Detoxification: Waste not…..want not Mark Pettus MD February 18, 2014

1. Detoxification: Waste not…..want not Mark Pettus MD February 18, 2014

4. Disease (how things appear) Pre-diabetes, Diabetes, Obesity, Metabolic Syndrome, Heart Disease, Stroke, Depression, Autoimmunity, Alzheimer’s, Cancer, Fibromyalgia, Chronic fatigue ADDHD, GAD, PTSD, Autism spectrum Core Metabolic Imbalances (what drives them) Inflammation Environmental Toxins-detoxification Fight-Flight (HPA axis) Microbiome (Gut-Immune) Root Causes (what are their origins) Gene-Epigenome-Environment Nutrition Movement Stress Response Environmental toxins Sleep Social Connection Trauma Conflict Management Mindfulness Spirituality-Meaning in Work, Love, Play

5. Learning objectives • Review some common sources of environmental toxins that pervade daily living. • Examine how the growing burden of environmental toxic exposure effects health and quality of life. • Examine lifestyle, behavioral, and supplement strategies that can reduce our burden and optimize our capacity for detoxification.

6. The Precautionary Principle “We as physicians must act on facts…and on the most accurate interpretation of them, using the best scientific information. That does not mean that we must sit back until we have 100% evidence about everything. When the state of the health of the people is at stake…we should be prepared to take action to diminish those risks even when the scientific knowledge is not conclusive” Horton. Lancet. 1998;352(9124):251

12. Exposure to environmental toxins • Since WWII, more than 85,000 new synthetic chemicals have been released into the environment. • As a species we are exposed to 6 million lbs mercury and 2.5 billion lbs of other toxic chemicals each year. • Most have not been tested for potential toxicity in adults (few in children) • Over 4 billion lbs of pesticides are used annually in the US. • Current law allows 350 pesticides to be used on the foods we eat. • The average home contains 3-10 gallons of hazardous materials. • Traces > 280 synthetic chemicals can be found in the average newborn

13. Toxic Load Toxic Metals Petro- Chemical Residues, Pesticides & Fertilizers Stress Resistance Allergies Organismic Load

19. How do we manage toxins?

22. The Effects of Toxins • Fatigue • Muscle aches / joint pain • Brain fog • Headaches • Sinus congestion and allergies • Digestive problems • Skin problems • PMS and hormone imbalances • Weight gain

23. Plausible evidence links toxic exposure with risk of: • Endocrine and reproductive disorders • Obesity • Selected cancers • Autoimmune diseases • Digestive disorders • Neurological disorders e.g. Parkinson’s, ALS, Alzheimer’s disease, autism spectrum, and multiple sclerosis • Behavioral health disorders e.g. depression, anxiety, attention deficit and hyperactivity • Allergies and asthma • Diabetes and cardiovascular diseases • Chronic fatigue, fibromyalgia, and multiple chemical sensitivity

29. Prevalent environmental toxic exposures: • Persistent Organic Pollutants“POPS” e.g. PCBs, dioxin, DDT, organochlorine pesticides, petrochemical fertilizers, herbicides • Perfluorooctanoic acid“PFOA”: water repellant in scotchguard, gortex, carpeting, upolstery and PTFE in teflon • Polybrominated compounds: PBDEs, flame retardants in TVs, computers, etc. “21st century PCBs” • PCBsin meat, fish, dairy • Bisphenol A “BPA” polycarbinated plastics, canned foods • Pthalatesin plastics, PVC, adhesives, food packaging, cosmetics, soaps • Atrazineagricultural pesticide and herbicide seeps into drinking water

30. Phthalates and Parabens (hair and skin care products) Fragrance (shampoos, deodorants, skin and body care) Diethanolamine (DEA) Triethanolamine(TEA) (found in many cosmetics) Diazolidinyl Urea, Imidazolidinyl Urea, and Quarternium-15 (skin and hair products)…all release formaldehyde..sensitivities Sodium Lauryl Sulfate (SLS) Sodium Laureth Sulfate (SLES) found in makeup, shampoos, conditioners and toothpaste. When combined with DEA and TEA they form nitrosamines which are carcinogenic Triclosan: a synthetic antibacterial in skin cleaners and household products…a hormone disrupter Cosmetics: looking good ≠ good health Cosmetic Safety Database www.cosmeticdatabase.com Natural Cosmetics: www.drhauschka.com; www.avalonorganics.com; www.evanhealy.com; www.sumbody.com; www.sophytoorganics.com

