Process Of Elimination
Natural steps for detoxification provide tools to enhance the body’s own processes—or aid in a more aggressive approach.
Natural detoxification is not a new concept: the use of herbs, minerals and other organic ingredients as a means of cleansing the body has been practiced for centuries and by cultures worldwide.
But detoxification is a natural process that goes on continuously in the body, said Dr. Leo Galland, creator of pilladvised.com and director of the Foundation of Integrated Medicine in New York. “Just because you’re not doing a detoxification program, doesn’t mean your body isn’t detoxifying,” he noted. “Your body is exposed to a multitude of toxic substances, and even in a pristine environment the toxins are generated internally, you’re also exposed to external environmental toxins. Internal toxins include normal metabolism and intestinal bacteria, which provide a very significant toxic load that has to be eliminated.”
Many common presenting symptoms— such as fatigue, headaches, malaise, irritability, mood swings, bloating, insomnia, and muscle/joint aches and pains—have been associated with elevated toxic burden. Conditions characterized by altered energetic function or gastrointestinal distress may also be associated with dietary and other environmental stressors, said Joseph Lamb, MD, director of intramural clinical research for California-based Metagenics, Inc.
“We’re exposed to an increasing number of chemical compounds and pollutants in air, food, and water,” he said. “Water-soluble xenobiotics (harmful foreign compounds) are eliminated through the stool, sweat and urine. But fat-soluble xenobiotics must be transformed into water-soluble compounds for excretion (metabolic detoxification). Simple metabolic detoxification programs can be a routine protocol to promote overall health by supporting the body’s natural ability to clear environmental and internal toxicants that can build up in the body over time.”
When to Detoxify
Anyone in good health may benefit from occasional 10-day programs, which are often presented as “spring cleaning” for the body as an easy reminder and patient education tool, Dr. Lamb suggested. “Those displaying minor symptoms associated with ‘environmental overload’ may require a more intensive 28-day program. Patients with fibromyalgia or chronic fatigue syndrome may also have compromised liver detoxification capacity or elevated toxic burden, and benefit from an ongoing or routine detoxification support program. Those with inflammatory bowel disease may also benefit from a modified elimination diet and nutrients that support Phase II detoxification.”
Other considerations Dr. Lamb noted include patients with increased stress or excess body fat. Since toxicants the body cannot clear are stored in fat, those beginning a weight-loss program may consider a professionally supervised cleansing regimen to support the body’s clearance activities in anticipation of the added influx of unwanted substances into the body that may likely occur during fat loss. And stress not only leads to unhealthy eating habits that can lead to weight gain, but may also increase internal productions of toxins, such as byproducts of impaired digestion.
Dr. Galland agreed. “The situations when a more structured and organized detoxification program should be implemented, beyond enhancing the body’s natural detoxification abilities, are generally people with chronic fatigue, those who used drugs (therapeutic or recreational), people with weight problems, fluid retention, neuralgic problems, liver or kidney problems, also people with joint pain, fibromyalgia, arthritis, allergies and food allergies.”
Dr. Galland stressed that the nature of the detoxification program has to be modified to the needs and characteristics of the individual. “For example, when someone on prescription medication undergoes a detoxification program, it’s likely that that program will interact with the way the body metabolizes the medication. That is one of the reasons I created pilladvised.com—to have a database of the interaction between drugs, foods and supplements. People with significant liver disease and people with any level of kidney impairment, have very special needs when it comes to detoxification and should not be treated the way that someone with normal kidneys who’s suffering from chronic fatigue,” said Dr. Galland. “The hypersensitive group have to be handled very carefully, especially people with chemical sensitivities, because I’ve seen them get much worse with detoxification.”
Who Should Not
Short, intensive detoxification programs should ideally be recommended for healthy adults displaying only minor symptoms (or none at all) as an occasional health-promoting regimen that supports the body’s natural detoxification activities, said Dr. Lamb.
“Because an elimination diet may cause some patients to feel ‘worse’ (e.g., caffeine withdrawal headaches, reduced energy or increased hunger due to calorie reductions/food eliminations) before they feel better, practitioners should consider the patient’s overall health before recommending any intensive metabolic detoxification program. Chronically ill patients should be prescribed medically supervised, longer and less-intensive programs.”
