TOBIN domain · OXI
Oxidative Stress
Redox imbalance, mitochondrial dysfunction, ROS/RNS burden, antioxidant capacity, metabolic stress and lipid oxidation indicators.
Full description
Oxidative Stress is an imbalance between reactive oxygen and nitrogen species and the body's antioxidant defenses. It leads to damage to fats, proteins and DNA, and to poorer mitochondrial energy production.
In TOBIN, oxidative stress is the link between exposures and metabolic disease. High blood sugar, insulin resistance, smoking, pollutants, excess iron and chronic inflammation all add to the oxidative load.
Components
5 componentsMitochondrial function
CMitochondria make cell energy (ATP) and are the main source of reactive oxygen species.
How it works: Overfeeding, inactivity and some toxins impair the electron transport chain, increasing leakage of free radicals and fatigue.
How it is assessed
- · Exercise tolerance and fatigue history
- · Lactate and specialty testing only when clinically indicated
Glycemic and lipid oxidation
AHigh glucose forms advanced glycation end-products (AGEs); oxidized LDL drives atherosclerosis.
How it works: AGE–RAGE signaling triggers inflammation; oxidized LDL is taken up by macrophages to form plaque.
How it is assessed
- · HbA1c, fasting glucose, insulin, HOMA-IR
- · ApoB, triglycerides, HDL
Antioxidant defenses
BGlutathione, superoxide dismutase, catalase and dietary antioxidants (vitamins C and E, carotenoids, polyphenols).
How it works: Glutathione needs cysteine, glycine and selenium; SOD needs zinc, copper and manganese.
How it is assessed
- · Diet quality (fruit and vegetable intake)
- · Selenium and zinc where deficiency is suspected
Methylation and homocysteine
BRaised homocysteine reflects low folate, B12 or B6 and promotes oxidative damage to blood vessels.
How it works: Homocysteine auto-oxidizes, producing hydrogen peroxide, and impairs nitric oxide.
How it is assessed
- · Homocysteine (above 15 µmol/L is elevated)
- · B12, folate
Sleep and circadian rhythm
BShort or irregular sleep raises oxidative and metabolic stress.
How it works: Sleep restriction reduces insulin sensitivity by 20–30% within days and raises markers of oxidative stress.
How it is assessed
- · Sleep hours and regularity (journal)
- · Screen for sleep apnea
Clinical bottom line: Antioxidant pills (vitamin E, beta-carotene) have not prevented heart disease or cancer in large trials, and beta-carotene raised lung cancer risk in smokers. The best evidence is for removing the drivers — glucose control, exercise, sleep, not smoking — and for a diet rich in vegetables.
What it covers
- · Mitochondrial & redox function
- · Antioxidant capacity
- · Metabolic & glycemic stress
- · Lipid oxidation markers
- · Sleep & recovery load
Symptoms and exposures scored
4 questions- · How many hours do you usually sleep?
- · How often do you feel exhausted even after rest?
- · How many days a week do you exercise?
- · Do you smoke, vape, or spend time around tobacco smoke?
