Amino Acids: An introduction to the building blocks of life
Age Management
The Building Blocks of Life
An Introduction to Amino Acids
By Scott Berliner, RPh
Stedman’s Medical Dictionary defines aging as “the gradual deterioration of a mature organism resulting from time-dependent, irreversible changes in structure that are intrinsic to the particular species, and that eventually lead to decreased ability to cope with the stresses of the environment, thereby increasing the probability of death.” If we accept this definition, anti-aging interventions halt this deterioration and produce a greater ability to cope with stress of all kinds.
It is generally accepted that this gradual deterioration involves multiple mechanisms in the body.1 The increased effect of free radicals, the catabolic stages of aging, the decrease in enzymes throughout the body, and the degenerative illnesses that accompany the aging process have prompted many health care providers to examine what can be done to slow down or reverse the process we call aging. Aging affects the oxidative state of the hypothalamus-pituitary-adrenal axis, thus impacting every system in the body.2
Replacing Deficiencies
A functional integrative medicine approach to age management encompasses replacement of the deficiencies that occur with aging. This includes enzymes, vitamins, minerals and essential fatty acids, as well as the amino acids necessary for the body to complete the actions it was able to complete in younger years. Aging is associated with mitochondrial dysfunction that can lead to membrane leaks in cell walls, which then can release reactive oxygen and nitrogen. The cycle is completed with the induction of a peroxidase reaction that further releases metals and free radicals and can induce cell death.
The deficiency pathway is particularly apparent in the brain, where neuronal cell death can lead to memory impairment. Studies have documented the benefit of functional foods and nutraceuticals in the prevention or amelioration of this response. Antioxidants alone cannot effect this change; amino acids, which provide structure for all proteins in the body, are also essential.
Amino Acid Supplementation
Many messages direct the body to perform different tasks. For example, exercise signals the muscles anabolically to create more muscle using the amino acids derived from protein.4 And inhibition of nitric oxide synthase inhibitor, which aids in the release of nitric oxide from l-arginine, increases systemic arterial blood pressure.5 Working in a similar manner, supplementation with l-arginine can reduce elevated blood pressure. Low levels of l-arginine in cardiovascular patients have been linked with erectile dysfunction.6 Therefore, I often recommend l-arginine as a natural treatment for erectile dysfunction.
Amino acid supplementation can also be beneficial for diseases involving the brain and nervous system. Although aging is not a disease, it produces many issues involving these same neuronal factors. Alzheimer’s disease, Parkinson’s disease and multiple sclerosis are just a few of the many degenerative illnesses affected by amino acid availability in the body. Many studies have shown that acetyl-l-carnitine can help regenerate peripheral nerves in patients with HIV or diabetes. In ample doses and with the correct cofactors, acetyl-l-carnitine improves many of the neurological problems involving poor supply of energy to the neuronal mitochondria.12
For Mental Health
For many years I have recommended amino acids for the management of mental health issues arising from neurotransmitter imbalances that are detectable in urine. With proper amino acid supplementation, we can correct imbalances in the excitatory vs. inhibitory neurotransmitters. The specifics of this supplementation are best determined in consultation with a pharmacist.
Several studies have used tryptophan depletion as a means of measuring the effects of amino acids on depression.8 I often recommend tryptophan to increase serotonin. In many cases, it works similarly to other pharmaceutical choices — minus the side effects of weight gain, lost libido or suicidal tendencies.
Another useful amino acid, l-theanine, is a major component of green tea that has relaxing properties similar to the benzodiazepines. L-theanine and L-TRYPTOPHAN are commonly used together to reduce the excitatory neurotransmitters epinephrine and norepinephrine. Together they increase inhibitory neurotransmitters such as serotonin and dopamine.
