Detoxification

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Many claims are made of simple herbal products to detox the body and this is very appealing to the public. The herbs do not directly detox the body, though, unless they are direct chelaters, able to conjugate with and transport heavy metal toxicities. Instead, the herbs useful in detoxification aid the body's own processes of detoxification, which are highly developed in the human physiology, and often need to be optimized with healthy choices in medical treatment as well as diet and lifestyle. More importantly, we need to prevent the rising tsunami of environmental toxins that often do not break down easily and thus increase in concentration in the environment and drinking water, which the United States Environmental Protection Agency states is not being treated effectively for a wide array of toxins and pathogens.

Utilizing a professional Complementary and Integrative Medicine (CIM/TCM) physician, such as a Licensed Acupuncturist and herblist with extensive herbal knowledge as well as experience with nutrient medicine, or a Naturopathic Doctor, insures that this process of detoxification is achieved. Detoxification is always occurring in the human organism, and without it we would surely die. Our job is to better understand this system of detoxification and enhance the body's innate ability to protect itself. A growing problem of Toxicant-Induced Loss of Tolerance (TILT) may occur in individuals reacting to toxin accumulation, and the body often needs help to reverse this complex and difficult health problem as well. Much advertisement convinces patients that only certain types of treatment will achieve this detoxificaton, or that simple dietary regimens and simple gastrointestinal herbal aids will do all that is necessary to detox, but this is just slick advertising to sell a product, which is unfortunate in the realm of health concerns. To achieve the needed results in detoxification an intelligent and individualized protocol needs to be designed and implemented, in some cases with persistence. Simple detox diets and expensive colon cleanses help, but not as much as real and proven aids to innate systems of detox in your body that have evolved over many many thousands of years. Often, this spin that simple detox protocols are all that is needed results in a lack of progress in detoxification, and future harm to health.

To make the most intelligent choice of products to detox, it is best to understand what this process really is. Detoxification in the body is mostly performed by the liver, which houses Kupfer cells that contain rich quantities of macrophages to clear unwanted cells and toxins from the blood, and is also able to conjugate difficult toxins to bile salts to facilitate excretion if these chemical cannot be broken down. The other major way of clearing in the body is thus by excretion from the intestines and bowel. Excretion of toxins via the fluids, by sweating and urination is a much less effective way of elimination in the body, and the use of saunas and drinking a lot of water will help only a little. Health of the liver and intestinal tract is therefore of utmost importance in detoxification, as is good bile flow. The kidney plays a less potent role to excrete, ridding the body of excesses of normal chemicals that are broken down in the detoxification process, but many toxins are not able to pass the blood filters into the kidney. Cellular detoxification is also an important subject, and has long been measured by the glutathione potential (see a separate article on this website entitled Glutathione Metabolism, restoration and balance). While most of our body's glutathione is found in liver cells, all aerobic cells primarily use the glutathione metabolism to detoxify and clear reactive oxygen species, free radicals, or oxidants. The ratio of reduced glutathione to oxidized glutathione is the primary measure of cellular detox and health, and to achieve this homeostatic balance we need to support this process with an holistic approach.

Standard detox regimens include 1) aiding the liver to cleanse the blood more efficiently with diet, herbs, supplements and acupuncture (and avoiding alcohol intake), and 2) aiding the bowels in the elimination and excretion of stored toxins through fasting, colon cleanse, diet, herbs, probiotics, and acupuncture. Added to this is 3) tissue clearing through antioxidant activity and chemicals that attract and bind to heavy metals, such as EDTA (chelation), and 4) aiding the cellular detoxification processes with promoting glutathione potential, clearing malondialdehyde, and promoting the Coenzyme Q10 potential. Clearing of toxins via sweating is touted but has little significant effect in studies. The number of ways that we might help the detoxification processes in the body are numerous, and should be tailored to the individual goals. Fasting has long been touted as an aid to detoxification due to the fact that less energy is exerted in digestion and assimilation of nutrients, and thus more energy is devoted to detoxification and elimination. Standard modern medical practice utilizes activated charcoal and milk thistle to detoxify the liver when acute liver toxicity threatens the health, utilizing both methods with great success, and both of these products are available and safe in standard practice. Chelation therapy using strong intravenous chemicals is also becoming a popular practice across the world, although it is still not accepted by the standard medical community in the United States except with acute threatening toxicities. For nontoxic chelation a formula utilizing EDTA and chlorella is now standard and effective for helping the body to eliminate heavy metal toxin accumulation. For patients concerned with accumulated toxicity that is less acute, and simpler, such as toxicity from cigarette smoking, alcohol abuse, or common environmental pollutants, a course of herbs and key nutrient supplements to enhance the liver glutathione and enzyme metabolism may be the focus of therapy, and acupuncture may enhance this process greatly.

While heavily advertised and promoted detox regimens with diet and simple herbal routines often affect the daily health and energy, the evidence of actual detoxification in a measurable objective sense is missing from studies. With actual detoxification, a process that is occurring continuously in the human body, happens, we may not be able to feel much of an immediate change, but the long term benefits to health are great.

What toxins are we clearing?

Accumulations of environmental chemicals from cleaning products, flame retardants, plastics etc., air and water pollutants, and chemicals from the food are the major toxins in our bodies. Of special importance is the accumulations in our tissues, especially in the organ tissues and central nervous system, of small particle heavy metals, such as lead and mercury, that enter our bodies from the air or via the food chain and water supply. We must thank the Obama administration in 2010 for finally enacting effective EPA regulations that curtail the enormous tonnage of airborne lead and mercury toxins in the major industries creating this toxicity, coal-fired power plants, smelters, chloralkili producers, and concrete manufacture. Other heavy metal toxicities are also of concern, not the least of which is iron accumulation. This issue is more thoroughly addressed in my article on lead and mercury, and iron overload toxicity on this website. In some individuals, the toxins that are most damaging are composed of the chemicals resulting from breakdown of various pharmaceutical drugs. This is dependant on the types of medications and the number of medications being broken down, or catabolized, in the body. Examples of this toxicity are cited below in additional information links.

Regulation of environmental toxins in the United States has been problematic, mainly due to the strength of the 1976 Toxic Substances Control Act (TSCA) in actually preventing the Environmental Protection Agency (EPA) to effectively regulate the introduction of new or existing chemicals in substances, products and foods. Under this carefully constructed Congressional law the EPA has only been able to ban or restrict 5 of the 85,000 chemicals in use today. This TSCA protects manufacturers from actually providing safety data before a product hits the market, and the legal wording of the law has resulted in the courts interpreting amazing protections for the industry. For instance, even though the EPA banned most products containing asbestos fibers in 1989, roughly 74 years after research in Great Britain determined that these fibers caused a devastating form of lung cancer, mesothelioma, the U.S. Court of Appeals overturned this ruling for many products containing asbestos fibers, and today some of these are still on the market, with asbestos-related cancers still causing about 120,000 deaths globally each year. 

The new law is expected to allow the EPA to review the 20 most risky chemicals for toxicity at a time and gives a 7 year limit on the evaluation. The bad part of the new law, the Chemical Safety Improvement Act (CSIA), is that the industry lobbied to prevent individual states from banning toxic substances while the federal EPA is investigating (preemption), even though this is a bipartisan bill and the Republicans have continuously harped on State's rights. Oh well. To obtain even this relatively weak reform of a 40 year old very weak law written to actually undermine the EPA, the Obama administration had to gather bipartisan momentum for 6 years, but it was a "step in the right direction", stated most environmental groups. Stronger legislation, the Frank R. Lautenberg Chemical Safety Act for the 21st Century Act (Senate bill 697), and the Alan Reinstein and Trevor Schaefer Toxic Chemical Protection Act (Senate bill 725), introduced in May and June of 2015, probably will not pass, but the EPA Administrator, Gina McCarthy, strongly supported them, and hopefully some of their provisions will be in the final bill sent to the President, unless the Republican Congress becomes convinced that Donald Trump will win the presidency, in which case we will be right back to almost no public protection against the industries producing more and more toxins each year, and the rising number of citizens with increased health damage related to accumulations of toxins and Multiple Chemical Sensitivity or TILT syndromes. Once again, both the supposed right and left in the political spectrum oppose this new legislation, and instead of moving forward, an endless and fruitless fight appears to be likely. The public needs to demand sensible compromise and protection of public health, especially the health of children and the next generation.

