Wednesday, June 15, 2011 11:36
Posted in category Asthma
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That is the question put by Dr Rogers, and the title of her book, which I recommend everyone should read. She may as well have asked: Are you an asthmatic or just toxic?The Body Detoxification SystemThe body possesses a unique detoxification system that, until recently, had been neglected. In fact, most medical textbooks of the 70s and 80s do not even mention it in terms of environmental illness.Yet a detoxification system exists in every cell of the body, although the one we are most concerned with is the one in the liver: the so-called cytochrome P-450. Its study received a great impetus when space medicine found it had to resolve problems arising from chemical contamination from outgassing materials in space capsules. Other scientists studied how the body protects itself against the onslaught of an ever-increasing number of chemicals, or xenobiotics, which permeate our environment. Our body has to process, metabolise or change practically everything that enters it. Most xenobiotics are changed into safer or less toxic substances so they can be excreted without poisoning the body further. As we have seen, however, the detoxification system can be inefficient, overloaded, damaged and, on occasions, swamped so that it almost comes to a standstill.The two phases of the detoxification processDETOXIFICATIONInhaled, ingested, or absorbed xenobiotics (foreign chemicals)Any of these pathways can be blocked or damaged by:Vitamin deficiencyMineral deficiencyAmino acid deficiencyFatty acid deficiencyEndo-toxin micro-organismsForeign chemicals for which the body has no mechanism for detoxifyingNewly formed metabolites (breakdown products) of xenobioticsDetox enzymes poisoned by heavy metals (mercury, aluminium, cadmium)Detox pathways overloaded from everyday chemicals in the environmentPoor genetics (lack of specific detox enzymes)Phase 1 occurs primarily in the liver and involves reactions like oxidation, reduction, hydrolysis and so on. All these fancy names mean is that the composition of the chemical is changed in specific ways (removing or adding electrons or hydrogen atoms, for example).The process of changing these chemicals in readiness for excretion cannot proceed efficiently without producing a cascade of ‘free radicals’, highly reactive particles that can cause unseen damage to delicate portions of living cells. Even when the poison eventually starts to exit from your body, it may do some damage to the kidneys, for example, on its way out.The back-up detoxification system which tries to take care of such eventualities is the second detoxification phase. This process is known as ‘conjugation’, from the Latin for attach, and it is a rather complex procedure by which the body attaches a protein or amino acid to the changed chemical, now called a metabolite, making it bigger and giving it an electric charge. This makes it easily excretable via the bile or stools, thus keeping the more delicate kidneys out of it. Amino acids play a major role in this process and one of the most important is a combination of three different amino acids (glutamic acid, cysteine and glycine) called glutathione ](GSH). Unfortunately, GSH is also involved in many other processes, such as the making of hormones, genetic materials, and enzymes. If the body is overloaded with chemicals which need GSH, less may be available for these other important functions.Cysteine appears to be the key to successful GSH synthesis and ability. The most efficient form is called ‘N-acetyl-cysteine’.Unfortunately all this is not as simple and foolproof as we would like. The process of detoxification (scientists prefer to use the term biotransformation) is a very complex one and the body has to choose between many possible metabolites into which to change the chemical. Sometimes it chooses the wrong one and the body ends up with a metabolite that is more toxic than the chemical we started with.Then there is another problem. The body has to choose, from so many available pathways, the most suitable at the time. Because detoxification involves enzymes and because there are innumerable enzymes, each highly specialised and specific for one reaction only, when the body is overloaded with one particular chemical it may not have enough reserves of one of the special enzymes needed at the time. Because no other enzyme will do, the xenobiotic continues on its own path of destruction. Many, if not all, the enzymes involved in detoxification need a particular vitamin or mineral in order to work. They are practically paralysed if there is a deficiency. Now you understand why most environmental doctors will give you what seems a mountain of vitamin pills to take. It’s a little bit like having lots of policemen lining the route of a demonstration, just in case something happens, because if trouble does start, any place where there are no police is likely to see havoc. The fact that there may be lots of priests or Salvation Army personnel around will not make a bit of difference because neither is specialised to arrest or fight rioters. The detox police are, in this case, the antioxidants.It’s quite possible to be affected by xenobiotics simply because you are, unknowingly, deficient in a key mineral or because your body has unusual requirements for that one nutrient. In that case it is called a ‘dependency’ rather than a deficiency. When, for whatever reason, there are more chemicals