Pathological Detoxifiers and Environmental Illness
Posted by: Maff
on Jun 26, 2009
A little while ago bolam56 posted in the forums about a subject which hasn't been addressed specifically on the site before - 'pathological detoxifiers'.
>> Here's the original post
I thought this subject deserved more attention as it can be a vital piece in the puzzle for those suffering from environmental illnesses including multiple chemical sensitivity (MCS), chronic fatigue syndrome (ME/CFS), and Gulf War syndrome.
To define what it means to be a pathological detoxifier first we need to understand the basics of how liver detoxification works:
Liver Detoxification
The detoxification of toxins by the liver basically occurs in two phases. Substances the liver must detoxify can be exogenous (from outside of the body) such as alcohol, drugs, pollutants, or endogenous (from inside the body) such as hormones.
Most toxins are fat-soluble which means they are easily absorbed and stored in the body (particularly fatty tissues, including the brain), but are difficult to get rid of. The overall aim of phases 1 and 2 of the liver detoxification system is to make toxins more water soluble so they can be easily excreted by the body in urine. Some remain predominantly fat-soluble and are excreted into bile and eventually removed from the body during a bowel movement.
Phase 1 mainly uses a class of enzymes known as the cytochrome P450 system to oxidise toxins and make them more easily excretable and/or easier for the phase 2 system to pick up and carry on the job. Some substances such as caffeine go through phase 1 and are then directly excreted in the urine without going through phase 2. Equally some toxins can bypass phase 1 and go straight into phase 2. In the most part however (and this will become important in terms of the pathological detoxifier), toxins pass through both phases of liver detoxification before the body can rid itself of them.
Phase 2 involves the binding, or "conjugation", of certain substances to the toxins coming out of phase 1 so they can be removed from the body. There are six different conjugation pathways - glutathione conjugation, amino acid conjugation (e.g. glycine, taurine), sulphation, glucuronidation, acetylation, and esterification. Glutathione conjugation is generally considered the most crucial but this is not to say the other pathways do not play an important role and all need to be functioning optimally for good health.
So basically - phase 1 prepares toxins for conjugation by phase 2 which renders the toxins safe and able to be excreted.
The Pathological Detoxifier
Problems arise because when we are exposed to increased amounts of toxins this increases the rate at which phase 1 operates and it can usually continue to work at this rate indefinately. This isn't a problem if phase 2 pathways can keep up. Unfortunately in many people, if phase 1 activity remains elevated for a prolongd period the substances used by phase 2 tend to become depleted and phase 2 can no longer function efficiently and keep up with phase 1. When this situation exists in an individual they are said to be a pathological detoxifier. Substances coming out of phase 1 can't all be taken care of by phase 2, so instead they circulate throughout the body causing symptoms of toxicity and disease. What makes things worse is that substances produced by phase 1 are sometimes actually even more toxic than the original toxins being detoxified. This is why it is essential that phase 1 and phase 2 are in balance.
If you suffer from environmental illness or unexplained symptoms, or you feel "toxic"...it may be that you are a pathological detoxifier and you literally are toxic. Fortunately there is a simple test available from various functional medicine labs that can determine if this is the case. The test involves taking a small dose of caffeine, paracetamol, and aspirin, and then collecting urine over a specified amount of time. By measuring the amounts of detoxification products of these substances in your urine the lab can determine how quickly phase 1 and a number of phase 2 pathways are working.
I myself had a Detoxification Profile carried out by Great Smokies Diagnostic Lab (now Genova Diagnostics) back in 2000 to investigate the causes of my chronic fatigue syndrome. My results suggested a trend towards me being a pathological detoxifer. See the following blog:
Detoxification Profile Results - The Pathological Detoxifier and Chronic Illness
For information about treating imbalanced liver detoxification see this blog:
Foods and Supplements to Balance Phase 1 and Phase 2 Liver Detoxification
About: Matthew Hogg ("Maff")
Diagnosed with M.E./chronic fatigue syndrome aged only 11 years old and subsequently associated illnesses including irritable bowel syndrome (IBS) and multiple chemical sensitivity (MCS). Despite his own struggles he has constantly sought to educate and support others suffering from such "invisible illnesses" through his website, The Environmental Illness Resource. He fully recovered from MCS using his own approach and holds a Bachelor of Science Degree in Nutritional Health.

