DETOXIFICATION STRATEGIES

That's all. Good day. Welcome to Medicine Health with Dr. Paul Anderson. That's me, I'm Dr. Paul. And today our topic is a tag-on from the last podcast that we did on detox and toxins and forever chemicals and all that, and got a lot of questions about, okay, specifically, like, how does does the body get rid of these things? What can we do to support them through the detoxification process? Uh, what things are more likely that we can do kind of on our own versus what would we need to have a healthcare provider help us with? So that's what we're going to get into today is, uh, you know, our, our toxic world and our toxic bodies and just what can we do about it. So first off, um, I want to say that we— and I think most people realize this— we live in a toxic world, and there's a lot of toxins like we talked about in the previous show. So you can go back there and listen to that on a pod burner, on YouTube, etc., uh, and, and you know why they're here and all of that. So nobody gets away from toxins. Now, one of the things we'll talk about today is we can minimize the effect of toxins on our body. We can minimize, uh, the intake and exposure to toxins, but we can't, uh, eliminate our exposure. So everybody, to one degree or another, has these environmental toxicants or toxins that their body is dealing with, and the more of them that we get, the more trouble we really have. So one of the goals of what I want to do today was just try and help us understand how this works. How does the body naturally try and get rid of stuff that shouldn't be in there— toxins, toxicants, etc.— and what are things that we can do to support that process and either non-specifically or specifically get the, get the junk moving out. So that's our goal now. One of the things that is always, you know, a question and sometimes a conundrum in the world of environmental medicine and dealing with toxins is, well, you know, should I do testing for these things? Um, what kind of testing is available? And if we're all toxic, do I need to, right? And you can make a case maybe for any number of answers to that question. What I will say is that we have a lot better, uh, what I would call screening testing for toxins and toxicants in our body than we used to. So whereas we now can get, you know, urine samples and, um, you know, infer certain chemical toxins and mycotoxins and metal and everything. Not that long ago, we used to not be able to do that. It was a lot harder to get testing done. You'd have to get fat samples and other stuff, and we still do that sort of thing. So as to the idea of testing, normally in our chronically ill patients or in a cancer patient who wants to do secondary prevention and prevent a recurrence, We do like to do the testing in a pretty broad screening test for these toxicants and toxins because it gives us an idea of where the body is at right now. It gives us an idea of acute and ongoing exposure. So maybe my water I'm drinking is full of toxins, or maybe I'm being exposed somewhere else. So that's a good reason for testing. And then it kind of allows you to say, well, this, you know, this appears to be a small, medium, or large type of a problem. And so I've seen people where most of the trouble they had was one type of toxin that maybe they had exposure to in their work. And then I've seen other people where, you know, they kind of had some of everything, and so their body was really fighting to kind of keep things level in that respect. So as we go through and you're thinking about, oh gee, do I need to test, etc.? I'm going to talk about things kind of from 2 points of view with respect to our body getting rid of toxins and toxicants. And that would be, number one, there's a lot of general things we can do to kind of just keep our exposure to a minimum and our elimination to a maximum. General things you may or may not really need testing for. As I said, in our chronically ill folks and our recovering cancer patients, we like to do the testing to see how much of their chronic illness or how much of their immune issues and cancer are to do with toxicants and toxins. In the average healthy human, it's often not recommended that someone just test for the fun of it or whatever, and a lot of that is sort of a two-edged sword. So one thing about testing healthy people for anything is you can look at it from a preventive point of view. For example, you look healthy, you exercise, your, you know, weight is good, you appear to be in good shape, but you still might want to do some preventive medicine screening tests such as blood sugar, blood sugar control, your cholesterol, inflammatory markers, all of those things, right? So testing a quote-unquote normally healthy person can be looked at as the test is guiding us towards maybe some prevention we can do. The other way to look at it in an otherwise healthy person is, would the test likely cause treatment that may or may not be indicated for the person? Okay, so a lot of the concern with early testing of a lot of things is Well, if we find something and then there's all this treatment that we do and it really wasn't going to make a big difference and move the needle, then did the test lead us to a correct decision clinically? And when it comes to environmental medicine and testing for these toxicants and toxins, it's less likely if the tests are interpreted appropriately that you're going to cause any harm or unnecessary treatment, and it's more likely that you're going to be preventive with this. Okay, so the testing thing is always, um, uh, dependent on your case, what