"I've seen vocal nodules and polyps shrink down to almost nothing after a few IV glutathione treatments. In many cases, these patients can avoid surgery," says Dr. Asher, who pioneered this novel therapy a few years ago.
The treatment is very simple: 2 grams of glutathione as an IV push via a 10 cc syringe with a butterfly needle.
"It has a tremendous positive effect in people with vocal fatigue, vocal fold nodules and polyps. These are common problems among professional singers and speakers who are constantly exerting their voices. If these conditions are severe they can be livelihood threatening. Such patients are often referred for surgery which is invasive, expensive, and not always effective," he told Holistic Primary Care in an interview.
The glutathione push is an excellent short-term rescue. He's used it to give Broadway singers immediate relief and get them through difficult weeks. But if given on a regular basis, the treatment can be truly therapeutic, in some cases reversing longstanding vocal cord lesions and voice problems.
A Welcome Option
Normally, the vocal folds are filled with glutathione, as is the tissue all along the entire airway, explained Dr. Asher. This makes sense, given that the respiratory tract is the body's primary place of oxygen exchange, which means lots of exposure to oxygen free radicals.
With excessive wear and tear, combined with aging, smoking, and exposure to environmental toxins, airway tissue stores of glutathione are depleted. Dr. Asher believes vocal fold nodules and polyps are actually a tissue response to chronic and uncontrolled oxidative stress.
IV glutathione represents a welcome therapeutic option for a problem for which there are few good conventional therapies. "Antibiotics, steroids, and proton pump inhibitors are the 3 big go-to drugs that most doctors use to treat vocal problems. None of them are very effective in this context and they're all terrible for you!"
The PPIs are particularly pernicious. "A lot of doctors recommend them based on the notion that vocal fatigue is caused by reflux. This is a highly questionable explanation, and use of these drugs can cause many downstream problems in the GI tract. They also contribute to osteoporosis, and deplete magnesium."
Dr. Asher said he initially became interested in glutathione after reading a study showing that kids with asthma have lower glutathione levels than those who do not have the disorder. This is especially true of kids who are frequently given Tylenol, which depletes glutathione as it is detoxified. The findings got him thinking about the role of glutathione in the airway.
He had not considered actually using it in practice until an encounter with a patient who had a lot of debilitating chronic fatigue symptoms, and who'd had positive experience with glutathione. "I was initially reluctant to give IV glutathione—or any IV treatments for that matter. I wasn't really doing IVs. But he basically begged me to do it, and so I relented. It had a big, big effect."
Among those effects was an improvement in the patient's voice. Dr. Asher began to wonder about glutathione's potential for helping other patients with serious vocal problems.
"If you're singing 8 shows per week, as many Broadway show performers must do, the demands on your vocal cords and your airway are very high. So I treat some of my Broadway performers every month."
Repeated treatments can produce lasting improvements. "I had one patient with severe vocal polyp, who was referred for surgery. I gave her four treatments over 8 weeks. Three weeks after the final treatment, there was a 90% shrinkage of the polyp, and it has been sustained for about 4 months."
Another patient—a Broadway performer--was having serious voice strain and was on steroids 6-7 days per week to get through her show schedule. Her problem was compounded by the fact that she was a smoker, as are many showbiz professionals.
A very prominent vocal cord surgeon told her that surgery was inevitable, Dr. Asher said. "I did aggressive IV glutathione---a 3 gram push every week. She responded beautifully. Her vocal cords look great, and she can do the shows without steroids."
He acknowledged that this is anecdotal, and that there are no studies of IV glutathione to treat vocal fold pathology. But he contends that his patients' responses—and the photographic evidence of lesion regression---speak for themselves (pun intended!).
Positive Side Effects
Glutathione shots are a safe option, and inexpensive, given their therapeutic punch. A vial of IV glutathione costs between $20-30. The total cost to patients ranges from $175-250 per treatment. IV glutathione can be obtained from most compounding pharmacies. Dr. Asher says he prefers Wellness Pharmacy, though he has no financial ties or other involvements with the company.
Glutathione can be given orally as a supplement or via a transdermal cream. Both can be useful for maintenance therapy, to keep someone's levels up once they've been boosted. But the initial therapy is best accomplished with IV dosing.
"It seems to restore something to the vocal cords." Some of the singers he's treated report that glutathione actually extends their vocal range, adding a note or two to the top, the bottom, or in some cases both ends of their usual range.
So far, the only "side effects" he's observed have been positive. The treatment can be helpful in reducing symptoms of reflux. It can also make a big difference in asthma patients. "You can reverse an asthma episode in a few minutes. It's a great acute rescue treatment."
He's also had curious success in resolving Dupuytren's contractures (aka palmar fibromatosis)—a thickening of the palmar fascia that causes fingers (usually the ring or little fingers) to bend involuntarily toward the palm. Glutathione injections partially resolved these peculiar contractures. "It's not a cure, but it certainly helps. I've talked to rehab doctors, and they say there's really no good treatment for Dupuytren's. So this is a nice option."