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Detoxification strategies for women'Health.

Introduction

Chemicals in the environment can disrupt the normal activity of estrogen, progesterone, testosterone, and other hormones in women. (1) They do so by binding directly to a hormone receptor, activating it, and causing the chain of events as if the hormone itself were binding to the receptor. (2) Chemicals may also bind and occupy the receptor, blocking normal hormonal activity, or may interfere with proteins that regulate the activity of hormones. (1), (2) These chemicals are known as hormone-or endocrine-disrupting compounds. Women are exposed to hormone-disrupting compounds every day, often without knowing it.

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The exposure to chemicals is coming from numerous sources, including:

* pesticides on found on fruits and vegetables

* nonorganic meat and dairy products tainted with dioxins

* fish that have high levels of mercury and pesticides

* bisphenol A and phthalates in plastic beverage bottles, tablecloths, shower curtains, food wrappings, and food storage containers

* unfiltered well water and city water

* household cleaning products, cosmetics, perfumes, dry cleaning, carpet, vinyl floors

* furniture, air fresheners, mattresses, shampoos, and so on. (3-9)

Studies have shown that low-dose daily exposure to chemicals can affect women's health. (10), (11) These chemicals affect the hormonal system, leading to such conditions as infertility, fibroids, endometriosis, fibromyalgia, thyroid disease, and more. (12-14) However, if all women are exposed to low-dose chemicals in the environment, then why do some women develop a condition linked to chemicals and others do not? This is where genetics needs to be considered, specifically genetic polymorphisms.

Genetics

Single nucleotide polymorphisms (SNPs) are a single base mutation in DNA. Polymorphisms in enzymes that metabolize environmental toxins play an important role in gene-environment interactions. They may contribute to determining who develops a health condition linked to chemicals in the environment and who doesn't. Toxins are broken down in the liver during phase I detoxification involving the cytochrome P450 enzymes. In phase II of liver metabolism, toxins are further broken down through conjugation reactions. Determining a woman's SNPs involved in liver detoxification can help determine the risk of developing a health condition linked to chemicals.

Body Burden

Whether a woman has a genetic change in her liver, making it difficult to clear chemicals from the body, or whether a woman has been exposed to so many chemicals that she simply can't clear them anymore, these chemicals build up in the body over time and cause disease. How many chemicals are in the average woman? This information comes from studies done to determine the body burden of chemicals in the average person.

In 2010 the Centers for Disease Control (CDC) released the Fourth Report on Human Exposure to Environmental Chemicals (www.cdc.gov/ExposureReport). The report outlines information collected from 2005 to 2006. 212 chemicals were tested for in over 2400 people living in the US. This reflected low-dose exposure from everyday life in this country. What was found is astonishing. For example:

* Polybrominated diphenylethers (PBDEs) found in the serum of nearly all of the 2400 participants. This is a flame retardant in our water, soil, and food;

* bisphenol A (BPA) in 90% of participants;

* perfluorooctanoic acid (PFOAs) in 100% of samples. This is used in nonstick pot and pans.

Another study conducted by the Environmental Working Group (EWG) looked to see if a mother's body burden of chemicals was being passed to the newborn during pregnancy. Researchers at EWG checked the umbilical cord blood of 10 newborn babies for 413 chemicals. All 10 babies had chemicals in their umbilical cord blood, and 287 of the chemicals tested for were found (www.ewg.org/featured/15).

Detoxification

Chemicals that build up in the body will start to affect a woman's health if they are not removed. The basic principle behind detoxification is to remove the toxins stored in your body. This is done by releasing chemicals that have been stored for years from fat tissue, organs, and extracellular spaces. Once they are released, they will reenter the bloodstream and be metabolized through the liver. This is where it is critical to support phases I and II detoxification pathways. Next, the organs of elimination need to be supported to get the toxic byproducts from the liver out of the body. It is important to determine that the kidney, lungs, bowel, and skin are functioning properly by running a CBC (complete blood count) and CMP (comprehensive metabolic panel) and addressing any underlying organ disease.

The four steps in detoxification include mobilizing stored toxins, supporting liver metabolism, elimination from the body, and avoiding reexposure to chemicals in the environment. The first part of detoxification involves getting the stored toxins to be released back into the bloodstream.

