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Restoring the Whole Person With Nutritional and Botanical Detoxification: A Clinical Perspective . David B. Wood, ND B.S. Microbiology, University of Washington, 1977 N.D., Bastyr University, 1983 Cofounder, President: Trinity Family Health Clinic, PS, 1984

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restoring the whole person with nutritional and botanical detoxification a clinical perspective

Restoring the Whole Person With Nutritional and Botanical Detoxification: A Clinical Perspective

David B. Wood, ND

B.S. Microbiology, University of Washington, 1977

N.D., Bastyr University, 1983

Cofounder, President: Trinity Family Health Clinic, PS, 1984

Cofounder, Vice President, CMO: Bio-Genesis Nutraceuticals, Inc, 2000

recommending a strategy

Recommending a Strategy

By supporting the body’s natural detoxification pathways we can help our patients achieve a higher level of health.

A true sense of well-being!

vision statement
Vision Statement
  • Our bodies have always had to deal with toxins. Whether we are talking about metabolic waste products of our own metabolism or environmental toxins (xenobiotics), in order to survive and thrive our bodies use various detoxification pathways to stay clear of their damaging effects.
  • My vision is to provide clinicians with the means to effectively assist their patients detoxify and achieve a level of health that allows them to fully enjoy their lives.
  • To Promote True Restoration!
goal and objective
Goal and Objective
  • In order for your patients to achieve their highest health potential, you (the health professional) and your patient must realize that ongoing detoxification is foundational. While continuous exogenous support may not be necessary, healthy endogenous organ function is critical for exceptional health to be realized.
goal and objective5
Goal and Objective
  • In this lecture I will review specific nutritional AND botanical support for enhancing Phase 1 and Phase 2 liver detoxification support as well as support for correcting intestinal dysbiosis and increased permeability ‘leaky gut’ conditions.
  • In this way I hope to help you:
    • Restore The Whole Person
goal and objective6
Goal and Objective
  • In addition, it must be understood that in many ways the whole body is a detoxification organ.
  • Our goal as physicians is not simply to mobilize toxins, but rather, to enhance our patients health to such an extent that their endogenous detoxification processes keep them healthy.
slide7
“The human body is, in its living state, a unity, a complete and rounded whole. Every sensation, every manifestation of force, every interrelation of the material of one part is intimately concerned with the sensation, force, manifestation and interrelations of all the other parts; no part suffers without involving all the rest in suffering and alteration.”
        • S. Hahnemann, Organon of Medicine
today s situation recent past
Today’s Situation(Recent Past)
  • Xenobiotic exposure (1989)
    • 100% of human fat cell biopsies show elevated levels of known toxins (examples: styrene, 1,4-dichlorobenzene (moth balls, house deodorizers), xylene (gasoline, paints), plus many others.
  • 100,000+ chemicals are common in commercial use.
  • 25,000 (25%) are known to be hazardous.
today s situation recent past9
Today’s Situation(Recent Past)
  • Xenobiotic exposure (Quantified 1989):
    • According to the 1989 Toxics Release Inventory National Report
      • 2,427,061,906 (billions) pounds of chemicals were emitted into our atmosphere.
      • 1,180,831,181 (billions) pounds of chemicals were released into the ground threatening our drinking water.
        • U.S. Environmental Protection Agency: Toxins in the community: national and local perspectives. The 1989 Toxics Release Inventory National Report. Washington, D.C.: Office of Toxic Substances 1991
today s situation recent past10
Today’s Situation(Recent Past)
  • Xenobiotic Exposure (Quantified, 1989):
    • 551,034,696 (millions) pounds of industrial chemicals were dumped into public sewage systems.
    • 188,953,884 (millions) pounds of chemicals were discharged into our surface waters
    • These were only from reportable sources!
    • These statistics are from 1989 data. Today’s situation is probably worse!
      • Corsello S, Ghen M, Kamhi E, Kratz A, Taylor J, Zampieron E. Cellular Detoxification: An Integrative Approach to Anti-Aging. Intrnl J of Int Med, Vol.2, No.6, Nov/Dec 2000
today s situation very recent past
Today’s Situation(Very Recent Past)
  • Xenobiotic exposure (Quantified 2000):
    • According to the 2000 Toxics Release Inventory (TRI) Public Data Release Report – Executive Summary
      • 1,661,326,638 (billions) pounds Total On- and Off site Releases
      • 88,756,085 (million) pounds Total Air Emissions
      • 14,621,472 (million) pounds Surface water Discharges (on site releases)
detoxification life and health depend upon it
Detoxification: Life And Health Depend Upon It!
  • Remember -
  • 100% of human fat cell

biopsies positive for

xenobiotic toxins:

    • Typical toxins present:
      • organic solvents
      • pesticides
      • herbicides
      • toxic metals
some of the many possible symptoms in the patient with impaired detoxification
‘Brain fog’

Chronic sensitivities

chemical, air, food

Joint Pain

Hives, rashes

Fluid retention

Headaches

Frequent illness

Immune dysfunction

hypo, hyper, auto

‘Feels unwell’

