Detoxification and chronic conditions

Townsend Letter for Doctors and Patients, Jan, 2007 by Gina L. Nick

Introduction

According to recent estimates, 125 million Americans have at least one chronic condition, with that number expected to rise to 157 million by 2020. Another 60 million Americans suffer from multiple chronic conditions. Unfortunately, while advances in medical science have yielded significant responses in treating or controlling acute conditions, there has not been a similar trend in managing chronic conditions. Nearly three-quarters of all Americans experiencing a chronic condition report difficulty in obtaining the needed care from a medical specialist--not surprising, given the complexity and multifaceted nature of these conditions.

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Further complicating the issue is the role that environmental toxins play in initiating or exacerbating chronic conditions. Research has demonstrated that toxins increase the extent of the severity of the symptoms by stimulating the inflammatory response. Furthermore, these toxins (many of which are man-made) have at least an additive effect--and frequently a synergistic effect--on the magnitude and duration of the inflammatory response, the extent of which certainly warrants further research. (1-5) However, this does not imply that there is little that a patient can do. In many cases, the inflammatory response that aggravates chronic conditions can be minimized or controlled by first understanding how toxins affect the immune system and then initiating improvements to the internal and external environments (6) to reduce the impact.

The Toxin-Inflammation Link

The extent of environmental toxins has increased exponentially since the 1930s, with the number of man-made chemicals now estimated to exceed over 160 billion kilograms per year. (7) These chemicals then find their way from the ecosystem into our systems, as documented by two surveys: the National Human Adipose Tissue Survey (NHATS), conducted by the Environmental Protection Agency (EPA), and the Food and Drug Administration's (FDA) Total Diet Survey.

The goal of NHATS was to investigate the presence of xenoestrogens--synthetic substances whose unintended side effect is an imitation or enhancement of the estrogen effect--in the environment and the direct effect of that presence on our bodies. During an 11-year period (1976 to 1987), pathologists and medical examiners from 47 metropolitan statistical areas collected and chemically analyzed a nationwide sample of adipose tissue specimens for the presence of these xenoestrogens. The results were alarming; 100% of the tissues analyzed had levels of organochlorine pesticides, PCBs, dioxins and furans, volatile organics, semivolatile organics and trace elements, OCDD (a dioxin commonly present in dairy and meat products), styrene (a solvent), 1,4-dichlorobenzene, xylene, and ethylphenol. This clearly demonstrated that no one is immune from these toxins and their associated detrimental effects.

The FDA's Total Diet Survey (an ongoing program also known as the Market Basket Study) revealed some equally disturbing statistics. The survey analyzed the levels of DDE inadvertently ingested and subsequently stored in adipose (fat) tissue for years following exposure. An analysis of DDE presence in foods commonly found in grocery stores ranged from 81% (in cheddar cheese, pork sausage, quarter-pounders, white sauce, and creamed spinach) and 87% (in lamb chops, salami, canned spinach, meatloaf, and butter) to 93% (in American processed cheese, hamburger, hot-dogs, bologna, collards, chicken, turkey, and ice cream sandwiches) and 100% (in raisins, fresh and frozen spinach, beef and bean chili con carne, and beef).

Both studies illustrated the thin and obviously highly permeable "wall" that separates the human body from those specific toxins. And, according to the National Research Council, there are other external contaminants as well that have documented immunotoxic (immune system malfunction) effects on the body. (8,9) These include chemical classes (metals, such as lead, methyl mercury, arsenic), polyhalogenated aromatic hydrocarbons, (e.g., PCBs, TCDD), pesticides (e.g., chlordane, carbofuran), aromatic hydrocarbons (e.g., benzene, toluene), drugs of abuse (e.g., cannabinoids, cocaine, opioids), and even therapeutic drugs (e.g., diphenylhydantoin, lithium), and natural products (e.g., antibiotics, plant alkaloids). (10)

Exogenous (existing outside the body) toxins can also induce autoimmunity, whereby one's own immune system attacks tissues or organs, leading to functional impairment and inflammation throughout the body. Examples of these toxin-induced autoimmune conditions include systemic lupus erythematosus, autoimmune hemolytic anemia, myasthenia gravis, pemphigus, glomerulonephritis, autoimmune thyroid disease, autoimmune hepatitis, and scleroderma. (11,12) Once these toxins enter the body, they prompt the release of proinflammatory cytokines which, for localized immune challenges brought about by toxins, lead to activation of peripheral nerves that signal the brain and, ultimately, an exaggerated pain response. (13)