How many people each year suffer some type of preventable harm that contributes to their death after a hospital visit?
| ||Interviews with Nutritional Experts: Measuring Your Antioxidant Status ||
Interview with Dr. Charles A. Thomas
as interviewed by Richard A. Passwater PhD
Forget about your cholesterol number - what are your levels of CoQ-10,
vitamin E, selenium, beta-carotene and vitamin C? You may eat well and take
supplements, but do you know if they actually get into your system? Are
the concentration levels of these protective substances in your blood below
par, middling, or in the higher protective range?
In recent Health Connection columns, the world's leading researchers
on antioxidants, heart disease, cancer and aging have explained how our
antioxidant defenses help us live better and longer. Our antioxidant defense
system includes large molecules such as the antioxidant enzymes and coenzymes,
together with small molecules such as the antioxidant micronutrients - many
of which turn out to be the familiar vitamins. Our diet helps determine
both the amount antioxidant micronutrients in our blood and cells, as well
as the levels of antioxidant enzymes and coenzymes that our bodies produce
is determined partly by heredity and partly by diet.
I stress that our diet is a factor in our antioxidant defenses, because
the needed nutrients must be in your diet in the first place. However, they
won't help you unless they are absorbed. It is not just what we eat, but
how well we absorb nutrients from our food and supplements. We can determine
out diets, but our antioxidant defenses are influenced by other variables
that are outside our control. The only solution is to MEASURE the
blood levels directly and then make adjustments as necessary based on these
Let me emphasize the importance of the latter with the research of Dr. Richard
Donaldson of the St. Louis Veterans' Administration Hospital. Dr. Donaldson
conducted a clinical trial with terminally ill cancer patients. He found
that when he could raise the patients' blood levels of selenium into the
normal range, their pain and tumor sizes were often reduced. The amount
of selenium needed to obtain normal blood levels varied from person to person.
Normal healthy people usually have normal blood selenium levels on normal
diets. However, cancer patients usually have low selenium levels on normal
diets. Apparently they could not get enough without supplements. Dr. Donaldson
found that he had to supplement the cancer patients with at least 200 to
600 micrograms of selenium per day and in some cases 2,000 micrograms of
selenium per day were required to obtain normal blood selenium levels.
As Dr. Gerhard Schrauzer told us in the December 1991 column, blood selenium
levels often indicate the presence of cancer and even the severity of cancer
in a patient. This is how he became interested in the role of selenium in
cancer. It seems that low blood selenium levels increase the risk of cancer
and that tumors may also deplete the blood of selenium. Some people absorb
selenium poorly and this increases the probability of developing cancer.
Selenium, of course, is just one element in the complex and overlapping
antioxidant defense system that includes nutrients such as vitamin E, beta-carotene,
vitamin A, coenzyme Q-10, vitamin C, and many others. Blind supplementation
is not a good idea, because some of these micronutrients like selenium and
vitamin A can be toxic at higher levels. When I first pointed this out several
years ago, many people wrote to me asking where they could get the blood
levels of these substances measured. Now, at last, there is such a laboratory
that can do just this. They measure the blood concentrations of more than
20 different substances that are related to the antioxidant defense system.
The results are plotted in graphs that make it easy to see exactly what
relative deficiencies actually exist so that they can be targeted for correction.
Do you know what your antioxidant profile is? Dr. Charles A. Thomas will
tell us some of the reasons why this information should be of interest to
Passwater: Dr. Thomas, you taught biophysics at Johns Hopkins University
and were a professor of biological chemistry at Harvard Medical School before
moving to San Diego to become Chairman of the Cell Biology Department of
the Scripps Research Foundation. I know that during this time your research
programs were funded by the NIH and that you are the author and co-author
of many papers. Exactly what kind of research was this?
Thomas: Most of my research has been on the structure and mode of
replication of viral DNA molecules. For example, we were the first to show
that a virus particle contains a single molecule of nucleic acid - which
turns out to be a general, but not unbroken rule. We demonstrated that many
of these DNAs begin and end with the same sequence of nucleotides and how
there were involved in replication and integration.
Passwater: Sounds like molecular biology to me! This is a far cry
from what you are doing now. How would you characterize your work at present?
Thomas: We are doing analytical biochemistry. We are measuring the
concentration of over 20 different substances in human blood serum that
are somehow related to the individual's ability to avoid degenerative diseases.
Passwater: Your present work seems completely different from molecular
biology - why did you switch fields?