your goals are for finding out the information, and what you're gonna do with the information. Now, there are some hard lines that I think exist when it comes to testing, and that's where you get to more interventional type treatments. So later on we talk about, say, chelation therapy for metals. you really need testing. You need good baseline testing, and then you need good follow-up testing so that that procedure, the chelation procedure, is being done appropriately. But on the other hand, if you're going to support your general detoxification and elimination pathways in your body, that's just part of, you know, good health and staying out of trouble. So the first thing that we always want to think about is if we have toxins and toxicants coming into our body, Then it would be the most preventive thing to eliminate or minimize the input of toxins and toxicants into the body. So removal and avoidance from our sources of exposure are number— job number one. The biggest ways into your body are what you eat and drink, because we eat and drink multiple times a day generally, and food and water and other liquids carry a lot of toxins in them, or they can. And so that's a kind of a gateway into the body. The next area beyond what we eat and drink is going to be the air we breathe. And then there's also topical exposure. So you might be putting things onto your skin that actually absorb into the skin and may have chemicals in them that you don't want in your body. Okay, so removal and avoidance— again, because we live in a toxic world, we can't do it 100%. But anytime we look at somebody, especially they get tested, uh, the first thing is, is this an ongoing exposure? And so, you know, the first job, do no harm in medicine, would be to try and minimize whatever that exposure is. And sometimes we have to get people's, you know, drinking water tested. Sometimes we have to look at the type of food that they're buying and eating. Sometimes we have to look at their home environment, especially if there's like mycotoxins involved, or their work environment. And then the other thing which is easy to overlook is what am I putting on my skin that may have toxicants that absorb into the body? So The reason this is important, the reason a baseline looking at, you know, removing as much as we can, avoiding as much as we can, is important, is let's say I do go in and we start to stimulate your depuration, detoxification, elimination pathways, and we're still putting all of this toxicant into our body. Well, I— that might be good to help get rid of what's there, but the highway on the way in is not slowing down. Right. And I've seen this with people where they have a baseline test and it shows this, that, and the other thing. And then they do all this aggressive treatment to try and help their body eliminate whatever it is. And 3 months in, or 4 months, or 6 months in, they do some follow-up testing. There's even more of the chemical there. Now, some of that is that once we start to detox, we start to eliminate more of the toxins. But the other thing, which is much more of an issue, is if I keep having my body exposed through one of many means to these toxicants, and then I'm detoxing, I'm just speeding up the movement of the toxins through the body. I'm not lowering the implications of where it's coming from. So as I did in the last webinar, I'm going to post a couple of links to the Environmental Working Group to help you see like what are the top toxic foods that we should probably buy organic? What are the cleanest foods that you might be able to get either way? Then you want to think about things like water filtration and being careful what we put on our skin, what the products are that we're using. And then with air, a lot of it depends on a number of things like what you're near. Are you near airborne sources of things? Do you need filtration for your air, etc.? So removal and avoidance become very important. This is an ongoing job really for all, all humans. Now I've said the words detoxify and depuration or depurate a couple of times. The difference— and they get used interchangeably, which is fine, it's a technical difference— but to detoxify is technically to move a chemical through a physiological biochemical process to decrease its toxicity to my body. So that means it's a metabolic process to detoxify, whereas to depurate— depuration is all of the big picture stuff that helps the body eliminate things, whether through a metabolic pathway like a detoxification pathway or through an emunctory or eliminatory pathway. Which can be a more global thing. So almost always when we're looking at detoxifying, we're looking at depurating and detoxifying together because it makes no sense to just detoxify a couple of things and leave your body unable to get rid of the rest of the junk that's there. So when we're thinking about how would we structure interventions or changes in our lifestyle or whatever to get into helping our body detoxify, eliminate, depurate, all of those things. The first thing is it might be good to figure out how does the body normally get rid of toxicants inside, because our body is set up to eliminate junk that gets inside. Now, it can't always eliminate everything. It can definitely not eliminate things that come in in high quantity, and there's some things for which the body doesn't really have a good elimination pathway. But for general toxicants, we have 3 big phases of liver detoxification. You also get a little bit of detoxification through the kidneys. You get some, some through the skin. But we start with the