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Detoxification - Part I by Daniel I Newman, M.D., N.D., M.S.O.M. www.rising-health.com We live in a toxic world. In addition to dramatically horrific events like the Fukushima nuclear disaster and the BP oil spill, we are constantly exposed to low level toxins from a variety of sources, whether it's drinking from plastic bottles or residual chemicals in our food. Toxins have been implicated in the development of practically all diseases that plague us today, including the steadily rising rates of cancer and infertility. But we are not powerless. Aside from letting our lawmakers know that we do not want to see further degradation of our environment, there are personal protective actions we can take. The process of reversing the accumulation of toxins in our bodies is called 'detoxification.' The first principle of detoxification is to avoid toxins wherever possible. While it is not feasible to avoid toxins altogether, there are many specific ways to limit to toxic exposure. The most critical step in toxicity avoidance is to educate yourself about what is toxic, what alternatives there are, and what protective steps you can take. To paraphrase a famous aphorism: 'the price of freedom from toxins is eternal vigilance.' Let's start with our food. Eating organic food decreases exposure to toxic herbicides and pesticides. (Residues of these chemicals are only fractionally removed by even fanatical cleaning of conventionally grown produce). Eating organic meat and poultry is even more important than consuming organic produce. Animals tend to concentrate toxins more than plants, so your exposure will be higher with a conventional burger than with an apple. Antibiotics and growth hormones comprise an additional toxin exposure with animal products as well. There are no organically raised fish; because antibiotic and pesticide use is heavy in farmed fish, wild fish are your best bet. Eating smaller fish, such as sardines, mackerel, cod, and salmon minimizes mercury exposure, and bottom feeders such as sturgeon should be avoided as well, as toxins tend to accumulate in sediment. Genetically modified food has been shown in animal studies to result in higher rates of infertility, disease, and death than food that has not been so altered. The federal government allows genetically modified plant and now animal based food products to enter the market without any proven record of safety. Thus, they are released without research proving that long term consumption is safe for humans. Preservatives, artificial coloring, artificial flavoring, and conditioning agents should also be avoided. Additionally, processing can create free radicals in oils, such as with canola oil, making it toxic by the time it hits the shelf, even if grown 'organically.' (Some oils, such as olive, sesame, coconut, and palm kernel can be processed safely). And beware: the powerful food processing industry has successfully lobbied to allow the addition of potentially harmful ingredients that do not even have to be put on the label! How you cook your food can also introduce toxicity. Studies have shown that experimental animals don't live as long on microwaved food as they do on food that has been conventionally heated. Cooking in aluminum can introduce this toxic metal into the food. Never cook food covered with plastic wrap, as toxic chemicals will off – gas (vaporize) into the food. Non-stick surfaces have been shown to be carcinogenic, and can taint the food as well. It's better to cook in high quality stainless steel, glass, or enameled cookware. Drinking water should be purified, whether you are on a well or using a municipal water supply. Municipal water supplies are chlorinated by law, and the chlorine combines with organic compounds in the water to produce carcinogens called trihalomethanes. Well water may not be chlorinated, but since the vast majority of groundwater has become contaminated with chemicals from the environment, it too must be treated. There are various ways to purify your water. An adequately sized pressed carbon block filter with a resin membrane (such as Multi-Pure®) can remove most of the petrochemicals and microorganisms in water. Reverse osmosis systems are even more effective, and can also remove fluoride, but are slower and more expensive. Look for one with a 95% or greater rejection ratio, and one that does not store the water in a plastic reservoir. Chlorinated water should be passed through a filter if used for the shower or bath. Untreated shower water forms chloroform gas, and chlorinated compounds may be absorbed through the skin during bathing. Chlorine filters are affordable and are easily installed in