is recommended, and caution is advised for any prolonged supplementation with moderate to high dose. Since iodine and iodide store in thyroid and breast tissues, prolonged supplementation is unnecessary.
  • AL-Neutralizer, or Aldehyde reducing antioxidant formula: as stated above, aldehydes are byproducts of various types of oxidant stress, especially when excess fermentation occurs in the gut, excess alcohol is consumed, or when candida overgrowth affects one. Studies of oxidant stress in the brain following short periods of decreased blood flow, or ischemia, which occurs in strokes and transient ischemic attacks (TIAs), show that malondialdehyde levels significantly increase as antioxidant acitivity in lipid peroxidation stress occurs. Aiding clearance of aldehydes with a formula of antioxidants has been shown to decrease symptoms related to chronic candidiasis considerably, especially the foggy brain, or hangover effect, often seen in this disease. A blend of Vitamin C, B1 as thiamin hydrochloride and pyrophosphate, B2 as riboflavin-5-phosphate, B3 as niacinamide, B6 as P5P, B5 as pantothenic acid, chelated magnesium, zinc, molybdenum, N-acetyl cysteine, betaine, and R-lipoic acid combine to form this potent aldehyde clearing product, available from Vitamin Research Products.
  • Flavonoids in herbs and foods: over 4000 polyphenolic compounds called flavonoids (water soluble aromatic oxygen-containing antioxidant compounds such as flavones and anthocyanins, often found in plant pigments), have been studied for their beneficial effects, and in a short time will be integrated into standard pharmaceutical products. Most Chinese herbs contain these flavonoids, with some of them now well studied, such as curcuma, quercetin, green tea catechins, and proanthocyanidins (OPCs).

There have been some reports of adverse effects of certain antioxidant use, although careful analysis has discounted this proof. Some studies using limited data have reported slight increases in mortality in smokers suffering from lung cancer, but no health risk was seen when all the randomized controlled studies were examined together. Some oil-based antioxidants may achieve toxic levels at high dosage, and this should be avoided, but most antioxidants are water-based and excreted efficiently in the body. Some herbs with high antioxidant content may interfere with efficient absorption of mineral nutrients in the diet. For this reason, herbs are generally taken between meals. It has been speculated that anti-oxidant therapy may interfere, theoretically, with radiation or chemotherapy, but multiple clinical trials have indicated that there are only beneficial effects in simultaneous use of antioxidants and these therapies in cancer treatment protocol. A high dosage of alph-tocopherol Vitamin D was associated with some negative outcomes in clinical trials, but not when concurrent supplementation with selenium was used, and now mixed tocopherols are recommended if a higher dosage or longer duration treatment is used. As with all therapies, a balanced effect and restoration of the natural homeostatic mechanisms of the body should be the goal, not an allopathic effect of altering the homeostasis. Restoring healthy function and letting the body do what it is genetically programmed to do is the most sensible strategy.

Information Resources and Links to Scientific Studies

  1. A 2008 comprehensive overview of oxidant free radicals and oxidative stress in disease was provided by experts at the Stanford University School of Medicine, in Palo Alto, California, U.S.A., the University of Paris, France, and the China Pharmaceutical University, in Nanjing, China, showing the importance of herbal antioxidants. The mechanisms by which excess accumulation of reactive oxygen species damage cells, tissues and genetic expression for specific diseases are presented, and the importance of herbal antioxidants is of course discussed. This class of antioxidants, mainly termed flavonoids, of which some 4000 are studied, comprise a large array of unique combinations in herbs and foods that act synergistically to provide a large array of beneficial effects. It is becoming accepted that professional antioxidant therapy will soon be integrated into standard care and preventive medicine: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614697/
  2. A 2007 review of the importance of various types of antioxidants in an array of diseases was presented by Dr. Khalid Rahman of the Liverpool John Moores University School of Biomedical Sciences, in the United Kingdom. We see the relationship between the different types of antioxidants, nutrients and cofactors needed to produce them in the metabolism, and how specific antioxidants are needed for specific health problems: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684512/
  3. A 2006 study at the New York University School of Medicine found that aldehydes are ubiquitous in our environment and may play an important role in oxidative-stress related disease and cancer: http://www.ncbi.nlm.nih.gov/pubmed/16872641
