Chemical Toxicity & Sensitivity | We Are All Polluted | Surviving 9/11
The Role of Biodetoxification in Overcoming Illness
By Allan D. Lieberman, M.D., F.A.A.E.M.

(Adapted from an article previously published for the 100th issue of HEAL Magazine.)

The Center for Occupational and Environmental Medicine houses one of only six (and one of the largest) Biodetoxification Units in the nation, designed to aid patients injured by acute or chronic exposures to toxic chemicals or other toxicants.  Opened in 1988, the Program for Biodetoxification has helped patients from all over the U.S. overcome serious illness and sensitivities and return to more normal, productive lives.

Of all the multiple systems of the body, the detoxification system is the least recognized or appreciated, yet it has the important job of breaking down and excreting hazardous agents to which we are continuously exposed.  All hazardous materials entering our body are limited to only three portals – we ingest, breathe, or touch them.  The liver and lungs are supplied with special abilities to detoxify and act as “guardians of the gates” to the gastrointestinal tract and respiratory system, to detoxify everything we eat, drink, or breathe.  The skin (touch) is probably the least recognized portal, but absorption through the skin can be even 50 times greater than through our lungs. (1)
From the dawn of civilization up until the industrial age, our built-in system of detoxification could easily handle the toxic loads presented to it.

With industrialization and massive increase in exposures to foreign and hazardous substances, this natural system of detoxification has been overwhelmed.  The consequence of such an overload results in many new manifestations of disease affecting every organ and system of the body.  Injury can occur as a direct hit to the exposed tissues from external toxins, or indirectly through an internal autoimmune process.  The latter occurs when the body no longer recognizes self from non-self and destroys itself. (2,3).  But the most devastating effect of toxic pollutants is the development of cancer.  While autoimmunity can occur in a reasonably short time, the latency of cancer can be from years to decades.

As we practice Environmental Medicine, we recognize more and more that we do not just get sick but are being made sick—often from the pollutant load we are exposed to throughout our lives (and even in the womb).

Every two years the National Health and Nutrition Examination Survey is performed by the CDC's National Center for Health Status.  Blood tests comprising over 100 toxic chemical analyses are employed as part of this survey, and results now show an average of 91 toxicants in the average person.  As specific chemicals are deemed too toxic for use and are phased out, new ones rapidly take their place.  Thus, in most people we no longer see high levels of DDE , the metabolite of DDT, but increasing levels of organophosphates, pyrethroids, phthalates and mercury.  The danger of these pollutants becomes obvious when we recognize them as carcinogens, endocrine disruptors, neurotoxins and immunotoxins.  Such complexity of effects on our bodies explains multiple and diverse health problems coming from toxic chemicals.

Our current generations are in crisis because we have overwhelmed our bodies' ability to handle the great quantities of hazardous substances to which we are exposed.  The only way to thwart or reverse the damage caused by these pollutants is to come to the aid of a failing detoxification system.  The medical establishment thinks nothing of doing renal dialysis on a patient in renal failure.  But to suggest a program of Biodetoxification for a body heavily polluted by hazardous substances is often considered unacceptable or experimental. The medical establishment even differentiates between “acceptable” programs for alcohol or drug detoxification and Biodetoxification.

Biodetoxification is a term we use to describe enhancement, through medical science, of our own natural detoxification system.

Learning how to reduce our body burden of these chemicals is critical to our health and survival.  In general, we specifically recommend a program for Biodetoxification for patients with known toxic chemical exposures and chemical sensitivity.  It is reasonable to assume that potentially we are all candidates for doing such a program of detoxification, as we are all polluted.

The role of Biodetoxification becomes even more apparent and important when we consider that the new field of scientific inquiry called epigenesis has revealed that environmental effects from toxic pollutants are passed from one generation to the next—even without any genetic mutationsThey occur from the attachment of a molecule (an adduct) to the DNA of any of our germ cells (i.e., the sperm or the egg).  We can see that although gene testing and research can be very important, Biodetoxification can also be very relevant to couples preparing for pregnancy. (4)

Biodetoxification is a scientific and cost-effective therapy taught by the American Academy of Environmental Medicine in its instructional courses.  The most comprehensive source of information on Biodetoxification can be found in Dr. William Rea's four-volume treatise. (5)

A Program for Biodetoxification is based upon three major physiological processes:

1.  Mobilizing stored xenobiotics from the tissues and especially the fatty tissues of the body.  Since most toxic chemicals tend to be lipophilic or attracted to fat, our adipose tissue becomes the final resting place for the world's toxic pollutants.
2.  Enhancing the body's own detoxification processes.
3.  Enhancing the excretion of toxicants from the body.

