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TABLE 1.1

idants. When the body is severely deficient in antioxidants, white blood cells can no longer protect themselves from their own free radicals and, as a result, die in large numbers. This results in an impaired immune system, leading to a worsening of the infection.

Stress: Worrying Up Free Radicals

Most of us think of stress in terms of psychological stress: being overworked or worried about bills and our future. In fact, stress is defined as anything that upsets our normal state of well-being, and can include extreme physical exhaustion, trauma, and even infections. Yet, medical science has gradually come to realize that psychological stress can actually do physical harm. Recent experiments using stressed animals have demonstrated that unrelieved stress results in a dramatic increase in free-radical generation within virtually every area of the brain—cortex, striatum, and hippocampus. In such cases, free-radical overproduction is the result of oxidation of neurochemicals (epinephrine, norepinephrine, and dopamine) within the brain that are released during stress, producing significant injury to vital brain structures.

It has been shown in both experimental animals and in humans that chronic, unrelieved stress can produce permanent damage to the brain. Humans placed under the extreme stress of captivity, such as POWs and those subjected to torture and prolonged sleep deprivation, may never fully recover. Ironically, brief periods of stress interspersed with periods of rest actually strengthens the brain. The bottom line is that during periods of intense stress we need to increase our antioxidant defenses.

Environmental Toxins

The toxicity caused by many poisons found in nature, as well as man-made toxins, are known to do their damage, in large part, by generating free radicals within tissues. For example, aluminum has been shown to trigger an enormous number of free radicals in tissues, especially in brain tissue. The same is true for iron, lead, mercury, and cadmium.

Fluoride, even in the small amounts added to drinking water, is also a powerful generator of free radicals. When combined with aluminum, as in most public drinking water, toxicity to the brain is increased significantly. While the amount of fluoride in drinking water is in the range of 1-3 ppm, in toothpaste it can be as much as 1,500 ppm. Brushing your teeth with fluoridated toothpaste exposes you to very high levels of this extremely toxic compound.

As for pesticides and herbicides, many kill insects and unwanted plants by causing them to generate extremely high levels of free radicals in their tissues. The herbicide paraquat, for example, is known to produce incredibly high concentrations of free radicals in humans, so much so that it can completely destroy the lungs.

Another source of free-radical generation is the use of illegal drugs. Amphetamines, such as methamphetamine (meth) and dexadrine, can generate high concentrations of these destructive particles within the brain, leading to an increased risk of degenerative brain disorders, such as Parkinson's disease and Alzheimer's dementia, later in life. One designer drug, called MPTP, can cause severe, almost instant, onset of Parkinson's disease, after even a single dose. One of its modes of action is to produce free radicals within the part of the brain responsible for this disease. The effects are irreversible.

Processed foods are filled with numerous additives, most of which have never been tested to see if they increase free radicals within the body. But there is one, called carrageenan, that we know increases free radicals. A polysaccharide made from a seaweed, the substance is known to produce intense inflammatory reactions when injected into tissues. In fact, the intense reaction is so reproducible it is used when researchers want to study inflammation. As we learned above, inflammation is strongly associated with intense free-radical production within tissues.

Another food additive that has been shown to increase free-radical production is monosodium glutamate or MSG. This additive, used in the majority of processed foods, often in disguised names, has been shown to significantly increase free-radical production, not just in the brain but in many other tissues as well. What makes it particularly dangerous is that this increase in free-radical production persists for prolonged periods of time following even a single dose of MSG, an especially dangerous condition for a baby's developing brain, and in the elderly brain as well.

Finally, the artificial sweetener, aspartame (found in NutraSweet®, Equal®, Spoonful®, and others) contains multiple breakdown products and primary components (phenylalanine, aspartic acid and methanol) that have been shown to increase free-radical production. For example, formaldehyde and formic acid formed from the breakdown of methanol, have been shown to severely damage DNA, most likely by such a mechanism. Another component, aspartic acid, is an excitotoxin that increases free-radical generation within the brain, especially the parts related to memory and fine coordinated movements.

Radiation: The Sun

We have known for some time that radiation damages tissues by increasing production of free radicals throughout cells and extracellular tissues. One of the best examples of this effect is exposure to the sun: the sun's rays contain damaging radiation in the form of UVA and UVB wavelength light. These rays penetrate deep into the layers of the skin where they interact with skin cells and produce large amounts of free radicals, leading to damaged DNA, cell proteins, and membranes. When free radicals interact with the skin's collagen and elastic tissues, these fibers are weakened, causing sagging and wrinkling of the skin. This is why sun worshippers develop early and extensive wrinkling and sagging of exposed skin.

