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Heavy Metal Detox with Dr. Christopher Shade: Rational Wellness Podcast 054

Dr. Christopher Shade discusses how to test for and remove heavy metals from the body with Dr. Ben Weitz.

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Podcast Highlights

2:25  Dr. Shade talked about how he got interested in studying mercury and developed a way to separate different forms of mercury as part of getting his PhD. 

3:35  Dr. Shade explained that he tried heavy metal chelaters like DMSA and DMPS and these made him much sicker, which led him to design better supplements for detoxification.   

5:45  I asked Dr. Shade to explain why his tests for heavy metals are more accurate than other tests on the market?  I then asked how serum testing can be that accurate, since it only reflects recent exposure and not metals that have been stored in the tissues for months and years?  This is why we do oral chelation challenge and collect urine for six hours to detect metals that have been stored in the tissues and are now being released through the urine.  Dr. Shade challenged that view and explained that chelaters like DMSA do not go into the cells and cause metals to dump into the urine.  What they actually do is pull metals from the lymph and the red blood cells and bind it out into a form that’s easily filtered out through the kidneys.  And serum reflects the body burden. And urine also is somewhat reflective of body burden and urine has a baseline level of metals, in contradiction to the assumption that there is no baseline of metals until the chelation challenge. Also, after the serum levels rise due to a recent exposure, such as eating some fish, it takes 45 to 60 days for the serum levels to go back to the previous level in a healthy person and up to 300 days in an unhealthy person.   

10:51  Dr. Shade described how organic methylmercury from fish is represented very well in the blood, while inorganic mercury from dental amalgams doesn’t represent itself very well in the serum.  But inorganic mercury is seen much better in the urine, provided that the kidneys are functioning properly and the kidneys can become damaged by mercury.  Quicksilver Scientific offers the Mercury Tri-Test, which separates out the inorganic from the organic mercury and measures mercury in blood, hair, and urine.  Hair is only reflective of organic (from fish) mercury and you can have a mouth full of almagams and it will not show up in the hair.  Quicksilver also offers the blood metals panel.  Here is a link to Quicksilver’s website with more information on their testing, including why urine challenge testing with oral chelators is problematic: https://www.quicksilverscientific.com/testing/clinical-metals-testing 

20:19  I asked if Dr. Shade ever measures antibodies to metals and he said that he is interested in looking at that and thinks that it may show patients who become symptomatic with metal exposure. 

22:18  Dr. Shade said that undiagnosed Lyme Disease may become symptomatic when treating the metals because raising the glutathione levels reboots the immune system. If you then send them out for more Lyme Testing they may then test positive when they were negative before. So you need to focus on controlling the infection with antimicrobials before you can effectively complete your metal detox program. 

22:58  Dr. Shade explains his approach to removing toxic metals from the body.  You can use the same approach for mercury, cadmium and arsenic, while the approach for lead is a little different.  Mercury is detoxified well by glutathione, but you also need glutathione S-transferase and transmembrane transporters and also magnesium. So if we want to build a system of detoxification, we need to build glutathione levels. We need to turn up the activity of the transferase, and we need to turn up and support the activity of the the transport proteins. And when it gets down to the GI tract, we need to grab it before it gets reabsorbed.

25:40  Liposomal glutathione is better absorbed and someone with mold toxicity or Lyme disease are sick and will have a tough time making glutathione from NAC. Taking liposomal glutathione is better than taking NAC in a diseased person.  Dr. Shade mentioned a study showing that 600 mg liposomal glutathione produced a 30% increase in glutathione levels in six hours while 600 mg IV glutathione only produced a 15% increase in six hours. 

30:15  Dr. Shade explains what a liposomal formula is and how it works.  You are creating a fat soluble bubble with phosphatidylcholine and tucking the glutathione in it, so it gets absorbed like a fat would and it passively absorbs into the upper GI tract.  Dr. Shade also explained that by making his liposomal products small enough, some of them will pass through the oral mucosa and directly into the capillaries, so you should hold the liposomal products directly in your mouth for 30 seconds before swallowing. He explained that all of his products are between 20 and 80 nanometers since below 100 they get much better absorbed but you also don’t want them to be too small or you have problems with nano particles toxicity. 

33:15  Once you get glutathione into the cells, then you need to up-regulate the transferase and get those membrane transporters working by invoking NRF2 by using Lipoic acid and polyphenols. You can also use sulfurophanes from crucifers and garlic oil.  The best polyphenols to use are green tea extract, pine bark extract, red wine extract, grape seed extract and haritaki. 

34:55  Dr. Shade explains that to get the transporter proteins working well, you need to stimulate the liver-gall bladder system and promote the flow of bile. The transport of toxins into the bile tree is synonymous with and linked intimately with bile transport. The two transporters that move bile from the hepatocyte into the bile tree are the bile salt export pump and MRP2, the multidrug resistance pump number 2. The MRP2 is the is also the toxin transport and thus it moves both toxins and bile salts.  These transporter proteins get up-regulated and down-regulated together, so cholestasis is toxostasis.  Thus, if you move bile, you move toxins.  If you don’t move the toxins from the liver into the bile, they get dumped into the brain and you get inflammation in the brain, the kidneys, you get lower back pain, skin rashes.  He likes to use herbal bitters to get bile and toxins flowing and also phosphatidylcholine to help solubilize the bile to keep it flowing. Then, when the toxins are moving through the GI tract, you want to use binders like thiol-functionalized silica, charcoal, clay, zeolites, and chitosan, so these toxins don’t get reabsorbed.

