Transcription
Hey everybody, Director Dan Kalish here, and I am excited to be doing a talk with you. Coming from Kalish Wellness, which is my, uh, website for patients. If you're interested, you can check it out. We're going to talk a lot about detox.
So, a little bit about my background for those of you that are not familiar with me. I'm an IFM certified practitioner. That's the Institute for Functional Medicine, certifies doctors that do what I do. I've been in practice since 1992, which is true and a little scary because that means I'm really old. Basically 56 years old right now.
Kind of patients I work with: weight gain, fatigue, depression, anxiety, hormone imbalances, digestive problems. We have a really wide spectrum of people. I work with children, I work with older adults. You know, yesterday my patient practice included patients from the age of nine years old through probably their late 70s. It's a really broad practice. It's all based on labs. All the programs that I design are lab-based. And all that work I do is, um, through phone consultations. I've been working on the phone in a virtual practice for 16 years now, and it's doable because everything that I do is based on labs.
And what I wanted to do today was talk a lot about detox and how detox is actually done because it's a term you hear, you know, all the time in the news, but maybe not like the real official version of it is not really well understood. And if you are interested in detox programs, the way it works in my practice is we start off with a health coach consultation, we do lab testing, and then I work with you directly and design lab-based programs based on all the testing that we do. And so we have a wonderful health coach named Jennifer. And if you're interested, you can set up a free consultation with Jennifer, our board-certified health coach, and get started. Okay? And again, the website is KalishWellness.com if you want to check it out. And let's get into our health chat for today.
So today's topic is detox. And in the world of functional medicine, we like to sequence things so that we can make you better without making you worse. And detox always comes last. A lot of the younger doctors get that one wrong. In fact, it's a constant subject of, uh, sorry, the wrong button there. It's a constant subject that we talk about in the classes that I teach because it's easy to get it wrong. And you don't want to get it wrong because you can make people worse. So you want to work on a various, these different body systems, a neuroendocrine, make sure the GI is working well before you get into detox.
And within the detox system, there are these different pathways that we look at. There's a test called an Organic Acids Test, which is the foundation for analyzing this stuff. And you can look at phase, what we call phase one and phase two detox pathways. You can look at oxidative stress and methylation. There's all these different variables that go into setting up a personalized detox program. And it's completely different from person to person. You really never know.
Now, what is the problem behind all this? Is that we live in a world which we have poisoned. A natural world which was quite beautiful is now full of biotoxins, industrial chemicals, heavy metals, herbicides. There's 82,000 bad things that we have developed and dumped in our rivers, lakes, and streams. And they inevitably get into our bodies. Some of these things we even dump on our food. How stupid can you be? We dump really bad toxic chemicals on in our food, you know, as we're growing it. That's called pesticides and herbicides. So clearly, these things are getting in the human body.
The CDC researches this on a regular basis. And every newborn baby now that is born in the United States has 50 to 70 toxins. They're born. Every adult has somewhere between 120 to up to as many as 700 chemicals and heavy metals. It's just saturating our tissues. And you have to get this stuff out, or it's going to make you sick. That's just the bottom line. Okay?
And we talk, we use this term called body burden, which is the accumulation of all the toxic chemicals, all the heavy metals that have been building up in your tissues. And you can inhale them. One of the highest risk ways that you get these things is just through air, believe it or not. Of course, you can eat them, swallow them, and you can absorb them through your skin. If you're rubbing on lipstick or using different kinds of things that you rub on your skin that may have these chemicals, they're going to get right into the body.
And so when we're looking at body burden and we're looking at this issue of, you know, do you need to detox? The answer is yes, everybody does. Right? Every baby, every adult in the United States needs to do this. Um, what are the total amount of chemicals in the system? It's more so that than it is a single one, you know, exposure for most people. And so we just want to find these things and get them out.
And so if you want to have a quick detox experience and you don't have, uh, the energy right now or interest maybe in seeing a doctor like myself, some of these toxins are water-soluble, which is convenient because it means if you drink enough water, you're just going to pee them out. So if you want to just do your own quick detox, double up on your water intake for two or three days. Don't do this for very long because it'll make you sick if you drink too much water, right? But just whatever amount of water you're drinking, double it for two or three days. That'll force your body to flush out all the water-soluble toxins.
