Toxins with Dr. Joe Pizzorno: Rational Wellness Podcast 052
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Dr. Joe Pizzorno speaks about how to remove toxins from your body and improve your health with Dr. Ben Weitz.
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Podcast Highlights
2:00 Dr. Pizzorno will be giving several talks on how toxins cause infertility and he said he is finishing a textbook with Walter Crinnion for doctors called Clinical Environmental Medicine that will be released in July. He said that environmental toxins have become the primary drivers of chronic disease.
3:22 I asked Dr. Pizzorno to explain how toxins damage our bodies? He explained that we should consider how environmental toxins cause diabetes. Toxins like phtalates that are commonly found in our health and beauty products and Bisphenol A in our soups and plastic containers that we put our foods in attach to insulin receptor sites so the cells stop responding to insulin resulting in the pancreas having to produce more and more insulin. Dr. Pizzorno said that he is shocked how commonly people in the US are being exposed and damaged by arsenic. Arsenic is commonly found in the water, the chicken, and the rice, which is really good at concentrating arsenic if it is grown in water that has arsenic in it.
7:12 Dr. Pizzorno said he is a big believer in eating organically grown food, but then you have to ask what water is being used to grow these organically grown fruits and vegetables and does it have arsenic in it?
7:43 I asked how do we know if we have toxins? What about some of the testing methods? Dr. Pizzorno explained that to determine current exposure, we can do serum and urine testing. The best test is to do a fat biopsy, but this is invasive, so tends to do a challenge test with a prescription chelating agent like DMSA or DMPS or EDTA, and then see how much that increases their secretion of metals into the urine. That actually is useful, but it’s also flawed. In general, I prefer more tests like blood tests and tissue biopsies than I do things like urine tests. Because it tells you what’s in the body, not what the body’s getting rid of. I asked what he thinks of antibody testing of chemical and metals, such as developed by Dr. Aristo Vojdani and offered by Cyrex Labs? He said that he finds these intriguing and he would consider using them but he would like to see more data on them before endorsing them.
15:04 I asked Dr. Pizzorno to talk about how to eliminate toxins from our bodies. He said that there are a three steps to take: First, decrease exposure. Then number two is support the body’s own natural detox systems, and the third one is, okay, let’s do stuff to directly get things out of the body. We talked about how to remove toxins from the water by having a whole house carbon filter that removes organic compounds. To support the body’s natural detox system you can increase fiber intake and take N-AcetylCysteine or NAC, which increases the body’s glutathione levels.
20:23 I brought up the thought that those of us like myself who treat a lot of patients with gut problems like IBS and SIBO may put patients on a low fiber diet to avoid feeding the bacteria we are trying to remove and we may actually inadvertently be increasing their toxin load as we try to improve our gut health. Dr. Pizzorno responded that in his The Toxin Solution book he has patients spend two weeks cleaning up their gut and he likes them to increase their fiber intake. Then, to help patients remove toxins, he recommends that they take oral DMSA 250 milligrams every third night, along with extra fiber and NAC. He said that it’s a slow process, but it’s extremely unlikely anybody will have a bad reaction. He also likes to use bile sequestrants like cholestyramine that bind to the chemical toxins in the gut. Dr. Pizzzorno said that in his book, The Toxin Solution, he spends two weeks avoiding toxins, two weeks improving gut function, two weeks improving liver function, and finally two weeks strengthening the kidneys. He said we now have an epidemic of kidney failure, which used to be rare. Now we’ve got dialysis centers all over the place. People’s kidneys are failing from all the chemicals they’re being exposed to including prescription and non-prescription drugs like nonsteroidal, anti-inflammatory drugs, like acetaminophen. For kidney detox, Dr. Pizzorno recommends an alkalinizing diet that reduces consumption of high sulfur amino acids and decreased salt consumption.
29:04 Dr. Pizzorno said that after detox, he does nutritional medicine. When we get people the nutrients they need so the body works properly.
29:47 Dr. Pizzorno explained his gut protocol to get it ready for detox. He explained his four step program: 1. kill the bad bacteria, 2. absorb the toxins that have been released, 3. re-seed with healthy bacteria, and 4. then stimulate the healing of the gut. Dr. Pizzorno developed this about 10 years before anybody ever heard about the 4R Program. That’s one of the reasons he’s one of the founders of the Functional Medicine movement.
31:56 Dr. Pizzorno said that instead of doing stool testing, he does a urine test in his office known as the Obermeyer or Indican test. It measures levels of indoles and skatoles in the urine, which indicate the breakdown of protein by the wrong bacteria in the gut that produces these chemical toxins. He has them return once per week to repeat the test. When their gut cleans up, the test improves. The formula for making up the indoles to perform the test is in his Textbook of Natural Medicine.
Dr. Joe Pizzorno is a Naturopathic Doctor who has written or co-authored more than 12 books including, The Encyclopedia of Natural Medicine, which has now sold over two million copies, and The Toxin Solution, his newest book. Here’s the website to learn more about this book: http://www.thetoxinsolution.com/ Dr. Pizzorno is one of the most important Naturopathic Doctors, educators, researchers, and one of the founding members of the Functional Medicine movement. You can also learn more about Dr. Pizzorno from his website: http://drpizzorno.com/ You can preorder Dr. Pizzorno’s forthcoming textbook on Clinical Environmental Medicine from Barnes and Noble.
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. Sign up for my free e-book 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 me again today. For those of you who enjoy this podcast, please go to iTunes and give us a ratings and review, because that helps more people find out about the Rational Wellness Podcast.