39:28  Dr. Shade explains why modified citrus pectin is not a good binder for toxins, though it helps remove toxins by reducing inflammation.

           

                             



Dr. Christopher Shade is a PhD researcher and a recognized expert on mercury and liposomal delivery systems. He has lectured and trained doctors in the U.S. and internationally on the subject of mercury, heavy metals, and the human detoxification system. He founded Quicksilver Scientific and Quicksilver is an industry leader in blood metals testing and the development and production of superior liposomal delivery systems. Quicksilver Scientific is the only company to offer advanced mercury speciation testing (the Mercury Tri-Test), which comprehensively assesses for the body burden of mercury. Here is more information about the metals testing: https://www.quicksilverscientific.com/testing/clinical-metals-testing  Quicksilver Scientific is dedicated to producing superior nutraceutical products tailored at supporting the human detoxification system for the optimization of health. https://www.quicksilverscientific.com/home

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure as well as chiropractic work by calling his Santa Monica office 310-395-3111.


 

Podcast Transcripts

 

Dr. Weitz:          This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting edge information on health and nutrition. From the latest scientific research, and by interviewing the top experts in the field.  Please subscribe to the Rational Wellness Podcast on iTunes and YouTube, and sign up for my free ebook on my website by going to drweitz.com.        Let’s get started on your road to better health.

                          Hey Rational Wellness Podcasters. Thank you so much for joining us again today. For those of you who enjoy this podcast, please give us a ratings and review on iTunes.

                          Our topic for today is heavy metal toxins. This is a very important topic. We recently had Dr. Joe Pizzorno on talking about toxins, and now we’re going to focus in on heavy metals, mercury, lead, all the other heavy metals. And these are incredible important, can have all kinds of effects for our health, can play a role in various chronic diseases. And I’m very excited that I’ll be speaking with Dr. Christopher Shade, who is a PHD researcher and the founder and CEO of Quicksilver Scientific, a heavy metal testing and nutritional supplement company. Quicksilver Scientific is known especially for its detoxification products and its unique supplement delivery systems, and it’s patented mercury speciation test. Christopher, thank you for joining me today.

Dr. Shade:         Thanks, Ben, it’s a pleasure to be here.

Dr. Weitz:          Good, good, good. So can you tell me a little bit about your background and how you became interested in mercury and heavy metal testing?

Dr. Shade:         Oh, sure thing. I’ve a very circuitous background to get here. Grew up a scientist in an academic family. Got a little disillusion with reductionist science, went out into the woods, I was an organic farmer for a long time, sort of a Thoreau summer starting farms and stuff. And then one thing or another led me back into getting a graduate degree around pollution in the environment. I was looking at agricultural pollution and I got a masters in that.

Dr. Shade:         Then when I went to do my PHD, I didn’t really find the research that was going on there that interesting, but I found this guy who was specializing in global cycling of mercury as a toxin in the environment. And I ended up working with him. And they needed new analytical developed, new systems for separating different forms of mercury, which is really crucial to understanding their movement through the environment and movement through the body. And so I developed that, patented that, and graduated and started a company around that testing, originally doing environmental testing and then switching over into health and wellness. Because I wanted to get back to this human focused look at toxins in the environment and health in the environment, and cycle it back into looking at personal health.

                         And I brought this testing in, showed it to people like Hal Huggins and Dietrich Klinghardt, original pioneers in mercury toxicity. And they really liked that, but you know you bring up a problem, you gotta bring up a solution. And at the time, everybody was working with chemical chelators for getting rid of mercury and other heavy metals. And I thought I would do testing in conjunction with people using chelators, and so I tried all those chelators on myself and I got myself really into a hole. I really blew out my adrenals, I blew out my neurological balance, my immune system.  And while I was in the middle of just being in this dark night of my biochemical soul, I was watching these functional medicine meeting lectures here in Boulder County.  I was watching Bob Roundtree and Nigel Plummer from Pharmax, and they were talking about GI health and the GI system calling the shots in so much stuff. And I realized that a lot of amalgam toxicity was having so many metals in the GI tract.  And I was trying to push things through the kidney, but I should clear out liver GI functioning first.

                          And that led me to make my first detox supplement, which was kind of a chelator for the GI tract. It was like taking a clay or an activated charcoal and making it specific for metals. And as I did that and cleared everything out of my GI tract, I just opened up all my problems, I just cleared everything away. And introduced that product, which is now known as IMD, or Intestinal Metals Detox.  I introduced that to Huggins and Klinghardt and it filled a big void in everybody’s tool chest and it led me to research why it worked, and that led me to understand all the processes of the glutathione system and how the body’s naturally supposed to get rid of these metals. And that metal toxicity is not a deficiency of chelators, it is a deficiency of your own chemo defense system. And then when we optimize that, we can get rid of all these metals and at the same time make us resilient or resistant to other toxic insults. And so my whole life work became developing systems for optimizing all of that in people.

