It's fair to say that glaucoma is a mitochondrial disorder. Many years ago, Dr. Ritch shared this important understanding of glaucoma with the FitEyes community:
All glaucomas have a final common pathway of retinal ganglion cell death involving low-grade inflammation, oxidative damage, mitochondrial dysfunction, and glial hyperactivation.
Dr. Ritch's concise sentence highlights four areas that we can focus on:
- low-grade systemic inflammation
- oxidative stress
- mitochondrial dysfunction
- glial hyperactivation
All are important. I have personally had good success keeping my inflammation biomarkers very low. I also feel I have a good program for managing oxidative stress (with a strong focus on dietary supplements and a good diet). I don't intend to neglect those. I don't yet know a lot that we can do about glial hyperactivation, except to keep our immune systems healthy and to maintain optimal overall health with an optimum lifestyle.
In past years I probably would have assumed that, of these four areas, managing systemic inflammation and oxidative stress would give the biggest rewards for glaucoma patients.
In fact, when Dr. Ritch and I discussed his "glaucoma in one sentence", I immediately started digging into the "oxidative damage" part of that equation because that's where a lot of nutrition science was focused at the time. Here's one of the first articles I wrote on the topic:
Glaucoma, Inflammation and Oxidative Stress: An Attempt to Unify Recent News | FitEyes.com
Indeed, antioxidants can help with mitochondrial dysfunction too, so getting systemic inflammation and oxidative stress in check provides a very good foundation for mitochondrial metabolic therapies (including things like vitamin B3).
The impressive results we are now seeing from mitochondrial metabolic therapies in glaucoma patients indicates to me that this is the area that offers the biggest bang for the buck. I am going to make mitochondrial metabolic therapies my #1 focus going forward. I'll keep doing the other healthy things I have done, but all my new efforts will now go into mitochondrial metabolic therapies until I feel I have this area optimized. I think this area holds great promise for all glaucoma patients.
With that background, I now wish to share this very relevant journal article:
Nutritional cofactor treatment in mitochondrial disorders - PubMed
Mitochondrial disorders are degenerative diseases characterized by a decrease in the ability of mitochondria to supply cellular energy requirements. Substantial progress has been made in defining the specific biochemical defects and underlying molecular mechanisms, but limited information is available about the development and evaluation of effective treatment approaches.
The goal of nutritional cofactor therapy is to increase mitochondrial adenosine 5'-triphosphate production and slow or arrest the progression of clinical symptoms.
Accumulation of toxic metabolites and reduction of electron transfer activity have prompted the use of antioxidants, electron transfer mediators (which bypass the defective site), and enzyme cofactors.
Metabolic therapies that have been reported to produce a positive effect include:
- Coenzyme Q(10) (ubiquinone)
- ascorbic acid
- vitamin E
- lipoic acid
- riboflavin
- thiamin
- niacin (aka nicotinic acid) and niacinamide (aka nicotinamide)
- vitamin K (phylloquinone and menadione)
- creatine
- carnitine
A literature review of the use of these supplements in mitochondrial disorders is presented.
There are other articles on this topic on Ask FitEyes, including:
Mitochondrial Correction for Degenerative Diseases | Ask FitEyes
Full text article available for logged in FitEyes members only.
Nutritional cofactor treatment in mitochondrial disorders (full text) | Ask FitEyes