Modern-day prescription antidepressants work by inhibiting neuronal serotonin or dopamine uptake or by acting as selective serotonin reuptake inhibitors. Amino acids can do this job naturally when properly used and dosed. In an encapsulated supplement form, this may require six to nine capsules a day because aminos are not concentrated the way pharmaceuticals are. This natural replacement of deficient precursors reduces the side effect profile of treatment. In fact, the side effects are usually beneficial because amino acid supplementation affects all amino acid functioning, not just psychological balance. An example is SAM-e. If is often recommended for depression, but it also helps with joint pain. One study found SAM-e to have a slower onset of action but comparable in effectiveness to celecoxib (Celebrex) in the management of knee osteoarthritis.provide CITATION NAJMWI, REINSCH S, HOEHLER F, TOBIS JS, HARVEY PW. S-ADENOSYL METHIONINE (SAME) VERSUS CELECOXIB FOR THE TREATMENT OF OSTEOARTHRITIS SYMPTOMS: DOUBLE-BLIND CROSS-OVER TRIAL. [ISRCTN36233495]. BMC MUSCULOSKELET DISCORD. 2004 FEB 26;5:6.
Anti-Aging Benefits
The anti-aging benefits of amino acid supplementation range from replacing essential amino acids (which we may not ingest enough of) to supplementing with nonessential amino acids (which we may not make enough of), especially when the affected system is under siege. Although our bodies make l-glutamine, this amino acid is often deficient in many areas of the body. I recommend it often for gastrointestinal issues such as colitis, diverticulitis and gastroesophageal reflux disease. Glutamine acts as a natural antibiotic in the gut. This action partially explains how all humans carry the H. pylori bacteria yet most people are asymptomatic.10
Glutamine can enhance the immune function of the gut, and studies have demonstrated increases in secretory IgA.11 I often recommend high doses of l-glutamine to patients with HIV — for the energy it provides as an initiator of glycolysis and to reinforce the gut health so necessary when strong antiviral medicines disturb the natural intestinal balance.
In addition, high doses of l-glutamine can be a powerful tool in restoring mitochondrial health. I am now exploring the use of l-glutamine with a new Krebs cycle intermediary called methyl pyruvate (Encell) as an initiator of glycolysis and a stimulator of cellular energy. Increasing energy on a cellular level enables every cell in the body to perform its tasks better.
A study of nebulized glutathione use in COPD treatment recently determined that this amino acid can increase endothelial lung function. I have compounded buffered glutathione for nebulization and have witnessed the same effects noted in the study. It appears to improve the health of the lungs.16 Another study documented this effect in the lungs of smokers with emphysema.17 This treatment deserves more investigation because late-stage COPD patients have few options other than oxygen inhalation. Further evidence was documented in a study that found low levels of glutathione in the nasal mucosa of patients with chronic sinusitis.18
Putting It Into Practice
The examples above are just a small representation of what is possible with the many amino acids necessary for the proper functioning of the human body. You are probably wondering: how do we know when supplementation of amino acids is necessary? Many providers do organic acid testing to ascertain deficiencies and then supplement accordingly. Sometimes this makes sense, but other times it is more important to question why a deficiency exists. In other words, is the problem an inability to absorb digestive nutrients or is it an inability to derive particular amino acids from protein? I think the best answer is to supplement the deficient nutrients to allow the different pathways to complete themselves — while you work on determining the reason the deficiency exists.
In my experience, digestive enzymes dosed with meals are particularly helpful. Also in my experience, low digestive hydrochloric acid levels are common and sometimes require rebalancing to correct pH and allow proper digestion to occur. The abuse of proton pump inhibitors may contribute strongly to this. The clinical importance of hypochlorhydria and its role in mineral and amino acid malabsorption is well documented.14,15 The variables are multitudinous and need to be considered before supplementation.