liver. That gives us 3 big targets where we can look in regard to what we're going to do about all this. So there's— you can kind of call them phase 1, phase 2, and phase 3 detoxification in the body and mostly in the liver, but the body. Phase 1, its main job is to enzymatically convert fat-soluble toxins to more water-soluble toxins or toxicants. So phase 1 works largely through the cytochrome P450 system. That system is run by cofactors that include a lot of minerals, The B vitamin B3 active form, the NAD family of nutrients, and some other nutrients. And the job there is to hydroxylate these chemicals so that we move them from fat soluble to water soluble or more water soluble. Now, phase 1 has some fallout from it, which is pro-oxidation, because this is a oxidation reduction step here. And so when we have a pro-oxidant activity, the body naturally will kick in with an antioxidant process called superoxide dismutase, SOD. And the SOD and then some other things like glutathione, etc., help to protect the body from all of the peroxide free radicals that phase 1 makes. So something that's always of interest that um, you know, sometimes students haven't thought of that we'll go over is, look, um, your body's detoxifying all the time. Our bodies now have to detoxify faster and more than they did 50 years ago, and certainly more than 100 years ago. So every day we're creating more free radicals, more oxidized free radicals in our body, simply because we're detoxifying. We don't know it. So if I all of a sudden start to give you more toxicants to move through phase 1, I'm going to increase the amount of, uh, of reactive oxygen, you know, free radicals, etc., which is fine if we support it. If we don't support it, we can get the body kind of backed up, and so it's detoxifying like crazy through Phase one, and then it's created all this peroxide radical, etc., and we don't have anything to really quench that to call that down. Well, then we feel sick because we're detoxifying. Well, it doesn't stop there. So phase one goes to phase two. That makes a lot of sense, right? One goes to two, and phase two is a conjugation step, and that all that means is a big word for. Let's add a molecule onto the toxicant from phase 1, and I would tell students that's like an anchor on the molecule, so it's going to go out usually through either the sweat or the urine. Okay. So phase 2 is putting something or changing the molecular structure of the toxin, toxicant, so that the body can see it and get rid of it. Now, does everything go through phase 1 in order to get to phase 2? No. Water-soluble toxicants can go right into phase 2 because they don't need to go through that lipid process of phase 1. And although some water-soluble things go through phase 1, not all of them do. So phase 2 is the big collector of everybody, all the phase 1 intermediates, and then the phase 2 direct Detox agents. Well, then after we combine these phase 2 processes, we combine the toxicant and whichever phase 2 process we're doing, then we have these molecules that have to get out of the body. And the way that that happens is we call phase 3, which is elimination. That's the actual getting out of your body. The number one way out through phase 3 is urination, which is why, you know, we want to keep hydrated when we're moving stuff through, etc. Number 2 way is going out through the liver and bound up in the bile, which goes into your digestive tract. And a lot of fat residues, fat-soluble things will be put in the bile. 'Cause it's a good solubilizer there. And so then the bile is full of these toxicants. It goes in, it does its digestive job, but then the hope is that the rest of the toxic bile goes out and you eliminate it through having a bowel movement. Now, whether it's the kidneys or the GI tract, or then the third way would be through your skin, you know, through sweating, which is another way out for the body. And if you really want to be complete, we could put in breathing because we breathe out a lot of toxins too. But the biggest thing about phase 3 is we want to enhance the body's ability to run phase 3. So that means we're going to be hydrating so that we can keep the stuff moving through the kidneys. We want to have appropriate flow of the bile, so We get rid of the GI stuff. So we need good flow of the bile, and then we need fiber in our diet to bind up the bile so it doesn't recirculate the toxin. And then with sweating, it's basically hydration and then heat to get the, get the sweat moving. So then if we look at that and we say, okay, phase 1 requires, you know, some B vitamin residues and some minerals. Phase 2 uses a lot of nutrients across the board, including glutathione and sulfates and other intermediates that go on there. And then phase 3 is going to be supported by fiber and binders and hydration in the gut, hydration for the kidneys. And then hydration and heat for sweat. This then leads us to a lot of things that we can do to just support all 3 of those pathways. Then as we are looking along and we think, okay, well, what do I do every day? Pretty much most people do, and that is eat and drink. Eating and drinking is really 2 huge effectors on Uh, your ability to depurate and detoxify. Eating and drinking on one side of the equation is I want to minimize as much as I can the toxins in my food and drink, just like I want to minimize toxins in the air. I want to minimize the toxins I'm putting on my skin. But food and drink is our biggest vector in for most of us for toxins. Now, yes, you could work in an industrial area, you know, it has a lot of airborne