line with the shower head, and beneath the bath spigot. The air we breathe is also important to consider. Most studies have shown that indoor air quality is generally worse than outdoor air quality. Therefore, make sure your home is well ventilated, and open the windows during nice weather. Air purifiers that contain both HEPA (for particulates, like mold spores and pollens) and charcoal (for chemicals) filters can be helpful in closed environments. When you clean your home, use non-toxic cleaners. While not all synthetic chemicals are toxic, most have either been shown to be so, or have been insufficiently tested in human studies to demonstrate that they are safe with long term exposure. Therefore, a good rule of thumb is that in any product, if you see among the ingredients list chemicals that you are unfamiliar with, avoid it and substitute a natural product if possible. There are many good books and other resources available offering suggestions for using natural and non-toxic household cleaners, as well as acceptable products for clothing, personal care, lawn cultivation, and gardening practices ( 'Homes That Heal' by Athena Thompson, and the Environmental Working Group website, ewg.org, are good resources). If you must use a toxic substance, wear gloves and other appropriate protective equipment. And, if the substance is volatile (i.e., if it evaporates, such as if you can smell it), wear a chemical filtration mask or respirator to minimize exposure. Synthetic perfumes and fragrances, present in a wide variety of products, are as toxic as gasoline, and have even been banned in some hospitals (as well as in my office). Natural fragrances found in essential oils can be substituted that are not only more esthetically pleasing, but can have medicinal properties as well. Some chemicals in the air may be odorless, or have concentrations that dip below the limits of our ability to sense them, though they are still released or 'off-gassed' into the environment in significant concentrations. Synthetic carpeting may release toxic chemicals like formaldehyde for years after installation. Plastics, furniture, paint, and building materials (such as particle board, press board, and treated woods) can also offgas for protracted periods of time as well. Plastics in contact with our food and water should particularly be avoided. They leech chemicals, called phthalates, that have been shown to disrupt our endocrine (hormone) systems. This may lead to a variety of health problems, including premature sexual development in girls. Some plastics, particularly the harder and less toxic polycarbonates, are coated with Bisphenol A (BPA), a known carcinogen. (Some states have already banned this chemical from products marketed to infants). It is therefore wise to store your water (and food, for that matter) in glass or stainless steel containers, rather than plastic. Detoxification - Part II by Daniel I Newman, M.D., N.D., M.S.O.M. Many toxins need to be transformed by the liver before they can leave the body. The processing of toxins by the liver is one of the most critical steps in the overall detoxification of the body. The liver contains chemical processing molecules, called enzymes. We are all born with genetic mutations (some of us more so than others), which impair the optimal function of these enzymes. At present scientific knowledge, we cannot fix them. However, we can support liver enzyme function by adding specific nutrients. These nutrients may come to us in foods, or be taken as targeted herbs and supplements. Some of them work by assisting the enzymes directly, while others can increase the levels of a very important anti-oxidant called 'glutathione,' which we will discuss in detail a bit later. Foods that can assist liver enzymes with detoxification include the cruciferous vegetable family, which contain what are called 'sulphur compounds.'These sulphur compounds, with the help of liver enzymes, grab on to toxins and escort them from the body. This is a bit like a marshal handcuffing a prisoner for transport. Examples of cruciferous vegetables are: broccoli(and especially broccoli sprouts), cauliflower, cabbage, brussel sprouts (hey, you either love them or hate them!), kohlrabi, horse radish, bok choy, water cress, collard greens, mustard greens, and kale. The allium family are also sulphur containing super foods. They include garlic, onions, leeks, chives, and shallots. Amino acids, which are what protein is made of, are also important for fueling liver detoxification. Certain amino acids can attach themselves to toxins to assist in their elimination. While the body can make many of these, some cannot be manufactured, and are called 'essential.' That is