P 11 Detox PPT Fa March 30 - Dr. Leslie Korn

LeslieKorn,PhD,MPHLMHC,ACS,RPP,NTP,NCBTMB

CopyrightDr.LeslieKorn,2018

Detoxification Strategies

Copyright,LeslieE.Korn,2018


Liver

•Majordetoxificationorgan• Phase1:takesfat-solubletoxinstransformsthemintowater-solublecompounds• CytochromeP-450enzymesattachtotoxins

• Phase2:thetoxinsarethenexcretedbykidneys&duodenum.• DetoxstrategiesfocusonsupportingPhase2detox

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Detoxification Processes

Eliminate&reduceharmful/toxicsubstances

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Detoxification Processes

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Glymphatic system• Newlydiscovered• Clearswasteproductsfromthebrain• Glymphaticsystemismostactiveduring(slowwave)sleep


Detoxification Strategies for Mood & Cognition

• LiverFlushes:Ayurvedicrecipe&Gonzalezmethod• CoffeeEnemas• 1-2dayJuiceandVegetablefastsforBioindividuality

• Carrot/apple/beetforliver/GB• FiberFlushforcolonhealth• SkinBrushing

• Sodiumalginate

• Hydrotherapy• Saunas/Sweats


Foods

• Foods• Supporteliminationoftoxins

• Cruciferous(cabbage,broccoli&brussellesesprouts)Richinsulforaphane,aninducerofglutathioneS-transferases(GSTs)&othercellprotectiveenzymes,enhanceP-450enzymes

• Sulphur(Onions,garlic)-daily• Seaweeds(kelp)• Bindtoxinsindigestivetract:Toxicmetals&radioactiveisotopes:alginates(brownseaweeds)(EliazWeil&Wilk,2007)

• Heavymetals:sodiumalginate+modifiedcitruspectin(every3months)8


Detoxification & Culture

• Detoxificationispresentineveryculture’straditionalmedicine

• Alterative(Blood-purifying)plantslikeBurdock(vegetable)• Bitter:Dandelion,bitterroot,purslane(verdolagainMexico)

• Japan:Bamboocharcoal&activatedcharcoal(poisoning)

• Toxins:Fibers&barks• Nutritious:Elmbark

• Purge&cleanse:clay,animal&plantoils,sweatlodges&saunas,watertherapies,inducedregurgitationfromherbs

• Enemas(metabolicbalance)


Cultural Traditions

•Modernreenactmentofancientritualsthatincorporatedetoxification

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Enemas

• Indigenouspeoples:enemasforhealth/religiouspurposes

•Animalskins/bladders/horns

• Substancesintorectum➡largeintestine➡intestinalwall➡bloodstream

• Directroutetoabsorbsubstances• Colonicirrigationfor“mentalconditions”

(Drs.Marshall&ThompsonNewEnglandJournalofMedicine1932)


Cultural Traditions•Detoxificationmethodsrootedinownculturaltraditions&religiousbeliefs

• Communitydetoxificationrevitalization:• PacificNorthwestEEUU:canoejourney(sobriety)• Thepowerofthegroupreinforcesthebehavioroftheindividual• Higherpower/purpose• Australia&PapuaNewGuinea:traditionalwalkabout•Wildernessprograms&outdoortherapies(teens)

•Movingthebody:• Releasinganxiety-producinglacticacid•Withdrawalfromaddictivetechnologies

• Restorerhythms,communitysharinghardships&triumphstogether12


Cultural Traditions

• Bloodimpurities/tissuehealing:Leeches/Segmentedworms• Purification:drinkingurine(Buddhist,Jains,earlyChristians)• Richinmelatonin&aminoacids

• EnhanceCircadianRhythm&slowbrainwaveactivity(Mills&Faunce,1991)

• LiverCleanse/Immunehealth:Carrotjuice(carotenoids)


Symptoms of Liver & Gall Bladder Congestion

• Nausea•Morningheadaches• Bloodshoteyes• Constipation• Lightcoloredorpoorlyformedstools• Painintheuppershoulders/underribcage