toxicants. You could be in an area where you're getting on your skin, or you could be using a lot of products that are toxic. All of that can be a big deal. But for the average person, what they eat and drink is going to be huge. So on the one side of the food and drink equation is let's minimize the amount of junk and toxicants in the food and drink. You can't eliminate it all, but let's minimize it. That's why I'll post those Environmental Working Group links and stuff. But then the other side is that our intake of food and drink can be more or less hydrating. So hydration comes through our food and drink. My fiber intake is very important when I'm detoxifying because I want to have enough fiber in there to bind up the bile so that it goes out in a bowel movement, doesn't recirculate the toxins. Back into the body. And then the cofactors of detoxification are largely nutrient and other chemicals from food. So we want to have good quality food that gives us vitamins, minerals, amino acids, fatty acids, and then things like fiber and, uh, the bioflavonoids and polyphenols and other chemistry from food that really help our body with Detox and depuration, redox, so oxidation reduction, antioxidants, all that stuff. So you want food to be the first thing. Then the next thing is going to be, what can I do beyond drinking more water, maybe heating myself up, moving around, move your body around, you know, eat the right food and all that? What can I do beyond that? Well, that's when you get into the interventional side of depuration and detoxification. And I'm going to go through the following in no real particular order. We're going to talk about them all kind of in regard to, you know, generally how would we do this. I'm going to give you my opinion when it comes to certain things I think you should do with a healthcare provider, because some of these things are, are pretty, you know, pretty low impact and work pretty well, uh, for everybody. And then some things, you know, really ought to have some medical supervision. Now, when it comes to supervision, one of the things you want to look for in a healthcare provider is if they are trained in environmental medicine. Now, there's a difference— we talked about this on the last program— there's difference between a toxicologist which is the medical specialty for toxicity, where most of what they do is for large-scale acute exposure to a toxin or toxicant. And so if you, um, you know, your child was eating paint chips full of lead, uh, or your, um, you know, you or someone had a big exposure at work to some bad toxin or some other thing, Then that is— you're going to wind up probably in the hospital to be tested and all this stuff. That's under the purview of what the toxicology specialty would do. Everybody else for low-level exposure, chronic exposure, is not usually going to be treated by a toxicologist. That's going to be more of the environmental medicine specialty. So you can find this a lot in the integrative type healthcare provider categories. So you could have an integrative, you know, MD or DO type of a doctor, and you might check, see if they do environmental medicine. You have a large number of the naturopathic physicians, the licensed naturopathic physicians in US and Canada that are specially trained in environmental medicine. And again, just because someone's a naturopathic medical doctor or an integrative medical doctor, it doesn't mean they have training in environmental medicine. So you might want to check on that, but that's more likely you'd find it there. And I've also seen other specialties such as acupuncture and oriental medicine providers, chiropractors. There's a lot of growing group of nurse practitioners and physician's assistants doing environmental medicine. So a lot of it just depends on where you're at and doing some searching for healthcare providers who provide environmental medicine guidance. Because when it comes to getting past things like eating and drinking and removing sources and all that, and then you get into, you know, a bunch of treatments, you often want somebody monitoring all that, maybe monitoring the testing. The first intervention that I listed is mostly because it's such a popular intervention, and that is sweating. On my little list here, I listed it as sauna. But the first thing that you want to know is that sweat is a part of phase 3 detoxification. And so once your body moves through phase 1 and/or 2, it's— the stuff is ready and it can go out through the urine, it can go out through the bile and the GI tract and the feces, or it can go out through sweat. The more you sweat, the more you will depurate and move the toxins out. Now, people get into long arguments about, well, this kind of sauna is better than that kind of sauna and all this, and there are some differences, but the bottom line is It's about sweating. So anything that raises your body temperature enough to make you sweat is a depurating experience. So that means is I've had patients where they had no access to a sauna or any heating device, and they didn't, you know, want to sit in their bathtub and heat up that way. I've had them just simply go out and do whatever exercise they did with one extra layer of sweats on. And you will sweat, obviously. And just by promoting the sweat out of your body through athletic activity, you're doing a lot of that. The other thing is, we, we used to believe, well, sweating in water doesn't do any good because, you know, whatever. Actually, it does. In a hot bath over a particular amount of time, a human can sweat out the equivalent of