Dr. Weitz:            Cool. So can you explain about your heavy metal testing and why it ends up being more accurate than so many other testing?  And I keep coming back to whenever I look at serum testing I always think, you know, that’s only going to give us current levels of metals and so that’s why we’ve tended to do the oral challenge and then collect urine for six hours afterwards, with the idea that we’re going to liberate some of these metals, mercury, that’s been stored in the body, sometimes for months, years, maybe decades at a time. So how can you get a sense from testing of stored metals as well as what’s circulating and has come into the body recently?

Dr. Shade:           Right. But this is all … What did you just say to me? You said, “Well I think that this is only what’s circulating.”  Why do you think that? Did you do the primary research? Did you figure out why you think that?  Or are you just parroting what the guys who did chelation testing told you? Answer the question.

Dr. Weitz:            I have always been told that certain testing is only-

Dr. Shade:           Exactly.  Always been told is the problem there.

Dr. Weitz:            Including by the way some of the companies that do certain testing will tell you that as well.

Dr. Shade:           This is just what became the dogma of what’s going on. And the reality is that 20, 30 years ago we didn’t have really good testing to look at baseline levels. Like in urine, if you extended your discussion you’d say, but in urine there’s no metals in urine so I challenge it. That’s not true at all. There’s always a baseline of metals that are going on in the urine. And they are a filtrate of what’s happening in the whole blood, which is the plasma and the red blood cell. And the plasma and the red blood cell are in a steady state with what’s in the tissues.

                           Now for that whole argument that you brought up to be correct, that would mean that the chelators would go into all the cells and take a representative amount out into the serum and then make it go into the urine. But if you look at DMPS and DMSA, all the data around that says that they don’t do that. All the data around it says that they never cross the blood brain barrier, they don’t go into the cells. What they do is take what’s in the lymph and the red blood cells and bind it out into a form that’s easily filtered out through the kidneys.

                           And in a very famous paper that was done in Sweden in the mid-’90s, they were trying to look at DMPS and if it really reflects long term body burden, or if it’s just amplifying what you can already find in the body.  And they took acutely exposed workers who work with mercury directly, they took dentists with a long term burden, and then they took people with amalgams and people without amalgams.  And they looked at inorganic mercury in the plasma, and inorganic mercury in the urine before and after taking DMPS, 300 milligrams IV.  And what they found was that the mercury in the urine is linearly correlated with mercury in the plasma, and mercury in the urine after the challenge was linearly correlated with mercury in the urine before the challenge, and with mercury in the plasma before the challenge.

                          You’ve got these compartments and there’s a back and forth between them all. It’s not that the mercury comes in and goes into the tissues and sticks there and then leaves the blood. What happens, like if we went out for dinner tonight and we eat swordfish, a high mercury meal, we’re going to absorb that mercury in there and it’s going to peak between 12 and 18 hours after we eat. And it’s going to be much higher than our baseline is. So from our baseline let’s call it, let’s just give it a number. Say I’m at 5. I’m going to eat this meal, my peak is going to go up through maybe even 10 or 15, and then over 2 to 3 days it’s going back to this next baseline. And let’s call that 6.  And from the time to get from 6 back to 5, the original baseline, how long is that? It’s 60 days, 45 to 60 days in a healthy individual. As many as 300 days in an unhealthy individual. It’s not 2 to 3 days. The 2 to 3 days story was about a bolus that goes in, it goes up and peaks and comes back to a new baseline, and then it comes back.  But where people were kind of throwing their hands up with what’s urine mean, what’s blood mean? What’s going on here?  Methylmercury represents itself very well in the blood and will give you high levels.  Inorganic mercury from dental amalgam doesn’t represent itself very well.  It works on a lower scale.

                       Now why is that? It’s because of the distribution between the blood and the tissues. There’s always more in the tissues, which the prevailing wisdom is right about. There’s more in the tissues than the blood. But there’s a ratio between the two. And maybe it’s 10 fold more in the tissues for methylmercury and 30 to 50 fold more for inorganic mercury. And so dental amalgams and blood levels didn’t seem to correlate very well. But fish and blood levels did correlate well. But dental amalgams correlated pretty well with urine, and fish didn’t so well. That’s because methylmercury you find a lot in the blood, inorganic mercury, small amount in the blood. In the urine it’s all inorganic mercury. And so it’s reflective of the inorganic mercury levels in the serum, if the kidneys are transporting correctly.  And this comes down when we talk about detox we’re going to talk about pathways in the liver, you have the same pathways in the kidney. And when they get damaged, and they’re easily damaged, then that urinary representation of the blood blows out and you have low urine, high blood. Alright, but if it is working, then urinary mercury’s an inorganic mercury exposure.  Hair, you have Naturopaths going through all these soups to explain what hair meant compared to blood or intake. Hair is only fish. You can have a mouth made out of dental amalgam, if you eat no fish you have no mercury in your hair.

                     So there was all this improper, imprecise understanding of the pools of mercury, the compartments, and the interactions between them all. And so we just said, we’ll take the chelator, boom, a bunch comes out through the urine and we can compare people that way. And you can, but it’s not a very sophisticated way to go. And humans always do this, in order to justify that, they create this whole story that the mercury’s never in the blood except for like the last two days, and it’s all in the cells and the challenge pulls it all out of the cells and gives you this long term mercury number. But I pulled five or six different papers out of the literature where they examine that, and none of it worked.