written by bolam56, June 28, 2009
Cheers!
written by Beth Laura, January 09, 2010
It's great to see refreshing information on the net like yours!
I have been suffering with systemic candidiasis with general chronic fatigue for nearly two years now. Doing the anti-candida diet religiously and after a 6 month break from anti-fungals last May I went back on them in November and it just knocked me for six! I now feel worse than I did two years ago! I am at my wits end and suicidal on many days. I have lost a very dramatic amount of weight, I am thirsty, exhausted after every meal, even eating little and often and my eyes get very dry and itchy. It's got to the point in the last week where I can't get out of bed for long as well.
I have just sent off my samples for a detoxificaton profile and am currently waiting on the results. With the symptoms that I currently have in addition to my original ones I am expecting it to come back as a "pathological detoxifier".
What symptoms did you experience before you started supporting your liver? Have you noticed a marked improvement since then? I already eat all the cruciferous vegetables everyday and take bayberry - 9 capsules daily and vitamin C every hour. What supplements would you say were the most effective for you?
I really need to start seeing a light at the end of the tunnel!
Thanks,
Beth
written by bolam56, January 09, 2010
I've been very keen on the subject of pathological detoxification as I feel it is what was causing my MCS. Maff and I have pondered in other posts on the primary harmful effect of Candida as being one of alcohol it gives off as a byproduct and the resulting acetaldehyde produced in the body from the metabolization of this alcohol. I was drinking alcohol during the time I came down with MCS, and this surely contributed to my condition; but whether you drink it or get it as a byproduct of Candida the effect is the same.
The supplements I credit most with resolving my pathological detoxification/MCS are:
NAC or N-Acetyl Cysteine (promotes glutathione production which gets rid of acetaldehyde). This must be taken on an empty stomach for best results. I haven't has a problem taking this on an empty stomach. If you do... A small carbohydrate meal might not hurt. It is protein which damages the NAC in your stomach if you take it with a protein meal. You need to take vitamin C with NAC, but it looks like you've already got this covered quite well.
PPC or Polyenylphosphatidylcholene (down-regulates phase 1 metabolism and provides choline for phase 2 metabolism) a dual benefit supplement! Simple Lecithin should also help, but it contains far less DLPC (dilinoleoylphosphatidylcholine) than the PPC, and you need to take quite a bit of Lecithin for it to be effective. Maybe 3 to 5 Lecithin gelcaps per day. PPC is available only on line... Brand names: PhosChol and HepatoPro, and one or two a day produced remarkable results for me. Both PPC and Lecithin promote mitochondrial membrane support which controls oxidative stress that occurs when mitochondria are damaged from alcohol/acetaldehyde. The most powerful liver protectant you will find!
B-Complex vitamins (alcohol metabolism burns through all B complex vitamins very quickly)
Thiamine HCL (hydrochloride) supplementation. Most vitamin B/thiamine supplements use thiamine mononitrate as their thiamine source, which is poorly absorbed in the gut, especially when there is alcohol producing Candida present in the gut! I have found Thiamine HCL to be more effective. Hard to find, but Solgar makes a 100mg thiamine HCL that is very cheap.
Maff said he has some problems taking the PPC when he tried it, but all of these supplements have remarkably low side effects and have been very easy for me to take. No tummy problems at all. Very good for you too.
Maff can probably add much to my little post here, and I'll be looking forward to what he has to say.
Good Luck, & GodSpeed.
B56
written by Beth Laura, January 11, 2010
Thank you for all your information!!! That is very helpful. I am 99.9% sure that all my candida die off has caused this problem to come about so severely. I stopped a lot of my supplements a few weeks ago as thought it might be another stress on my liver. I've just started to gradually reintroduce them and have started again on B-Complex this week.
I will wait to see what my results tell me - hopefully will get them next week and then I can start to combat this head on!
Thank you again for all your knowledge. Hopefully Maff can add to this also.
Beth
written by bolam56, January 11, 2010
written by Beth Laura, January 11, 2010
Took the necessary aspirin etc for the test last Sun 3rd and since then I have been bedridden. I think just those aspirin was too much for my liver. All week I was struggling to eat without feeling the exhaustion of the digestive process! Feeling slightly better today. The fact that it is taking my body at least 7 days to clear those pills suggests something must be up. Hopefully will get results next week. I just hope to be able to get back onto anti-fungals at some point in order to live my life again!!!
written by Beth Laura, January 12, 2010
Thank you for your help. Good luck with your degree! All your information is greatly appreciated. I'm hoping to get my results back next week.