Lab ranges
Graded 0–100 against published cutoffs| Test | Grading points (value → concern 0–100) | Source |
|---|---|---|
| HbA1c% · higher is worse | 5.6→0 5.7→40 6.5→80 8→100glycemic stress | ADA Standards of Care: 5.7–6.4% prediabetes, ≥6.5% diabetes range |
| Fasting glucosemg/dL · higher is worse | 99→0 100→40 126→80 180→100glycemic stress | ADA: 100–125 mg/dL impaired fasting glucose, ≥126 diabetes range |
| ApoBmg/dL · higher is worse | 90→0 100→40 130→80 160→100atherogenic lipid load | ACC/AHA & ESC: ApoB ≥130 mg/dL is a risk-enhancing factor |
| Triglyceridesmg/dL · higher is worse | 149→0 150→30 200→60 500→100metabolic lipid stress | NCEP ATP III: 150–199 borderline, 200–499 high, ≥500 very high |
| HDL cholesterolmg/dL · lower is worse | 50→0 40→40 30→80 20→100low protective lipid | NCEP ATP III: <40 mg/dL low (men), <50 (women) |
| ALTU/L · higher is worse | 33→0 40→30 80→60 200→100hepatic load | ACG: upper limit of normal ≈ 29–33 U/L (men), 19–25 (women) |
| GGTU/L · higher is worse | 50→0 100→50 200→100hepatic and oxidative load | Typical laboratory upper limit ≈ 50 U/L |
| Homocysteineµmol/L · higher is worse | 10→0 15→60 30→100methylation / B-vitamin strain | >15 µmol/L elevated in most laboratory references |
| Reverse T3ng/dL · higher is worse | 24→0 30→50 40→100stress / illness pattern of T4 conversion | Typical reference 9–24 ng/dL; guidelines (ATA) do not recommend rT3 for routine diagnosis — grade D |
| Total cholesterolmg/dL · higher is worse | 199→0 200→30 240→60 300→100lipid load | NCEP ATP III: <200 desirable, 200–239 borderline, ≥240 high |
| LDL cholesterolmg/dL · higher is worse | 99→0 130→30 160→60 190→100atherogenic cholesterol | ACC/AHA 2018: ≥190 mg/dL severe; 160–189 high; optimal <100 |
| Non-HDL cholesterolmg/dL · higher is worse | 129→0 160→40 190→70 220→100atherogenic cholesterol | NLA: non-HDL <130 mg/dL desirable |
| LDL particle number (LDL-P)nmol/L · higher is worse | 1000→0 1300→40 1600→70 2000→100atherogenic particle burden | NMR LipoProfile (Labcorp): <1000 optimal, 1300–1599 borderline-high, ≥1600 high; MESA |
| Small LDL-Pnmol/L · higher is worse | 527→0 700→50 1000→100small dense LDL (insulin-resistance pattern) | NMR LipoProfile: ≤527 nmol/L reference |
| LDL particle sizenm · lower is worse | 20.5→0 20.3→40 19.5→100small LDL pattern B | NMR: >20.5 nm pattern A, ≤20.5 pattern B |
| HDL particle number (HDL-P)µmol/L · lower is worse | 30.5→0 26→50 20→100low protective particles | NMR LipoProfile: ≥30.5 µmol/L reference |
| Lp(a)nmol/L · higher is worse | 75→0 125→50 250→100inherited atherogenic particle | ACC/AHA & EAS 2022: ≥125 nmol/L (≥50 mg/dL) risk-enhancing; measure once in lifetime |
| sdLDL-C (small dense LDL)mg/dL · higher is worse | 30→0 40→40 60→100small dense LDL | Denka assay (Quest Cardio IQ, Boston Heart): <30 mg/dL optimal (lab-specific) |
| Lp-PLA2 activitynmol/min/mL · higher is worse | 123→0 150→50 225→100vascular inflammation | PLAC Activity test (FDA-cleared): >123 nmol/min/mL higher risk |
| Oxidized LDLU/L · higher is worse | 60→0 70→50 100→100lipid oxidation | Lab-specific (Cleveland HeartLab ~<60 U/L); research-grade, grade C |
Formulas
- Symptom score = average answer (0–4) × 25
- Lab score = 0.6 × worst marker + 0.4 × average marker
- O score = 60% symptoms + 40% labs (whichever exists if only one)
- HOMA-IR = fasting glucose (mg/dL) × fasting insulin (µIU/mL) ÷ 405; above about 2.5 suggests insulin resistance (Matthews 1985)
- Bands: 0–33 lower · 34–66 moderate · 67–100 higher
Symptom score = average of your answers in that domain (0–4 scale, shown as 0–100). Lab score = 0.6 × the most out-of-range marker + 0.4 × the average of that domain's markers, where each marker is graded 0–100 against published clinical cutoffs. When both exist, the domain score = 60% symptoms + 40% labs. If you logged your journal in the last 14 days, 20% of the score comes from it: daily symptoms (I, O), sleep under 7 hours (O, B), low energy (N, O) and low mood (B).
Conditions where this domain weighs heavily
iClinical organizational scores based on the TOBIN framework. They group signals for review and are not validated diagnostic instruments or a medical diagnosis.
iDetection of an exposure does not establish that it caused a disease. This platform separates exposure, association, plausible mechanism, clinical evidence and demonstrated causation.