Just because it makes you poop, doesn’t mean that you are detoxing!

Just because it makes you poop, doesn’t mean that you are detoxing!

This isn’t an exciting post but we have to stop throwing the word ‘detox’ around.  If you do not define what you mean by it, the term is meaningless, and the vast majority of people are using the term as a symptom catch-all and that is simply not how detoxification works.

 

DETOX. For such a little word, it is sure used a lot in dietary supplement claims and reports.

Starting a new supplement & you’re feeling bad? You must be detoxing!

How does supplement X work? It detoxes you!

Have a headache? You are detoxing!

Do you have gas & bloating? You are detoxing!

Constipation? Diarrhea? You are detoxing!

You have a rash? You are detoxing!

Not losing weight? Your fat cells need to detox!

Blah, blah, blah.

Let’s start by detoxing the term detox!
I really don’t like the word DETOX. I think it has become highly overused, and most people don’t have a clue what it means or what they are actually referring to when they use the term. So in effect, it has become a vague term that people use when they don’t have anything better to say. In fact, in one British study, a network of 300 career researchers investigating ‘detox supplements and products’ found that no two companies even used the same definition of “detox” and most companies made vague claims without even referencing what “detox means or proof that it actually works.”1
Do I believe that the body accumulates toxins which impair health? Absolutely. Can I think of any science proving or even suggesting that a specific supplement can detox the body of all of these environmental toxins? Absolutely not.
To be clear, this isn’t an exciting blog post. There is nothing exciting about detoxification, especially when so many people have it so spectacularly wrong. First, let’s review some basic physiology. Everything your body ever comes in contact with, and everything you ever breathe in or consume needs to be processed through either your liver, your kidneys, your lungs, your bowels, or through your skin. Water soluble substances don’t pass through the skin readily but are filtered by the kidneys fairly efficiently. Oil-soluble substances can be absorbed readily through the skin and are processed by the liver, and sent through the bowels for elimination. Gaseous substances, like anesthetic, are cleared directly from the lungs. Most of the toxins you are exposed to will be via your mouth in the form of what you eat and drink. Looking at the digestive tract for a moment, consider it a ~30 foot tube connecting your mouth to your anus. Approximately 80% of your immune system is centered in and along that tube, and maintaining its balance is a single, fragile layer of cells only one-cell thick. If this layer of cells is damaged, the selective barrier loses its selectivity, and foods, toxins, and other substances that would normally pass through your system with little consequence, can now be absorbed directly into your system (where your body can mobilize antibodies and inflammation for protection against this onslaught). In addition, there is an intricate balance of over 500 different types of bacteria (about 3 pounds worth all together) that live along is this tube which form part of a collective ecosystem to help you digest food, produce vitamins, make nutrients available, regulate hormones, and excrete toxic byproducts of your metabolism. When this lining or bacterial ecosystem become impaired, then you suffer from a wide variety of health complaints because your organ systems simply cannot operate at full function. Now, your body being the masterpiece of engineering it is, it tries to maintain an equilibrium, or ‘steady state’. So it takes these substances that it recognizes as foreign and it walls them off or stores them in the tissues it deems less critical for survival. As far as your body is concerned, your fat stores are less critical to your immediate survival needs than the health of your ligaments, nerves, and muscles. So initially, your body packs away these metabolites and toxins in fatty tissues and this can lead to cysts, lipomas, or benign tumors. Next in the line of potential storage spots, your body likes the myelin sheath – that fatty layer of insulation that surrounds your nerves and aids with nerve conduction. Connective tissues like ligaments, bones, and blood, and then tissues such as nerve and muscle tissue come next. Areas bathed in fluid, like joints are always prime targets for metabolite deposition (an example would be uric acid crystals depositing in joints in people with gout). If toxic and metabolite exposure goes on long enough, entire organ systems can be affected and thereby become dysfunctional.
Getting back to your gut, many supplement companies do not take into consideration actual human physiology when they talk ‘detox’. I swear that most people think the word detox is synonymous with the word poop. Let me be very clear, just because something makes you have a bowel movement – that doesn’t mean you are detoxing. Every symptom you have is not a sign of detoxing, nor is it a sign you need to detox. Nothing gets me more wound up than all of these ambiguous posts online that blame every negative side effect or symptom on toxins. And please, don’t get me started on all of these posts where people come to a group forum and ask a legitimate health question, only to have their symptoms brushed off or minimized by some well-intentioned but ill-informed individual under the guise that “all is fine, you are just detoxing!” As a health care professional, when I see someone referring to the word ‘detox’, I read their statement as “I don’t know what I’m talking about and have nothing better to say, so I am going to baffle them with BS”.