However, detoxification is something a practitioner should consider for every patient, according to Dr. Galland. “It should be supporting the methods the body uses to detoxify itself and try to decide what are the specific needs of this person. And always keep in mind the notion of ‘first, do no harm.’”
Treatment
Detoxification may include supplements for daily or targeted use, as well as more comprehensive nutritional protocols that include dietary and nutritional supplement recommendations.
“Natural approaches to toxicity include herbs, vitamins, fruits, diet, sauna, chelators and minerals,” noted Kent Adams, CEO of LifeHealth Science, LLC in Ohio, manufacturer of Znatural Toxin Remover supplement. “Each method has strengths and weaknesses, and is appropriate for specific toxins. Each method has specific duration and mode of administration.We recommend a slow systemic chelation method for 90 to 120 days. This has the least impact on the body. In a recent plateau study, 50 percent of participants still required additional detoxification after six months of use. Many toxins can be stored in deep adipose tissues and require a longer process to draw these toxins out.”
Trendy water or juice fasting may cause Muscle wasting and an increased feeling of fatigue, said Dr. Lamb. “It’s important to maintain adequate nutritional intake during a detoxification program, and that includes macronutrients (protein, carbohydrates and fats) as well as essential vitamins/minerals and other targeted phytonutrients and herbs. Adequate rest and intake of water and fiber are also beneficial.”
Walter J. Crinnion ND, chair, Environmental Medicine Department Southwest College of Naturopathic Medicine in Tempe, AZ, emphasized that the initial “detoxification” is to reduce ones toxicant exposures in their home air and food. He offers step-by-step lists for this in his book Clean, Green and Lean (Wiley, Pub). He also notes to reduce ones’ exposure to toxicants in personal care products.
Crinnion said after reducing daily exposures, one needs to start increasing one excretion of toxicants:
1. Alkalinize urine (such as Enzymedica’s pH-Basic product), this reduces the renal recycling of toxicants
2. Increase green tea, green leafy veggies (chlorophyll), brassica family veggies and rice bran (eating brown rice)—all of these things increase the amount of toxicants in the toilet
3. Colonic irrigations two to three times weekly for two to six weeks
Afterward, patients can expect to feel improved energy and clarity of mind, as well as a reduction of toxicant-related symptoms, Dr. Crinnion added.
Product, Lifestyle Recommendations
Nutritional products may include a variety of ingredients that should have adequate scientific support demonstrating benefit in specific cleansing or protective activities—such as macronutrients, essential vitamins and minerals, phytonutrients, amino acids and herbs, including some that have been commonly used in ayurvedic and traditional Chinese medicine. “Adding a specialized eating plan, such as a modified elimination diet, helps prevent the ingestion of new environmental toxicants or foods with known allergenic potential that can increase the internal production of potentially harmful compounds,” said Dr. Lamb. “Ensuring adequate rest supports program success, and exercise restrictions may also help preserve needed energy to fuel detoxification activities during a program that includes reduced calorie intake.”
“There are many approaches that a patient can undertake,” added Bear Walker, chief science advisor with Cell-Wellness in New York, who noted one of the safest approaches is US Cell-Wellness Humic Detox, a 100 percent natural solution that can be started very slowly and increased over time to remove all the toxins. “In addition to Humic Detox, I highly recommend 48 to 64 ounces of water intake daily and a minimum of 20 minutes exercise to aid in removing the toxins out of your body.”
Nutrition Education Manager Neil E. Levin, CCN, DANLA, with Protocol for Life Balance in Illinois said his company’s ProtoClear Dietary Cleansing Program is designed to last for three weeks, though some individuals with delayed sensitivity reactions (IgG) may double the duration and other individuals may choose shorter regimens, at the recommendation of their health care practitioner. The formula is a powdered meal supplement drink mix that can easily be added to water, juice or other preferred liquid. It was designed to provide the neutral, typically non-reactive base of an elimination diet. The ingredients in the ProtoClear mix contain a balanced mix of protein, carbohydrates, electrolytes, vitamins, minerals, antioxidants, amino acids and herbal extracts.Working together within the body, the formulation can help eliminate toxins, protect and nourish cells, and provide the Constituents needed for optimal health.
