We deeply respect the fundamental goal of the International Association of Firefighters (IAFF) to care for the health and wellness of its members. We respectfully disagree with their recently stated position that glutathione is not a safe and effective treatment.
Licensed medical providers have utilized glutathione in the practice of environmental medicine for decades. However, we have long recognized the need to expand upon the peer-reviewed research behind the clinical use of glutathione, specifically to reduce the chemical burden in firefighters, and are actively exploring partnerships to that end.
Licensed medical providers have utilized glutathione in the practice of environmental medicine for decades. However, we have long recognized the need to expand upon the peer-reviewed research behind the clinical use of glutathione, specifically to reduce the chemical burden in firefighters, and are actively exploring partnerships to that end.
Glutathione (IV & Nebulized) for Firefighter Toxicant Exposure
What the evidence currently shows about safety and efficacy
Author: Chris Holder, ND. Wild Oak Medicine and Integrative Health Action Network (IHAN).
Author: Chris Holder, ND. Wild Oak Medicine and Integrative Health Action Network (IHAN).
Why This Is Being Considered
Firefighters are occupationally exposed to a well-documented mix of toxicants: polycyclic aromatic hydrocarbons (PAHs), benzene, formaldehyde, heavy metals, and per- and polyfluoroalkyl substances (PFAS, “forever chemicals”) through smoke, soot, and contaminated turnout gear. This exposure is linked to elevated rates of certain cancers, cardiovascular disease, and other chronic disease, which has driven real interest in interventions that could reduce the body's toxicant burden. Despite this, there are currently no established, proven treatments for reducing firefighter toxic exposure. The existing research base is dominated by exposure-characterization studies (documenting what firefighters are exposed to and what shows up in their blood and urine) rather than intervention trials. This document reflects an effort to evaluate glutathione as a candidate intervention and to determine whether it can be shown to be both safe and efficacious for this purpose.
Mazumder NU, Hossain MT, Jahura FT, Girase A, Hall AS, Lu J, Ormond RB. Firefighters' exposure to per-and polyfluoroalkyl substances (PFAS) as an occupational hazard: A review. Front Mater. 2023;10:10.3389/fmats.2023.1143411. doi: 10.3389/fmats.2023.1143411. Epub 2023 Mar 23. PMID: 38074949; PMCID: PMC10698640.
Sousa G, Teixeira J, Delerue-Matos C, Sarmento B, Morais S, Wang X, Rodrigues F, Oliveira M. Exposure to PAHs during Firefighting Activities: A Review on Skin Levels, In Vitro/In Vivo Bioavailability, and Health Risks. Int J Environ Res Public Health. 2022 Oct 4;19(19):12677. doi: 10.3390/ijerph191912677. PMID: 36231977; PMCID: PMC9565977.
Barros B, Oliveira M, Morais S. Biomonitoring of firefighting forces: a review on biomarkers of exposure to health-relevant pollutants released from fires. J Toxicol Environ Health B Crit Rev. 2023 Apr 3;26(3):127-171. doi: 10.1080/10937404.2023.2172119. Epub 2023 Feb 6. PMID: 36748115
Firefighters are occupationally exposed to a well-documented mix of toxicants: polycyclic aromatic hydrocarbons (PAHs), benzene, formaldehyde, heavy metals, and per- and polyfluoroalkyl substances (PFAS, “forever chemicals”) through smoke, soot, and contaminated turnout gear. This exposure is linked to elevated rates of certain cancers, cardiovascular disease, and other chronic disease, which has driven real interest in interventions that could reduce the body's toxicant burden. Despite this, there are currently no established, proven treatments for reducing firefighter toxic exposure. The existing research base is dominated by exposure-characterization studies (documenting what firefighters are exposed to and what shows up in their blood and urine) rather than intervention trials. This document reflects an effort to evaluate glutathione as a candidate intervention and to determine whether it can be shown to be both safe and efficacious for this purpose.
Mazumder NU, Hossain MT, Jahura FT, Girase A, Hall AS, Lu J, Ormond RB. Firefighters' exposure to per-and polyfluoroalkyl substances (PFAS) as an occupational hazard: A review. Front Mater. 2023;10:10.3389/fmats.2023.1143411. doi: 10.3389/fmats.2023.1143411. Epub 2023 Mar 23. PMID: 38074949; PMCID: PMC10698640.
