Health Sciences Institute e-Alert
August 4, 2003
Dear Reader,
Brushing your teeth could save your life. That may sound like
an exaggeration, but it's not. Especially if your teeth and
gums are cleaned on a regular basis by a dental hygienist.
In the e-Alert "Revealing the Matrix" (5/21/03) I told you
how good oral hygiene has been shown to help prevent
pneumonia, the disease responsible for more than 60,000
fatalities each year. According to studies published in the
Journal of Periodontology and the Journal of the American
Geriatrics Society, bacteria that develop along the gum line
often accumulate in the throat. When your immune system is not
performing at an optimal level, this can create respiratory
problems such as pneumonia.
The health of your teeth and gums may also have a direct
effect on the health of your heart. This isn't really news -
since the late 90's we've seen growing evidence that
periodontal disease (an advanced form of gum inflammation)
may be linked to an increased risk of heart disease. But
research now shows that in addition to diligent brushing and
flossing, using supplements of an important amino acid could
provide another very effective defense against periodontal
disease, and, in turn, pneumonia and heart disease.
Down in the crevice
A recent study conducted at the University of Birmingham in
the UK examined 20 subjects - 10 with healthy gums, and 10
with advanced gum disease. From each subject, researchers
took samples of gingival crevicular fluid (GCF), a fluid
within the gums that is routinely released from the crevices
under the teeth. All of the subjects with healthy gums were
shown to have high levels of the antioxidant glutathione,
while the subjects with periodontal disease had substantially
lower levels of glutathione. When blood serum levels were
tested for glutathione, the same disparity was recorded for
the two groups.
The fact that this study tested for glutathione (as opposed
to any number of other antioxidants) is significant. In the e-
Alert "The Workhorse" (1/9/03) we took an in-depth look at
glutathione - an enormously effective antioxidant found in
every cell of the body, most notably in immune system cells.
Glutathione has not only been shown to protect against
disease, but may also protect other antioxidants (such as
vitamins C and E) from oxidizing, prolonging and enhancing
their effectiveness.
Which came first... ?
But while the UK study results would indicate that boosting
glutathione levels might help prevent and control periodontal
disease, other questions remain. The researchers wondered,
for instance, if lower levels of glutathione directly
contribute to gum disease, or if free radicals, produced by
gum disease inflammation, depletes the stores of glutathione.
The answer may very likely be "yes" on both counts, but we'll
have to wait for further research before we have definitive
answers.
The word that jumps out here is, "inflammation." A 1997 study
from the University of North Carolina at Chapel Hill revealed
that patients with advanced gum disease, who had also
suffered heart attacks, all showed significantly higher
levels of C-reactive protein (CRP) than heart attack
survivors who did not have gum disease.
This isn't a surprise, inasmuch as we've seen before that
elevated CRP is a key marker for inflammation. But it does
establish further evidence linking periodontal disease and
heart disease. In the e-Alert "Burst of Inflammation"
(11/21/02), I told you about a study that showed how the
levels of C-reactive protein have been recognized as an
important marker of heart disease risk.
Taken together, these studies add further circumstantial
evidence to a cycle of cause and effect that goes like this:
A low level of the antioxidant glutathione may be associated
with periodontal disease; periodontal disease is
characterized by inflammation; inflammation brings up CRP
levels; elevated CRP levels may indicate a risk of heart
disease; a risk of heart disease may be reduced by an
increased intake of antioxidants; and elevated levels of the
antioxidant glutathione may help prevent periodontal disease.
Is anybody else a little dizzy?
Protection & prevention
Later this year the final results are due from a major
National Institutes of Health study about the connection
between periodontal health and heart disease. In the
meantime, the UK study offers promising evidence that
antioxidants (and specifically glutathione) may prove to be
an important defense against periodontal disease.
So, what's the best way to raise glutathione levels? One way
NOT to do it is by oral supplement. Taking glutathione orally
is regarded as ineffective because the molecules are too big
to pass through the intestinal walls to the blood stream.
There is, however, an important amino acid I've told you
about in previous e-Alerts, called N-acetylcysteine (NAC)
that gives a powerful boost to your body's natural production
of glutathione.
Supplements of NAC are available in health food stores and
through Internet providers. The typical dosage ranges from
250-600 mg daily, unless a specific problem (such as
bronchitis) calls for higher dosage. (As always, consult with
your doctor or health care provider before taking a new
supplement - especially in high doses.)
The food sources that deliver glutathione precursors are
meats and fresh fruits and vegetables. But even with a diet
high in the proteins that supply glutathione amino acids, one
of those amino acids - cysteine - is more difficult than the
others to come by. A natural food component with high
concentrations of glutathione precursors (including cysteine)
is milk-serum-protein concentrate - more simply known as
whey.
If you've been diagnosed with periodontal disease, or if
you're currently undergoing treatment for it, share this
information with all of your health care providers -
physician, dentist, periodontist - knowing that an important
key to both gum and heart health may be as simple as
enhancing your production of glutathione and increasing your
intake of other antioxidants.
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.. and another thing
Want to boost the effectiveness of one of the most critical
vitamins in your diet?
In last week's e-Alert "Icing the Pizza" (7/30/03), HSI
Panelist Allan Spreen, M.D., gave us a mini-seminar on the
different types of vitamin E. He mentioned in passing that
the effect of vitamin E is enhanced with an additional
supplement of the mineral selenium. So what would be the
ideal daily dosage of these two supplements for the optimal
combined effect?
Here are Dr. Spreen's guidelines for vitamin E and selenium
intake:
"The 'standard' is usually 400 iu (international units) of
vitamin E and 200 mcg (micrograms) of selenium for general
antioxidant protection. In athletes or in the presence of
heart disease I'd take people higher than that. You can get
too much selenium, and I'd always stay under 1,000 mcg
(personally I never went above 400 mcg).
"Vitamin E is so non-toxic that the dose is difficult to
determine. Heart disease patients can go up to 2,400 iu or
higher (though technically 'iu' only exists relative to the
alpha form, not the other forms).
"Finally, those starting out with vitamin E should begin with
small amounts and work up. Occasionally the nutrient can be
so stimulating to the heart muscle that there can be a
transient increase in blood pressure, so your health care
practitioner should monitor."
My thanks to Dr. Spreen for rounding out our mini-seminar on
Vitamin E.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
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Sources:
"Glutathione In Gingival Crevicular Fluid and its Relation to
Local Antioxidant Capacity in Periodontal Health and Disease"
Journal of Clinical Pathology, Molecular Pathology,
2002;55:367-373;
www.mp.bmjjournals.com
"Antioxidants Missing in Mouths with Gum Disease" Alison
McCook, Reuters Health, 11/26/02,
www.reuters.com
"New Research Finds Link Between Gum Disease, Acute Heart
Attacks" David Williamson, University of North Carolina at
Chapel Hill, 11/8/00, unc.edu/news
"Periodontal Disease Index" Family Gentle Dental Care,
www.dentalgentlecare.com/gum_disease
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