Thomas: Well, actually there is a connection. My interest in the
replication and transcription of nucleic acids led me to think about how
DNA was damaged; how mutations arise; what are the damaging agents and where
they come from. In those days everyone was concerned about low levels of
radiation and toxic residues from pesticides and effusions of industry.
This was politically correct and well-funded by government agencies. When
I looked into this question, I discovered that radiation and toxic residues
could only be responsible for a negligible portion of the damages that are
Passwater: If these environmental agents are not especially significant,
what are the most damaging agents and where do they come from?
Thomas: The most mutagenic agents are oxygen radicals that are being
generated by the normal biochemistry of every cell in our bodies (and in
the bodies of every other animal that lives in air). Early in my reading,
I came across a paper by Drs. Helmut Sies and Britton Chance. This work
summarized evidence that about one-to-two percent of all the oxygen we breathe
was not converted to water and energy, but rather to the formation of superoxide
radical (O2.-) and its descendants such as hydrogen peroxide
(H2O2). This paper had a strong influence on my thinking.
Passwater: It's uncanny how the academic lives of many of the scientists
in this series are entwined. Both Dr. Packer and myself have personally
been involved with the research of Dr. Britton Chance and Dr. Helmut Sies
will be the subject of a future interview. But, before I wander too far
off the subject, please explain why their paper had such a powerful influence
Thomas: Yes, I quickly made a calculation that if all this superoxide
radical (O2.-) and hydrogen peroxide (H2O2) were converted to
hydroxyl radical (OH.), the cell and the animal would be killed
Passwater: Please elaborate.
Thomas: You see, when x-rays (or any ionizing radiation) pass through
body tissues, the largest portion of the damaging effects are due to the
splitting of water molecules and the formation of the hydroxyl radical.
The fact that one percent of the oxygen was shunted into the path of radical
formation, meant that the cell would, in effect, be receiving the equivalent
of more than a million rads per day, when a thousand rads is enough to kill
most anything, including humans.
Passwater: That's an interesting approach, comparing the amount of
radicals produced in normal metabolism to the amount produced by ionizing
Thomas: Yes, in a sense we are producing the same radicals by normal
metabolism as are produced by x-rays. My calculation could have been wrong,
but probably not. What was more likely is that even though these radicals
are produced, there is some highly efficient way of preventing them from
doing most of the damage that they would otherwise do. There was some kind
of antiradical defense system that Nature had put into place and that prevents
all but a small fraction of the damages.
Passwater: Aha! This gets us to the antioxidant defense system.
Thomas: Yes, we would not be alive without it. However, with the
passing of time, nutritional deficiencies, disease states, emotional stress,
the consumption of toxic materials like tobacco smoke and alcohol, or whatever,
the antiradical defense system becomes impaired and the rate of damage increases.
Mutations and cancer result.
Passwater: Can you explain what is known about the anti-oxygen-radical-defense
Thomas: Sure, but remember that entire books are devoted to this
subject. Briefly stated, most of the radicals are generated in the mitochondria
where 98 percent of the oxygen that the cell consumes is reduced to water
by an efficient process called "respiration." The radical by-products
of respiration promptly encounter detoxifying enzymes that efficiently convert
them to water.
Passwater: But nothing is ever 100% perfect?
Thomas: Right - even a tiny percentage of unwanted radical production
can do a lot of damage. This tiny percentage that gets through the antiradical
defense system is probably responsible for a major part of what we know
Passwater: What are you doing at PANTOX Laboratories to help us reduce
Thomas: We are measuring the blood serum levels of many of the small-molecule
components of this antioxidant defense system. Many of these are familiar
vitamins; some are not. They represent the last and final layer of defense.
If they are not around, the tissue components are oxidized at a significantly
Passwater: This means to me that we would expect that people who
have low levels of these micronutrients would experience higher levels of
heart disease and cancer etc. Is this right?
Thomas: Indeed it is, and this is what attracted me to this field.
There are published papers describing the higher incidence of almost every
degenerative disease with lowered levels of vitamin E, vitamin C, carotenoids,
coenzyme Q-10, bilirubin, or selenium. You yourself introduced your readers
to the importance of monoriting their blood levels of antioxidants -- especially
selenium and vitamin E in terms of cancer prevention and treatment -- in
1987 in the March issue of Let's Live. Very basic ideas sometimes
take a long time to gain recognition.