                    Get this, one paper on DMSA, they took a grouping of people who had worked in the Chlor-Alkali factory, you sit there with a pool of mercury and stir it, and it’s an electrolysis cell, to split sodium chloride into sodium and chlorine. It’s the highest exposure you can ever get. So they all worked there and then they stopped working there for either one year or three years, but that’s the highest level of burden you can take into your body there is.  And then they took the general population and they measured urine before and after DSMA chelation.  Before DMSA chelation the guys who worked with the pools of mercury before were higher than the mainstream. But after chelation, the differences leveled out totally. There was no statistical difference between the two and there’s a reason for that. Because DMSA is really no good on inorganic mercury, which is what you get for that vapor form. But it’s pretty good on methylmercury. So this is a measure of how much fish these two groups ate. And it’s the same, because they were just a cross section of the population for methylmercury exposure, but one of them had significant inorganic mercury exposure.  So there’s all these papers showing the failure of the challenges to show long term burden. The exception being EDTA challenge and bone lead versus blood.  EDTA challenge is better correlated with bone lead than blood is, but blood’s still not bad.  You just have to take these scales, you’re looking for these huge, big scales, you’ve focused them down, and key for us for mercury, you separate methyl and inorganic mercury.  Give them their own reference ranges in the blood. Then once you have that inorganic mercury separated away from the fish-based methylmercury, that’s supposed to correlate perfectly with urine. And when it doesn’t, then you see it building up in the blood and you know where the damage is. It’s to transporters in the proximal tubules. It’s not even related to glomerular filtration. And you know when you treat them you have to focus on that. So there’s the whole story.

Dr. Weitz:      Yeah, so to sort of highlight a couple of points that you’re making is number one, the oral chelators like DMSA, they’re not effective at removing mercury and heavy metals from the tissues like we think they are.

Dr. Shade:     No, they remove from the blood plasma, maybe a little bit of soft tissue, lymph, and then the metals redistribute from the cells into the blood. And that’s when it’s important to have things that up regulate the chemistry that dumps out of the cells into the blood. Like lipoic acid. If you go to the Cutler theory, Cutler thought that DMSA was clearing the body and lipoic acid was clearing the brain. And he would start with DMSA and then he would move to DMSA and lipoic acid. DMSA clears from the blood and then lipoic acid gets the cells that dump into the blood. And then the DMSA can take it.

Dr. Weitz:      Interesting. So the first point is the oral chelators are not effective at removing the metals from the tissues. And two, the serum testing is actually effective for measuring mercury that’s in the body for up to 300 days.

Dr. Shade:     Yeah. And as long as you have the right testing. If you go to Labcorp, they’re not measuring low levels, and they’re not separating the two forms of mercury. So once you separate the two forms and you can measure really, really low, then everything’s good.  For instance, if say we’re measuring you and you have a lot of dental amalgams, but you never eat fish. Your total mercury in the blood might be say 0.5 parts per billion. Now the limit of detection for Quest is 1 part per billion. And some labs it’s 0.5. And so you’ll like less than the detection limit, less than 1. And they’ll say you have no mercury. But all of it is inorganic mercury. If you look at our reference ranges once you separate methyl and inorganic mercury, 0.5 parts per billion if inorganic mercury is the 95th percentile. It’s a very, very high amount.

                      And if your urine to blood ratio is good and your kidneys are working well and if you measured your urine, your urine would actually be fairly high. And so it was just, oh, we’ll measure serum. It only shows a little bit of one story. We’re measuring urine, only shows a little bit of story. You gotta put all this stuff together with the right technology. And there’s a beautiful story about the disposition of the metals and your excretion ability all in that one test.

Dr. Weitz:            So your company offers this tri-metals test that measures mercury through serum, urine, and hair.

Dr. Shade:           Yeah, that’s called the Mercury Tri-Test. Those three, blood, hair, urine.

Dr. Weitz:            And then there’s another test that measures multiple metals, and that’s a serum test.

Dr. Shade:           Yeah, that’s our blood metals panel, where you’re looking at nutrient metals and toxic metals. So the nutrients, you’ve got classic calcium, magnesium, copper, zinc. Most are really important because they have to be in a certain ratio. When you have high copper and low zinc, you’re synergistically toxic with all your other metals and it’s a marker of a serious dysfunction. So is calcium:magnesium.  Then you’ve got co factor detoxification metals like selenium, molybdenum, which is crucial for sulfur cycling, and you’re taking a lot of sulfur compounds when you’re detoxing. And lithium, which is a big one for B vitamin cycling.  And then in your toxics you’ve got the major four, arsenic, cadmium, lead and you have mercury but just as total mercury. If you’re just looking at somebody who’s a big fish eater and you want to know is it high, is it low, it’s sort of a good first cut.  A lot of people think, well if it’s high there then I’ll go do the Tri-Test. But if you have a patient who has dental amalgams but doesn’t eat fish, you’re not going to see anything in the total mercury blood. You need to go to the test that separates the two and looks at inorganic separate from methyl. It’s like they’re two totally different metals.

Dr. Weitz:            So ideally, if you have somebody that you suspect has serious metal issues, you really need to do both tests.

Dr. Shade:           You do both and you have a map of everything then. Both functional excretion capacity, sourcing, and your whole metals map, nutrient and toxic all together.

