Age – Associated Oxidative Stress

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Age – Associated Oxidative Stress

Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

As a result, the Fullscript Integrative Medical Advisory team advises using an evidence-informed approach to protocol development. To simplify this process for practitioners, we have assembled a sampling of evidence-based standardized protocols that practitioners can use as a foundation when developing individualized protocols.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through D-quality evidence. These are categorized as follows:

Class Qualifying studies Minimum requirements
A Systematic review or meta-analysis of human trials
B Human RDBPC ≥ 2 studies and/or 1 study with ≥ 50
C Human RDBPC or RCT 1 study < 50 subjects
D Human trials or In-vivo animal trials

RDBPC = Randomized Double-Blind Placebo Controlled
RCT = Randomized Controlled Trials

Please refer to the complete Rating Scale for further information.


The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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Age – Associated Oxidative Stress

The biomarkers of oxidative stress have been strongly linked to aging.1,2 Oxidative stress biomarkers, such as lipoprotein phospholipase A2 (Lp-PLA2), isoprostanes, malondialdehyde (MDA), 8-hydroxy-2-deoxyguanosine (8-Oxo-dG), derivatives of reactive oxygen metabolites, oxidized glutathione/glutathione, 4-hydroxy-2, 3-nonenal (4-HNE), and protein carbonylation, have been linked to increased frailty and pre-frailty.1 In addition, cardiovascular mortality has been associated with increased serum markers of oxidative stress, such as derivatives of reactive oxygen metabolites (D-ROM) and total thiol levels (TTL).2

CoEnzyme Q10

100-200mg, once per day, minimum 12 weeks3,4,5

  • Superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were increased, and malondialdehyde (MDA) and diene levels were decreased after CoQ10 supplementation3,5,6
  • CoQ10 supplementation has been shown to decrease the level of age-related cardiovascular fibrosis through its antioxidant and anti-inflammatory actions4,7 
    • Endothelium function was shown to be improved with CoQ10 supplementation by counteracting the oxidation of nitric oxide8
    • CoQ10 supplementation was shown to increase brachial artery flow-mediated dilatation (FMD) by altering local vascular oxidative stress4
CoEnzyme Q10 in the Fullscript catalog.


2000mg (Longvida®), once per day, minimum 12 weeks9

  • Curcumin (in a Longvida® proprietary preparation) supplementation has been shown to increase vascular nitric oxide bioavailability, reduce oxidative stress, and, therefore, improve artery endothelial resistance9
  • IL-6, hs-CRP, and MDA levels have all been shown to be decreased by curcumin10
  • Malondialdehyde (MDA) was lowered by curcuminoids at a dose of 600mg per day; when piperine was used in combination, the effect was greater11
  • Curcumin may also increase superoxide dismutase (SOD) activity11
Curcumin in the Fullscript catalog.


299-745mg, once per day, minimum 5 weeks12,13

  • 8-hydroxy-2′-deoxyguanosine (8-Oxo-dG), 8-iso-prostaglandin F2α (8-iso-PGF2α), erythrocyte catalase, and glutathione reductase (GR) activities were all reduced12 
  • Waist circumference, body mass index, and leptin were decreased in overweight or obese nonsmoking subjects12
  • Glutathione peroxidase (GSH-Px) activity was increased and CRP levels remained stable compared to placebo13
  • Resveratrol has been shown to up-regulate plasma membrane redox system (PMRS) and ascorbate free radical reductase14
  • In different age groups, resveratrol provided protection against protein carbonylation and lipid peroxidation; cellular levels of glutathione (GSH) and sulfhydryl (-SH) was restored during oxidative injury in erythrocytes14
Polyphenols in the Fullscript catalog


Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials
Non-RDBPC human or In-vivo animal trials