The difficulty with many environmental toxicants is that they are "fat-attracting" (lipophilic) and are thus easily absorbed through fat-containing cell membranes in the skin, lungs, or gastrointestinal tract.   This is also the difficulty in eliminating them, since lipophilic substances tend to be readily reabsorbed.  The successful elimination of toxic pollutants often depends upon their conversion to water-soluble chemicals through a two-phase process of biotransformation, involving enzymes in the liver, lungs, and other organs and tissues.  Once fat-soluble chemicals become water-soluble, they are more easily and rapidly excreted from the body.

It is this knowledge of complex but natural biochemical processes that forms the basis of the Program for Biodetoxification.

Using a four-week intensive Program for Biodetoxification, the body’s burden of toxicants that would normally require a number of months or years to be mobilized and removed are safely detoxified, under close medical supervision, in a matter of weeks.

Patients’ blood and urine are monitored to maintain physiologic balance, and vital signs are constantly monitored to assure each individual’s stability.  In addition, patients are taught how to safely continue six to nine months of less intensive maintenance Biodetoxification procedures at home once they complete the intensive phase (with only periodic re-evaluations to monitor continued progress).

NOTE:  The importance of safe, closely monitored Biodetoxification under medical supervision cannot be emphasized too strongly, especially for those who have been occupationally injured by highly toxic chemicals or by long–term chronic toxic exposures at home.  Too rapid mobilization of toxins or incomplete removal of their by-products can cause a patient to worsen, often dramatically.

Table 1 below shows the many steps and supplements used to carry out the American Academy of Environmental Medicine's endorsed Program for Biodetoxification, as offered at our Center:

TABLE I:  Intensive Four-Week Program for Biodetoxification

Methods Used to Monitor Patient Safety

1. Comprehensive initial evaluation, physical examination, and laboratory testing prior to admittance to the Program for Biodetoxification
2. Weekly laboratory testing (blood and urine, other tests as needed by an individual)
3. Personal consultations daily to weekly with the staff medical doctors to assess each patient’s physical status and closely monitor progress
4. Constant monitoring of each patient’s vital signs

Methods Used to Enhance Biodetoxification

1. Mobilization of lipophilic toxicants via:
    a.   Heat depuration therapy in a dry sauna (140-150 degrees Fahrenheit)
    b.   Deep tissue massage
    c.   Lymphatic drainage via light beam generator therapy
    d.   Aerobic exercise
 
2. Enhancement of biotransformation via:
    a.   Oral nutritional supplementation of key required nutrients to enhance and replace those lost with the toxicants
    b.   Intravenous supplementation of key vitamins and minerals, glutathione, and other nutrients.

3. Increased excretion and inhibition of reabsorption via:
    a.   Oral polyunsaturated oils, chosen for optimal Omega-3/ Omega-6 ratios        
    b.   Chlorophyll binding
    c.   Calcium and magnesium salts
    d.   Activated charcoal

Methods Used to Facilitate Heavy Metal Chelation

1. Experience dictates increased injury to the body when heavy metals such as lead, mercury, arsenic, cadmium, and antimony are also part of the body’s toxic burden.
2. A heavy metal burden necessitates the use of specific chelating agents both orally and intravenously, although sauna in itself is also an effective way of reducing metal toxicity.

It is important to recognize the role of heavy metal toxicity in its interference with the normal physiology of our complex body systems.  There are over 3000 enzymes in every cell, and of these, half are metallo-enzymes containing about 15 trace minerals known to be essential to normal enzyme activity (including chromium, cobalt, iron, molybdenum, nickel, selenium, tin, and vanadium).  The remaining 1500 enzymes do not actually contain metals but are influenced by metal-acting co-enzymes or catalysts.  Thus almost no process goes on in the body without the aid of metals.  If these essential metals are rendered inactive by displacement with toxic metals (such as lead, cadmium, mercury, arsenic and tin) or by imbalances in the levels of essential metals, then normal functioning of enzymes may be compromised.

What can an intensive Program for Biodetoxification accomplish?

A Program for Biodetoxification, conducted according to the American Academy of Environmental Medicine’s comprehensive guidelines, safely and effectively reduces the body burden of most toxic chemicals.  In so doing, it also reduces many patients' presenting signs and symptoms.  At the Center for Occupational and Environmental Medicine in North Charleston, SC, we have had approximately 550 patients complete our Program over the last 19 years.  To further assess our success with this program, we mailed a survey to all past participants for whom we had current mailing addresses (125 patients total) and sixty-four percent (80 patients) responded.  Their survey responses revealed that with few exceptions, most participants felt the Program for Biodetoxification was one of the best things they had done for themselves.

