by Theron G. Randolph, M.D. and R. Michael Wisner
Due to the number of inquiries that we receive about the Hubbard method of detoxification we decided that a brief but informative essay on this subject would be met with approval by lay persons and professionals alike. The following information has been taken from chapters of the new edition of my book "An Alternative Approach to Allergies - The New, Field of Clinical Ecology Unravels the Environmental Causes of Mental and Physical Ills ", New York, Harper and Row - TGR
Veterans of environmental illness are well aware that there are many unanswered questions in the field of clinical ecology. One major question has been why some chemically-susceptible patients don't do as well as others when they have managed to strictly control their environment and minimize their chemical exposures.
Even among the patients who respond well to standard treatment, many are bothered periodically by reactions that they find impossible to explain, and therefore doubly frustrating. What causes these seemingly arbitrary reactions? Identifying such causes and effective treatment is a vital ongoing process of clinical ecology. This article outlines the result of a recent line of inquiry into a particular cause and its treatment
Exposure from Within and Without
Since the discovery of the chemical susceptibility problem in 1951, clinical ecologists have been concerned with the patient's exposure to exogenous factors-that is, chemicals, allergens and other factors found outside the human body. However it has become apparent that there is an endogenous or internal pollution problem that cannot be ignored.
We are exposed to an overwhelming number of chemical contaminants every day in our air, water, food, and general environment. The body is generally well-equipped to excrete those chemicals which are water soluble, but not as well equipped to excrete some of the fat-soluble ones. Thus, manv fat-soluble chemicals tend to accumulate in the body's fatty tissues, where they may persist indefinitely. This process is called "toxic bioaccumulation".
Over 300 foreign chemicals have been identified in human fat, which is found in most organs and systems of the body, including the brain and nervous System as well as human breast milk. A national EPA survey has found that most Amerlcans have dozens of identifiable contaminants in their fatty tissue, including several known carcinogens. That certain chemicals tend not only to accumulate in the fat, but to persist there for long periods of time is shown by a number studies.
For example, Michigan residents contaminated by the highly toxic fire retardant PBB showed no significant reduction of levels in the fat over a period of 6 years.
If fat-soluble toxins remained locked in the fat where they are deposited, they would perhaps be of less concern to us. However, fat is very mobile within the body; whenever the body is stressed, stored fat may be, released. back into the bloodstream, and with it its burden of toxic material.' Since the body is ill-equipped to excrete these toxins, they tend to circulate freely throughout the body, only to return later to the fat. The resulting exposure can target various organs and body systems.
Studies show that fat can be mobilized by such common influences as heat exposure, exercise, emotional stress, illness and the overnight fast during sleep. Mobilization during sleep may explain why the symptoms of certain patients are more severe in the morning.
The intermittent release of fat-stored toxics may also explain why a significant proportion of chemically-susceptible patients do poorly even when they manage to control their environment and minimize chemical exposures. These endogenous chemicals seem to be causing acute reactions which are both confusing and frustrating to the person who is consistently watching his or her exogenous exposures.
Health Effects of Endogenous Exposure
Response to,endogenously-stored chemicals varies from person to person. Some are strongly affected, some apparently very little. With some people, severe adverse effects to chemicals are immediate; with others, immediate symptoms are ml 'Id, but could represent precursors of more serious diseases which may manifest years later.
Some factors that influence response are: severity of bioaccumulation, individual sensitivities, genetic predisposition, present diet and environment, and the age of patient."
Careful clinical investigation is required to establish how important endogenous toxins may be in an individual case.
The clinical ecologist is usually concerned with symptoms stemming from the subtle effects chemicals may have on a variety of body systems before permanent damage has taken place. Such symptoms will be familiar to many chemically susceptible people: they can include such conditions as headaches, tiredness, mental confusion and lack of acuity, irritability, memory loss, cold or flu-like symptoms, eye and mucous membrane irritation, skin disorders, musculoskeletal pains, etc.
Because these and other symptoms can be caused in chemically-susceptible people by either exogenous or endogenous exposures, or a combination of both, one task of the physician is to establish which type of exposure is affecting a particular patient most, and should therefore be treated first.
The optimum treatment for patients found to be reacting to endogenous chemical exposures ' is detoxification therapy aimed at reducing levels of fat-stored chemicals. To accomplish this successfully, a detoxification technique must accomplish three biological goals:
1. Enhanced mobilization of stored chemicals from fat depots within the body.
2. Adequate distribution of mobilized chemicals to the channels of excretion
3. Enhanced excretion through any or several of the body's natural routes-lungs, gastrointestinal tract, kidneys (urinary tract), or skin via excretion of sweat or sebum (skin oil).
Until recently, we lacked a safe and effective treatment for accomplishing such detoxification. Within the last decade, however, a technique has been developed, tested in independent scientific trials and shown by clinical use to be both safe and effective. This technique is known as the Hubbard method.