Sousa G, Teixeira J, Delerue-Matos C, Sarmento B, Morais S, Wang X, Rodrigues F, Oliveira M. Exposure to PAHs during Firefighting Activities: A Review on Skin Levels, In Vitro/In Vivo Bioavailability, and Health Risks. Int J Environ Res Public Health. 2022 Oct 4;19(19):12677. doi: 10.3390/ijerph191912677. PMID: 36231977; PMCID: PMC9565977.
Barros B, Oliveira M, Morais S. Biomonitoring of firefighting forces: a review on biomarkers of exposure to health-relevant pollutants released from fires. J Toxicol Environ Health B Crit Rev. 2023 Apr 3;26(3):127-171. doi: 10.1080/10937404.2023.2172119. Epub 2023 Feb 6. PMID: 36748115
The Rationale for Glutathione
Glutathione is the body's most abundant intracellular antioxidant and a central player in redox homeostasis, cell signaling, and defense against oxidative stress across virtually every organ system.
In the liver, glutathione drives phase II (conjugation) detoxification: glutathione S-transferase enzymes attach glutathione to electrophilic xenobiotics, including reactive intermediates of PAHs and other combustion byproducts, forming water-soluble conjugates that are further processed into mercapturic acids and excreted in bile or urine.
Because this conjugation pathway consumes glutathione, heavy or repeated toxicant exposure can deplete glutathione stores, and depleted glutathione has been linked in the broader medical literature to increased susceptibility to oxidative damage and to the pathogenesis or progression of a range of diseases, including cancer, cardiovascular disease, and inflammatory and metabolic conditions.
Restoring or boosting glutathione levels is an active area of clinical interest well beyond firefighting, from cystic fibrosis and COPD to neurodegenerative disease, providing a broader base of biological plausibility for glutathione-based interventions even though firefighter-specific outcome data does not yet exist.
Liver disease offers a particularly relevant example. Metabolic dysfunction-associated steatotic liver disease (MASLD) and its more advanced form, metabolic dysfunction-associated steatohepatitis (MASH), are associated with depleted glutathione levels and hepatic oxidative stress. An open-label pilot study found that oral glutathione supplementation improved liver enzymes and reduced hepatic fat content in patients with MASLD, and a subsequent pharmacological review detailed glutathione’s mechanistic role in MASLD/MASH pathophysiology and its potential clinical applications.
Cardiovascular disease shows a similar pattern. Reduced glutathione peroxidase-1 activity has been associated with a higher risk of cardiovascular events in patients with coronary artery disease, and other markers of oxidative stress have similarly been linked to increased mortality risk in this population. More recent research has examined glutathione’s role in protecting vascular endothelium from oxidized-LDL-induced dysfunction, a key mechanism in the development of atherosclerosis.
Ballatori N, Krance SM, Notenboom S, Shi S, Tieu K, Hammond CL. “Glutathione dysregulation and the etiology and progression of human diseases.” Biological Chemistry, 2009;390(3):191–214.
Lu SC. “Dysregulation of glutathione synthesis in liver disease.” Liver Research, 2020;4(2):64–73.
Honda Y, et al. “Efficacy of glutathione for the treatment of nonalcoholic fatty liver disease: an open-label, single-arm, multicenter, pilot study.” BMC Gastroenterology, 2017;17:96. doi:10.1186/s12876-017-0652-3.
Santacroce G, et al. “Glutathione: Pharmacological aspects and implications for clinical use in non-alcoholic fatty liver disease.” Frontiers in Medicine, 2023;10. doi:10.3389/fmed.2023.1124275.
Tan M, et al. “Glutathione system enhancement for cardiac protection: pharmacological options against oxidative stress and ferroptosis.” Cell Death & Disease, 2023 Feb 16;14(2):131.
Blankenberg S, et al. “Glutathione Peroxidase 1 Activity and Cardiovascular Events in Patients with Coronary Artery Disease.” New England Journal of Medicine, 2003;349:1605–1613. doi:10.1056/NEJMoa030535.
Patel RS, Ghasemzadeh N, Eapen DJ, Sher S, Arshad S, Ko YA, Veledar E, Samady H, Zafari AM, Sperling L, Vaccarino V, Jones DP, Quyyumi AA. Novel Biomarker of Oxidative Stress Is Associated With Risk of Death in Patients With Coronary Artery Disease. Circulation. 2016 Jan 26;133(4):361-9. doi: 10.1161/CIRCULATIONAHA.115.019790. Epub 2015 Dec 16. PMID: 26673559; PMCID: PMC4722941.