why an adequate intake of good quality eggs, dairy, meat, fish, and fowl are important when detoxifying. Traditional dietary principles dictate that to strengthen a particular organ, you want to eat that organ from an animal. Liver is the best source of both vitamin B12and folate, which are necessary for the optimal function of liver detoxification enzymes. Since the liver can also house toxins, it is important, as with all food, that to obtain liver from an organically grown, pastured animal. Other foods that have been traditionally used, and later scientifically shown, to assist the liver in processing toxins include: beets(especially the greens), artichoke, dandelion, turmeric, and green tea. Some foods, as well as supplements, support the liver in its role in detoxification by building up glutathione levels. Glutathione is the most important anti-oxidant in the body. It is manufactured inside the cells to protect us from 'free radicals:' those highly reactive molecules that can damage cells. High levels of glutathione are important for the liver's protection and optimal function, since it is constantly exposed to toxins. While we can swallow glutathione as a supplement, it is poorly absorbed orally. We can take it by other routes, such as intravenously, or, in specialized circumstances by nasal spray or by inhaling a mist. However, in most circumstances, we are best served by trying to heighten the production of glutathione by our cells. The amino acids glutamine, glycine, and cysteine are the building blocks of glutathione. I usually combine these (substituting N-acetyl cysteine for cysteine, for technical reasons), along with the amino acid taurine in a special blend called the 'Amino Acid Detox Powder' specifically for the purpose of boosting glutathione levels. Vitamin C and vitamin E, important anti-oxidants in their own right, have also been shown to increase the amount of glutathione. R-lipoic acid, the natural form of alpha lipoic acid, is also an important anti-oxidant that can raise glutathione. Similarly, the mineral selenium can increase the quantity of glutathione. The herb milk thistle can also raise glutathione levels. We use it either individually, or combined with other liver protectant herbs, along with magnesium, B vitamins, and the water soluble nutrients choline, inositol, and methionine . Vital Detox Nutrients is a formulation that contains many of these ingredients. Whey protein has also been shown to boost glutathione. However, it is very important to choose good quality whey protein. I believe that whey protein is only as good as the milk it comes from. Therefore, you want to choose whey protein that comes from cows that have been pasture raised organically. And, you want to make sure the milk is processed at low temperature without the use of chemicals. Once toxins have been processed by the liver, they are discharged into the bile, where they are stored in the gallbladder. During meals, bile is squirted into the intestine, and then hopefully eliminated. Gallbladder function and bile flow have been traditionally improved by using bitter herbs or a bitter alcoholic beverage (termed an 'aperitif') before a meal. (Let's not forget America's favorite bitter beverage -coffee)! Bitter foods at the start of a meal can also be helpful, such as endive, chicory, escarole, or radicchio. The amino acid SAMe, which can be taken as a supplement between meals, can assist an enzyme that produces a major component of bile. Lecithin, a particular type of fat called a phospholipid, can help gallbladder function by making bile more fluid. Lecithin is found in the highest concentrations in egg yolks, liver, shellfish, soybeans, wheat germ, and shellfish, and fatty meats. Some components of bile are recycled by the intestine, and toxins can be accidentally reabsorbed as well. An adequate intake of fiber , in the form of fruits, vegetables, whole grains, or supplements can help sponge up toxins in the gut and minimize their re-absorption. In summary, the liver is the foundation of detoxification. It processes many (if not most) of the chemicals our body tries to eliminate. There are a number of foods, herbs, and supplements that support the liver in this mission. Raising glutathione levels, the body's premier antioxidant, is also central to boosting liver detoxification. This can also be enhanced by taking targeted foods, herbs, and supplements. Here is a summary of my recommendations of foods and supplements to enhance liver detoxification: Cruciferous vegetables. (See list above). Allium vegetables. (See list above). Organic, raw milk from pastured cows, or whey protein derived from it. Green tea. (Either drink, or take 1 cap twice daily