Thus far we have seen that free radicals are commonly produced during the normal energy-producing reactions within our cells; that is, it is part of life. What is less appreciated is the fact that if we increase our metabolism, we also increase free-radical production. So how do we increase our metabolism? One of the most common ways is by exercising. It is now known that intense exercise dramatically increases free-radical production and lipid peroxidation. This has been demonstrated in carefully conducted experiments in marathon runners and extreme athletes. There is also some evidence that extreme athletes have a higher incidence of free-radical diseases such as cancer, immune suppression, and cardiovascular disease.
Another way our metabolism is increased is by overactivity of the thyroid. Normally, the thyroid gland hormones regulate our metabolism. Overproduction increases metabolism (hyperthyroidism) and underproduction (hypothyroidism) slows metabolism. Persons suffering from hyperthyroidism require a greater supply of antioxidants to protect themselves against this increase in free-radical production. Medical practitioners rarely take this into consideration.
It was observed many years ago that underfeeding lengthens the life spans of several species of lower animals. This finding has been reproduced in scientific studies several times since then. At least two highly respected scientists maintain a very low food intake in an effort to increase their longevity. While no one has specifically connected free-radical generation to the phenomenon of aging, it is obvious that one of the effects of underfeeding is a reduction in the production of thyroid hormones and a slowing of metabolism. It is also well known that overfeeding, especially of high-energy foods like sugars and carbohydrates, dramatically increases metabolism and hence free-radical generation. So the whole effect of low-calorie diets may be related to decreasing metabolism and, therefore, a better way to increase longevity is to improve the body's antioxidant defenses rather than dramatically and dangerously lowering nutrient intake.
Along this same line, but less well-known, is the observation that low-protein diets also increase longevity and high-protein diets are linked to shortened life spans. If confirmed, this finding could diminish the popularity of the high-protein diets being advocated by some popular authors. We already know that high-protein diets increase the incidence of osteoporosis, heart disease, and kidney disease, and high-protein diets in certain diseases, such as Lou Gehrig's disease (ALS), have been shown to significantly elevate blood levels of several destructive amino acids, including glutamate and aspartate.
Infections, traumatic injuries, burns, and even stress all increase metabolism. In fact, with burns, severe infections, and extensive traumatic injuries, the metabolic rate can become very high, producing a dramatic increase in free radicals flooding the body. This explains, at least in part, the deadly nature of these disorders. Unfortunately, modern medical treatment rarely addresses the free-radical problem in the clinical setting. Rarely are such patients treated with increased antioxidants or any antioxidants at all, even though the medical literature clearly shows that rapid depletion of antioxidants is universal in all of these conditions—another example of the fallacy of so-called "evidence-based medicine."
As a neurosurgery resident in training, one of my responsibilities was to care for patients suffering from serious brain injuries. Having been interested in surgical nutrition, even as an intern, it amazed me to see these patients literally subsist on an intravenous infusion of water, salt, and glucose for weeks, with no other form of nutritional supplementation. These patients would come to us robust and healthy, and within three weeks to a month they would look like POWs in a communist gulag. It never dawned on anyone that the patients were literally starving, often to the point of death.
I knew from my own investigations into the metabolism of trauma that seriously injured patients have much higher metabolic rates than do persons at rest. In fact, their metabolisms are higher than those of persons running the Boston marathon! If these patients develop infections, which is likely in a starving person, their metabolic rates go up even higher. At the time we didn't know that much about free radicals, but it was obvious that unconscious people with very high metabolic rates needed more nutrition than sedentary people. Unfortunately, common sense does not always prevail in modern medicine.
After teaching myself how to administer high concentrations of nutrition intravenously or by a feeding tube inserted into the stomach, I started giving these patients an accelerated program of nutritional supplementation which included vitamins, minerals, trace elements and adequate amounts of proteins and carbohydrates. The results were dramatic in the salvageable patients: they regained lost weight, had fewer infections, and their neurological improvement exceeded anything I had seen before. Incredibly, it changed nothing as far as the protocol used by the chief of the service to treat trauma patients. They just kept right on starving patients. Unfortunately, little has changed twenty-five years later. I still see seriously ill patients lying in the hospital with IV bags containing only water, salt, and sugar.
Chronic smoldering infections and inflammations are also known to result in very intense generation of free radicals, a condition that has been demonstrated in such diseases as Lyme disease, viral hepatitis, encephalitis, lupus, rheumatoid arthritis, multiple sclerosis (MS), Alzheimer's disease, and Lou Gehrig's disease (ALS). All of these diseases improve with a judicious use of selected antioxidants. The reason for this is twofold.
First, inflammations and infections increase the metabolic rate, which as we have seen, increases free-radical generation. Second, the immune system attacks and destroys foreign invaders by releasing an intense barrage of free radicals from the white blood cells that have thronged to the site of the infection. For example, when bacteria invade your skin, your immune system sends a swarm of white blood cells and other immune cells to the site of invasion. As they approach the bacteria, the white blood cells dramatically increase their metabolism, producing a blast of free radicals which they release around the bacteria. It is the free radicals that kill the bacteria. So, you ask, why aren't the white blood cells also killed? It's because white blood cells have a very high concentration of antioxidants, about six times higher than normal cells.
When we have a smoldering infection that the immune system cannot kill outright, the free-radical attack by the body's immune system continues for years, leading to damage not only at the site of the attack, but to all tissues of the body. Increasingly, this is thought to be the basis of many so-called autoimmune diseases, such as rheumatoid arthritis and lupus. It may even explain many cases of arteriosclerosis. Ironically, even specialists treating these well-known free-radical diseases do not put their patients on increased doses of selected antiox-
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