Partial loss or exaggerated sense of smell or taste

Digestive disorders

Chronic fatigue, exhaustion

Unable to concentrate, irritable, confused

Mood swings

Restlessness

Some of the Many Possible Symptoms in the Patient with Impaired Detoxification
recommendation
Recommendation
  • Exercise
    • Have fun! Take up cycling, running, swimming, weights, dancing, walking, kayaking, bowling, inline skating, hiking.
  • Work at seeing life through the eyes of LOVE, JOY, PEACE AND FORGIVENESS. Very Detoxifying!
  • Be creative!
recommendation17
Recommendation
  • Exercise enhances circulation (blood and lymph) and perspiration
    • good circulation is essential to optimal detoxification
    • increased nutrient delivery to target tissues
      • cellular macro and micronutrient delivery
      • mitochondrial nutrient delivery
    • increased waste elimination capacity (washing via blood, lymph and elimination via lungs, skin, colon, kidneys)
    • improved oxygenation
    • Get moving!
detoxification whole body approaches
Detoxification: Whole Body Approaches
  • ARC program:
    • Avoid: exposure to xenobiotics as far as is practical
      • What lifestyle changes is your patient willing to modify?
    • Reduce: stored accumulated toxic burden
    • Correct: imbalances and deficiencies that impair endogenous mechanisms for neutralization and elimination of toxins
detoxification arc program
Detoxification: ARC Program
  • Nutritional strategies:
    • Positive lifestyle changes (diet, exercise, stress reduction)
    • Liver detoxification support
    • Intestinal detoxification support
    • Enhancing whole body detoxification
      • kidneys
      • circulation (blood, lymphatic)
      • perspiration
      • respiration (lung, nasal/sinus)
recommendations
Recommendations
  • Diet:
    • Reduce or eliminate:
      • Processed/refined foods (high in chemical preservatives, artificial colors, artificial flavors, fillers, binders, sugar, hydrogenated oils, low in fiber and nutritional value)
      • Non-organic foods (high in pesticide, herbicide and hormone residues)
recommendations22
Recommendations
  • Reduce or Eliminate:
  • Fish (large predator) high in toxic metal content (especially Hg, .5 - 1.0 ppm) Principle of Bioacummulation
      • shark, swordfish, various bass, king mackerel, orange roughy, pike and porgy
    • Dairy (except Whey) promotes absorption of MeHg and enhanced enterohepatic circulation (EC)
      • EC: Instead of clearing toxin it is reabsorbed back into the systemic circulation
recommendations23
Recommendations
  • Rule out food/environmental allergy:
    • Allergic reactions will create inflammatory processes which over time may impair optimal detoxification
    • Create a ‘safe diet’. This diet is individualized for each patient based on their genetics (blood type), allergies, and consists of foods with lower toxic chemical residue.
recommendation24
Recommendation
  • Diet:
    • Balanced CHO/PRO/FAT intake (40/30/30) (“Choosing Health…” M. Percival)
      • Blood sugar balance
      • Insulin/cortisol regulation
        • elevated cortisol impairs detoxification , enhances EC
      • Prostaglandin regulation - reduction of inflammation
recommendation25
Recommendation
  • Positive Nitrogen balance
    • high CHO diets enhance toxic metal accumulation
    • Fish protein promoted excretion of Hg. Eat low Hg content (.12 - .14 ppm) seafood (shrimp, sardines, Alaskan pollock, most tuna and salmon. URL:http://www.epa.gov/ost/fish/
    • Adequate amino acidsto support GSH (glutathione) production
recommendation26
Recommendation
  • Increase fluid intake
    • Pure water is essential to life. Water is the conduit for nutrient delivery and waste elimination. Our bodies are 70% water except in underlean individuals.
    • Water is essential for healthy kidney function
    • Adults - depending on activity/weight - approximately 8 - 8oz glasses of pure water per day.
recommendation27
Recommendation
  • Stress Reduction:
    • Stress is a killer!
      • Stress raises cortisol output and leads to connective tissue thinning, impaired cellular utilization of thyroid hormones, impaired immune system response and increased EC.
      • Stress interferes with the healthy circadian hormonal rhythms
      • Stress interferes with the healthy regulation of blood glucose and impairs insulin utilization.
recommendation28
Recommendation
  • Stress Reduction:
    • Encourage a healthy attitude toward life
    • Promote prayer and meditation
    • Prescribe ‘play time’
      • Most adults take life too seriously! Encourage them to have fun. Most will need to schedule this for it to happen.
    • Take up a hobby
      • Drawing, painting, blowing bubbles, listening to relaxing music, going for walks, enjoying the beauty of creation. “Stop and smell the Roses.”
recommendation29
Recommendation
  • Exercise IS A FOUR LETTER WORD?
  • Remember when you were young you didn’t think about exercise. You played!
    • Have fun! Take up cycling, running, swimming, weights, dancing, walking, kayaking, bowling, inline skating, hiking.
    • Be creative!
recommendation30
Recommendation
  • Exercise enhances circulation (blood and lymph) and perspiration
    • good circulation is essential to optimal detoxification
    • increased nutrient delivery to target tissues
      • cellular macro and micronutrient delivery
      • mitochondrial nutrient delivery
    • increased waste elimination capacity (washing via blood, lymph and elimination via lungs, skin, colon, kidneys)
    • improved oxygenation
slide31

Get your patients

moving!