The proper use of amino acids can delay the progressive nature of age-related disease. From hypertension to erectile dysfunction, many of the issues we face as we age can be ameliorated or eliminated with a proper balance of amino acids. With the proper vitamin and mineral cofactors, most adults can benefit from supplementation. How do NPs determine what these cofactors are? What is some general advice for NPs who want to recommend amino acid supplementation? BLOODWORK, ORGANIC ACID ANALYSIS, HAIR ANALYSIS, URINE AND SALIVA ARE ALL USED IN DIFFERENT WAYS TO DETERMINE THE DEFICIENT COFACTORS. MOST OF THE TESTING COMPANIES OFFER COMPREHENSIVE TRAINING MANUALS TO HELP PRACTITIONERS DETERMINE WHAT IS NECESSARY AND OFTEN OFFER PERSONAL SUPPORT BY KNOWLEDGEABLE QUALIFIED PEOPLE ON THEIR STAFF
No matter what a person’s amino acid status, it is important to maintain a healthy lifestyle with appropriate exercise and diet. The stresses of life, as well as genetic propensities, often lead to issues beyond dietary control. For many imbalances, it is beneficial to consider this all-important family of nutrients before moving on to more potent pharmaceutical alternatives. In the world of functional and integrative medicine, amino acids are valuable tools in slowing the progression of aging and the diseases we experience in the aging process.
Scott Berliner is a compounding pharmacist who owns Life Science Pharmacy in Harriman, N.Y.
References
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3. Ferrari CK. Functional foods, herbs and nutraceuticals: towards biochemical mechanisms of healthy aging. Biogerontology. 2004;5(5):275-289.
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6. Wierzbicki AS, et al. Asymmetric dimethyl arginine levels correlate with cardiovascular risk factors in patients with erectile dysfunction. Atherosclerosis. 2005;volume(issue):pages.
7. Hart AM, et al. Acetyl-l-carnitine: a pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy. AIDS. 2004;18(11);1549-1560.
8. Hart AM, et al. Systemic acetyl-L-carnitine eliminates sensory neuronal loss after peripheral axotomy: a new clinical approach in the management of peripheral nerve trauma. Exp Brain Res. 2002;145(2):182-189.
9. Praschak-Rieder N, et al. Effects of tryptophan depletion on the serotonin transporter in healthy humans. Biol Psychiatry. 2005;volume(issue):pages
10. Lu K, et al. The acute effects of L-theanine in comparison with alprazolam on anticipatory anxiety in humans. Human Psychopharmacol. 2004;19(7):457-465.
11. NajmWI, et al. S-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: double-blind cross-over trial. [ISRCTN36233495]. BMC Musculoskel Discord. 2004;5:6.
12. Kawabubo M, et al. Natural antibiotic function of a human gastric mucin against Helicobacter pylori infection. Science. 2004;305(5686):1003-1006.
13. Yu B, et al. Enhancement of gut immune function by early enteral feeding enriched with L-glutamine in severe burned miniswines. Zhonghua Zheng Xing Shao Shang Wai Ke Zhi. 1996;12(2):98-100.
14. Lamson DW, Brignall MS. The use of nebulized glutathione in the treatment of emphysema: a case report. Altern Med Rev. 2000;5(5):429-431.
15. Gressier B, et al. Protective role of glutathione on alpha 1 proteinase inhibitor inactivation by the myeloperoxidase system. Hypothetic study for therapeutic strategy in the management of smokers’ emphysema. Fundam Clin Pharmacol. 1994;8(6):518-524.
16. Westerveld GJ, et al. Antioxidant levels in the nasal mucosa of patients with chronic sinusitis and healthy controls. Arch Otolaryngol Head Neck Surg. 1997;123(2):201-204.
17. Cater RE 2nd. The clinical importance of hypochlorhydria (a consequence of chronic Helicobacter infection): its possible etiological role in mineral and amino acid malabsorption, depression and other syndromes. Med Hypotheses. 1992;39(4):375-383.
18. Hunt RH. The protective role of gastric acid. Scand J Gastroenterol Suppl. 1998;146:34-39.
