UNDER THE MICROSCOPE

Glutathione hit the front pages and trended on social media for the wrong reasons. The wife of a first-time senator posted that nothing can stop her from having her glutathione intravenous (IV) drip, even while she’s in the senator’s office. Naturally, netizens came down hard on her citing her arrogance and abuse of privilege, saying she has cheapened the image of that institution by doing so.

The DOH also chimed in stating that it has not sanctioned the use of IV glutathione for skin whitening, but it is only used clinically for cancer patients undergoing certain chemotherapy treatments.

Actually, glutathione has also been clinically evaluated in various formulations as topical (for skin application), oral, intranasal and nebulized forms. Researches have shown it to be beneficial in cystic fibrosis and Parkinsonism. Increased levels of glutathione are associated with higher levels of self-rated health, fewer illnesses, reduced cholesterol, body mass index, and blood pressure and improved immune functions.

Glutathione is involved in many biological processes such as free radical neutralization, maintenance of bodily functions in iron metabolism, the blood-brain barrier, vitamin C and E regeneration, transport of mercury out of cells and brain. It also serves as a coenzyme that speeds up chemical reactions within the body.

And yes, a study showed that glutathione in oral, topical and IV forms produced skin lightening, though IV glutathione-treated subjects experienced adverse effects with liver dysfunction in 32 percent of patients and a case of anaphylactic shock. 

There is no mention of kidney damage in the studies on the effects of glutathione in doses of 500 mg. daily on the kidneys.

Oral glutathione also had beneficial effects on non-alcoholic fatty liver disease with significant reductions in serum ALT (serum enzyme marker of liver injury), as well as reduced levels of triglycerides and ferritin.

Conversely, glutathione depletion is associated with neuroinflammation, neurodegeneration, infection, cancer, Alzheimer disease, Parkinson disease, HIV, cystic fibrosis, periodontitis, diabetes, schizophrenia and bipolar disorder. However, causality has not been directly attributed to low glutathione levels. Glutathione depletion is also part of the aging process, so it is postulated that increasing glutathione levels can reverse or ameliorate some aging effects.

Research has thus shown glutathione in any formulation has beneficial effects overall but IV glutathione is associated with serious adverse effects. So, why are certain sectors, medical and cosmetic, pushing IV glutathione aggressively in non-medical settings where it can result in injury or death? Is it because they are capitalizing on the public’s penchant for “magical” effects with the intravenous use of glutathione? Filipinos generally are needle-shy which accounts for the difficulty in convincing people to donate blood, but they see IV fluids as dramatic in effect when resorted to in hospitalized patients . Therefore, they conclude that any IV medication must be powerful, which is flawed logic. It just reflects the “magic-realist” thinking pervasive in our culture.

What is even more puzzling is why the DOH is not more aggressive in regulating the use of IV glutathione. The FDA, in addition to its regulatory power in approving medical drugs and devices,  can call on the assistance of any law enforcement agency  to enforce its rulings, not just issue warnings about the dangers of IV glutathione. 

In failing to exercise its mandate, the DOH is in effect allowing the inappropriate use of IV glutathione that has proliferated among cosmetologists and even beauty salons, sans medical supervision. Aside from the above side effects, unsterile needles, which may have been reused, can lead to infection of the injection site, as well as possibly passing on viral infections as HIV-AIDS, hepatitis B and hepatitis C. 

Contraband IV glutathione, which is not licensed for use by the FDA, is most probably being used in the country for such skin-lightening procedures. These products are also most probably smuggled, since they cannot be brought in legally without FDA approval. 

The DOH should strictly implement its policies to avoid further injuries and deaths as what happened to a patient who went into anaphylactic shock and died due to the use of IV glutathione. If it does not, then the onus of responsibility for these preventable deaths falls squarely on their shoulders.

But then, the DOH seems content to advise those who think they have been prescribed IV glutathione wrongly to consult a lawyer or the Public Attorney’s Office for advice if it constitutes medical negligence, effectively washing its hands off on the matter. So, what if the culprit is not a doctor?

As for the Filipino public, will it kill you if you have brown skin?