What we're then worried about are the fat-soluble toxins. Toxins which build up. These are called lipophilic. Lipo meaning fat, lipo meaning fat, philic meaning loving. Like Philadelphia is the city of love, right? Lipophilic or lipophilic toxins are the bigger problem here because you can't drink a glass of water and flush them out. They're going to be produced specifically by the chemical manufacturers to be lipophilic, okay? But which is good for the stuff that they're doing in the chemical world, but bad for human beings. Bad for human beings because lipophilic toxins love our fatty tissue. For women, it could be the breast. For all of us, it could be your brain. 60% of your brain is made of fat. And so when the lipophilic or fat-soluble toxins get into the body, they collect in the fatty tissues. You don't want a lot of this junk in your brain. And it happens on a regular basis and it causes problems with neurotransmission, right? With your brain being able to conduct signals.
And so just a quick little, you know, overview of how that works. You have a chemical toxin, you have a metal like a mercury or lead that has an affinity, that loves fat. So it goes into your brain, it hits your neurons or your nerve cells, it starts to cause disarray. It's like, um, I don't know, it's kind of like if you just took a wine glass and hit it with a hammer, right? Your neurons are pretty sensitive and they're getting whacked by these chemicals and heavy metals. And then they don't work very well. And then, you know, if that happens to enough of the neurons in your brain, then you're going to start to have depression or anxiety or not sleep well, or you'll eat too much and gain weight, or some bad stuff will start to happen. Again, 60 to 80% of the central nervous system, your brain, is made up of fat. Who would have thought that? You know, that's kind of what your body has decided to construct this for, which is a great design. However, when you think about fat-soluble toxins like mercury and all these pesticides, it can be a really dangerous and not great thing.
Okay, so now within the liver, you have two detox pathways: phase one and phase two. And these detox pathways are specifically designed to bind up fat-soluble toxins, to turn them into something that's water-soluble through this sort of alchemy. This is a miracle of what your liver can do. And then to dump them out. Okay? So phase one and phase two grab fat-soluble toxins, they make them water-soluble, and then toss them out of your body. And if phase one and phase two are not working very well, then you're going to have problems with detoxification.
And so phase one is run by the fancy term is called cytochrome P450 enzymes. The normal terms are called B vitamins, okay? And antioxidants. So the B vitamins and antioxidants are critical for running phase one. And we measure these with the lab test. We measure your niacin, we measure your riboflavin, we measure your folate, we measure your B12. And if there's problems there, then we give those supplements to you in a therapeutic dose to get phase one working. It's very targeted. If you need B3, you need B3. If you don't need B3, it's not going to help. And any individual vitamin like B3 could be toxic if you take it and you don't need it. So you don't want to go out and overdose on a whole bunch of B3 unless you run a lab and you see that you need it. Okay? If you just take vitamin B3 by itself in a high dose without needing it, it, in and of itself, can act as a toxicant, right? So that's why we do the labs because you want to be very targeted and specific. If you're low on B3, taking it will run this detox pathway more efficiently. But don't just go out and take all these supplements because they can be as harmful as they can be helpful if you don't know what you're doing.
So phase two. Okay, phase one, B vitamins and antioxidants. Phase two is run by these complicated reactions. The fancy terms are glucuronidation and glutathione conjugation and amino acid conjugation and methylation. And that doesn't matter a whole lot. The important part is that the nutrients that are used are sulfur-containing amino acids like glycine and taurine and glutamine and acetylcysteine is probably the most famous. So these are pretty amazing. These sulfur-containing amino acids just grab that toxin and make it water-soluble, and your body can then flush it out. Okay? So you have phase one and phase two detoxification, very, very important.
Toxins when they build up cause weight gain. Toxins when they build up cause fatigue. Toxins when they build up prevent fat burning. And toxins when they build up damage mitochondria. These are all very bad things because then we end up really fat and really tired and just, you know, not understanding what's going wrong. Okay? The reason why they can do that is because these toxins get into your fat tissue right at the same time as they're damaging your fat-burning mechanism, which is your mitochondria. So you're going to get tired because you can't burn fat. You're going to build up body fat. And you're storing the toxins literally in this body fat. So there's a big incentive to not burn the body fat because then you're going to release even more toxins. And so you have to be really careful about losing weight. And some people feel horrible when they lose weight because they're dumping all these toxins out as they're losing body fat. You just have to do that carefully.
