Clinical indicators for detoxification

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By Kim Furtado, ND

Some clinicians may struggle to determine if a patient may benefit from detoxification. As previously described, heart disease and diabetes have long been understood as chronic diseases that can be addressed by diet, exercise, and other lifestyle factors. These components remain a top priority for patients, and successful detoxification requires some of the same adjustments.

A whole foods-based diet with lots of fresh vegetables, fruits, whole grains, and lean proteins makes sense. However, when faced with a patient with diseases traditionally understood as amenable to lifestyle modifications, it is important to not lose sight of the impact pollution is having on their pathophysiology. The dilemma is also that sometimes patients who have made significant changes to their lifestyle may still struggle and progress poorly.

Most patients who have a chronic inflammatory disease will benefit from detoxification. Chronic low-dose exposure to toxins depletes antioxidants, undermines many physiological processes, and progressively damages cells, tissues, and organs. When a clinical goal includes processes like immune support, endocrine balance, neurological repair, and antiinflammation, it seems logical to search for and remove immune suppressing toxins, endocrine disruptors, neurotoxins, and other inflammatory chemicals.

Most commonly, a practitioner might understand the need for clinical detoxification because a patient presents with a known high toxic exposure, either through industrial exposure or personal exposure. This exposure may be from personal habits such as smoking, frequent seafood ingestion, or high amounts of silver amalgam fillings. This may also be discerned through history taking that a person has lived near a source of air pollution such as an industrial complex or coal fired power plant or to a known source of water pollution. These patients may or may not have multiple symptoms directly related to acute exposures, but do have these known sources, which can be assessed, explained, and treated.

The best way to truly know that liver detoxification support could help a patient is to understand what role the liver is playing in the symptom picture. This requires a good working knowledge of liver function. Many commonly treated conditions are not overt liver diseases, but the liver has a role in the pathophysiology.

In addition, since some toxins are classified as endocrine disrupting chemicals, symptoms related to endocrine disruption could indicate a need for clinical detoxification. This relates to reproductive health, diabetes, thyroid disorders, and adrenal concerns. Toxins classified as neurotoxins, immune toxins, carcinogenic, reproductive toxins, obesogens, and metabolic dysregulators can have a role in those related symptom pictures. The underlying factor of diseases observed from pollutant exposure is oxidative stress and inflammation. In my practice, all those related pathologies are clinical indications for detoxification.

Clinical Thinking Process

STEP 1: THINK ABOUT LIVER FUNCTION AND ASK HOW THE PATIENT’S SYMPTOM PICTURE OR DIAGNOSIS RELATES TO ONE OR MANY OF THE LIVER’S FUNCTIONS.

• Albumin production: Creates osmotic balance in blood, but also carries hormones, vitamins, and enzymes through the body. Relates in general to many conditions and hormone issues.
• Bile production: Bile is critical for digestion and absorption of fats in small intestine. Fats are critical for good nerve function.
• Filters blood and removes toxins: Through first pass effect, all blood leaving gastrointestinal tract passes through liver to remove toxins, byproducts and other harmful substances. This function is relevant to many clinical diseases associated with toxins.
• Hormone metabolism: Critical role in peripheral conversion of thyroid hormone and steroid hormone metabolism
• Processes glucose: Liver removes excess glucose from blood, stores as glycogen, and can also convert it back to glucose.
• Regulates amino acids: All protein production in body relies on amino acids and are needed for neurotransmitters, antibodies, and more.
• Regulates blood clotting: Bile from liver is required for absorption of Vitamin K, critical for blood clotting components and cholesterol production
• Resists infections and regulates immune system: Filters microbes from blood stream and influences immune function with antibody production, nutrients, and other factors
• Stores vitamins and minerals: Significant amounts of vitamins A, D, E, K, B12, as well as iron and copper are stored in liver. Relates to many conditions. Vitamin D particularly influential of cellular proliferation and directly relates cancer risks.

STEP 2: BY CONNECTING THE SYMPTOM PICTURE TO LIVER FUNCTION, INVESTIGATE WHAT TOXINS ARE ASSOCIATED WITH THE DISEASE BY USING THE COLLABORATIVE FOR HEALTH AND ENVIRONMENT’S DISEASE AND TOXICANT DATABASE.

STEP 3: ASSESS BODY BURDEN WITH APPROPRIATE TESTS GUIDED BY THE SEARCH RESULTS, AND ADDRESS CLINICAL NEEDS THROUGH IMPROVING THE RELATED LIVER FUNCTIONS. FOCUS CLINICAL DETOXIFICATION ON REMOVING IDENTIFIED TOXINS AS ABLE.

Editor’s note: This article is an excerpt from An Introduction to Clinical Detoxification in Integrative Medicine. Click here to read more.