Age – Associated Oxidative Stress

Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through D-quality evidence.

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

Age – Associated Oxidative Stress

Description:
The biomarkers of oxidative stress have been strongly linked to aging.1,2 Oxidative stress biomarkers, such as lipoprotein phospholipase A2 (Lp-PLA2), isoprostanes, malondialdehyde (MDA), 8-hydroxy-2-deoxyguanosine (8-Oxo-dG), derivatives of reactive oxygen metabolites, oxidized glutathione/glutathione, 4-hydroxy-2, 3-nonenal (4-HNE), and protein carbonylation, have been linked to increased frailty and pre-frailty.1 In addition, cardiovascular mortality has been associated with increased serum markers of oxidative stress, such as derivatives of reactive oxygen metabolites (D-ROM) and total thiol levels (TTL).2

CoEnzyme Q10

100-200mg, once per day, minimum 12 weeks3,4,5

Superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were increased, and malondialdehyde (MDA) and diene levels were decreased after CoQ10 supplementation3,5,6
CoQ10 supplementation has been shown to decrease the level of age-related cardiovascular fibrosis through its antioxidant and anti-inflammatory actions4,7
- Endothelium function was shown to be improved with CoQ10 supplementation by counteracting the oxidation of nitric oxide8
- CoQ10 supplementation was shown to increase brachial artery flow-mediated dilatation (FMD) by altering local vascular oxidative stress4

CoEnzyme Q10 in the Fullscript catalog.

Curcumin

2000mg (Longvida®), once per day, minimum 12 weeks9

Curcumin (in a Longvida® proprietary preparation) supplementation has been shown to increase vascular nitric oxide bioavailability, reduce oxidative stress, and, therefore, improve artery endothelial resistance9
IL-6, hs-CRP, and MDA levels have all been shown to be decreased by curcumin10
Malondialdehyde (MDA) was lowered by curcuminoids at a dose of 600mg per day; when piperine was used in combination, the effect was greater11
Curcumin may also increase superoxide dismutase (SOD) activity11

Curcumin in the Fullscript catalog.

Polyphenols

299-745mg, once per day, minimum 5 weeks12,13

8-hydroxy-2′-deoxyguanosine (8-Oxo-dG), 8-iso-prostaglandin F2α (8-iso-PGF2α), erythrocyte catalase, and glutathione reductase (GR) activities were all reduced12
Waist circumference, body mass index, and leptin were decreased in overweight or obese nonsmoking subjects12
Glutathione peroxidase (GSH-Px) activity was increased and CRP levels remained stable compared to placebo13
Resveratrol has been shown to up-regulate plasma membrane redox system (PMRS) and ascorbate free radical reductase14
In different age groups, resveratrol provided protection against protein carbonylation and lipid peroxidation; cellular levels of glutathione (GSH) and sulfhydryl (-SH) was restored during oxidative injury in erythrocytes14

Polyphenols in the Fullscript catalog

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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References

1

A

https://www.ncbi.nlm.nih.gov/pubmed/28364871

2

A

https://pubmed.ncbi.nlm.nih.gov/26666526/

3

B

https://www.ncbi.nlm.nih.gov/pubmed/29936921

4

C

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671099/

5

C

https://www.ncbi.nlm.nih.gov/pubmed/21996047

6

A

https://www.ncbi.nlm.nih.gov/pubmed/30758695

7

A

https://link.springer.com/chapter/10.1007%2F978-3-030-25650-0_6

8

C

https://www.ncbi.nlm.nih.gov/pubmed/17644511/

9

C

https://www.ncbi.nlm.nih.gov/pubmed/28070018

10

A

https://www.ncbi.nlm.nih.gov/pubmed/30402990

11

A

https://www.ncbi.nlm.nih.gov/pubmed/30527253

12

C

https://www.ncbi.nlm.nih.gov/pubmed/26136593

13

C

https://www.ncbi.nlm.nih.gov/pubmed/25517279

14

D

https://pubmed.ncbi.nlm.nih.gov/23537202/

Aging – Skin Health

Collagen

Total of 2.5-10g per day, minimum 4 weeks2,3,4,5,6,7,8

Collagen supplementation increases skin hydration, elasticity, and dermal collagen density1
Type I collagen hydrolysate derived from fish has been shown to improve wrinkles and roughness, as well as increase collagen density, skin firmness, skin moisture, and skin elasticity2,7,8
Bioactive collagen peptides have been shown to reduce skin wrinkles, have a positive effect on dermal matrix synthesis, and increase procollagen type 1 and elastin3,4

Collagen in the Fullscript catalog.