up to a pint of sweat. That's a lot of sweat. Now, you might sweat out more if you're in a sauna, you know, but you're going to sweat stuff out. So anything that heats you up, whether it's you moving, super hot bath, sauna, that will drive stuff out. Even to the degree that, you know, in our courses we teach physicians, you know, about detoxifying metals, we'll share some research that actually shows that, you know, sweating actually will carry metals out of the body too. And again, we kind of used to think, well, that was mostly through the urinary tract, which it is, but sweating also does that. Sweating is really good for chemical toxins too. So sweating— sauna is probably the easiest way to get there, but you could also work out with extra gear on and sweat. Anything that gets the fluid moving out of you, up and including heated water, like a sauna or, excuse me, like a hot whirlpool, something like that. The next thing is similar, but it adds another factor in, and that is various types of hydrotherapy. Now hydrotherapy is a— we've done whole programs on it. It's a large topic and it can be looked at a number of ways. But most hydrotherapy has the idea of a hot phase and a cold phase where you heat the body up and then cool it down, and that is structured in different ways. So there are hydrotherapy treatments that involve water immersion partially and fully. There are hydrotherapy treatments that involve heating your body up in a sauna and then doing cold water and towels or something to cool you off. There's hydrotherapy treatments where you heat up towels to heat the body up, and then you put cold towels on once the body's hot. So there's a lot of ways into that. The reason hydrotherapy is nice as a sort of a utility treatment is there are ways to do it using stuff that you might have around, such as Towels and water. And, uh, what you would do clinically is to use the towels, you know, over the core, the chest really, uh, and heat the body up first. And then, um, and that might take a few rounds of the towels being refreshed. And then what we would do after they were heated up is take a towel that was with cold water, put that on and then their body would heat it up. And the sign when the body has heated the towel up means that the towel's been on long enough and they've gone through this cycle. Now, this hot to cold idea is used a lot in physical therapy and other parts of physical medicine. It's a very old traditional treatment in a lot of European medicine and also some traditional Asian medicines. But the 2 benefits that it does, one is it creates the heating effect. So it's kind of like, you know, a sauna heats you up and that helps you sweat out stuff. But the other thing is with the hot-cold, you get this, you could quote unquote think of it as a pumping effect or a bimodal effect where now you're, you're moving your body more, your blood more quickly through your body. The heat and then the cold is shunting the blood around. And you can even, depending on how much of this, you know, hydrotherapy you do, you can even improve some of the movement through the liver and the bile and some of the movement, like I said, out through sweating and even certain other things that can change as you go along. So sauna being anything with heat, hydrotherapy generally being anything with hot and cold involved. So, for example, when I was in China, you know, it was very common in the hotels to have hydrotherapy suites as part of their spa area. And so you would get into that. They usually had 2 really hot dip pools, one a little hotter than the other, and you get yourself heated up as much as you can, and then they would have a really cold pool. That you would go and immerse yourself in. And that's sort of like the, the big version of a hydrotherapy treatment. Like I said, it can be done with towels and be done a number of other ways. I was once at a hospital outside of the US that did a lot of hydrotherapy, and they had a number of options in their physical medicine area. They had the pools you could use. They had a tendon mediated, meaning someone's helping you, where they put you into a sauna, get your body temperature up, and they bring you out and have you do a cold plunge, and then they go back in and heat up and all of this. What's interesting is if you're chronically toxic, hydrotherapy, sauna, other heat treatments, etc., they can feel good, but they also can kind of stir up some of the depurating and detoxing. And so a sign you always want to look for is if you've heated yourself up or you did a heat treatment or hot and cold like hydrotherapy and you feel really sick afterwards, then there's one of those 3 parts or a bunch of those 3 parts of detoxification that we want to support more to let the body get rid of things. Probably a couple things come into play here. One is if you're dehydrated Nothing in detoxification or depuration works well if you're dehydrated. In our patient handouts, one of the first things that it said is, do not let yourself get dehydrated and do not let yourself get constipated. Why? Because of the 2 big ways out of your body. People who get dehydrated and constipated when they're detoxing get very sick and get very, very ill. So then the next thing is, if you're hydrated well, but maybe your body is dumping and it's dumping through the bile, and then you're recycling the toxins back in your body, the way around that beyond hydration then is a binder. So fiber is the first binder in our diet, but then a lot of people when they're detoxifying will take extra binder. So they might take a fiber