As stated, the TSCA (Toxic Substances Control Act of 1976) prevents the EPA from effectively preventing toxic chemicals from being freely placed in food, products, cleaners, farming products, etc. In 2015, the U.S. EPA listed the most toxic list of environmental and drinking water contaminants that are not effectively removed from drinking and bathing water, called the CCL-3 (Contaminant Candidate List 3). This list names 6 most important groups of chemicals that the public needs to pay attention to, including pharmaceuticals dumped and excreted that do not break down or break down into toxic metabolites, pesticides, biological toxins frequently used by industry and often spun as "natural", disinfection products, chemicals used in commerce (a very broad array of toxic chemicals allowed in all products and food), and waterborne pathogens. To see this EPA review, just click here: https://www.epa.gov/ccl/contaminant-candidate-list-3-ccl-3 . Most of us have assumed that our governments are providing us with safe water and a safe environment, both outside and inside the home, and we see that this is just not true.

In 2016, the group called Targeting Environmental Neurodevelopmental Risks (Tendr), a coalition of concerned scientists and physicians, responding to the new Chemical Safety Improvement Act, called for stronger regulation of chemicals in industrial use that have association with neurodevelopmental disease, shifting the burden of proof to the chemical industry to prove safety when there are clear associations, rather than allowing the burden of proof to stay with the government to unequivocally prove causative harm. The percentage of children with a neurodevelopmental disability has risen to over 15 percent and even with the new law it is very difficult to positively prove that a specific chemical causes these disorders, as there could be many causative factors. Singled out in this call from Tendr are organophosphate pesticides (over 75 types), flame retardants, phthalates in soft plastic, lead, and combustion-related air pollutants.

The amount of toxic pesticides, chemical fertilizing agents, and other farm chemicals is growing as corporations take over more and more of our nation's farms and destroy more and more of the natural barriers to erosion and runoff into our water supply. As the rate of topsoil depletion accelerates, the need for more chemicals to maintain high crop yields increases. This toxicity also empties into our oceans and accumulates in our seafood. Mining and drilling, especially as we go deeper into the earth, with natural gas fracturing methods, and shale oil drilling, also creates massive amounts of water toxicity due to the need to use water to create pressure to break up rock and force oil and gas to the surface. Much of this "fracking" wastewater contains radioactive and heavy metal contaminants from deep in the eath, and this is dumped into our water supply. Natural toxins are also created by the body's metabolism, the most damaging and ubiquitous being the oxidant free radicals, and excesses of protein fragments, but normal healthy bodily function and diet are effective in eliminating natural toxic accumulations, unless the body is overly stressed by ill health or obesity. In addition, acetaldehyde toxicity (malondialdehyde) is an area of focus in recent years, and is related to alcoholism and chronic candidiasis as well as environmental aldehydes.

As stated, synthetic medications, and the products created from the catabolism of synthetic medications, are treated as toxins in the liver and intestinal tract. The rate of chemical breakdown in the liver, or detox, usually determines the levels of prescription drugs in the body. When liver detoxification is not efficient, these levels of circulating synthetic drugs may be altered, resulting in overdosage and potential harm. Many side effects of medication occur well after starting the medication, and are the result of slow increases in circulating levels of the chemicals because of inefficient breakdown, or catabolism, of the drug. There are many published cautions or contraindications in drug combination, and these are mainly addressing the drugs that use the same metabolic methods of breaking down the drugs in the liver. Too often, these contraindications and warnings are ignored. The family of liver enzymes referred to as P450 are the most well known metabolic factors that regulate the rate of drug catabolism (breakdown). Dangerous drug interactions may occur when one drug inhibits or induces a P450 enzyme activity and slows or speeds the breakdown of other drugs in the liver, resulting in altered levels of circulating dosage. By taking a number of drugs that utilize the same P450 enzymes, the chance that the circulating levels will be altered over time increases. Sometimes, the stress that this creates on the liver contributes to unhealthy liver function, which may significantly decrease the ability of the body to detoxify.

Not only the taking of a number of medications that compete for the catabolic pathway and thus alter the concentration and accumulation of drugs with toxicity, but low levels of these drug toxins and toxic metabolites ingested in drinking water and food are sometimes a problem for the body's innate detoxification system. A 2011 report from the World Health Organization (WHO), entitled Pharmaceuticals in Drinking Water, noted that "conventional wastewater treatment facilities generally have activated sludge processes or other forms of biological treatment such as biofiltration. These processes have demonstrated varying rats of removal for pharmaceuticals, ranging from less than 20% to greater than 90%... Comparatively, advanced wastewater treatment processes, such as reverse osmosis, ozonation and advanced oxidation technologies, can achieve higher removal rates for pharmaceuticals." For many of us, the water that we drink may not be treated with these advanced technologies and we may be ingesting a large variety of pharmaceuticals and drug metabolites that our bodies need to detoxify. In recent years, chlorine, which is able to remove up to 50% of pharmaceuticals, has been replaced with chloramines, which the WHO study noted had much lower removal efficiency, especially for antibiotics. The report noted: "There are few comprehensive, systematic studies on the occurrence of pharmaceuticals in drinking water." As the number of pharmaceuticals prescribed rises dramatically, and the compliance in taking these pharmaceuticals declines, many individuals simply dispose of these drugs in the toilet or sink, and this has led to higher concentrations of pharmaceuticals in the water. This water is also used to irrigate farms and often sprayed on fresh vegetables and fruits in irrigation. While the limited studies available suggest that the concentration of pharmaceuticals in drinking water has not reached an accumulative level of high concern, this WHO study points out that elevated concentrations may occur. The relevant concern for most of us is the potential that a wide variety of sources of environmental toxins may lead to a sum total that is difficult to detoxify, not to a concern that a single type of toxic material has reached a level of immediate danger. For individuals that are exposed to a variety of toxins, have a potential for innate toxicity from a variety of sources, including low grade infections and bacterial endotoxins, or fungal infections, and have a potential inefficiency in the potential to detox, these individuals may need to adopt an holistic protocol to help with innate detoxification.

Addressing liver health is of prime importance in detoxification. It is best to decrease the stress on the liver by decreasing the amount of chemicals in the body, by adopting a more natural diet and home environment, and by decreasing medication dependency whenever possible. Most drugs are immediately broken down by a certain percentage in the liver (over 4-12 hours), although some directly deposit in the body tissues, such as muscle, fat and bone, and may accumulate, just as other chemical toxins do. The rate of immediate breakdown, or catabolism, is called the half-life, implying that half of the drug is broken down into metabolites in a short period of time. This determines the time between dosage of the drug. The more prescription drugs that are taken the more stress is placed upon the liver detoxification system, probably resulting in less efficiency in detoxifying unwanted chemicals or pollutants that we ingest by eating, drinking or breathing, as well as the other drug metabolites. When the liver is unable to clear toxins and chemicals efficiently, these environmental toxins and drug catabolites may circulate and deposit in the body tissues, often with fatty encapsulations to prevent contact with normal tissues. This type of tissue accumulation increases over time and eventually contributes to degeneration, disease and aging.

