SEATTLE — Fire and medical authorities are cautioning Western wildland crews about a glutathione supplement promoted to firefighters exposed to toxic smoke, warning that the glutathione supplement has not been proven safe or effective and could carry contamination risks.
Experts say glutathione, delivered either intravenously or via a nebulizer, lacks clinical evidence for treating or preventing illness tied to smoke exposure. They also warn that compounded products can introduce pathogens if sterile production is compromised.
Two pharmacies issued recalls in August after lab testing detected bacterial contamination. One reported patients experienced fever, chills, severe headache and other symptoms linked to the product, according to recall notices.
The International Association of Firefighters, which represents about 360,000 first responders, advised caution last week, noting that glutathione is not approved by the U.S. Food and Drug Administration. The union urged skepticism toward disease treatment or prevention claims tied to the compound.
Glutathione was recently offered to crews working fires that destroyed hundreds of structures in and around Spokane, Washington. During morning briefings, on-scene medical unit leaders from California directed firefighters to a tent where a nonprofit staffed by licensed naturopathic physicians provided the compound.
The Integrative Health Action Network, a group of naturopathic doctors, has offered the supplement during multiple incidents, including the January 2025 wildfires in Los Angeles County. The group’s involvement with firefighters dates to a 2017 blaze that devastated parts of California’s wine country.
While research has not validated its use, some firefighters say the treatment helps them feel better after breathing toxic smoke and have urged California regulators not to restrict access.
Sean DeCrane, the IAFF assistant to the general president for health and safety, said the Spokane promotion prompted outreach from physicians and members concerned about unproven claims. He said the union also received reports that some firefighters felt worse or became ill after receiving the product, and he called for proper evaluation and testing of any medical interventions marketed to firefighters.
In response to the advisory, Jen Riegle, a naturopathic doctor and co-founder of the Integrative Health Action Network, said the organization agrees peer-reviewed research is needed to assess whether glutathione can reduce firefighters’ chemical burdens and that it is exploring partnerships to pursue such studies.
Growing evidence links wildfire smoke to broad health harms, particularly when urban fires combust household electronics, batteries and chemicals. Tens of thousands of Americans die each year from the long-term effects of smoke exposure, according to researchers.
Firefighters often cannot practically use respirators with oxygen tanks in extreme wildfire conditions. As a result, they encounter a wide range of chemicals with immediate and long-term health implications, DeCrane said.
Pasadena Fire Captain Matt Caffey, a paramedic for 28 years who helped battle last year’s Eaton fire in Southern California, described coughing, vomiting and brain fog from neighborhood burn smoke. “You can’t remember things. You’re just so behind the eight ball. You can’t catch up. You’re not recovering,” he said.
Caffey is among firefighters who say the glutathione supplement provides relief. He encouraged the Integrative Health Action Network to deploy to Spokane. In 2025, the California Board of Pharmacy reversed course on rules that would have made access to the compound more difficult following pushback from some firefighters.
Experts emphasize that individual reports of improvement do not constitute proof. Dr. Cora Sack, a pulmonary specialist in environmental and occupational lung disease at the University of Washington School of Medicine, said such accounts are “interesting and provocative and deserve further study,” but added, “we lack clinical evidence of its efficacy.”
Glutathione is an antioxidant produced mainly in the liver that neutralizes unstable molecules that can damage cells. Wildfire smoke drives oxidative stress, Sack said, creating a plausible biological rationale for antioxidants. She does not endorse glutathione without clear evidence.
Nebulized administration may constrict airways in people with asthma or chronic lung disease, she noted. Because the compound is prepared in sterile compounding pharmacies, contamination has on occasion led to poisonings. Recent recall notices warned that injecting a contaminated product could trigger fevers, low blood pressure, inflammatory reactions, anaphylactic shock or death.
Luke Montrose, a Colorado State University professor who studies wildfire smoke and disease risk, said glutathione has anti-inflammatory properties. “But because it hasn’t been studied, I’m hesitant,” he said.
Debate over the glutathione supplement intensifies
As wildfire seasons lengthen and smoke exposure mounts, pressure is growing for rigorous trials to determine whether the glutathione supplement offers benefit or introduces unacceptable risk for firefighters on the line. State efforts such as California wildfire landscaping rules adopted to curb risk have similarly highlighted the growing urgency around wildfire dangers.