Our topic for today is toxic chemicals that we get exposed to on a daily basis in modern society. We’re going to talk about the role they play in chronic diseases, what we can do to avoid them, and how to detoxify them from our bodies once they become incorporated into us.
Our special guest today is Dr. Joe Pizzorno who’ll be joining us today to talk about toxins. Dr. Pizzorno is one of the most important naturopathic doctors, educators, researchers, and one of the founding members of the Functional Medicine Movement. Dr. Pizzorno has written or co-authored more than 12 books including, The Encyclopedia of Natural Medicine, which has now sold over two million copies, and The Toxin Solution, his newest book, which was released last year, and which I highly recommend.
Dr. Pizzorno, thank you for joining us today.
Dr. Pizzorno: Well, thanks for the invitation. I’m delighted to be talking with you today.
Dr. Weitz: I’d like to start the interview by asking you what have you been up to lately? Because I’ve seen some of your recent talks, and I know you’re doing a lot of projects related to toxins.
Dr. Pizzorno: Two things have really taken all my attention right now. First off, I’ll be giving a lecture at the end of the month. Actually two lectures, one for consumers, one for doctors, on how environmental toxins cause infertility, because as you know, infertility is becoming a bigger and bigger problem. I’ve been looking at all the research around infertility.
The second major area I’m working on right now is that I’m co-authoring with Dr. Walter Crinnion a new textbook for doctors called, Clinical Environmental Medicine. We’re now just doing the final proofs before it goes to publication. I would say not only is it one of my most important books, but it’s also one of my most depressing books.
Because when we started looking at the data on toxins and disease, it is just stunning. We’re poisoning ourselves. I’m making the case, and I’m literally lecturing all of the world on this, that environmental toxins have become the primary drivers of chronic disease. Not that nutritional deficiencies and excesses have gone away as a cause of disease, we’ve simply added an even worse problem.
Dr. Weitz: Yeah, shocking, shocking.
Dr. Pizzorno: Very worrisome.
Dr. Weitz: Yes. Toxins seem to be involved in almost every chronic disease, and they’re found in our food, our water, in our environment, and the products we put on ourselves.
Dr. Pizzorno: Yup, everywhere.
Dr. Weitz: Can you talk about how toxins damage our bodies?
Dr. Pizzorno: There’s a number of ways in which it happens. Actually, I have three slides, each of which has three reasons. There’s nine key reasons why this happens. I won’t go through all of them.
Dr. Weitz: Sure.
Dr. Pizzorno: I’ll look at the high points. The first one that got me most interested in this area probably because the most research is there, is how toxins cause diabetes. It looks like there are two mechanisms by which this happens. The one which appears to be most important is that many chemical toxins like, oh, how about the phthalates that are in our health and beauty products, or how about bisphenol A, that’s in our canned soup, for example, and all those plastic things that we have our food in.
They actually bind to the insulin receptor sites on the cells, so that the cells don’t respond to insulin like they should. Our poor pancreas has to overproduce insulin in order to get sugar into the cells. Well, that’s a good example of how incredibly adaptive our bodies are to the challenges of living. Also, when you’ve overused an organ for 20 or 30 years like that, it burns out and now, you’ve got diabetes. Looking at just one condition like diabetes, which is 20 times more common now than when I was a student in naturopathy medical school half a century ago, this epidemic is primarily due to environmental toxins basically blocking insulin receptor sites.
Not only that, things like bisphenol A and phthalates, but also arsenic. One of my biggest surprises in looking at the research is how commonly people are being damaged by arsenic. Of course, it might, excuse me at the obvious joke that people only think they have arsenic toxicity when their spouse is trying to poison them. While that may be happening, the reality is that 10% of the public water supplies in the U.S. have arsenic levels known to induce disease in humans, and only half the water supplies have even been tested for arsenic.
Dr. Weitz: Wow.
Dr. Pizzorno: Now, I suspect, I’m being a little pejorative here, sorry, but I suspect some of those public water supplies tested and found the arsenic and didn’t want to report it because of what they found. This air, water, food, health and beauty aids, household cleaning products, everywhere all these chemicals and metals are poisoning or bodies.
Dr. Weitz: I heard you talk about how arsenic is often contained in chicken.
Dr. Pizzorno: Yes. Up until recently, the USDA allowed farmers to put arsenic compounds into chickenfeed-
Dr. Weitz: Wow.
Dr. Pizzorno: … for two key reasons. Number one is that it helps address the parasites in chickens that they get when they live in close quarters, and second is it helps to plump them up, makes them fatter so then they can make more money. They finally stopped approving that. Now it doesn’t mean it’s not still happening, but hopefully, we’ll see the arsenic levels in chickens finally start to go down.
Dr. Weitz: Yeah, we’ll probably see it get re-approved.
Dr. Pizzorno: The problems the chickens have haven’t gone away, so now they’re using different compounds. I’m sure we’ll find them toxic as well.
Dr. Weitz: Apparently, there’s a lot of arsenic in rice as well.
Dr. Pizzorno: It turns out, and I don’t know why, but rice is very good at absorbing arsenic. If rice has been grown in one of those water supplies that have arsenic in it, and as [inaudible 00:06:33] will absorb it. It turns out rice is a significant source of arsenic for anybody who eats rice.
Dr. Weitz: Is there any way to get rice that doesn’t have arsenic?
Dr. Pizzorno: Well, of course, if the rice has been grown with water that does not have arsenic in it, it’s not going to have arsenic. I’ve been now asking the organic rice farmers, please tell us how much arsenic is in your rice, and none of them have answered me.