• Skindullwithboils&Infections

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Reduce toxic substances

•Householdcleaners/mattresses&carpetsthatareneurotoxic•External(exogenous)toxicfoods&substances(pesticides&toxiccleaners)•Majordetoxificationorgans:Liver&Skin•Pharmaceuticals

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Neurotoxins

•Mattressesandcarpetscontainneurotoxins

• Toxiccleaningsupplies&draincleaners•Applecidervinegar:• Anti-bacterial• Anti-mold

• Anti-fungalcleanser• Cleandishes,counters,floors,toilets,&tubs

• Addbakingsoda&salt=scrubbingpaste

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Bread & Yeast

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• Toxicityespeciallyforthosesensitivetoalcohol• Yeastfermentssugar➡alcohol&endogenousalcoholproductioniselevatedaftereatingfoodsrichincarbohydrates

(Logan&Jones,2000)• Yeast:alcohol(ethanol)➡acetaldehyde

(Nosova,Jousimies-Somer,Jokelainen,Heine,&Salaspuro,2000)• Changinglevelsofgutflora (James,2006)

• Leadingtochroniccandidiasis• Acetaldehydetoxinscancauseleakygut (Nosovaetal.,2000)•Whichisimplicatedinallergies&autoimmuneillnesses


Fasts

•Waterfasts/citrusjuicefasts,forexample,arecontraindicatedindiabetesoranxiety

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Juice for the Liver & Gall Bladder

•Carrots,apples,&beetsasfreshjuices⬆sugar

•Greatcleanserforthegallbladder&liver.Vitamin-richdrink• 50%carrots,35%apples&15%beets• Canaddcelery/parsley(naturaldiuretics)

• Cilantro(Chineseparlsey)removesheavymetals

Cilantro/Parsley Pesto Detox• Ingredients• 2cupsoffirmlypackedorganiccilantroleavesandstems

• 2cupsoffirmlypackedorganicItalian,• flatleaf,parsleyleavesandstems• ½cupofchoppedorganicwalnuts• ½cupoforganicoliveoil• 1tsp.ofkelppowder• ¼teaspoonofseasalt• 2garliccloves• Directions:• Usingafoodprocessororblender,• mixallingredientstogetheruntilsmooth.


Copyright,LeslieE.Korn,2018Copyright,LeslieE.Korn,2018

Sodium Alginate: Seaweed

HeavyMetalDetox

Take2sodiumalginatecapsaday,every25daysfor3days


• BrownAlgae-bindswithmetalpollutants• Excessbarium• ExcessCadmium• ExcessZinc• OtherexcessheavymetalsProtectiveagainstradiation

ThomasA.DavisFranciscoLlanesBohumilVoleskyGuillermoDiaz-PulidoLaurenceMcCookAlfonsoMucci1H-NMRstudyofNaalginatesextractedfrom

Sargassumspp.inrelationtometalbiosorptionAppliedBiochemistryandBiotechnologyAugust2003,Volume110,Issue2,pp75–90.

Brown Algae


Bentonite Clay/Montmorillonite

• InternalUse• 1tbsp.mixedwith8ouncesofliquid

• Naturalclaymineralofvolcanicorigin• Mechanismofactionisphysical• Colloidalstructurechargedparticlesofsodium,calcium,magnesium&potassiumions,allowittobindwithunwantedsubstancesinthestomach,smallintestine&colon• Notdigested,norabsorbedintothebloodstream• Substancesareboundtothebentonite,&excretedbowel• Topicaluse:applytoskin• Combinewithactivatecharcoalincasesofpoisoning


Charcoal

Copyright,LeslieE.Korn,2018Copyright,LeslieE.Korn,2018

Lymphatic system


Skin Brushing

• Lymphatichealth,skinhealth,&dissociation,depression,&anxiety

• Pleasurable&grounding,safeself-careactivity

•Daily:checkin&connectwithfeelingssensations&theboundariesofthebody

• Chronicstressisassociatedwithloweredimmunefunction• Stimulationoflymphaticsystemeffectiveatpreventingcolds&congestiondueallergies


