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Detoxification with Dr. Bryan Walsh: Rational Wellness Podcast 77

Dr. Bryan Walsh discusses proper detoxification with Dr. Ben Weitz.

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Podcast Highlights

3:04  Dr. Walsh had the typical health care provider’s view that we are all toxic and we should detoxify when we can. But then he heard a detox guru talking about phase three detoxification and it didn’t accord with his understanding of it.  Secondly, he learned that there was a phase zero detoxification. Thirdly, he had read that there was a biphasic response to toxins in that certain nutrients at a low dosage increased detoxification enzyme activity, while at a higher dosage it inhibited the same enzyme for detoxification.  This meant that the amount of some of these nutrients found in food would stimulate detoxification, while the concentrated, isolated forms and the amounts found in supplements such as in detox formulas and powders might actually be inhibiting detoxification.  This led Dr. Walsh into doing a deep dive into the scientific literature and to formulate a detox program that does not include a lot of supplements.

8:24  Which toxins each person gets exposed to has to do with your socioeconomic status, your occupation, where you live, your lifestyle, what kind of cosmetics and cleaning products you use, your water, and your air.  When you look at the data from National Health and Nutrition Examination Survey data from the CDC, we’re excreting all kinds of toxins, including heavy metals like mercury and arsenic, organophosphates, organochlorines, and aflatoxins from mold.  Some toxins exert oxidative stress and others are endocrine disruptors and may disrupt the thyroid, sex hormones or adrenal function.  Toxins may also have a direct cytotoxic effect on our cells.  Some toxins affect the endocrine system, while some have more of an effect on the neurological system and the brain.

13:52  Dr. Walsh doesn’t like most of the serum or urine tests for toxins and prefers using questionaires.  Here are two of the questionaires that he finds helpful to screen for toxic exposure:  http://www.eha-ab.ca/acfp/docs/taking-an-exposure-history.pdf  and  http://familymed.uthscsa.edu/qeesi.pdf

19:22  To properly detox you have to do three things: 1. Mobilize, 2. Optimize the detoxification pathways, and 3. Promote excretion. To mobilize, you want to go on a hypocaloric diet so that you start breaking down fat stores, which will mobilize toxins stored there. You should also use a 6-8 hour time restricted eating period, which means that you should have your two or three meals within an eight hour period of time and have no food the rest of the time. To optimize the detox pathways, this is heavily nutrient dependent, requiring certain vitamins, minerals, amino acids, and other nutrients.  You need methyl groups, you need sulfur groups, you need glutathione, you need certain amino acids, like glycine. To promote excretion, you have to sweat, so Dr. Walsh recommends using a sauna.  You want to drink a lot of water, so that you urinate.  You want to consume enough fiber so that you poop and include some binding agents to insure that the toxins leave the body.

28:18  Detoxification does occur in the liver, but also in the kidneys, the enterocytes, and even in the testes.  The four phases of detoxification include phase zero, which is the entry of these environmental pollutants into the cells. Phase one makes the fat soluble compound water soluble by adding a hydroxyl group. But it also produces a toxic intermediate, so it is important that phase two be sufficiently upregulated so that these toxic intermediates go through conjugation or sulfation or methylation or glucuronidation or glutathione or acetylation.  Then phase three takes that water soluble detox product out of the cell to be excreted through stool, urine or sweat.  You need to be careful to avoid nutritional supplements like curcumin, piperine, and milk thistle, which inhibit phase three of detoxification. For excretion, it is important to include fiber and binding agents, like bentonite clay, charcoal, and chitosan.  And it’s also crucial to sweat, such as by using a sauna, though Dr. Walsh does not like steam rooms, unless you are using purified water.  But overall, Dr. Walsh is not a believer in taking a bunch of nutritional supplements for conducting a detoxification program.  For example, when you take curcumin via food, it enhances phase III detoxification, while curcumin as supplement decreases it: https://www.ncbi.nlm.nih.gov/pubmed/18439772

43:17  Dr. Walsh also recommends as part of his 10 day detox program, 4 days of a modified Fasting Mimicking diet.  He cites the work of Dr. Valter Longo from USC who has published research on the anti-aging benefits of it, though he is not worried about the issue of a low calorie diet mobilizing toxins, which Dr. Walsh is concerned with.  So Dr. Walsh uses the same macronutrient ratio recommended by Dr. Longo, which is basically a low protein, ketogenic program, though Dr. Walsh recommends including foods that facilitate detox.  While Dr. Longo recommends the same amount of low calories to everyone, Dr. Walsh recommends low calories, but with the exact amount of calories based on your weight.

 

 



Dr. Bryan Walsh is a board-certified Naturopathic Doctor who sees patients and teaches at the University of the Western States and is an expert at detoxification. Dr. Walsch’s web site is drwalsh.com and he offers a course on detox for patients https://www.metabolicfitnesspro.com/walshdetox/  and also a course on detox for other doctors and practitioners: https://www.metabolicfitnesspro.com/everything-you-wanted-to-know-about-detoxification-2/

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 and also weight loss, as well as sports 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.

Hello, Rational Wellness podcasters. Thank you so much for joining me, again, today, Dr. Ben Weitz here. For those of you who enjoy the Rational Wellness Podcast, please go to iTunes and leave us a ratings and review. That way, more people can find out about the Rational Wellness Podcast. Today we’re here. We’re going to speak about detoxification, getting rid of toxins from our bodies. We all are probably aware of the fact that we live in an environment in which there are toxins in the air, in the food, pesticides, chemicals in products that we put on our skin, use in our house. We have tons of information that we been exposed to about all these different toxic substances that get into our bodies and, potentially, have negative health affects.