The rate, or efficiency, of toxin breakdown, or catabolism, in the liver is primarily determined by the enzyme metabolism. Enzymes are a class of molecules, mostly proteins, that regulate rates of metabolism and catabolism. When the liver is dysfunctional, the blood tests show that the liver enzyme transaminases are high in circulating blood. These are termed AST and ALT (aspartate aminotransferase and alanine aminotransferase) on your blood tests. High transaminase enzymes in circulation implies a problem with liver function, and/or high stress put upon the liver. Normal levels are exceeded in liver disease, but even levels in the high end of the normal range imply liver stress of a subclinical nature. More important enzymes of detoxification, such as glutathione peroxidase, are not routinely analyzed in blood tests. Enzyme metabolism may be normal on the blood test, but the liver may still have problems affecting detoxification metabolism. Studies have proven that acute alcohol intake can dramatically affect the Kupfer cell function in the liver temporarily, and decrease the detoxification related to bacterial endotoxins (PMID: 14639920). If the liver tissues accumulate toxic metabolites, such as oxidant free radicals, the tissues may become inflamed, and may harden (cirrhosis), and this may decrease efficiency of liver metabolism significantly. Fatty accumulation in the liver in the form of stored glycogen may also decrease the capacity of the liver to detoxify, as well as trap toxins in fatty accumulations. Excess consumption of fructose contributes greatly to this fatty liver accumulation, and poor liver function, or excess liver stress impairs the ability to the liver to catabolize glycogen stores at a fast enough rate. Therapy is directed toward clearing antioxidants and protein fragments, increasing circulation, and aiding the enzyme and glutathione metabolism in the liver. The degree of ill health of the liver is determined by the physician, who then prescribes the most tailored logical combination of herbs and supplements. Typically, a short course of herbal formula, with milk thistle, Vitamin B6, L-cysteine, L-glutamine, zinc monomethionine, alpha-lipoic acid, and N-acetylcysteine optimize the goals above. Proteolytic enzymes may also benefit tissue clearance in the liver. This course of nutrients optimizes various antioxdant pathways and provides the best bioavailability of glutathione, the key antioxidant.

Studies have shown that common environmental toxins, or pollutant chemicals, accumulate in the body tissues. Even a healthy person with a good diet, in an urban area, accumulates a large amount of toxic chemicals in the tissues over time. The older we are, the more difficult this detox becomes. Since true detox of our tissues is a complicated process, repeated, or habitual, detoxification help is the only real way to clear the body of toxins. Promotion of liver and intestinal health, as well as the avoidance of as many chemicals as possible is also essential, and should become a lifelong process. This involves a diet of organic foods, unpolluted water, and breathing of unpolluted air whenever possible, as well as avoidance of household chemicals such as chemical cleaning products. When this entire regimen is adopted, maximum detox is achieved. Since elimination by the GI tract is one way of detoxifying, fasting may also be a valuable aid, if you can tolerate fasting. What is most important, once again, is a healthy functioning GI and liver system. You may want to correct your digestive problems, and improve liver health with a course of treatment before adopting a detox regimen. This will insure better results. Herbal therapies may also provide stronger intestinal detoxification. Herbs with a high content of tannic acids can precipitate toxic substances in the intestinal lumen, converting them to insoluble substances, so that a high fiber diet or fast can eliminate them. Wu bei zi is an herb used in China for this purpose. Safe and effective herbal and nutrient chelating formulas may be utilized under guidance periodically. Acupuncture works in a symbiotic fashion to help the body detoxify and eliminate more efficiently.

The subject of detoxification is not as simple as many advertisers would lead you to believe. A simple change in diet with a mild herbal formula that aids the intestinal tract helps, but is only mildly effective. Once again, the medical advice presented on medical websites such as this one is more complicated than we would wish for. The idea that the human physiology is simple, and correcting problems with our health can be achieved with the magic pill or simple routine, is a fairy tale, though, that we all buy into in a consumer society. It's easier to advertise simple solutions, and so this is what we repeatedly hear. Reality is more complicated, but can be simplified by putting the process into the hands of a professional and following the professional advice.

So what about all these advertised products to detox and colon cleanse?

We see that products with a few simple herbs may help but are not the complete answer to detox. The claims are overblown. Be especially wary of products that don't list the ingredients, spend too much on advertising, and support the product with the endorsement of a single M.D. Standard medical schools provide no instruction in herbal medicine and little nutritional medicine. Trust the professional herbalist that has graduated from a medical college specializing in Traditional Chinese Medicine (acupuncture et al) or Naturopathy. To really achieve detox one should work to develop a complete program. Guidance by a professional holistic or naturopathic physician is highly recommended due to the complexity of the process. There are a number of products that can be very potent and valuable in detox, though. Let's discuss a few of these most valuable products I use and see and how they work.

Glutathione S transferase is a family of enzymes of the liver that is used by cells to detoxify and clear toxins and drugs from the body. The P450 and glucuronosyl transferase are emphasized in drug clearing metabolism, but the glutathione enzyme activity has a greater relationship to clearing toxins and cancer causing compounds. Sandalwood essential oil (most safely taken as alcohol extract or double boil water extraction), St. John's wort , or Hypericum perforatum, and other herbs, are found to be potent in increasing this enzymatic activity, as well as the combination of nutrient supplements already mentioned. St. John's Wort (Di er cao), contains a high level of quercetin and quercitrin as well, potent antioxidants, as do many Chinese herbs used to clear and protect the liver. Milk thistle (Silybum marianum) has been well studied and found to benefit liver function and speed enzymatic detox, as have Schisandra berries (wu wei zi), turmeric (jiang huang), and alpha lipoic acid (R-lipoic acid is the more active form). Schisandra chinensis berries have been proven to significantly increase the liver glutathione level and glutathione reductase enzyme activity. A percentage of the population lacks the 2D6 gene and has difficulty in liver detox metabolism, and these people are especially in need of herbal and nutrient aids. Studies also confirm that a percentage of the population lacks other significant genetic coding for liver detoxifying enzymes, P450, glutathione S-transferase, and N-acetyl transferase, increasing their risk for leukemia and stomach cancers significantly. The benefits of these detoxifying regimens in preventative medicine appear great in recent scientific study (see citations below).

While St. John's wort, or Hypericum perforatum, has long been touted as a potent detoxifier, mainly when warning against potential herb-drug interactions, though, and the increased clearing of medications that utilized the P450, CYP3A4, enzymatic clearing pathway in the liver, studies have shown that the level of clearing of most of these drugs is not significant in blood circulation, prompting researchers to explore exactly how the herbal chemicals may inhibit effective dosage of drugs through detoxification. In other words, the assumption that St. John's Wort could alter circulating levels of some medications through its strong detoxification stimulation in the liver was found to be untrue in human studies, and research was funded to discover why. What was found was that St. John's wort may present as a potent P-glycoprotein inhibitor in the gut. P-glycoprotein is a natural cell membrane protein in the human organism, expressed heavily in the intestinal membrane cells, that increases the cellular detox, or pumping of foreign substances out of the cell, and is ATP-dependent. While numerous studies at various University medical schools have shown that there is no evidence of sustained interference with drug levels in circulation, studies by pharmaceutical researchers continue to publish warnings that the herb does negatively interact with many drugs. 