31. High Bluefish Grouper Marlin Tuna (yellowfin, blue, albacore) Tilefish Seabass Mahi Swordfish Low Arctic cod Anchovies Catfish, Crab Flounder Haddock Herring Mackerel Non-farmed salmon Trout Tilapia Oysters Tuna (skipjack and chunk light) Fish and mercury

33. Mercury • Environmentally ubiquitous: levels 30x higher last 2 generations • Enters water and soil from natural deposits, volcanic activity, mining ore, and disposal of wastes e.g. batteries • Enters the air and rain from coal- and oil-fired power plants, incinerators, waste and manufacturing plants that use mercury to produce chlorine-containing plastics, PVC piping, pesticides, etc. • Methyl mercury formed in soil and water by algae and bacteria, then ingested by fish; also in fungicides • Elemental mercury and amalgams used in dental fillings, batteries, electrodes, barometers, fluorescent light bulbs, red tatoo dye, skin-lightening creams and thermostats • Federal Toxic Release Inventory: over 6 million lbs of toxic waste in the form of mercury compounds in toxic waste generated by industry, most of which is released directly into the environment

34. Mercury: Health Effects • Damages enzymes and other proteins by binding sulfhydryl groups, e.g., metallothionein, hemoglobin, glutathione • Promotes oxidative stress by formation of lipid peroxides, H2O2, and hydroxyl radical • Depletes glutathione and selenium • Penetrates nerves and binds to cysteines on Ach receptors • Damage to brain and kidneys • Cognitive dysfunction, depression, irritibility, tremors, changes in vision and hearing • Probable carcinogenic

37. Principles of Healthy Detoxification • Minimize your exposure to toxins by eating organic foods, avoiding large fish, and • Filtering your air with an ionizer • Drink filtered water • Keep your bowels moving once or twice a day • Use of flax seeds, probiotics, and magnesium citrate • Eat organic animal products. • Eat 8-10 servings of colorful fruits and vegetables and include cruciferous veggies, garlic daily, watercress, green tea, cilantro, chlorella, berries, dandelion root, etc. • Eliminate nicotine and moderate alcohol intake (e.g. no more than 1 drink/day)

38. Principles of Healthy Detoxification • Exercise 5 days a week with conditioning, strengthening, and stretching exercises • Eliminate white flour and sugar and HFCS • Sweat profusely at least 3 times a week e.g. sauna, steam, detox bath • Try special detoxification supplements • Consider removal of dental fillings • Mindfulness practice • Minimize char-broiled meats (heterocyclic amines)

39. What else can a person to do to reduce toxic burden? • Buy and eat organic whenever possible • ? Safety of microwave popcorn (PFOS) grease repellant • Consider glass or ceramic containers instead of plastic • Decline stain protection treatments for upholstery or floor coverings • Ask about VOCs (volatile organic compounds) in paints, new carpeting, furniture • Avoid polycarbonate plastics with “7” and “3” stamped on bottom. Consider aluminum instead. • Switch to stainless steel or hard-anodized aluminum pots and pans when Teflon cookware wears out • Vacuum/dust at least once per week: Air purification ionizers • Carbon Filter water

40. Cruciferous and Allium Vegetable Families

41. Enhance Blood and Lymph Circulation • Aerobic exercise • Yoga • Massage and body work • Sauna and heat therapy • Skin exfoliation and brushing

42. Mind-Body Detoxification

43. Supplements • Multivitamin with mineral supplement daily • Milk Thistle • Omega-3 fish oils • Probiotics • Magnesium citrate • N-Acetyl Cysteine (NAC) • Vitamin D • Co-Q-10; Alpha lipoic Acid • DMSA heavy metal chelation

44. Ewg.org

45. Great web sites to explore • www.foodnews.org • www.consumerlab.com • www.centerforfoodsafety.org • www.orgfood.com • www.diamondorganics.com • www.ewg.org • www.greenhome.com • www.allergybuyersclub.com • www.seventhgeneration.com • www.cosmeticdatabase.com

46. Thank you.