QUESTION: Hello Doctor,

I'm 25 female, I take Stressttabs with zinc or Berocca, whichever is available at my local pharmacy.

I want to start taking antioxidants, but don't know what to look for.
Are there any FDA approved antioxidants? And what is the best for skin?


ANSWER: You probably already know the three surest ways to ensure youthful skin: Protect your skin from the sun, don't smoke, and eat a healthy diet.

In addition, a variety of vitamins and antioxidants may also improve the health and quality of your skin. Here are a few of the most effective ones:

Vitamins C and E and Selenium for Your Skin

Research has found that vitamins C and E, as well as selenium, can help protect the skin against sun damage and skin cancer. And they may actually reverse some of the discoloration and wrinkles associated with aging. These antioxidants work by speeding up the skin's natural repair systems and by directly inhibiting further damage, says Karen E. Burke, MD, PhD, of the Mount Sinai School of Medicine's department of dermatology.

Burke recommends taking supplements containing 1,000 to 3,000 milligrams of vitamin C, 400 international units of vitamin E (in the D-alpha-tocopherol form), and 100-200 micrograms of selenium (l-selenomethionine) to gain the most benefit. (Don't give selenium to children until they have all of their adult teeth because it can interfere with the proper formation of tooth enamel.)

Coenzyme Q10 for Your Skin

Coenzyme Q10 is a natural antioxidant in the body that helps the cells grow and protects them from the ravages of cancer. A drop in natural levels of coenzyme Q10 that occurs in our later years is thought to contribute to aging skin. A study published in the journal Biofactors found that applying coenzyme Q10 to the skin helped minimize the appearance of wrinkles. Most studies conducted so far have used a 0.3% concentration of it.

Alpha-lipoic Acid for Your Skin

This antioxidant, when applied topically as a cream, may help protect the skin from sun damage. Studies have looked at creams with 3%-5% concentration, applied every other day and building up slowly to once daily, and found some improvement in sun-induced changes in the skin.

Retinoic Acid for Your Skin

Retinoic acid is the active form of vitamin A in the skin and the "gold standard" in anti-aging skin care, according to Burke. Topical retinoic acid (brand names Renova and Retin-A) treats fine wrinkles, age spots, and rough skin caused by sun exposure. In a study published in the Journal of Dermatological Science, researchers found that treatment with retinoic acid restored the elastic fibers that keep skin taut, and reduced the appearance of wrinkles.

Retinoic acid comes in gel and cream forms, which are typically used once a day. Although dermatologists used to believe that retinoic acid made the skin more sensitive to the sun, they now know that it actually protects against further sun damage.

If you apply retinoic acid in too high of a concentration and too often, it can cause redness, extreme dryness, and peeling. Burke recommends starting with a low concentration (retinoic acid products range from 0.01% in gels to 0.1% in creams) and applying it once every second or third night to reverse photo damage more slowly.

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QUESTION: What about glutathione?
Also Doctor any FDA approved antioxidant you can prescribe?

Antioxidants are also used by some patients during cancer treatment in the hopes of reducing the side effects of chemotherapy. Two prescription antioxidants, Mesnex® (mesna) and Ethyol® (amifostine), are available which specifically prevent certain side effects of cancer agents such as ifosfamide, cyclophosphamide, and cisplatin. Since these two antioxidants are for prescription use only, they have been evaluated in human studies by the Food and Drug Administration (FDA) and found to not reduce the effectiveness of cisplatin, cyclophosphamide, or ifosfamide in the treatment of cancer. Non-prescription antioxidant supplements are considered to be dietary products and are not regulated by the FDA. Human studies showing the impact of dietary supplements on chemotherapy effectiveness are not required for these products to be sold in the United States.

Some common side effects associated with glutathione usage include chest pain, shortness of breath and other breathing issues, tightness in the throat and chest and allergic reaction-type symptoms like breaking out into hives, rashes, swelling up, or having excessive itchiness.

Other Side Effects
Zinc deficiency is another possible side effect of taking glutathione, particularly for people taking it long term. Most people do not experience this side effect as a result of glutathione, but there have been reports of zinc deficiency from combination medications containing glutathione. If you experience this side effect, you should seek medical attention.

Because of the side effects, I rarely recommend the medication.


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Michael S. Fisher, <B>Ph.D., M.D.</B>


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