Today we have Dr. Bryan Walsh, who’s a board certified naturopathic doctor, who sees patients, teaches courses in biochemistry and physiology at the University of Western States. He’s also scientific advisor at Lifetime Fitness. He’s devoted a considerable amount of time researching and writing about the concept of detoxification to help us to get rid of some of these toxins. That’s what we’ll be discussing today, his particular approach to detox. Dr. Walsh, thank you for joining me today.

Dr. Walsh:           Thanks for having me. It’s a pleasure to be here.

Dr. Weitz:            How did you get interested in detox as a particular topic?

Dr. Walsh:           Well, that’s a great question. I’ve been steeped in the health world for a long time, well before I became a naturopathic physician. I started out as a fitness professional a long time ago, read up on nutrition as much as I could. I was a massage therapist. I was really into that world and it doesn’t take long being in that world to come across this concept that we’re all toxic and we’re going to die if we don’t detoxify. You’re introduced to all these different ways of supposedly detoxifying your body from foot baths, to colonics, to you can see people online saying, “Drink a little bit of lemon juice in the water. It’s a great way to detoxify the body,” and all these different claims.

My initial, I guess, exposure to this whole concept was that of what everybody else’s is. We’re super toxic. It’s killing us slowly and if we care about out health, we should probably detoxify. And that was it for a really long time. Then, I forget the specific time, but there was a time, recently, I’d say maybe this year or last year. I heard a particular detox guru talking about phase three detoxification. Which most people in this industry have heard of, it’s been around for a little while. I think phase three might have been discovered in the early ’90s. The way that he was describing phase three didn’t entirely jive with what my understanding was. This guy is a guru, I’m not. At least, I don’t consider myself to be. I thought, “That doesn’t really … that’s not right. I don’t think.”

I decided to go into the scientific literature and say, “What is phase three really?” I’ve heard a lot of people say a lot of things about phase three. What it is, what it’s not. I decided, I was like, “I’m not going to listen to anybody else, I’m going to do this myself.” You know how PubMed works. Where you go in and you read a paper. Then it’s cited in other papers and then you go down, the next thing you know, you have 50 tabs open in Firefox or Chrome and you’re reading all these papers. This little mini dive to just trying to figure out what phase three was three things happened.

One was I realized that this guru, who’s teaching people about phase three to sell his supplements, wasn’t entirely accurate. I have a problem with that, as we were just talking about that prior to this interview. In this space, whatever you want to call it, Functional Medicine, nutritional medicine, alternative complimentary medicine. We need to be 100% accurate with what we’re talking about, because we’re so intensely scrutinized by conventional medicine. First of all, the way he was describing phase three to practitioners wasn’t entirely correct.

The second thing that I saw was that there’s a phase zero detoxification. Which, I’ve been in this business for a long time, and I have never heard anybody ever, at any time, utter phase zero. I thought, “Wait a minute, what is this phase zero, that I’ve never heard about?” If we’re talking about detoxifying people, it should be a part of this conversation that we’re having. So, that blew my mind.

Then the third thing, and this may have been one of the things that really sealed the deal for me, was I started reading about what’s called a biphasic response when it comes to certain compounds, or nutrients, or herbs, or minerals, whatever. This biphasic response, specifically in these papers, was talking about how, at a low dose, increases certain detoxification enzyme activity, but, at a high dose, inhibits the very same enzyme for detoxification.  I thought, “Well, wait a minute.”  A low dose would be the kind that you find in food.  So if you were to eat the herb, itself, or to take turmeric, for example, for its curcumin content that, that might stimulate detoxification.  But these papers didn’t explicitly say this, but in a high dose, which I read as, isolated, concentrated, supplement form.  Trying to get as much of the herb, or nutrient, or compound in your body, as possible, might inhibit detoxification.

When those three things happened … All it was, was this guy was talking about phase three. I thought it was wrong. I decided to look it up myself. A, he was a little bit wrong about phase three. B, there was a phase zero that I never heard about. And, C, I really wondered if what we’re doing, as an industry, if we were actually detoxifying people, or not, by giving people these powders, and potions, and supplements in concentrated, isolated forms when the studies were pretty clear that many of the things that we’re using in detoxification formulas might actually be inhibiting detoxification. Then I though, “Oh my gosh, I need to completely get any bias out of my head. Everything that I though I knew about detoxification.” Wiped my brain clean. Wiped my desk clean. And I started from the very top. I said, “All right, what have I heard? That we’re toxic. All right. What does the literature really say? Are we, in fact, toxic or not?”  Two was, are these things stored inside of us? We hear that they are. Is there a synergistic effect of multiple low-dose toxin exposure all at the same time? We hear that, but what does the scientific literature say? Does the dose matter? We hear that the dose makes the poison. And, at the doses that we’re probably exposed to, that it’s not going to cause a problem, so I wanted to look into that.

 Then after answering all these, I guess, basic questions that you and I have heard about for a really long time in this industry. If those are true, if we do have exposure, if it does get stored, if it is causing damage, if there is a synergistic effect, if the dose doesn’t matter, and if a low dose can cause just as much damage as a high dose, what can we do about it? What does the scientific literature say or suggest is the most efficient and safe, I will add, safe, efficient, effective ways of actually detoxifying the body, and assessment. That was a big … How do we test this? You know the labs. There’s labs out there that are supposedly these toxin panels and will … What does the literature suggest about those, as well?  That was the dive. I ended up reading over 300 papers on this topic over the course of months.  That’s my story with this.  So I have come up, now, for air again with a brand new view of what detoxification is.  With really solid answers to those questions that I feel very confident talking about, in fact.

Dr. Weitz:            Okay, maybe we could start by just talking about what are some of the most common toxins that we get exposed to in our environment, and get stored in our bodies. What are some of the health consequences of some of these?