A full 95 percent of the responding patients rated our Program for Biodetoxification effective in improving overall health.  Eighty percent of the patients rated their improvement as 50 percent or more.

In addition, our survey found that the problem of chemical sensitivity associated with odor sensitivity (cacosmia) was reduced in 71 percent of those treated, while only 21 percent reported no change in chemical sensitivity, and 8 percent saw a worsening of chemical sensitivity.

Could the Program for Biodetoxification help most people with Chemical Sensitivity?

We were curious to see why the difference in improvement of chemical sensitivity for different patients (as outlined in the previous section).  Our four-week intensive Program for Biodetoxification is followed by instruction in less intensive, but nonetheless effective maintenance Biodetoxification measures, to be continued at home after leaving the Center, for an average time of six to nine months.  Our survey results show that of those who did not continue the maintenance Biodetoxification measures they had been taught at the Center for the recommended six to nine months, 70 percent reported ultimately a gradual worsening of their chemical sensitivity.  Thus all parts of the program, the four-week intensive and the six to nine-month at-home maintenance, are necessary to reap full and lasting benefits.  The beauty of the program is that when done properly, it does have lasting benefits and has freed many, many people to live much more normal, productive lives.

The rate of reduction in patients’ chemical sensitivity has recently been further improved by the addition of   patients' use of a nasal spray, developed by Kaye Kilburn, M.D., combining a redox agent with glutathione. Nasal glutathione itself decreased chemical sensitivity but the addition of the redox agent was even better. (5)  We are constantly exploring and utilizing current research, as well as feedback from our patients, to improve our program.

Click here to read a testimonial from one our Biodetoxification Program participants.

Wouldn’t Environmental Controls, if practiced widely, bypass the need for Biodetoxification?

It would be nice if we could bypass the need for Biodetoxification programs by stopping production of environmentally toxic chemicals.  However, that is not easy to do and doesn’t seem possible any time in the near future.   An alternative then is for man to find a safe and effective way to reduce the body burden of these chemicals.  Biodetoxification as described above is safe and effective, but prevention is equally important.  Important preventive measures are eating organically grown food, drinking clean water, and avoiding all food and water which is bottled or stored in soft plastics, a potent source of endocrine-disrupting phthalates.  (Soft plastics are generally those that easily dent or bend.)  In addition, we must seek an energy policy that reduces combustion of petrochemicals and coal in favor of cleaner sources of energy.

I often say to my patients that while we are cleaning up our environment, we need to begin cleaning up ourselves!  A Program for Biodetoxification as we have described in this article is an extremely successful and cost-effective way.

References:
1.  Libichs, To JC, et al. Occupational Exposures of Herbicide applicators.  Am. Indus. Hyg. Assoc. Journal 45:46-62 1984.
2.  Casarett and Doull's Toxicology chapter 12. Toxic Responses of the immune system.  P.394-397.  McGraw Hill. 5th Ed. 1996.
3.  Abou-Donia, M. Garrettison, L.K.  Detection of Neurofilament Auto antibodies in Human Serum following chemically induced Neurologic disorder.  Environmental Epidemiology and Toxicology 2, 37-41.2000.
4.  M Anway, A. Cupp, M. Uzurney and M. Skinnber, "Epigenetic Transgenerational actions of endocrine disruptors and male infertility," Science 308:1466-69, June 3, 2005.
5.  Rea, William. Chemical Sensitivity Vol. 4 Chapter 35 Thermal chamber Depuration and Physical Therapy. P. 2433-2479 CRC Press 1997.
6.  Kilburn, Kaye. Presentation at 23 RD Annual International Symposium on Man and His Environment in Health and Disease.  June 11, 2005, Dallas Texas.

Disclaimer:
All material provided on the Center for Occupational & Environmental Medicine web site is for educational purposes only. Access to the web site does not create a doctor-patient relationship nor should the information contained on the web site be considered specific medical advice for any person, patient and/or medical condition. Consult a physician regarding the application of any opinions or recommendations from this website, for any symptom or medical condition. Dr. Lieberman specifically disclaims any liability, loss or risk, personal or otherwise, that is or may be incurred as a consequence, directly or indirectly, resulting from use or application pertaining to any of the information provided on the web site.