Dr. Weitz:            You ever measure the antibodies to metals?

Dr. Shade:           No, but every time I hang out with-

Dr. Weitz:            Dr. Vojdani?

Dr. Shade:           Yeah.

Dr. Weitz:            He spoke at our meeting last month so I got to hang out with him, it was great.

Dr. Shade:           Yeah. And so hopefully I hired guys to be in charge of a clinical research program here, and we’re starting to really crank out a lot of stuff. And so that’s on our list is to reach out to Dr. Vojdani and get a bunch of patients. Because he had said to me, “Well I think when you see the levels are high you’re going to see antibody response.” My take is very different.  When you see an antibody response, that’s going to mean that a certain level of metals is infinitely worse than maybe a higher level with no antibodies. So the antibody and the levels together will correlate with symptomology. And we’ll see, because you’re going to find a lot of people who are super symptomatic at low levels, and it’s this diffused whole immune dysregulation and neurological dysregulation. And the amount of mercury is really hard to justify that that’s doing it alone. But if they’re allergic to that mercury, then that can give those symptoms.

Dr. Weitz:            Yeah, boy, those can be some of the toughest patients, some of these chronic patients, and you’ve been doing mercury protocols and years later they’re still sick. Those are the toughest patients.

Dr. Shade:           Yeah, they’re very difficult. It’s very multifactorial, why did the immune system turn on it. There’s usually layers and layers of stuff going on.

Dr. Weitz:            Yeah, in one of the discussions you were having with somebody else, you were talking about how when you’re trying to get rid of metals or mercury, at a certain point sometimes that will increase some of the infections and you’ll have to stop and fight that off, like SIBO will recur.

Dr. Shade:           One of the things that we see a lot is that with lyme, undiagnosed lyme, when we start treating the metals we bring the glutathione levels up, it reboots the immune system and it starts reacting to the lyme and they feel horrible. And then you send them out for more lyme testing and then they show positive on their Western blots, and then they have to take a side road and get some antimicrobial therapy before they can come back and just do the metals. Although there’s still detoxification support for that. So in the complex cases I would say there’s a sort of pendulum between microbial focusing and toxin focusing.

Dr. Weitz:          So can you talk about your strategy for helping to remove metals, and how much does it change depending upon the metal?

Dr. Shade:         Oh, good, good question. And I’ve gone to a more broadly focused detoxification strategy, but let’s just look at mercury now. And mercury, cadmium and arsenic are playing by basically the same rules, and lead plays by a different set of rules. And then cadmium a little bit straddles the fence between the two. So mercury is the classic glutathione dependent detoxification. So if we’re in a cell, say there’s a cell here and we got a protein and there’s a mercury stuck to it, we gotta get the mercury off of the protein because mercury’s blocking the function of the protein. So you’re going to have glutathione floating around in the cell. But it doesn’t just go and grab the mercury on its own. You need glutathione S-transferase. Glutathione S-transferase is part of the phase two detoxification proteins called transferases, where they link something you make, like glutathione, onto something you want to get rid of, like mercury. And so that transferase would be me, and it changes the bond structure on the mercury so it can come off the protein and go with the mercury. 

Dr. Shade:         So then we got a mercury glutathione complex in the cell, we gotta get it out. Now it doesn’t just passably diffuse out. There is a series of transmembrane transporters that depend on magnesium and ATP, meaning you need to energy to turn them over and you need magnesium. And they actively push that complex out of the cell.  Okay, so the cell’s free, but it’s out in the body. And it’s in the extracellular environment and then that’ll join in to the blood flow and then how do we get it out from there? In the liver you got another transmembrane transporter that’s feeling around for these things, grabs it, pulls it into the hepatocyte, and another one that’s another one in these family of transporters that dumps it into the bioflow. And then from the bioflow goes down to the GI tract and out to fecal excretion. That’s when everything’s working well.

                        So if we want to build a system of detoxification, we need to build glutathione levels. We need to turn up the activity of the transferase, and we need to turn up and support the activity of the the transport proteins. And when it gets down to the GI tract, we need to grab it before it gets reabsorbed.  So we like to bring in liposomal glutathione for building glutathione.

Dr. Weitz:        Now how much is glutathione actually absorbed? Those of us in a Functional Medicine world have it in our heads, we’ve been told glutathione’s not absorbed, you gotta take NAC, that’s the only way to do it. If you end up in the emergency room with acetominophen toxicity, they’re going to give you IV NAC, so NAC’s the way to go. But now that we have these better forms of glutathione, like liposomal, how much is actually absorbed?

Dr. Shade:       Right, and so in … These total amounts absorbed in kind of vary and we’re doing a lot of research to show how much goes in and how these different approaches compare. But first, why would we do … Let’s just assume we get the liposome in and then we’ll come back to how well liposomes are absorbed, and what’s required for a liposome to be absorbed, because all liposomes aren’t the same. It’s like all cars are not the same, all wines are not the same. There’s a vast range of quality.