This method of detoxification was originally conceived as a technique for ridding the body of drug residues. Aside from being the author of a great deal of other non-medical research, L. Ron Hubbard was well known for his contributions in the field of drug rehabilitation. In the mid-1970's, he concluded that accumulations of drugs and foreign toxics in fatty tissues were causing learning and perceptual problems long after ingestion of the drugs or exposure to the chem'lcals. He began an investigation into methods which might be used to reduce endogenous levels of drugs and other toxins and developed a precise technique for their reduction.
Since the Hubbard method appeared to do successfully what no other form of therapy was attempting to do, it became the focus of some scientific scrutiny by medical doctors and scientists looking for a safe, effective means of reducing body burdens. The Foundation for Advancements in Science and Education (FASE), a non-profit research group based in Los Angeles, sponsored several studies to test the technique. The findings of the researchers who participated in these studies have been published by the Royal Swedish Academy of Science, by the World Health Organization's International Agency for Research on Cancer, and in the journals "Medical Hypotheses" and "The Journal of ToxicologyCutaneous and Ocular Toxicology", among others.
Dr. Megan Shields, a co-investigator in several of these studies, along with other doctors, later introduced the technique into clinical practice in California. This large practice specializes in chemical detoxification therapy and is administered by HealthMed, which is owned by a nonprofit organization.
Michigan Disaster Provides Training Ground
A 1982 study of the technique chose as its test population some unfortunate victims of a chemical disaster in the state of Michigan. In the early 1970s, the toxic fire retardant PBB was accidentally substituted for a nutritional supplement for farm animals. The resulting contamination of meat, milk and a number of other foods ended with the ingestion of the chemical by virtually the entire population of Michigan.
Victims of this disaster had been the subjects of intensive study by a Mt. Sinai School of Medicine team. The team found that 97% of individuals tested in the state had detectable levels of PBB in their fatty tissues by 1978, and that there was clear-evidence of widespread health effects. They also found that there had been no significant reduction of PBB levels over the six year period following the contamination. Their conclusion was that the PBB was there to stay.
During the Michigan trial, subjects chosen from the earlier Mt. Sinai study were put through a precisely controlled Hubbard regimen. Results were very promising. Before and after fat biopsies of the participants indicated reductions averaging 21.3% of all 16 chemicals studied, including the PBBs and PCBs.
The findings of a four month follow-up exami nation may be even more significant. They showed that the toxicant levels of the subjects continued to go down even after treatment. After four months, the average reduction of all 16 chemicals studied was 42.4%. Some physicians speculated that this continued drop may indicate a rehabilitative effect on the body's natural processes of toxic elimination.
This finding of post-program improvement was also made by a Florida cardiologist who conducted regular tests on an individual exposed to Agent Orange (dioxin) following his completion of the Hubbard regimen. He found his patient's tissue level of DDE had been reduced by 29% immediately after treatment. At the end of 250 days it had been reduced by 97%. He further reported that after treatment, his patient was free of the symptoms of dioxin poisonings
The Hubbard Regimen
As administered during clinical trials, the treatment is individually tailored to accomplish the following:
- Fat mobilization is accomplished through therapeutic cardiovascular exercise and preciselycontrolled dosages of nicotinic acid (vitamin B3), Both these elements are adjusted by a physician to a patient's level of tolerance. B-3 is gradually increased throughout treatment according to precise protocol.
These protocol call for increases in the dosage of nicotinic acid only after careful analysis of patient response to prior dosages so as to ensure the patient is achieving the optimal result each day. Failure of the clinician to moderate dosage correctly, either through lack of understanding of the process or failure to monitor patient response, may result in patient discomfort or possibly more serious complications. Exact adjustment of increments of niacin, which is so critical to the proper mobilization and excretion of toxics, is one of the hallmarks of a properly managed Hubbard regimen.
The exercise and nicotinic acid also increase circulation into body t'ssues, assisting the pickup of freed toxics and enhancing their distribution to the channels of elimination.
Enhanced excretion is accomplished via the skin, through moderate heat treatment in wellventilated heat chambers. These are operated at an average temperature of 160 F in contrast to the usual 200 F-210 F of a nontherapeutic sauna. Both the water-based and oil -based systems of the skin are activated by heat, providing conduits for excretion of toxic substances through oil and water excreta.
Heat exposure is alternated with periods of cool down and rest. Optimal heat exposure varies from patient to patient but is generally 10 to 30 minutes. Vital signs are monitored during cooling off periods. The patient typically alternates heat and rest periods for a total physical therapy period of from 2 to 4 hours per day. Combined with therapeutic exercise this is 2 hours to 5 hours per day.
- Cold pressed polyunsaturated oils, adjusted to individual patient tolerance, are administered to retard the assimilation of toxic chemicals which can occur in the- intestines, and to assist their excretion through the colon.21
- Water, potassium and salts are administered as needed to replace those lost through concentrated sweating.16
- Other nutrients and minerals are supplied in strict proportion to the gradually increasing doses of niacin. Balancing of vitamins and minerals in forms which are most assimilable is required to prevent the development of deficiency symptoms. The skill in biochemistry required to clinically balance these supplements further distinguishes a clinician experienced in administration of the precise Hubbard treatment. The,physician adjusts the therapy to allow for individual intolerances to nutrients and other factors.