On Organic Acids Testing, it's a simple urinary test I do on every new patient. You can measure specific detox markers. And get even more advanced. One of the pathways that's very little known is one called the urea cycle. And that has to do with arginine, which is an amino acid. The urea cycle clears ammonia. And if your body can't clear ammonia effectively, then you're going to have ammonia building up and hitting your brain. And that doesn't feel very good. Okay? So this is a third version of a pathway. We've got phase one and phase two, I mentioned earlier, the B vitamins, antioxidants, and sulfur amino acids. And then now this is a different detox pathway entirely. Different still happens in your liver. Entirely different pathway about getting rid of the body stores of ammonia. And that revolves around an amino acid called arginine. So you can see one treatment won't affect the other. So like if you take N-acetylcysteine for phase two, it'll have zero effect on their urea cycle and on the clearance of ammonia. They're completely different, completely different, uh, pathways that are relatively unrelated.
And here's a couple of markers just you can see when we're doing that. When we're doing the lab, there's a marker called orotate. And if that one's high, you have a toxicity of ammonia. There's another marker called alpha-hydroxybutyrate. And if that's high, you have a large glutathione demand. Glutathione is the principal antioxidant in the human body that prevents all these toxins from causing problems. And if you have a sulfate marker that's either high or low, that's also indicative of a phase two liver detox problem. So again, you can measure specifically, is there a glutathione issue? Phase two issue? Ammonia clearance issue? What is really going on with detox? And how do you want to approach this patient in terms of clearing the toxins out?
Now, part of why this is so important is because environmental toxins damage. Um, they get stored in fat tissue, but they can damage through oxidative stress. As processed, colostrum stress, mitochondria. And mitochondria are where we're making energy, where we're burning up fat for fuel and burning up carbohydrate for fuel. And as the mitochondria get damaged, your metabolism is going to be damaged. And you're going to start to put on body weight. Okay? As the mitochondria are damaged, this little thing called a carnitine shuttle, which is how you burn body fat, is going to be compromised. So in a normal healthy body, you take some fat, you bring it in as a fatty acid, you bring it into this, uh, mitochondria through carnitine, carnitine shuttling it around, and then you turn it into ATP or cellular energy. If your mitochondria aren't working very well, this process shuts down. And these other chemicals start to build up in the body. And we can measure these other chemicals. If they're high, we know that you're not burning fat very well. Okay? And that is super important if we're going to do a detox program. This pathway has to be working extremely well.
Well, again, we can mention Jennifer here for our wonderful certified health coach. So here's another look at all this, right? Is that oxidative stress? We talked about oxidation damages the mitochondria. Here's a nice little visual on what that can look like in the real world. With our, we all have experience with this, right? You take an apple and you cut it in half, and it starts to turn brown. That's oxidation. I don't think you'd leave it in your kitchen so long that it would look like this. But everybody's cut an apple in half or seen a little piece of apple and it starts to get brown. Now, why is it getting brown? That's kind of weird, right? Well, the white part of the apple, the inside part that you chomp into, doesn't have antioxidants to protect it. Where are the antioxidants? In the skin of the apple. So, you know, when you're eating an organic apple, make sure you always eat the skin. The inside of the apple is important for fiber and lots of other stuff, but the antioxidants are in the skin. And so when you cut an apple in half and you expose the inside of the apple to air, it starts to get oxidized. That's what air does, right? Oxidation, hence oxygen, right?
And so if you think about, if you cut a mango in half and get around the seed and you make the whole thing work and you cut, it's hard to cut slice mangoes, right? But if you slice a mango in kind of approximately in half and you leave it out on the counter for half an hour next to your apple, does it turn brown? No, it doesn't. It's orange and it stays orange. Why is that? Because the antioxidants are the orangey stuff that you're seeing inside the fruit. And I'm not saying mangoes are better than apples, but just so you can see, nature has a way of doing all this. It protects us, it protects fruit, it protects everything with antioxidants.
In a normal cell that's attacked by free radicals or oxidative stress, you're going to get damage or structural damage. And this causes big problems. It causes oxidative stress. Causes problems like, this is a list of like really bad things that can happen to you. DNA damage. When the DNA is damaged, you have abnormal cell replication. That's what we call cancer. Okay? It can cause inflammation. That's sort of probably what's most famous for causing joint pain, sore everywhere, bloated, inflammation. We talked about this one already. Oxidative stress can cause mitochondrial problems. And that means that you're going to be tired, you're going to start to gain weight. And oxidative stress can damage your lipids or fats. And that'll cause problems with cell membranes. Or we could put out here the brain itself. So a lot of oxidative stress from a lot of environmental toxins in your body ends up damaging systems in a really dramatic way.
