Oxygen: Origins and Biology – Part 2
The Medicine with Heart Journey: Cellular Optimization
Oxygen: Ketones, Ketosis and Free Radicals
In part 1 of this series, the genesis, biology, and cellular processes of oxygen were reviewed. In part 2, the following components of oxygen are explored.
- Ketones and cellular respiration
- Oxygen and free radicals
- The impact of oxidative stress on health
Cellular Respiration: Ketones and Ketosis

In addition to the glycolytic pathway of energy production, the body can also utilize ketones as an energy source and the biochemistry of the ketogenic diet is relatively simple. The ketogenic diet attempts to emulate the body’s response to starvation or fasting by eliminating carbohydrates as the provider of S-acetyl CoA, and thus the body´s source of energy. When carbohydrates are unrestricted in the diet, the glucose present in cells or in the blood is enzymatically converted to pyruvate through the glycolytic pathway.
The metabolic process of generating ketone bodies from S-acetyl CoA occurs through ketogenesis and takes place primarily in the liver (2). The first step is the condensation of two molecules of S-acetyl CoA to form S-acetoacetyl CoA (3). This is followed by an aldol addition of another S-acetyl CoA to the β-carbonyl with subsequent hydrolysis of one of the coenzyme A thioesters to generate a carboxylic acid (4). The S-acetyl CoA is cleaved by HMG-CoA lyase to generate acetoacetic acid, which can subsequently be reduced by 3-hydroxybutyrate dehydrogenase to generate (R)-β-hydroxybutyric acid (5) . The process of utilizing fatty acids and ketones for energy/ATP production also requires oxygen in the β-oxidation of fatty acids, which provides an alternative to glycolysis to supply energy for the body.
Through the constant process of energy production, whether through glycolysis or fatty acid oxidation, free radical molecules are being generated in significant quantities.
Oxygen and Free Radicals

When considering the role of oxygen on a cellular level, incorporating a basic understanding of free radical compounds can be helpful.
Free radicals are chemical species possessing an unpaired electron that can be considered as fragments of molecules, and which are generally very reactive (7). They are produced continuously in cells either as accidental by-products of metabolism or deliberately during, for example, phagocytosis (8). The most important reactants in free radical biochemistry in aerobic cells are oxygen and its radical derivatives (superoxide and hydroxyl radical), hydrogen peroxide and transition metals (9) . Cells have developed a comprehensive array of antioxidant defenses to prevent free radical formation or limit their damaging effects (10) . These include enzymes to decompose peroxides, proteins to sequester transition metals and a range of compounds to ‘scavenge’ free radicals. Reactive free radicals formed within cells can oxidize biomolecules and lead to cell death and tissue injury (11).
As noted in a 2008 review (12) :
When cells use oxygen to generate energy, free radicals are created as a consequence of ATP production by the mitochondria. These by-products are generally reactive oxygen species (ROS) as well as reactive nitrogen species (RNS) that result from the cellular redox process. These species play a dual role as both toxic and beneficial compounds. The delicate balance between their two antagonistic effects is clearly an important aspect of life. At low or moderate levels, ROS and RNS exert beneficial effects on cellular responses and immune function. At high concentrations, they generate oxidative stress, a deleterious process that can damage all cell structures (13-14). Oxidative stress plays a major part in the development of chronic and degenerative ailments such as cancer, arthritis, aging, autoimmune disorders, cardiovascular and neurodegenerative diseases. The human body has several mechanisms to counteract oxidative stress by producing antioxidants, which are either naturally produced in situ, or externally supplied through foods and/or supplements. Endogenous and exogenous antioxidants act as “free radical scavengers” by preventing and repairing damages caused by ROS and RNS, and therefore can enhance the immune defense and lower the risk of cancer and degenerative diseases (15-16).
The above insight into free radical impacts and potential solutions provides a context for the application of hypoxic hormesis as, in a sense, it could be considered by an exogenous (from the outside) and endogenous (from the inside) approach to effective management of free radical balance. There are various hypoxic protocols that can be mechanically applied externally to reduce oxygen intake and there are also purely biological methods to limit cellular oxidative processes. These techniques will be reviewed in future articles in this series.
Conclusion
Oxygen is fundamental to human physiology and is essential to maintenance of life. Simultaneously, it results in compounds, such as free radicals, that can have deleterious consequences. The various roles and outcomes of oxygen metabolism open various potentials around how oxygen can be utilized and managed to positively impact human physiology.