Marasinghe CK, Je JY. “Glutathione as a Therapeutic Agent for OxLDL-Induced Endothelial Dysfunction and Atherosclerosis Prevention.” Cell Biology International, 2025;49:1163–1172. doi:10.1002/cbin.70047.
Ghezzi P. “Role of glutathione in immunity and inflammation in the lung.” International Journal of General Medicine, 2011;4:105–113.
Aebi S, Assereto R, Lauterburg BH. “High-dose intravenous glutathione in man. Pharmacokinetics and effects on cyst(e)ine in plasma and urine.” European Journal of Clinical Investigation, 1991 Feb;21(1):103–110.
Glutathione is the body's most abundant intracellular antioxidant and a central player in redox homeostasis, cell signaling, and defense against oxidative stress across virtually every organ system.
In the liver, glutathione drives phase II (conjugation) detoxification: glutathione S-transferase enzymes attach glutathione to electrophilic xenobiotics, including reactive intermediates of PAHs and other combustion byproducts, forming water-soluble conjugates that are further processed into mercapturic acids and excreted in bile or urine.
Because this conjugation pathway consumes glutathione, heavy or repeated toxicant exposure can deplete glutathione stores, and depleted glutathione has been linked in the broader medical literature to increased susceptibility to oxidative damage and to the pathogenesis or progression of a range of diseases, including cancer, cardiovascular disease, and inflammatory and metabolic conditions.
Restoring or boosting glutathione levels is an active area of clinical interest well beyond firefighting, from cystic fibrosis and COPD to neurodegenerative disease, providing a broader base of biological plausibility for glutathione-based interventions even though firefighter-specific outcome data does not yet exist.
Liver disease offers a particularly relevant example. Metabolic dysfunction-associated steatotic liver disease (MASLD) and its more advanced form, metabolic dysfunction-associated steatohepatitis (MASH), are associated with depleted glutathione levels and hepatic oxidative stress. An open-label pilot study found that oral glutathione supplementation improved liver enzymes and reduced hepatic fat content in patients with MASLD, and a subsequent pharmacological review detailed glutathione’s mechanistic role in MASLD/MASH pathophysiology and its potential clinical applications.
Cardiovascular disease shows a similar pattern. Reduced glutathione peroxidase-1 activity has been associated with a higher risk of cardiovascular events in patients with coronary artery disease, and other markers of oxidative stress have similarly been linked to increased mortality risk in this population. More recent research has examined glutathione’s role in protecting vascular endothelium from oxidized-LDL-induced dysfunction, a key mechanism in the development of atherosclerosis.
Ballatori N, Krance SM, Notenboom S, Shi S, Tieu K, Hammond CL. “Glutathione dysregulation and the etiology and progression of human diseases.” Biological Chemistry, 2009;390(3):191–214.
Lu SC. “Dysregulation of glutathione synthesis in liver disease.” Liver Research, 2020;4(2):64–73.
Honda Y, et al. “Efficacy of glutathione for the treatment of nonalcoholic fatty liver disease: an open-label, single-arm, multicenter, pilot study.” BMC Gastroenterology, 2017;17:96. doi:10.1186/s12876-017-0652-3.
Santacroce G, et al. “Glutathione: Pharmacological aspects and implications for clinical use in non-alcoholic fatty liver disease.” Frontiers in Medicine, 2023;10. doi:10.3389/fmed.2023.1124275.
Tan M, et al. “Glutathione system enhancement for cardiac protection: pharmacological options against oxidative stress and ferroptosis.” Cell Death & Disease, 2023 Feb 16;14(2):131.
Blankenberg S, et al. “Glutathione Peroxidase 1 Activity and Cardiovascular Events in Patients with Coronary Artery Disease.” New England Journal of Medicine, 2003;349:1605–1613. doi:10.1056/NEJMoa030535.