Methods used to mobilize pesticides, solvents, and other fat-loving chemicals include:

* caloric restriction

* sauna therapy

* chelation

Caloric restriction can release chemicals stored in adipose tissue back into the bloodstream, but they don't get eliminated from the body without support for liver metabolism and excretion. These chemicals can then get redistributed to other organs and tissues. (15), (16)

Sauna therapy can also be used to mobilize and excrete chemicals that are stored in the body. Several studies have been published on the Hubbard protocol form of sauna therapy. A study done on 7 rescue workers from the World Trade Center disaster showed that sauna therapy reduced symptoms as well as blood levels of chemicals. The workers had health complaints since working at ground zero, including headaches, breathing problems, muscle and joint pain, and skin rashes. The study measured their blood for levels of PCBs, dioxins, and polychlorinated dibenzofurans. After undergoing the Hubbard sauna therapy protocol, all 7 had a reversal in symptoms and PCB levels declined by 65%, and dioxins and dibenzofurans were below detection limits. (17)

The Hubbard protocol included:

* daily regimen of physical exercise

* sauna at 140-180 [degrees]F for 2.5 hours with short breaks for hydration

* nutritional supplements centered on increasing doses of niacin

* administration of additional vitamins, minerals, electrolytes, and essential oils, including vitamins A, D, C, E, and B complex; minerals such as calcium, magnesium, iron, zinc, manganese, copper, and iodine; sodium and potassium; and a blend of polyunsaturated oils, including soy, walnut, peanut, and safflower

Dr. William Rea, a specialist in environmental medicine and multiple chemical sensitivity (MCS), has utilized sauna therapy for years in mobilizing chemicals from the body. He published a study using sauna therapy on 210 patients with MCS; 86% had symptom improvement, and 63% had reduction in serum toxins. (18)

The Rea protocol included:

* sauna at 140-160 [degrees]F for 2 hours

* exercise before sauna

* massage after sauna

* niacin up to 3000 mg

* vitamins, minerals, amino acids--oral and IV

Chelation is the pharmacological mobilization of heavy metals from storage sites and is another method for mobilizing toxins. The three main chelating agents in the US are calcium ethylenediaminetetraacetic acid (CaEDTA), dimercaptosuccinic acid (DMSA), or 2,3-dimercapto-1-propane sulfonic acid (DMPS). Chelation and heavy metal testing were discussed in depth in my column in the January 2011 issue of the Townsend Letter.

Next, liver phase I and phase II metabolism need to be supported. A good multivitamin/mineral is required to provide cofactors for phase I and II enzyme pathways. It should include vitamin A (from mixed carotenes), vitamin C, vitamins D and E, all of the B vitamins, calcium and magnesium, zinc and copper, molybdenum, kelp and iodine, selenium, choline, and inositol.

Other nutrients to consider include the following:

Whey protein has been shown to increase levels of glutathione in the body. Glutathione is a major antioxidant that protects the liver. (19)

Green tea is a potent antioxidant and increases glutathione. The polyphenols detoxify damaging toxic chemicals. It is shown to prevent the occurrence of cancers, including breast cancer, which is linked to environmental toxins. (20), (21)

Curcumin (turmeric) is a plant that has been shown to reduce environmental estrogen-induced growth of breast cancer cells. It also increases levels of glutathione in the liver. (22)

Arcticum root, commonly known as burdock, is traditionally used as a blood purifier to clear the bloodstream of toxins. It stimulates bile secretions and aids in detoxification. (23), (24)

Taraxacum root, commonly known as dandelion, enhances the flow of bile. It acts on the liver by increasing production and flow of bile to the gallbladder and causes the gallbladder to contract and release stored bile into the intestines. This is why it is considered both a choleretic and a cholagogue. (25)

Silymarin, the active constituent of milk thistle, is one of the most well-known liver herbs. It is used to treat liver toxicity from organic solvents and to improve liver function tests in numerous liver conditions. Silymarin causes an alteration of the hepatocyte cell membrane that prevents toxin penetration. It increases glutathione and can scavenge free radicals. (25)

Beetroot has antihepatotoxic effects. It is effective against fat deposition in the liver. Beet assists in liver detoxification because it has a high concentration of betaine, a methyl donor in the liver's transmethylation pathway. (26), (27)

Artichoke is a powerful liver-protecting herb that acts as an antioxidant in the liver and protects against chemical toxins. It also increases glutathione levels in the liver cells. (28)

Diindolylmethane (DIM) is a metabolite of indole-3-carbonol (I3C). Both increase liver phase I and II pathways and help metabolize estrogens and chemicals mimicking estrogen. Both I3C and DIM alter urinary estrogen metabolite profiles in women. DIM can regulate and promote a more efficient metabolism of estrogen. (29), (30)

Calcium-D-glucarate is a substance naturally produced by humans and is also found in fruits and vegetables, particularly cruciferous. It can increase glucuronidation, an enzyme pathway in liver phase II detoxification necessary for excretion of toxic compounds. Calcium-D-glucarate also inhibits the enzyme beta-glucuronidase, allowing the body to excrete estrogen before it can be reabsorbed and raise serum levels of estrogen. (31), (32)

N-acetylcysteine (NAC) is a powerful antioxidant with rapid oral absorption. It is the precursor to reduced glutathione (GSH). NAC promotes liver detoxification by restoring glutathione levels in the body. It also protects against environmental toxins by scavenging reactive oxygen species. NAC can increase the metabolism of estrogen through the liver. (33-35)