In 2004, Schering-Plough Research Institute, in Lafayette, Louisiana, published an article in the Journal of Pharmacy and Pharmacology, that stated that two chemicals in St. John's wort, hyperforin and hypericin, demonstrated direct P-glycoprotein inhibition, and this may explain some of the supposed clinical observation of negative effects on certain drugs, explaining how the drugs do not seem to work as well with co-administration of St. John's Wort. A follow-up study was performed in 2005 at Kyushu University, Fukuoka, Japan, which found that the chemical hyperforin in St. John's wort actually induced the expression of P-glycoprotein, while hypericin appeared to inhibit. The cells studied, LS180 in the intestinal membrane, did show increased efflux of digoxin correlated with P-glycoprotein levels, but effects on the P-glycoprotein-mediated transport of digoxin. This study apparently showed a modulatory effect of the chemicals in St. John's wort, and a contradictory effect from the pharmaceutical research study. Once again, we find no evidence of actual consistent drug-herb contraindication, though this is widely reported still. On the other hand, we do see a significant modulatory effect of St. John's wort, or Hypericum, as an aid to cellular detox, both in the P-glycoprotein detox of the intestines, and in the glutathione detox in the liver. This much studied negative herb-drug interaction should never have been a significant concern, not only because of lack of actual proof of clinical harm, but because herbalists do not prescribe a high dosage of St. John's Wort for extended periods of time, which would be needed to achieve this "potential" negative herb-drug contraindication. Professional herbalists use St. John's Wort in a low dose, usually in a larger formula of herbs, and almost always to achieve a restorative goal, not to hook the patient on a chronic use of a single medication for the rest or their life, which is a tactic used in standard medicine, not professional herbalism.

There are many herbs that are proven to aid innate detoxification in the human body, though. Formulas in TCM utilize a number of herbs to work synergistically to improve liver function. I utilize such formulas as Ecliptex, Shu Gan +, Adv Chole Clear, and others, which are prescribed based on the individual's overall health diagnosis. The NIH is currently entering phase three of clinical trials of the simplest liver formula, Xiao Chai Hu Tang, called Sho-Saiko-to in the Japanese clinical trials of liver clearance of Hepatitis C. Xiao Chai Hu Tang is the basis for many Chinese herbal formulas to aid liver detoxification and health. To check out the study parameters presented by the NIH, click here: http://clinicaltrials.gov/ct2/show/NCT00633230.

Activated charcoal is very effective to attract toxins from the intestinal tract. Flax, fennel and fenugreek seeds have long been used in traditional medicine to cleanse the intestinal tract. The best way is to mix the seeds, take a heaping tablespoon each day, soak in warm water, and then chew thoroughly and swallow. This tastes weird because of the mucilage, but will be very effective if taken for a week or so daily.

Most advertised herbal detox formulas use simple herbal strategies with fennel, dandelion root, etc. These herbs are beneficial but not extremely effective chemically in aiding liver function or bowel elimination, and they certainly do little to aid chelation. These herbal products are often based on the most common herbs appearing in research, are very gentle, and may have little noticeable impact, and thus generate less complaint of the common clearing effects sometimes seen when the body goes through a more vigorous detoxification, which may include itching, stomach upset, or loose bowel movements. Does the patient know that these products are working? The answer is no. These products are kept simple and achieve mild stimulation, giving the patient the impression that they are detoxing because they feel a little better when a healthy diet and herbal supplements are used. Most often these simple commercial products do not utilize sound science and have exagerrated claims of effectiveness. While commonly advertised detox herbal products may not provide a strong detox stimulation, they can't hurt. Dandelion, burdock, fennel, fenugreek, and nettle can all be added to your diet and give benefit in aiding the body's natural detoxifying mechanisms. To achieve a potent detoxification, though, utilizing professional individualized protocol to achieve specific detox goals is recommended.

Some combinations of herbs and nutrient medicines provide intelligent formulas to achieve detoxificating goals. Acetaldehyde toxicity is common in the population, via chronic candidiasis, air pollution, excess alcohol consumption, etc. and the product AL Cofactors by Complementary Prescriptions includes key nutrients to help the body clear this toxicity and promote increased glutathione metabolism, such as Pantothenic Acid (B5), Zinc glycinate chelate Molydenum glycinate chelate, Magnesium glycinate chelate, N-acetyl cysteine, Betaine, and R-Lipoic Acid. This and similar formulas provide a synergistic array of studied nutrient molecules. Such products as this provide an economical treatment product to help achieve goals, and can be used for a short course with acupuncture and herbal medicine. It must be noted, though, that taking even such a well formulated product does not achieve complete detoxification and clearance, and each patient is an individual, with different detox needs. This is why a professional that is knowledgeable is able to help you achieve these goals in an objective manner that is thorough and comprehensive. By seeking out this professional treatment protocol one can be assured of achieving the strongest help in detoxification in a short period of time.

To reiterate, detoxification and removal of stored heavy metals (chelation) are processes that each healthy body engages in daily. The patient may want to increase the rate of detoxification and chelation, and a variety of strategies, ranging from very gentle, to very strong, are available. Very potent chelation and detoxification needs to be supervised in a clinic, while gentle protocols can be utilized at home, or with therapy from a professional herbalist and Complementary Medicine physician utilizing nutrient medicine. Products on the grocery or drugstore shelf may not be dependable, or may be too gentle. A TCM physician with knowledge of this therapy may utilize three strategies. One, herbs and supplements that are proven to aid the liver in its natural detoxification processes, and the glutathione system in its cellular detox can be prescribed; two: intestinal clearing may be aided by herbal formulas, activated charcoal, and various specific herbs and nutrients, individually prescribed on a case-by-case protocol; and three: chelation of heavy metal and toxin accumulation in tissues can be stimulated with a variety of herbal and nutrient products. You may read more about chelation of heavy metals, and heavy metal environmental toxins on another article on this website, and you may read more about the glutathione metabolism as well.

Aldehydes, Malondialdehyde, excess Reactive Oxygen Species (ROS), Superoxides, and Bacterial exotoxins and endotoxins

A number of common toxins that may degrade the cell membrane or the organelles of the cell may accumulate or be produced on a daily basis, and exceed the body's capacity to clear them, resulting in dysfunction of the cellular processes. Aldehydes are the product of alcohol metabolism, and the term refers to alcohol dehydrogenation, which may occur with the consumption of excess alcohol, the breathing of smog or cigarette smoke, the overgrowth of candida, and a host of other toxic occurrences. An aldehyde is a simple organic molecule that is similar to a carbohydrate, like alcohol, with oxygen bonded to carbon and hydrogen, but with a large variety of radical groups attached that determine a diverse array of chemical properties. Our immune systems would not readily attack aldehydes, as they are simple and ubiquitous in our body, or fairly natural. Common aldehyde toxins in the environment include formaldehyde, benzhaldehyde, tolualdehyde, butyraldehyde, acetaldehyde, proprionaldehyde, and most sugars are derivatives of aldehydes, hence, unnatural sugars, such as high-fructose corn syrup, may be linked to aldehyde neurotoxicity. Some of these industrial aldehydes are involved in the manufacture of resins, polyurethanes, plasticizers, and synthetic vinegars and acid neutralizing food additives (acetic acid). Malondialdehyde is a type of highly reactive aldehyde that is a primary marker for oxidative stress, and is generated by reactive oxygen species. Malondialdehyde causes toxic stress in cells and forms advanced lipoxidation end-products (ALEs), which are similar to advanced glycation end-products (AGEs). Malondialdehyde also is involved in DNA mutation, reacting with guanosine and adenosine in the genetic material. Although there is little clinical study as of yet of malondialdehydes in relation to pathology, excess levels are associated with corneal keratopathy and osteoarthritis, atherosclerosis-induced pathologies, and are increasingly being studied in relation to central neuropathies. The NIOSH (National Institute for Occupational Safety and Health, part of the Centers for Disease Control and Prevention (CDC) of the U.S.A.) considers malondialdehyde to be a potential occupational carcinogen.