Patel RS, Ghasemzadeh N, Eapen DJ, Sher S, Arshad S, Ko YA, Veledar E, Samady H, Zafari AM, Sperling L, Vaccarino V, Jones DP, Quyyumi AA. Novel Biomarker of Oxidative Stress Is Associated With Risk of Death in Patients With Coronary Artery Disease. Circulation. 2016 Jan 26;133(4):361-9. doi: 10.1161/CIRCULATIONAHA.115.019790. Epub 2015 Dec 16. PMID: 26673559; PMCID: PMC4722941.
Marasinghe CK, Je JY. “Glutathione as a Therapeutic Agent for OxLDL-Induced Endothelial Dysfunction and Atherosclerosis Prevention.” Cell Biology International, 2025;49:1163–1172. doi:10.1002/cbin.70047.
Ghezzi P. “Role of glutathione in immunity and inflammation in the lung.” International Journal of General Medicine, 2011;4:105–113.
Aebi S, Assereto R, Lauterburg BH. “High-dose intravenous glutathione in man. Pharmacokinetics and effects on cyst(e)ine in plasma and urine.” European Journal of Clinical Investigation, 1991 Feb;21(1):103–110.
What Has Actually Been Studied
IV Glutathione
There are no published randomized controlled trials evaluating IV glutathione for reducing PFAS, PAH, or other toxicant levels in firefighters.
Since 2023, three entities – nonprofits Integrative Health Action Network and the Volunteer Fire Foundation, and an environmental medicine clinic, Wild Oak Medicine – all based in Santa Rosa, California, have partnered to offer multi-month, doctor-led firefighter detoxification treatment programs in Sonoma County, California and Los Angeles.
These programs are not peer-reviewed clinical trials and have not been presented as such. They are uncontrolled treatment/pilot programs, and they are free for the firefighters who participate. All associated costs are covered by grants, private donations, and participating fire departments and unions.
We report before/after changes in individual biomarkers, which cannot rule out normal biological variation, lab measurement noise, or concurrent lifestyle changes (diet, sauna use, reduced exposure) as the actual cause. The treatment program, which utilizes glutathione in both Intravenous and nebulized forms, also contains several other components including dietary supplements, sauna and education. The program has consistently garnered meaningful clinical response in firefighter patients, both in symptom reduction and toxin level reduction.
The intent behind these pilot programs is to generate preliminary proof-of-concept data- evidence that the intervention is feasible, that firefighters will participate and tolerate it, and that biomarkers move in a plausible direction, in order to justify and design a larger-scale trial with appropriate randomization, placebo/control arms, and blinding. This is a legitimate and common early step in intervention development, but it means the current data should be read as hypothesis-generating rather than as confirmation of efficacy.
ABC7 Los Angeles, “New treatment program offers hope to firefighters battling toxins in blood after wildfires,” Jan. 2026 - single-patient case account.
Nebulized Glutathione
Nebulized glutathione has been studied more rigorously in respiratory disease (COPD, cystic fibrosis), with small trials suggesting it is generally tolerated at doses up to 600 mg twice daily in non-asthmatic patients. This tracks with meta-analytic evidence that blood glutathione levels are significantly depleted in COPD patients compared to healthy controls, providing biological rationale for attempting to restore pulmonary glutathione levels via inhalation. However, a controlled trial in patients with mild asthma found that nebulized glutathione caused significant bronchoconstriction (FEV1 dropped 19% vs. 1% with placebo) along with cough and breathlessness, an effect blocked by pretreatment with a bronchodilator. No published trial has tested nebulized glutathione specifically for reducing firefighting-related toxicant burden.
A broader literature review of inhaled (nebulized or aerosolized) glutathione across pulmonary diseases and respiratory-related conditions found that glutathione in the epithelial lining fluid (ELF) of the lower respiratory tract functions as a first line of antioxidant defense, and that inhalation is the only known route that reliably raises ELF glutathione levels. That review graded the existing published evidence across conditions including COPD, cystic fibrosis, HIV-related lung disease, and idiopathic pulmonary fibrosis as generally favorable, though composed mostly of case series and small trials rather than large randomized controlled trials. More recent literature has extended this rationale beyond pulmonary disease, proposing nebulized glutathione as a strategy to raise antioxidant levels in the central nervous system for neurodegenerative conditions, an application that likewise remains hypothesis-generating, based on proposed mechanisms rather than dedicated clinical trial data.