Get your patient's moving!

recommendation32
Recommendation
  • Reduce: Toxic burden
  • Assess Detoxification Capacity: Rule out:
      • Impaired detoxification:
        • appropriate laboratory tests:
          • liver detoxification panels (blood, urine, saliva - challenge test)
          • Organic acid panels (urine metabolic end product screening)
          • Urine, Serum or Hair heavy metal screening
          • Digestive/Microbial/Parasitology (stool)
          • Intestinal Permeability (lactulose/mannitol challenge - urine)
labs detoxification capacity
Labs: Detoxification Capacity
  • Some labs to contact for information on available screening tests:
    • Diagnos - Techs (1-800-87TESTS)
    • Doctor’s Data, Inc (1-800-323-2784)
      • www.doctorsdata.com
    • Great Smokies Diagnostic Laboratory
      • (1-800-522-4762) www.greatsmokies-lab.com
    • Metametrix Clinical Laboratory
      • (1-800-221-4640) www.metametrix.com
labs toxic burden
Labs: Toxic Burden
  • Accu Chem Labs (1-800-451-0116)
  • Pacific Toxicology (1-800-328-6942)
  • National Medical Services (national reference lab)
    • (1-800-522-6671) www.nmslab.com
recommendation36
Recommendation
  • Enhance endogenous Glutathione production (GSH): with ToxiHMF, UltraPure Whey protein, L- Glutamine
    • Some substances rendered less toxic by GSH:
      • Halogenonitrobenzenes and congeners - fungicides
      • 2-Chloro-S-triazines and cogeners - herbicides
      • Aryl Nitrocompounds - nitrates, nitrosamines
      • Phenoltetrabromphthaleins - dyes
      • Aryl & alkyl halides - solvents, intermediates
      • Aryl & alkyl esters - solvents, flavorings
      • Alkene halides - plastics (vinyl chloride)
      • Allyl compounds - intermediates
recommendation some substances rendered less toxic by gsh
RecommendationSome substances rendered less toxic by GSH:
  • Alkyl methanesulfonates - dyes, detergents
  • Organophosphorus compounds - insecticides
  • Arylhydrocarbon epoxides (arene oxides) - solvents
  • Arylhalide epoxides - solvents
  • Other epoxide intermediates - solvents
  • Alpha, beta - unsaturated compounds
  • Arylamines, arylhydroxylamines, carbamates, and related compounds - phenols
  • Steroids - drugs (phenolics)
  • Quinones and catechols - drugs
  • Isothiocyanates - such as methylisocyanate
  • Trichloromethylsufenyls - pesticides
recommendation some substances rendered less toxic by gsh38
RecommendationSome substances rendered less toxic by GSH:
  • Tricarbamates - pesticides
  • Heavy metals - such as lead, mercury, arsensic, cadmium - found in paints, cans, gasoline, amalgam fillings, batteries, plating, food
  • Bacterial toxins - Clostridia difficile
  • Automobile exhaust, cigarettes
  • Many over-the-counter (OTC) and prescription (Rx) drugs - substances detoxified by the liver and too numerous to name
    • Braverman ER, Pfeiffer CC. The Healing Nutrients Within: Facts, Findings and New Research on Amino Acids. Keats Publishing, New Canaan, CT. p.101, 1987
recommendation39
Recommendation
  • Enhance endogenous Metallothionine production: Rx TriZinc + Ultra Pure Whey protein
    • “Metallothioneins (MTs) store and release essential metals, such as zinc and copper, maintaining the low intracellular concentration of free essential metals. Thus MTs fulfill a regulatory capacity and influence transcription, replication, protein syntesis, metabolism, as well as other zinc-dependent biological processes.”
recommendation40
Recommendation
  • “Recent suggestions have implicated the metallothionein proteins (MTs) as potential ‘scavengers’ of brain mercury.”
    • Aschner M et al, Methylmercury alters glutamate transport in astrocytes. Neurochem Int, 2000. 37(2-3):p.199-206.
recommendation41
Recommendation
  • Balance Phase 1 to Phase 2 processes
    • Phase 1 processes (cytochrome P450 family)
      • modification of toxin to bioactive intermediate compound which can now be prepared for elimination through Phase 2 conjugation
      • Phase 1 cytochromes throughout body (liver, intestine, adrenals, skin, brain, breast, etc)
recommendation42
Recommendation
    • especially CYP3A4
      • up to 50% of total CYP in human liver
      • metabolizes approximately half of all therapeutic agents
  • Oxidation
  • Reduction
  • Hydrolysis
  • Hydration
  • Dehalogenation
recommendation43
Recommendation
  • Balance Phase 1 to Phase 2 processes
    • Phase 2 processes (conjugation of bioactive intermediate compound with water-soluble substrate for preparation for elimination via urine or biliary-stool)
      • Glutathione conjugation
      • Sulfation
      • Glucuronidation
recommendation44
Recommendation
  • Methylation
  • Acetylation
  • Amino acid conjugation
    • A variety of chemicals (exogenous/endogenous) are conjugated through the above pathways.
    • For additional information see: Functional Assessment Resource Manual. Great Smokies Diagnostic Laboratory
recommendation45
Recommendation
  • Balance between Phase 1 and Phase 2 pathways is the key.
    • Phase 1 (excessive): excessive free radical reactive intermediate production. Possible liver damage, cancers, etc.
    • Phase 1 (suppressed): inability to detoxify substance. Bioacummulation of toxin.
    • Phase 2 (depressed): inability to conjugate and clear reactive intermediates produced from Phase 1
slide47