Malondialdehyde (MDA) toxicity has long been a biomarker measure of oxidative stress, as well as cellular toxicity, as has glutathione capacity been a marker of the capability of cellular detoxification as well as a biomarker of cellular toxicity. While this particular aldehyde is a simple compound (CH2(CHO)2), it has long been used a an indicator of lipid peroxidation, or excess toxicity of the phospholipid membranes of the cells, as well as excess prostaglandin synthesis, a marker of chronic inflammation. Malondialdehyde is highly reactive and generated from reactive oxygen species (ROS), especially when they degrade polyunsaturated fats, and are found in heated processed sunflower and palm oils. Malondialdehyde is both mutagenic and carcinogenic in excess, reacting with DNA. The bottom line is that generation of excess malondialdehyde and deficiency in clearance of this cellular toxin are both significant threats to health, contributing to cell dysfunction, and well as cancer. A study published in The Journal of Biological Chemistry, October 25, 2013 (43), headed by Laura J. Neidernhofer and J. Scoot Daniels of the A.B. Hancock Jr. Memorial Laboratory for Cancer Research, at Vanderbilt University School of Medicine, Nashville, Tennessee, stated: "these data represent the first investigation of the biological consequence of the replication of MDA (malondialdehyde)-modified double-stranded DNA in human cells. Not only does the study reveal that MDA-induced DNA damage is mutagenic, it also provides evidence for the occurrence of a previously undetected lesion that may be highly mutagenic, a DNA ICL (interstrand cross-links). This lesion may contribute significantly to the genotoxicity associated with lipid peroxidation and oxidative stress." These malondialdehyde ICL DNA mutations were found to occur in normal acidity, or pH, but were more likely to occur in acidic environments. This landmark study finally proves that malondialdehyde toxicity is highly linked to cancers, something that researchers such as Dr. Max Gershon noted more than 60 years ago, but was denied validity in standard oncology.

So, many health and environmental factors could contribute to malondialdehyde and aldehyde toxicity. The question is what will help decrease it. Alpha lipoic acid (ALA), or the more active form R-lipoic acid, functions in an oxidized form for the transfer of active aldehyde acetyls to acetyl-CoA. Carnosine is an antioxidant the removes aldehydes and opposes glycation (AGEs). N-acetyl cysteine counteracts the effects of acetaldehyde, and helps lower malondialdehyde levels (PMID: 22883437). Methylselenocysteine may reduce malondialdehyde, and exerts significant antioxidant effects. A 2013 study by the Department of Food Science and Technology at the Campus de Espinardo, in Mucia, Spain (Garcia-Villalba R et al) showed that an extract of European Olive leaf (Olea Europaea) reduced malondialdehyde (MDA) levels in postmenopausal women by about 32 percent, and well as showing significant beneficial antioxidant effects (PMID: 24158653). A 2013 study at Korea University Medical School showed that CoQ10 significantly reduced excess malondialdehyde in subjects with atherosclerotic ischemic changes that induced bladder dysfunction and overactive bladder syndrome (PMID: 23306086). Lycopene, a polyphenol antioxidant pigment found in carrots and tomato skins, has been shown to significantly reduce malondialdehyde levels in obstructive jaundice, and reduce genotoxicity (PMID: 23154037). The Chinese herb Cordyceps (Dong chong xia cao) was found to significantly reduce malondialdehyde levels in subjects with oxidative stress induced by exhaustive exercise (PMID: 24047103). The Chinese herb Salvia militiorrhiza (Dan shen) was found to significantly reduce malondialdehyde levels in subject with cardiac damage and iron overload toxicity (PMID: 23700113). Numerous studies are also now proving that specific acupuncture stimulations may reduce malondialdehyde toxicity, as study designs look for more specific effects of acupuncture stimulation. The number of such herbal, nutrient and acupuncture studies increases monthly now across the world. Combining these strategies in a single treatment protocol is obviously more effective than any one strategy alone. In addition, as with all treatment, specific detoxifying treatment will work differently on individuals, and a more comprehensive treatment protocol will insure better success.

Bacteria may be pathogenic as well as symbiotic in the human body. While research in recent years has revealed that we are more bacterial than human as an organism, and our bacterial biota is very important to our health and function, this also reveals the difficulties in recognizing and counteracting pathological bacterial toxicity. Low-grade bacterial infections may go unrecognized and exert significant toxic effects throughout the body. Pathological and pathogenic bacterial have two types of toxins that affect us, exotoxins and endotoxins. Exotoxins are toxins that affect the outer membrane of the cell, while endotoxins affect the cell interior. These toxins may not only exert excess stress on the human cells, but may also stimulate unwanted immune responses, and induce autoimmune responses. These bacterial toxins may be slowly released with low-grade bacterial infections, but may also be released suddenly when the bacterial cells are destroyed. Three main types of bacterial exotoxins include (1) superantigens, (2) exotoxins that damage the host cell membrane, and (3) A-B toxins that interfere with host cell functions. A single type of pathogenic bacterium, such as Clostridium perfringens, produces at least 20 types of exotoxins that may create expanding zones of dead human tissue. Clostridium difficile is perhaps the most prevalent of bacterial infections causing gastrointestinal pathology, especially diarrhea, but also linked to inflammatory bowel disease. All chronic pathogenic bacteria produce these exotoxins and endotoxins, and the human immune system is highly challenged to counter these toxicities.

Separate articles on this website more fully explore the pathology and treatment of bacterial endotoxins, exotoxins such as superantigens, and the subject of glutathione and how to improve glutathione function and homeostasis. These articles are entitled Glutathione Regulation and the Importance of Maintaining Balance, Bacterial Endotoxins, Lectins, and Chronic Inflammatory Diseases, and Superantigens: Prevention, Treatment and Their Role in Difficult Diseases. These important subjects are complex and cannot be dealt with by pretending that they are simple and we just need to take a single miraculous herbal or nutrient product to correct the problem. By taking the time to fully understand these health issues one can actually make a significant step in solving or preventing many very difficult chronic health problems. This is not intended to deny any work that you are doing in detoxification to date, but to let you know that this is a complex task, and that a focus on the key aspects of the human detoxification process and how to aid this process is very important in making much more progress.

Organochlorines and organophosphates in pesticides, insecticides, polyvinylchloride (PVC), solvents, and insulators, and the toxic accumulation in the environment and water

There are many organochlorines in nature and industry. We have known for some time that a number of common derivatives of organochlorines are particularly toxic, though, and accumulate in animal tissues, such as dioxins. Unfortunately, we did not act quickly to stop this type of environmental pollution, and now the most industrial nation in the world, the United States of America, is highly affected. Organochlorines do appear in nature, somewhat rarely, in bacteria, plant terpenes, flavonoids, alkaloids, and in fatty acids and steroid hormones, and even dioxins are produced in forest fires, as these organochlorines are subjected to high heat. Tree frogs have been found that produce an organochlorine called epibatidine that is heavily researched to find a new analgesic alkaloid for pain relieving medication. The human organism has of course evolved ways to break down and detoxify organochlorines, but with the levels accumulated in our waters from industrial farm runoff, and wastewater from industrial manufacture, the level of organochlorines in the human body sometimes exceeds its ability to detoxify.

Studies have implicated accumulation of dioxin in a number of diseases, especially cancers. For instance, a 2002 study by Sherry Rier and Warren Foster, published in the Oxford Journals (see link below), shows that numerous studies link dioxin exposure to endometriosis. This occurs because these organochlorines modulate immune and endocrine functions. Dioxins have been shown not be directly causative of cell mutation, or altering of genetic expression, but nevertheless are clearly linked to cancers and abnormal tissue growths. The exact mechanisms of injury are still not clear, despite a lot of study of the subject, mainly in affected Asian countries, where Agent Orange, pesticides, and herbicides, as well as unregulated industrial wastes from American companies have caused much immediate and acure toxic exposure. While dioxins are now ubiquitous in the environment, higher levels of tissue accumulation have been implicated in a number of diseases. Since some dioxins have a clearance half-life in human tissues of 7-11 years, accumulation to toxic levels is not uncommon. The World Health Organization believes that up to 90 percent of common exposure is via the diet, and especially eating other animal tissues. This has led to the largest food recalls in human history in recent years. In 2008, Ireland recalled many tons of pork products when up to 200 times the safe limit on dioxin level occurred, and a number of such large recalls of meat and dairy products have occurred, generally from the contamination of the food the animals were given. Even in recent years, decades after the banning of PCPs in pesticides, we still see toxic accumulations in food products, including meats, dairy, poultry, eggs, fish, and even desserts produced with tainted thickeners.