More recent case reports have described rapid subjective improvement in dyspnea within about an hour of oral or IV glutathione administration in patients with COVID-19 pneumonia, and a separate review discussed the biological rationale for glutathione's role in modulating the inflammatory cytokine response (including IL-6 and TNF-α) implicated in severe respiratory illness. These reports are anecdotal and cannot establish causation, but they add to the broader signal that glutathione delivered by inhalation or IV route may have measurable effects on respiratory symptoms in acutely ill patients, a signal that supports continued investigation rather than confirming a specific dose or protocol for firefighters.
Sotgia S, et al. “Systematic Review and Meta-Analysis of the Blood Glutathione Redox State in Chronic Obstructive Pulmonary Disease.” Antioxidants, 2020;9(11):1146.
Marrades RM et al. “Nebulized Glutathione Induces Bronchoconstriction in Patients with Mild Asthma.” American Journal of Respiratory and Critical Care Medicine, 1997;156(2):425–430. PubMed 9279219.
Griese M et al. “Inhalation Treatment with Glutathione in Patients with Cystic Fibrosis: A Randomized Clinical Trial.” American Journal of Respiratory and Critical Care Medicine, 2013 (pilot study; larger confirmatory trials called for).
Prousky J. “The Treatment of Pulmonary Diseases and Respiratory-Related Conditions with Inhaled (Nebulized or Aerosolized) Glutathione.” Evidence-Based Complementary and Alternative Medicine, 2008;5(1):27–35.
Horowitz RI, Freeman PR, Bruzzese J. “Efficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases.” Respiratory Medicine Case Reports, 2020;30:101063.
Guloyan V, Oganesian B, Baghdasaryan N, et al. “Glutathione Supplementation as an Adjunctive Therapy in COVID-19.” Antioxidants, 2020;9(10):914.
Lana JV, et al. “Nebulized Glutathione as a Key Antioxidant for the Treatment of Oxidative Stress in Neurodegenerative Conditions.” Nutrients, 2024;16(15):2476.
Safety Considerations
Reactive airway risk:. Nebulized glutathione can trigger bronchospasm particularly in patients with asthma or other reactive airway disease, and especially in those who are sensitive to sulfites. This is a documented effect, not a theoretical one: clinical data show that nebulized glutathione can provoke immediate drops in lung function in sensitive individuals. That said, after thousands of administrations of glutathione, the authors of this paper have not experienced a serious bronchospasm requiring discontinuation or the administration of albuterol in any patient. Asthma is not an absolute contraindication to nebulized glutathione, but it requires caution.
IV glutathione is generally well tolerated in the doses used clinically, but published safety data specific to repeated dosing in healthy firefighters over time is limited; rare reports of allergic-type reactions to IV glutathione exist in the broader IV-therapy literature.
Because dedicated trials in this population don't yet exist, dosing, frequency, and long-term safety in firefighters specifically are not established. Protocols in current use are based on clinical experience and extrapolation, not firefighter-specific trial data.
Medication timing: glutathione participates in phase II conjugation and clearance of certain drugs, so administering glutathione therapy too close in time to certain medications could theoretically alter how quickly those medications are cleared from the body; medication timing relative to glutathione treatment should be reviewed with a prescribing physician or pharmacist.
Cancer risk: glutathione is also used by cancer cells to buffer oxidative stress and resist chemotherapy and radiation, so elevated glutathione levels can, in principle, protect malignant cells as readily as healthy ones; this dual role is a relevant caution given firefighters’ already-elevated baseline cancer risk, and is not yet addressed by firefighter-specific safety data.The strongest, most consistent evidence for harm involves established or occult (undetected) tumors rather than promoting initiation in a cancer-free individual.
Kennedy L, Sandhu JK, Harper ME, Cuperlovic-Culf M. Role of Glutathione in Cancer: From Mechanisms to Therapies. Biomolecules. 2020 Oct 9;10(10):1429. doi: 10.3390/biom10101429. PMID: 33050144; PMCID: PMC7600400.
Bansal A, Simon MC. “Glutathione metabolism in cancer progression and treatment resistance.” Journal of Cell Biology, 2018 Jul 2;217(7):2291–2298. doi:10.1083/jcb.201804161.
Bottom Line
Glutathione has a biologically plausible role in detoxification, and IV and nebulized forms are in active, legitimate use in pilot wellness programs for firefighters, with the explicit goal of building toward a properly controlled large-scale trial. We are actively in the process of pursuing an IRB-reviewed trial at a major university on 100–500 firefighters using a multimodal intervention that includes nebulized and IV glutathione.