Skin Brushing Instructions

•Alwaysindirectionoftheheart•Beginatthefeetandsweepthebrushovertheskininlongbrushes

• Coversamepathway3timeseach

•Workupfront&backofbody,feet,legs,abdomen,&armswithspecialattentiontothearmpits&breasts(avoidnipples),thebuttocks,back,&neck


Oil Pulling

• Lipophyllicdetox• Saponification/detergenteffectthatreducesinflammatorybacteria&plague(linksofgumdisease,heart/brain)

• Ayurvedictreatmentforguminflammation,bacterialinfections

• Coldpressedsesameoil/coconutoilorcombination

• Swishatablespooninthemouthfor10-15minutes,spitout


Nasal Irrigation / Neti Pot


Enemas & Trauma

• Someclientswillnot/cannotdoenemas• Hxofabusewithenemas• Sexualabuse• “Analretentive”types• Theseclientsdonotdoaswell


Coffee Enema

• Thecoffeeenemaisusedprimarilyforliver/gallbladderdetoxification

• “Dialysisofthebloodacrossthegutwall”• Supportliverfunction,dilutebile&bloodvessels,reduceintestines’inflammation,&enhancegluthianoneStransferase,thusfacilitatingthephase2liverdetoxificationpathway

(Walker,2001,p.49)•MerckManualCoffee

(Gonzalez&Issacs,1999)• Senseofrelaxation,reducepainsignificantly,&promotewell-beingbystimulatingparasympatheticresponse

(N.Gonzalez,personalcommunication,June23,2002)


Liver Flush

•First,ortho-phosphoricacidhelpsremovecalcium&lipids(fats)fromarteries,&normalizescholesterolmetabolism•Orthophosphoricacidworks+malicacid(applejuice):•Dissolve&softengallstones•Removecalcium&fatsfromarteries


How the Liver Flush Works

•MagnesiuminEpsomsaltsrelaxesthesphincterofthegallbladder&bileducts,allowingforeasypassageofthesoftened,shrunkenstones• Thecream&theoilcauseastrongcontractionofthegallbladder&liver,forcingoutstoredwastes,bile,&stones,whicheasilypassintothesmallintestine


How the Liver Flush Works

•Thesewastes&stonesarethenexcreted•Theliverflushisasimplewayofremovinggallstoneswithoutsurgery,whileatthesametimeloweringcholesterollevels&improvingliverfunction


The Colon: Fiber Flush

•1teaspoonofpsyllium20minutesbeforeeachmeal(3/day)⬇

glucoseabsorption&⬇hunger.

•1every3monthsfor5days


Hydrotherapies

•Theuseofwater

•Altermood

•Decreasepain• Increaseenergy• Increaserelaxation/wellbeing• Improvebloodflow&oxygen


Hydrotherapies

•Hotrelaxesdrivesbloodtosurface• Coldstimulatesdrivesblooddeep• Ice/soaks/baths/footbaths•Hotandcoldalternating;stimulatesbloodflow•Herbal/salts/minerals•Mustardfootsoaks


Baths

•MagnesiumSulfate•Mustard

•VinegarBaths


Cold Water

• Contraction

• Reducesinflammation&pain

• Moodbooster!

• ApplyicetoxyphoidprocessforGERD&hiatalhernia

• IcePackbetweenshoulderbladestoenhancerespiration,anxiety,asthma


Hot Water

• Calming

• Relaxesmuscles

• Soaking

• Addingaromas

• Mineralsalts


Reducing or Eliminating Pharmaceuticals

“For every drug that benefits a patient, there is a natural substance that can achieve the same effect.”