                       But first just assume that it gets in there. Why would you use that instead of NAC? Now in the cases of really compromised individuals who are very sick, people with lyme disease, mold toxicity, things where there’s actually blockages of the enzymes that are synthesizing glutathione.  For instance, there was a paper done using ready liposomal glutathione in cell cultures and they took immune cells from HIV patients, which are notoriously poor at making glutathione, and they’re getting all these infections because of the low glutathione. And that’s one thing that people miss about glutathione is it’s an essential factor for proper immune response, it’s not just about detoxification.  So they found in these cells, they were challenging them with the tuberculosis culture, they culture the white blood cells, the put tuberculosis in, and for the cells to be able to handle the tuberculosis, they needed to raise the reduced glutathione levels. And then the cells could deal with this. And they tried two ways to do it.  One was NAC, and the other one was liposomal glutathione into the cell cultures. And they needed 5,000 times more NAC to raise the glutathione levels up the way that the liposomal glutathione did. 5,000 times. Because those enzymes are epigenetically being blocked by disease states. So when you’re sick, just pouring NAC in, it’s hard to get the levels up. You’re healthy, that’s a good way to go. If you have snips for poor glutathione production, then you want to think about both as differing strategies.

                      Then liposomes, what gets in, what doesn’t. We’re actually in the middle of a study right now where we’re measuring all the different liposomes on the market and the factors that go in to getting these into absorption. And we just got a study back from our Japanese partners, we’ve got a bunch of Japanese doctors who use our stuff, they wanted data on glutathione, I didn’t have it yet, so they went and got Doctors’ Data, blood glutathione test. They took 10 people, measured baseline, gave 5 of them IV and 5 of them liposomes, 500 milligrams each. And then they measured them six hours later. To see not right away, if you do an IV you spike up, but often you spike right back down. So they said six hours later, what’s the effect on this system?  IV six hours later there was a 15% jump above baseline. Liposome, a 30% jump. Anything that gets you a 30% jump is awesome. But the fact that we just beat the IV, because the IV has no mechanism for really interacting with cells. Glutathione’s not really good at getting in the cells. But the liposome showed its ability to raise the levels for an extended period of time. It was a beautiful piece of work. But in all the other data that we’ve got on liposomes, the membranes have to be right and the size has to be right.

Dr. Weitz:       And by the way, liposomal basically means putting it in a fat soluble form, right? Essentially combining it with phosphatidylcholine.

Dr. Shade:      Well what you’re doing is using phosphorylcholine to make a little bubble that’s sort of watery on the outside, fatty on the inside. And you’re making like a little cell and you’re tucking the glutathione in there. And so it absorbs like a fat would. It passably diffuses across the upper GI. So that’s why they say it’s like it’s like fat soluble, because it absorbs like a fat.

                       But if you make them small enough, they pass right through the oral mucosa into the capillaries in the oral mucosa. In fact in the blood uptake studies that we did with vitamin B12, we had a very significant bump in the blood levels in two minutes after holding it in the mouth. That’s why with our liposomes you take them orally, you swish them around your mouth, you let them hold in there 30 to 60 seconds and you swallow. The uptake begins there. Even if … You get to the stomach acid and the bile salts, you’re starting to beat on those liposomes. So the faster you start that journey, the better.  And that journey only begins that far up in the GI tract when they’re really small. We call them nano liposomes because they’re below 100 nanometers. And all of our products are between 20 and 80 nanometers. This is not a threat, don’t worry about nano tech. Because when you’re absorbing fats in your diet, you make something called a chylomicron. It’s triglycerides surrounded by phosphatidylcholine with a couple of apolipoproteins that you use as delivery vehicles to bring the fatty acids to the cells to use them. And those range down to 70 nanometers in size. So those are lipidnanoparticles, and you have a whole enzyme system for dealing with phospholipid based nano particles to take them apart, use the phospholipids in your cells, in your membranes. You can use them as fatty acids for energy, you can make acetylcholine.

                    So this delivery system is really good but it only worked when we got it below 100 nanometers. And all this other stuff on the market is selling you the dream of the liposome but they’re 2, 3, 400 nanometers, and I just don’t see any evidence that they’re working. So we’re really spending a lot of money and a lot of time working out exactly what works and what doesn’t work. Alright, so that’s the glutathione story.

Dr. Weitz:     What about the idea of spraying some in your nose, because Dr. Vojdani was talking about how there’s a route of entry from the nose for bacteria directly into the brain.

Dr. Shade:     No, that’s a great idea but it’s not a dietary supplement, then it’s a compound pharmacy product. Because a dietary supplement has to go through the GI tract.  Don’t think I don’t have a couple of nasal applicators here in my office. I did that, but I can’t do it on the market. So there’s the story there.

                     So back to our detox story, we got glutathione in, and now we need to up-regulate the transferase and get all those transporters working. So now we want to invoke NRF2, which is the little switch, the protein inside the cytoplasm that when you activate it, it goes into the nucleus and turns on all the chemo protective genes. It’s like the light switch for all the protection genes. So you want an NRF2 up regulator. So the things that do that, lipoic acid is probably my favorite. There’s a number of compounds from crucifers, like sulforaphane is very well known but there’s some drawbacks with those. There’s things from garlic that work very well. And don’t get deodorized garlic because it’s actually the stink of the garlic that works, it’s garlic oil that does it.  Then polyphenols, I love polyphenols.

Dr. Weitz:     Resveratrol.

Dr. Shade:    Well resveratrol’s not a great NRF2. It’s more in the SIRT 1 activation, so mitochondrial up regulation. But it is a polyphenol. And then people say curcumin, and that’s not the best either. The good ones are green tea extract, pine bark extract, red wine extract, grape seed extract. The Ayrevedic polyphenols from haritaki is one I use a lot. So all of those are really good NRF2 up-regulators.