“ProtoClear was developed not only to help detoxify the cells, but also to serve as a nutritional complement to the dietary and exercise portions of the program,” said Levin. “It is important when taking a detoxification support program supplement to look at minimizing the potential toxicities of the ingredients. For example, many rice protein samples have tested high for heavy metals, so ProtoClear utilizes non-GMO pea protein as an alternative protein source that also is not commonly reactive to most people. Routine testing for heavy metals, microbiological contamination and chemical analysis of ingredients further assures that our detoxification formula will aid in reducing, rather than adding to, a patients’ toxic burden.”
At LifeHealth Science, colon cleansing and systemic detoxification are essential steps in sustaining natural health, said Adams. “Recent studies confirm that pathogens in the intestines have impact on everything from the immune system to allergies. Systemic detoxification is necessary to remove the stored toxins at the cellular level. These stored toxins impact health from memory, muscle strength, coordination, mood and sleep to energy and vitality. Bioavailable systemic chelators are the best solution.We believe natural minerals offer the best alternative.”
Relevant Research
As for detoxification-supporting nutrients, there is a growing body of research on the beneficial properties of common ingredients. “Preliminary research also suggests the connection of prolonged, elevated toxic burden with a growing number of chronic illnesses,” said Dr. Lamb. “Detoxification protocols, per se, are not a frequent topic of research to date, and these protocols may vary widely in research—from single nutrient applications to more comprehensive programs.”
Studies done on how bodies detoxify are numerous and have been for a long time, according to Dr. Galland. “A lot of that research has been done from the perspective of cancer prevention. Companies that are making these formulas have incorporated the concepts of detoxification. And the research has been done in places like Johns Hopkins. It’s basic science research, so it’s had very little impact on conventional medical practice. Natural practitioners are probably more aware of it than conventional specialists. As far as research on a general detoxification program, that’s mostly being done under the auspices of manufacturers of products,” he said.
Metagenics’ proteomic research laboratory has identified ingredients that increase production of metallothionein (MT), a family of cysteine-rich, low molecular weight proteins, which helps the body to excrete toxic heavy metals from the body. Ingredients in Metagenics formulas— including special hops extracts, turmeric, zinc and others—are utilized in specific forms and ratios designed for safety and efficacy. The company has also conducted clinical research with novel formulas and ingredient combinations in its Functional Medicine Research Center to further support the safety and efficacy of its products.
“The way conventional medicine is organized intellectually is on the lines of disease. So the question would be what disease are you treating?” Dr. Galland pointed out. “There is some research out of Belgium on the role of leaky gut and increased intestinal permeability in chronic fatigue and depression, and the effects of the regimen that aims to heal the leaky gut phenomenon. This is an important step in detoxification— dealing with increased intestinal permeability, which they do through diet and certain supplements.” Dr. Galland said the researchers demonstrated that treatment with diet and nutrients not only reversed laboratory signs of the leaky gut syndrome, but also improved symptoms of fatigue, malaise and depression. “These are almost never placebo-controlled trials; they’re uncontrolled, multiple case reports,” he added.
LifeHealth Science is working with Cleveland Clinic and Case Western Reserve University researchers on various medical uses for its patented and patent-pending technology, Adams pointed out. “We believe that detoxification can help reverse symptoms of aging.We also believe that detoxification can help prevent intergenerational spread of toxins,” he concluded. “The Environmental Working Group has done excellent work on the toxins found in the placenta and breast milk. Removing toxins helps people live better.”
Detox Ingredients
Joseph Lamb, MD, director of intramural clinical research for Metagenics, listed what he believes to be the most beneficial ingredients for detoxification:
• A high-quality protein. One that provides methionine and cysteine in a highly absorbable form is also of benefit to Phase II conjugation since these amino acids support production of the sulfation and glutathione cofactors.
• Glutamine and glycineboth. These both support Phase II conjugation. Glutamine has also been shown to raise glutathione levels, an important substance used in both Phase I and Phase II detoxification, and as an antioxidant and a conjugating nutrient, respectively.
• Fibers in rice bran. These have been shown to preferentially bind mutagens over wheat, corn, barley or oat fibers.
• Green tea catechins (EGCG). Research suggests these to be bifunctional modulators that provide many beneficial activities, including induction of Phase I CYP450 enzymes and Phase II glucuronidation and glutathione conjugation enzymes.
• Vitamin B12, folate, methionine and choline.Methyl-group donors, these support balanced biotransformation and Phase II conjugation reactions.
