Nutritional strategies for glucose 6-phosphate dehydrogenase (G6PDH) deficiency.

Nutritional strategies for glucose 6-phosphate dehydrogenase (G6PDH) deficiency.

January 17, 2020 2 By William Morgan


Philipa says, what are the best ways to optimize
glutathione status for someone who has a G6PD deficiency? Oh I
read about this, where did I read about it. I believe it was riboflavin. I believe, and I don’t think I mentioned this
in episode 58, the riboflavin podcast, but I believe it might have been the case that
riboflavin was shown to be of benefit for normalizing oxidative stress in people who
have glucose 6-phosphate dehydrogenase deficiency. So for people who don’t know what this is
G6PD is, glucose 6-phosphate dehydrogenase is an enzyme that you use to take energy from
glucose specifically, you can’t take it from anything else, and you use it to recycle glutathione
which is a master antioxidant of the cell. You also need this to support the recycling
of vitamin K and folate and you need this for synthesis of neurotransmitters and a bunch
of other stuff. But the big problem with G6PD deficiency is
that you can have, this isn’t the only problem, I think a lot of things are going to go wrong
when you can’t use this pathway, like I just said, but the big thing that people are, that
people usually use as the hallmark is that the red blood cells become more vulnerable
to hemolysis and that is a result of oxidative stress from poor glutathione recycling in
the red blood cell. So one of the adaptive responses to having
glucose 6-phosphate dehydrogenase deficiency is that the glutathione reductase enzyme,
which is the enzyme that uses riboflavin and niacin to recycle glutathione with the energy
taken from glucose 6-phosphate dehydrogenase. That enzyme, glutathione reductase, it develops
a voracious appetite for riboflavin that makes all the riboflavin that won’t go anywhere
else get sucked up into that enzyme. So basically you become very dependent on
riboflavin support of glutathione reductase because you have lost G6PD, the enzyme that’s
involved in passing the energy on to riboflavin in glutathione reductase. And I would try, I’m not, I would start with,
look there’s probably no harm to starting at 400 milligrams of riboflavin a day, but
if you feel like you want to be more cautious about it, I’d start at 5 or 10 milligrams
a day, test the effect on glutathione status. You know in this case I think you want to
look at erythrocyte glutathione status, I don’t usually recommend that test, but it
might be a more relevant test specifically for this condition. Even though in general what I would usually
recommend for glutathione status would be plasma levels of glutathione, or actually
LabCorp, I think LabCorp does whole blood glutathione. That might be, I don’t remember what LabCorp’s
test is, but you might not have infinite options here. Anyway whatever your testing glutathione with,
I would first and foremost look at high-dose riboflavin maybe in the moderate high dose
range of 5 to 10 milligrams, maybe in the high high dose range of 1 to 400 milligrams
and see if that helps.