―CarlPfeiffer.MDPioneeringorthomolecularphysician&scientist

Copyright,LeslieE.Korn,2018 42

Client Questions & Concerns

• Manyclientswantadvice&supporttoeither:• Improvetheefficacyoftheirmedications

• Reducedosage• Eliminateorstayoffmedications

Copyright,LeslieE.Korn,2018 43

Client Questions & Concerns

• Understandhowclientswanttoaddresstheirsymptoms• Knowtheirfearsandconcernsaboutmedication• Prioritizenon-pharmaceuticalapproachestoaddresstheirsymptoms

• Instillhopethattheirsymptomscanbemanagedandeveneliminatedwhencombiningpsychologyandnutritionalinterventions


Reduction & Elimination of Pharmaceutical Medications

• 60,000patientswithMDaged65+years•Tricyclicsincreasetherelativemortalityrateby16%•SSRIby54%,SNRIby66%

• Somepatientsmaybenefitfromacutepharmacotherapy• Butclinicalbenefitsaredebatable• Shouldbeweighedagainstadversesideeffects• Continuation&maintenancetherapyisnotrecommended• Lackofclearclinicalbenefits• Increasedvulnerabilitytochronicdepression,increasedsuiciderisk(particularinolderadults)higherall-causemortality

Hengartner,M.P.(2017).Methodologicalflaws,conflictsofinterest,andscientificfallacies:Implicationsfortheevaluationofantidepressants’efficacyandharm.FrontiersinPsychiatry,8(275).https://doi.org/10.3389/fpsyt.

2017.00275


Mitochondrial Function

• Multiplestudies:• Psychotropicmedicationcontributestomitochondrialdysfunction• Typicalandatypicalantipsychoticmedicationscaninhibitthemitochondrialrespiratorychain• Moodstabilizervalproicacidcaninhibitthemitochondrialrespiratorychain• Secondaryimpairmentofmitochondrialfunctionthroughtheinductionofcarnitinedeficiency

• SSRI’sinhibitmitochondrialfunctioninanimalmodelsofdepression&potentiallytoxicinhighdoses• DysfunctionofthemitochondrialrespiratorychainanddecreasedATPproduction

PsychotropicmedicationsandmitochondrialtoxicityRebeccaAnglin,PatriciaRosebush&MichaelMazurekNatureRev. Neurosci.13,293–307(2012)


Elements of Psychotropic Withdrawal

• Psychoeducation• SelfcarePlan• PrescribingClinician• WithdrawalSchedule• NutritionalSupplementationProtocol:

• SocialSupportTeam• TherapeuticSupports• SleepRegulation• At-HomeDetoxificationMethods


Coming Off Psychotropic Medications

•Workwiththeprescriber • Prescribersrarelywanttohelppeopledetoxifyfrommeds:toolaborintensive

• Nutritionaltherapyroleinpreventing,reducing/eliminatingpharmause

• Identifygoals&timeline

• Requirebasicadherencetoacomprehensiveprepprogramfor3months(diet,nutrients,exerciseselfcare) • Basicrule:1yearonthemedication=1monthtowithdraw(mayvary) •Workwithcompoundingpharmaciestoprovideliquidmedstotitratedownml.eachweek

• Identifywhatthebrain/mindiscraving&substitute


Case: Wilma

• 40mg.dailyofProzacfordepression75mgofTrazadoneforsleep7years

• Wantedtowithdrawfromthemedications


Pre-withdrawal Nutritional Plan

•Omega3fattyacids,(minimumof2000mg/day)•FullspectrumvitaminE(400-800IU/day)•BComplexincludingB-12andB-6


Self Care Plan

•Workwiththeclientfor4-12weekstoprepareforwithdrawal&elimination

• Self-careplaninplace:• Consistsofgoodqualityfood,nutritionalprotocol• Dailyexercise• Therapeuticsupportslikeacupuncture&massage


Pre-withdrawal Nutritional Plan

•Omega3fattyacids,(minimumof2000mg/day)•FullspectrumvitaminE(400-800IU/day)•BComplexincludingB-12andB-6•Skillbuildingtotoleratediscomfort


Prescribing Clinician

• Communicatetheplanwiththeprescriber

• Engagesupport•Workwithateamofprescribingprofessionals(MD,ARNP,ND,)• Compoundingpharmacist(R.Ph.)


