Clinical Glutathione by EuroMedica

POSSIBLY EFFECTIVE

• Cisplatin-induced neurotoxicity. Intravenous glutathione seems to reduce neurotoxicity from cisplatin. Details: Clinical studies in cancer patients receiving cisplatin shows that administering glutathione 1.5 grams/m2 by intravenous injection over 15 minutes seems to help prevent neurotoxicity and other toxicities from cisplatin when compared with control. Glutathione may also increase the highest dose of cisplatin that patients are able to tolerate (5373,5374,5377,5378,5380). In one study, this same dose of intravenous glutathione was administered, along with intramuscular glutathione 600 mg on days 2-5 (5374).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging. Although there is interest in using oral glutathione for aging, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Alcohol use disorder. Although there is interest in using oral glutathione for alcohol use disorder, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Athletic performance. Oral glutathione has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical trial in young, resistance-trained males shows that taking glutathione (Setria, Kyowa Hakko Bio) 200 mg in combination with L-citrulline 2 grams daily for 8 weeks in conjunction with resistance training has no effect on muscle strength, as measured by leg and bench presses, when compared with L-citrulline alone or with placebo (97394). The trial shows the increase in lean body mass with training to be significantly higher with glutathione and L-citrulline compared with placebo at 4 weeks. However, by 8 weeks of training lean body mass is not different between supplementation and placebo. An additional small, cross-over trial in young, endurance-trained males shows that taking glutathione 200 mg in combination with L-citrulline 2 grams (Setria Performance Blend, Kyowa Hakko Bio) daily for 8 days does not improve high speed running performance, as measured by time to exhaustion, when compared with placebo (112285).
• Angioplasty. It is unclear if intravenous glutathione is beneficial in patients recovering from angioplasty following myocardial infarction. Details: A small clinical trial in Italian adults undergoing primary percutaneous coronary intervention (PCI) for recent ST-elevation myocardial infarction (STEMI) shows that intravenous infusion of glutathione sodium salt 2500 mg/25 mL over 10 minutes before angioplasty and at 24, 48 and 72 hours after angioplasty reduces length of hospital stay by around 2 days; reduces markers of oxidative stress, inflammation, and cardiomyocyte damage; and improves measures of left ventricular function at 6-month's follow-up when compared with placebo (111417,111418).
• Alzheimer disease. Although there is interest in using oral glutathione for Alzheimer disease, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Cardiovascular disease (CVD). Although there is interest in using oral glutathione for preventing CVD, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Cataracts. Although there is interest in using oral glutathione for cataracts, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Chronic fatigue syndrome (CFS). Although there is interest in using oral glutathione for CFS, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Cirrhosis. It is unclear if oral glutathione is beneficial for improving cirrhosis severity. Details: A small clinical study in patients with cirrhosis shows that taking glutathione 500 mg daily with or without vitamin B6 50 mg daily for 12 weeks does not affect disease severity or reduce oxidative stress when compared with placebo (104392). These findings are limited because the study might not have been powered to detect a difference between groups, as 21 of the 61 participants were lost to follow-up.
• Cognitive function. Oral glutathione has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small cross-over trial in healthy adults shows that taking a product providing 20 mg/day of glutathione as part of a combination product containing probiotics (L. helveticus, Lactiplantibacillus plantarum, Bifidobacterium longum), inulin, zinc, potassium, magnesium and lactoferrin (Puraflor, GSK Consumer Healthcare) for 4 weeks does not affect cognitive performance during acute stress when compared with placebo (110923).
• Contrast induced nephropathy. It is unclear if intravenous glutathione is beneficial for preventing contrast induced nephropathy. Details: A small, non-blinded clinical study in patients aged 65 or older with diabetes undergoing percutaneous coronary intervention (PCI) shows that intravenous reduced glutathione 180 mg daily for 4 days, starting 6 hours prior to PCI, in conjunction with saline hydration, does not reduce the rate of contrast induced nephropathy when compared with saline hydration alone. Saline hydration was administered at a rate of 1 mL/kg/hr, starting 6 hours prior to PCI and continuing for 12 hours after PCI (107477). However, this study may have been inadequately powered to detect a difference between groups.
• Cystic fibrosis. It is unclear if oral glutathione is beneficial in children with this condition. Details: A small clinical study in children ages 2-10 years old with cystic fibrosis shows that taking glutathione powder 65 mg/kg daily in 3 divided doses for 6 months does not impact weight or inflammatory biomarkers when compared with placebo (104391).
• Glaucoma. Although there is interest in using oral glutathione for glaucoma, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Idiopathic interstitial pneumonia. Although there is interest in using inhaled glutathione for idiopathic pulmonary fibrosis, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Nonalcoholic fatty liver disease (NAFLD). It is unclear if oral glutathione is beneficial in patients with NAFLD. Details: Preliminary clinical research shows that taking glutathione 300 mg daily for 4 months reduces alanine aminotransferase (ALT) levels by around 13% and triglyceride levels by around 16%, but has no impact on aspartate aminotransferase (AST) levels or liver stiffness, when compared with baseline in patients with NAFLD (97397). The validity of these findings is limited by the lack of a comparator group.
• Osteoarthritis. Although there is interest in using oral glutathione for osteoarthritis, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Parkinson disease. It is unclear if intranasal glutathione is beneficial for improving Parkinson disease symptoms. Details: A small clinical study in patients with Parkinson disease shows that taking glutathione intranasally 100-200 mg three times daily for 3 months has no effect on symptoms when compared with placebo (97398). More evidence is needed to rate glutathione for these uses.

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POSSIBLY SAFE ...when used orally in doses up to 500 mg daily for up to 2 months (5361,5362,97394,97396,97399,104392). ...when used by inhalation in doses of 600 mg twice daily for up to 3 days (5367,5368,5369). ...when used intramuscularly (5374,5375,5384). ...when used as an intravenous injection (5344,5354,5357,5358,5359,5360,5373,5374,5377,5378,5380).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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General ...Glutathione seems to be well tolerated; however, a thorough evaluation of safety outcomes has not been conducted.
Serious Adverse Effects (Rare):
Inhaled: Bronchoconstriction and shortness of breath.

Dermatologic ...Topically, glutathione has resulted in an intolerable rash and irritability in five children (90637).

Pulmonary/Respiratory ...Inhaled (nebulized) glutathione can cause airway narrowing and bronchoconstriction resulting in shortness of breath and cough in patients with asthma (5372).

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