Dr. Walsh:           That’s actually … That’s interesting. That’s a difficult question to answer, because … Well, I just give you an example. There was one specific paper that I found that said that based on one’s socioeconomic status, we are exposed to different toxins.  For example, somebody might have a garden in their backyard, and they’re, therefore, spraying pesticides.  But somebody with a lower socioeconomic status might eat more fast food and, therefore, are more exposed to certain other toxins.  A certain class might use more, what’s it called, sunscreen on themselves, or their kids, or certain cosmetics.  They’re all common.  When you look at the NHANES data, in terms of what people are excreting. We’re excreting everything. We’re excreting everything from elements, so things like arsenic, and the heavy metals, mercury, aluminum. We are exposed to a lot of organo-phosphates and organo-chlorines that persist of organic pollutants. We’re exposed to … Some people might be exposed more to aflatoxins, because they have mold exposure, which other people don’t.

I actually think that’s a really difficult question to answer, because it depends on, well, according to studies, your socioeconomic status, the job that you have, where you live. We’re out in well-water country. I can tell you that we don’t use any pesticides in our yard garden, but I drive down the road, and these farmers around us are spraying who knows what. That’s absolutely getting into our water.

Dr. Weitz:            Absolutely.

Dr. Walsh:           But, on the other hand, and somebody that lives in an urban society and is drinking city water. They’re going to have different exposures. So it depends on your lifestyle. What kind of cosmetics and cleaning products do you use? What kind of food you eat? The water, the air, all these things. I think it’s difficult to say what are the most common ones, because that really will be specific to one’s diet, lifestyle, job, where they live, for example.

The second part of your question is the damage. That was another question I had. We hear these things are so bad. Well, why? Why do they cause problems? And it turns out that depending on the specific, I’ll call it a toxin, they’re really xenobiotics or environmental pollutants. Or the class that they’re in, they really do exert different effects. One of the most common ones, though, that across the board is oxidative stress, surprisingly. I didn’t know that, that was going to be the case, but in many individuals that have multiple chemical sensitivity, they exhibit a tremendous amount of oxidative stress. Other ones, you hear them as endocrine disruptors, but what does that really mean?

It turns out the stuff is so compelling, though, when you look at it. Depending on the environmental pollutant, let’s just talk about thyroid. Just about every single aspect of thyroid hormone physiology can be negatively impacted by an environmental pollutant. So, starting up at the top, the hypothalamus, the pituitary, TCH, thyroid’s ability to bind onto … thyroid binding globulin on the receptor, itself, and conversion on the thyroid’s production of this, every single step. We often think of the sex hormone, that these are all estrogenic. That’s not entirely true. There are some that have been shown to suppress adrenal function, and suppress cortisol, for example.

Then there’s other ones that have direct, what I call cytotoxic effects, on a cell. For example, certain ones might mess up the membrane of the mitochondria. Other ones might negatively impact some of the enzymes involved in the citric acid cycle, or the electron transport chain. Other ones have more indirect effects, like with the immune system, and then that will have system-wide effects. It’s really … There’s so many of these things out there. There’s so many classes of these and they all exert different effects. That it’s hard to say. Some of them exert more neurological symptoms, whereas other ones might impact the endocrine system more. It really depends on the environmental pollutant and what specific effects it causes. But …

Well, here’s another quick one. In the scientific literature, so many chronic conditions have been linked back to xenobiotic or environmental pollutant. Things that you don’t … I mean, of course, the neuro developmental things, like ADD, ADHD, and autism, as well as, things like Alzheimer’s and Parkinson’s. But then there’s things, like obesity, things we never think of, but the studies are really clear, cardiovascular disease, atherosclerosis, hypertension, and even diabetes. Some of these papers say the correlation is so strong that, perhaps, xenobiotic exposure is, not only associated with diabetes, but maybe a significant contributor.  Anyhow, that just speaks to the fact that it depends on what it is, but it can impact virtually any part of a cell, the mitochondria, the pliable membrane, the endoplasmic reticulum, enzymes, transporters, hormones, neurons. You name it, they can cause damage in some way.

Dr. Weitz:            What’s the best way to screen to see what kinds of toxins that we have in our body?

Dr. Walsh:           That was disappointing to me. When I looked into the literature to see what really was the … That’s the big question, of course, because … So, right now, what have we talked about?  Yes, we’re exposed. There’s absolute proof that they’re stored. They do cause damage. Then the next rational question is, all right, well, how toxic am I? When people are talking about how toxic they are, what they’re actually asking is, what’s my total toxic load or total body burden? Which is really to say, “How much do I have stored in my body?” That’s really the question. And the problem is, there’s no way to assess that. There’s no way to evaluate that. I know that people, “Well, what about the hair tissue mineral analysis test?” No. What about the urinary test to show excretion? No. I can go into some of the reasons why too.

One of the gold standards in toxicology, when evaluating this, is a fat biopsy. That’s really what we’re looking at … How much is stored in fat? Well, it turns out that for a variety of reasons, and there’s papers on this too, that suggest that you have different amounts of stored xenobiotics in subcutaneous fat, than you do visceral fat, than you do in different fat depots in different areas of the body. And these papers say that, that doesn’t correlate to serum levels, so you can’t do a blood test and say that, that reflects you and what your storage is, because it may differ.  Then there was one, and this is a rodent study, so you have to take that into consideration. Well, here’s a good example. Let’s say you and I, right now, let’s say we practice in the same area. We live the exact same lifestyle, exact same exposure. You’re following a hypocaloric diet, right now. Intermittent fasting, time restricted feeding, hypocaloric diet. I’m stuffing my face, standard American diet. I’m eating more than my basal metabolic rate. We both go to do a test. Now, because you’re in a hypocaloric state, you’re probably mobilizing more of your stored xenobiotics, and every mammal study says that. That when there’s a hypocaloric, or fasted, state, serum levels of xenobiotics go up every single time, every single mammal, including humans.