Dr. Weitz: Huh.
Dr. Pizzorno: Which I find a little worrisome.
Dr. Weitz: Yeah, that may be one more of the variables that’s so difficult to control. You go and you get organically grown fruits and vegetables, but what water are they using?
Dr. Pizzorno: Yup, yup. I’m a very, very strong believer. Everybody should only be eating organically grown foods, but now having said that, you have to make sure that those organically grown foods are grown properly and are not contaminated.
Dr. Weitz: Yeah, I think ultimately we have to accept that we’re all going to get exposed to a certain amount of toxins.
Dr. Pizzorno: Yeah, yeah. We can’t get around it, so what we have to do is decrease exposure as much as we can and then support the body’s own ability to get rid of toxins.
Dr. Weitz: Right. How do we know if we have toxins? What about some of the testing methods?
Dr. Pizzorno: Yeah, great question. I gave a lecture at NIHM last October entitled, How to Practice Environmental Medicine. When you think about toxicity realize that we don’t have, you might say, a monolithic population. I break the population down into three groups when we think about toxins.
The first group is what I would call the yellow canaries. This is from an old practice of coal miners, where they’d bring yellow canary birds down into the coal mines. When they started to faint, they knew they were being exposed to carbon monoxide, and they would then rush out of the mines. The reason they would use the yellow canaries is because they’re much more sensitive to the toxins than are the humans. Yellow canaries are those humans that are most sensitive to toxins. They have their own set of issues.
Then we have people who have an obvious exposure. An obvious exposure will be something like you have a mouth full of silver fillings. Because if you’ve got 10 silver fillings in your mouth, you’re leaking 10 micrograms of mercury into your body every day. And don’t believe the dentist when they say, “Ah, it doesn’t go into your body,” because there’s a direct correlation between the amount of mercury in your mouth and the amount of mercury in your brain, in your kidneys, and your tissues. There’s no question that there’s an exposure problem.
But the third category is probably the biggest, of course, overlaps with the other, but that is anybody with chronic disease must consider the role of toxins in that chronic disease. I’m seeing more and more … I’ve looked at tons of research, and I would assert that at least half of chronic disease is due to environmental toxins. Which means that it’s preventable, and in many cases, even reversible.
Dr. Weitz: It’s so interesting. You can put somebody on what seems like an appropriate diet say for a condition like diabetes, but if part of their diabetes is being fueled by toxins, unless you also address the toxin factor, no amount of low carb eating is necessarily going to make those insulin receptor sites work properly.
Dr. Pizzorno: Right. That’s absolutely true. Let me go a little further than that, because you brought up a good point. It’s something I’m actually starting to talk more about. That is, how do you measure success in medicine? Now what conventional medicine says, people have diabetes which means basically high blood sugar, and we are properly treating the diabetes if the drugs we use will decrease the blood sugar levels. Well, of course, that’s reasonable to do, because super-high blood levels of glucose cause all kinds of problems.
But what if you had instead a measure which is, how well is the body itself controlling blood sugar? Because even though things like metformin and insulin will decrease the number of the side effects of high blood sugar, they still will have people progress to the sequelae of diabetes. Which means their arteries and their nerves start to degenerate. They get peripheral neuropathy. They start losing their kidneys, start losing their eyesight, increasing rate of dementia all those kinds of things. Okay.
It’s slowed down by metformin and insulin, but that’s not a substitute for the body itself maintaining proper blood sugar control. Because when the body maintains blood sugar control, you don’t get the sequelae. You don’t get the loss of blood flow and neurological function, and things of this nature.
In many ways, conventional medicine has justified its existence by using these lab tests that seem to show benefit, but in reality, it’s just covering up the fact that the body’s not working properly. If the body’s not working properly, doesn’t matter how much drugs you’re taking, the body’s going to break. You’re going to get disease, and your quality of life and longevity will be lower.
Dr. Weitz: Interesting. On the testing, what kind of tests do you recommend that people get that practitioners use? I know there’s serum testing. There’s urine testing. There’s provocative urine testing. But there seems to be a lot of question as to how accurate these tests are.
Dr. Pizzorno: Yes, a very good point. When we’re testing, we have to break it down to two categories. One is current exposure, because you want to make sure, is a person currently being exposed? Because if they are, I don’t care how much detox you do. If they’re currently being exposed, they’ll get worse, so acute exposure. What’s generally accepted is blood and urine for that purpose. That’s fine for most acute exposures.
The problem is … What we’re more concerned about is, what’s in the cells? What’s in the brain? Now what are the deep body load of those toxins? That’s more difficult to get. For example, if you want to know how bad your chemical toxin exposure is probably the best thing to do is to do a fat biopsy to see what’s in there. Okay, well, that’s fine. You can only pick up fat soluble chemical toxins, but the fat soluble chemical toxins tend to be the worst anyway. In order to determine how much metal is in the body, many of us are using what’s called challenge testing. We give a person a drug, like DMSA or DMPS or EDTA, and then see how much that increases their secretion of metals. That actually is useful, but it’s also flawed. There’s no question that it’s not a perfect test.
Because the only way to determine how much mercury a person has that’s causing trouble, for example, with the brain causing dementia is to do a needle biopsy of the brain. In general, patients don’t want you sticking needles into their brain. The bigger the needle that you need for tissue biopsy, the worse it is. We have to infer what’s going, and those methods aren’t very good. But they’re better than just blood and urine. And mercury being a great example, because if blood and urine are so great for determining acute exposure, then you’d expect that blood and urine to correlate very well with each other in their levels of mercury. It turns out blood and urine and mercury don’t correlate with each other very well at all. In general, I prefer more tests like blood tests and tissue biopsies than I do things like urine tests. Because it tells you what’s in the body, not what the body’s getting rid of.
