Gut Check – Laying the Groundwork for Detox
Tina Beaudoin, ND
With detox has becoming much more popular in the last decade and it’s likely that some of your patients have come to you asking for a ‘good detox’, however it’s not generally advisable to have that be your starting point if you want to effectively detoxify the body and decrease one’s total body burden of toxins and toxicants.
Jumping first into a detox would be like putting in a new, whole-house water filtration system in your basement and not replacing the old, grime-covered lead pipes that deliver the filtered water to your kitchen, shower, and faucet.
Adequately preparing your body to handle the sharp increase of toxins that will be mobilized during a detox often requires a bit of preparation in terms of making sure the gastrointestinal system is functioning optimally with healthy GI flora.
We each have nearly 10 pounds of bacteria in our gut that serve to support the digestion of food, synthesize B vitamins and Vitamin K, produce ATP from non-digestible carbohydrates, convert T4 to active T3, inhibit intestinal pathogens, deconjugate bile acids, enhance lactose tolerance and glucose balance, stimulate and modulate the immune system (balance TH1/TH2 responses), produce antimicrobial substances, maintain mucosal barrier integrity and metabolize xenobiotics. These are just some of the activities of healthy gut flora.
Pathogenic bacteria release endotoxins (particularly the lipopolysaccharides from gram-negative bacteria) that have multiple effects: impairing optimal immune function, impeding nutrient absorption (and even turn nutrients into toxins), damaging mitochondria, increasing systemic inflammation, weakening the gut barrier and central to this discussion, significantly increasing the toxic load that the liver must metabolize. Elevated lipopolysaccharides/LPS levels lead to a reduction in glutathione production as well as a significant reduction in function of cytochrome P450 enzymes; reducing Phase 1 detoxification. Phase 2 detox is also compromised with elevated LPS as it down-regulates glutamate-cysteine ligase and reduces the synthesis of SAMe and the methyl groups available for methylation.
You can choose to treat based on symptomatology and clinical presentation or opt for laboratory testing to help identify the specific culprits. The Indican test is a urine test that gives a simple screening tool for generalized dysbiosis. Breath testing is also available to help identify small intestinal bacterial overgrowth/SIBO. There are also a variety of stool tests available that not only test for pathogenic or opportunistic overgrowths of bacteria, yeast, and parasites but also some functional testing to give one an idea of pancreatic function, absorption and inflammation. Some tests also provide sensitivity testing that will guide you to exactly which therapeutics (both antibiotics and nutraceuticals) will be effective for the specific pathogenic overgrowths found on testing.
Stay tuned for “Detox: Essential Preparation” in our next Element publication for a deeper dive into preparing the GI tract and addressing dysbiosis as well as essential exposure reduction recommendations.
i. Morgan, ET. Suppression of constitutive cytochrome P-450 gene expression in livers of rats undergoing an acute phase response to endotoxin. Mol Pharmacol. 1989 Nov;36(5):699-707.
ii. Ko, K. et al. Changes in S-adenosylmethionine and GSH homeostasis during endotoxemia in mice. Lab Invest. 2008 Oct;88(10):1121-9.