                     And with that comes glutathione S-transferase. There’s also a bump to glutathione synthesis in there. So that’s working, and there’s also a bump to the transport proteins. But to really get the transport system working well, I like to work from the GI–gallbladder–intestinal axis here. Why am I talking about that? Because the biggest transport system that’s happening here is from the hepatocyte into the bile ducts. And that transport of toxins into the bile tree is synonymous with and linked intimately with bile transport.  There are two transporters that move bile from the hepatocyte into the bile tree. And it’s the bile salt export pump and MRP2, the multidrug resistance pump number 2. The MRP2 is the toxin transport, it moves toxins and it moves bile salts, and obviously the bile salt pump moves bile salts. These guys get up-regulated and down-regulated in unison. So cholestasis is toxostasis. If you move bile, you can’t move -toxins.

                   So what happens to the toxins that are in the liver when you can’t move them into the bile? There’s another door out of the liver back into the blood. It’s a pressure release valve. When you wind up a bunch of toxins in the hepatocyte, and the hepatocyte can’t deal, it can’t move them out fast enough, it dumps them back into the blood.  Where do they go from there? Brain, neuroinflamation. Kidneys. Lower back pain. Skin, rashes and things coming out through the skin. These are all the classic detox reactions, and they’re all caused from a failure to continue to move bile. So we’re taking our cues here from the early 1900s and the prohibition time when bitters was the medicine for everybody because it was the only way to drink, but it also cured half of what ails you, because stuck liver was what was going on. And when you open up liver, bitters activate those transporters, and when you open that up and you dump bile, you dump toxins and you start feeling better. So we use a lot of bitters.  We use a lot of phosphatidylcholine just on its own, not even in liposomes, because PC is always being donated from the hepatocyte cell membranes into the bile flow because it helps fluidize the bile flow. People talk about thick bile, PC is what’s solubilizes it. And it actually forms little mixed micelles with the bile salts so that the bile salts, which are a detergent, don’t dissolve the bile tree.  And the reason you have pressure release valves from the hepatocyte is when bile salts build up in there, they dissolve the hepatocyte. And so you’re dumping those back into the blood and then bringing them up when you can use them. So when you’re always moving out, you’re always moving toxins out of the system.

                 But what else are you doing? You’re cleaning the upper GI tract. Everybody’s talking about SIBO and SIFO, like it’s a new infection. Do you really believe that you have an infection in the small intestine that has to be treated? Why do you have an infection? It’s not like a creature came in and is living there in a classical infection sense. It’s crawling it’s way … It’s just bacteria in your lower GI tract crawling their way into the upper GI tract. Because the upper GI tract is supposed to be washed by bile. The antimicrobial detergent that washes the upper GI tract and acutely brings glutathione along with PC into the upper GI tract as part of the metabolism in the upper GI.  Upper GI is doing mostly chemical reactions. Detoxing things in food, and pulling things out of blood and dumping them into that GI tract, and then the microbes start growing further on down. And in fact, in people with congenital intrahepatic cholestasis, meaning you’re not able to move bile salts from the hepatocyte into the bile tree, those people are statistically higher cases of SIBO, and when you treat them, it keeps coming back.

                 So this bile flow, this keeping things moving out, is a crucial part of keeping the transport chain open, keeping the liver open, and then coming in with binders to bind these toxins in the GI tract so you don’t absorb them. And that’s binders like our IMD, which is thiol-functionalized silica for metal, or charcoal. Clays and zeolites, Chitosan, those are all grabbing different parts of the toxin pool and we blend those all together-

Dr. Weitz:            What about pectins, like modified citrus pectin?

Dr. Shade:           Now modified citrus pectin, I don’t buy into that at all. So remember my … No, I buy into it’s use therapeutically, I don’t buy into the idea that it can bind toxins. Because remember my PHD is in mercury chemistry. I designed the whole analytical system we use to model out what molecules bound mercury as it moved from the sky to the rain to the bacteria to the plankton to the fish to the people. We know this stuff really, really well. And there ain’t nothing in modified citrus pectin that’s going to be a good toxin binder.

          But remember this, inflammation blocks detoxification. When inflammation is down, detoxification gets blocked because detoxification’s part of the antioxidant system and inflammation is pro oxidant. So they just go like this. And modified citrus pectin is a very nice immune modulator, especially in the GI tract, and it turns down inflammation in the GI tract. When you turn down inflammation in the GI tract, you release a stuck immune system and allow it to detox more. And I believe that that’s why modified citrus pectin has a therapeutic value in detoxification. And it probably does bind a lot of other toxins that are made, maybe it binds an endotoxin, maybe it binds some of the other dysbiotic toxins, maybe it gets a little bit of mold toxin. It does have a therapeutic thing but arguing for it mechanistically as a mercury binder is not a good path for the argument.

Dr. Weitz:            It’s interesting because it’s in a lot of products that are designed for removing heavy metals.

Dr. Shade:           Yeah. And again, I think therapeutically it works but not in the way that they’re describing. And my whole goal, my whole path here has been one of shedding light on the path, and the light is on the light of the mechanism that things are working. I am big into empirical medicine and knowing what’s worked and what hasn’t. But until you reduce that to mechanism, you can’t take the next step of effectively bringing together the best players for a different problem, and designing a higher order of natural medicine.