On a very simplistic level, when we were embryos and our guts formed, one collection of nerves, the ‘neural crest’, forms and divides with one section becoming the central nervous system and the other section becoming the enteric nervous system. These two nervous systems are connected by the longest of your cranial nerves – the vagus nerve. This vagus nerve starts in the brain and terminates in the gut and this is the source of the brain-gut connection that you read about. It is also why you have ‘gut feelings’, why eating certain foods are addictive or simply make you feel good, why you want to eat when you are stressed, why food sensitivities can cause behavioral changes, and why medication such as antidepressants can cause stomach upset or nausea.

 

When most people refer to detoxification they are referring to liver function, or to Phase 1 and Phase 2 conjugation in the liver specifically.    This is truly your major site of detoxification and it is the organ most intimately connected to hormone balance.  In Phase 1, blood carrying toxins enters the liver, and the liver prepares these toxins , usually moving them towards being water soluble, and makes them more accessible to Phase 2.  In Phase 2, there are a sophisticated set of reactions involving a multitude of things, including Cytochrome P450.  In all, there are 6 main types of reactions that occur in the liver – with each one being completely chemically different.  That is why there is no magic detoxifying agent that can clean you out entirely. Of these 6 main reactions, 3 (glucuronidationmethylation, and sulfation) are the most likely to be impaired, and the other three are more likely to affect your hormone levels.

  • During sulfation, your body adds sulfur groups to certain toxins so they can be removed.  Your body requires sulfur-bearing amino acids like cysteine and methionine,  and B-vitamins like B12 and B6, and folic acid for these processes.
  • During methylation, your body requires methyl donors to facilitate the toxin removal. Up to  40% of the population may carry genetic anomalies which hinder this process.
  • During glucuronidation, your body requires glucuronic acid, various B vitamins and a significant amount of specific magnesium ions to work properly.

This all leads to glutathione conjugation, where your body then uses master antioxidants like glutathione, superoxide dismutase, and catalase, along with the antioxidant vitamins A, C, E, and selenium.

OK, so have I bored you to death yet?  This is as exciting as watching paint dry, right?  But if you have stuck with me this long, you might be asking me what this really means?  In a nutshell, it means that there is no single supplement or product that can act as a total detoxing agent.  Anyone who suggests otherwise, is steering you wrong and just doesn’t understand basic physiology.   CBC Marketplace (click link to watch the video) , Canada’s version of  20/20 style news exposè , recently did a show where they had  a group of sorority girls from my alma mater follow Dr. Oz’s popular 48 hour detox or act as a control group. Extensive blind testing was provided by a team of medical specialists before and after the ‘detox’, and would you be surprised by their conclusion that they could discern absolutely no differences between the two groups upon the completion of the detox program?  This leads us to a very important point, if you can’t find any biochemical proof that toxin levels are decreasing, then what are you really doing?  There is an incredible lack of scientific literature that supports most detoxification claims; not only can people not agree what detoxification is, but they can’t prove that they are causing it.

You can take specific supplements or combinations of supplements to pull, chelate, or adsorb (not absorb) specific toxins from the body, like using chlorella to bind with excess mercury you may have in your body from consuming shellfish or having amalgam fillings;  using EDTA to pull lead from environmental exposure; or using N-acetyl-cysteine to detoxify from acetaminophen exposure.  But (big BUT) when it comes to detoxification, there is no magic bullet.  You can’t go around claiming that every supplement under the sun is ‘detoxing’.  They just don’t work that way, and even if a substance supports a step of detoxification, it doesn’t cause detoxification in its own right, and blaming all negative symptoms on detoxification is haphazard and potentially dangerous.