Alpha-lipoic acid (ALA) is a powerful antioxidant that scavenges reactive oxygen species, protecting against oxidative damage caused by environmental toxins. ALA induces liver phase II detoxification enzymes and specifically stimulates glutathione synthesis. ALA is effective in removing heavy metals from the body by itself and when combined with DMSA. It can promote clearance of estrogens in the liver by increasing the phase II glutathione pathway. (33), (36)

Methylcobalamin (vitamin B12) and Methylfolate (folic acid) are naturally occurring substances in the body. Each of these consists of a methyl group that, when metabolzed, cleaves off and increases methylation. Methylation is part of liver phase II metabolism and is responsible for breaking down estrogens. By supporting methylation pathways, you promote detoxification of estrogens and environmental estrogens. (37-39)

Once the liver breaks down the released chemicals, they need to be eliminated from the body through the kidney and bowel. Lastly, it is important to educate women on how to avoid reexposure to chemicals in the environment.

Methods to support elimination include:

* hydrotherapy: castor oil packs and sauna therapy

* bowel support: fiber, coffee enema, colonics

Summary on Avoiding Toxins in Daily Life

* Buy only organic fruits and vegetables that are free of pesticide residues.

* Buy hormone-and antibiotic-free meats and dairy products.

* Buy fresh or frozen foods and avoid canned foods lined with plastic.

* Eat wild fish low in mercury, such as wild Alaskan salmon, blue crab, flounder, haddock, pollack, and trout.

* Do not store or heat food in plastic containers; use glass.

* Buy in bulk to decrease plastic packaging.

* Store food in glass jars when you get it home.

* Drink water out of glass containers rather than plastic.

* Filter your own water.

* Use a home air filter.

* Use earth-friendly detergents, cleaners, and soaps.

* Try to rework your conception of what looks beautiful, and avoid herbicides and pesticides.

* Use natural pest control instead of insecticides.

* Replace vinyl miniblinds, shower curtains, and placemats with fabric.

* If you're building a home or remodeling, use earth-friendly, nontoxic materials.

* Use a nontoxic dry-cleaner, or air out dry-cleaning before bringing it into the home.

* Use natural, organic, unbleached tampons without a plastic applicator.

* Avoid fragrances, and remember that unscented is not fragrance free.

* Use only nontoxic cosmetics, lotions, shampoos, deodorants, and other products.

* Remove your shoes when you enter the home.

Summary

When evaluating women's health conditions, there are many factors to consider, including chemicals that women are exposed to through the air, food, water, and plastics. Evaluation begins with an in-depth exposure history. Testing for heavy metais, pesticides, solvents, phthalates, and single nucleotide polymorphisms (SNPs) is available from various labs. After completing a 4-step liver detoxification plan, it is important for patients to prevent reexposure to these chemicals by learning how to avoid toxins in everyday life.

You can learn more about the environmental links to women's health conditions, including methods of exposure, testing, treatment, and avoidance, in my book, 8 Weeks to Women's Wellness: The Detoxification Plan for Breast Cancer, Endometriosis, Infertility and Other Women's Health Issues.

Notes

(1.) Colburn T, Dumanoski D, Myers JP Our Stolen Future. Penguin Group; 1997:70-86.

(2.) Steingraber S. Living Downstream, Addison-Wesley; 1997.

(3.) Environmental Working Group [Wep page]. www.ewg.org.

(4.) Wolfe MF, Seiber JN Environmental activation of pesticides. Occupational Med 1993;8(3):561-573.

(5.) Wheeler L. Power plants are focus of drive to cut mercury. USA Today. Oct. 29, 2007. Available at:http://www.usatoday.com/news/health/2007-10-29-mercury-cover_N.htm

(6.) Shaw SD et al. PCBs, PCDD/Fs, and organochlorine pesticides in farmed Atlantic salmon from Maine, eastern Canada, and Norway, and wild salmon from Alaska. Environ Sci Technol. 2006;40(18):5348-5354.

(7.) Vom Sall FS, Hughes C. An extensive new literature concerning low-dose effects of bisphenol-A shows the need for new risk assessment. Environ Health Perspect. 2005;113(8);926-933.

(8.) Tsumura Y et al. Eleven phthalate esters and di(2-ethylhexyl) adipate in one-week duplicate. diet sample obtained from hospital and their estimated daily intake. Food Addit Contam. 2001;18(5):449-460.

(9.) Manuel J A healthy home environment. Environ Health Perspect. 1999;107(7):1-7.

(10) Welshons WV et al. Large effects from small exposures. Mechanism for endocrine-disrupting chemicals with estrogenic activity. Environ Health Perspect. 2003;111:994-1006.