In part 2 of this series, the following components of oxygen have been reviewed:
- Ketones and cellular respiration
- Oxygen and free radicals
- The impact of oxidative stress on health
Now that a broad framework around oxygen and oxygen’s role in human physiology has been established, the pragmatic application of oxygen, oxygen hormesis, and potentials for utilization as a tool for healing and health optimization will be explored in subsequent articles in this series.
References
(1) Williams, M. S., & Turos, E. (2021). The Chemistry of the Ketogenic Diet: Updates and Opportunities in Organic Synthesis. International journal of molecular sciences, 22(10), 5230. https://doi.org/10.3390/ijms22105
(2) Williams, M. S., & Turos, E. (2021). The Chemistry of the Ketogenic Diet: Updates and Opportunities in Organic Synthesis. International journal of molecular sciences, 22(10), 5230. https://doi.org/10.3390/ijms22105230
(3) Williams, M. S., & Turos, E. (2021). The Chemistry of the Ketogenic Diet: Updates and Opportunities in Organic Synthesis. International journal of molecular sciences, 22(10), 5230. https://doi.org/10.3390/ijms22105230
(4) Williams, M. S., & Turos, E. (2021). The Chemistry of the Ketogenic Diet: Updates and Opportunities in Organic Synthesis. International journal of molecular sciences, 22(10), 5230. https://doi.org/10.3390/ijms22105230
(5) Williams, M. S., & Turos, E. (2021). The Chemistry of the Ketogenic Diet: Updates and Opportunities in Organic Synthesis. International journal of molecular sciences, 22(10), 5230. https://doi.org/10.3390/ijms22105230
(6) Pham-Huy, L. A., He, H., & Pham-Huy, C. (2008). Free radicals, antioxidants in disease and health. International journal of biomedical science : IJBS, 4(2), 89–96.
(7) Cheeseman, K. H., & Slater, T. F. (1993). An introduction to free radical biochemistry. British medical bulletin, 49(3), 481–493. https://doi.org/10.1093/oxfordjournals.bmb.a072625
(8) Cheeseman, K. H., & Slater, T. F. (1993). An introduction to free radical biochemistry. British medical bulletin, 49(3), 481–493. https://doi.org/10.1093/oxfordjournals.bmb.a072625
(9) Cheeseman, K. H., & Slater, T. F. (1993). An introduction to free radical biochemistry. British medical bulletin, 49(3), 481–493. https://doi.org/10.1093/oxfordjournals.bmb.a072625
(10) Cheeseman, K. H., & Slater, T. F. (1993). An introduction to free radical biochemistry. British medical bulletin, 49(3), 481–493. https://doi.org/10.1093/oxfordjournals.bmb.a072625
(11) Cheeseman, K. H., & Slater, T. F. (1993). An introduction to free radical biochemistry. British medical bulletin, 49(3), 481–493. https://doi.org/10.1093/oxfordjournals.bmb.a072625
(12) Pham-Huy, L. A., He, H., & Pham-Huy, C. (2008). Free radicals, antioxidants in disease and health. International journal of biomedical science : IJBS, 4(2), 89–96.
(13) Halliwell, B., & Gutteridge, J. M. (2015). Free radicals in biology and medicine. Oxford university press, USA.
(14) Young, I. S., & Woodside, J. V. (2001). Antioxidants in health and disease. Journal of clinical pathology, 54(3), 176–186. https://doi.org/10.1136/jcp.54.3.176
(15) Valko, M., Rhodes, C. J., Moncol, J., Izakovic, M., & Mazur, M. (2006). Free radicals, metals and antioxidants in oxidative stress-induced cancer. Chemico-biological interactions, 160(1), 1–40. https://doi.org/10.1016/j.cbi.2005.12.009
(16) Chatterjee, M., Saluja, R., Kanneganti, S., Chinta, S., & Dikshit, M. (2007). Biochemical and molecular evaluation of neutrophil NOS in spontaneously hypertensive rats. Cellular and molecular biology (Noisy-le-Grand, France), 53(1), 84–93.
Want To Work With Our Clinic?
Do you have a chronic or mystery illness that no one has been able to help you with? Are you simply wanting to re-connect with a healthier version of yourself? It’s Time To Finally Feel Better!