I have kept a running list of the ‘detox’ references I have seen in the online groups I follow over the past few weeks.  Here is a list of symptoms that I have seen people blame on supplementation:

  • fatigue
  • hives and other skin rashes
  • weight gain
  • gas
  • bloating
  • nausea, vomiting
  • dizziness
  • insomnia
  • inability to concentrate, mental fog
  • headaches/migraines
  • diarrhea
  • constipation
  • heart palpitations

These are not symptoms of supplement-induced detoxification!!! These are symptoms of dehydration and starvation.  When many people undertake a detox plan or a new diet, they dramatically cut their caloric intake and unfortunately the do not consume enough water, or consume substances with diuretic properties which therefore increase their odds of becoming dehydrated.  On day one of a typical ‘detox ‘/ diet, people often feel bad.  They are hungry, may experience dizziness or irritability, and feel fatigued.  By day two, their body starts breaking down  muscle mass to provide them with energy and they may experience additional mood swings, difficulty sleeping, or overwhelming fatigue.  By the third day, they are likely having headaches, muscle pain or stiffness, and even dizziness or nausea.  Rolling into the fourth and fifth days (if they have lasted that long), their body has started to adapt to the new situation and slowed down your metabolism so they don’t feel the same degree of hunger, but they still may be dealing with altered mood, headaches, and nausea. Many people who report a 6-8lb weight loss during the initial period of any detox or diet are truly losing water and a small degree of muscle mass.  They are not losing fat!   You will notice that when you look at symptoms in this light, they are nearly all truly the result of dehydration and lack of calories, they have nothing to do with ‘detoxing’.

Yes, we can take steps to reduce our intake of toxins, and that may be the most practical approach to detoxification, but we can also take supplements  which reduce inflammation or support optimal liver functioning so that our livers are best equipped to deal with the chemicals we assault them with.  For anyone interested in detoxing, it should be clear that this isn’t a process you undertake in a few days or weeks, it should be a lifestyle change where you eat ‘clean’ and provide your body with a variety of fresh  fruits and vegetables, along with vitamins and minerals, and other key nutrients to ensure that our systems are always handling toxins adequately.  When someone tells me that they want to ‘detox’, my number one question is what they want to accomplish.  Most commercial detox programs are nothing more than fancily packaged bowel stimulants.  They make for expensive laxatives, and have no proven, measurable results, and for that reason, I do not recommend them.

While I am at it, I want to tackle ‘gluten sensitivity‘ and candida overgrowth’.  As these are two other catch-alls that get as much ill-informed press as detoxification. First, let’s look at gluten.   Do I believe that gluten is an issue?  Yes.  Do I think it is anywhere as prevalent as what people like to say?  No.  In fact, a recent study2 found that people with self-reported (and to be fair, the gluten sensitivity tests are horribly unreliable) gluten sensitivity actually had no physical reactions from consuming gluten and instead experienced a total elimination of all of their GI symptoms by eliminating FODMAP’s (Fermentable Oligo-Di-Mono-saccharides and Polyphenols, or rather fermentable,  poorly absorbed, short-chain carbohydrates) from their diet.  FODMAP’s are what we would traditionally consider to be high-residue foods, things that linger in the gut and prove a fertile ground for bacteria to grow and feed off of.  When bacteria thrive in disproportionate quantities or in imbalanced ratios, people can experience significant gas, bloating, cramping, constipation, diarrhea, etc.  So what are these FODMAPS?    The most common ones are fructose containing substances such as  fruit, agave, honey, and HFCS.  Oligosaccharides such as beans, lentils, wheat, onions, cabbage, and the other cruciferous vegetables.  Disaccharides like dairy (particularly in unfermented dairy products), and sugar alcohols like xylitol, malitol, and sorbitol, which are found in many diet products.  So looking at this list, you can be eating what you think is a perfectly healthy diet but causing undue havoc with your gastrointestinal tract and immune system.  A  lot of people are jumping on the gluten-free bandwagon as of late.  In fact, I have colleagues who make their living being gluten-free gurus.  I have sat down with internationally known scholars in the field and I just don’t see that gluten is the whole answer.  Face it, we were all raised on gluten, and while there were a small portion of the population that have celiac disease and cannot metabolize gluten, the majority of us, for hundreds of generations, did just fine with it.  It was the advent of genetic modification that heralded the onset of all of this gluten fuss.  It countries that do not allow GMO wheat, they do not have the same gluten issues that we face in the United States. I will say that in the allergy blood tests I run on people, I frequently see wheat as an allergic agent but infrequently  see gluten, so my personal experience supports the findings of this and other studies.