Dr. Weitz: What do you think about the chemical antibody testing that’s available now?
Dr. Pizzorno: It’s intriguing, and I’m following it. I’m sure you’re aware of the work of another chiropractor, Dr Datis Kharrazian.
Dr. Weitz: Yeah, yeah. We just had a Functional Medicine Meeting, and Dr. Vojdani spoke at the meeting.
Dr. Pizzorno: Oh great, okay. You know the work of-
Dr. Weitz: He developed a lot these tests.
Dr. Pizzorno: Aristo and Datis are doing some, I think, really important work. What they’re doing that I find so interesting is they’re pointing out that these chemicals and metals are binding to normal body tissues. Normal body tissue, normal body proteins, which the immune system says are okay. Well, when you change some … adding a chemical or a metal, you’ve now made a new molecule that the body now thinks is an invader, and now you’re setting people up for auto-immune disease. I think these tests are quite intriguing and may be quite valuable. I think we’re a little early in the process for me to be using them clinically, but they’re at the point now where I would consider using them. I’m not quite ready to say that this is the way to go.
Dr. Weitz: Yeah, cool. Can you talk about some of the ways that we can get rid of toxins from our bodies?
Dr. Pizzorno: There are three key methods. Number one is stop exposure. I’m going to be really aggressive about this, stop exposure. Because many of these toxins, we’re actually pretty good at getting rid of. Now, I mentioned arsenic for example. Half life of arsenic in the body is only two to four days. That tells me as we evolved as a species, we were exposed to arsenic, we figured out how to get rid of it.
But if your water has arsenic in it, if you’re eating rice and chicken, you’re constantly being exposed to the arsenic which is why it’s the number one toxin right now. It’s a big, big issue. What do we do-
Dr. Weitz: What do we do about water? How do we get rid of toxins in our water?
Dr. Pizzorno: It depends upon the toxin. If it’s the chemical toxins, a carbon block filter would work just fine. In our house, we have a carbon block filter, a big one, on the water supply coming into the house, so the water in our showers has now been cleaned up. Because it turns out a lot of these organic compounds in the water are more efficiently absorbed by inhaling them than they are by eating them or drinking them.
Dr. Weitz: Like chlorine and stuff?
Dr. Pizzorno: Chlorine, yes, problematic, but I’m much more concerned about the chlorinated organic compounds. When we chlorinate the water supply to kill bacteria, and it does that by the chlorine binding to the organic molecules in the bacteria and kill them that way. Those chlorinated organic compounds are actually pretty toxic and many of them are carcinogenic. Now, they’re not a big cause of cancer. I read a study where the public health people said, “Okay, we know that by chlorinating the water supply, we’ve basically dramatically improved human longevity.” If you look at human longevity, three quarters of it was from public health putting … doing things like putting chlorine into the water supply to get rid of invading organisms that are killing babies, so that works really well. The researchers also know that about three people out of every 10,000 who are consuming this chlorinated water will get cancer from that chlorinated water because of these carcinogens. Now I’m sure these chlorinated compounds cause other trouble as well. It’s a small factor, and if that was the only factor, that’s okay. But the problem is it’s only one of many, many factors.
There are over 100 chemicals and metals in our environment at high enough levels to damage human physiology and cause disease. You might say, “Well, that one only causes like 1% of disease. Why worry about it?” Well, because it’s one of 100. You have to get all hundred of them. You can’t just pretend that they don’t count. They all count. They add up. It’s worse than that, and that is these things are synergistic. One plus one does not equal two. One plus one equals three. One plus one plus one does not equal three, one plus one plus one equals ten. As our body load of toxins increases, our ability to protect ourselves from the toxins becomes depleted, and you get more and more disease.
Dr. Weitz: Interesting. When it comes to doing detox, there are so many different detox programs out there. You see all these programs at the health food store just take this set of pills; just use this detox powder. There are so many different opinions on how to do detox. You get in a special sauna, stick your feet in this ionic bath …
Dr. Pizzorno: Let’s finish this question you asked me.
Dr. Weitz: Okay.
Dr. Pizzorno: First one, decrease exposure. Then number two is support the body’s own natural detox systems, and the third one is, okay, let’s do stuff to directly get things out of the body-
Dr. Weitz: Okay.
Dr. Pizzorno: … you might say, by chemistry.
Second one is to support the body’s own innate systems. There are a lot of approaches we can take. The two simplest ones which are safe for virtually everybody is number one is increase your fiber. Because our body is constantly dumping garbage through the liver into the gut, and the body’s expecting there to be fiber there to bind to the toxins and get it out of the body. If you have all of those systems, we’re consuming 100 to 150 grams of fiber a day, unfortunately the average person now only consumes 15 to 20 grams of fiber a day. Excuse me. Spring has finally come.
Dr. Weitz: Bless you.
Dr. Pizzorno: Okay. One thing you can do then is to increase fiber, so that when the liver … Sorry.
Dr. Weitz: What type of fiber? You like the modified citrus pectin?
Dr. Pizzorno: I like pretty much every fiber except wheat bran fiber. Whether it’s pectin or oat bran or flax seed or whatever it may be, or eating fruits, I like, beans and such, just more fiber will help detoxify.
