Transcript Detoxification - What is Integrated Medicine?

Detoxification
Leo Galland M.D.
Foundation for Integrated
Medicine
Foundation for Integrated Medicine
OUR BODIES DETOXIFY
• Exogenous, foreign
substances
• Endogenous, internally
created substances
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ENDOGENOUS
SUBSTANCES
• Gut toxins
– bacteria
– parasites
– yeast
• Hormones
• Bile acids
• Metabolic intermediates
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EXOGENOUS
SUBSTANCES
• Xenobiotics
– herbicides
– pesticides
• Air pollutants
– auto exhaust
– tobacco smoke
• Pharmaceuticals
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DETOXIFICATION
TRANSFORMS MOLECULES
• Functionalization
Phase I
• Conjugation
Phase II
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MAJOR SITES OF
ENZYMATIC DETOXIFICATION
• Liver
– most important organ
• Lung, intestine, kidney & skin
– demonstrable detox capability
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LIVER DETOXIFICATION
• PHASE ONE: OXYGENATION
• PHASE TWO: CONJUGATION
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PHASE ONE ENZYMES
• Cytochrome P450 system (20-30
enzymes)
• Use oxygen to alter molecules
• By-products include free oxygen
radicals
• End products may be more dangerous
than the initial chemicals
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PHASE ONE ACTIVITY
• Increased in tobacco smokers
• Increased or decreased by medications
• Increased by char-broiled meats and
high intake of alcohol, BHT or
vegetable oils
• Variably influenced by phytochemicals,
especially flavonoids
• Decreased in vegans
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PHASE ONE INDUCERS
• cabbage, broccoli, brussel sprouts
(indole-3-carbinol)
• oranges and tangerines (limonene)
• caraway and dill seeds (limonene)
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PHASE ONE INHIBITORS
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grapefruit (naringenin)
turmeric (curcumin)
capsicum (capsaicin)
cloves (eugenol)
onions (quercetin)
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• ZINC DEFICIENCY DISRUPTS
PHASE ONE ACTIVITY, SHIFTING
ENZYME PATTERNS TO
INCREASE THE PRODUCTION
OF CANCER PROMOTERS
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PHASE TWO:CONJUGATION
• sulfate
• amino acids: glycine, taurine, glutamine,
ornithine, arginine
• glutathione
• methylation
• glucuronic acid
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PHASE TWO INHIBITION
• nutritional deficiency
• toxin exposures that exhaust supplies of
substrates or co-factors
• example: acetaminophen, alcohol and
low protein intake deplete glutathione,
which is needed for acetaminophen
detoxification
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PHASE TWO STIMULATION
• cabbage, broccoli, cauliflower, brussel
sprouts, kale (glucosinolates)
• garlic oil, rosemary, soy
• citrus peel, dill and caraway oils
(limonene)
• curcumin
• S-adenosyl methionine (SAM)
• milk thistle (silymarins)
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Glucosinolates Must Be Hydrolyzed by
the Enzyme Myrosinase
• Glucosinolates (>70 types) are
separated from myrosinase in plants,
not sprouts
• Crushing the plant before cooking
liberates the active phytochemical
• Sulforaphane releases nuclear
respiratory factor-2 (Nrf2), induces
glutathione S-transferase
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Glucosinolates Must Be Hydrolyzed by
the Enzyme Myrosinase
• Indole-3-carbinol is converted to
diindolyl methane (DIM) by acid
conjugation in the stomach
• DIM stimulates CYPA1/1A2, which
alters estrone metabolism to reduce
estrogenic activity and inhibit growth of
breast cancers
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PHASE TWO GENETICS
• Genetic variation in the activity of
different Phase two enzymes in the
liver, brain or intestines may account for
disease susceptibility:
• colon cancer
• breast cancer
• Parkinson’s disease
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ANTIOXIDANT BENEFITS
• protect DNA and cell or organelle
membranes from free radical damage
• elevate levels of glutathione
• stimulate immune responses
• increase activity of tumor suppressor
genes
• inhibit activity of enzymes needed for
tumor growth
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ANTIOXIDANT
PROTECTION
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vitamins E and C
carotenoids (carotene, lycopene, lutein)
flavonoids
selenium
glutathione
lipoic acid
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Foundation for Integrated Medicine
PLANT FUNCTIONS OF
FLAVONOIDS
• Production stimulated by lack of
light
• Stress: microbes, heavy metals,
ozone, sulfur dioxide, pH
changes
• Inhibit photo-oxidation and
microbial growth
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CLASSES OF FLAVONOIDS
• Glycosides
– rutin, hesperidin
• Aglycones
– flavonols (quercetin)
– anthocyanidins (catechin)
• Proanthocyanidins
– dimers, trimers of anthocyanidins
• Tannins
– polymeric anthocyanidins
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FLAVONOID EFFECTS ON
MAMMALIAN CELLS
• Potent anti-oxidants
–quench free radicals
–chelate transition metals
• Inhibit oxygenases: PG
synthetase
–5-lipoxygenase
• Alter activity of ION pumps
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Foundation for Integrated Medicine
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Foundation for Integrated Medicine
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METHYLATION
• protects DNA from mutation
• depends upon methionine (SAM), folic
acid, vitamin B12
• enhanced by dimethylglycine (DMG),
choline, betaine
• CAVEAT: methylation inactivates genes;
aberrant methylation may inactivate
tumor suppressor genes
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THE INTESTINES
AND DETOXIFICATION
• absorption and excretion of toxins
• second largest volume of detox
enzymes
• intestinal toxicity stresses the liver
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DETOXIFYING AGENTS
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dietary fiber (beans, grains)
antioxidants (vegetables, seeds, fruit)
Phase Two inducers (crucifers)
glutathione enhancers (selenium...)
methylation enhancers (folic acid...)
spices (turmeric, rosemary)
herbs (milk thistle, Ginkgo biloba)
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AB, 6 year old girl with
psoriasis
• Prior to age 3: infantile colic, rarely ill
• Age 3: otitis media associated with guttate
psoriasis, treated with steroids and dovenex
• Naturopath: avoid junk food, use flax oil and
primrose oil
progressively worse
• On a 50% fruit and vegetable diet, nightshade
free
dramatic improvement, leaving few
tiny patches on arms
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AB, 6 year old girl with
psoriasis
• Her psoriasis controlling diet
-Breakfast: Granola, soy milk, water
-Lunch: Whole wheat bread, tuna,
cheese, almond butter, fruit conserves,
water
-Dinner: Chicken, salmon, noodles,
brown rice, salad, vegetables
-Snacks: fruits and vegetables
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