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Welcome!

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Tracy’s health counseling certification is from Columbia University for the Institute of Integrative Nutrition in New York.

She has completed ongoing training and is working on a certification in understanding the root causes of chronic illness with the Institute of Functional Medicine and on an additional Masters degree in Human Nutrition at Bridgeport University.

She holds a Masters degree in Engineering from MIT and a Masters degree in Management from The Sloan School at MIT.

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Heavy Metal Toxicity

Part 1

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● Key Reminders● An Introduction to Toxicity● Detoxification Basics● Heavy Metals● For More Information

Agenda

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Optimal Health is Not Complicated

Maximize Put in what’s needed for this unique person

Raw materials your body needs to function and heal Oxygen, Water, Vitamins, Minerals, Antioxidants, Protein, Healthy Fats Belief that the therapy one is choosing is effective and safe

MinimizeTake out what’s harmful for this unique person

Toxins, Infections, Allergens, Stress, TraumaLimiting beliefs, fear, negative expectations

PrioritizeCreate an environment for healing for this unique person

Sleep, Rest, Laughter, Stress ReductionExercise, Stretching, BreathingMeaningful RelationshipsPositive visualizations and associations

And then the body will heal itself – will naturally seek wellness.

Simplifying the face of health can be very calming and inspiring to

your clients.

Of course, we are not very good at doing these three things consistently. The result? Chronic Dis-ease in the body.

This is Why Your Clients and Patients Need You!

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All Things are Interconnected

Oxygen Intake and Spiritual Mindset

Stress and Stress Management

Toxins and Detoxification Ability

Sensitivities and Allergies and Immune Health

Energy Generation and Circulation

Nourishment and Absorption Ability

Genetic Predispositions and Infections

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An Introduction to Toxicity

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What are Toxins?

Any substance that causes structural damage or functional disturbances in the human body.

Exposure can occur – Externally - ingestion (e.g. water, pesticides, transfats, drugs), inhalation

(air), injection, or absorption (e.g. water, textile coatings, personal hygieneproducts, cleaning products)

– Internally – microbial or metabolic byproducts (e.g. bilirubin, hormones)

Includes many naturally-occurring and synthetic, man-made substances. Just because something is “All Natural” doesn't make it harmless!

Toxins...– Are everywhere and unavoidable but can be reduced

– Are rapidly increasing in volumeand variety in our environment

– Have synergistic, additive effects

– Can be managed and excretedby a healthy body in small amounts

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Where are Toxins?

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100,000+

as of 2006

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Toxicity Overload is Common

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Toxicity Overload is Common

Estrogen Mimickers

BPA

Triclosan

Glyphosphate

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Toxicity Overload is Common

“Heavy metals” Mercury Arsenic Lead Cadmium Aluminum

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Courtesy of the Institute of Functional Medicine, Dr. Kenneth Bock

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An Introduction to Detoxification

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Human Detoxification Tenets

Part of the body's innate defense system – to manage both internally-generated and externally-acquired toxins.

Includes processing excess amounts of healthful substances (e.g. estrogen, Vitamin D, quercetin) as well as any amount of toxic substances (e.g. BPA, mercury, pesticides).

Something our bodies are doing all the time, every day. Requires specific nutrients Begins in the gut lining – continued primarily in the liver

but happens to some extent in all tissues, especially lungs, kidneys, skin, and brain.

Can be genetically impaired or improved Must convert fat-soluble substances

to water-soluble ones that can be readily excreted from the body (e.g. urine, stool, sweat).

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Human Detoxification Tenets

Allows for storage of toxins that cannot be readily processed, primarily in our fat (adipose) tissue

– WS clinical tip: weight loss frees up toxins and needs detoxificationsupport to avoid inflammation and potential re-storage of toxins elsewherein the body

Toxic build-up can result from one-time acute exposure or (much more commonly) chronic, low-level exposure.

