Glutathione Supplementation

Great YouTube presentation.  I would like to get your well informed, recommendations for a good, but reasonably priced glutathione supplement for my mother who has been diagnosed with vascular dementia.  —D

Dear D,

I do not recommend a glutathione supplement yet, because none of the product vendors has done a long-term (months) deep-tissue assessment of glutathione levels, in humans or in animals.  Liposomal glutathione and Max GXL look good, but I don’t trust RBC (red blood cell) or WBC (white blood cell) data points without confirmation in muscle, liver or brain tissue.  More importantly, glutathione recycling is more easily and reliably affected by raising cellular metabolic rate.  The top-down approaches are easy and effective:  hormone replacement therapies with bioidentical T4, T3, cortisol, testosterone and progesterone, anti-estrogen therapies with aromatase inhibitors and estriol replacement, and biofeedback therapies (EEG, heart-rate variability, meditation, etc.).

The bottom-up approaches are also fairly easy and effective:  coconut oil, MCT oil in butter (50:50), carb-restricted diets, grain-free diets, mitochondrial nutrients (carnitine, ALC, lipoic acid, coenzyme Q10, B3, NADH, B1, B2), broad-spectrum nutrition (a multivitamin with minerals, a B-complex formula with about 10x RDA of each of the Bs, and higher-than-traditional D3).

I also think highly of neuroprotective therapies like pregnenolone, progesterone, deprenyl (selegiline), melatonin and DMSO (if having bad breath and body odor is not an issue).

In addition to the metabolic mechanisms, vascular dementia is more likely to have a immature-collagen pathology underlying it.  If collagen is not fully matured, it is not only weak (increased risk of hemorrhage) but also inflammatory (MMP-activating).  Collagen therapy is amazingly effective for cardiovascular diseases (see Matthias Rath’s protocol), as long as you have sufficient time for it to work (many weeks to many months).  The elements are:

Vitamin C
(1000 mg 4x daily, one gram with breakfast, lunch and dinner, and one gram before bed).  500 mg is maintenance.  Use acidic vitamin C (ascorbic acid) for with-meal dosing, to assist digestion.  Use buffered (neutralized) mineral ascorbates for before-bed dosing, to minimize stomach upset from too much acidity.  For aggressive protocol, add 1000 mg of buffered C on waking and between meals.

One complicating factor that is contraindicated for the vitamin C is clinical or subclinical hemochromatosis, or too-high iron levels.  If your mother has not had a serum ferritin test in the last five years, have one done ASAP (with her next medical visit).  While you are at it, get the rest of the iron assessment testing done:  transferrin, total iron binding capacity, and hemoglobin.  If she has had a serum ferritin test and it is not high (i.e., it is low or mid-range), then the C will work to make collagen more healthy instead of reacting with iron to produce free radicals that damage the vascular system AND having immature collagen.  High iron may be one of the critical risk factors for cardiovascular disease in middle-aged men, but nobody pays any attention to it.

Bioflavonoids (low dose, broad spectrum).  I don’t know of a supplement like this, but a workaround is to buy seven different bioflavonoids and rotate them daily.  Each can be labeled with a different day of the week to keep track.

Lysine, proline and glycine.  These three amino acids are required in high amounts to make collagen.  If vegetarian, you can give your mom these as free-form amino acids (roughly 2 grams of each).  Better, and less expensive, is to give predigested collagen protein (aka, hydrolyzed collagen protein), which dissolves in water and can be drunk, or it can be added to blender drinks and cooking recipes.

Copper, iron and silicon.  These three trace minerals are necessary for collagen maturation (cross-linking and hydroxylation, for strength and slipperiness, respectively).  Type-II copper deficiency is not fixed by taking copper supplements, but transdermal copper and copper bracelets do partially bypass the liver’s sequestration of copper.  Copper cream does in one day what copper bracelets do in a month.  Iron is somethibng to supplement ONLY when the serum ferritin level is low.  Even with full-blown anemia, iron should not be supplemented when serum ferritin is high.  Silicon is a micronutrient for collagen.  Horsetail grass herb is the traditional supplement.  Bamboo extracts are the new twist.  I have concerns about inorganic silicic acid supplements.