Fair-skinned people who sit in the sun for thirty minutes or more develop a deep reddening of the skin we call a sunburn—and it does burn. This is a good example of the destructive power of free radicals. With exposure under these conditions, so many free radicals are produced that the skin's antioxidant defenses are quickly depleted, leaving the skin totally unprotected against further free-radical injury. This is why the skin suddenly turns red. Repeated burning of the skin dramatically increases the risk of skin cancer, especially a highly fatal form called malignant melanoma. If you fall asleep in the sun for several hours, the destructive effect of free radicals can be so extensive as to cause your skin to break down, with the appearance of blistering and even ulceration of the skin. Extreme exposure to the sun can result in severe systemic effects we call sun poisoning: this will land you in the intensive care unit.

A good example of the vital importance of antioxidants in the skin is found in cases of a rare genetic disease called xeroderma pigmentosum, in which a person is born with virtually no antioxidant defenses, especially in the skin. Even mild exposure to the sun can cause extensive destruction and promote the development of multiple skin cancers. Even more frightening is that the risk of developing internal cancers also increases substantially. Antioxidant supplementation can significantly reduce the risk of developing these sun-related cancers.

Topical as well as oral antioxidants provide significant protection against free-radical damage to the skin and delay skin aging.

X-rays: Diagnostic and Therapeutic

Most of us at some time or other have had x-rays taken. In the 1960s and 1970s it was considered wise to have a yearly chest x-ray to catch disease early, a preventive measure especially for cancer. Today, for the same reason, the medical establishment encourages all women to have an annual x-ray series for early detection of breast cancer, but each time x-rays pass

Free Radical Cell Damage
FIGURE 1.2 Demonstration of the intense bombardment by free radicals within a cell. These free radicals damage cell membranes, DNA, and protein enzymes.

through the body free radicals are produced. In the case of a chest x-ray or even a breast exam, this produces only minor elevation of free radicals and limited damage to the DNA with each dose—but the effect is accumulative.

More extensive radiological examinations, such as a lower and upper GI series or an arteriogram, can expose you to a significant amount of damaging x-rays. One estimate is that annual radiological breast exams increase the risk of breast cancer by 2 percent a year: over ten years you will have increased your risk 20 percent. This is not necessarily a call to avoid all mammograms, but you should increase your antioxidant defenses before you undergo such an exam. And there are other ways to screen for breast cancer that do not involve radiation, such as careful digital examinations, MRI scan, thermograms and ultrasound exams.

In the past, x-rays were used to treat benign conditions, such as scalp ringworm, scoliosis, tonsillitis, and to shrink the thymus gland. Being a new and untested tool, doctors thought it was harmless. It wasn't until a clever observer began to look at the high incidence of cancer and jawbone destruction seen in workers who painted radium watch dials that caution began to creep into this area. Madam Curie also died of cancer as a result of her extensive exposure to x-rays during her studies of the mysterious invisible ray.

Young girls exposed to gamma radiation to treat scoliosis were found later in life to demonstrate a very high incidence of breast cancer compared to those who had not been exposed. Likewise, children treated with radiation to rid them of ringworm infestations of the scalp were later found to have significantly increased rates of thyroid cancer, leukemia, and brain cancers.

One of the most tragic episodes in medical history occurred during the 1930s and 1940s when doctors using the new x-ray machine discovered a mysterious tumor appearing in the chest x-rays of small children. Suddenly, there occurred an epidemic of these dangerous-looking chest tumors discovered by the new roentgen machine. Some enterprising doctor decided to try the new roentgen-generating machine on the tumor. Sure enough, after a few treatments the tumor began to disappear. Ultimately, thousands of children were radiated to rid them of this "dangerous" tumor.

Thankfully, other doctors studied this so-called tumor—and discovered that it was the thymus gland! It seems the thymus gland is large during early childhood and slowly shrinks in size until it disappears from view later in life. Unfortunately for the young victims, the thymus gland is one of the major lymphatic organs responsible for the development of the immune system.

At one time, enlarged tonsils and adenoids were treated by the revolutionary non-surgical technique using the new x-ray machine. Those unfortunate victims were left to lead a life fraught with cancers of the esophagus, permanent immune suppression, and oral and facial cancers. I have seen one of these unfortunate people in my practice: the poor man now suffers a living hell every day of his life.

Now let us suppose that you are sixty-five years old and have poorly controlled diabetes. Your doctor decides you need to have a gallbladder x-ray series and an upper and lower GI series to find the cause of an unrelenting abdominal pain. By the time you have finished the x-ray series you will have a folder full of x-ray film that you can barely lift, and in the process will have received a significant dose of radiation to major areas of your body, including your bone marrow.

