Transcript Getting Clear: Nutritional Intervention In Detoxification

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
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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!
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Vision Statement
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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!
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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.
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Goal and Objective
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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:
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Restore The Whole Person
Goal and Objective
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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.
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
“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
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Today’s Situation
(Recent Past)

Xenobiotic exposure (1989)
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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.
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Today’s Situation
(Recent Past)

Xenobiotic exposure (Quantified 1989):
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According to the 1989 Toxics Release Inventory National
Report
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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
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Today’s Situation
(Recent Past)

Xenobiotic Exposure (Quantified, 1989):
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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
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Today’s Situation
(Very Recent Past)

Xenobiotic exposure (Quantified 2000):
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According to the 2000 Toxics Release
Inventory (TRI) Public Data Release Report –
Executive Summary
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1,661,326,638 (billions) pounds Total Onand Off site Releases
88,756,085 (million) pounds Total Air
Emissions
14,621,472 (million) pounds Surface water
Discharges (on site releases)
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Toxics Release Comparison
1989 and 2000
3,500,000,000
3,000,000,000
2,500,000,000
2,000,000,000
1989
2000
1,500,000,000
1,000,000,000
500,000,000
0
Total
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Air
Water
Detoxification: Life And
Health Depend Upon It!
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Remember 100% of human fat cell
biopsies positive for
xenobiotic toxins:
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Typical toxins present:
 organic solvents
 pesticides
 herbicides
 toxic metals
Without exception all
humans have
bio-accumulated toxins!
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Some of the Many Possible
Symptoms in the Patient with
Impaired Detoxification
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‘Brain fog’
Chronic sensitivities
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chemical, air, food
Joint Pain
Hives, rashes
Fluid retention
Headaches
Frequent illness
Immune dysfunction
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hypo, hyper, auto
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‘Feels unwell’
Partial loss or
exaggerated sense of
smell or taste
Digestive disorders
Chronic fatigue,
exhaustion
Unable to
concentrate,
irritable, confused
Mood swings
Restlessness
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.
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Very Detoxifying!
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Be creative!
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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
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Get moving!
Detoxification: Whole Body
Approaches
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ARC program:
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Avoid: exposure to xenobiotics as far as is
practical
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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
First Do No
Harm!
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Detoxification: ARC Program
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Nutritional strategies:
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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)
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Recommendations
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Diet:
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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)
Recommendations
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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
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Recommendations
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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.
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
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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 acids to support GSH
(glutathione) production
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Recommendation
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Increase fluid intake
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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.
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Recommendation
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Stress Reduction:
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Stress is a killer!
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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.
Recommendation
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Stress Reduction:
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Encourage a healthy attitude toward life
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Promote prayer and meditation
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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.”
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Recommendation
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Exercise IS A FOUR LETTER WORD?
Remember when you were young you
didn’t think about exercise. You played!

Have fun!

Be creative!
Take up cycling,
running, swimming, weights, dancing,
walking, kayaking, bowling, inline
skating, hiking.
7/16/2015
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
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Get your patients
moving!
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Recommendation
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Reduce: Toxic burden
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Assess Detoxification Capacity: Rule out:
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Impaired detoxification:
 appropriate laboratory tests:
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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
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Some labs to contact for information on
available screening tests:
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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.greatsmokieslab.com
Metametrix Clinical Laboratory
 (1-800-221-4640)
www.metametrix.com
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Labs: Toxic Burden
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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
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“When in
doubt: treat
the liver”
Old Naturopathic saying
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Recommendation

