Detoxification: Debunking Myths and Embracing the Asymmetrical Bet
Detoxification, a topic heavily discussed in the realm of functional and integrative medicine, often elicits curiosity, confusion, and even criticism. Frequently, conventional medicine dismisses detoxification, citing lack of evidence or dubbing it mere pseudoscience. This multi-part series aims to delve into detoxification, emphasizing its significance and influence on health. Our initial focus is on toxicants, and how we can measure their levels. In our subsequent blog, we will explore detoxification techniques and when to consider genomic testing prior to detoxifying.
Unveiling the Culprits: Toxicants
Mainly, we grapple with these offenders that tend to accumulate in our fat, bone, cells, and cell membranes.
Molds: The primary antagonist here is indoor air pollution, which typically arises from water-damaged buildings. The World Health Organization posits that nearly 1 in 4 buildings suffer significant indoor water damage, with estimates likely being higher in tropical storm and hurricane-prone regions like South Florida. The biological growth in such buildings can create a toxic concoction of mycotoxins, actinomyces, and endotoxins, leading to an imbalanced immune system, bodily and neural inflammation, impaired detoxification pathways, and a host of symptoms across multiple body systems.
Chemicals: Over the past century, thousands of new chemicals have infiltrated our environment. Global chemical manufacturing grows by approximately 3.5% annually, potentially doubling by 2030. Some of the worst perpetrators include persistent organic pollutants, glyphosate, phthalates, BPA, vinyl chloride, fire retardants, PFCs, formaldehyde, and asbestos. Among the numerous, yet understudied, impacts of chemical pollution, three particularly concerning effects are developmental neurotoxicity, reproductive toxicity, and immunotoxicity.
Heavy Metals: Heavy metal exposure can originate from diverse sources such as air pollution, paint, dental fillings, fish, personal cosmetics, and medical implants. The chief culprits include mercury, lead, arsenic, cadmium, and aluminum.
Evidence: Why the Controversy?
Despite their evident impact, toxins continue to spark controversy within conventional medicine. This primarily arises from differing legal and regulatory perspectives on medical evidence. In Europe, the onus falls on companies to prove the safety of their chemicals. Conversely, in the U.S., the Environmental Protection Agency (EPA) must demonstrate the dangers of these chemicals, with new regulations being increasingly rare. Consequently, allopathic medicine, except for occupational medicine, rarely recognizes toxins as a root cause, often leaving primary care physicians unprepared to identify toxins as potential triggers of health conditions.
In contrast, ‘The Lancet,’ a highly respected, evidence-based European journal, conducted a systematic review of environmental toxins for their Commission series, first published in 2018 and updated in 2022. They discuss the concept of the ‘pollutome,’ a subset of the exosome, divided into three zones based on the level of evidence. As of 2022, they estimate that pollution-related deaths account for one in six global fatalities (around nine million deaths annually based on the evidence in Zone 1), marking a 66% increase over the past two decades. This surge is attributed to industrialization, uncontrolled urbanization, population growth, fossil fuel combustion, and a lack of robust national or international chemical policy.
The Lancet Commission admits that much of the exposure in developed countries remain under-researched, highlighting a dire need for further study. They note, “Undercounting of the disease burden attributable to chemical pollution is probably substantial, because only a small fraction of the many thousands of manufactured chemicals in commerce have been adequately tested for safety or toxicity, and the disease burdens attributable to these chemicals cannot be quantified. . . . . For most of the thousands of manufactured chemicals now in commerce, there are no reliable data on developmental toxicity, reproductive toxicity, immunotoxicity, the effects of long-term low-level exposures, or the health risks of chemical mixtures.”
The CDC has put out a list of their toxic substance priority list (https://www.atsdr.cdc.gov/spl/#2022spl , their top 10 items out of a list of 275 items are
- Vinyl Chloride
- Polychlorinated Biphenyls
- Polycyclic Aromatic Hydrocarbons
Our practical observations and emerging scientific literature affirm that the accumulation of toxicants can trigger or exacerbate a variety of chronic conditions, including:
- Neurodegenerative Diseases: The strongest evidence hails from animal models of Parkinson’s disease, where the build-up of synuclein protein was precipitated by chemical exposure. Regulatory measures in the Netherlands to reduce potential Parkinson’s-inducing chemicals have resulted in a significant decrease in the disease’s incidence over the last decade. We’ve observed remarkable cognitive improvements in patients when levels of mold and heavy metals are reduced.
- CIRS/Mold Illness/Sick Building Syndrome: A robust body of research links indoor air pollution and water-damaged buildings to chronic inflammatory response syndrome (CIRS). Despite this evidence not being widely recognized by national specialty guidelines, it has successfully withstood multiple legal challenges (e.g., Dauber) in various U.S. state courts and jurisdictions.
- Autoimmune Conditions: Conventional medicine generally accepts that a combination of genetic factors and environmental exposures likely underlie many autoimmune conditions, although the exact exposure triggers remain undetermined. Detoxification-enhancing approaches, like the Wahls protocol, have been documented in the peer-reviewed literature to improve outcomes for autoimmune conditions such as multiple sclerosis.
- ME/CFS and fatiguing illnesses: Toxins often exacerbate symptom burdens in fatiguing illnesses like ME/CFS, where the initial trigger may have been a reactivated viral or tick-borne illness.
- Breast Implant Illness: There’s an increasing body of evidence linking silicone breast implants to a wide range of chronic symptoms.
The Asymmetrical Bet
Considering this, the informed patient finds themselves facing an “asymmetrical bet.” They’re confronted with the following questions:
- What toxins could I be exposed to? How can I measure them before and after detoxification?
- How safe is detoxification?
- What will be the impact of detoxification on my chronic conditions?
In the next part of this series, we will strive to answer these questions, providing a comprehensive understanding of detoxification and its place in maintaining our health.
Fuller R et al. Pollution and health: a progress update. Lancet Planet Health 2022; 6: e535–47 ; https://doi.org/10.1016/S2542-5196(22)00090-0
Landrigan P et al. The Lancet Commission on pollution and health 2018 ; http://dx.doi.org/10.1016/S0140-6736(17)32345-0