We now know that at the onset of diabetes, the body begins to produce an inordinate amount of free radicals and that the number of these free radicals increases dramatically as diabetic complications develop. Diabetes is even more treacherous for older people since free-radical production increases, the body's antioxidant supply is severely depleted, and tissues are much more vulnerable to the damaging effects of x-ray radiation. What to do?

If you know ahead of time that you will have an extensive radiological study, you should prepare yourself by increasing your antioxidant intake. Doing so will significantly lower your risk of cell, and especially DNA, damage. This has been shown in multiple studies. The antioxidants, alpha-lipoic acid, N-acetyl L-cysteine (NAC), and the carotenoids, are recommended in such cases. More about this in chapter nine.

Sometimes you face a situation in which you will be unable to plan ahead for an x-ray study. For instance, you may be in an automobile accident or develop an acute disease, such as a heart attack or stroke. It is for this reason that you should always keep your antioxidant defenses strong. In such cases, an ounce of prevention is certainly worth a pound of cure.

You may also face the unpleasant prospect of receiving very high doses of radiation when undergoing treatment for a cancerous disease. By concentrating the x-rays or gamma rays on the tumor, radiation oncologists are able to harness the destructive power of radiation against the cancer cells. The sensitivity of cancers varies: some tumors virtually melt away and others show next to no improvement under radiation therapy.

In the past, therapists were unable to direct radiation to the tumor alone and inadvertently radiated extensive volumes of normal tissues, resulting in hair loss, skin burns, and a breakdown of deep tissues. As a neurosurgery resident, some of my all-too-frequent cases were patients who had become paraplegic suddenly—even years later—following radiation treatment for chest tumors. The scatter radiation from the x-ray beam damaged the spinal cord resulting in prolonged radiation-induced free-radical damage. No one thought to increase the antioxidant defenses of these patients, even though the medical knowledge was available at the time—more evidence-based medicine.

Today, radiation oncology is much more sophisticated, using radiation types that spare the skin and concentrate the destructive beams mostly on the tumor. Still, some radiation does scatter into the surrounding normal tissues, and in patients with extensive tumors the health effects of this scatter effect can be significant. For twenty-six years I gave cancer patients powerful antioxidants before, during, and after their radiation treatments, with a significant reduction in complications and an improved effectiveness of the radiation against the tumor.

Radiation oncologists worry that using antioxidants during therapy will not only protect the surrounding normal tissue, but could also protect the tumor against the radiation as well. For this reason, many radiation oncologists will discourage their cancer patients from taking antioxidants. Several recent experiments have shown that specialized antioxidants not only do not protect the tumor from radiation injury, but actually enhance the x-rays' destructive power against the tumor, at the same time protecting normal tissues. This is because cancer cells are different, biochemically and structurally, from normal cells.

Because the body's immune defenses are concentrated in the bone marrow and lymph tissue, these sites are exceedingly sensitive to radiation injury. In addition, cells in these areas divide so rapidly they are much more sensitive to radiation injury. One thing you do not want to do during cancer treatment is to suppress the immune system, which is the most important destroyer of cancer cells. Even after your cancer is cured, your immune system runs a constant body-wide check (called immune surveillance) to make sure no new cancer cells appear. Antioxidants very effectively protect the immune system during radiation treatments, and are important even after treatment has stopped.

Low Magnesium and Free Radicals

Magnesium is one of the body's most incredible minerals. It plays a vital role in over three hundred biochemical reactions, protects the nervous system from strokes, excitotoxins, and other injuries, and acts as an antioxidant. A recent survey of a large number of healthy individuals found that over three-fourths were consuming less-than-recommended amounts of magnesium and two-thirds of that number had severe deficiencies. Further, certain medical conditions, such as cardiovascular disease, hypertension, diabetes, and renal disease, increase one's risk of low magnesium. Likewise, low magnesium levels increase complications associated with these diseases.

Magnesium is a mineral found mainly within the tissues and not the blood stream. Many doctors make the mistake of testing for blood levels of magnesium and conclude that normal findings indicate an adequate magnesium supply. This is just not true. You can have a normal blood value and very low tissue levels, which would put you at a very high risk for hardening of the arteries (atherosclerosis) and associated complications such as coronary heart disease, strokes, and peripheral vascular disease (poor blood supply to the extremities).

In addition, tissue magnesium deficiency puts you at a very high risk of developing a major neurological disease such as Parkinson's disease, Alzheimer's dementia, or ALS. One reason is that low magnesium levels in tissues double the number of free radicals in the body, and increase their killing ability over twofold. Adequate tissue magnesium levels are very protective against free-radical injury. In addition, magnesium dilates blood vessels, thereby improving blood flow to the brain, heart, and kidneys and, in addition, acts at the neuron membrane to prevent excitotoxic damage in the nervous system.

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