Then the second one just one simple supplement, and that’s N-Acetyl Cysteine or NAC for short. That increases production of glutathione which plays a huge role in detoxification. There are a lot of other ways we can support detox. In my new book, The Toxin Solution, … Well, actually, it’s new in terms of the paperback came out, the hardback came out last month, anyway, so I talked in there about ways to support the body’s own detox systems.
Dr. Weitz: One interesting point I’d like to make is since I treat a lot of patients with gut problems, one of the trends with patients with IBS and small intestinal bacterial overgrowth is putting the patients on a low-fiber diet, because a lot of times fiber makes your gut worse, because it feeds these bacteria. It’s interesting that we may actually inadvertently be increasing our toxin load as we try to improve our gut health.
Dr. Pizzorno: If you look at my book, the first two weeks, I show people how to avoid toxins. The second two weeks, I say, “Now how do we clean up the gut.” Because indeed, the wrong kind of bacteria in the gut will cause all kinds of trouble. I’m one of these people who … I’m not a great believer in the whole SIBO diet and things like this. Not that they don’t help people in the short term, but in reality what I think they are is they’re just an indication that the gut’s not working properly, fix the gut. Because all those other foods they’re saying you have to avoid, they’re also natural, healthy foods. It’s not the food’s problem, it’s the gut’s at the problem.
Now the third category then is to directly get toxins out. One way to do that, for example, is to be aware of what toxin the person has, and then look at what molecules we can give that person to get the toxin down more efficiently. I’ve seen a lot of people with high levels of lead and/or mercury. A lot of that is because as people get older when they start losing bone the lead and mercury stored in the bones starts getting released into the system. For those people, I recommend oral DMSA, and I recommend not very much, 250 milligrams every third night, along with extra fiber and NAC. It’s a slow process, but it’s extremely unlikely anybody will have a bad reaction, and over time-
Dr. Weitz: DMSA is by prescription now, right?
Dr. Pizzorno: [crosstalk 00:22:10]-
Dr. Weitz: Depending on the state, I guess?
Dr. Pizzorno: Yes. It used to be available in health food stores, now it’s only by prescription. Actually, when I’ve used it with my patients, I always use it by prescription, because I want to make sure about the quality and dosage and such. Whereas in health food stores, some if you’re with … If you buy from a good manufacturer, everything’s fine. Unfortunately, there are also bad manufacturers, so it’s hard to tell between them.
Dr. Weitz: You mentioned NAC. What do you think about taking glutathione orally or IV?
Dr. Pizzorno: Oral glutathione is broken down by the bacteria in the gut. While oral glutathione will increase glutathione levels, it does … Basically, it’s expensive cysteine. It’s much cheaper to give people N-Acetyl Cysteine than it is to give them oral glutathione. Now, having said that, you can give them topical glutathione, intranasal glutathione, IV glutathione, there are a lot of other ways to get glutathione into the body. But just oral glutathione doesn’t work real well.
Dr. Weitz: Right, they have all these new liposomal forms, and there are claims-
Dr. Pizzorno: Those are better.
Dr. Weitz: Yeah. M’kay. Go ahead with your detox protocols.
Dr. Pizzorno: Okay. Now for a person that has really high levels of chemical toxins, you can speed the process up by giving people, I hate to say it, but sometimes I do recommend drugs. That is, I give them bile sequestering drugs. Things like costyramine, cholestyramine, things of that nature actually bind to the chemical toxins in the gut much more efficiently than even fiber does. This is a good way of getting toxins out if someone has a really high chemical load.
Dr. Weitz: What about using clay or charcoal as binders?
Dr. Pizzorno: Right. Clay and charcoal, those all should work. Unfortunately, there’s not much research on them. That’s not surprising, because nobody makes money with those things. I wish there was more research on them. There’s a very small amount of research on rice fiber. There’s a small amount of research on wheat fiber, but not near as much as we would like, but what’s there is very encouraging.
Dr. Weitz: Okay.
Dr. Pizzorno: Let’s talk about another method, and that is sweating, saunas, okay?
Dr. Weitz: Yeah.
Dr. Pizzorno: Heavy exercise. It turns out if you … Have you had Stephen Genuis on your show?
Dr. Weitz: No.
Dr. Pizzorno: If you get a chance, I recommend it. He’s an MD in Edmonton, Alberta.
Dr. Weitz: Okay.
Dr. Pizzorno: He spends half his time doing research on toxicity and half his time detoxifying patients.
Dr. Weitz: Oh, cool.
Dr. Pizzorno: Everybody knows, well, saunas are supposed to be detoxifying because of all the sweating. Everybody knows that, but who actually tested it? Stephen went and got a bunch a people, got some volunteers, had them sweat, took the sweat, looked in a laboratory to see what was in it, full of chemicals and metals particularly cadmium. Sweating is a very effective detox system, and I recommend people do a sauna at least once a week and preferably twice a week to get the toxins out.
Dr. Weitz: Do you like infrared sauna?
Dr. Pizzorno: The nearest we can tell, it doesn’t matter how you’re sweating, just as long as you’re sweating. Whether it’s infrared sauna or regular saunas or running or like me playing basketball, it doesn’t matter, just, you’ve got to sweat.
Dr. Weitz: Cool.
Dr. Pizzorno: I can keep on going for as long as you want.
Dr. Weitz: Let’s keep going on with the detox protocols. You mentioned mercury and lead, and it’s interesting … Myself and I know other Functional Medicine practitioners sometimes get these chronic patients with these elevated levels of mercury and some of these other toxins, and it seems like it’s very, very difficult to get rid of them. What do you do with some of these patients?