Phase I

intermediary

[cytochrome P450 enzymes]

metabolites

more polar

Enzymes, Cofactors &

more water-soluble

Other Nutrients Used

nonpolar

  • oxidation

(lipid-soluble)

riboflavin (vit. B2)

  • reduction

niacin (vit. B3)

  • hydrolysis

Reactive Oxygen

  • hydration

folic acid

Intermediates

  • dehalogenation

vitamin B12

glutathione

branched-chain

flavonoids

phospholipids

Nutrient/Plant Derivatives

carotenes (vit. A)

lipid-soluble (nonpolar)

ascorbic acid (vit. C)

toxins stored in adipose

tocopherols (vit. E)

tissue contribute to

selenium

mobilized toxin load

copper

zinc

manganese

coenzyme Q10

Secondary

thiols

Free radicals

tissue damage

bioflavonoids

silymarin

pycnogenol

catechins (green tea)

*Toxins =

Endotoxins

*end products of metabolism

*bacterial endotoxins

Exotoxins

*drugs

*alcohol

*chemicals

agriculture

food additives

household

pollutants/contaminants

*microbial

* toxins

Reactions

( )

Phase I Liver

Detoxification Pathway

&

Supportive Nutrients

pyridoxine (vit. B6)

amino acids

Antioxidant/Protective

Superoxide

(found in garlic, onions,

& cruciferous vegetables)

botanical and nutritional intervention for impaired liver detoxification
Impaired Phase 1 (Cytochrome P450 system)

lipotrophics

B2, B3, B6, B12, folic acid, NADH

acetyl l-carnitine

taraxicum

chelidonium

chionanthus

catechin

EFA’s

antioxidants

Botanical and Nutritional Intervention for Impaired Liver Detoxification
slide49

Phase II

[conjugation pathways]

intermediary

metabolites

glycine

taurine

glutamine

ornithine

arginine

excretory

derivatives

  • sulfation

Phase II

Liver

Detoxification

Pathways

&

Supportive

Nutrients

polar

  • glucurondidation
  • glutathione*conjugation

water-soluble

  • acetylation
  • amino acid conjugation

Serum

Kidneys

  • methylation

Urine

*N-acetylcysteine, cysteine,

Bile

methionine are precursors

Feces/stools

Secondary

tissue damage

botanical and nutritional intervention for impaired liver detoxification50
Botanical and Nutritional Intervention for Impaired Liver Detoxification
  • Impaired Phase 2 (Conjugation)
    • amino acids: Whey protein, glutamine, methionine, aspartic acid, glycine, ornithine, arginine, cysteine, NAC, taurine
    • Fe, Mo, Mg, Zn, Cu, Se
    • Mg sulfate, Na sulfate
    • cruciferous vegetables
    • soy, garlic, ellagic acid
    • reduced glutathione
    • Liska DJ. The detoxification enzyme systems, Alt Med Rev, Vol.3, No. 3, pp. 187-198, June 1998.
botanical and nutritional intervention for impaired liver detoxification51
Botanical and Nutritional Intervention for Impaired Liver Detoxification
  • Hypoallergenic CHO/PRO/FAT ratio balanced diet
  • Balanced nutrientsto support Phase 1 & Phase 2 detoxification pathways (individualized based on lab tests)
  • Cholagogues to support liver elimination via biliary system
    • Rx: (BioG) BioLiv 1-2 BID - TID
  • Hepatoprotectants (tissue protective factors - vitamin, mineral, amino acid, botanical)
    • Rx: (BioG) BioLiv 1-2 BID - TID
botanical intervention for impaired liver detoxification
Botanical Intervention for Impaired Liver Detoxification
  • Single herbs useful to support and assist the liver in detoxification include:
    • Artichoke (Cynara scolymus)
    • Burdock (Arctium lappa)
    • Dandelion (Taraxicum officinalis)
    • Milk Thistle (Silybum marianum)
slide53

Artichoke has been used traditionally for liver and gallbladder complaints

  • It assists in detoxification by enhancing bile flow (cholagogue activity) thus supporting enhanced clearance of toxins via the biliary/colon route
slide54