supplement or one of the other binders. Or if you've ever been treated for mold mycotoxins, binders are a huge part of that treatment because you have to bind it up or it just goes right back into the body. So you want to support yourself, and if you have a reaction to these treatments, you want to make sure you're supporting your, your body's elimination more. This is another reason why having a healthcare provider help you, you know, someone who specializes in and detoxification, depuration, because they can then guide you and say, it looks like, you know, we need to get you even more hydrated, more binder in, or whatever, you know, what they're going to do. Now, sometimes when you say hydrotherapy, people will think that you mean like enemas or colonics. So instead of the water going from the outside of your body, it's going into your colon or rectosigmoid area. So colonics— a colonic procedure is where you irrigate the entire colon. It's a large-scale amount of fluid. An enema usually is where you irrigate the rectosigmoid, the lower part of the colon, and both can be very useful for people. Okay. Now, I normally say this at the top of the hour, but This is all for information. I really want you to work with your healthcare providers, whoever does your detox, and refine this. This is not medical advice to you, so don't go off and freestyle and do stuff just because I said it. Because what do we always say on this channel? Uh, taking medical advice from people on TV or the radio is probably dumb. So you really want to work with somebody. But just generally speaking, if you're looking at Colonic irrigation, enemas, that sort of thing. Usually you're getting help with that, uh, because especially for a colonic, there's a lot of technology involved and obviously a lot of, you know, time and fluid, and the pressure has to be right and all that stuff. But why would you do that? The reason you would do it is there's so much toxin that is presented to our colon every day. It is a big way to remove things And even with binders and hydration, sometimes things move too slowly through there. So to the degree that you can see, especially with a lot of chemical toxicants that we find on testing, people who do periodic colonic therapy will lower their levels of chemicals quite rapidly, more rapidly than just doing the other depuration ideas. So again, anything kind of going up into your rectum or your colon, you want to get some advice on that. But it is a way to move things through the body. Then there are things that people— there's a lot of this on the internet, and some of it's pretty innocuous and some's kind of scary. That would be liver cleanses and bile flush or gallbladder flushes, stuff like that. Number one, a liver cleanse is sort of a general, uh, topic that could be anything. Usually when you look at a liver cleanse, it's supporting phase 1 and 2 and then getting the stuff out to support phase 3. So that means that there's usually nutrients to support all those pathways. There's intermediates like glutathione support and other stuff to support phase 2. And then there's, you know, hydration and binders and sweating to support phase 3. So a liver cleanse is just really augmenting the rest of your detox pathways and protocols. But then when you get down to something like a gallbladder flush or a bile flush, what people are trying to do there— and this is where, without supervision and really some pre-testing, you really shouldn't do these bile flushes, in my opinion— You're stimulating the biliary tract and removing bile from the liver, pumping it out into the GI tract, etc. So that sounds like, all right, well, I'm stimulating, you know, an eliminatory pathway. True. The problem is if you have some gallbladder stones which people have without symptoms sometimes, or if you have a very inflamed gallbladder, which you may have some low-grade digestive symptoms and not realize that, and you suddenly stimulate your gallbladder, you can have all sorts of side effects. So, on the quote-unquote easier end, it might just be abdominal pain. It might be something like some very bad diarrhea because you stimulate bile movement. Bile causes the GI tract to contract more, so you'd move the feces through faster. Or in the worst-case scenario, you dislodge a stone, and you're going from the gallbladder, which is larger, to the bile duct system, which is very small. And the stones, if they get stuck in there, then you can have your bile back up, and/or if you get stuck down lower, bile and your pancreatic enzymes It can trigger not only pain, but potentially pancreatitis. It could rupture, and you could, you know, you could go into shock or septic, etc. It can do a lot of bad things. So if you're looking at gallbladder bile, you know, flushing, that really should be done with some pre-testing to see the shape of your gallbladder, and also somebody who can kind of help you manage how that affects you, and then how much binder do we need to pick up the bile, all of that on the other end. But those things you do hear a lot about. So remember, liver cleanse could be just generally supporting your detox pathways and depurating. A bile flush or gallbladder flush is a very specific thing with specific steps, and, uh, it can go fine, or it can have things like abdominal pain or diarrhea or other dysfunctions Or you could move a stone to the wrong place and have very, very bad side effects from that. So it's all relative. That just should be done with some guidance. Then there is the idea of using binders. So binders are fiber or fiber-like substances that