The D3 situation deserves special discussion due to vitamin D’s effects of calcium, ossification (bone building) and calcification (soft-tissue calcium deposition).  Calcification is often a secondary problem in vascular disease and vascular dementias.  The calcium stiffens soft plaque, turning it into concrete.  And it also deposits directly in vascular tissue, along with muscle and joint tissue.  So if your mother has hardening of the arteries and/or tissue/joint pain on flexing or massage, she could need higher D3 doses.  I’ve taken 50,000 IU for a month, and Dr. Prendergast has given many hundreds of his patuients 50,000 IU for 6-months to a year.  But he and I only do this with zero (or almost zero) calcium supplementation.  The D3 so enhances calcium utilization that 100 mg of calcium with high-dose vitamin D is like 1000 mg of calcium supplementation in a “normal” low-D human.  So the no-calcium protocol actually helps the high-dose vitamin D3 mobilize soft-tissue calcium and convert it into ossified calcium in the bone.  I consider 5000 IU of D3 to be a normal amount, which is less D than you would make exposed to the sun for an hour at noon while naked.  So 10,000 IU is a low-high dose, 25,000 IS is a medium-high dose and 50,000 is a high-high dose.  Two men, one taking 175,000 IU and the other 225,000 IU for more than a year got into the early stages of D toxicity.  But when calcium is carefully controlled, this risk is minimum.  Prendergast has never seen any D toxicity, and his specialty is endocrinology.

Nattokinase can be tried as a short-term assessment of coagulopathy.  It is an anti-fibrotic enzyme that is best taken between meals.  I think the best protocol is one capsule on Monday (upon rising), two capsules on Tuesday (one on rising, one before dinner), three on Wednesday (one on rising, one before dinner and one before bed), four on Thursday (one on rising, one mid-morning, one mid-afternoon and one before bed, and four on Friday, Saturday and Sunday.  If there is a positive cognitive trend over the week that maximizes at the end of the week, then a coagulopathy is likely.

Good luck.  —Steve  650-321-2374

PS:  Don’t forget that many drugs can produce dementia as a side effect.  Blood pressure, cholesterol drugs, and many more.

PPS:  Get audio and videotapes of her cognitive performance before and after to protect you and her from “professional” retaliation.  You can easily be accused of elder abuse (it has happened before!), and she can be victimized by being forced back into drug use.  So take the time to document everything.


I am not a medical professional so please excuse my lack of understanding but are you saying that cocnut oil can raise metabolic rate thus recycle glutathione. I though glutathione molecules are lost(egested/excreted with toxin) in its detoxifying processes. Also would you recommend NAC or N-Acetylcysteine as it is a (cheap compared to immunocal) suppliment containing probably the most difficult to obtain component of the glutathione molecule, cysteine. I heared of persons taking glutathione suppliments(like immunocal) for over a decade with good results are long term assesments of suppliments really that necessary after all I heard that NAC is used in hospitals.  Thanks again.


Loss of glutathione through conjugation with mercury and excretion through bile is minimal.  More importantly, it is immediately replaced by glutathione biosynthesis.  Glutathione is a tripeptide of cysteine, glutamate and glycine, all of which are reasonably available from animal (better) and vegetable (OK) proteins.

Glutathione only acts as an antioxidant in its reduced form.  When oxidized, it is no longer an antioxidant.  Oxidized glutathione (GSSG) is recycled into reduced glutathione (GSH) by NADPH, which is made from NADH, which is the immediate “energy” output of the Krebs cycle.  So yes, a glutathione molecule can be used hundreds or thousands of times as an antioxidant before getting irreversibly damaged or excreted.

Taking cysteine and NAC do raise glutathione in the short-term.  But the effect is not sustainable.  Cysteine is equally active as an antioxidant as glutathione, and cysteine is oxidized into Cystine and reduced back into cysteine, exactly parallel to glutathione.  So the cysteine acts exactly like glutathione in both redox chemistry, antioxidant and feedback suppression of glutathione biosynthesis.  So taking cysteine lowers glutathione over the longer term.  Cysteine also has pro-aging effects like tryptophan and histidine, so I suggest that you focus on the energy-based systems keeping your glutathione topped out, not on trying to increase the absolute amount of glutathione.

Testimonials are not reliable ways to judge the biochemistry of supplementation.  The placebo effect is huge (30%), and the under-reporting of adverse events can be 10 to one in a neutral environment, 100 to one in a social environment, and 1000 to one in a hostile environment.

Hospital use is no indication that something is either safe or effective.  Hospitals (and doctors) kill more people than cancer or heart disease.  And if the under-reporting problem is as bad as I think it is, iatrogenic death is greater than cancer and heart disease combined.

Although coconut oil can raise metabolic rate, it may not be significant in people with acute metabolic challenges, like B1 deficiency, lead poisoning, or estrogen dominance.  Figuring out the bottlenecks in energy systems takes some degree of sleuthing.  One formula does not fit everybody.   —Steve

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