Fortunately my mother is a nutritional therapist so she will be able to help me interpret the results. She would probably wonder why I am on here asking all these questions when I could just ask her! But it's useful to get as much information as possible to collate with what she already knows, as well as her colleague Erica White, who is very experienced with Candida also.
My mum had it about 15 years ago and struggled slightly with liver due to anti-fungals, but never to this extent so this is newer territory for both of us.
I take Beta TCP to thin my bile and massage my gallbladder regularly. I breathe a sigh of relief whenever I hear it gurgling which is every day at the moment so I'm glad about that, but due to constipation I'm just not clearing the toxins out of my colon, so they keep circulating.
I wish you the best with your progress.
Thank you very much for your help!
written by mags, March 31, 2010
My husband is 45. He has worked at a plastics thermoforming plant for 21 years. For the last 15 years, his health has been slowly declining--extreme sensitivity to any foods causing severe full body cramp, burning/stinging sensations in the extremeties, painful/buring urination, throat swelling, brain fog, apraxic speech...It seems like anything that he puts in his body over time overwhelms him, whether it be food or supplements or etc. It is making life very difficult and joyless for him.
Our naturopath suggested an environmental toxins test, which revealed high levels of phtalates, parabens (hmm...found in plastics) and benzene. We took the info. to a medical toxicologist with the hopes that he could dissect the information and set us on the path to healing. He scoffed at the results, although he ordered many, many more tests--both blood and urine. He practically assured us, though, that they would all come back "normal". So far, that is true.
It seems clear to me that John is having trouble detoxifying. In fact, the naturopath's limited knowledge of the results indicated that phase II of the detoxification process is not working appropriately, leaving the toxic products produced after phase I to overwhelm his body.
How can we address this problem with limited ability to use foods, supplements, etc. due to his extreme sensitivity to everything? Is there a particular doctor or clinic that you can suggest for help for him?
We need your help! Please share your thoughts!
Thanks,
Mary
written by bolam56, March 31, 2010
Bolam56 here... One of the frequent flyers on this board.
Your story sounds familiar... My career in healthcare collapsed about 2 1/2 years ago after 20 years of huffing all the chemicals and disinfectants we use in surgery at the hospital. I was seen by two toxicologists, a neurologist and my GP for 3 years before I gave up hope and changed jobs. The doctors all parrot out their mantra that low level chemicals just can't hurt anyone, and unless we waited until my condition deteriorated to a point where I was sick enough for something major to show up on their tests, there was nothing that could be done. It's a sad state of affairs considering research on second hand smoke has proven even minute amounts of some chemicals can cause great harm.
I was drinking alcohol after work at the time, and I learned alcohol "competitively inhibits" metabolism of many other toxins... It seems the enzymes that break down toxins always prefer to break down simple molecules first, and alcohol is a vary small/simple molecule, so while my body handled the alcohol OK, other toxins were building up. Alcohol can also promote pathological detoxification by exhausting phase 1 enzymes and ramping up phase 2 CYP-450 enzymes (10 to 30 times normal). Even after I was too sick to drink, the condition persisted.
I transferred to the woman's center of our hospital, where we use fewer toxic chemicals due to the babies that are breathing the air there, but I still got no improvement in my chemical sensitivity until I found "phospholipid therapy". I had tried every supplement under the sun when I stumbled upon PPC (polyenylphosphatidylcholine), a polyunsaturated form of simple Lecithin, brand names "PhosChol" and "HepatoPro". I noticed a difference right away, and was much better in a months time. It took 6 months on PPC before the chemicals at work no longer bothered me anymore.
Ironically, I'm happier at the woman's center, as the work there is much easier and I'm 53 now. Having my career collapse wasn't such a bad thing after all, and I eventually found a cure for my chemical sensitivities after over 3 years of trying different doctors and supplements.