Toxic build-up could trigger development of adipocytes in the body and increase storage of fat as a primal protective mechanism*

* http://www.ncbi.nlm.nih.gov/pubmed/12006126 and http://cot.food.gov.uk/pdfs/tox2013.pdf andhttp://drhyman.com/downloads/Toxins-and-Obesity.pdf

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Detoxification Flow: Simplified

Toxin Absorption

Toxin Excretion

Toxin Absorption

Toxin Polarization

Toxin Conjugation

Toxin Excretion

Simple, right? But not very common!

Oxidize toxin and make it more “sticky” (& more toxic!)

“Cytochrome P450” enzymes (CYP)* are catalysts (57)

Detoxification steps: Phase 1 Phase 2 Phase 3

* For much more detail on these vital enzymes: http://www.fasebj.org/content/6/2/745.full.pdf or a table of whichCYP enzymes detoxify specific drugs or herbal substances: http://medicine.iupui.edu/clinpharm/ddis/main-table/

Free Radical Damage

Bind toxin to a water-soluble “escort” (less toxic)

NrF2 activates Phase 2 enzymes (6)

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Liver detoxification pathways and supportive nutrients

Urine, Stool, Sweat,

Exhalation

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Typical American Balance Problem?

Phase 1 Upregulators Caffeine, Excessive alcohol, Cigarette smoke,

Charbroiled meat, many common medications (e.g. omeprazole)

Phase 2 Upregulators Cruciferous vegetables, B-vitamins, eggs,

healthy digestion, sufficient sleep, low insulin (low-glycemic diet), youth, being female (especially premenopausal)

Phase 1 and Phase 2 Imbalance Oxidative damage and Inflammation! Out of the frying pan & into the Fire “Traps” toxins in the body A Simple example: Tylenol toxicity. N-acetyl cysteine (“NAC”) is

administered in emergency rooms to increase glutathione (phase 2).

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Liver detoxification pathways and supportive nutrients

Urine, Stool, Sweat,

Exhalation

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Phase 2 Conjugation Processes

1) Sulfation(e.g. HCAs (heterocyclic amines fr. overcooked meats), steroid hormones)

2)Methylation(e.g. arsenic, catecholamines (such as dopamine and epinephrine), sulfites)

3)Glutathione conjugation(e.g. mercury, lead, cadmium, fat-soluble vitamins, many herbicides)

4)Acetylation(e.g. histamine, serotonin, cigarette smoke, exhaust fumes)

5)Glucuronidation (e.g. BPA, over 2/3 of pharmaceuticals)

6)Amino Acid conjugation (e.g. sodium benzoate, aspirin)

Many toxins can be (or must be) conjugated via more than one process. Some toxins, especially mercury, directly interfere with the enzymes that

create the Phase 2 processes which would get rid of it. A vicious cycle!

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Phase 2 Detox Needs Nutrients

1) Sulfation – needs methionine and cysteine (from protein),molybdenum, magnesium

2) Methylation – needs methionine (from protein) and key B-vitamins (B6, B9, B12)

3) Glutathione conjugation – needs cysteine, glycine, glutamicacid (from protein), selenium, Vitamin B6

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The Experience of Toxicity is Individual

What is toxic to one person is fine for another person. Our toxin tolerance is particularly individual.

Genetics

Toxic Excretion

Environment

Toxic Exposure and Absorption Nutrition

Toxic Retention

Inflammation/Disease

Comfort/Wellness

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The Role of Genetics: Detox SNPs

What is toxic to one person is fine for another person. Our toxin tolerance is particularly individual.

"Several single-nucleotide polymorphisms, (we have been calling them SNPs, of which nearly 2,000,000 have now been identified through the human genome studies) in which the variant amino acid reduces coenzyme binding and thus enzymatic activity, are likely to be remediable by raising cellular concentrations of the cofactor through high-dose vitamin therapy.“

- Dr. Bruce Ames

http://ajcn.nutrition.org/content/75/4/616.abstract

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Common Heavy Metal Detox SNPs

What is toxic to one person is fine for another person. Our toxin tolerance is particularly individual.

Methylation can be impaired via “MTHFR SNPs”: C677T and A1298C variants.

– Affects a gene which creates an enzyme called MTHFR that convertsfolate for use in the methylation process.