Passwater: Let's say a person has a poor PANTOX Profile where he
is pretty low in just about everything. Can he do anything about it?
Thomas: Absolutely! By consuming significantly higher levels of micronutrients
in the form of supplements, he usually can elevate his serum levels.
Passwater: This will reduce his risk for cancer and heart disease?
Thomas: You and I certainly are convinced, but we have to be careful
here. There are a few intervention studies that support this conclusion,
but the most important intervention studies are yet to be completed. Based
upon what we know about the biochemistry and physiology of antioxidant protection,
we are expecting these intervention studies to confirm our expectation.
Passwater: What have you learned from measuring PANTOX Profiles on
thousands of people?
Thomas: Well, the first thing you have already mentioned above: "What
you eat is definitely NOT what you get!" We have some people who
have never touched a nutritional supplement who have near-ideal PANTOX profiles
(although they admit to eating plenty of fruit and vegetables). We have
others who have high beta-carotene but no significant vitamin A. This means
to me that they no longer have the enzymatic ability to convert beta-carotene
to vitamin A. We have others who have high levels of vitamin A, but no carotenoids.
It's a zoo out there. I never expected that people could be so individually
Passwater: Another example of Dr. Roger William's teaching of biochemical
individuality! Are there any special groups of people who would benefit
from having their profiles measured.
Thomas: Yes, of course. Those who have experienced cancer or heart
disease, cataracts, macular degeneration etc. They should optimize their
present antioxidant defenses. This also applies to members of their families,
because family members often share the same diet and lifestyle. PANTOX is
participating in a large number of clinical studies relating to heart disease,
cancer, Alzheimer's and other diseases of aging.
We have recently started providing PANTOX Profiles on Downs Syndrome children.
Most Down's individuals have an extra chromosome 21, so they have a fifty
percent excess of every gene on that chromosome. Among them is the gene
for superoxide dismutase (SOD) which converts superoxide anion radicals
to hydrogen peroxide. This leads to a fifty percent increase in the amount
of SOD in their cells and probably an increase in the concentration of hydrogen
peroxide, although this has not been measured. Therefore, Down's individuals
would be expected to be under greater oxidative stress. In the limited number
of children that we have studied, they do indeed seem to have depleted serum
levels of lipid-soluble antioxidants and vitamin C. These results are guiding
special supplementation programs for these children.
Passwater: The extra SOD is beneficial when it dismutates superoxide
anion radicals to peroxide, but unless there is also additional catalase
to reduce the peroxide to water, the person is still under oxidative stress
from the accumulating peroxide.
Pro-oxidants are also of interest in determining the antioxidant statue.
Does the PANTOX Profile include iron?
Thomas: Indeed it does. We measure serum iron, total iron-binding
capacity (TIBC) and serum ferritin. (Ferritin is a protein that stores iron.)
There are now many publications that demonstrate the key role of iron as
a catalyst for the formation of the hydroxyl radical. Since the hydroxyl
radical reacts very close to the iron ion that catalyzes its formation from
hydrogen peroxide, iron ions are responsible for directing oxidative damage
to the site to which they are bound.
Passwater: In vitro studies suggest that free iron ions in
the body might catalyze oxidative damage. The body takes great care to scavenge
free iron ions so that this damage is minimized if it does occur in vivo.
There is considerable debate and a great deal of scientific interest in
the possible involvement of stored iron in radical formation in vivo.
In any case, in normal individuals, stored iron does not appear to be dependent
on the amount of iron in the diet.
Iron, in contrast to many other minerals, is regulated in the body primarily
by absorption rather than by excretion. The absorption of dietary iron is
strongly regulated by body iron stores. When iron stores are low, the body
is more efficient at absorbing dietary iron and vice versa.
However, there are individuals with abnormal iron regulation who accumulate
too much iron stored in the blood. Hemochromatosis and hemosiderosis are
examples of iron-storage diseases.
Thomas: Yes, an excessive amount of stored iron is bad for you, but
we have to have some iron in order to live. We need it in hemoglobin, for
example and hundreds of vital enzymes, including the antioxidant enzyme,
catalase which reduces hydrogen peroxide to water. We want to avoid excessive
amounts of stored iron. Excessive amounts of stored iron leads to "homeless
iron" which targets the damages that I just mentioned. This is a perfect
example of why measurement is so important. If we have too little iron we
are likely to experience iron-deficiency anemia. Too much stored iron and
we are likely to experience a faster rate of aging. On a typical office
visit to a physician, iron-deficiency anemia is easy to detect and correct,
the other, too much stored iron, will not cause problems for many years
and is likely to be overlooked or dismissed by the physician.