I don't know if PPC would help your husband or not, but it is usually very well tolerated, and is supposed to be quite good for you too. My girlfriend now takes it for her stomach problems she had from taking NSAID medications for her headaches. PPC is not cheap... The best price I have found is for PhosChol at NutriEssential. $61.95 for 100 softgels. I was taking 3 per day when I first started them, but have tapered back to 1 or 2 per day once I got better.
Here is their website:
http://www.nutriessential.com/shop/product_view.asp?id=1303785&StoreID=7DF1736952024D7D905095869F15FB9C&private_product=1
You can read more about PhosChol here: http://www.phoschol.com/
And PPC here: http://www.lef.org/magazine/ma...eport.html
There are clinics that do IV phospholipid therapy too, but I have found the oral therapy worked just fine. It just takes a little longer.
Good Luck and GodSpeed to you and your husband!
B56
written by hd8, July 07, 2010
What I did want to share is what HAS worked wonders for me. First I will say that I became intolerant of most every food and substance I came across. One of the vicious cycles in this "syndrome" involves becoming too acidic. We're all too acidic from the toxic by-products produced in our guts, combined with the stress of not being able to detoxify properly. Plus, many of us are so scared of consuming any toxins that we switch to reverse osmosis water (which is HIGHLY acidic!) and we do further damage.
I recommend taking 400-500 mg of Magnesium Glycinate a day. NOT Magnesium oxide. And I prefer it over the more widely marketed citrate forms as well. I recommend a Calcium chelate as well. This changed my life. Also, even when I was taking these doses, I found that I still had to STOP DRINKING REVERSE OSMOSIS WATER.
Another caution: Even though probiotics are commonly held to be beneficial in cases of intestinal dysbiosis, I have had extreme intolerances with them due to another symptom of gut troubles: carbohydrate malabsorption. Probiotics are LACTIC ACID producing organisms and, while they are beneficial, if they grow in number too much, you do run the risk of excess lactic acid in your body.
Calcium d-glucarate has been the single most helpful supplement, though. When my liver gets overwhelmed, toxins pour out of my skin, leading to what appears as a "scalded skin" like display of symptoms. Very painful and disfiguring. However, I never have any doubt when something is working or not working: because my skin shows it. That being said, I have had to take VERY high doses of Calcium d-glucarate (4,000+ mgs/day) to curb the skin reactions. But it has succeeded wonderfully.
Calcium d-glucurate is essential in the glucuronidation piece of phase II, as Maff has also articulated. It metabolizes lipids and steroid hormones. I have had a history of using synthetic hormones (birth control pills and the diabolical Depo-Provera "shot") and thus, I suspect a large part of my inability to properly metabolize estrogen has come from this.
In my extensive research on the matter I have come across an important caution with regard to milk thistle that I should point out here. I could never tolerate milk thistle (always lead to skin reactions and what appeared to be liver problems). I have subsequently found that milk thistle, while helpful for all of the other phase II pathways, is actually inhibitory of glucuronidation. So for people with trouble metabolizing hormones, I recommend not using it. I need all the help with glucuronidation that I can get!
Best of luck to everyone struggling with this very convoluded syndrome. Thank you all for sharing your stories and what has worked well and what hasn't. SO appreciated!
Heather
written by hunterw, July 15, 2012
i'm only five days in and my symptoms have improved DRASTICALLY.
i have a medical research background (until MCS sensitization and the resulting inability to interact with society). my sister in law is an MD and i worked for an MD PHD, so i'm going to try to pursue your discoveries through the proper channels of academia to try and cure us all.
you are a glorious person.









My work comp toxicologist would just parrot out his mantra of: "at inhalation levels, these chemicals (glycols/phenoxyethanol) simply can not hurt you... You'd have to drink them".
As I researched the toxilogical profiles of these chemicals, I would often come across comments on the possibility of "potentially sensitive subpopulations" that might be reactive at lower than normal levels, but none ever discussed pathological detoxifiers.
It seems doctors simply refuse to accept any medical condition they can't measure/confirm with standard medical (blood/urine/imaging) techniques... Hopefully, with the tests you mentioned (caffeine, paracetamol/acetaminophen, and aspirin clearance) to demonstrate the potential for pathological detoxification, we'll have some much needed ammo in our war for recognition of MCS as a "real" disease.
PS Great to hear Australia has joined Germany in recognizing MCS as "real"...
Go Team!