– Increasingly this test is available from integrative physicians.– Affects up to one-third of the American population.

Glutathione conjugation can be impaired with SNPs: GSTM and GSTP variants

– Affects the gene which creates the enzyme called glutathione s-transferase which forms the glutathione molecule.

– Still a more esoteric test only available via functional testing panels.(see sample test results for Genova's “DetoxiGenomic” panel)

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Pulling it All Together: Inflammation and DiseasePurpose Inc.©

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Inflammation & Cellular Communication

Inflammation is the body’s response to threat or injury. Necessary for triage and survival. e.g. wound-healing (swelling, redness, fever)

Cells secrete chemicals (e.g. cytokines)which communicate the need to Calm the body (anti-inflammatory) or Alarm the body (inflammatory)

Harmful if Chronic or Inappropriate

The most common chronic inflammation triggers: food, bugs, toxins, stress. Common chronic inflammatory symptoms are often what our clients think of as

“just getting old”! e.g. swollen joints, achy muscles, congestion, headaches, diarrhea, constipation, GERD,

depression, lethargy, ongoing fatigue, skin rashes, itchiness, bloating, poor memory, irritability, brain fog

But they become things we know to be highly-debilitating or deadly Diabetes, Atherosclerosis, Asthma, Multiple Sclerosis, Alzheimers, Cancer…

Generally, Inflammation means a loss of Tolerance.

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With appreciation to Dr. Dan Lukauzer, Institute of Functional Medicine, AFMCP

An example:

Mercury amalgam tooth fillings

FHx: Poor glutathione production

Low Selenium, antioxidants

Malaise, mood swings, headache

Chronic Depression

An example:

Arsenic from high shellfish intake

FHx: Poor methylation

Low vegetable intake (folate)

Itchy, scaly, bumpy skin

Chronic Eczema

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Finding the Interconnectedness in Your Clients

GENES

ILL-NESS

ENVIRONMENT:

The Good, The Bad, and the Ugly

WELL-NESS

Food

Stress

Medications

Family History

Toxic exposure

Symptoms

Emotional trauma

Injury

Personal hygiene products

Allergies

Infections

Nutrient Deficiencies

HydrationExercise

Relaxation

Mindset

Digestive Health Sleep

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Chronic Toxicity

“Low levels of toxin exposure may initially cause no (or only subtle) effects, but over the long term can lead to frank dysfunction that may be remote in both space and time from the toxin exposure.

That is, slow accumulation with delayed expression of toxic effects.”

- Dr. Kenneth Bock, MD

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Etiology of Inflammatory Dis-Ease

Dysbiosis

Infection

Food sensitivities

Toxins

Inflammation Arthritis

Eczema

Asthma/Allergy

Psoriasis

Chronic Fatigue

Fibromyalgia

Chronic PND, headache, muscle pain, etc.

BUT there may be no GI symptoms whatsoever!

Tendonitis

Cancer

Atherosclerosis

Auto-immune disease

e.g. TNF-αIL-1IL-6IFN-γCRPESR

Genetic Expression

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An Introduction to Heavy Metals

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Defining Heavy Metals

● Traditionally: metals with perceived environmental risk which were of aheavier atomic weight than iron

● For our purposes: Mercury, Lead, Cadmium, Aluminum, Arsenic● Natural substances, typically diffuse in nature, but concentrated with human

activities.● As with other toxins,

can enter humansvia inhalation,ingestion, or skinabsorption.

● Non-nutritive● Toxic effects to

humans from acute or chronic exposure

● Essentially all humanshave some of all thesetoxins in their bodies.

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Damage from Heavy Metals

● Indirect e.g. an inflammatory reaction from the immune systemreacting to the metal as a foreign invader (e.g. damaging theendothelial lining of an artery or triggering an autoimmune reaction)– Removing mercury amalgams reduces the autoimmune

reaction in Hashimotos thyroiditis*● Direct e.g. intra- or extracellular dysfunction

(e.g. microtubule neuron degeneration in responseto mercury exposure**)– Lead can replace calcium in key enzymes,

negatively affecting cognitive transmission ***● All can penetrate the blood-brain barrier using a variety of

transport mechanisms.****● Toxins cause inflammation which can damage mitochondria, then

rendering us less able to make cellular energy (ATP): “Tired'n'achy”● Can negatively affect the function of nearly any tissue in the human

body. But as with all other toxins, the dose-response can varysubstantially depending on absorption and detoxification capability.