• Glucosinolates from watercress. These have demonstrated activities as bifunctional modulators of detoxification activities, including inhibition of select Phase I activities with concomitant induction of Phase II glucuronosyl transferases and glutathione S-transferases. Broccoli seed also contains glucosinolates.
• Ellagic acid (found in pomegranate). Promoting balanced detoxification via several mechanisms, it modulates expression of glutathione-synthesizing enzymes, glutathione- S-transferases and other Phase II enzymes. It has also demonstrated direct binding to certain toxic substances and decreased lipid peroxidation.
• Sulfate donors NAC and sodium sulfate. These are extremely important in a detoxification program. NAC helps protect against oxidative stress and supports production of glutathione, which is a cofactor for Phase II conjugation reactions and plays a role in heavy metal metabolism.
• Antioxidant vitamins (e.g., A, C, E), beta carotene, herbs (e.g., turmeric) and minerals (e.g., zinc, manganese, selenium). These may help protect against free radicals generated during the hepatic detoxification process.
• Extracts from artichoke.With a history of traditional use in promoting healthy liver function, research suggests that several constituents of artichoke, including chlorogenic acid and cynarin, have marked antioxidant and hepatoprotective properties.
• Chlorophyllin. It has been suggested by research to bind to some ingested toxins to interfere with their absorption and promote their elimination. Research also indicates that it may modulate the activity of detoxification enzymes and provide antioxidant protection against free radicals.
• Silymarin (from milk thistle). Used in traditional medicine throughout the world as a hepatoprotectant, recent studies demonstrate its effective liver-protectant functions.
A Case of Mercury Toxicity
The challenges with environmental toxins is coping with them and making them less dangerous to the body, said Dr. Leo Galland, a New York-based integrative practitioner, who discussed a case of mercury detoxification. “That’s an area where a detoxification program can be very helpful. Heavy metal and volatile organic chemicals can contribute to neurological disorders, chronic fatigue, respiratory problems, skin problems—there’s almost no area of the body that can’t be affected, but the nervous system is particularly sensitive to those toxins,” he said.
He offered a case report in which heavy metal detoxification backfired. “I saw a patient who had been relatively asymptomatic; she wasn’t aware of a problem. She consulted a practitioner who determined she had a very high mercury load. [The practitioner] did a chelation with DMPS.” The mercury exposure was traced probably to time the patient spent in China, Dr. Galland noted. “The patient needed to be detoxified and she felt sick after the first DMPS challenge. She recovered; so a few weeks later it was done again [by the practitioner]. She went into a state of panic and anxiety, which I believe was from the mercury toxicity.
“I’ve seen people become manic after DMPS. I think it’s because it pulls mercury from soft tissue. Sometimes if a person has a lot of mercury, [DMPS] allows the mercury to get into the nervous system. This woman became hypertensive to just about everything and it took me about a year to restore her to normal.”
There were three critical elements to do that, Dr. Galland noted.
First was avoiding further exposure, such as avoiding fish and using no chelating agents.
Second was taking zinc. “Zinc is one of the least appreciated and most critically important nutrients for the patients I see. It affects immunity, detoxification and neurological function,” he explained. “One of the side effects of DMPS is that it chelates zinc, and it reduces the zinc level. Zinc is critical for heavy metal detoxification.”
Third was to use a mixture of nutrients designed to enhance (along with zinc) the activity of an enzyme called metallothionein, which is present in all cells and functions to pump metals out of cells. (The main stimulant to metallothionein activity is zinc.) “It was that combination of zinc and the metallothionein nutrients that really over time restored this woman to normal in the face of mercury toxicity,” said Dr. Galland.
Symptoms—such as fatigue, headaches, malaise, irritability, mood swings, bloating, insomnia, and muscle/joint aches and pains— have been associated with elevated toxic burden.
Practitioners should consider detoxification for every patient; the nature of the program should be modified to the needs and characteristics of the individual.
Metallothionein has been found to help the body excrete toxic heavy metals
FOR MORE INFORMATION:
Cell-Wellness, (573) 767-1226,
www.uscellwellness.com
Enzymedica, (888) 918-1118,
www.enzymedica.com
LifeHealth Science, LLC, (216) 706-6093,
www.lhscience.com
Metagenics, Inc., (800) 692-9400,
www.metagenics.com
Protocol for Life Balance, (877) 776-8610,
www.protocolforlife.com