Passwater: If a person has too much stored iron, what can be done
to correct that?
Thomas: Actually, its very easy: you make a blood donation, or a
series of blood donations at two-month intervals. Each unit of blood removes
almost 1/4 a gram of iron from the iron stores in the body. New blood cells
must be made and the iron required to do so is removed from the major iron-storage
depots in the liver.
Passwater: Good advice. Not only would that help the person with
too much stored iron, it would help another person needing a transfusion.
As a paramedic (EMT-A) I have treated a great many accident victims who
have needed blood transfusions to save their lives. I have also spilled
appreciable quantities of my own blood on a couple of occasions -- once
to the point of no detectable pulse or blood pressure -- so I can personally
attest that giving blood saves lives. But too many people fear donating
Thomas: Nothing in medicine is safer. There are 12 million blood
donations made every year, and some individuals have given many gallons
over time, all with no recorded ill-effects. Cycling females lose up to
3 pints of blood per year, and they are the most healthy humans alive.
Passwater: Do you donate blood regularly?
Thomas: Of course. My stored iron levels are now comparable to a
25 year old female.
Passwater: What effect does high levels of stored iron have on the
Thomas: We have found a most astonishing thing. Those people who
have high levels of stored iron (as indicated by high serum ferritin values
and low TIBC) have sharply lower beta-carotene values - it is as though
they are using up their carotenoids (although there are other explanations).
Among those people with "HiFer-LoBeta-Car," we find many who have
depleted levels of vitamin C, E, and A. If this is the case, the serum level
of glucose almost always is elevated. I imagine that the body is increasing
the glucose level as an "antioxidant of last resort." There are
papers indicating that if serum iron is lowered, the serum glucose levels
are normalized. I believe that the relationship between iron loading, depleted
antioxidants and late-onset diabetes should be more carefully studied.
Passwater: Now that is interesting and it is something researchers
ought to follow up. By the way, how does PANTOX operate?
Thomas: PANTOX Laboratories is a CLIA-approved reference laboratory
that is licensed in California. To date we have measured PANTOX Profiles
in over 3,000 blood samples. The PANTOX Profile must be ordered by a licensed
practitioner in the State where the sample of blood is taken. Most of our
orders come from physicians but many come from other practitioners.
Passwater: How can readers get their Profile done?
Thomas: If readers would like to have their own PANTOX Profile done,
they can call Pantox Laboratories at 800-PANTOX6 (800-726-8696). We can
send information and a specimen kit (including simple instructions on how
to transport the sample) to their physician or other qualified health practitioner,
or perhaps recommend a doctor in their area who is already familiar with
the PANTOX Profile and how to interpret and use the results.
Passwater: How much does it cost and is it covered by insurance?
Thomas: Clinically, PANTOX Profiles are used both as part of diagnostic
and treatment protocols and as preventive diagnostic screens. The cost (currently
$275, $250 if payment is sent with the specimen) is typically reimbursable
when a valid ICD-9 diagnostic code is included on the Patient Information/Requisition
form. In that case, the panel is considered eligible for coverage by virtually
all insurance plans and we accept Medicare assignment. We will bill patients
(and submit insurance claims on their behalf, if their insurance information
is included with the sample), or we will bill the doctor directly, if preferred.
Passwater: How often should a PANTOX Profile be repeated?
Thomas: For a person who has a poor profile and has taken steps to
improve it, we suggest a repeat four to six months later. For a person who
is maintaining a good profile, a simple annual biochemical checkup is recommended.
Passwater: Good advice. Would you like to leave our readers with
any parting message?
Thomas: Almost everyone in the US dies of the diseases of aging.
To reduce the rate of aging - that is to maintain optimal health - is a
matter of personal responsibility; no government and no insurance company
will ever be able to provide health for the individual: he must do this
for himself. I hope that PANTOX will enable the individual to assume more
responsibility for his own health.
Passwater: Thank you Dr. Thomas.
All rights, including electronic and print media, to this article are copyrighted
to Richard A. Passwater, Ph.D and Whole Foods magazine (WFC Inc.).
|Richard A. Passwater, Ph.D. has been a research biochemist since 1959. His first areas of research was in the development of pharmaceuticals and analytical chemistry. His laboratory research led to his discovery of......more||