Dr. Pizzorno: Yes. I want to state as strongly as I can, that a lot of people say, “Oh, I’m toxic, therefore I should do a detox system protocol.” Well, don’t do a detox protocol until you’re sure that your organs of elimination are working properly. Because if you stir things up and can’t get rid of them, you’ll make yourself worse. A lot of people get discouraged about detoxification because of not appreciating that this is a process that must be done properly. In my book, The Toxin Solution, I spend two weeks, make people aware of where the toxins are coming from so you stop putting them into your body, two weeks to clean up the gut, two weeks getting the liver to function properly, and two weeks getting the kidneys functioning properly. We now have an epidemic of kidney failure. This is something that used to be so rare, and now we’ve got dialysis centers all over the place. Because people’s kidneys are failing from all the chemicals they’re being exposed to including prescription and non-prescription drugs. The nonsteroidal, anti-inflammatory drugs, particularly acetaminophen, are very, very damaging to the kidneys.
Okay. Now we have a cleanup, get everything cleaned up, and now we can start going on a detox program. The detox program that I recommend is having people do regular saunas, at least twice a week preferably three times a week. Increase their fiber. Go on a mild caloric restriction, I don’t want to do a lot of caloric restriction. Because for a person saturated with toxins, and they start losing weight, and their fat starts breaking down, it releases the toxins. Just a little bit to help release, and then I put them on an alkalinizing diet. Reason for that is that many of the toxins in the body are more efficiently released when the body becomes more alkaline. I put them on an alkalinization diet, and what does that mean? What that means is decreasing consumption of high sulfur containing amino acids, which means basically less meat, and it also means decreasing consumption of salt. We consume so much salt that we impair the kidneys’ ability to get rid of other toxins such as excess acid but other toxins as well. By making the body more alkaline through decreasing sulfur and sulfur containing amino acids, and decreasing salt, we now have the body more able to get rid of the toxins, and we start detoxifying.
Another point that’s important here is if you’re going to do detoxification not only must you do it properly, but you must also recognize it takes time. We’ve been trained to buy the modern chemistry to expect treatment from doctors to be really fast.
You have pain, you go and take an anti-inflammatory drug, a nonsteroidal anti-inflammatory drug, your pain inflammation well, within a few hours, it’s dramatically better. Well, modern living through chemistry. It sounds good. Well, of course, most of those drugs work so quickly, because they simply poison the body’s enzyme systems that are producing the symptoms not actually dealing with why people are sick but anyway get quick results.
Then we do nutritional medicine. It’s not as fast as drugs, but it is a little quicker than detoxification. When we get people the nutrients they need, it can be weeks, sometimes even months, to get enough nutrients into the body, so the body works properly. That’s fairly good.
How about for detoxification? First, you have to stop the toxins coming in. Then you’ve got to get the toxins out of the body. Then all those enzyme systems that have been poisoned by those toxins, they’ve got to be replaced, and now your body can start healing. This takes months to even years to get the job done. But if you work at it properly, the health benefits you get are profound and long-lived.
Dr. Weitz: Cool. How do you support the gut to get it ready for detox?
Dr. Pizzorno: There’s a protocol I’ve been using on patients now for, oh God, 40 years. I developed it myself, and I noticed that other people have now developed derivatives of it, but it’s very straight forward. First off, kill off the bad bacteria, and I use good old goldenseal to do that. Because goldenseal will kill the bad bacteria but leave the good bacteria alone.
Dr. Weitz: Goldenseal is basically a source of berberine?
Dr. Pizzorno: Right. The berberine and hydrastine in the goldenseal kill off things like Clostridium and other toxic bacteria.
The second thing I do, and I’ve learned from my poor patients, is that when you kill off all that toxic bacteria, they release a lot of their toxic constituents. Remember there’s 10 times as many bacteria in your gut as there are cells in our body. When they die, they release everything that’s in the cells, bacterial cells, and lots of problems. You have to use a lot of fiber while you’re doing this to make sure you’re absorbing the toxins as they’re being released.
Next thing we want to do, of course, is re-seed the gut with proper bacteria. I prefer broad-spectrum strength bacteria, not just one bacteria, but lots of good ones. Finally, we need to stimulate the healing of the damaged gut.
So four steps: 1. kill the bad bacteria, 2. absorb the toxins that have been released, 3. re-seed with healthy bacteria, and 4. then stimulate the healing of the gut.
Dr. Weitz: Essentially, your version of the 4R Program.
Dr. Pizzorno: I did this about 10 years before anybody ever heard about the 4R Program. That’s one of the reasons why I’m one of the people who helped found Functional Medicine. Because I’ve been working on this for a long time.
Dr. Weitz: Right.
Dr. Pizzorno: It’s why I have literally hundreds of patient stories, people with this, that, and the other chronic disease where I did this foundational, age-old naturopathic program which is: clean up the gut. And clean up the gut, a lot of disease goes away.
Dr. Weitz: Right.
Dr. Pizzorno: Old time age old adage and that is, “Disease begins in the gut.” I was taught that when I was a third-year student almost half a century ago.
Dr. Weitz: That’s great, very profound. You ever do stool testing to see what’s in the gut first?
Dr. Pizzorno: Yes and no. The method that I use for determining how toxic the gut is, is relatively simple and inexpensive, because that allows me to do it more frequently. There’s something called the Obermeyer test, also known as the Indican test. I don’t know if you’ve run across this.
Dr. Weitz: Is it like a urine test?
Dr. Pizzorno: A urine test, right.
Dr. Weitz: Okay.