Now, I’m in an anabolic state. I’m storing things. When we go to do this toxic panel, you come out sky-high in all these toxins. And you see your practitioner and they’re like, “Oh my gosh, you are so toxic. You must do a detoxification program.” Then, me, because I’m in an anabolic stuffed fed, overfed state. That mine are probably stored. And my levels, on my test, might come back as normal or low. And the practitioner says, “Wow, you’re not toxic, at all.” When, in fact, I might be far more toxic, in terms of my storage, than you are, but you’re in a hypocaloric state. Right there, that totally negates … It’s a severe confounding variable when considering assessments.

Then the last one, that rodent study I was going to say, they showed that when these … They put these rats on a yo-yo diet, poor rats. They would go hypocaloric and their xenobiotic levels would go up in their blood. Then they’d make these rats hypercaloric and guess what happened? These xenobiotics went into different tissues. You might have a certain amount in a certain fat depot in your body that does get mobilized, but then it’s going to go somewhere else depending on your caloric state. In terms of screening, all of this is my opinion. It’s based on the scientific literature, but people can use it how they want. Is there is some pretty good questionnaires that are out there, that are in the … They’re validated questionnaires in the scientific literature that, I personally, think are amongst the best ways of screening if we have toxic exposure or not.

Dr. Weitz:            Can you mention which ones those are?

Dr. Walsh:           There’s a whole bunch of them. One of them is abbreviated and I forget the actual … It’s [Quesy 00:17:59]. If you do links to this in your show notes, we can-

Dr. Weitz:            Yeah, I will. Yeah, maybe you can email me.

Dr. Walsh:           That one’s the most elegant. It’s fairly long. I’ll give you a couple of them that I like for two reasons. One is this one is very comprehensive. It’s not quick, 10 questions, are you toxic or not. It looks at a variety of things from your actual physical exposures and your lifestyle, as well as symptoms across a variety of systems in the body. And I think is really very comprehensive. The benefit of some of these, though, is it forces you, when you ask these, or answer, these questions to jog your memory to see what your exposures might be that you are totally unaware of. Right now, you can say, “What are my exposures? I drink reverse osmosis filter water. I eat organic food. I use coconut oil for my lotion. Apple cider vinegar for my deodorant. I don’t have any exposures.”  But when you go through some of these questionnaires that have these questions, you say, “Oh my gosh, I work in a building that whatever.” They’re really good at helping, not only see if you might have a certain amount of toxicity, if you will, but also what the sources might be.

Dr. Weitz:            Okay. In your concept of detoxification … Actually, you were talking about the phases of detoxification. I’m not sure everybody even knows what phase one and phase two are, and you were talking about phase zero and phase three. Well, actually, your concept of detoxification, you have three basic principles, and then you list the phases in a second one. Maybe we could go through your three main important principles of detoxification that you outline in your program.

Dr. Walsh:           Yeah. And, again, I humbly will say that I think my … I’m a teacher, not by choice, I think I was born into it. When I look past throughout my entire life, everything has been teaching. I say that because when I go through what these three principles are, there’s a feeling you know that being empowered just feels amazing. That you feel like that you know enough information that nobody can pull the wool over your eyes. That you’re an informed individual. So by teaching these three things, these are just … These are principles that must be in place for anything to call itself a detoxification program. I say this so that when people are evaluating, “Well, what about this detoxification?” They can run it past this list of three things.  The first thing that for something to call itself a detoxification, that it absolutely must include is mobilization. You have to get these things out of storage.

Dr. Weitz:            I thought you were going to say it has to come in a box, just kidding.

Dr. Walsh:           No. It can, if it’s a well developed one, it absolutely can, UPS, no.

Dr. Weitz:            Okay.

Dr. Walsh:           You have to mobilize in the first place. The best ways to mobilize, that I’ve seen, and also makes physiological sense, is to go on a hypocaloric diet. Now, i think a calorie restricted diet, I also believe a time-restricted feeding in a window of about six to eight hours, is probably the best. And all that calorie restriction means is less than, essentially, your basal metabolic rate. Exercise. So the technical word is, lipolysis, which is the breakdown of the lipids, or fat cells, but that’s where the majority of these things are stored. When you are in a state, a catabolic state of lipolysis, you do get mobilization of toxics, period. This is not conjecture.

Dr. Weitz:            Right.

Dr. Walsh:           Every mammal study that I’ve looked at, including humans, when people, or mice, or monkeys go hypocaloric, their levels in the blood go up every single time.

Dr. Weitz:            You’ll have to admit that virtually every detox program out there involves some sort of modified fast or fast. They pretty much all involve eating less foods.

Dr. Walsh:           Right.

Dr. Weitz:            So this concept, I think, is incorporated in most of the commercial detoxification-

Dr. Walsh:           Whether they knew it, or not, right. It absolutely involves that.

Dr. Weitz:            Right.

Dr. Walsh:           The second thing, then is, and this speaks to those phases of detoxification. You have to optimize detoxification. Step one is to get them out swimming in your body. All these things, now, are mobilized. They’re going through your blood. You are not going to get rid of them. These are the fat soluble ones that you do not, you cannot … The normal routes of excretion are any water forms of excretion. You can sweat it out. You can urinate it out. There’s a little bit of water in stool, so you can poop it out. You can, technically, salivate it out, or if you cry a lot, you watch a lot of This is Us reruns, then you can cry it out, technically, through tears.