The key point in dioxin and other organochlorine toxicities is not the acute direct exposure, but the chronic effects exceeding what has been called the body burden. Current ubiquitous normal background exposure and accumulation is not expected to significantly affect human health, but exceeding the body burden, which could be different in individuals, does present a significant chronic toxic stress. Organochlorines have been shown to affect the health in many different ways, as endocrine disruptors, affecting the xenobiotic enzyme cytochrome P450 CYP1A1 metabolic pathway of detoxification, creating increased reactive oxygen species and oxidative stress, affecting the aryl hydrocarbon receptor (AhR) and disrupting regulation of biological response to aromatic hydrocarbons, and acting as cancer promoters. Specific organochlorines may have somewhat opposite effects at receptors. For instance, certain dioxins in pesticides act as estrogen inhibitors, and others as estrogen-like initiators at receptors. The end result is an exceeding of the body burden and a wide variety of deleterious health effects through a variety of mechanisms. 

This chronic toxic stress needs to be dealt with in an intelligent and step-by-step manner, with a holistic approach, and in the case of organochlorines, needs to focus and detox of fatty tissues and cellular detox. A large number of studies in Asia, focused on the generations of disease associated with Agent Orange dioxins from the Vietnam War, or Southeast Asia Conflict, as well as some horrific chemical dumping allowed in India by American companies, have led to a greater understanding of the pathophysiology, but alas few Western Journals will publish this supposedly controversial information. What we are left with is the advice on how to avoid dioxins, mainly by decreasing meat consumption and eating local organically fed and grazed meat, and local organically grown or true wild fish, but little data on just how to counter the toxic effects of dioxins in the fatty tissues of the body. While there is no simple solution to eliminating the body burden of organochlorine toxicity and other xenobiotics, a complete and thorough holistic regimen, based on practical choices that are individualized, and a variety of aids to body detox mechanisms, will achieve the goal.

As stated, while many of these organochlorines have been banned and reduced in use, the accumulation in the environment that does not break down easily, and the accumulation in the body tissues and cells, is still an alarming problem. Since these very harmful industrial chemicals were finally regulated, and decreased in use by popular knowledge and objection, another type of harmful toxic class of pesticides and herbicides has been widely used and again calls for its ban or at least drastic reduction are rising in scientific and healthcare circles. Organophosphates represent a very wide array of products overused in agriculture and household use that clearly cause damage to the maintenance and function of the nervous system and are linked to neurological developmental disorders, which by coincidence have risen in incidence dramatically since these chemicals have become more widely used. These chemicals were developed as chemical warfare agents to attack the human nervouse system, and primarily affect the phosphorylation of enzymes that are important to the nervous system, but also create toxicity in other regards. The measure of toxicity in legal regulation has concerned acute toxicity only, and this acute exposure has been proven to cause both central and peripheral nerve pathology. What is more difficult to regulate and prove is the chronic injury with accumulation in the environment and tissues, and laws in the United States have protected the industry from such regulation. It is very clear that these organophosphates are prevalent and ubiquitous now and that the individual potential for detoxification are all important. In the bigger picture, the promotion of more local and organic agriculture with less need for these chemicals helps dramatically as well, and of course continued progress in governmental regulation of toxins.

Utilizing Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) to achieve effective detoxification benefits

As this article explains, detoxifcation is becoming increasingly important in health maintenance today and many advertised detox regimens are proven to be less than effective in actually achieving measurable and proven levels of detox. To insure that this important natural bodily function is working for you at an optimal level, one needs to provide aids in healthcare maintenance and preventive medicine that are proven to work. This artcle provides links to scientific studies that show that short courses of frequent acupuncture and moxibustion stimulation and professional guidance and prescription of quality herbal and nutrient medicines achieve specific and objective goals in this regard. Such care needs to be individualized to choose the best protocols, and be goal oriented with a more proactive role by the patient. Becoming informed and proceeding in a sensible step-by-step manner may reap huge rewards in the present and future regarding your health. While there may not be a lot of slick advertising for CIM/TCM care in detoxification, the actual objective proof is there, and most heavily advertised detox protocols promoting simplisitc products and regimens are not really supported by such objective evidence.

Information Resources and Additional Information with Links to Scientific Studies:

  1. A 2010 United States Centers for Disease Control and Prevention (CDC) fourth annual report on the extent of human exposure to environmental chemical toxins and toxic burden shows that at this time 212 compounds were being measured in the population, finding considerable accumulated toxicity in the general population. Of course, much of the actual data on accumulated toxins found in the blood and urine of population is buried in large reports that are difficult to read, which is typical of government public health information, and the public may need to demand clear and concise reporting to show actual benefit: http://www.ncbi.nlm.nih.gov/pubmed/20806995
  2. A 2009 assessment of the levels of environmental toxins found in the population of the United States was published in the journal Environmental Science and Technology, assembled by scientists at the United States Centers for Disease Control and Prevention, and National Center for Environmental Health, in Atlanta, Georgia, U.S.A. the report showed that serum, blood and urine testing revealed that such chemical toxins as hexachlorobenzene was detected in 99.9 percent of the population over the age of 12, beta-HCH detected in 69.5 percent of the population over the age of 12, DDT dioxin detected in 73.8 percent, a DDT metabolite in 99.7 percent, and similar rates of toxicity for a host of other harmful chemicals were found: http://www.ncbi.nlm.nih.gov/pubmed/19320182
  3. Finally, after 40 years, the totally industry-friendly and ineffective Toxic Substances Control Act, passed by Congress to thwart the EPA and very effective, with on 5 of more than 85,000 toxic chemical banned, was replaced by Congress with the Cemical Safety Improvement Act in May of 2016. A response from the Environmental Working Group shows that this bill is an improvement but still falls very short of any serious goal of curbing harm from environmental and industrial toxic chemicals: http://www.ewg.org/release/chemical-reform-law-falls-short-protecting-public-health-environment
  4. A 2006 study on the impact of persistent organic pollutants such as DDT and organochlorines found in most commercial pesticides, as well as PCBs, PCDD, and TBT, was conducted by researchers at the University of Metz in France, and it was found that regional declines in wildlife populations were linked to these toxins, and that negative hormonal, biochemical and physiological effects could explain these links. Such study was the foundation for actual research and calls for the further ban of such chemicals in the environment still affecting the human population, staunchly resisted by the industry, especially companies that produced these chemicals and disseminated them widely, such as Monsanto and Dow, who are now embroiled in much controversy concerning the widespread introduction of glyphosate herbicides and matching genetically modified staple food crops: http://www.ncbi.nlm.nih.gov/pubmed/16055165
  5. A 2013 list of chemical fact-sheets from the United States Centers for Disease Control and Prevention, elucidate the most conservative estimates of toxicity and harm in the population. Persistent toxicity from the DDT metabolite DDE is found in the majority of the population despite its long ban, the chemical perchlorate, found to affect the thyroid metabolism and cause or contribute to hypothyroidism, was found in the entire population, phthalates in soft plastics, adhesives, detergents, lubricants, soaps, shampoos, and hair sprays were found in most of the population, and women consistently had higher levels accumulated due to the use of soaps, personal care, and cosmetics with phthalates in them - the list of persistent harmful environmental toxins found in the majority of the population goes on and on: http://www.cdc.gov/biomonitoring/DDT_FactSheet.html
  6. A 2010 review on the inadequacy of detection methods of organochlorine, organophosphate and carbamate pesticide levels in the environment, by experts at th Rhode University School of Medicine, in Grahamstown, South Africa, show that we need to to use better methods to even objectively measure this toxicity, which is still largely ignored and unregulated. Use of simple enzyme assays with acetylcholinesterase, butyrlcholinesterase, alkaline phosphatase, organophosphorus hydrolase, and tyrosinase would provide more effective screening, and should be demanded: http://www.sciencedirect.com/s...http://www.sciencedirect.com/science/article/pii/S0045653510011768
  7. Environmental toxicity with heavy metal toxins in the form of organic molecules released into the air and water, as well as the food, is of prime concern to environmental toxicologists, as hundreds of tonnes per year are released into the environment, mainly from dirty coal-fired power plants and smelters (see the article on this website entitled Lead, Mercury et al, neurodegenerative disease, immune and endocrine dysfunction, and organ damage from heavy metal toxins. A review of chelation therapy with EDTA and oral vitamins and minerals was conducted at Michigan State University in 2013, reviewing findings of the NIH Trial to Assess Chelation Therapy (TACT) and other studies, and noted that EDTA and oral chelating therapies are proven to eliminate palladium, cadmium, nickel, and aluminum, and other xenobiotics (environmental toxins), and been shown to improve systolic blood pressure and other cardiovascular parameters, with application to detoxification in cancer, neurodegeneration, cardiovascular disease, and kidney disease, and is shown to be safe, nontoxic and effective: http://www.ncbi.nlm.nih.gov/pubmed/22991933
  8. A review of the research and efficacy of the chelator DMSA, now FDA approved as safe and effective is presented here by the City Hospital of Birmingham, United Kingdom: http://www.ncbi.nlm.nih.gov/pubmed/19663612
  9. A review of the research of the chelating supplement EDTA, studied and used since abut 1954, shows that it is FDA approved and effective, and that a standard oral supplement will result in a significant effect when taken for about a month. The only adverse potential is the depletion of essential minerals, and a simple supplement of an essential mineral complex following completion of an oral EDTA course will prevent such problems: http://intelegen.com/nutrients/chelation_oral.htm
  10. A 1963 study of potential toxicity of the chelator EDTA taken orally, showed that even with extreme doses exceeding the suspected toxicity levels that all study animals showed no signs of health injury in autopsy. Even the animals given an extreme dosage of 250 mg per kilogram of body weight for a year, which would exceed normal supplement levels by hundreds of times, that the animals were in better health at the end of the year: http://www.sciencedirect.com/science/article/pii/0041008X63900395
  11. An example of medication breakdown, or catabolism, in the liver, which produces even more harmful chemicals than the medication itself, is cited in this study of AZT catabolites: http://molpharm.aspetjournals.org/cgi/content/abstract/39/2/258
  12. A 2011 report from the World Health Organization (WHO) reveals that a rising problem of accumulation of pharmaceuticals and their metabolites in drinking water is occurring, with little real data on the subject, and a wide range of water treatment efficiency, ranging from less than 20 percent clearing of these toxic metabolites to 90 percent. While the acute toxicity is not often and evident threat, this study shows that pharmaceuticals, particularly antibiotics, are part of the whole array of environmental toxins that we need to decrease, and as more and more pharmaceuticals are being used by both humans and in food animal farming, we cannot ignore this toxicity: http://www.who.int/water_sanitation_health/publications/2011/pharmaceuticals_20110601.pdf
  13. A 2015 assessment of liver toxicity and disease by experts at Laurentian University Greater Sudbury, in Ontario, Canada, emphasizes the importance of the liver system in detox and the impact of toxins on the mitochondia of liver cells and resulting dysfunctions. These experts note that such problems may result in more than 100 liver diseases or disorders. Clearing of oxidative stress, heavy metal toxicity, and a variety of xenobiotics (environmental chemicals that the organism is not evolved to clear): http://www.ncbi.nlm.nih.gov/pubmed/26161384
  14. A conservative but informative article from the American Heart Association explains some of the pharmacodynamics of prescription drugs and the effect on the liver, with drug-drug contraindications and explanation of ill effects on the liver metabolism with statin drugs to lower cholesterol: http://circ.ahajournals.org/cgi/content/full/109/23_suppl_1/III-50
  15. A 2000 FDA labeling approval for a synthetic estradiol oral contraceptive reveals that concentrations of drugs in the body vary considerable from person to person depending on the individual health of the liver metabolism and competition for detox pathways. Medications can create liver stress that contributes to toxicity: http://www.fda.gov/cder/ogd/rld/19190s34.pdf
  16. A 2011 survey of Naturopathic Doctors by experts at Bastyr University and the University of Washington found that 92 percent of responding Naturopathic Doctors reported using detoxification protocols for their patients, but that high quality human clinical studies of the efficacy of detox protocols is lacking. What is needed is more clinical studies of high quality and more laboratory measures of toxicity: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3239317/
  17. A 1983 study in Japan measured the effect of moxibustion stimulation on the cellular detoxification in laboratory animals and found evidence that this classic treatment technique, often used with acupuncture needle stimulation, did in fact increase phagocytic activity in liver Kupfer cells: http://www.ncbi.nlm.nih.gov/pu...http://www.ncbi.nlm.nih.gov/pubmed/?term=kupffer+cells+acupuncture
  18. A 2014 randomized controlled study showed that electroacupuncture stimulation at the common used points DU20, SP6 and LV3 daily for 14 days stimulated broad cellular detoxification in laboratory animals, decreasing superoxide dismutase need (antioxidant), and aiding glutathione metabolism, while reversing the malondialdehyde content in targeted cells of the brain: http://www.ncbi.nlm.nih.gov/pu...http://www.ncbi.nlm.nih.gov/pubmed/25069193
