Detox is a hot topic right now. I can't go a week without hearing about someone on a parasite cleanse, liver detox, and other such things. The detox industry has grown to a whopping $68 billion globally as more consumers are becoming interested in its far-reaching claims of health benefits. Many people approach detoxification for its positive effects on skin, digestion, weight loss, mental clarity, and reproduction.
While the concept of removing toxins from our bodies is nothing new under the sun, there is a strong case to be made that we need it now more than ever. The number of synthetically derived compounds (plastics, herbicides, pesticides, pharmaceuticals, etc.) that have entered circulation since the 1940s is well into the millions. Combine that with the degradation of food, water, and air, and then add the prevalence of EMF and sensory overload, and you have a recipe for bioaccumulation of toxicity.
In this post we will take a look at what exactly constitutes a toxin, their various flavors, the body's systems for clearing them, the truths and myths of detox, and the Chinese medical perspective.
What is a toxin?
A toxin is any substance, organic or inorganic, that causes damage or disease to an organism. Narrowly speaking this includes venom, mycotoxins, bacterial toxins, heavy metals, certain pharmaceuticals and defensive plant compounds. Broadly speaking it is possible to include radiation, heat, exercise, and sound (and really any other substance or activity) as toxins as well.
With all toxins the poison is in the dose. A little bit, and there usually isn't a problem. A lot, and anything will kill you. The lethal dose fifty (LD50) is the amount of a substance required to produce death in fifty percent of the population that it is given to. For pharmaceuticals, the LD50 is routinely determined on rodents and the numbers are extrapolated to humans. Some pharmaceuticals have a very narrow therapeutic window, meaning that the dose that helps patients is very close the the point of possible toxicity. Lithium use for bipolar disorder is a prime example of this.
Hormetic Stress
If "the dose makes the poison," then the dose also makes the medicine. A hormetic stress is anything that produces a positive effect in a system when encountered at a low dose. Exercise is the quintessential hormetic stress. A moderate amount of it is perfectly healthy and beneficial, even though each time that we exercise we are subjecting ourselves to a temporarily negative consequence. It is the long term adaptation to exercise are that we are after.
Technically speaking, all toxins could be potential hormetic stressors. The obvious ones are things like exercise, herbs, drugs, heat and cold exposure. The not so obvious ones are the polyphenols inside of the plants that we eat, the psychological stresses that build resilience, and ultraviolet radiation from the sun. The thing that all of these have in common is that they stimulate the body to change its own compounds, hormones, structures, cognition, etc. that will make it more prepared to handle the stressor the next time we encounter it. Think of it as the learning process for the body and mind and spirit.
Hormetic adaptation even goes as far as justifying a beneficial level of exposure to bacteria, viruses, and other parasites. There is mounting evidence to support the theory that if our immune system lacks invaders to fight, then it will attack its own cells thus leading to autoimmune disorders. Purposeful inoculation with pinworms can be incredibly helpful for patients who suffer from ulcerative colitis, Crohn's disease, and other inflammatory bowel disorders.
What is detox?
Detox, short for detoxification, is the body's process of removing harmful substances. This includes both exogenous toxins and metabolites produced by the body. The primary antioxidant that we use in this process is called glutathione. It is produced in the liver and circulates throughout the body, but is most abundant in the liver and kidneys. Glutathione is responsible for scavenging potentially harmful free radicals as well as sequestering heavy metals and xenotoxins.
Contrary to popular belief there is no such thing as an exogenous antioxidant. The foods that claim to be high in antioxidants like berries, red wine, coffee, and green tea are actually high in plant polyphenols. These polyphenols, when ingested, act as hormetic stressors and cause the body to produce a higher baseline level of glutathione. The same is true with certain drugs, supplements, and herbs. One of the proposed mechanisms of action for SSRIs in the treatment of depression is that they decrease inflammation in the brain by increasing glutathione activity.
While it is tempting to think that by adding more glutathione to the system, or more substances that increase glutathione, that the body's ability to detox will improve, but this is only partly true. The body has a physiological limit to its detoxification capacity that is independent of glutathione. If the other mechanisms of detox like lung, liver, and kidney function are suboptimal, then this limit will be quickly reached. Furthermore, glutathione has a low absorbability in the body, and supplementation has mixed efficacy.