Those are all … I mean, in theory, you could measure any one of those as a form of toxin … Those are all measurable things. We have to take these things that are fat, they like fat, and turn them into things that like water, so we can get rid of them. Those are those four phases of detoxification; phase zero, phase one, phase two, phase three. You have to optimize those. If you’re not, then these things just go in the body and you can’t excrete them, because they’re still fat soluble. Then the third, and last one is, you have to focus on excretion. I’ll just take a step back and say, “Let’s talk about different detox programs to see if they fit those things.”

Mobilization, improved detoxification pathways, and then to really, really facilitate excretion in some ways. Let’s say that somebody were to do a juice fast, some popular juice fast where the juice comes in a box, or maybe they’re just juicing things on their own. Are they in a hypocaloric state? Probably, if all they’re doing is just drinking juices, they’re probably in a hypocaloric state. So they’re probably mobilizing, and that’s fine. Step two is, are they improving detoxification pathways? Now, it depends on what they’re consuming. There are studies that suggest that things commonly juiced, things like carrots and celery-

Dr. Weitz:            We’ve had a technical difficulty, so we’re going to continue this podcast. We’re not exactly sure where we left off, but hopefully we won’t have any lost train of thought. So, go ahead Dr. Walsh tell us more about detox.

Dr. Walsh:           Yeah, no problem. You can tell me if I’m going too far backwards. I was saying the three things that are required in order for somebody to do a detoxification program; mobilization, optimizing detoxification, and then optimizing excretion. Those three things are critical. Then what I said was if you go back, and you start evaluating things that are supposed to be detoxification programs, where they detoxify the body, they have to have those three things. So, just a juice fast, is really common. You mentioned that most juice fasts are hypocaloric, so they probably are increasing mobilization. But then, I think this is the part that we got a little bit glitchy, is depending on what somebody’s consuming, you may, or may not, be either stimulating or inhibiting detoxification pathways. The things that have been shown in the literature to stimulate detoxification pathways, people typically aren’t juicing things like, broccoli, for example, or cabbage, or possibly things like mung beans, which aren’t really juiceable.

Dr. Weitz:            But it is the case that detox is a nutrient dependent process, right?

Dr. Walsh:           Absolutely. Well, yes. I mean, if you want to really get into the biochemistry of it, there are a number of different micro-nutrients, vitamins, and minerals that are even required for these pathways to be taken place in the first place.

Dr. Weitz:            Right.

Dr. Walsh:           In phase two, which I’ll get to, but just really quickly. You need methyl groups, you need sulfur groups, you need glutathione, for example, you need certain amino acids, like glycine. It’s heavily nutrient dependent.

Dr. Weitz:            Hence, the concept of trying to put together a program that has concentrations of these nutrients has some basis in the science, right?

Dr. Walsh:           Totally. Here’s the point. Is a juice fast a detoxification program? From the mobilization standpoint, yes, it probably is. You will be mobilizing. But from optimizing detoxification, I think that, that’s highly skeptical. And it depends on what somebody’s juicing. There’s some evidence in the literature that things that people usually juice, like apples, carrots, and celery may actually inhibit certain detoxification pathways, so then, that’s questionable. Then for excretion, if somebody is just doing a juice fast, they are not doing anything to enhance excretion. In fact, if they’re only consuming juice and, therefore, not fiber, and we can go into great detail on this, or not, but they’re probably urinating, and that’s fine. If they’re not sweating, that’s a huge problem. It’s a huge problem when it comes to detoxification.

Certain things are preferentially excreted via sweat, other ones are preferentially excreted via biliary, in the bile and the gastrointestinal tract. If you’re not sweating, or your not binding things up severely in your gastrointestinal tract, and in the juice fast, you’re not, then you’re not excreting. I, myself, would say that a juice fast is not a detoxification program. Yes, it mobilizes whether, or not, it increases detoxification pathways depends on what you’re consuming. Then the third one, excretion, I’d say a big, no, to that.

Does a colonic, is that a detoxification? Well, if you’re not mobilizing, then, no, all you’re doing is your moving things through your bowels faster. Which is great, that’s excretion, that does nothing for the second step detoxification of the first step, mobilization. That’s what I really want people to do is to be able to look at a detox … something that is allegedly a detoxification program, and say, “Does this increase mobilization?” Check, yes. “Does this increase detoxification pathways?” That’s a big one. That’s questionable with a lot these nutrients that people are using in powders, and supplements, and capsules. And excretion, is just saunaing detoxification? You maybe excreting things that you had swimming around in your interstitial fluid, technically, but not out of your cells, because you might not be in that mobilized state.

Dr. Walsh:           So those three things are critical for something to be called, to truly, truly be called a detoxification.

Dr. Weitz:            Can we go through those detox pathways? People typically talk about phase one and phase two of detoxification. It’s phase zero and phase three that are the newer ones. Typically, people talk about phase one and phase two as related to the liver, correct?

Dr. Walsh:           Yeah, well, and that’s not true, at all. When people talk about these … I’ll tell you what the phases are, then we’ll talk about why it’s not just a liver. The liver happens to be a huge organ and, yes, it does this, but the kidneys do this very well. The enterocytes of the intestines do this very well. In men, it turns out the testes, actually, do this very well also. Which isn’t surprising, given the role of the testes in terms of, essentially, passing along somebody’s DNA in that xenobiotics. If one couldn’t detoxify well down there, then that could really disrupt somebody’s …

Very simply, if you’re to picture, like a box. I’m trying to look for a prop real quick, but I don’t have one. If a box is a cell or, you’re in a room there. I would say, if somebody’s in a room it’s pretty easy to picture. If this room has two separate doors, this is as simple as it is. Phase zero is quite simply the entry door into your room, which is the cell. Your cell has a nucleus and mitochondria. It has a computer. It has lights and electricity and ATP. That first door is phase zero. That’s the entry of one of these environmental pollutants inside of a cell. You can say a liver cell, but it’s not the only organ that does this. It comes in, now, it’s inside the liver cell. We’ll say it’s a person came through that door.

