In 1957, Dr. Denham Harman observed that free radicals increase with metabolic activity associated with biological oxidation/reduction reactions. Dr. Harman’s research suggested that aging and many degenerative age-related diseases – such as cardiovascular disease, cancer, Alzheimer’s and diseases of the skin – could be the result of accumulated free radical damage to cellular components, particularly DNA. He concluded that antioxidants might play an essential role in protecting the body against such damage.

Scientists have identified a number of specific free radicals that are important determinants of aging and disease prevention. These free radicals are the toxic by-products of normal energy metabolism and, to a lesser degree, other environmental factors.

The accumulation of the free radical, results in a change in cell structure that leads to a loss of cell function and decline in the functional integrity of the body’s organs and tissues. This damage is believed to be closely linked with the onset of many age-related diseases.

Oxidative stress status (OSS) is the net result of the rate at which damage is occurring in the body, and the rate at which damage is being cleared. An important factor determining the rate at which damage occurs is an individual’s antioxidant status (AOS). Measurement of OSS and AOS enables the physician to customize interventions designed to reduce the patient’s overall oxidative stress and increase the probability of optimal health. Targeted treatments including lifestyle changes, such as diet and exercise, have been shown to make significant improvements in both AOS and OSS.

Oxidative Stress Assessment (Code 10190)

Factors Related to Oxidative Protection

Albumin – a protein that performs many important functions including control in scavenging free radicals.

Ascorbate – Vitamin C; has been shown to promote arterial relaxation and diminish the oxidation of LDL, the harmful form of cholesterol that causes disease.

Bilirubin – is known to act as an antioxidant that provides protection against oxidative stress.

Coenzyme Q10 – in addition to its cardiovascular effects, this vitamin provides valuable antioxidant protection, particularly in the mitochondria, or energy factories, of every living cell.

Glutathione – Glutathione is among the body’s most important free radical scavengers.

Homocysteine – an important free radical scavenger.

Iron Binding – these measurements include UIBC and total iron binding capacity (TIBC). Iron binding proteins function in the body to store iron and keep it from exerting its harmful, pro-oxidative effects.

Total Carotenoids – this KSL panel measures eight different carotenoids, which together provide valuable information regarding the oxidative protection offered by this important class of antioxidants. Included are alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, lycopene, retinol, retinyl palmitate and zeaxanthin.

Total Tocopherols – the most important tocopherols in human antioxidant protection include alpha, which plays a very important role in preventing LDL oxidation, and gamma, most commonly available in food. Most over-the-counter dietary supplements consist solely of alpha-tocopherol. This KSL assay allows physicians to assess levels of both of these important tocopherols.

Uric acid – elevated uric acid levels appear to correlate well with improved oxidative stress protection.

Factors Related to Oxidative Damage

Ceruloplasmin – a protein much like ferritin; binds iron and copper. Although these metals are required in small amounts, high levels can cause oxidative harm to the body.

Copper – a trace metal that the body requires in small amounts for important metabolic functions. Increased amounts of copper are potent pro-oxidants and facilitate oxidative damage.

Ferritin – a protein that binds iron; although it has protective qualities it is a measure of overall iron load. Excess Iron causes oxidative stress.

Glucose – elevated glucose levels are diagnostic of diabetes mellitus, one of the most prevalent pro-oxidant conditions.

Hemoglobin A1c – HbA1c is formed as hemoglobin is gradually glycosylated throughout the 120-day lifespan of red blood cells.  Therefore, the amount of HbA1c in the blood provides a good measure of the average blood glucose level over the past two months. It is, perhaps, the best indicator of overall blood glucose control. Since HbA1c is an indication of glycoxidation of bodily proteins, blood levels should be as low as possible.

Iron – a powerful pro-oxidant; has a strong role in promoting the oxidation of lipids. Oxidized lipids lead to arterial inflammation and blockage.

Also Available:

Isoprostanes – indicators of oxidative damage that have been shown to be associated with risk of cardiovascular disease. They are formed by the free radical catalyzed non-enzymatic peroxidation of arachidonic acid in cellular membranes and lipoproteins. (iPF2-alpha-III, iPF2-alpha-VI, 2,3-dinor-PGF2-alpha)

DNA Damage – oxidative damage to DNA may be an important contributor to aging and degenerative disease. 8-Hydroxy-2-deoxyguanosine (8OhdG) reflects the patient’s potential for cell mutation and, therefore, cancer risk. 5-Hydroxymethyl-2-deoxyuridine (5OhmU), in conjunction with 8OhdG, is a useful marker of oxidative damage status.

KSL Articles

Heward C, & Su Y.  Oxidative Stress Assessment at Kronos Science Laboratory (read article)

Critical Reviews of Oxidative Stress and Aging:  Advances in Basic Science, Diagnostics and Intervention. Chapter 81: Database Analysis of Human Intervention Studies (The Kronos Longitudinal Study of Aging and Anti-aging Interventions).  World Scientific Publishing Co. Pte. Ltd. Singapore 596224. © 2003. (read article)

S. Mitchell Harman, Christopher Heward.  Brocklehurst’s Textbook of Geriatric Medicine and Gerontology, 6^th Edition.  Chapter 15: Anti-Aging Interventions.  Elsevier Science Limited, London.  © 2003. (read article)

Liang Y, Wei P, Duke RW, Reaven PD, Harman SM, Cutler RG, Heward CB.  Quantification of 8-Iso-Prostaglandiin-F(2alpha) and 2,3-Dinor-8-Iso-Prostaglandin-F(2alpha) in Human Urine Using Liquid Chromatography-Tandem Mass Spectrometry.  Free Radic Bil Med. 2003 Feb 15;34(4):409-18. (read article)

Harman SM, Liang L, Heward CB, Reaven P, Ping W, Cutler RL, Duke R. Comparisons of Urinary Excretion of Three DNA Oxidation Adducts and Isoprostane F2a Measured by Liquid Chromatography-Mass Spectrometry in Smokers, Ex-smokers, and Non-smokers. Free Rad Biol Med 35:1301-9, 2003. (read article)

Nieman DC, Henson DA, McAnulty SR, McAnulty LS, Morrow JD, Ahmed A, Heward CB. Vitamin E and Immunity after the Kona Triathlon World Championship. Medicine and Science in Sports and Exercise. 2004 Aug;36(8):1328-35. (read article)