Enhance endogenous Glutathione production (GSH): with
ToxiHMF, UltraPure Whey protein, L- Glutamine
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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
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Recommendation
Some substances rendered less toxic by GSH:
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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
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Recommendation
Some substances rendered less toxic by GSH:
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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
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Recommendation
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Enhance endogenous Metallothionine
production: Rx TriZinc + Ultra Pure
Whey protein
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“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 zincdependent biological processes.”
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Recommendation
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“Recent suggestions have
implicated the metallothionein
proteins (MTs) as potential
‘scavengers’ of brain mercury.”
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Aschner M et al, Methylmercury alters
glutamate transport in astrocytes.
Neurochem Int, 2000. 37(2-3):p.199-206.
Recommendation
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Balance Phase 1 to Phase 2 processes
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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)
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Recommendation
especially CYP3A4
 up to 50% of total CYP in human liver
 metabolizes approximately half of all
therapeutic agents
Oxidation
Reduction
Hydrolysis
Hydration
Dehalogenation
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Recommendation
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Balance Phase 1 to Phase 2 processes
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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
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Recommendation
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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
Recommendation
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Balance between Phase 1 and Phase 2
pathways is the key.
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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
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REDUCE STORED TOXINS
Xenobiotic Detoxification
PHASE II
Nonpolar
Xenobiotic
PHASE I
Cyt.P450
oxidation
reduction
hydrolysis
Conjugation
reactions
Intermediary
Metabolite
More polar
More water-soluble
Excretion
in some instances
*sulfation
*glucuronidation
*glutathione
conjugation
*acetylation
*amino acid
conjugation
*methylation
Conjugated
Metabolite
Polar
Water-soluble
Excretion
Serum-kidneys-urine
or Bile-faeces
*Toxins =
Endotoxins
*end products of metabolism
*bacterial endotoxins
Exotoxins
*drugs
*alcohol
*chemicals
agriculture
food additives
household
pollutants/contaminants Phase I
*microbial
[cytochrome P450 enzymes]
intermediary
metabolites
* toxins
Reactions
nonpolar
(lipid-soluble) •oxidation
•reduction
•hydrolysis
•hydration
•dehalogenation
lipid-soluble (nonpolar)
toxins stored in adipose
tissue contribute to
mobilized toxin load
more polar
Enzymes, Cofactors &
more
water-soluble)
Other Nutrients Used
(
riboflavin (vit. B2)
niacin (vit. B3)
Reactive Oxygen
pyridoxine (vit. B6)
Intermediates
folic acid
vitamin B12
glutathione
branched-chain
amino acids
flavonoids
phospholipids
Antioxidant/Protective
Nutrient/Plant Derivatives
Phase I Liver
Detoxification Pathway
&
Supportive Nutrients
Superoxide
Free radicals
carotenes (vit. A)
ascorbic acid (vit. C)
tocopherols (vit. E)
selenium
copper
zinc
manganese
coenzyme Q10
thiols(found in garlic, onions,
& cruciferous vegetables)
bioflavonoids
silymarin
pycnogenol
catechins (green tea)
Secondary
tissue damage
Botanical and Nutritional Intervention
for
Impaired Liver Detoxification
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Impaired Phase 1 (Cytochrome P450 system)
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lipotrophics
B2, B3, B6, B12, folic acid, NADH
acetyl l-carnitine
taraxicum
chelidonium
chionanthus
catechin
EFA’s
antioxidants
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Phase II
intermediary
metabolites
Phase II
Liver
Detoxification
Pathways
&
Supportive
Nutrients
[conjugation pathways]
sulfation
glucurondidation
glutathione* conjugation
acetylation
amino acid conjugation
excretory
derivatives
polar
water-soluble
Serum
glycine
taurine
glutamine
ornithine
arginine
methylation
*N-acetylcysteine, cysteine,
methionine are precursors
Kidneys
Urine
Bile
Feces/stools
Secondary
tissue damage
Botanical and Nutritional Intervention
for
Impaired Liver Detoxification
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Impaired Phase 2 (Conjugation)
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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. 187198, June 1998.
Botanical and Nutritional Intervention
for
Impaired Liver Detoxification
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Hypoallergenic CHO/PRO/FAT ratio balanced
diet
Balanced nutrients to 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
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Botanical Intervention for
Impaired Liver Detoxification
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Single herbs useful to support and
assist the liver in detoxification include:
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Artichoke (Cynara scolymus)
Burdock (Arctium lappa)
Dandelion (Taraxicum officinalis)
Milk Thistle (Silybum marianum)
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
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Arctium lappa (Burdock
root):
Animal and invitro studies show that
burdock may have:
Antibacterial, antineoplastic,
antioxidant, antiretroviral, antiinflammatory 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
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“Death
begins in the
colon”
Old Naturopathic saying
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Why is Intestinal Health
Important?
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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
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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.
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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
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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
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Some of the Many Possible
Symptoms/Indications of Intestinal
Dysbiosis
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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
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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
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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)
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Botanical and Nutritional Intervention
Intestinal Digestive Impairment
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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 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)
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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.
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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
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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)
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Botanical and Nutritional Intervention
Intestinal Permeability Excess