Then phase one is biochemically not too challenging, but I’ll say what it does biochemically and then I’ll change it back to this metaphor or analogy. Phase one makes that fat soluble compound, first of all, makes it water soluble. It does so, not exclusively, but either by adding what’s called a hydroxyl group or exposing one that was already there. Now, this has this hydroxyl group on it. It’s water soluble. The way that I use this as an analogy. If somebody walked through the door, phase zero. They’re now inside the cell and you, put a sticky note on their forehead, just right on their forehead, or you start berating them, “You suck as a human being. You’re a horrible, miserable, ugly, smelly human being.”

Now, and that’s phase one. Now, this person is really angry. Who wouldn’t be if you start to berate … and they have a sticky note?  So they start trashing your room. They throw your computer across the desk. They start knocking lights over. They start doing all these things.

Dr. Weitz:            Fake news.

Dr. Walsh:           But in a cell, after phase one, and this isn’t across the board, all the time, but it’s actually considered to be more damaging to the body than, in some cases, the original environmental pollutant was, after phase one. You just berated this person, “You’re fat, ugly and your breath stinks.” Now, they’re really, really mad, but that’s phase one. But phase two is collectively called conjugation, and conjugation means, to add something.  Now, in phase two, you’re like, “I’m so sorry. Here’s $100 bill.” Well, the person may have had hurt feelings about what you said, but now you gave them $100 and they’re not angry anymore. After phase two, it’s still water soluble, but it just got $100 bill. It’s not going to damage anything inside of your cell anymore. It’s not going to damage your room. Now it’s a happy person. You made fun of it, it was angry, it started messing things up after phase one. Phase two, you handed it something, now, he’s happy.

Dr. Walsh:           Now-

Dr. Weitz:            Now, let me just stop you for one second. So the story that’s often told about detox, especially from some of the companies that provide these detox programs is, phase one produces a toxic intermediate that’s why if you just do a juice fast you get all these toxic reactions, and headaches, and all these negative things. You have to have the right nutrients that help support phase two, so you take that toxic intermediate, put it into a water soluble form so it can get excreted. Therefore, you support phase one and phase two, and that’s the end of the story.

Dr. Walsh:           Yeah. That’s a good story, but if the intermediate metabolite, after phase one. With that hydroxyl group, it’s technically a free radical. Now, I haven’t seen too many people that get sick from free radicals, if that makes sense?

Dr. Weitz:            But doesn’t that explain when somebody does a juice fast and they have toxic reactions-

Dr. Walsh:           I think that part of it-

Dr. Weitz:            – and the amino acids and the other nutrients for phase two.

Dr. Walsh:           I don’t know. I’m not convinced that, that … It might be because of mobilization, and they’re not excreting things. I don’t know if it’s only because it goes through phase one. Technically, I mean, they’re water soluble, but technically it’s still inside the cell. It hasn’t gone out of the cell yet, so that’s a good story, and it might be true, but I don’t think there’s any proof as to that’s what’s causing this.

Phase two is the conjugation. You hand them $100 bill, or in the case of actual biochemical pathways, sulfation hands to the sulfur group, methylation hands to the methyl group, glucuronidation hands to the glucuronic acid, glutathione gets glutathione glycine, acetylation gets in the acetyl group. That’s the $100 bill. Now, it’s water soluble and happy. Now, it has to get out of the cell to go back into the interstitial fluid, which is water, to be excreted. That’s the other door and that’s phase three. Now, here’s the problem. There’s certain things that can block phase zero, like diesel exhaust has been shown to block food. It’s fairly new. It’s only been discovered in the early 2000s. But phase three, curcumin blocks phase three, piperine from black pepper, which is usually used with curcumin to make it more available, blocks phase three. Milk thistle, honestly, is a mild phase three inhibitor, as well.

And here’s the thing, so now you have this happy person that could leave that third door. Then you’re done with them. You’ll never see them again, because they get excreted. But here’s the problem, you know, beta glucuronidase, which undoes glucuronidation. There are other enzymes that can undo conjugation, which to put it back into the metaphor is, there are things that can take that $100 bill away from that person, whether it was sulfation or methylation. Can take that $100 bill and, now, they’re the intermediate metabolite again. If you block phase three, and that person, metabolite, after phase two stick around inside that cell, now, the conjugation reaction can be undone. Now, it’s back in the intermediate metabolite. That’s why making sure that … This becomes my opinion, at some point here, but I don’t know that we should be taking a lot of supplements when it comes to a detoxification program. Because the reality is, and I can go head-to-head with a lot of people on some of these things, it’s really hard to say whether something actually improves detoxification or not.

Not from enzyme activity, or MRNA expression, for these proteins. There are all these things, but if it actually … What I’ve looked at, which is biphasic response, is that food, and the doses that are found in food, will generally stimulate detox … There was one great paper, by the way, that looked at food-based curcumin and isolated curcumin. Food based stimulated detoxification pathways and isolated absolutely inhibited. In fact, conventional medicine … Think about cancer, think about chemotherapy. What they really want is to keep that chemotherapeutic agent inside of the cell, so that it can fight cancer, correct?

Based on what we’re saying is that best way to do that is to block phase three. If you close that second door, you keep inside that cell whatever is inside that cell. If it’s a chemotherapeutic agent, that’s what you want to be able to exert more of an effect on cancer. What is conventional medicine using as a potential phase three inhibitor to help augment, or improve, chemotherapy? Is curcumin, so should curcumin be in a detoxification program? If it’s truly detox, you want to open up phase zero, have phase one and phase two working very well, and keep that second set of doors wide open, phase three, so that stuff can actually get out. Then, for the third part of the detox, is to be excreted via sweat, via bile and poop, via urine, or, like I said, technically, salivate, saliva, or tears.