The Big Four
Our body has four made modes for eliminating toxins: breathing, sweating, urination, and defecation. The smoother these systems are operating, the better the detoxification process will be. We have already talked breathing in another post so we won't get into too much detail here, other than to mention that breathing is the primary way that we release the carbon that is stored in fat cells. The shrinking of fat mass in our body is one of the most effective pathways of eliminating stored toxins, as the body uses fat to store harmful substances until they can be dealt with later.
Humans have used sweating as a form of detoxification since ancient times. The Native American sweat lodge, the Scandinavian sauna, and the Greek bathhouse were all ways of purifying the body. Modern versions of these are the sauna at the gym, a hot yoga class, or a really hot bath--anything that gets the pores open.
Elimination in the form of urine and feces is the most robust way of disposing of toxins. The kidneys filter all of the blood in our body 60 times each day, keeping a tight control on the homeostasis of the plasma and blood pressure in the body. They accomplish this through a complex filtering system that removes substrates from the plasma and secretes them as urine. Similarly the liver works as a filtration system secreting excess salt, cholesterol, bilirubin, and xenotoxins in the bile. The large intestine will also trap toxins in the fecal matter if there is a healthy ecosystem of bacteria and insoluble fiber.
The Big Four detox pathways work best when we are breathing well, exercising sufficiently, drinking ample water, and eating properly.
Emotional Toxins
There is an emerging body of evidence that emotions, situations, and relationships can be toxic as well. The psycho-emotional system has it's own built-in level of stress tolerance and can be overloaded by excess force. Some people have a temperamentally higher set-point for dealing with stress, whereas others tend to internalize conflict much more readily. This stress will then spill over onto other systems of the body like the nervous system, the digestive system, and the respiratory system.
Taking appropriate measures to clear emotional toxins include mediation, reflective journaling, and meaningful conversation with those we trust. Dysfunctional emotion that is not properly processed will inevitably find a less healthy outlet such as repression, violence towards self or others, and disease. We will discuss this further in the section about Chinese medicine, but the Western neuropsychobiological models are finding more and more agreement on the power that our internal world plays in our health.
One effective, albeit challenging, method for increasing our tolerance of highly emotional states is exposure therapy. Just like in hormesis, there is a dose of negative emotion that is beneficial for us. We must have the courage to confront the small triggers first, so that we can take on the bigger ones in the future. Applying this strategy to our greatest fears, our most hidden inner secrets, is a way of clearing out the toxicity that builds with constant worry, avoidance, and oppression.
Detox and Chinese Medicine
Many of the mechanisms of detox that we have already discussed are the same in the Chinese medical model. The Liver, Kidney, Lung, Bladder, and Large Intestine are the primary organs of detoxification. The Chinese consider toxins as "impure substances" and they recognized that they were just part of the food we ate and the air we breathed. The system of digestion, which includes the Stomach, Spleen, Liver, Gallbladder, Small Intestine, and Large Intestine, is responsible for separating the pure from the impure and facilitating the production of the "clear qi."
The Chinese also had an intimate knowledge of the ability of emotions to affect health. Each organ system has its own associated psychoemotional aspect, that when under (or over) developed creates pathology. The more easily a person can process emotions and transform them into learning experiences, the more healthy they become. It is no coincidence that the organ most responsible for setting appropriate boundaries is the Liver. A lack of boundaries opens the flood gates of potential toxicity. The Liver does its first round of maturation during early childhood, which is the exact time that children are beginning to develop their autonomy--the reason why early trauma is so difficult to extricate.
Conclusion
Interestingly, in Chinese medicine the Liver is also the seat of creativity. This points to the need for a flexible approach to how we deal with our stresses and also our detoxification. A one-size-fits-all template is not appropriate, yet neither is forgetting the foundational pieces. The truth is somewhere in the middle. When folks approach me with questions about various detoxes, I like to keep this perspective in mind. The dose makes the poison, but also the medicine.
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