We want to reduce your oxidative stress. And we can do that by lab testing. We actually measure oxidative stress. It's pretty amazing. You can do that. In fact, if you think about it, some of these labs that I run, it's worth the money for this entire Organic Acids profile just to see this one marker, which looks at the level of oxidative stress your body is under. Because we're all being exposed to these chemicals. That's essential argument, right? And then the question is, are you eating enough fruits and vegetables with enough antioxidants to negate the damage that's occurring from all these environmental toxins? And you can measure the oxidative stress itself and see if it's high. Then you need to take that seriously and do something about it.
There's another big subject called methylation. And methylation is kind of like important everywhere. I've been studying methylation for years. I studied methylation on Monday for like five hours. It's a really interesting subject. But the short version of methylation is that it's really, really important for detoxification. And it's really, really important for your mood and your brain chemicals. And we can measure methylation. And it's very common that people have methylation defects, which means that they're not very good at getting rid of chemicals, heavy metals. And methylation issues also are going to imply that you don't make your brain chemicals real well. So you're going to have a multiple reasons here why you're going to have potentially anxiety or depression or insomnia or fatigue or weight gain when you have a methylation problem. Methylation takes on a pretty large importance.
Okay, so when we talk about testing and you work with my health coach and work with myself, like we test everybody basically. We test people who are perfectly healthy who want to stay healthy. Maybe they're really healthy and like, I don't want to die from cancer and heart disease, and I'm really healthy and I want to just make sure I stay that way. Whether you're 30 or 50 or 70 years old, you know, we work with complex chronically ill patients to do these health assessments. And usually they have problems. You want to work with these kinds of labs on all kinds of levels, just depending on where your, you know, consciousness is at, let's say. Okay?
So if you're interested, you can schedule a consultation with Jennifer and learn more about the work that we do here. And as a quick review, let's just think about the different kinds of toxicity. Phase one, phase two, that has to do with lipid or fat-soluble, uh, toxins. Those are difficult to get out. You can't just, I mean, you can get that, you can flush them out by losing a lot of weight, but that can be a little dangerous. So they're lodged into the fat. We really have to get phase one and phase two working because phase one and phase two are going to grab those fat-soluble toxins and remember and make them water-soluble so you can flush them out. That's the point of phase one and phase two.
You have your water-soluble toxins, which are not a big deal. If you double up on your water intake for three or four days, you're going to flush them out. And you can do that every few months just as a quick flush. The water-soluble ones will come out of your system within a few weeks, they'll be gone. So we're not too concerned about those. But make sure that you stay hydrated. And you want to do like a home detox program, double your water intake for two or three or four days, and you'll flush them out.
And then we have this obscure pathway that I talked a little bit about, but not a lot, which is the ammonia clearance pathway. That has to do with arginine and this lab marker called orotate. And that one gets missed 100% of the time because it's an obscure little pathway. People aren't thinking about it. And it's kind of hard to test for. So you really have to understand the labs to look for that one. A lot of people have a genetic defect where they don't clear ammonia very well just based on their genes. And so we'll see that orotate marker go up. Then we use arginine to flush the ammonia out of your brain. And specifically the ammonia buildup specifically targets the brain.
Then we talked a little bit about oxidative stress and antioxidants in the role of antioxidants with phase one and phase two. And also how oxidative stress damages mitochondria, which are in control of fat burning. How important that is. So we measure antioxidants. Then we wound up, you know, at the end talking a little bit about methylation and methylation defects. It's very common for people to have genetic defects with methylation. That'll show up on the lab. And the solutions for a methylation problems are folate, vitamin B12, vitamin B6, and a very, very important amino acid called methionine to help with methylation defects.
And then another big picture item, I'm just going to reiterate, which is you don't want to take any of these things unless you know you need them supplement-wise. Because any supplement that can be incredibly helpful can also act as a toxicant. Meaning if you take it and you don't need it, it's going to build up in your tissues and cause more problems than it's going to solve. So I'm a really strong proponent of detox programs through lab testing. If you don't want to do that and you're just interested in detox, try the water detox for three or four days. And if that's not enough, then try a juice detox. Use green juices. Green juices on a regular basis will also activate all these detox pathways. Uh, but you don't need any lab testing to, you know, to know that green juice is healthy for you. Okay?
Okay, I'm gonna wrap it up for today. And we'll be having another one of these health chats soon. All right, thank you everyone. Bye for now.