Dr. Pizzorno: The urine test measures something called indoles and skatoles in the urine. What these are, are the, you might say, the breakdown of protein by the wrong bacteria in the gut that produces these chemical toxins. I say to the patient, “I think you have a toxic gut, and you have a lot of indoles and skatoles,” and, of course, you get a blank face with your patient. Then I say, “Well, they have other names. They’re also called putrescine and cadaverine.” Okay?
Dr. Weitz: Right.
Dr. Pizzorno: When you say that, all of sudden the patient says, “Oh, that doesn’t sound good.” Anyway, I use this test, and it’s a real simple urine test. Actually, I used to … My undergraduate degree is in chemistry, so I actually-
Dr. Weitz: Is this part of an organic acids profile?
Dr. Pizzorno: No, it’s unfortunately not.
Dr. Weitz: Okay.
Dr. Pizzorno: I wish it was available, but it’s a test … There is a website on the internet that does sell it. It’s real inexpensive, and if you have any chemistry capability of your own, you can make up the test yourself.
Well, you take some of the patient’s urine. You shake it up in this little vial, turns bright blue in proportion to the amount of indoles and skatoles or putrescine and cadaverine in the gut. As I put them on the protocol, I have them come back once a week to test the urine. It’s really inexpensive to test.
Dr. Weitz: You do the test in your office just like that?
Dr. Pizzorno: We do the test in my office, it’s real easy.
Dr. Weitz: Wow, very cool.
Dr. Pizzorno: Anyway, I just have them come back. I don’t have to see it myself. I have to make sure they’re progressing. We test them every week, and what we find is as we clean up the gut, the indoles and skatoles go away. It goes from blue to light blue to clear, and as their gut cleans up all their health improves as well. It’s a nice objective reinforcement for the patient to show that the subjective feeling their having of feeling better is also objectively demonstrated with the test.
Dr. Weitz: Wow, that’s great. That’s a real practical tool that we can use.
Dr. Pizzorno: Yes, very practical, very useful.
Dr. Weitz: Where do you get the reagent from?
Dr. Pizzorno: If you look at my book, the Textbook of Natural Medicine, I have the formula for making up the indoles … The Obermeyer test is in my-
Dr. Weitz: Okay, cool. It’s in the appendixes in the back?
Dr. Pizzorno: Right.
Dr. Weitz: Yeah, yeah. I just finished reading it, highly recommend that book very, very-
Dr. Pizzorno: Yeah. Now, that’s in the Textbook of Natural Medicine, not in my consumer book, The Toxin Solution.
Dr. Weitz: Oh, okay. Okay. Okay. Cool. Let’s see, so what is your liver detox protocol? How do we support the liver? Now, we’ve been talking about Phase 1 and Phase 2 of liver detox. Now people are talking about Phase 3. Somebody just mentioned Phase 0, so I guess it’s getting more and more complicated.
Dr. Pizzorno: You always have to be careful about losing the forest by looking too closely at the trees. I think these are all of interest, and indeed people have problems in every one of them.
When I go back to the liver, I do really foundational things. That is first off, are the nutrients a person needs available for the liver to function properly? For example, look at those Phase 1, Phase 2, particularly, Phase 1 liver detox systems. They are all based on iron molecules, iron-containing molecules. If a person is low in iron, for example, most menstruating women, if they’re low in iron, they’re going to have trouble with their detox systems. Because they can’t make enough of the enzymes. I want to make sure they have enough iron. Also, those detox systems, enzymes both Phase 1 and Phase 2, are highly dependent upon magnesium and neuro-magnesium as well as the B vitamins. What I do with these people is, I make sure they’ve got the minerals they need like iron and magnesium, make sure the B vitamins are there so the detox functions properly.
In addition, there are some herbal medicines we can use to do things like, I know it’s an age old thought that has been derided by conventional medicine, but liver detox. There are herbs you can use to help the liver get rid of the bile and other things that built up in the liver that are full of toxic material. Things like artichoke, for example, Cynara, is good at detoxifying the liver. And milk thistle, for example, upregulates liver detox systems. Basically, make sure the nutrients are there, get the herbs in there to help stimulate things, and get the liver working quite well.
Dr. Weitz: Phase 2 is really crucial, right? Otherwise, you create too many toxic intermediates?
Dr. Pizzorno: Right. The way that many of the most difficult to detoxify chemicals are eliminated by the liver is they’re first activated by Phase 1 detoxification.
Then and the [inaudible 00:36:46] molecules are actually way more toxic, and then they’re then bound to Phase 2 in something called conjugation, where these activated intermediates are more easily conjugated. Phase 2 conjugates them with things like, for example, glutathione.
I mentioned glutathione before. Well, if you have a person who’s been consuming a lot of alcohol, for example, they’re depleting the glutathione stores. If they consume a lot of acetaminophen, they’re depleting their glutathione stores. What happens is that Phase 2 does not work as well, so they actually have more toxic compounds there.
I then looked at Phase 2 and realized some compounds in Phase 2 can be easily depleted. We want to make sure there’s plenty of it there. That’s why N-Acetyl Cysteine is such a good molecule for detoxifications, because it increases glutathione production.
Dr. Weitz: Now, NAC, it’s interesting you brought that up. It’s my understanding that in order for Phase 2 of liver detox to work properly, you need sulfur containing amino acids like cysteine. But if you put the patients on a low sulfur diet in order to alkalinize them, you may be depleting Phase 2 liver detoxification.
Dr. Pizzorno: That’s a very good point. The NAC is a sulfur-containing amino acid and a small percentage of the population, I think maybe around 3%, I’m not sure but just looking at what experience has been treating people, have trouble metabolizing sulfur compounds. They typically are the deficient in molybdenum or the enzymes are genetically made so they don’t work very well, and people need extra molybdenum.