literally work like a sponge to soak up the bile as it goes through. And why is this binder idea so important? Well, here's a way to think about it. In your liver, which does most of the detox pathways— are everywhere, but your liver does the biggest job— your liver is going to send out toxins from phase 1 and 2 into phase 3. Meaning urinate them out, feces, or sweat. And so some of those toxins that might be— remember I said phase 1 is going from fat soluble to less fat soluble, more water soluble. So some of those things might be directly fat soluble that get bound up in the bile and sent out with it. Some things may be a phase 2 intermediate. Where it's partly, you know, it's, it's less fat soluble, but it's okay. It'll dump it into the bile and the bile hold on to it. Physiologically, what does bile do for us in digestion? It helps to emulsify the fat we eat. So bile is very good at suspending fat, so fat toxins. What happens to the bile once it's done helping us digest? Well, it gets to the end of the small intestine and 95 to 98% of the bile is reabsorbed back into your blood. Well, if you do that and the bile is full of toxic junk, those chemicals go right back in your blood and you get sicker. Okay, you recirculate the chemicals. So the idea of the binders is if I'm stirring up detoxification and getting stuff into the bile, toxins and toxicants, then I want to bind up and I want to poop out as much, uh, bile as I can because your liver will always make more for you. And so binders are a real critical thing in all detox. Now, most people who do mycotoxin detox, like mold detox, realize this and they have you on rotating different types of binders. Um, nowadays, most people who try and do chemical depuration and detox know to use binders. But also with metal detox, that's— you're doing chelation, we normally do binders as well because there are some metals that actually are partially eliminated through the gallbladder bile system and not as much through the kidneys. So you really, you want to bind those babies up too. So binders become incredibly important. Now, when you're thinking about all of this, again, binders are kind of like every other interventional thing. You're going to be eating some amount of fiber, which is a binder anyway, so you can eat more fiber. Some people take fiber supplements as a binder, and that's fine. You just need to remember, if you're dehydrated and you take too much fiber, it'll actually, instead of going through you, it'll cause you to slow down and be constipated. So fiber and binders and hydration have to go together. Okay. The other thing about binders that has to go with them is the bile has to be able to move and get out. So rather than doing, say, a bile dump or a bile stimulation, you know, gallbladder flush or something, sometimes what we'll do with patients is a little more gentle and constant, and that's use something that is a cholagogue, meaning it Helps the bile to be formed and flow smoothly and go out. And we use different things there. There's plants like, you know, curcumin, turmeric. Curcumin is helpful with that. Phospholipids like phosphatidylcholine can be helpful, other things of that nature. As long as you're, you know, you got the choleretic coming, stimulating the bile movement, and then the binder catching it on the other end, that's a great combo. Then there's just general nutritional support, and again, that comes in different levels. You can do that through your food and drink. So first, with food and drink, we get it as low toxin intake as we can. Next is we get it as high nutrient value as we can. So most of the chemicals that are not vitamins, minerals, or amino acids or fats, uh, are going to be in colorful plant material, so colorful veggies usually. So you get a rainbow of vegetables, that really helps with the polyphenols the flavonoids, all those other chemicals there. And then we think of vitamins, minerals, amino acids, and fatty acids coming from the food we eat proper. So if we've cleaned up the food we eat, we can get a lot of support there. Then you can go on and you can do supplements. And again, if you're going to do a bunch of supplements, work with somebody who can guide you, because we see people all the time that are quadrupled up on things that they don't need. You're spending money where you don't have to. Or they're on really expensive detox supplements that really aren't that potent and aren't doing a whole lot. So that's very important. Then last but not least, uh, and again, there's other things we could talk about, but this is what we did to fit the hour in today, is chelation therapy. Now, chelation therapy might be the most known, uh, detox depuration therapy. But here's the thing with chelation therapy, it is specifically designed to use a drug to bind onto a metal and carry that out of your body, because the natural purpose of our body, natural flow of our biochemistry, is our body doesn't know what to do with toxic metals. Okay. So When it comes to metals, our body doesn't have natural— it has a little, but it doesn't have a lot of natural, like, chelation, where it's actually going to grab on. Chel means claw, means I literally, like, grab on. Um, so a chelator literally will bind onto the metal and take it out. Now, you have enzymes in your body because people say, well, we have chelate enzymes. So ferrochelatase is an enzyme in your body, and what it does is it grabs iron and puts the iron into your heme molecules for your hemoglobin function. The problem is, if you have lead in your system, ferrochelatase will grab the lead and either