Wednesday, August 06, 2014

Inorganic Sulfate, Tylenol, and Asthma

Several recent studies have identified a strong correlation between tylenol exposure and asthma.  According to one study, just a single dose of tylenol before age 1 increased the odds ratio of developing asthma by 60%.  Children who reveived 1 dose of tylenol monthly had over a 500% increased odds of developing asthma.   

But correlation doesn't equal causation.  What could be the causal link between tylenol and asthma.  The Liver is tasked with detoxifying tylenol. Phase 1 metabolism produces the NAPQI free radical that depletes glutathione, a major antioxidant in the body.  NAPQI is what kills people who overdose on tylenol.  Phase 2 metabolism involves sulfate conjugation which makes tylenol more water soluble and better able to be excreted by the kidney. It may be that both mechanisms lead to asthma and other chronic inflammatory illnesses via glutathione and sulfate deficiency.

Some doctors and scientists are just now 
beginning to hypothesize that inorganic sulfate deficiency may be directly related to numerous chronic inflammatory illnesses like asthma. The interesting thing to consider is which medicines like Tylenol deplete sulfate via sulfate conjugation as well as the many sulfate-containing medicines used to treat these disorders.

Medicines that require phase 2 sulfate conjugation:

Vitamin D
Bile Acids

Food additives that deplete dietary inorganic sulfate:

Aluminum Phosphate (baking powder)
Tricalcium Phosphate (juice additive) 
Sodium Benzoate (food preservative, metabolite of cinnamon)

These first two additives react with soluble inorganic sulfate in the food producing insoluble aluminum sulfate (Alum) and calcium sulfate (Gypsum). The food preservative sodium benzoate is a d-aminoacid oxidase inhibitor.  Sodium Benzoate blocks the thiosulfate intermediate β-mercaptopyruvate in sulfate formation from d-cysteine.

Sulfated medicines used to treat chronic inflammatory disease:

Magnesium Sulfate- asthma
Albuterol Sulfate- asthma
Terbutaline Sulfate- asthma
Condroitin Sulfate- osteoarthritis
Glucosamine Sulfate- osteoarthritis
Plaquenil Sulfate- lupus, rheumatoid 
Codeine Sulfate- pain, cough
Morphine Sulfate- pain, cough
Heparin Sulfate- clotting disorders

Serum sulfate levels are tightly controlled in the body and do not necessarily reflect total body sulfate levels.  The body doesn't necessarily need dietary inorganic sulfate but can produce sulfate through a complex process by converting sulfur amonoacids cysteine and methionine into sulfate using folate and B12 and other B-vitamins.  Serum Homocysyeine is a great surragate marker for inorganic sulfate deficiency and indicates when the body is catabolically scavenging sulfate from the body tissues.  

Serum Homocystein levels are elevated in many chronic inflammatory conditions.  However, lowering these levels by supplementing with folate and B12 never reversed the disease process.  It may be that supplementing with Epsom salt (MgSO4) will.

I noticed that B-vitamins and Taurine are popular additives to many energy drinks. Interesting that all these additives are related to sulfate metabolism. 


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