Detoxification - an overview
As part of normal metabolism, the body produces toxins which have to be eliminated, otherwise they poison the system. Therefore, the body has evolved a mechanism for getting rid of these toxins and the methods that it uses are as follows:
- Antioxidant system - for mopping up free radicals. See Antioxidants
- The liver - detoxification by oxidation and conjugation (amino-acids, sulphur-compounds, glucuronide, glutathione, etc) for excretion in urine.
- Fat-soluble toxins can be excreted in the bile. The problem here is that many of these are recycled because they are reabsorbed in the gut.
- Sweating - many toxins and heavy metals can be lost through the skin.
- Dumping chemicals in hair, nails and skin, which is then shed.
This system has worked perfectly well for thousands of years. Problems now arise because of toxins which we are absorbing from the outside world. This is inevitable since we live in the world as it is now. The problem is that these toxins may overwhelm the system for detoxification (such as alcohol), or they may be impossible to break down (e.g. silicone, organochlorines), or they may get stuck in fatty organs and cell membranes and so not be accessible to the liver for detoxification (many volatile organic compounds).
We all carry these toxins as a result of living in our polluted world. However, much can be done to get rid of them or decrease our load, and the mechanisms that we can employ are as follows:
Stone age or Paleo Ketogenic diets
Reducing the toxic load from absorbed pesticides or food additives is obviously essential. Increasing the fibre content of food and the bacterial numbers in the gut also facilitates detoxification. Just not being constipated is helpful! See Stone Age Diet. More often I now prescribe the ketogenic diet - please see Ketogenic diet - the practical details and My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds.
If the body becomes deficient in a mineral such as zinc, it will grab hold of another mineral that "looks" a little bit like zinc. Typically, nickel or cadmium fits the bill. If one is deficient in selenium, then mercury or aluminium is "used" by the body instead. So, being deficient in an essential micronutrient will encourage the body to accumulate toxic ones. Vitamin C strips out many heavy metals. Iodine is a good chelator of heavy metals. Vitamins and minerals also act as essential co-factors to allow liver detoxification.
Efficient digestion of food
See Malabsorption - failure to get the goodness from food. Taking Probiotics encourages the good bacteria which have lived in harmony within the gut for thousands of years and facilitate detoxification of chemicals and production of essential nutrients. (See Kefir).
Exercise and getting hot
Getting hot (exercise, sauna, sunshine) mobilises toxins from fat. This literally shakes up the molecules so that those not well stuck on are mobilised and available for detoxing. Exercise also facilitates sweating and all toxins can be eliminated through the skin, either by sweating, or by mobilisation onto the fatty layer on the surface of the skin, which can then be washed off. A sun, sand (cricket on the beach!) and sea holiday is an excellent way of detoxing! Please see this page first if you suffer with CFS - Exercise - the right sort in Chronic Fatigue Syndrome
Spa therapy, showers and washing
This is an essential part of exercise or far infrared saunaing. Having mobilised toxins from subcutaneous fat onto the surface of the skin, they then need to be washed off. However, beneficial minerals can be absorbed through the skin and this is the basis of spa therapy. People have worked out from practical experience over hundreds of years which spas are suitable for different medical conditions. For example, Epsom spa, which is full of Epsom salts (magnesium), is an excellent treatment for arthritis and joint pains. It is also a good way of detoxing.
Use bath water which is at a comfortable temperature - not too hot initially. Put a double handful of Epsom salts in the bath water and soak your body for as long as comfortable - at least 10 minutes. Do use soap - this breaks down the waterproofing of the skin and lets magnesium be absorbed better through the skin. Epsom salts will reduce numbers of bacteria and yeasts on the skin and this helps many skin conditions such as eczema, acne and other skin infections. If you can stand a hotter bath this will improve mobilisation of toxins in subcutaneous fat onto the surface of the skin where they will be washed away.
The skin is the largest organ of the body! Getting hot will mean the heart has to work hard to pump blood around this large organ (as you go red!). Indeed, your pulse may rise to over 100 beats per minute. This means considerable extra work for the heart - something that many CFSs will not tolerate. So go gently and monitor your pulse until you work out from experience what you can or cannot tolerate.
When you get out of the bath, lie down at once on a towel on the floor, dab dry, until you have cooled a little and are sure you can sit or stand without feeling dizzy or faint.
Repeat as often as you can tolerate!
See Magnesium for more detail on epsom salt baths.