7/16/2015
Rx repair factors: Intestinal Repair Complex
1 tsp BID – TID and/or IRC caps 2-3 BIDTID
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
Finocarbo plus is useful
in balancing the digestive
function:
Reduces indigestion
Reduces bloating,
intestinal gas
Reduces abdominal
discomfort
Aides in toxin absorption
Enhances gastric and
biliary secretion
7/16/2015
Botanical Intervention
Constipation
Sollievo combines 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
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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

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E Coli, Streptococcus species. Mild against
Proteus species.
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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:


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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
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)
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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

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Miller AL, Dimercaptosuccinic acid (DMSA), a nontoxic, water soluble treatment for heavy metal
toxicity. Alt Med Rev, 1998. 3(3): p. 199-207
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
7/16/2015
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.
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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
7/16/2015


Personally I rarely use DMSA or DMPS
My products of choice are:
Toxi HMF
&
BioAlkalizer
(Occasional Use)
7/16/2015
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 Lmethionine this compound easily crosses
the BBB accumulating in the brain and
kidneys
 Possible therapeutic intervention:
methionine, phyenylalanine and leucine can
block transport across BBB
7/16/2015
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
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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.”
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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.”

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Ballatori N et al, N-acetylcysteine as an antidote in
methylmercury poisoning. Environ Health
Perspectives, 1998. 106(5):p.267-71
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.
7/16/2015
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)
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Whey Protein
Rx: (BioG) UltraPure Whey Protein
1 Serving daily
 Increases endogenous production
of GSH


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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 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.
7/16/2015
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
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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
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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)
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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

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Intestinal Functional Foods

Rx: (BioG) Intestinal Repair Complex 1
tsp BID-TID or IRC capsules 2-3 BIDTID
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
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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
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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
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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
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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!
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Algorithm: Detoxification with
Nutraceuticals/Botanicals
Determine Patient needs Detox Program
(Health history, chemical/environmental sensitivity
Provocative testing, screening questionaire(s))
Yes
Complicated?
Yes
No
+
Standard Intervention: BioCleanse, Toxi HMF,
UltraPure Whey Protein, IRC powder, Finocarbo plus,
Sollievo, UltraFiber Plus, ProFlora Plus
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Response Favorable?
1/4-1/2 dose
Standard
Intervention
Yes
No
Finish
Intervention
Standard Intervention 1/4-1/2 dose +
Needs Botanical Support
for Liver and/or Kidney
Function?
Liver
Kidneys
Pathological
detoxifier, abnl LFT,
etc
Elv BUN/Creatinine
Artichoke, Burdock,
Dandelion, Milk Thistle,
BioLiv
Stinging Nettles
Horsetail
Dysbiotic Bowel?
Bacterial, Fungal or Ameobic
Pathogens
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ParaBiotic Plus, Dysbioplex FNG
Green Tea caps
Burdock Root
(Complete first or Tx for at least 2 weeks prior
To starting Standard Detox Intervention)
Digestive Deficiencies?
(HCl, Pancreatic, or SI brush
Border enzymes)
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UltraGest,
BioPan,
PanZyme, or
Vegizyme
“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)



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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


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
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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!
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Resources


Primary
Moss, J. Moss Nutrition Report.
Monthly issues from March 2000 to
February 2001.
www.mossnutrition.com (“mnr
mnr”)
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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
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Further Information

BioGenesis Nutraceuticals, Inc.


1.866.272.0500
David B. Wood, ND



7/16/2015
425.778.5673
[email protected]
[email protected]
“Beloved, I pray that you may
prosper in all things and be in
health, just as your soul prospers.”
3John:2
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