Hyaluronic Acid

Oral: 120mg, once per day, minimum 6 weeks9,10
Topical: Apply 0.1% hyaluronan formulations, twice per day, minimum 2 months12

Oral hyaluronic acid has been shown to increase skin moisture content and skin elasticity9,11
Compared to placebo, greater improvements in wrinkle volume ratio, wrinkle area ratio, and whole sulcus volume ratio were observed when oral hyaluronic acid was administered10
Significant reduction in wrinkles was observed when oral hyaluronic acid was consumed for more10
Topical hyaluronic acid administration produced greater improvements in skin hydration, skin firmness, overall elasticity, and wrinkle depth when compared to placebo12,13,14

For a more detailed review of collage, refer to the Fullscript reference sheet: https://fullscript.com/hcp/collagen

Hyaluronic Acid in the Fullscript catalog

References

1

A

https://www.ncbi.nlm.nih.gov/pubmed/30681787

2

B

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206255/

3

B

https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.12174

4

B

https://www.researchgate.net/publication/259628887_Oral_Intake_of_Specific_Bioactive_Collagen_Peptides_Reduces_Skin_Wrinkles_and_Increases_Dermal_Matrix_Synthesis

5

B

https://www.jstage.jst.go.jp/article/nskkk/56/3/56_3_137/_article/-char/en

6

B

https://www.researchgate.net/publication/255957972_Oral_Supplementation_of_Specific_Collagen_Peptides_Has_Beneficial_Effects_on_Human_Skin_Physiology_A_Double-Blind_Placebo-Controlled_Study

7

B

https://globalhp.com/wp-content/uploads/2018/08/PO-OG-Improves-Facial-Skin-Conditions.pdf

8

B

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073484/

9

B

https://pubmed.ncbi.nlm.nih.gov/25834304/

10

B

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522662

11

D

https://pubmed.ncbi.nlm.nih.gov/29228816/

Aging and Longevity Support

Multivitamin

Multivitamin formulation, minimum 8 weeks1

Multivitamin use was associated with longer telomere length in women aged 35 to 742
Multivitamins containing a combination of minerals and herbs were shown to decrease perceived mental stress in an elderly population several hours after intake4
Multivitamin intake in elderly women was associated with an increase in inhibitory neural processes, which translates into an improvement in neural efficiency during memory retrieval3
Multivitamins were shown to improve alertness and negative mood symptoms in men aged 50 to 69 years old1

Multivitamin in the Fullscript catalog.

Omega-3 fatty acids

1.25-2.5g of Omega-3 PUFA, total per day, minimum 8 weeks5,6,7

Omega-3 PUFA has been shown to increase telomerase levels and lengths5,6
Omega-3 PUFAs have shown to reduce IL-1β, TNF-α, and IL-6, factors that contribute to the effects of inflammaging7

For a more detailed review of Omega 3 fatty acids, refer to the Fullscript reference sheet: https://fullscript.com/hcp/fish-oil

Omega 3 fatty acids in the Fullscript catalog.

New and upcoming research:

Astragalus membracanus

10-50mg of TA-65, total per day, minimum 12 months8

Decline in the percentage of senescent cytotoxic T cells (CD8+ and CD28-) and natural killer cells were observed in seropositive patients9
TA-65 has been demonstrated a clinically significant effect in lengthening telomerase and decreasing the percentage of short telomerase8,9

Astragalus membracanus in the Fullscript catalog.