Podcast episode (hosts Wendie Trubow and Dr. Ed Levitan) featuring Dr. Nafysa Parpia discussing the concept of “pretox” — a preparatory, medically guided approach for patients who cannot tolerate rapid detox because they are already in a state of inflammation, oxidative stress, and mitochondrial dysfunction. Dr. Parpia explains why quick cleanses (juice cleanses, short fasts) can worsen symptoms by increasing inflammation and mobilizing stored toxins without adequate evaluation or medical supervision, and she outlines which patient groups commonly need pretox (autoimmune disease, fibromyalgia, chronic/long‑haul infectious sequelae, and other complex chronic illnesses). The episode emphasizes personalized assessment (toxin testing, genes of detoxification, organ-elimination function) and medical oversight before initiating detoxification.
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If you want to live like you matter, ditch the pills, look great, and feel freaking amazing. You're in the right place. I'm Dr. Wendy Trubo. And I'm Dr. Ed Levitan. Welcome to the Feel Freaking Amazing podcast, where we empower you to live a vibrant and healthy life by optimizing your structural, chemical, emotional, social, and spiritual lives. Hold on to your hats. You're really focusing on pre talks. So what is a pre talks?
Yes. So I coined this term because I have so many patients who've come to me that they've tried to detox prior to coming, and it went terribly. So they maybe they had headaches from it or brain fog or joint pain or muscle pain. Most of my patients already have these symptoms, but then they got exacerbated from the detox. Right. So detox causes temporary inflammation. That just comes with the territory. So now, if these patients are already in a state of inflammation, if we try to detox them, it's just going to further increase their inflammation. Right. So their mitochondria, instead of creating ATP for cellular use, they're now creating external ATP. That's the cell danger response. It's stage one of the cell danger response in a state of oxidative stress and inflammation. And that's supposed to be temporary, but in a lot of these patients, it's not temporary anymore because they've had so many insults to their system. Those insults include environmental toxins and a multitude of infections.
So would these patients know that they needed a preto if they had tried to do a detox and got sicker? Basically, these hypersensitive, highly reactive humans.
I. Yeah. And the thing is, they don't know. So they try a detox, and then they come, and you've probably had this happen, too. They say, don't, please don't put me through a detox. I don't. I don't want to do that again. I've tried it. It was horrible. Then I say, okay, we've got to take a step back and try to understand why this happened to you. And then let's prepare you. And that's a very deep and personalized process for each patient.
So talk to me about who are the people who typically need a preto.
Thank you. Yeah. So I'm going to start with a caveat. Right? So our bodies were designed to eliminate toxins and cellular waste naturally, but we didn't evolve to catch up with this burden of environmental toxins in our environment. That's just not how we were designed. We haven't caught up with that yet? I don't know if we ever will. Right. So this constant exposure to toxins results in an increased toxic load in people. And then more research shows that environmental toxins, chronic low grade exposures, do cause autoimmunity and they do cause immune dysregulation. So patients who suffer from complex chronic illnesses, I'm finding, actually this is the majority of my patients, they need pretox first because they're coming in a highly inflamed state, in a state of, of oxidative stress. So this includes patients who have autoimmune conditions, fibromyalgia, chronic Lyme long haul syndrome, post infectious illnesses, all these mystery cases, mystery illnesses. Usually underneath that is oxidative stress and inflammation that's driven by a combination of environmental toxins and infections.
I'm laughing as you're saying this, Nafisa, because I'm thinking about the patients who walk in and they say I have this list of diagnoses and they're all chronic. And I'm thinking what you have is inflammation and mitochondrial dysfunction and toxic exposure and stress. So I'm thinking of it as a totally different way. And I'm laughing as you say these things because I feel like we're on the same page, that you're not your diagnosis, what's happening underneath that is that your body is in a state of stress and oxidative stress. So I think you and I are also on the same page because I'm not a fan of. I don't believe that quick fixes work. And you alluded before we got on camera to quick cleanses, detox programs. Talk to me about the difference between a pre talks, a detox and a quick cleanse.
Okay, so, so when, when we're doing a preto, we're really taking into the consider, taking into consideration why the patient can't handle that detox. Not only that, but why do they have these nebulous, these nebulous symptoms that have been very, very hard for doctors to pin down. Usually these patients are given waste basket diagnoses or there's no diagnosis or they're told this is all in your head. We can't figure this out. So we're going to send you to psychiatry right away. We know there's something else going on and you're inflamed, you're in oxidative stress. We can test this on the labs and of course I do. I'm sure you do also. How inflamed are you? How much oxidative Stress are you under and why? I'm looking for the root causes. Now if a patient has stress in their organs of elimination, their liver, their kidneys, their lungs, then I know they're not ready for a detox and I want to pre tox them first. And what were you asked?
Something I want to know about the things that people think of, typically like a juice cleanse or a three day fast or some type of quicker program that a lot of people buy into thinking, oh, I'm going to detox, but it makes them sicker or it doesn't get them where they want to go. How do you compare that to detox?
Okay, so first of all, everything I was just talking about, these things need to be evaluated for the person's not ready for a quick fix detox. Because when that happens, we might start flushing toxins and we're going to increase stress in the body, we're going to increase inflammation, we're going to put more stress on the mitochondria that might even cause underlying infections to surface and become more active. First of all, we want to investigate why. Second of all, a lot of these times, these quick fixes, they're not taking into account what the person is currently exposed to. Maybe they have an exposure of mold and therefore mycotoxins in their house. Maybe they're not taking into account heavy metals. Maybe the person has osteoporosis. When we have osteoporosis, lead that's been stored in the bones gets released as the bones turn over. And so this needs to be medically supervised and the quick fixes are not medically supervised. And so when you're not understanding what's happening in the patient at the medical level, it's just going to fail. Right? So I think that a lot of people think of detox as a casual thing to do, but I actually consider it to be medical in nature. Not only that, we want to test the environmental toxins, their genes of detoxification, their genes of inflammation. How high are your load of metals? You have an acute exposure of metals. Do you have a body burden of metals? How about pesticides? Glyphosate, mycotoxins? Like I mentioned before, there's so much to discover that's pertinent to each patient that's just not regarded in a quick fix detox.
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