* http://www.ncbi.nlm.nih.gov/pubmed/16804512** https://www.youtube.com/watch?v=lCzT1yuau_4 *** http://www.ncbi.nlm.nih.gov/pubmed/10227691 **** http://pharmacy.mc.uky.edu/faculty/files/jad.pdf

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Mercury (Hg) *

● Source: coal-burning, mining, and foundry work putselemental (inorganic) mercury in the air.– Down to earth by rain and into the water via runoff.

– Bacteria in the water supply convert to organic (methyl) Hg.

– Phytoplankton consume it; Hg is concentrated up food chain

● Point of intake: mercury/silver dental amalgams, seafood(esp. large fish), vaccine preservative, household accident(e.g. broken thermometer, fluorescent light bulb),contaminated well water (prior pesticide use)

● Mercury fillings can outgas for many years in response tomild stimulus. ** Substantially higher levels of organic andinorganic mercury found in those with amalgam fillings. ***

● Accumulates in the tissues, especially the jaw (ifamalgams), kidneys, liver, intestines, and brain.

* http://www.atsdr.cdc.gov/phs/phs.asp?id=112&tid=24**https://www.youtube.com/watch?v=hqIdGwAMxxs *** http://www.ncbi.nlm.nih.gov/pubmed/11385194

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Mercury (Hg)

● “Mad as a hatter”. Especially implicated * in neurological effects,DNA damage, damage to cellular membranes, autoimmunity, **and both liver and kidney damage and dysfunction.

● Particularly strong binding affinity to sulfur groups, one of the body's primarydetoxification agents.

● There is an association between higher mercury exposure and increasedincidence of type 2 diabetes. ***

● Causes nerve cell changes characteristic of Alzheimers'****● Generates highly toxic hydroxyl free radicals, to which is often attributed the

worst neurotoxic effects*****● In study of patients with chronic mercury toxicity, 32.3% exhibited severe fatigue,

88.8% memory loss and 27.5% depression. Removal of amalgam mercury fillingsand detox treatment reduce symptoms to level of healthy controls.******– Neurologically, look in particular for a combination of fatigue, anxiety, tremor,

depression, forgetfulness, insomnia, irritability, memory loss, peripheral neuropathy.– Allergies, WBC count below 4500/uL, muscle twitch/spasm (magnesium doesn't help)

* http://www.mdpi.com/1422-0067/3/9/965** http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2326774/ *** http://care.diabetesjournals.org/content/early/2013/02/14/dc12-1842.full.pdf **** http://www.ncbi.nlm.nih.gov/pubmed/15580166 *****http://www.ncbi.nlm.nih.gov/pubmed/11895129****** http://www.ncbi.nlm.nih.gov/pubmed/16891999

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Aluminum

● Sources: cookware, food packaging, many antacid drugs, all vaccines,conventional antiperspirants, marijuana, contaminated water.

● Substantiated as both a primary trigger for and exacerbating factor forAlzheimers' disease. * Very small molecule makes for easy BBB entry.

● Aluminum impairs glutathione production (and thus slows clearance of otherheavy metals such as mercury).**

● Associated with post-vaccination auto-immune syndromes. ***● Question in osteomalacia****,Parkinson's disease, Alzheimers or dementia

(memory loss, forgetfulness, cognitive slowness)

*http://www.ncbi.nlm.nih.gov/pubmed/23380995 and http://www.ncbi.nlm.nih.gov/pubmed/24577474** http://medind.nic.in/iay/t06/i3/iayt06i3p128.pdf *** http://www.ncbi.nlm.nih.gov/pubmed/23557271 **** http://www.ncbi.nlm.nih.gov/pubmed/3915958

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Heavy Metal Toxicity

Part 1

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