not work anymore or put that over into your hemoglobin, and that's going to help make you sick. So you can see that your body really isn't set up for, like, lead. It's not gonna work. So chelation is the use generally of a drug to grab onto a metal and remove it from the body. There's a few categories of chelation drugs. So the very common one is EDTA, ethylenediaminetetraacetate. And the usual versions of that are, are a disodium or calcium disodium, or maybe a magnesium disodium. EDTA usually used as an intravenous IV bag. Some calcium EDTA is made in a liposomal oral form, can be used. Then there are the dithiol chelators that are a little better at binding up mercury and some of the other metals and actually do a pretty good job on lead too. DMPS and DMSA are the 2 primary dithiols. They have relatives like BAL, which is an old-time injectable chelation agent. It doesn't work as well as DMPS, but BAL has been around forever. Penicillamine is not a relative of the dithiols, but it's another one we don't use too much anymore in environmental medicine. And then you've got specialty chelators like DTPA. The forms of DTPA are used for gadolinium poisoning. and some other things of that nature. But here's the thing with chelation, probably, you know, the biggest things that I would say, because I've, uh, clinically, uh, ordered and employed chelation with patients for 3 decades now, and it can be done very safely, but it also can be unsafe. And by that I mean it can be done in a way that is not monitored well. And with especially intravenous chelators, if it is done improperly and you're not monitored properly, it can trigger a shift in your natural electrolytes and other cell functions that might put you into a dysrhythmia, a heart arrhythmia. Uh, it could cause any number of other problems up through and including a heart attack. Etc. So you really— if you're going to do chelation, you really want to work with somebody, because even if you're doing oral chelation, you can deplete your body of the natural nutrients that we need to use, because the chelators are not that smart. They are chemically set up to bind to something that is a metal, an ion of a certain charge and size and other things. But one of the problems that we see is they like, say, lead and mercury and bad things. Chelators also like to bind up iron, which might be good or bad binding iron up, but also zinc, copper, chromium, a lot of the other minerals that our body uses to work. And in fact, if you give too much chelator, in addition to endangering your heart, you can decrease your phase 1 detox because it's very sensitive to ion movement. So that's not to say that chelation can't be done safely. It can. You know, I train people to do it safely. It just has to be done in, in a big picture. The other thing is, with the internet now, you know, you can go online, um, and you can, um, order, you know, suppositories for EDTA and other, other real drugs, but they're sold— I don't know how they're sold that way. You can order liposomal EDTA and other chelators, so you can get it and be taking them. And I've had people come in and say, well, how long you been doing that? Oh, a year, you know. And no one's checked their labs, no one's checked their electrolyte levels, uh, none of that stuff. Not good. Okay. So even if you're doing an oral treatment, please do it with some healthcare practitioner who's trained to do that, who can monitor you. Because the other problem with being unmonitored and doing chelation is a lot of us, you know, those of us who are 60+, let's say, um, yep, uh, our bones might be breaking down a little or might be breaking down a lot. Yeah. And if your bones are breaking down, the 50, 60, 70 years worth of metals you've been storing in your bones are now being released. So, you know, you start to use a chelator and you're chelating those metals out, that's fine, but your bones just keep— are going to keep dumping. Okay, so that— So as a matter of safety, you can have a clinician check you out first and make sure that they stop the supply side of the metals, if that's your bones, and then chelate you. Okay, so there's a lot with chelation that's really good. It can be done very well. It's always— or it should always be done with depuration in mind. So we should be supporting phase 1, 2, and 3 of detox. We should be supporting the functions of the liver and kidneys and sweating and all that stuff. Um, so yeah, it can be done very safely. It can be done very well. But chelation especially really needs monitoring. So again, all of this is for your information. Medical advice should come from medical professionals, and if you're looking for any of this, look for someone trained in environmental medicine. Usually there's trainings and certifications they can do there. So mentioned links and stuff like that, those go on to the YouTube channel, so we move this off Facebook Live and CTR Network over to YouTube channel and down in the description box. So on the right-hand side, there's a little V, press on that, goes to the description. Now, if you press that V and it goes to an ad, there's sometimes 2 Vs and they trick you into going to the ad. Look for the one that's got the title of this video. And then on your computer, on the left side, it'll say more or show more. Click on those words, show more or more. Be down below. So all the show notes, all that stuff goes on YouTube. YouTube is DRA Online, Dr. A Online, or just go to dranow.com and I have links to everything there. But I got to get off the radio. I'll see you here on CTR Radio next week. Thank you.