Arctium lappa (Burdock root):

  • Animal and invitro studies show that burdock may have:
  • Antibacterial, antineoplastic, antioxidant, antiretroviral, anti-inflammatory and hepatoprotectant properties.
  • In addition to protecting the liver, burdock’s antibacterial properties can help in detoxification by reducing the level of Bacillus subtilis and other bacterial pathogens.
  • PDR of Botanical Medicine, 2004
death begins in the colon

“Death begins in the colon”

Old Naturopathic saying

why is intestinal health important
Why is Intestinal Health Important?
  • Healthy liver phase 1/phase 2 balance will be difficult to achieve if leaky gut and microbial dysbiosis are present
  • CYP3A4 (high intestinal activity): involved in steroidal hormone metabolism (testosterone, progesterone, estradiol, androstenedione, cortisol)
  • Enterohepatic circulation (EC) will recycle toxin interfering with elimination
why is intestinal health important59
Why is Intestinal Health Important?
  • Putrefaction, fermentation, leaky gut and microbial dysbiosis will increase endotoxin load (indican, skatcol, putricine, cadaverine, etc., many) on the liver making exotoxin (xenobiotic) elimination inefficient at best.
    • Rowland, IR. Toxicology of the colon: Role of the Intestinal microflora,in Gibson GR & Macfarlane GT eds., Human Colonic Bacteria: Role in Nutrition, Physiology, and Pathology, CRC Press, Boca Raton, 1995, pp. 155-174.
some of the many possible symptoms indications of intestinal dysbiosis
Hx Frequent ABO Tx, Corsticosteroids, BCP use

High CHO, sugar diet

Sensitive to perfumes, chemicals, cigarette smoke

Worse damp, wet weather

Crave sugar, bread, EtOH

Fatigue, lethargy, ‘drained’

Feeling ‘spacey or unreal’

Allergies

food, airborne, chemical

Chronic Sinus Sx

Numbness, burning or tingling

Some of the Many Possible Symptoms/Indications of Intestinal Dysbiosis
some of the many possible symptoms indications of intestinal dysbiosis61
Some of the Many Possible Symptoms/Indications of Intestinal Dysbiosis
  • Muscle aches
  • Pain and/or swelling in joints
  • Headaches
  • Can’t think/concentrate/poor memory
  • Itching
  • Digestive Sx
    • Abdominal pain
    • Constipation
    • Diarrhea
    • Gas/Bloating
    • Mucus and/or blood in stool
slide62

Consequence of detoxifying a patient with poor intestinal health:Your patient will go through “detox reactions”, feeling sick as your Rx’d treatment mobilizes toxins that are not being effectively eliminated from the body