I don’t know if that answers the question. But that’s phase zero. Phase zero is entry into the cell. Phase one redox, oxidation, the hydroxyl group is added or exposed, intermediate metabolites, sometimes more toxic, not always. Phase two conjugation gets handed something. Phase three exits the cell and then is excreted, as long as the body is excreting.

Dr. Weitz:            Interesting.  In order to promote excretion, you talk about using particular fibers and binding agents to help get rid of some of these toxins?

Dr. Walsh:           Yeah. What I did, again … Bentonite clay, I’ve been familiar with bentonite clay, as a fitness professional, and different types of fibers, and all these things. But what I wanted to do was look to the literature and say, “Well, what actually shows an improvement in the excretion and, not necessarily, of xenobiotics, but of bile.” So like a bio-acid sequester, like cholestryramine, the old cholesterol lowering drug, bound up bile to excrete it. If we can bind up bile, because so many xenobiotics are found in bile, and is their primary form of excretion, we need to bind up bile. We need to bind up all the stuff in the gastrointestinal tract for a variety of reasons, but I tried to find things that had some scientific basis behind it, so things like charcoal, for example, fiber, soluble, insoluble fiber.

An interesting one is chitosan or ketosan, which is typically used for fat loss, not very well. But there is papers showing that it is, actually, effective at increasing xenobiotic excretion via bowel habits. The other big one is sweat. You have to sweat. In fact, I recently came across a paper that, the short version was and, again, if I come back in a future life as a lab rat doesn’t sound very good. They had two groups of mice or rats and they gave one group a pretty significant burn on their skin, which is unfortunate. They injected both sets of mice with a certain xenobiotic and, not surprisingly, the ones that had a burn had higher levels of this environmental pollutant, because skin is such a major route of excretion. And, in fact, is the preferred route of excretion of some xenobiotics, not all, but some.

So if somebody is not actively sweating, during this hypocaloric phase, then I don’t think we’re getting rid of as much as we need to. To the point then, this is a bold statement. But I have some more papers that I’ll be adding as some bonus content coming down the pike. This stuff just blows your mind, blows your mind. I would not, myself, my family, or any patients, or clients put them on a fat loss program without supporting detoxification pathways, period. If they couldn’t sweat, I would say, “You probably don’t want to do a detoxification program.” If it’s really … I’ll just give you a tip on some of these things. There’s evidence that weight loss actually increases one’s risk for dementia, cardiovascular disease, diabetes and cancer, very strong, and the author cite this as a reason. Weight loss induces mobilization of xenobiotics. They go up and if you’re not getting rid of them, cause damage to cells way down the level.

Now, you look good in sexy jeans, or skinny jeans, but in 20 years might have cancer, or dementia, because of the weight loss. And, in fact, a steady increasing BMI, as one ages, seems to be protective over some of these thing, which is counter to what we want to look like, ourselves, but it’s very compelling stuff. Yeah, this is real, man. I would not do a fat loss program without making sure I was sweating and excreting and supporting detox. I would not. I would not put a patient on one, because I think that the detriments are too strong.

Dr. Weitz:            Sounds good. I know you’re a fan of infrared saunas, or a particular type of infrared sauna, right?

Dr. Walsh:           Well, you know, no, actually. I don’t like steam rooms, because of the water that they’re potentially using. I think that you can have a lot of model organic compounds found in steam. Again, unless it was purified water. But, no, here’s the thing. Again, I try not to have much of an opinion, but base it off of what I’ve read in the literature. Interestingly, in the literature, when they collect the sweat they’ll have a cohort of people to collect their sweat to look at xenobiotic levels. But they don’t tell them how to sweat. So, whether it’s via exercise or in a sauna, it didn’t matter. That when you sweat, you excrete. There’s people out there that might split hairs about a far infrared sauna and a near infrared sauna or the old ones, which are called the radiate heat saunas.  Listen, from what I’ve read, I tend not to like to split hairs over things, just sweat, man. If all you have is an old coal one, and you pour your water on it, and that’s all you have. That’s fantastic, do it. I love near infrared, personally. I think far infrared are interesting. There’s some questions about the electromagnetic frequencies, and stuff, and some of those things. But the goal is to sweat. I don’t care how somebody … In fact, I have people contacting me about my program. They’ll say, “I don’t have access to a sauna, but what if I went up into my attic?” I’m like, “As long as it’s not filled with asbestos or all this toxic stuff up there, then fine. Listen, sweat. It doesn’t matter.”  I like how the near infrared saunas feel and the bright red lights. But, no, I think to say one’s superior is myopic, personally. I think just sweating, according to science, is the most important aspect.

Dr. Weitz:            Interesting. I got that from an interview you did with Mercola. Maybe it was Mercola who liked the near infrared.

Dr. Walsh:           Yeah, he likes near infrared more than far.

Dr. Weitz:            Okay.

Dr. Walsh:           But that’s splitting hairs. To me-

Dr. Weitz:            He didn’t like the EMF thing about it.

Dr. Walsh:           No, just to sweat is the most important aspect.

Dr. Weitz:            Let’s go-

Dr. Walsh:           I would say this … Sorry to interrupt. What’s nice about the sauna, though, is it’s controlled. You can control the temperature and the time, so that, in terms of knowing the quantity that you’re sweating. That’s why I suggest the sauna, but if someone doesn’t have access to it, just sweating is what’s important.

Dr. Weitz:            Let’s go over one more thing. This will be the final question. Is part of your program involves … I know you have a 10-day detox program and part of it includes a four-day version of the Fasting Mimicking Diet that’s been popularized by Dr. Valter Longo, who sells you this box, or his company, and people who are part of this program called, ProLon, sell you this box of pre-packaged foods that you open up and make soup and things like that. You basically have put together a program that involves using real food, but to create the same effects.