in the body than the detox system can handle, damage can occur, often to the mitochondria — the so-called powerhouse of the cell. By the time the detox system catches up with any backlog, some damage may already have occurred. This is why you do not always feel better as soon as you take all the supplements prescribed. They may just stop further damage from occurring.A blockage or slow-down of detox activity can cause other problems. The chemical that can’t get through may damage you, but so will all the chemicals which follow. They may cause further damage to the detox system, starting a chain reaction that can lead to all sorts of health problems, including cancer. The pathway your body chooses to get rid of a chemical depends on what enzymes are available, the level of nutrients (vitamins, minerals, amino acids etc..) on hand, the total load at the time and the degree of damage to detox pathways that may have been caused by other chemicals.The detoxification pathway bottle-necksIn phase one, some xenobiotics are first changed into alcohols which then must be metabolised to aldehydes. Only from the aldehyde stage can the chemical be safely excreted as an acid, via the urine. Alcohol dehydrogenase is the enzyme that changes an alcohol into an aldehyde.Two important factsFemales tend to have fewer alcohol dehydrogenase enzymes than males. That is one of the reasons they are more easily affected by lower doses of alcohol.Compared with Europeans, Australians have a disproportionate number of asthmatics. They also drink more alcohol, or they drink more without eating at the same time, than most Europeans.Phase two bottle-necks occur whenever there are not enough antioxidants.What are some of the clues that you have become sensitive or overloaded chemically?You will be aware of strong-smelling chemicals, perfumes, cleaning materials and so on. They may make you feel uneasy.You are not able to tolerate a lot of alcohol.If you think of it, from time to time you seem to feel vaguely unwell, or some symptoms seem to be worse when you go into a shopping mall, a department store or a new hotel.There are some medicines that simply don’t do you much good and you can’t tolerate.The same applies to some nutritional supplements, herbs, vitamins or minerals, which sometimes make you sick.Here Today, Gone TomorrowOne of the most frustrating experiences for an environmental doctor is to be faced by a patient who is clearly bombed out by chemicals but says: ‘Impossible! If chemical X was a problem, how come nothing happened when I was exposed to it on some days, while at other times I felt unwell? It so happens that the days I am unwell (at the office, home or wherever…) are always the days when I have a lot of stress. Also I know it’s not the chemical, because when I am unstressed and happy, many of the symptoms disappear, even though I am working/living in the same place. And anyway, I have been exposed to X for twenty years and it’s never worried me before.’ What these patients say is such common sense! Alas, common sense sometimes needs to be replaced by lateral thinking.The body is not trying to get rid of exactly the same number or types of chemicals all the time or every day. Say your body is working flat out to rid itself of the trichloroethylene you were exposed to all night long because you had a batch of freshly dry-cleaned clothes in your wardrobe. It may also be busy trying to get rid of an accumulation of formaldehyde out-gassing from your new lounge-room carpet, which you inhaled while watching television. As an analogy, let’s say that by the time you wake up the camel’s back has a high pile of ‘straws’ on it. You enter the office, someone turns on the photocopier and ten minutes later, bingo! You feel unwell. The last straw broke the camel’s back. But only because you slept in a room with a wardrobe full of freshly dry-cleaned clothes and spent several hours in the same room as a new carpet. So although the photocopier is the last straw, it is no more responsible for your trouble than the dry-cleaning or the carpet. Remove any one of them and you may not have become sick. Anyway, you get better later on and by the time you get home many of the xenobiotics have outgassed from the dry-cleaning and you don’t watch television as much that night.The next day when the photocopier starts up, there is still a little room on your camel’s back, so you don’t feel a thing.Naturally, the same thing happens if your stress levels are high enough to lower your resistance, place demands upon your body, use up energy, and so on.Let’s go back for a moment to detox Phase 1 and its bottlenecks. When the detox process is halted at this point, some of the alcohols and aldehydes may be metabolised to epoxides. These are dangerous and highly reactive chemicals, suspected of playing a major role in the predisposition to cancer (mutation), allergies, immune suppression and cellular ageing.Nutritionally, the best protection against such blockages is an ample supply of zinc, GSH, selenium, magnesium, vitamins C and E, beta carotene and amino acids containing sulphur (apart from meat and fish, sulphur can be found in eggs, cruciferous vegetables, onions and garlic).When detoxification pathways don’t work well, chemicals get shuffled around by the body, searching for a way out. In doing this they can interfere with the detoxification of other chemicals so that any one xenobiotic which, until then, was being cleared merrily on its way, all of a sudden starts