Please contact us if you would like to aid in formation of a clinical trial or in funding a trial.
IV Glutathione
There are no published randomized controlled trials evaluating IV glutathione for reducing PFAS, PAH, or other toxicant levels in firefighters.
Since 2023, three entities – nonprofits Integrative Health Action Network and the Volunteer Fire Foundation, and an environmental medicine clinic, Wild Oak Medicine – all based in Santa Rosa, California, have partnered to offer multi-month, doctor-led firefighter detoxification treatment programs in Sonoma County, California and Los Angeles.
These programs are not peer-reviewed clinical trials and have not been presented as such. They are uncontrolled treatment/pilot programs, and they are free for the firefighters who participate. All associated costs are covered by grants, private donations, and participating fire departments and unions.
We report before/after changes in individual biomarkers, which cannot rule out normal biological variation, lab measurement noise, or concurrent lifestyle changes (diet, sauna use, reduced exposure) as the actual cause. The treatment program, which utilizes glutathione in both Intravenous and nebulized forms, also contains several other components including dietary supplements, sauna and education. The program has consistently garnered meaningful clinical response in firefighter patients, both in symptom reduction and toxin level reduction.
The intent behind these pilot programs is to generate preliminary proof-of-concept data- evidence that the intervention is feasible, that firefighters will participate and tolerate it, and that biomarkers move in a plausible direction, in order to justify and design a larger-scale trial with appropriate randomization, placebo/control arms, and blinding. This is a legitimate and common early step in intervention development, but it means the current data should be read as hypothesis-generating rather than as confirmation of efficacy.
ABC7 Los Angeles, “New treatment program offers hope to firefighters battling toxins in blood after wildfires,” Jan. 2026 - single-patient case account.
Nebulized Glutathione
Nebulized glutathione has been studied more rigorously in respiratory disease (COPD, cystic fibrosis), with small trials suggesting it is generally tolerated at doses up to 600 mg twice daily in non-asthmatic patients. This tracks with meta-analytic evidence that blood glutathione levels are significantly depleted in COPD patients compared to healthy controls, providing biological rationale for attempting to restore pulmonary glutathione levels via inhalation. However, a controlled trial in patients with mild asthma found that nebulized glutathione caused significant bronchoconstriction (FEV1 dropped 19% vs. 1% with placebo) along with cough and breathlessness, an effect blocked by pretreatment with a bronchodilator. No published trial has tested nebulized glutathione specifically for reducing firefighting-related toxicant burden.
A broader literature review of inhaled (nebulized or aerosolized) glutathione across pulmonary diseases and respiratory-related conditions found that glutathione in the epithelial lining fluid (ELF) of the lower respiratory tract functions as a first line of antioxidant defense, and that inhalation is the only known route that reliably raises ELF glutathione levels. That review graded the existing published evidence across conditions including COPD, cystic fibrosis, HIV-related lung disease, and idiopathic pulmonary fibrosis as generally favorable, though composed mostly of case series and small trials rather than large randomized controlled trials. More recent literature has extended this rationale beyond pulmonary disease, proposing nebulized glutathione as a strategy to raise antioxidant levels in the central nervous system for neurodegenerative conditions, an application that likewise remains hypothesis-generating, based on proposed mechanisms rather than dedicated clinical trial data.
More recent case reports have described rapid subjective improvement in dyspnea within about an hour of oral or IV glutathione administration in patients with COVID-19 pneumonia, and a separate review discussed the biological rationale for glutathione's role in modulating the inflammatory cytokine response (including IL-6 and TNF-α) implicated in severe respiratory illness. These reports are anecdotal and cannot establish causation, but they add to the broader signal that glutathione delivered by inhalation or IV route may have measurable effects on respiratory symptoms in acutely ill patients, a signal that supports continued investigation rather than confirming a specific dose or protocol for firefighters.
Sotgia S, et al. “Systematic Review and Meta-Analysis of the Blood Glutathione Redox State in Chronic Obstructive Pulmonary Disease.” Antioxidants, 2020;9(11):1146.
Marrades RM et al. “Nebulized Glutathione Induces Bronchoconstriction in Patients with Mild Asthma.” American Journal of Respiratory and Critical Care Medicine, 1997;156(2):425–430. PubMed 9279219.