  4. A comprehensive 2007 study at the University of California at Los Angeles (UCLA) found that oxidative stress at the cellular level, related to mitochondrial energy production, is perhaps the most important aspect of cardiovascular health and disease. Decrease in oxidative stress and glutathione potential, as well as selenium deficiency, and decrease in endothelial nitric oxide synthase (eNOS), were found to be important considerations. Reducing dietary and lifestyle stresses on these factors, enhancing mitochondrial health, and supporting cellular detoxification and antioxidant metabolism is shown to be perhaps the most important aspect of prevention of cardiovascular disease, as well as a potential aid in therapy: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700041/
  5. A 2010 study at the University of Lisbone, Research Institute for Medicines, in Spain, confirms that carbon-based mercury toxicity (see info on this on this website) is successfully cleared with various antioxidant and chelating therapies, such as selenite, alpha lipoic acid, increased glutathione (GSH), dimercaprol (BAL), and DMSA. These may clear mercury accumulation and inhibit harmful mechanisms, allowing N-acetyl cysteine, selenocysteine, and other agent work to clear tissue toxicity better: http://www.ncbi.nlm.nih.gov/pubmed/20810785
  6. An October 6, 2010 article in the New York Times Health section reports that studies of pharmaceutical antioxidant drugs, which block production of free radical oxidants rather than help the body normalize oxidant stress, comes with significant potential ill effects. Studies also showed that simple loading of antioxidants might inhibit the natural production of endogenous antioxidants, and chronic use of these supplements is not recommended: http:/well.blogs.nytimes.com/2010/10/06/phys-ed-free-the-free-radicals/
  7. A 2005 study in Leipzig, Germany, showed that simple chronic taking of antioxidant supplements could have negative effects on the long-term health and function of the body. Taking antioxidants when needed is important: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680430/
  8. A 2003 study at University College Dublin, Ireland, showed that iodine and iodide appear to play a significant antioxidant role in the thyroid and breast: http://www.ncbi.nlm.nih.gov/pubmed/14757962
  9. A 2006 study at China Medical University in Shenyang, China, found that supplementation with iodine / potassium iodide solution for a period of time alleviated oxidative injury to the thyroid and reduced the need for glutathione and SOD activity in the thyroid. This product is called Iodoral, or Lugol's Solution. There is speculation that excess prolonged iodine supplementation may weaken anti-oxidative protections, but this is still unclear. Nevertheless, professional guidance and caution with prolonged higher dosage of iodine supplementation is warranted: http://www.ncbi.nlm.nih.gov/pubmed/16796889
  10. A 2008 study at the Beijing University of TCM in China demonstrated that specific point stimulations in acupuncture achieved targeted and significant antioxidant effects: http://www.ncbi.nlm.nih.gov/pubmed/18481726
  11. A 2012 study at the School of Aethetic Medicine, in Yichun, China, found that acupuncture beneficially modulates superoxide dismutase (SOD) activity, glutathione metabolism (GSH-PX), and clears malonaldehyde toxicity: http://www.ncbi.nlm.nih.gov/pubmed/22574567
  12. A 2012 study at the Federal University of Ceara, Fortaleza, Brazil, showed with a level of evidence of 2 (ratings go from 1-3) that both manual acupuncture and electroacupuncture, at the points Du14, DU2, and LV13, decreased oxidant stress and increased glutathione metabolism both locally and systemically: http://www.ncbi.nlm.nih.gov/pubmed/22678136
  13. A 2011 study at Kansai University of Health Sciences, Osaka, Japan, found that both manual acupuncture and electroacupuncture increased glutathione metabolism significantly in muscle tissues. It was also found that the amino acid carnitine, associated with muscle fatigue, was increased by manual acupuncture, but not by electroacupuncture: http://www.ncbi.nlm.nih.gov/pubmed/19592478
  14. A 2015 study at 5 University Medical Schools in Taiwan found that electroacupuncture at the single point LV3 produced a number of physiological reactions that could help lower high blood pressure and benefit heart muscle and function. One of these benefits measured was the increased expression of superoxide dismutase (SOD), a key antioxidant enzyme needed to clear superoxides: http://www.ncbi.nlm.nih.gov/pubmed/26566622
  15. A 2015 study at Capital Medical University, in Beijing, China found that the well-studied neuroprotective effects of acupuncture stimulation are achieved partly via the Nrf2 pathway of expression to counter oxidative stress: http://www.ncbi.nlm.nih.gov/pubmed/?term=nrf2+acupuncture
  16. A 2008 Korean study of Traditional Chinese herbs measured their antioxidant capacity and explains which herbs were the most potent, some boosting the antioxidant capacity in the body by 150-300%. The variance in measurable effects utilizing different processes of measurement suggest that different herbs exert different types of antioxidant effect, though: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814189/