I have now done several tests on tens of people before and after saunaing where the tests prior to saunaing demonstrate the toxic load of pesticides, volatile organic compounds, heavy metals, or whatever. When I have re-tested, in every single case, every parameter has been improved. This only applies currently to eighteen patients, but because the results are so positive, I can now be confident that saunaing is a good way of detoxing. The important thing to remember is that saunaing does not just get rid of the nasty toxins; it also gets rid of beneficial minerals. It is therefore very important to re-hydrate with water containing these minerals. See Detoxing - Far Infrared Sauna (FIRS). Roughly speaking, 50 saunas halves the chemical load.
In this process a large molecule such as DMSA, DMPS, or EDTA is used either orally or intravenously to grab or chelate out toxic minerals. There is no doubt that this technique is effective at increasing urinary excretion of these metals and my experience is that chelation therapy is more reliable than any other method to remove heavy metals. Some people do not tolerate the chelating agent very well, although most do.
For details of oral chelation therapy using DMSA click on Mercury - Toxicity of Dental Amalgam - Why you should have your dental amalgams removed.
The idea here is to replace contaminated fats in cell membranes and fatty organs with clean fats. This technique has been pioneered by Patricia Kane in America, who uses intravenous organic phospholipids in patients with problems such as Parkinson's disease, autism, motor neurone disease, or whatever to flush out neurotoxins stuck in fats in brain cells. She sees remarkable success. Similar results can be achieved by taking fats by mouth, but they are not quite so dramatic. Oral therapy would include high dose organic phospholipids such as lecithin and egg yolk, combined with essential fatty acids from the Omega 3 and 6 series. I use VegEPA. See Lipids, fats and essential fatty acids and Phospholipid exchange.
A major route of detoxification of fat soluble toxins is in the bile. Bile is rich in fat and so a valuable resource which the body recycles by reabsorbing the bile fats together with their toxic load! Stool weight is 2/3rds probiotics so by using probiotics to prevent constipation and ensure a regular through-put helps strip out fat soluble toxins in the gut. It is possible colonic irrigation has a similar effect.
Massage and lymphatic drainage
Raymond Perrin has demonstrated that osteopathic techniques to improve lymphatic drainage do help many patients with chronic fatigue syndrome. He postulates that the mechanism of this is to reduce toxic load and the immune reaction against that toxic load which results from tissue damage.
Improve antioxidant status
Many chemicals exert their malign influence through the production of free radicals, so improving antioxidant status will limit damage. See Antioxidants.
Reduce load of recreational drugs
Alcohol, caffeine and many prescription drugs (such as paracetamol, statins, etc) have to be detoxified through the liver. Taking these drugs will therefore block the metabolism of other xenobiotics and effectively increase their toxicity.
Reduce load of toxins produced from within the body
If one is fermenting foods instead of digesting them then noxious substances such as various alcohols, D lactate, hydrogen sulphide etc will be produced which make a toxic load the liver has to deal with. See Fermentation in the gut and CFS.
Correct Hormonal Imbalances, especially Thyroid and Adrenal Function
These glands are responsible for maintaining the metabolic rate. Slow metabolic rate will result in slow detoxification. See Thyroid disease, Common Hormonal Problems in CFS - Adrenal and CFS and Adrenal gland problems.
EPD or Neutralisation
When people get exposed to chemicals, they can sensitise to them. Desensitising techniques can reduce this sensitivity and the best results are achieved when desensitisation is combined with reducing the toxic load. See Enzyme Potentiated Desensitisation (EPD).
Exercise again combines many of the above because it provides a combination of heat and sweating, massage, increasing metabolic rate and reduced gut transit time. As the body heats up it will radiate far infra red! Please see this page first if you suffer with CFS - Exercise - the right sort in Chronic Fatigue Syndrome
Co-factors to Facilitate Detoxification
In the liver there are two phases to detoxification - firstly an oxidation reaction followed by conjugation in which a co-factor is stuck onto a xenobiotic to render it water soluble so it can be peed out in urine. These co-factors include amino acids and therefore a high protein diet is helpful. Glutathione is a common co-factor and is often low in patients with chemical poisoning. Sulphur compounds are also very helpful such as sulphate and this may explain why Epsom salts in the bath or taken internally also facilitate detoxification.
A good example of this in action came out of the research into thalidomide. This drug prescribed to women in pregnancy as a "pregnancy safe hypnotic" caused serious birth defects if the women took it between the 38th and 42nd day of pregnancy. But not all babies were affected. This drug was tested in rats - no offspring were abnormal. This was a mystery to researchers, until someone had the bright idea of putting the rats onto nutritionally depleted diets. Then they started to get the foetal abnormality of phocomelia ("flipper limbs"). It was a combination of toxic stress (the drug) and nutritional deficiency which caused the problem to become apparent.
And Probably others!
Many chemicals exert their malign influence through the production of free radicals, so improving antioxidant status will limit damage. See Antioxidants.
How can one test for toxic load?