Now when I’m giving people N-Acetyl Cysteine, particularly over a period of time or in particularly higher dosages, I also give them molybdenum to make sure they’re metabolizing it properly. With everything, it’s always a balance. Yes, N-Acetyl Cysteine is more acid-forming, but that’s easily taken care of by eating more fruits and vegetables. Real simple.
Dr. Weitz: Right. I think some of these detox powders have those specific amino acids as well. Do you ever utilize those as part of your protocol?
Dr. Pizzorno: I have used them, and I think they are useful. I notice that some patients like to be put on a program. They want to get a box with stuff in it that has everything they need. Days one to four, take this formula, then days five to seven, take this formula. Which is fine. There are good ways of doing this, and I support that.
Dr. Weitz: Can we order the Pizzorno detox box from you?
Dr. Pizzorno: Well, you can actually, if you go to Bioclinic Naturals. They have something called, the 7-Day Detox Kit, and that’s something that I helped design, and-
Dr. Weitz: Oh, okay. Cool.
Dr. Pizzorno: By the way, fair warning, I’ve had a lot of people tell me it was wonderful. But one out of four people, it detoxifies them too quickly. If you use that formula and aren’t feeling very good, it means your detoxing too quickly. You need to back off. But for everybody else, it works real well.
Dr. Weitz: Yeah, yeah. I find a lot of times, a 30-day detox is easier to do than a one week or two week or 10-day detox.
Dr. Pizzorno: Right. I want to reinforce what you just said. We have to realize, detox is not a fast process. If you think you’re doing a fast process more likely you’re going to run into trouble. It takes times.
Dr. Weitz: Especially if these toxins are stored in your body for long periods of time, in your bones, in your fat.
Dr. Weitz: Right. I think some of these detox powders have those specific amino acids as well. Do you ever utilize those as part of your protocol?
Dr. Pizzorno: I have used them, and I think they are useful. I notice that some patients like to be put on a program. They want to get a box with stuff in it that has everything they need. Days one to four, take this formula, then days five to seven, take this formula. Which is fine. There are good ways of doing this, and I support that.
Dr. Weitz: Can we order the Pizzorno detox box from you?
Dr. Pizzorno: Well, you can actually, if you go to Bioclinical Naturals. They have something called, the 7-Day Detox Kit, and that’s something that I helped design, and-
Dr. Weitz: Oh, okay. Cool.
Dr. Pizzorno: By the way, fair warning, I’ve had a lot of people tell me it was wonderful. But one out of four people, it detoxifies them too quickly. If you use that formula and aren’t feeling very good, it means your detoxing too quickly. You need to back off. But for everybody else, it works real well.
Dr. Weitz: Yeah, yeah. I find a lot of times, a 30-day detox is easier to do than a one week or two week or 10-day detox.
Dr. Pizzorno: Right. I want to reinforce what you just said. We have to realize, detox is not a fast process. If you think you’re doing a fast process more likely you’re going to run into trouble. It takes times.
Dr. Weitz: Especially if these toxins are stored in your body for long periods of time, in your bones, in your fat.
Dr. Pizzorno: A good example is people with high levels of mercury. Well, most people will say, “Well, let’s give you an IV,” DNPF, for example. Well, an IV DNPF will get the toxins out really quickly, but you’re much more likely to have adverse drug reactions. I use the oral protocol instead. It takes maybe three times longer, but you don’t get side effects. I’d rather it be a little slower and not cause unexpected damage.
Dr. Weitz: That’s great. Well, thank you Dr. Pizzorno. This has been a great interview. You’ve given us a lot of very interesting information about toxins, and how to avoid them, and how to get rid of them.
Dr. Pizzorno: Great, happy to help.
Dr. Weitz: For those listening to this, how can they get a hold of you?
Dr. Pizzorno: Well, you can go to my website drpizzorno.com. D-R-P-I-Z-Z-O-R-N-O dot com. I’m trying to set it up, so that it’ll be easier for people to connect with me. I’m still learning about all this social media stuff.
Dr. Weitz: Right.
Dr. Pizzorno: Also, I have a Twitter account Dr. Pizzorno D-R-P-I-Z-Z-O-R-N-O.
Dr. Weitz: Okay.
Dr. Pizzorno: Whenever I say something interesting, I’ll tweet it. Not whenever … When I have some time, and I say something interesting, I’ll tweet it. Because I say interesting things all the time. I don’t always have time to tweet it though.
Dr. Weitz: Right. And The Toxin Solution, they get a hold of that wherever bookstores … at all the bookstores, Barnes and Noble, Amazon. And when is your textbook for clinicians on environmental medicine going to be available?
Dr. Pizzorno: Clinical and Environmental Medicine will come out July 7th, and Elsevier will be the medical textbook publisher. I’m really excited about it. Because, while, I have a good body of knowledge in this whole area of environmental medicine, Walter Crinnion my co-author also has a huge body of knowledge. What’s was surprising to us is there wasn’t actually a lot of overlap in our knowledge bases. By putting both of our work together in one textbook and really being rigorous and looking at a lot of science, I think we’ve created something that’s going to be fantastic. I’m so excited that’s going to be coming out.
Dr. Weitz: That’s great. I can’t wait. I’m very excited for that book to come out, so put me on the list.
Dr. Pizzorno: Okay.
Dr. Weitz: Thank you, Dr. Pizzorno. Hope to talk to you soon.
Dr. Pizzorno: Great chatting with you.