  17. A 2015 study at the Shanghai University of Traditional Chinese Medicine, in Shanghai, China, showed that a fermented form of cultivated Cordyceps (Dong chong xia cao), now widely produced and utilized in China due to the scarcity and demand of the limited supply of wild Cordyceps, significantly increases the glutathione peroxidase and catalase metabolism, total superoxide dismutase (SOD) in heart tissue, reduces toxic malondialdehyde in liver and heart tissues, and exerts significant clearing of oxidant radicals. The study was performed on laboratory animals with induced oxidant stress from the chemotherapy drug doxorubicin. Such study in the laboratory demonstrates the value of this herb, traditionally used to boost immune strength and benefit heart health: http://www.ncbi.nlm.nih.gov/pubmed/26600716
  18. A 2011 study at the King Abdulaziz University School of Medicine, in Jeddah, Saudi Arabia, found that the herb Bilberry (Vaccinium myrtillus) exerts strong antioxidant protective effects against cardiac toxicity in laboratory animals treated with the chemotherapy drug doxirubicin, reducing glutathione depletion, malondialdehyde toxin, and increasing superoxide dismutase and glutathione peroxidase acivities: http://www.ncbi.nlm.nih.gov/pubmed/21455099
  19. A 2016 study at the Tianjin University of TCM and the Nankai University College of Medicine, in China, showed that a key chemical in the Chinese herb Trypterygium wilfordii, or Lei gong teng, called triptolide, exerts up-regulation of SOD, or superoxide dismutase, and downregulates generation of excess oxidative free radicals, protecting brain cells from such damage as seen in Alzheimer's disease from excess accumulatoin of beta-amyloid plaques: http://www.ncbi.nlm.nih.gov/pubmed/26679104
  20. A 2005 study at IMIM in Barcelona, Spain, a renowned research university, showed that the supplement N-acetyl cysteine (NAC) induces superoxide dismutase (SOD) and clearly increases manganese SOD in muscle tissue: http://www.ncbi.nlm.nih.gov/pubmed/16319332
  21. A 2008 review of extensive Russian research over 40 years concerning the antioxidant and adaptogenic effects of chemicals in Schisandra chinensis (Wu wei zi), a potent medicinal berry much used in Chinese herbal therapy, showed that this herb strong antioxidant activities, and benefitted the central nervous, sympathetic, endocrine, immune, respiratory, cardiovascular, and gastrointestinal systems.: http://www.ncbi.nlm.nih.gov/pubmed/18515024
  22. A 2012 study at National Taiwan University in Taipei, Taiwan, found that the active herbal chemical Resveratrol, found in a number of Chinese medicinal herbs as well as grape skins, but in high concentration in Polygonum cuspidatum (Hu zhong), effectively activated cellular pathways that upregulated the gene expression Nrf2, central to regulation of many antioxidant and detoxification pathways. Resveratrol, a potent herbal chemical, was also found to elevate glucose uptake and protect against insulin resistance in liver cells. Such scientific study is clarifying how these herbal chemicals produce such dramatic antioxidant effects: http://www.ncbi.nlm.nih.gov/pubmed/22917016
  23. A 2012 study at Gazi University, in Ankara, Turkey found that high-fructose corn syrup, the most widely used sweetener in food production, causes increased vascular oxidative stress as well as metabolic disturbances. Laboratory animals fed high-fructose corn syrup showed an increase in cellular superoxide production and decreased eNOS (endothelial nitric oxide synthase), and the chemical Resveratrol, derived from various Chinese herbs, was found to reverse this oxidant vascular damage: http://www.ncbi.nlm.nih.gov/pubmed/22465803
  24. A 2012 study at Firat University, in Elazig, Turkey, found that the Chinese herbal chemical Curcumin, found in a number of common Chinese medicinal herbs, including Curcuma zedoaria (E zhu), Curcuma aromatica (Yu jin) and Turmeric (Jiang huang), exerts a significant antioxidant effect attributable to modulation of the genetic signaling pathway of Nrf2 expression, as well as expression of HO-1 heat shock proteins: http://www.ncbi.nlm.nih.gov/pubmed/22939939
  25. A 2015 study at the University of Arkansas School of Medicine, in the U.S., the Hubei University of Chinese Medicine, and the Huazhong University of Science and Technology, in China, showed in a laboratory study that the chemicals in the Chinese herb Mu dan pi, or Moutan cortex, markedly increased the activity of superoxide dismutase (SOD) and glutathione, as well as reduced significantly the malondialdehyde content of cells and promoted the antioxidant metabolism in a number of ways. Genetic antioxidant expression was upregulated as well, and this showed that Mu dan pi extract was protective against myocardial infarct (heart attack) and leukemia: http://www.ncbi.nlm.nih.gov/pubmed/26610043
  26. A 2015 randomized controlled study of the antioxidant effects of a Chinese herbal formula entitled B401, by experts at the National Taiwan Normal University, in Taipei, Taiwan, showed that this formula significantly reduced reactive oxygen species (ROS) and increased expression of the antioxidant enzyme superoxide dismutase 2 in brain tissues, showing the potential for this TCM herbal formula to treat and prevent neurodegenerative disease, such as Alzheimer's and Parkinsonism. Formula B401 has been widely studied for an array of benefits in aging, and consists of Ginseng (Ren shen), Dang gui (Angelica sinensis), Shu di huang (Rhemannia glutinosa), Huang qi (Astragalus), Nu zhen zi (Ligustrum lucidum) and Han lian (Eclipta prostrata), all very common herbs in many Chinese formulas: http://www.ncbi.nlm.nih.gov/pubmed/26609226