(11.) Crinnion WJ Environmental medicine, part 1: The human burden of environmental toxins and their common health effects. Altern Med Rev. 200;5(1):52-63.

(12.) Hruska KS et al. Environmental factors in infertility Clin Ob Gyn. 200;43(4):821-829.

(13). Brouwer A et al. Interactions of persitent environmental organochlorines with the thyroid hormone system: mechanism and possible consesquences for animal and human health. Toxicol Ind Health. 1998;14:59-84.

(14.) Engel CC, Adkins JA, Cowen DN Caring for medically unexplained physical symptoms after toxic environmental exposures: effects of contested causation. Environ Health Perspect. 2002;110(4):641-647.

(15.) Jandacek RJ, Tso P. Enteropatic circulation of organochlorine compounds: a site for nutritional intervention. J Nutr Biochem. 2007;18:163-167

(16.) Jandacek RJ et al Effects of Yo-Yo diet, caloric restriction, and olestrsa on tissue distribution of hexachlorobenzene. Am J Physiol Gastrointest Liver Physiol. 2004;288:G292-G299.

(17.) Dahlgren J et al President organic pollutants in 9/11 world trade center rescue workers: reduction following detoxification. Chemosphere. 2007;69(8):1320-1325.

(18.) Rea WJ, Pan Y, Johnson AR, et al. Reduction of chemical sensitivity by means of heat deputation, physical therapy, and nutritional supplementation in a controlled environment. J Nutr Environ Med. 1996;141-148.

(19.) Balbis E et al. Whey proteins influence hepatic glutathione after CC14 intoxication. Toxicol Ind Health. 2009;25:325-328.

(20.) Nakachi K et al. Influence of drinking green tea on breast cancer malignancy among Japanese patients. Japan J Cancer Res 1998;89:254-261.

(21.) Dulloo A et al. Influence of drinking green tea on extract rich in catachin polyphenols and caffeine in increasing 24-hour energy expenditure and fat oxidation in humans. Am J Clin Nutr 1999;70:1040-1045.

(22.) Hall DC. Nutritional influences on estrogen metabolism. Appl Nutr Sci Rep 2001;1-7.

(23.) Linninger S et al. The Natural Pharmacy. 2nd ed. Rockland, CA: Prima Health; 1999.

(24.) Mowrey DB. The Scientific Validation of Herbal Medicine. New Canaan, CT: keats Publ.; 1986.

(25.) Murry MT. The Healing Power of Herbs. 2nd ed. Rockland CA: Prima; 1995.

(26.) Jellin JM et al. Natural Medicines Comprehensive Database. 4th ed Stockton, CA: Therapeutic Research Foundation; 2002.

(27.) Gruenwald J et al. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Co.; 2000.

(28.) Liska DJ, Roundtree R. The role of detoxification in the prevention of chronic degenerative diseases. Appl Nutr Sci Rep. 2002.

(29.) Higdon JV et al. Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res. 2007;55(3):224-236.

(30.) Rogan EG. The natural chemopreventive compound indole-3-carbinol: slate of the science. In Vivo. 2006;20(20):221;228.

(31.) Head KA, ed Calcium-D-glucarate. Alt Med Rev. 2002;7(40):335339.

(32.) Walaszek Z, Hanausek-Walaszek M, Webb TE. Antiproliferative effects of dietary glucarate on the Sparague-Dawley rat mammary gland. Canc Lett. 1990;499(1):51-57.

(33.) Patrick L. Toxic metals and antioxidants: part II. Alt Med Rev. 2003;8(2):106-128.

(34.) Pande M et al. Combined administration of a chelating agent and an antioxidant in the prevention and treatment of acute lead intoxication in rats. Env Toxico Pharm. 2001;9:173-184.

(35.) Zahid M et al Inhibition of depurinating estrogen-DNA adduct formation by natural compunds. Chem Res Toxicol. 2007;20:1947-1953.

(36.) Flier J et al. The neuroprotective antioxidant ALA induces detoxification enzymes in cultured astroglial cells. Free Radic Res.2002;36(6):695-699.

(37.) Hall DC. Nutritional influences on estrogen metablism. Appl Nutr Sci Rep. 2001;1-7.

(38.) Nishizawa Y et al Effects of methylcobalamin on the prolilferation of androgen-sensitive or estrogen-sensitive malignant cells in culture and in vivo. Int J Vitamin Res. 1997;67(3):164-170.

(39.) Pietrzik k, Bailey L, Shane B. Folic acid and L-5-methylterahydrofilate: comparison of clinical pharmacokinetics and pharmocodynamics. Clin pharmacokinet. 2010;49(8);535-548.

by Marianne Marchese, ND www.drmarchese.com
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Title Annotation:Environmental Medicine Update
Author:Marchese, Marianne
Publication:Townsend Letter
Article Type:Report
Geographic Code:1USA
Date:Apr 1, 2011
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