botanical and nutritional intervention intestinal digestive impairment
Botanical and Nutritional Intervention Intestinal Digestive Impairment
  • Stool -
    • alkalosis and/or elevated valerate, isobutyrate, meat fibers and indican
    • Rx:(BioG) UltraGest or PanZyme 1-2 BID - TID with meals
      • Hydrochloric acid (Betaine and/or Glutamic Acid HCl)
      • Botanical Bitters (Gentiana lutea)
      • Pancreatic enzymes + HCl (PanZyme)
botanical and nutritional intervention intestinal digestive impairment64
Botanical and Nutritional Intervention Intestinal Digestive Impairment
  • decreased chymotrypsin, elevated triglycerides, cholesterol, positive for undigested carbohydrates
  • Rx: (BioG) BioPan or Vegizyme 1-2 BID - TID before meals
    • Pancreatic enzymes
    • Vegetable enzymes (for those with pork allergy or evidence of small intestine brush border enzyme deficiency)
botanical and nutritional intervention intestinal digestive impairment65
Botanical and Nutritional Intervention Intestinal Digestive Impairment
  • Stool (elevated bowel pathogens: bacterial, fungal, amoebic, etc.)
    • Pathocidal treatment (kill them suckers!)
    • Rx: (BioG) ParaBiotic Plus 1-2 BID - TID with meals or if only fungal: Rx: Dysbioplex FNG ½ to 1 tsp BID
      • or appropriate therapy based on stool sensitivity tests
      • Natural options (berberine, garlic, olive leaf, uva ursi, grapefruit seed extract, artemesia, oregano, black walnut, thyme oil, tea tree oil, undecylenic acid, caprylic acid)
botanical and nutritional intervention intestinal dysbiosis correction
Botanical and Nutritional Intervention Intestinal Dysbiosis Correction
  • Beneficial Bacteria (decreased)
    • Rx: ProFlora Plus 2 QD- BID without food
      • appropriate probiotic (human specific, able to bind to receptor sites)
      • L. acidophillus, L. rhamnosus
      • Bifidobacteria
      • Treatment initiated after completion of antimicrobial phase.
botanical and nutritional intervention intestinal dysbiosis correction67
Botanical and Nutritional Intervention Intestinal Dysbiosis Correction
  • Beneficial Bacteria (growth factors)
    • Rx:
      • Diet (CHO/PRO/FAT ratio balanced)
      • Diet - increase fiber intake (food sources, Rx flax, psyllium, etc)
      • FOS (fructo-oligosaccharides)
      • Whey protein - UltraPure Whey Protein
botanical and nutritional intervention intestinal permeability excess
Botanical and Nutritional Intervention Intestinal Permeability Excess
  • “Leaky Gut” factors:
    • decreased SIgA, increased urinary lactulose, increased lysozyme, increased lactoferrin, etc.
      • correct digestive deficiencies
      • avoid allergens (esp food, but also best to reduce environmental)
      • balance flora (eliminate pathogens, increase beneficial)
botanical and nutritional intervention intestinal permeability excess69
Botanical and Nutritional Intervention Intestinal Permeability Excess
  • Rx repair factors:Intestinal Repair Complex 1 tsp BID – TID and/or IRC caps 2-3 BID-TID
  • Note: powder and capsule formulas differ
    • Glutamine, NAG
    • Disaccharidase enzymes
    • Botanicals (aloe, ulmus, althea, glycyrhiza)
    • Additional support:
    • Butyric acid, Vitamin E, antioxidants
  • reduce toxic metal burden (esp. Hg)
botanical intervention intestinal permeability excess
Botanical Intervention Intestinal Permeability Excess
  • Finocarbo plusis useful in balancing the digestive function:
  • Reduces indigestion
  • Reduces bloating, intestinal gas
  • Reduces abdominal discomfort
  • Aides in toxin absorption
  • Enhances gastric and biliary secretion
botanical intervention constipation
Botanical Intervention Constipation
  • Sollievocombines the laxative properties of Senna with herbs that promote healthy intestinal regulation.
  • This formula reduces the side effects of anthrquinones.
  • During any detoxification program CONSTIPATION should be avoided.
  • Sollievo can assist the detox program by maintaining normal bowel regularity
recommendation nutritional intervention
Recommendation: Nutritional Intervention
  • Correct: Benefits of reducing bowel pathogens and enhancing friendly bacteria
    • Pathogens can deconjugate toxins ‘activating’ them
    • Pathogens enhance EC allowing toxin to be reabsorbed rather than eliminated
    • Green Tea has antimicrobial activity against
      • E Coli, Streptococcus species. Mild against Proteus species.
recommendation nutritional intervention74
Recommendation: Nutritional Intervention
  • Imbalanced Flora (E.coli, streptococci, staphylococci, and yeasts - predominate methylators) can:
    • methylate inorganic mercury (poorly absorbed) to methyl mercury (MeHg) (easily absorbed)
  • Beneficial bacteria can:
    • demethylate soluble MeHg into poorly absorbed inorganic mercury (Hg), which is more easily eliminated via the stools
    • Chipman JK & Coleman R. Mechanism and consequences of enterohepatic circulation, in Hill MJ ed., Role of Gut Bacteria in Human Toxicology and Pharmacology, Taylor & Francis, Bristol, PA, 1995, pp. 245-259.
botanical intervention for enhanced kidney bladder toxin clearance
Botanical Intervention for Enhanced Kidney/Bladder Toxin Clearance
  • Assisting toxin clearance through the kidneys should not be overlooked. Here are two botanicals that I especially like:
    • Horsetail (Equisetum arvense)
    • Stinging Nettle (Urtica dioica)
chelation
Chelation
  • DMPS

(2,3-dimercapto-1-propanesulfonic acid)

    • Ruprecht J, Scientific Monograph: Dimaval (DMPS). 1997, Houston Tx: Heyltex Corp.
  • DMSA (2,3-dimercaptosuccinic acid)
    • Rx: (TR) Captomer
    • Miller AL, Dimercaptosuccinic acid (DMSA), a non-toxic, water soluble treatment for heavy metal toxicity. Alt Med Rev, 1998. 3(3): p. 199-207
chelation79
Chelation
  • NAC (N acetyl - L - Cysteine)
    • Rx: ToxiHMF 2-3 BID
  • Green foods (Barley grass, Rye grass, spirulina, macro and micro trace minerals, etc.)
    • Rx: BioAlkalizer 1 tsp QD-BID
dmps vs dmsa
DMPS vs. DMSA
  • Toxicology
    • raging debate over which is safer
    • DMPS appears safer than DMSA (Chemet/Succimer/Captomer) for adverse side effects
    • However slow methodical removal using DMSA has had good patient compliance with few side effects
    • DMPS increases excretion of Zn, Cu. DMSA conflicted reports some say does, some reports says no significant mobilization.
dmps vs dmsa81
DMPS vs. DMSA
  • Effectiveness
    • Both are definitely effective
      • DMSA most effective for removing from all organs except kidneys
        • eventually DMSA equals kidney Hg elimination of DMPS
      • DMPS most effective for kidney Hg removal (135% incr. Excre)
        • DMPS + Potassium citrate 163% increased excretion
        • Potassium citrate + NAC 163% increased excretion
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Personally I rarely use DMSA or DMPS
  • My products of choice are:

Toxi HMF

&

BioAlkalizer

(Occasional Use)

a word about n acetyl l cysteine nac
A Word about: N-acetyl L-Cysteine (NAC)
  • L-Cysteine:Avoid Rx’ing.
    • Combines with MeHg to form a compound which closely resemebles L-methionine.
    • Using same transport system as L-methionine this compound easily crosses the BBB accumulating in the brain and kidneys
    • Possible therapeutic intervention: methionine, phyenylalanine and leucine can block transport across BBB
a word about n acetyl l cysteine nac84
A Word about: N-acetyl L-Cysteine (NAC)
  • NAC: Concerns from some researchers that NAC may have the same effect as L-cysteine
    • no research to back up concerns. Statements were opinions only. Based on L-cysteine research, not NAC research
    • research actually shows
      • NAC enhances MeHg elimintion
slide85
NAC
  • “NAC efficiently mobilized methylmercury from all tissues examined, including the brain. The Hg content of blood, kidneys, and liver in mice that received NAC was approximately 10-20% that of control animals, whereas brain levels were decreased to about one-half those of controls.”
slide86
NAC
  • “Nearly 90% of the dose was eliminated in only 2 days when mice were exposed continuously to NAC in their drinking water.”
  • “The rapid urinary excretion of NAC most likely explains its ability to enhance urinary methylmercury excretion.”
    • Ballatori N et al, N-acetylcysteine as an antidote in methylmercury poisoning. Environ Health Perspectives, 1998. 106(5):p.267-71
slide87
NAC
  • “N-Ac-L-Cys did not increase cerebral MeHg uptake showing that addition of an acetyl group to L-Cys abolished its ability to increase cerebral MeHg levels.”
    • Thomas DJ and Smith JC, Effects of coadministered low-molecular weight thiol compounds on short-term distribution of methyl mercury in the rat. Toxicol Appl Pharmacol, 1982. 62(1):p.104-110.
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NAC
  • “The ability of NAC to enhance methylmercury excretion when given orally, its relatively low toxicity, and its wide availability in the clinical setting indicate that it may be an ideal therapeutic agent for use in methylmercury poisoning.”
    • Ballatori N et al, N-acetylcysteine as an antidote in methylmercury poisoning. Environ Health Perspectives, 1998, 106(5):p. 267-71.
slide89
NAC
  • NAC does not effect tissue distribution of essential minerals! (Ca, Mg, Fe, Zn, Cu)
  • When Potassium citrate is given with DMPS or NAC elimination of Hg in the urine was further increased
  • Note:
  • ToxiHMF (contains NAC, K Citrate and other chelators)
whey protein
Whey Protein
  • Rx: (BioG) UltraPure Whey Protein

1 Serving daily

  • Increases endogenous production of GSH
    • Bounous G, Gold P, The biological activity of undenatured dietary why proteins: role of glutatione (Abstract). Clin Invest Med, 1991. 14(4):p.296-309.
whey protein91
Whey Protein
  • excellent source of cysteine/cystine
    • “Whey protein, derived from milk, contains about 2.5-3.0 percent cysteine/cystine and about 22 to 25% percent branched chain amino acids. Therefore, a high quality, partially hydrolyzed whey protein product provides a good source of cysteine/cystine to support intracellular GSH production and metallothionein synthesis, yet adequate leucine to minimize the transport of metals into the CNS.”
      • Quig D., Cysteine metabolism and metal toxicity. Alt Med Rev, 1998. 3(4):p.262-70.
ratio balanced functional foods
Ratio Balanced Functional Foods
  • Rx:(BioG) BioCleanse or BioInflammatory Plus Functional Foods
  • Several Advantages for the patient and doctor-
    • balanced CHO/PRO/FAT profile
    • hypoallergenic (typically rice protein)
    • balanced vitamin, mineral, antioxidant profile
    • Phase 1/Phase 2 detoxification pathway support promoting balanced detoxification pathways
ratio balanced functional foods93
Ratio Balanced Functional Foods
  • Easy way to get the foundation in place for your toxic patient.
  • Designed specifically to help those individuals with impaired detoxification pathways
  • Can modify dosage up/down to suit patient needs
  • Can add supportive capsule product(s) to increase coverage
  • Choose from Functional Food for general detox needs or Functional Food for patients with underlying inflammatory conditions who need detoxification support
ratio balanced functional foods94
Ratio Balanced Functional Foods
  • General recommendations:
    • Follow dosing according to schedule in product handout
    • Generally set up for 17 - 21 day cleansing program.
    • Can be used indefinitely for chronic patients. Determine maintenance dosage.
    • Dosage can be modified for each individual - PRN
    • Have patient follow hypoallergenic diet also detailed in product information handout (Elimination phase)
ratio balanced functional foods95
Ratio Balanced Functional Foods
  • After detox add foods back according to program directions (Challenge phase)
  • Watch for any symptoms of allergy.
  • Develop long term ‘safe diet’ based on patient response during reintroduction of avoided foods
intestinal functional foods
Intestinal Functional Foods
  • Rx: (BioG) Intestinal Repair Complex 1 tsp BID-TID or IRC capsules 2-3 BID-TID