to pile up. What can happen to your body as a result of all this?Judy, who until that day was unaffected by the toluene outgassing from her carpet, feels unwell at home. If she tells anyone, chances are they will shout ‘neurotic’ unless, of course, they are familiar with the biochemistry of detoxification. When considering environmental illness, it is well worth keeping in mind a few simple principles:Health is not just the absence of disease.Many illnesses do not have a single, easily identifiable cause.Everyone is biochemically unique.In a group of sick people each individual may have his or her particular trigger or allergen that is responsible for much the same symptoms.The opposite is also possible. The same trigger, allergy, chemical or whatever may provoke different symptoms, even different illnesses in some individuals. An asthmatic may suffer more breathing difficulties but someone with chronic fatigue may just become more tired.Any material which outgasses (emits particles called ‘osmols’) can be breathed, will enter the bloodstream and may affect any organ, including the brain, even if you can’t smell it.Once you become sensitised or overloaded, chances are you will become more and more sensitive to more and more factors, be they foods, chemicals or inhalants.Once exposed, there sometimes occurs a resetting phenomenon whereby one becomes affected more easily by lower doses or shorter exposure times. The symptoms may become more severe with repeated exposure.The brain is a common target of xenobiotics.The environment is not constant. It changes all the time.For that reason, among others, reactions or symptoms are not always the same, as they depend on both the state of the environment at the time and the individual’s capacity to detox.Therefore, reducing the total load must be the most basic step.In practice, this means that even apparently minor, superficial factors which are not known to provoke noticeable symptoms or reactions must be eliminated if possible. Such factors as allergies, moulds sensitivities, Candida, dust mites, hypoglycaemia, hormonal problems, pre-menstrual syndromes, nutritional deficiencies, imbalances or dependencies — even excesses.So remember: detox, avoid, protect and educate yourself and others.There is a general set of rules for environmentally ill people:Understand, and get your doctor to learn, that xenobiotics can take up residence within macrophages and produce no symptoms or illness until further stimulation by an antigen (allergen, virus, bacteria) causes them to begin a flood of interlukins, thus altering dramatically that individual’s immune response capabilities, sometimes without measurably altering the actual numbers of immune components. It is in this way that one becomes an asthmatic and starts to react allergically to all sorts of things only after a severe viral illness.The effects of exposure to xenobiotics (in the following example, solvents) have been shown to be time-synergistic. This means that damage by a single solvent may take about twelve years to occur. If someone is exposed to two solvents simultaneously, the mean time before damage occurs is reduced to about seven years. Exposure to three solvents can shorten this to around four years. There is a good possibility that the same or a greater degree of exponentiality occurs with many xenobiotics.Remember that moulds can be toxic and cause allergies. Fungi can produce powerful mycotoxins.If your home has been treated with pest-control chemicals, do not vacuum too often as it redistributes dried-up chemicals into the air. Have the carpet thoroughly cleaned first, without using more chemicals.Never sleep in a freshly painted or wall-papered room.Switch electric blankets off at the main plug site before getting into bed.Do not leave clock radios on near the bedhead.Do not have a bedroom over your garage.If you are allergic, and especially if you are asthmatic, avoid barbecues and charcoal-cooked foods.Avoid permanent-press clothes and do not sleep on a synthetic mattress or polyester sheets.Use natural, non-toxic paints and do not use wood oils and oil paints in the bedroom.If you want to nurture your liver, sleep between 8 and 11 p.m. is the most important recuperative time for that organ.Avoid jogging or riding a bicycle in a metropolitan area and never do it where there is vehicle traffic.If chemicals are a problem and if you are asthmatic you will have to detox your diet, your body, your home (especially your bedroom) and your mind.DietEat as naturally as possible. Choose organic products whenever possible. Even organic lamb and beef are available these days. Check food allergies and intolerances and make sure the diet is optimal for you.BodyAvoid drugs whenever possible, including alcohol. Use as few chemicals on your body as possible. Use hypoallergenic natural products whenever possible.Home, Especially the BedroomClean up dust, mould, outgassing sources, and so on, and use plants to ‘soak up’ chemicals.Always get advice from experts on equipment and systems such as water filters, air conditioning, dehumidifiers and anti-mould and anti-dust mite procedures, but be careful. There are firms which advertise such services that will take your money and not do a suitable job. As a safeguard, ring one of the environmental groups to find out who they recommend.MindRemember that angry, negative thinking is stressful. Love and laughter are the best medicines.*25\145\2*

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