Lastly, I have received a bunch of questions lately about candida, and specifically the validity of the candida saliva test.  I am of the professional opinion that everyone has candida, it is just a matter of whether your immune system keeps it in check or not.

Truthfully, candida is like Epstein-Barr virus; if you go looking for it you are going to find it.  It may be more advantageous and easier on your wallet to simply treat for candida if you believe you have symptoms of candida overgrowth.  Now, the candida saliva test (where you spit a mouthful of saliva into a glass of distilled water and look for ‘strings’) isn’t overly accurate.3  It can be better said that it is a test of saliva viscosity or thickness, it isn’t reproducible, nor is it specific.  Yes, some people have oral candida (also called thrush) and will produce a positive spit test, but many people have  candida-free mouths but may have candida over growths on their skin, or in their intestines or vagina’s.  Yeast is an equal-opportunity offender.  You can spend hundreds of dollars having blood, stool, or skin tests done, but does that really change your course of treatment?  If you believe you have it, it may be a lot easier and cheaper just to treat for it, and treat for the appropriate length of time* (*most treatments need to be for a minimum of six weeks to be truly successful).  Now I am officially on the record as saying I feel the candida saliva test is a no-harm-no-foul test.  You can do it if you want, it doesn’t cost you anything but 10 minutes of your time, and it may or may not help you confirm that you have an issue.  I do not think it is fool-proof or diagnostic by any means, but some people need to see things in order for them to believe them, and this is a tangible test that anyone can do but it should not be something you bet the bank on!

1. Detox Dossier.  Retrieved 1/24/14 : http://www.senseaboutscience.org/data/files/resources/48/Detox-Dossier-Embargoed-until-0001-5th-jan-2009.pdf

2.  No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Retrieved 1/24/14 from  http://www.ncbi.nlm.nih.gov/pubmed/23648697

3.  http://www.acneeinstein.com/candida-spit-test-unreliable/

How to Talk to Your Doctor About Dietary Supplements

How to Talk to Your Doctor About Dietary Supplements

As I mentioned in a previous blog post, My Doctor Doesn’t Recommend Plexus Slim (or supplements in general)  , statistics show that the average medical doctor received only 23.9 hours of education in nutrition during their entire medical school career.1  Typically that education centered around  fat, protein, and carbohydrate metabolism, and identifying overt signs and symptoms of nutrient deficiency or toxicity  because National Boards love to ask questions about things you will virtually never see like beriberi (thiamine deficiency) or pellagra (niacin deficiency).  So, in all actuality, most physicians never learn much at all about individual nutritional substances outside of common vitamins and minerals unless they have taken a personal interest in it and searched out more information on their own time.

 

So when you show up to your doctor’s appointment wanting them to approve you taking a supplement, chances are very high that they will be completely unfamiliar with the ingredients and their knee-jerk reaction will be to tell you not to take it.

So, how do you get your doctor’s consent to take a supplement when they don’t know anything about it?

The single most important thing you can do to aid your doctor in their decision is to provide them with appropriate information.  Your doctor doesn’t have the time or the resources to look up 15 separate ingredients while you are at your appointment, so you need to do this for them.  If you present to the doctors office prepared with the following, you have dramatically increased your odds of getting appropriate medical advice as to whether that supplement is worth you trying.