Developing a Withdrawal Schedule

• Developacalendar&timelinefortaperingoffthemedication• Definethetherapeuticsupports&whattheyprovide&atwhatspecificintervals• Keepsharednotebook,digital/web-basedsharedcalendar


Developing a Withdrawal Schedule

• Thewithdrawalschedulewillbedesignedbasedon• The“half-life”ofthespecificmedication/drug• Howmanydifferentdrugspeoplearetaking&whichorderisprioritized• Howmanymonths/yearspeoplehavebeenusingthemedication(s)•Whattheclient&clinicianidentifyasoptimal&achievable

• Stresslevelsintheclient’slife,includingacuteperturbations• Socialsupportsthatareinplacetocarryouttheplan


The 2:1 Rule

• 2:1rule:halfaslongtowithdrawastimeonthemedication• e.g.onProzacfor6months;take3monthstotaper• Reducemg.ormicrogram/ml.stabilizeatthatlevelfor1-2weeks• Prozacfor6months,use3monthstoslowlytaperthedosage.•Onmedicationfor2yearswouldtake1yeartowithdraw


Social Support Team

• Holdingameetinginperson/viaconferencecalltoeducateeveryoneabouttheprocessandtoengagesupport• Shouldbeundertakenmuchlikeanydrugaddiction• Intensivestagesrequiringfulltimecare&thensupportsforrelapseprevention&care


Therapeutic Supports

• Formofaspalikeatmosphereofself-carebothinthehome&outsideincludingreflexology&acupuncture• Clienttaketimeoff,atleastreducetheworkloadduringtheinitialwithdrawalphasethisisadvisable• RegulateSleep


Effects on Nutritional Status

• Benzowithdrawal&comprehensivewithdrawalschedulesforeachspecificdrugtype• Peoplewhotakeanti-depressantswithdrawfromthebenzofirst•Melatonin(1mg)&niacinamide(400mg4-6timesaday)uptoatotal1500-2500mg/daydividedthroughouttheday

(Prousky,2005)• SeeAshtonforBenzowithdrawal(2002)https://www.benzo.org.uk/manual/


First Steps: Month 1

• Priortowithdrawalofmedications&drugs

• Eliminateglutenandcaseinifnecessary,• Foodadditives• InitiateOmega3and6Fattyacids,FreeAminoAcids,VitaminE,BComplex,Minerals&Probiotics• Initiatedailyskinbrushing&twiceweeklysaunabaths


Month 2 and 3

• Beginthewithdrawalprocesswithataperingscheduleappropriateforthespecificdrug/medication• Additionalnutrientstoincludeadditionalaminoacidstargetingtheappropriatereceptorsthatthemedicationtargets• Continuepsychotherapeuticsupportfortheemotionalups&downsofthewithdrawalprocess• Providenutritionalsupporttoeasewithdrawal• Providehope


Detoxification

• YerbaPrima• SkinBrushes,Bentonite,PsyilliumHuskPowder

• https://yerba.com/


Summary

• Identifycurrentmedications&theirsideeffects

• Identifymedicationseffectonnutritionalstatus

• Developanenhancedself-careplanwiththeclient• Planascheduleforwithdrawalincooperationwithprescribingclinician

• Conductafamily/socialsupportsessiontoidentifyspecificareasofsupportorobstacles

• Identifyin-patientorat-homewithdrawalprocesses

• Reviewcliniciancontactavailabilitytotheclient


Summary

• Engage(para)professionalsupportsforfoodandnutrientadministrationwherenecessary

• Beginnutritionalprotocolsatleast2-4weekspriortoinitiatingwithdrawal

• Createan“availabilitycontract”withtheclientsotheclientcanreachtheclinician

Thank you!drlesliekorn.com [email protected]

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P 11 Detox PPT Fa March 30 - Dr. Leslie Korn