Oxidative stress and the free radical damage that
it causes to
cellular structures is a real problem in this toxic world. High
of free radicals are associated with exposure to environmental
pollutants, inflammatory diseases, and low antioxidant status. Free
radicals are very unstable and reactive with other molecules. Once
free radical reactions begin, they tend to multiply by chain
reactions with cellular material. The chain reactions tend to have
long lasting effects and the potential to cause cellular damage
cell membrane or DNA disruption). It is important to remember that
our body needs a certain amount of oxidative stress to deal with
toxins, microbes, etc. Both too much and too little oxidative stress
is a problem.
Identifying oxidative stress can be quite difficult in practice,
without relying on expensive panels from out-sourced labs. What
can we do
in practice to help determine whether or not oxidative stress is
problem using some of the tools at our disposal? I like to be able
order expensive panels when my "gateway" testing indicates
is a good idea.
What do I mean by "gateway testing"? An example of a
test for oxidative stress would be the Oxidata urine free radical
It is a test that should be run routinely in practice, especially
those patients whose symptomology points to a possibility of
oxidative stress. An Oxidata test result that is grossly abnormal
would be a "gateway" to ordering the more expensive out-sourced
lab panels for oxidative stress. Another gateway test for oxidative
stress would be your Chem screen and CBC.
One of the first things on a chem screen that may indicate some
kind of oxidative stress and free radical activity is a total
cholesterol that is suddenly below its historical normal. Unoxidized
acts as a lipid soluble antioxidant and a free radical scavenger
the body, so decreased levels put the body at risk for developing
oxidative stress, especially lipid peroxidation, and increases the
chance of free radical induced diseases. I do not see a suddenly
decreased cholesterol level very often, but when I do I am much
more likely to order an oxidative stress panel from one of my out-
Other biomarkers on a blood chemistry and CBC that may indicate
oxidative stress are a decreased lymphocyte count. I will do an
article on the neutrophil/lymphocyte ratio at some point in the
future, but a low lymphocyte count is not a good thing to see.
Platelet levels may also be decreased along with an increased
globulin and uric acid level.
Red blood cells are particularly sensitive to oxidative stress,
can cause red blood cell hemolysis. This will increase bilirubin
levels. If you see an increased bilirubin level always order a
fractionation to see what the cause is. Increased RBC hemolysis
will typically raise the indirect bilirubin level.
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