 

  1. Print off the SUPPLEMENT FACTS box/sheet on the product you wish to take.  This is the ‘snapshot’ of the label that lists all ingredients, in order of quantity, and lists product dosing, and any warnings or contraindications.  You can get print these off from any supplement company’s website as they are required to make these available to you.
  2. If your prospective supplement has a study published on their website, print off a copy of that too.  Remember though, that many supplement companies do not publish studies on their supplements so they do not run into hot water with the FDA by making a product claim.
  3. Look up the main ingredients in the product and print off an information sheet about each one.  Use reputable websites that your doctor would be inclined to positively receive information from such as MedlinePlus,  WebMD Supplement Center, or the Physicians Desk Reference – Herbal Medicines. Please don’t use Wikipedia or other questionable sources!  If at all possible, keep the print out on each ingredient to a single page – that way your doctor can quickly skim the information.
  4. Use Pubmed to print off Abstracts (not the full studies) of any of the ingredients in relation to health conditions you may have.  Here is an example I searched for – chlorogenic acid, weight loss and this study  pops up.  ***Be careful here, because few nutritional journals are indexed at Pubmed, and the nutritional studies posted in medical journals are often AGAINST supplementation, or use rat or other lab animal models and are not based on human trials.
  5. Lastly, have these all together in a file or envelope that you can present to our doctor and NEVER ask them “I want your approval to take ________”.  This type of question opens them up to legal liability .  It is far better to word your question the following way, “Is there anything in this supplement that would be contraindicated with my medications or health history?”  That way you are not asking for their personal opinion, nor their approval, but you are doing your due diligence that the supplement should be safe for you.  Remember, the doctor works for you, and you hire them for their expertise.  If they shoot down all supplementation, then they are not working in your best interest.  For this reason, I recommend you also print out my blog post My Doctor Doesn’t Recommend Plexus Slim (or Supplements in General)  because it covers the exact statistics of risk for dietary supplements and counters any arguments an uninformed doctor may give you.

 

For more information, please visit and LIKE my page on Facebook at https://www.facebook.com/DrJsHealthCare

 

1.  Adams, KM, Lindell, KC, et al.  Status of nutritional education in medical schools. 1,2,3,4.  Am J Clin Nutrition, April 2006, vol 83. No 4, 941S-944S.

 

 Image courtesy of stockimages at FreeDigitalPhotos.net

Are these 4 hormones making you fat?

There is so much information and misinformation about weight loss on the internet that it is hard to wade through it all.  Everyone has a different theory – it is fats, it is carbs, it is meat, it is dairy, it is preservatives, it is too many calories, it is not enough exercise, it is an inevitable part of aging, it is estrogens, it is not enough testosterone, it is mercury in retrograde…  blah, blah, blah…  Surely someone must have some answers!

 

Well, ten years of nutritional practice has taught me that no one has all of the answers.  If you find someone who claims otherwise – RUN the other way!  Weight loss science is constantly changing and it is as mercurial as the people who espouse individual diet plans.  Quite simply, there is no quick fix and there is no single plan that will work for 100% of everyone.  Period.

 

What I can tell you is that there are certain hormones that play key roles in many people’s weight gain or inability to lose weight.

 

1. Your body is not producing enough adiponectin.   Adiponectin is a protein specific to fat cells and it is believed to play a role in the development of insulin resistance and atherosclerosis.  Typically, the more body fat you carry, the lower your adiponectin levels, with increased levels of visceral fat (that fat hidden in your abdomen, packed around your internal organs) being especially correlated to decreased levels of adiponectin.  Almost every symptom associated with metabolic syndrome or insulin resistance can be directly tied to adiponectin, so – how do you make more of this hormone and head off these problems?  First, you need to increase your magnesium intake with supplements (like BioCleanse, or magnesium glycinate) and magnesium rich foods (raw spinach, pumpkin seeds, nuts, seeds, beans, lentils, fish, brown rice, bananas, figs, avocados, dark chocolate, etc.).  Second, you should look into fish oil (omega 3 fatty acid) supplementation and exercise to increase your adiponectin levels.