Dr. Weitz:            Right. Just a word on the SIBO. You know part of the theory about one of the reasons for SIBO, apart from decreased bile secretion, is that you get decreased motility and you get a blockage of the migrating motor complex which causes these peristaltic waves to happen in between eating that helps to clear out the small intestine.

Dr. Shade:           Flush, clean, flush, clean, flush, clean. You’re right. And so it has two sides to it. How do they get blocked, are they poisoned, is it a microbe, is it a toxin? But somehow they get locked down.

Dr. Weitz:            Well there’s that whole cytolethal toxin theory of Dr. Pimentel’s, and they even have a blood test for it.

Dr. Shade:           And what are those called?

Dr. Weitz:            It’s a cytolethal-

Dr. Shade:           [crosstalk 00:42:43] toxin?

Dr. Weitz:            It’s an endotoxin secreted by a campylobacter jejune or some form of food poisoning that secretes a toxin that then damages the nervous system of the small intestine.

Dr. Shade:           Yeah. And when you go into the body and you look at what really amplifies toxins-

Dr. Weitz:            It secretes a cytolethal toxin distending toxin.

Dr. Shade:           Cytolethal distending toxin.

Dr. Weitz:            Yeah, Dr. Pimentel has a test for it, I think it’s called the IBS check test.

Dr. Shade:           Okay, cool, I’m going to look more into that. Because things like endotoxin amplifies all the toxicity through the body because it’s pro inflammatory. And there’s papers looking at the damage of mercury alone and mercury plus endotoxin and it’s synergistically higher. And I was talking about those transporters that are moving the bile salts and the toxins. Well what blocks them the best? Endotoxin. And it actually causes the transporters to be pulled out of their membrane and internalized into a little vesicle in the hepatocyte. And you really want to damp the inflammation, get those transporters back in there to drain everything out.  And it was great, we put a paper, Carrie Decker and I wrote a paper in Townsend Letter about all these pathways and nutraceuticals work on these things. And one of the interesting things about milk thistle is that it actually preserved the transporter’s ability to stay in the membrane during the stress of high toxicity.

                           But another thing that blocks that is excess estrogen. And something that opens it up is progesterone. So there’s estrogen progesterone balance, estrogen dominance actually locks up your gallbladder. And in the brain estrogen dominant winds up the glutamate system which gives you anxiety, it makes you sympathetic dominant. But the gallbladder’s also para sympathetically innervated, so it’s working against you on so many different levels. So stress, estrogen dominance, leaky gut and endotoxin, all this is blocking your ability to detoxify.

Dr. Weitz:            And Dr. Vojdani at Cyrex Labs has a test, it measures anticytolethal distending toxin and also vinculin. That’s the part of the small intestine that gets damaged and they have a test for that.

Dr. Shade:           See me writing all this down. Distending toxin, I like that. Alright.  See, this goes back to understanding mechanism. The more we understand mechanism, the more we can reach out to other people that are working in different fields and say let’s bring this together and really let’s lock this down. And it’s an amazing time in the whole history of natural medicine where you go into PubMed and you see that there’s research being done all over the world on all the different natural compounds and the genes they hit, the proteins the express, interactions between the two. We’re getting all of the mechanism of all these transporters all down. This is a brilliant time where we can design the most powerful natural medicine systems.

Dr. Weitz:            That’s great. This has been an awesome discussion, Dr. Shade. So for listeners and practitioners who are interested in getting some of this testing done, or getting a hold of your products, are the testing and products available to laypersons or should they just go through functional medicine practitioners like myself? How does it work?

Dr. Shade:           Yeah, so Quicksilver Scientific is dominantly a professional company. We’re offering the testing to the practitioners, they pass it through. You guys buy the supplemental through wholesale, you pass them through. You use our protocols or individual products. But there’s such a world of hyper informed self medicators out there, and they’re dying for this stuff and I gotta give it to them because that’s me, too. And so we do sell direct to consumer all but some. Like there’s some real pro-grade stuff, like the EDTA, that’s practitioner only. But most of the other stuff is available. Even the testing, but but that’s state by state, about half the states allow direct access testing where you can buy a kit from us, go to to a clinic, get the blood draw done and send it back.  But it’s always good to go through a practitioner, because they’re going to bring a wealth of experience of all the other things that they’ve seen. And they’re going to button up the whole protocol and they’re going to put the little extra things you need in there. There’s “Oh no, did you think about doing this and this?”  So both are available, but we’d like people to work with practitioners.

Dr. Weitz:            That’s great. And for those who want get more information, where should they go?  

Dr. Shade:           Quicksilverscientific.com. And we have a whole new website being launched in about two weeks. Right now Quicksilver Scientific, if you’re buying as an individual, it will move you over to Quicksilver Life, our second website, which is a retail website. But they’ll all be merged together as Quicksilver Scientific in about two to three weeks. And there’s different things, it’ll be one site with different things available to you depending upon your journey in there, there’ll be more stuff available to the practitioner.

Dr. Weitz:            That’s great. Thank you, Dr. Shade.

Dr. Shade:           Great, thank you so much, it’s been great hanging out here with you, Ben.

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