Many of the functional biochemical tests I do regularly show evidence of toxic stress, which we can then be investigated by other means. For example, when measuring levels of superoxide dismutase, it is common to find the gene that codes for SODase is blocked. This can be investigated further by doing DNA adducts. DNA adducts looks at a whole range of chemicals that may be stuck onto DNA - this is an important thing to know because a chemical stuck onto DNA is potentially a pre-malignant condition. See DNA adducts
Tests of Mitochondrial Function Profile often show blockage to translocator protein. This can be investigated further by looking at chemicals stuck on to translocator protein. See Translocator protein studies
Fat biopsy for pesticides or Volatile Organic Compounds - this is an extremely useful way of looking at what may be stuck in one's fat and can pick up a whole range of pesticides and volatile organic compounds. It is a very easy test to do - just the fat contained in the bore of the sampling needle is sufficient for analysis.
Toxic elements in urine following DMSA - this is a challenge test to look for heavy metals in urine. The problem with sweat tests and hair tests is that some people are poor detoxifiers, do not dump heavy metals efficiently in sweat and hair, or even urine and therefore these tests are misleading. This test is a useful way of getting around this problem. The idea here is to take DMSA (a chelating agent). This can give one an idea of heavy metal toxicity.
Hair Mineral Analysis - this can be a useful way of picking up heavy metals, but some people who are poor detoxifiers do not seem to get rid of heavy metals in hair. Again, this may be unreliable.
Some substances cannot be tested for easily because they get into the body, cause damage and then leave the body. Obvious examples are formaldehyde, fluoride, noxious gases, carbon monoxide, sulphur dioxide, nitrous oxide and radiation damage. Drugs of addiction such as heroin, cannabis, ecstasy can all be detected by drug screening in a person who has recently imbibed such a drug. My website does not offer these tests.
Many toxins such as alcohol and prescription medications cause damage, but are not looked for or do not come up in routine tests. Silicones cannot be detected because they are so closely related to glass, furthermore, silicone is universally used in sampling equipment such as needles.
Which toxins are found regularly?
There is no one test for all chemical poisoning. However, having now done many hundreds of these tests I am beginning to get a feel for what comes up more often than others. Obviously it depends on what somebody is occupationally exposed to, for example organophosphates come up very commonly in farmers with sheep dip flu, but rarely in others. What I find most commonly are as follows:
- Nickel and other metals such as mercury (dental amalgam), cadmium (smoking).
- Polybrominated biphenyls - known carcinogens used as fire retardants in soft furnishings.
- Lindane - and other organochlorines used as timber treatment in houses and gardens.
- Molecules indicating poor antioxidant status - such as malondialdehyde.
- Nitrosamines result from smoked food or smoking.
- Hair dyes - it is frightening how often diazole hair dyes turn up stuck on to DNA.
- Triclosan - a commonly used disinfectant.
- Toxic fats - e.g. transfats or fats that have resulted from cooking at high temperatures such as Diolein.
The major causes of toxicity, in my opinion, in order of importance:
- Dental amalgam
- Air pollution - from polluting industry. This is a very major cause of asthma and respiratory disease, heart disease, cancer and birth defects.
- Indoor air pollution - fire retardants, formaldehyde and other such volatile organic compounds, cosmetics (especially hair dyes and aluminium containing deodorants), wash powders and cleaning agents.
- Cooking - nickel from stainless steel saucepans, transfats from poor quality of food, or burnt food.
- Pesticide residues in food.
- Smoking - nitrosamine and cadmium.
- Occupational exposure in farmers, Gulf War veterans, firemen with 9/11 syndrome, aeroplane industry (see www.aerotoxic.org)
- Silicone prostheses - breast implants
- Traffic pollution - benzene.
- Other pollutants such as noxious gases are not picked up in these tests.
- Mitochondrial Function Profile
- Translocator protein studies
- DNA adducts
- Fat biopsy for pesticides or Volatile Organic Compounds
- Toxic elements in urine following DMSA
- Hair Mineral Analysis
- Stone Age Diet
- Nutritional Supplements - what everybody should be taking all the time even if nothing is wrong
- Malabsorption - failure to get the goodness from food
- Exercise - the right sort in Chronic Fatigue Syndrome
- Detoxing - Far Infrared Sauna (FIRS)
- Mercury - Toxicity of Dental Amalgam - Why you should have your dental amalgams removed
- Lipids, fats and essential fatty acids
- Phospholipid exchange
- Fermentation in the gut and CFS
- Thyroid disease
- CFS and Adrenal gland problems
- Common Hormonal Problems in CFS - Adrenal
- Enzyme Potentiated Desensitisation (EPD)
- Ketogenic diet - the practical details
- My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds.
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