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Jeffrey Bland, Ph.D

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Chronic Illness-What Works? Understanding Metabolic Detoxification

Posted: 09/30/09 09:57 AM ET

Just because a healthcare concept is not new does not mean it should be overlooked as potentially important in improving health and reducing the burden of chronic disease. Today's post is Part Two in a series called "Chronic Illness: What Works," and I base my observations and recommendations on my 30+ years as a nutritional biochemist and healthcare advocate. In Part One of this series I discussed the Four R Program. Today I will focus on a therapy called "Metabolic Detoxification."

Years ago, the term "detoxification" was often only applied to a program for those with a drug or alcohol abuse issue, but today there are much broader and more significant applications of this concept in health care. What are the summary guidelines of a well-designed program that differentiates a "fad" detoxification program from a properly managed and professionally supervised metabolic detoxification program. From my experience, the characteristics of a safe metabolic detoxification program should include the following:

* Fresh vegetables and fruits that are organic
* Adequate calories and nutrient intake to prevent under nutrition
* Foods and supplements that are free of common food allergens such as gluten (from grains) and casein (from dairy)
* Elimination of stimulants, synthetic chemicals, alcohol, tobacco products and modified food ingredients
* Adequate amounts of fluid intake as pure water (6-8 glasses per day)
* Moderate amounts of exercise
* Adequate fiber to promote proper bowel function and prevent constipation
* Adequate (but not excessive) protein, with an emphasis on vegetable protein (my colleagues and I have found rice protein to be well tolerated)
* Intake of specific nutrients that have been found to support proper detoxification function, including epigallocatechin gallate from green tea, glucosinolates from cruciferous vegetables (broccoli, cauliflower, brussel sprouts, and cabbage), resveratrol from grapes and peanut skins, isoflavones from soy, and polyphenols and anthocyanidins from berries.

Let me give you a case study from the physicians at the Functional Medicine Research Center in Gig Harbor, Washington:

"Laura" was a 47-year-old mother of two teenage children who was seen a number of years ago. Her symptoms included pre-diabetes, elevated blood cholesterol and triglycerides, increased body weight over a five-year period, fatigue, depression, sleep disturbances, esophageal reflux disorder, and early signs of the onset of menopause, including hot flashes and night sweats. She had been prescribed several medications to manage her symptoms, and was told to go on a low-calorie diet and start a regular walking program for exercise. She had been on this combination therapy for a year with little improvement in her overall health and vitality.

In "Laura's" blood chemistry screen, doctors at our clinic noted that she had evidence of a marginally elevated liver enzyme profile, suggesting to them that she had early stage evidence of a fatty liver disorder. Research that had been published in the medical literature suggested that this condition might, in part, be due to excess accumulation of various toxic chemicals. This correlation between the accumulation of toxic chemicals termed "persistent organic pollutants" or "POPs" and alteration in liver function and chronic illness has been documented through studies by investigators at the School of Medicine in Daegu, Korea and the School of Public Health at the University of Minnesota in Minneapolis (Clin Chemistry 2007;53:109298; Diabetes Care 2007;30:622-28; Lancet 2008;371:287-888).

Our research group completed and published a clinical study with patients who suffered from the symptoms of toxicity and metabolic disturbance. The intervention program that was employed in this study was a diet that was free of additives, chemicals, and allergens, and enriched with nutrients that have been demonstrated to support the body's proper detoxification function. The results of this study were remarkable in that over the three weeks of the intervention the patients' symptom scores decreased more than 50% and biochemical evidence of improved liver detoxification function was confirmed (Altern Therapies 1995;1:62-70). This was the same metabolic detoxification "Laura" was engaged in and she had an amazing response to it. She was able to eliminate almost all of her medications over a period of twelve weeks while on the supervised program, but most importantly her sleep, energy, mood, and vitality all improved. She commented she "felt twenty years younger."

We would all like to have a complete understanding of the physiological and cellular processes related to how a personalized metabolic detoxification program results in the improvement of health. Unfortunately this is a very complicated story that is just now unfolding. Recently, this hypothesis as to the role of metabolic detoxification in reducing the risk to chronic disease has gotten some additional support with the publication in the Journal of the American Medical Association of an association between the level of the chemical bisphenol A (a substance used in the manufacture of certain soft plastics) in the urine and the risk to metabolic diseases such as diabetes, cardiovascular, and liver diseases (J Am Med Assoc 2008;300:1302-1308 and 1353-1354). It has also been reported in 2009 that chronic exposure to the herbicide Atrazine at low levels causes mitochondrial dysfunction resulting in insulin resistance and the risk to type 2 diabetes (PLoS one 2009;4:e5186,1-10). There is also evidence that the accumulation of toxic metals such as mercury, lead, or cadmium can also produce reduced mitochondrial function and lowered bioenergetics that correlates with the increased risk to various chronic diseases (Toxicol Appl Pharmacol 2008;231:34-42; Am J Clin Nutr 1995;61:646-650; and Free Radi Biol Med 1995;18:321-36).

I do not believe that anyone knows exactly how a well designed metabolic detoxification program influences the body, but there is ample evidence from many studies to indicate that it can have a favorable impact on the immune and energy processing systems of the body. From work that we have done in our research laboratories as well as reading about the work of other investigators, I conjecture that part of its benefit is through the improvement of the function of the energy powerhouse in the cells called the mitochondrion. These organelles within the cells are very susceptible to toxicity. In a recent study from my own research group, we reported that a properly balanced metabolic detoxification program can have a favorable effect on the body's acid-alkaline balance, which in turn helps to regulate cellular mitochondrial function. (Altern Therapies 2007;13:62-70).

The answers are forthcoming, but in the mean time we need to recognize that history is a good teacher and that many people have benefited from a properly designed and implemented metabolic detoxification program. It is more than just a "feel good" experience. The outcome from these programs can be seen through the lens of improved blood chemistries, improved cardiovascular fitness tests, and improved cognitive and neurological test results. The results of a metabolic detoxification program can be objectively demonstrated.

To learn more about aspects of the program visit www.jeffreybland.com; to learn more about functional medicine education programs and referrals to practicing healthcare providers, visit www.functionalmedicine.org.

From my experience, metabolic detoxification therapy represents one of the three key successful programs for improving health and reducing the risk to chronic disease that can be administered at home under the supervision of a licensed health professional. Like "Laura," there are many people who could benefit from the administration of a properly designed metabolic detoxification program. I believe if we could implement this approach more widely in health care it would make a significant contribution to improving health and reducing the burden of chronic illness, while also helping people understand how to take charge of their own health.

In Part Three of this series, I will discuss my third choice of therapies for improving health, a therapeutic lifestyle change program.