Advantages:

  • Nutritional support for “Leaky Gut” repair
  • Ease of use: everything in one pleasant tasting product
  • Simplifies treatment for patient improving compliance
  • Can be mixed with BioCleanse or BioInflammatory Plus Functional Foods
intestinal functional foods97
Intestinal Functional Foods
  • Soothing factors for intestinal inflammation
  • Digestive support with brush border disaccharidase enzymes (amylase, cellulase, invertase, lactase, maltase)
  • Support for intestinal CYP enzyme balance and glutathione production
summary general treatment outline
Summary: General Treatment Outline
  • Avoid/Reduce/Correct (ARC)
  • Diet - Hypoallergenic, organic, balanced CHO/PRO/FAT, avoid dairy (except whey)
  • Chelation - DMPS, DMSA (Captomer), ToxiHMF, green foods: BioAlkalizer
summary general treatment outline99
Summary: General Treatment Outline
  • Enhance endogenous elimination - Ratio balanced functional foods such as BioCleanse or BioInflammatory Plus , ToxiHMF, UltraPure Whey, TriZinc, Glutamine powder or (IRC), Glutathione, L-Histidine, Garlic7000, UltraFiber, ProFlora Plus, digestive aides
  • Enhance protective factors - antioxidants (ARLA, Vit. E, Selenium, etc.), B vitamins, EFA (esp. Omega 3), botanicals
vis medicatrix naturae the healing power of nature

Vis Medicatrix Naturae: The Healing Power of Nature

Our bodies strive for health and healing. This is innate. Supply what the body needs and it will heal itself. Work with the body, not against it!

algorithm detoxification with nutraceuticals botanicals
Algorithm: Detoxification with Nutraceuticals/Botanicals

Determine Patient needs Detox Program

(Health history, chemical/environmental sensitivity

Provocative testing, screening questionaire(s))

Yes

Complicated?

Yes

1/4-1/2 dose

Standard

Intervention

+

No

Standard Intervention: BioCleanse, Toxi HMF,

UltraPure Whey Protein, IRC powder, Finocarbo plus,

Sollievo, UltraFiber Plus, ProFlora Plus

No

Finish

Intervention

Response Favorable?

Yes

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Standard Intervention 1/4-1/2 dose +

Needs Botanical Support

for Liver and/or Kidney

Function?

Liver

Pathological detoxifier, abnl LFT, etc

Kidneys

Elv BUN/Creatinine

Stinging Nettles

Horsetail

Artichoke, Burdock,

Dandelion, Milk Thistle,

BioLiv

Dysbiotic Bowel?

Bacterial, Fungal or Ameobic

Pathogens

slide103

ParaBiotic Plus, Dysbioplex FNG

Green Tea caps

Burdock Root

(Complete first or Tx for at least 2 weeks prior

To starting Standard Detox Intervention)

UltraGest,

BioPan,

PanZyme, or

Vegizyme

Digestive Deficiencies?

(HCl, Pancreatic, or SI brush

Border enzymes)

slide104
“Ease it Out”David Quig, Ph.D.Scientific Symposium 8/2000 International and American Associations of Clinical Nutritionists
  • Detox slowly
    • Optimize function
      • Liver
      • Gut (Do not detoxify a constipated patient, remember EC)
        • Lewis SJ & Heaton KW. The metabolic consequences of slow colonic transit (Abstract), Am J Gastroenterol, Vol. 94, No. 8, pp. 2010-2016, August, 1999.
      • Kidneys
      • Blood sugar balance (Insulin/cortisol)
concluding thoughts
Concluding Thoughts
  • Healthy endogenous detoxification is critical for full health potential to be realized
  • Resist the “green medicine” approach of symptom/prescription

Tolle Causum:

Identify and Treat the Cause

concluding thoughts106
Concluding Thoughts
  • Work to improve your patients health at the cellular level
  • Healthy cells produce healthy glands/organs and balanced chemical processes, which allow us to be healthy, coping with our internal/external environmental challenges

Restoration cannot occur until these conditions are met!

resources
Resources
  • Primary
  • Moss, J. Moss Nutrition Report. Monthly issues from March 2000 to February 2001. www.mossnutrition.com (“mnr mnr”)
resources108
Resources
  • Secondary
  • Functional Assessment Resource Manual, Great Smokies Diagnostic Laboratory
  • Crinnion, W. Chemical Sensitivity: Natural History, Causes and Treatments, 45th Annual NW Naturopathic Physicians Convention, Tacoma, WA. May 11-13, 2001
further information
Further Information
  • BioGenesis Nutraceuticals, Inc.
    • 1.866.272.0500
  • David B. Wood, ND
    • 425.778.5673
    • dwoodnd@trinityclinic.com
    • dwoodnd@bio-genesis.com
slide110
“Beloved, I pray that you may prosper in all things and be in health, just as your soul prospers.”3John:2