between meals). Turmeric. (Either use in cooking, or take 1 cap twice daily with meals). Bitter food, aperitif, or bitter herbs (10-15 drops in water before meals). Liberal fiber containing foods (See above list) or supplements (such as Salba seeds 1- 2 tbs daily). Vital Detox Nutrients 3 caps 3 times daily with meals. Amino Acid Detox powder 1½ tsp twice daily in water between meals. After toxins are processed by the liver, they are expelled from the body through our skin (by sweating), lungs (by breathing), kidneys (through urination), and colon (through bowel movements). Detoxification - Part III by Daniel I Newman, M.D., N.D., M.S.O.M. In Part I, we talked about important strategies for avoiding toxin exposures. Part II discussed how to enhance the function of the liver, which is the central detoxification organ of the body. In Part III, we will talk about how to knock toxins loose from where they may be stored in the body, and help the body to expel them. Since most toxins are stored in fat, breaking down fat or increasing its circulation can dislodge toxins so our body can eliminate them. If you have more fat than you need, losing weight is one such strategy. Even if you are not overweight, periodic fasting can mobilize fat stores, not only in visible areas, but in the internal organs as well. However, since the liver needs extra nutrients to handle the increased flow of chemical toxins, fasting should be nutritionally supported under the supervision of a physician skilled in this area. Exercise can increase blood flow and raise body temperature, both of which can promote toxin circulation. Even gentle shaking, such as bouncing on a mini-trampoline (which mimics ancient Chinese qi gong exercises) can increase the flow of lymph. Lymph is a clear body fluid that moves toxins from the cells into the veins via thin walled canals called 'lymphatics,' thereby assisting toxin removal. Passive strategies, such as massage, can also increase circulation and the drainage of lymph from the cells into the circulation. Topical applications of Castor oil packs, in which a cloth saturated with the oil is placed against the body and heat is applied, such as with a hot water bottle, have traditionally been used to promote lymph drainage as well. (This appears to be especially helpful when the pack is placed over the liver). Saunas are probably the most enduring method of dislodging toxins from fat stores in the body. Any sauna will do, but infrared saunas appear to be the most effective, in that their rays penetrate up to several inches into flesh. There is some controversy about which infrared wavelengths are preferable, far or near, but they both appear to be effective. Infrared saunas can be used at lower temperatures than a regular sauna, generally 115°F -130°F, so they tend to be better tolerated by heat sensitive people. If purchasing a sauna, it is important to choose one that is made from woods that will not release natural volatile oils, and that are put together without the use of toxic glues. Two of the best are Sauna Ray and Heavenly Heat. The cell membrane, which is the structure that encloses every cell in the body, is primarily made of fat. A category of fats called 'phospholipids' are critical for the health of that membrane, so it remains fluid and porous enough for toxins to easily leave the cell. Phospholipids can be taken orally (as the supplements lecithin or SeriPhos) or intravenously (under physician supervision). Lecithin is naturally found in high concentrations in egg yolks and organ meats. Some toxins, specifically heavy metals such as lead and mercury, are not necessarily stored in the fat, nor can they be reliably removed by the above strategies. Rather, because they tend to chemically bond themselves into cells, they must be removed by a strong chemical 'magnet' in a process called chelation. Intensive chelation, using drugs called chelating agents, should only be attempted under the supervision of a physician with adequate training and experience in the testing and treatment of heavy metal toxicity. Yet there are safe and gentle strategies that can be used to enhance chelation of the body's heavy metals. This includes the use of the herbs garlic and cilantro, the algae chlorella, and a preparation called Toxguard, which combines a seaweed extract called calcium alginate with citrus pectin. The glutathione boosters I mentioned last month, Rlipoic acid and NAC (N-acetyl cysteine) are also natural chelators. Homeopathy, the use of substances prepared as 'remedies' in tiny dosages, is also used to promote the mobilization and removal of toxins via a process called 'homeopathic drainage.' While it is not yet clear how it works, there