Griese M et al. “Inhalation Treatment with Glutathione in Patients with Cystic Fibrosis: A Randomized Clinical Trial.” American Journal of Respiratory and Critical Care Medicine, 2013 (pilot study; larger confirmatory trials called for).
Prousky J. “The Treatment of Pulmonary Diseases and Respiratory-Related Conditions with Inhaled (Nebulized or Aerosolized) Glutathione.” Evidence-Based Complementary and Alternative Medicine, 2008;5(1):27–35.
Horowitz RI, Freeman PR, Bruzzese J. “Efficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases.” Respiratory Medicine Case Reports, 2020;30:101063.
Guloyan V, Oganesian B, Baghdasaryan N, et al. “Glutathione Supplementation as an Adjunctive Therapy in COVID-19.” Antioxidants, 2020;9(10):914.
Lana JV, et al. “Nebulized Glutathione as a Key Antioxidant for the Treatment of Oxidative Stress in Neurodegenerative Conditions.” Nutrients, 2024;16(15):2476.
Safety Considerations
Reactive airway risk:. Nebulized glutathione can trigger bronchospasm particularly in patients with asthma or other reactive airway disease, and especially in those who are sensitive to sulfites. This is a documented effect, not a theoretical one: clinical data show that nebulized glutathione can provoke immediate drops in lung function in sensitive individuals. That said, after thousands of administrations of glutathione, the authors of this paper have not experienced a serious bronchospasm requiring discontinuation or the administration of albuterol in any patient. Asthma is not an absolute contraindication to nebulized glutathione, but it requires caution.
IV glutathione is generally well tolerated in the doses used clinically, but published safety data specific to repeated dosing in healthy firefighters over time is limited; rare reports of allergic-type reactions to IV glutathione exist in the broader IV-therapy literature.
Because dedicated trials in this population don't yet exist, dosing, frequency, and long-term safety in firefighters specifically are not established. Protocols in current use are based on clinical experience and extrapolation, not firefighter-specific trial data.
Medication timing: glutathione participates in phase II conjugation and clearance of certain drugs, so administering glutathione therapy too close in time to certain medications could theoretically alter how quickly those medications are cleared from the body; medication timing relative to glutathione treatment should be reviewed with a prescribing physician or pharmacist.
Cancer risk: glutathione is also used by cancer cells to buffer oxidative stress and resist chemotherapy and radiation, so elevated glutathione levels can, in principle, protect malignant cells as readily as healthy ones; this dual role is a relevant caution given firefighters’ already-elevated baseline cancer risk, and is not yet addressed by firefighter-specific safety data.The strongest, most consistent evidence for harm involves established or occult (undetected) tumors rather than promoting initiation in a cancer-free individual.
Kennedy L, Sandhu JK, Harper ME, Cuperlovic-Culf M. Role of Glutathione in Cancer: From Mechanisms to Therapies. Biomolecules. 2020 Oct 9;10(10):1429. doi: 10.3390/biom10101429. PMID: 33050144; PMCID: PMC7600400.
Bansal A, Simon MC. “Glutathione metabolism in cancer progression and treatment resistance.” Journal of Cell Biology, 2018 Jul 2;217(7):2291–2298. doi:10.1083/jcb.201804161.
Bottom Line
Glutathione has a biologically plausible role in detoxification, and IV and nebulized forms are in active, legitimate use in pilot wellness programs for firefighters, with the explicit goal of building toward a properly controlled large-scale trial. We are actively in the process of pursuing an IRB-reviewed trial at a major university on 100–500 firefighters using a multimodal intervention that includes nebulized and IV glutathione.
Please contact us if you would like to aid in formation of a clinical trial or in funding a trial.
Learn More About Glutathione & Firefighter Health
To learn more about glutathione, its role in detoxification, and the research supporting its use in firefighter health, visit our Glutathione & Firefighter Health resource page.
To learn more about glutathione, its role in detoxification, and the research supporting its use in firefighter health, visit our Glutathione & Firefighter Health resource page.
IHAN Public Statement — August 31, 2026
Read IHAN’s current statement on firefighter health, glutathione, clinical safety, and the need for more rigorous research.
Read IHAN’s current statement on firefighter health, glutathione, clinical safety, and the need for more rigorous research.