Dr. Walsh:           Yeah. The short version is, if someone’s never done a detoxification, just an average person, that maybe has never done one. I recommend doing what I put together, just my view on this, is a 10-day program. The first six days, because of what you talked about, is the very high nutrient … It’s low calorie. It’s hypocaloric, you have to mobilize, but it’s fairly high protein. It’s high protein to ensure that, whoever this average person is, that maybe wasn’t eating perfectly, isn’t particularly healthy, might be protein deficient, or I should say, amino acid deficient. That they have the sulfur groups, and they have the methyl groups, and they have the glycine and all the precursors, the glutathione, in order to really support those phase two detoxification pathways.

That’s why I recommend the 10-day program for somebody who hasn’t done it before. That’s the first six days. Then the last four days, or someone could do five, if they wanted. It is what I refer to as a modified fasting mimicking diet.  Now, I think the work that Longo did is … the papers are brilliant. I think they’re fantastic. The findings of these things are so interesting.  My concern, however, is that every paper that I’ve looked at, where any mammal goes hypocaloric, their xenobiotic levels go up, period. He’s looking at this from diabetes reversal, and autophagy, and mitophagy, and all these health promoting effects, and that’s great.  However, instead of … So the macro-nutrient ratios that he’s come up with are brilliant. The calorie levels, which I won’t get into, but I think that should be based on one’s weight, rather than just having set calorie levels.  So a very hypocaloric diet with very specific macro-nutrient ratios.

Dr. Weitz:            By the way, what are those macro-nutrient ratios?

Dr. Walsh:           It depends if it’s … According to the one paper that I use, that have the specific ratios. Honestly, it’s basically ketogenic.  It’s very low calorie, first of all, but it’s moderate carbohydrates, very, very low protein.  In fact, you can, in what I put together, you can reach your protein levels just by eating vegetables for that are required.  It’s very low protein, which there’s no additional protein that’s actually consumed.  The amount of protein found in the vegetables that I consume, you hit your mark.  Then a little bit of fat.  It’s like carbs, protein, and fat, so that somebody can be in a ketogenic state and not push themselves out. My concern with his work, however, is while really compelling stuff that he’s produced is what about this xenobiotic thing? What about these papers that I’ve seen that show that, if you lose weight, or if you mobilize, and that can cause some other chronic conditions or situations much later in life? Instead of just saying, “Here’s some soup or here’s some avocados and some tofu, or whatever it is to reach the macro-nutrient ratio level that he recommends.” I recommend specific food that, according to the literature, have been shown to support detoxification pathways.

I mean, again, what he’s put together is brilliant. I think it’s genius. I think it’s fantastic. I have no problems with it, other than, if you just eat rice and avocados to meet those macro-nutrient ratios, you’re basically doing nothing to help support detoxification pathways. And these people will have increased environmental pollute levels in their blood, period. I say, instead of eating foods to meet the macro-nutrient ratios, eat specific foods that, according to the literature, have been shown to support detoxification impact. That’s the 10-day.

Now, what I do recommend for someone, like yourself, however, if you’d really wanted to do a good detoxification program over the course of a few months, is not to do … You’re a healthy guy. You eat a healthy diet. You live a lifestyle. I think that you could do two four to five day fasting mimicking diets a month. In week one, you might do four or five of those days. Then, again, in week three do another four or five days. And the next month, do the same thing. So you don’t need to do the full 10 days, because arguably those last four or five days, where it’s really hypocaloric, that’s where you’re going to get the maximum, and it’s time restricted eating, you’re going to get the maximum mobilization. And if you’re eating the right foods … I have some evidence that this absolutely lowers xenobiotic levels.

For someone, like you, that’s already healthy, I don’t think you need to do the 10 days. I think four to five day, modified fasting mimicking diet, a couple times a month would be the most effective way.

Dr. Weitz:            Awesome. It’s been a great interview Dr. Walsh. How can we find out about your fasting programs and the other programs you offer?

Dr. Walsh:           Remember, I don’t agree just with fasting. I think we’re too sick to-

Dr. Weitz:            I’m sorry. I’m meant your detox programs.

Dr. Walsh:           I know.

Dr. Weitz:            How can listeners and viewers-

Dr. Walsh:           Yeah. If you go to drwalsh.com, D-R-W-A-L-S-H dot com, backslash detox, that’s all you have to do. Then there’s a funny little picture of me with two buttons. One says, “Practitioner,” and one, basically, says, “Non-practitioners,” because I created two programs. The practitioner version of this goes into great detail. They both go into the science. I show the studies on the screen. I walk people through the pathways on the whiteboard. Again, I don’t want to tell people what to do without having the reason why the recommendations are there. So that they’re knowledgeable and empowered and understand why they’re doing these things. Why everything is in the program that’s in there. I don’t just say, “Take these potions and detox.” I want them to know. The difference in the programs is the practitioner program is about nine hours. The non-practitioner is about four hours of video. The practitioner program goes in way more detail in the biochemical pathways of phase zero, phase one, phase two, phase three. I go heavier into the science. It’s more technically detailed, but they both have the same output, where it’s, here’s the program, here’s how to do it.

Dr. Walsh:           When I add on some of these additional, bonus, content features, both programs … And the practitioner program, if a practitioner gets the practitioner program, they also get the non-practitioner program for free.

Dr. Weitz:            Great. Any other points of contact you want to give out for people who would like to get hold of you?

Dr. Walsh:           No, that website is the hub.

Dr. Weitz:            Good. Good. Excellent. Well, thank you, Dr. Walsh.

Dr. Walsh:           It was my pleasure. Thanks so much.

 

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