is preliminary research to suggest that homeopathic remedies can protect cells from the damage of toxins, and many physicians have reported clinical benefit in their patients from using this approach. Once toxins have been dislodged from their homes, put into circulation, and, if necessary, been processed by the liver, they then need to get out of the body to complete detoxification. This can occur through the lungs ,kidneys, colon, and skin. Inhaling clean air, increasing the rate of breathing through exercise, and conscious deep breathing, can all be helpful in assisting elimination via the lungs. Most of us breathe too shallowly, and training ourselves to breathe more deeply with techniques taught in yoga and qi gong can be quite helpful. The kidneys filter about 175 gallons of blood plasma daily. We can assist them by drinking plenty of clean, filtered water every day . This is especially important if we are losing excess water by sweating in saunas or through exercise. Gentle herbs such as horsetail and corn silk have traditionally been used as teas to support kidney function. Ensuring adequate, at least daily, bowel movements through exercise, water intake, and fiber consumption is critical for detoxification. Colon hydrotherapy, or 'colonics,' in which the colon is cleansed with a stream of warm water, can be of powerful assistance here as well. Aside from washing the colon, colonics have been found to stimulate the white blood cells of the immune system. And, because some of the water during a colonic is absorbed and goes into the liver, I suspect that it may have a flushing effect, as evidenced by bile releases I have seen when patients undergo the procedure. Toxins are eliminated from the skin through sweating. This can be accomplished with exercise and saunas, as well as through taking hot baths. Substances are often added to the bath to magnify its effects, including sea salt, Epsom salts, essential oils, clay, or, my favorite, medical grade peat (Moor Mud). (For more information on the therapeutic benefits of bathing, see my article in the Rising Health newsletter: http://www.risinghealth.com/repository/129659916453_129287797623_rhnewslttr_v2n11.htm). I do not generally recommend the use of bentonite (montmorillonite) clay, due to its extremely high aluminum content. I certainly do not recommend taking it internally. Ionic foot baths, in which an electrical current is run through a foot tub, have become popular lately. Its virtues are controversial, and I have not yet seen a shred of reputable scientific evidence to validate manufacturers claims. My advice is to soak your entire body, which has much more surface area than just the feet; and don't electrify your tub! Here is a summary of my recommendations for mobilization and elimination strategies for detoxification in reasonably healthy adults who are not pregnant or lactating: As part of a regular, year round routine: Exercise 3 - 6 days weekly, hard enough to make you sweat. Practice deep breathing whenever you can! Do the mini-trampoline, qi gong, and/or massage, 10-30 minutes, 3-6 days weekly. Eat super detox foods every day, like egg yolks, organ meats, garlic and cilantro. Drink at least ½ oz. of filtered water per pound of body weight,more if you sweat significantly. Ensure good bowel movements, at least daily, through adequate fiber, water, and exercise. As part of a more intensive detoxification routine, either year round, or for 8-12 weeks in the spring and fall. Medically supervised fasting, 1-3 days weekly. Castor oil packs over the liver for 45 minutes, 3-6 days weekly. Saunas, especially infrared, for 15-30 minutes, 3-6 days weekly. Colon hydrotherapy course: 2 days in a row, then once weekly for 4 weeks, then every other week for 8 weeks. [Get clearance from your physician first if you have heart, kidney, or liver disease, or are elderly]. Moor Mud baths for 20 minutes every other day. Supplements to assist with detoxification: o Lecithin 1-3gm, 3 times daily with meals. o SeriPhos 1-2 caps, 3 times daily with meals. o o o o o R Lipoic SR150mg 3 times daily with meals. Toxguard 2 caps 3 times daily away from food. NAC 600mg twice daily away from food. Chlorella 2.6gm 3 times daily away from food. Liver detoxification boosters, as listed in Detoxification, Part II: (http://www.rising-health.com/repository/130506762116_rhnmay2011.pdf) If this list seems overwhelming, don't despair. Choose a couple of items that appeal to you, and gradually increase your level of detoxification over time. People can feel fatigued or ill if detoxifying too intensely, so back off if that happens to you. And remember, every little bit helps! Daniel Newman, MD, ND, MSOM www.rising-health.com