 

2. Insulin imbalance.  Think of insulin as a key that unlocks your cells so your body can take the glucose (sugars) in your blood stream and store it away in the cell for later.  If you don’t have enough insulin, your circulating blood sugars remain too high, and these negatively affect your vasculature system, your fat storage, your blood pressure, your ability to heal, and even your brain.  Much of the medical community thinks that insulin resistance stems from the body not having enough insulin, but other researchers, like Dr. Mark Hyman, MD, believe that too much insulin is the problem.  He postulates that elevated levels of circulating insulin are even more problematic, and that many of the drugs and methods used to treat elevated blood sugar levels , actually cause the body’s tissues to be flooded with too much insulin, which slowly cause your body’s cells to become resistant to it, which means that greater and greater levels of insulin are needed to see any effect, which leads to vicious blood sugar and insulin swings, making these hormones rollercoaster throughout the day. The ingredients in Plexus Slim support the  normalization of your insulin resistance.  In addition, some studies have shown that consuming 2 tbsp. of apple cider vinegar before a high fat meal may work as well as drugs at decreasing blood sugar levels.  If you consume artificial sweeteners, do yourself a giant favor and STOP!

 

3.  Too much ghrelin.  Ghrelin is your hunger hormone and it is found in the cells that line your stomach.  It stimulates the hunger center of the brain and makes you desire sweet or rich foods. In fact, it is so efficient at stimulating your hunger centers, that elevated levels of ghrelin will make you feel the same way as if your were in full starvation mode – desperately craving the richest, highest calorie foods you can imagine.  Furthermore, it makes you feel unsatisfied with the amount and quality of food you have eaten, whether you are truly full or not.  It’s why you can slip in that piece of pecan pie or chocolate cake for dessert when you are already uncomfortably full from eating that big turkey dinner.  A classic sign that you have too much ghrelin is that you feel you have room for dessert, or you find you are a bit hungry an hour or so after you eat. You fridge-cruisers know who you are!  Ghrelin cycles in 4 hour increments, so typically you would be hungriest 4 hours after your last meal.   So how do you address ghrelin?  There are a few different things you can do.  First, make sure you are getting enough sleep.  8 hours of sleep per night is the ideal.  If you are getting less, or have poor quality sleep, please know that sleep deprivation causes your ghrelin levels to increase.  Protein intake also staves off the release of elevated ghrelin levels, so make sure that each meal starts off with high quality protein sources (this is particularly important for breakfast). Consuming a small bowl of broth or soup before a meal is an excellent way to prevent ghrelin levels from rising too much.

 

4. Cortisol overload.  We are designed for fight or flight.  Cortisol is produced as a response to stress (and who isn’t stressed nowadays?).  It increases your cravings for sweets and carbohydrates, it increases  muscle breakdown for energy production, it increases the percentage of fat that is stored in your abdominal area, and it increases your levels of depression and anxiety – which make you eat more, which further increases your cortisol levels, creating a vicious cycle,  resulting in you feeling tired and burnt out all of the time.  Supplements such as fish oil, Rhodiola, lactium, magnesium, DHEA, and b-vitamins can all help reduce cortisol levels.  Other things that have a positive effect include slow exercise like yoga or walking, meditating, praying, or just getting into a ‘zone’ where you let your creativity reign.  Limiting coffee, and making sure you get enough sleep are other ways to keep cortisol levels normal.

So before you give up he fight, have a good look at these factors and see which ones may pertain to you and take the action steps needed to achieve your ideal weight.  I have found Plexus Slim to be an excellent tool for my patients and clients in achieving their ideal weight in a safe and efficient manner.  It truly is the non-diet, because it never involves meal replacements, shakes, calorie counting, points, or anything else.  It simply helps to normalize insulin resistance and inflammation levels so your body can release the weight it’s been hanging on to.  In addition, it makes it easy to make healthier food choices.  You didn’t gain those 40 extra pounds in a month, and it will take you time to lose it, but the key is you.  You have to draw that line in the sand and start something.  4 months from now, you can be the same weight you are now (or even heavier!), and still have those aches and pains, fatigue, gastrointestinal issues, etc., or 4 months from now you can feel like a million bucks.  No one can ever force you to change because the choice truly is yours, but, if you want help and are sincere about making change, I will help you every step of the way!

 

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