  19. A 2014 study at the Hong Kong University of Science and Technology showed that the very common immune protective Chinese Herbal Formula traditional titled Yu Ping Feng San, composed of just Huang qi (astragalus), Fang feng (saposhnikoviae), and Bai zhu (atractylodis) does enhance membraine detoxification in the intestines by modulation of the nitric oxide synthase, COX-2, and alkaline phosphatase enzyme metabolism. Such herbal formula is thus valuable within a more intensive detox protocol with specific herbs, nutrient medicines, antioxidants, acupuncture and moxibustion: http://www.ncbi.nlm.nih.gov/pu...
  20. A 2014 study at Guangzhou University of Chinese Medicine and the University of South Florida School of Medicine found that the Chinese herb Schisandra chinensis berry (Wu wei zi), which is used to aid the liver with antioxidant and anti-inflammatory action, may also beneficially modulate drug metabolizing enzymes and drug transporters to aid liver detoxification, perhaps utilizing the nuclear factor-like 2 (Nrf2) red blood cell derived pathway of detoxification, and increasing the expression of key chemicals that provide energy for liver cells: http://www.ncbi.nlm.nih.gov/pubmed/25552902
  21. A 2014 study at Sun Yat-sen University and the U.S. National Cancer Institute of the NIH showed that the common Chinese herb Schisandra chinensis (Wu wei zi), in the form of the Wuzhi tablet from China, an alcohol extract of Schisandra sphenanthera, is proven to exert significant protection against liver toxicity induced by excess acetaminophen use, modulating the CYP-mediated detox pathway (P450 cytochrome) and the Nrf-2 antioxidant response element (ARE) to "induce detoxification and antioxidation". This common Chinese herb is found in many formulas, used to calm, aid sleep, benefit heart health, and tonify, providing patients with detox when they are not even aware of it. Larger dosages of Schisandra, and perhaps even addition of an alcohol extract tincture in therapy could do much to achieve detox: http://www.ncbi.nlm.nih.gov/pubmed/25217484
  22. A 2013 study at the University of Madras School of Medicine, in Tamil Nadu, India, showed that Milk Thistle, or Silymarin, effectively achieves effective detoxification in the liver, as well as normalization of liver enzymes, and suppresses and prevent liver cancer. Many studies of Milk Thistle confirm the broad detox benefits of this herb, which is best utilized within a more holistic herbal protocol: http://www.ncbi.nlm.nih.gov/pubmed/23397134
  23. A thorough review of Milk Thistle, or Silymarum mareianum, by the University of Maryland Medical Center, shows that this herbal extract is proven to benefit as an adjunct in liver detoxification and to boost liver function, as well as having benefits as an adjunct treatment for cancers and hepatitis. This review from standard medicine is telling in that it confirms proven efficacy but continues to state that human clinical trials still have shown mixed results, but then reveals that these few negative results in human studies are attributed to the small size or poor quality of the trials, not to actual scientific evidence that the medication does not work. The slant of such reviews has also implied for decades that we cannot assume that such simple herbal adjunct medicines can replace standard pharmaceuticals as an 'alternative', but this has been a purported view put forth by standard medicine, not physicians of Complementary and Integrative Medicine such as TCM herbalists, who study such matters and fully recognize that these herbal and nutrient medicines are just part of a holistic protocol that needs to be integrated with standard care, not replace it. Once again, the warnings for use include the term "potential" in negative interactions, as this contraindication and negative harm has not been proven despite decades of research to find this proof: http://umm.edu/health/medical/altmed/herb/milk-thistle
  24. A 2005 study at Kyushu University, School of Pharmaceutical Sciences, in Fukuoka, Japan, showed that chemicals in St. John's wort, or Hypericum perforatum, showed both an inhibitory and inducing effect on P-glycoprotein in cells of the intestines, demonstrating a modulatory effect on the body's detox mechanism. This modulatory effect is the reason that there are no actual clinical cases of negative Herb-Drug interactions that have harmed patients, despite the enormous number of repetitions of warmings of "potential" contraindications that we can now, with further study at esteemed University Medical Schools, see is industry propaganda to deny patients the benefits of Hypericum perforatum and other Hypericum herbal extracts: http://www.ncbi.nlm.nih.gov/pubmed/15640377
  25. A 2013 study in China showed that the herb Potentilla chinensis, or Wei Ling Cai, long used to treat bacterial infections and parasitic plasmodium, and relax smooth muscle, was a remarkable aid to clearance of alcohol-induced liver injury or dysfunction in laboratory animals, clearing malondialdehyde toxicity and improving liver function and antioxidant activity. In addition, this herbal extract showed that it modulated inflammatory effects, decreasing over-expression of TNF-alpha, IL-1beta and other cytokines linked to many chronic inflammatory and autoimmune diseases: http://www.ncbi.nlm.nih.gov/pubmed/24432383
  26. A 2007 study at the Annamalai University School of Medicine, in Tamil Nadu, India, found that the common herb fenugreek seed, or Trigonella foenum graecum, long used in Traditional Chinese Medicine (TCM) along with fennel and flax seed to detox the intestinal tract, is proven to exert significant detox and liver protective effects as well, here compared favorably with the biochemical effects of Silymarin, or Milk Thistle: http://www.ncbi.nlm.nih.gov/pubmed/17484288
  27. A 2008 study published in the European Journal of Cancer Prevention showed that a percentage of the population is born with genetic polymorphisms, or tendency to express misshapen protein enzymes, related to alleles expressing P450, glutathione S-transferase and N-acetyl transferase. In the population with deficient expression of both the glutathione and acetyl transferase enzymes, risk of acquiring acute myeloid leukemia, or bone marrow cancer, increased nearly 12%: http://www.ncbi.nlm.nih.gov/pubmed/18287869. Another study in 2000 found a significant relationship between deficient expression of P450 and glutathione transferase enzymes and esophageal cancers: http://www.ncbi.nlm.nih.gov/pubmed/10868687. These studies were a follow-up to a 1997 study of glutathione deficiency genotypes and the relationship to cancer susceptibility by the University of Pennsylvania School of Medicine: http://www.ncbi.nlm.nih.gov/pubmed/9298582?
  28. A 2013 study by cancer experts at Vanderbilt University School of Medicine, in Nashville, Tennessee, U.S.A. found that at normal pH and cellular environment, that excess Malondialdehydes created DNA mutations that could lead to cell dysfunction and cancer. Reducing oxidative stress when necessary, as well as clearing of excess aldehydes, is thus very important in cancer prevention: http://www.jbc.org/content/278/33/31426.long
  29. A 2013 study at the University of Genoa, Italy, found that when alcoholic patients underwent detoxification therapy to clear excess malondialdehydes, that those patients who continued to drink alcohol in excess did not achieve significant malondialdehyde clearance, and this was heightened by adding a significant habit of cigarette smoking.: http://www.ncbi.nlm.nih.gov/pubmed/24133914
  30. A 2013 study at Seville University, in Seville, Spain, found that selenium levels in circulating blood correlated highly with liver damage in alcoholism, and that the ratio of selenium and malondialdehyde in blood circulation could be a significant indicator of liver damage in alcoholism. The supplementation with methylselenocysteine could be a significant addition to therapy in malondialdehyde toxicity, and alcoholism: http://www.ncbi.nlm.nih.gov/pubmed/24157457
  31. A 1999 study of DNA damage by malondialdehyde, but researchers at Vanderbilt University Medical Center, Nashville, Tennessee, shows a number of pathways that may contribute to DNA damage, cancers, autoimmune dysfunction and chronic inflammatory disease: http://www.sciencedirect.com/science/article/pii/S002751079900010X
  32. A 2012 study at Yichun College, in Yichun, China, showed that acupuncture can adjust the oxidant free radical metabolism in study subjects, clearing MDA (malondialdehydes) and increasing detoxifying metabolism of glutathione and super oxide dismutase (SOD): http://www.ncbi.nlm.nih.gov/pubmed/22574567
  33. A 2002 at McMaster University in Ontario, Canada, and Vanderbilt University School of Medicine, Nashville, Tennessee, reviews the compelling evidence that organochlorine dioxins are associated with both prevalence and severity of endometriosis, via modulating effects on the immune and endocrine systems: http://toxsci.oxfordjournals.org/content/70/2/161.short
  34. An overview of dioxin organochlorine toxicity by the World Health Organization is informative: http://www.who.int/mediacentre/factsheets/fs225/en/
  35. A 2004 interview with Dr. Robert Lawrence M.D., associate dean of Preventive Medicine at the Bloomberg School of Public Health at Johns Hopkins University, elucidates the mounting evidence of dangers from exceeding dioxin levels in human tissues, and the evidence that our increasing incineration of plastic waste is contributing a lot to the environmental exposure: http://www.jhsph.edu/news/stories/2004/lawrence-dioxin-poisoning.html
  36. A 2008 review of organochlorines and the diverse pathways of toxicity and damage to health when the accumulation in fatty tissues exceeds the body burden was published in Health Science Journals, authored by experts at the University of Athens Medical School, in Athens, Greece, and the Technological Educational Institute of Athens. For some reason, this research is not being readily published in Western Medical Journals, and there is little funding for such research in U.S. Universities: http://www.hsj.gr/volume2/issue2/review_89_98.pdf
  37. A 2013 review of common detox routines to clear organochlorines and other xenobiotics from tissues to relieve such problems as endometriosis, by the acclaimed Townsend Newsletter, written by a Naturopathic Doctor, is a good example of current research-based regimens, utilizing a holistic approach with diet, lifestyle changes and herbal/nutrient supplement regimens. The suggested nutrient and herbal medicines include DIM, NAC, ALA, curcumins, green tea epicatechins and quercetin, and support of glutathione metabolism with B12 and active folate (5MTHF): http://www.townsendletter.com/FebMarch2013/enviromed0213.html