- It is necessary that the patient follow a regular daily schedule (patients should never miss a day while undergoing treatment) and get adequate sleep. Generally, the patient follows the same diet that he or she is accustomed to, with greater emphasis on fiber and leafy green vegetables. No other medications are required and only those specifically ordered by a physiclan would be continued during treatment.
The length of treatment varies with each individual; 25 days is about average.
Many environmentally ill patients have shown significant improvement through the Hubbard technique. While it is not a cure for environ. mental illness or any disease, results of studies and clinical practice clearly show that reducing body burdens of toxic chemicals by the Hubbard regimen generally brings about improvement in patient symptomatology and overall health.15 The Tables on page 5 illustrate results obtained in four actual case studies. All measures are parts per million in adipose tissue.26
A Precise Treatment Regimem
Because it includes some elements familiar to many health-conscious people, the Hubbard regimen can sound deceptively simple. It must be stressed that it is the synergy of these factors, each precisely controlled and monitored daily by trained personnel, which leads to consistent results with little patient risk. Inexact application in untrained hands could have some pitfalls. For example:
Patients often come to treatment with various complex sensitivities to heat, salts, oil, vitamins, exercise, etc. The physician always tailors the therapy to individual tolerances, biochemistry and state of health while each essential element of the therapeutic technique is maintained.
In one day of heat treatment, as much as four to twelve pounds of fluid may be displaced from the body. The patient must be closely monitored for early signs of dehydration as well as loss of salts, minerals and other nutrients.due to excretion. Blood chemistry analysis as needed and daily medical monitoring allow for precise replacement to avert dehydration or depletion.
Heat treatment mus t occur in a well-ventilated chamber with temperature no lower than 140' F and never higher than 180' F. Saunas found at health clubs are inadequately ventilated with fresh oxygen and are usually far too hot for this therapy. Random and unsupervised use of a sauna for periods longer than 30 minutes may put a person at risk of heat exhaustion, heat stroke or other serious medical problems. Nothing in this article should be construed to mean that one should try procedures such as these on one's own.
Cardiovascular exercise must be geared to an individual's physical abilities and tolerance. When properly programmed and supervised, a tolerable regime adequate to produce increased circulation is always possible without undue stress or risk.
The necessity for exact application of this technique must be emphasized. An environmentally ill patient is already in a tenuous health position. If undertaken, the treatment should be administered by practitioners and staff expertly trained and interned in the Hubbard method. Although some casual versions of the treatment have been attempted, best results have been obtained using the original procedure researched and developed by Hubbard.
Indication for Treatment
It is unlikely that internal pollution alone would be the cause of an environmentally ill patient's entire symptomatology. Thus, for- certain patients, its reduction may not be the first priority. Patients should carefully review all the data at hand and evaluate their need for detoxification with their personal physician.
Physicians may find detoxification therapy indicated for the following categories of chemically-susceptive patients:
1.Patients,who, though diagnosed and treated with standard clinical ecology techniques, continue to present unexplained acute and/or chronic symptoms apparently unrelated to exogenous exposures to environmental chemicals or excitants.
2. Patients with known histories of higher than average exposure to toxic chemicals at work or otherwise.
3. Patients with a positive toxicity screen.
Although observed in a number of patients who have responded well to detoxification treatment, the above are not definitive indications of the need of detoxification treatment. In categories I and 2, conservative use of a toxicity screen, such as analysis of toxic chemical levels in blood serum, adipose tissue and/or sweat could provide further insight.
The most reliable method for testing body levels of fat-soluble chemicals is biopsy (removal and examination of tissue, in this case fat, from the living body). Studies have shown that levels of contaminants are consistent in various fat depots throughout the body. Fat samples can be obtained easily today by needle aspiration, a mild and relatively non-invasive technique. Analysis can be performed using high-resolution laboratory techniques which can accurately detect foreign chemicals at the parts-per-billion level. While useful for some purposes, blood tests cannot be considered to be reliable for accurate measurement of total body burdens of chemicals.
Avoidance Still Best Public Health Policy
The individual who has developed environmental illness over a period of several years should realize that he or she has what is best viewed as a chronic condition. Thus, even upon very successful completion of detoxification treatment caution should be exercised when determining what reexposure will be permitted.
In light of this the following rules should be applied:
1.Heavy occupational exposures of a chronic nature:must be scrupulously avoided. Find other gainful employment.
2.Mild intermittent exposures to known toxics whether occupational or at home, should be avoided as much as practical.
3.No matter how good the patient feels, former excitants which seem to have little or no effect on the individual after treatment should not be indiscriminately contacted. A wiser approach is to follow a systematic policy of allowing only gradual reexposure. Care should be taken to ensure, as much as possible, that only one chemical be allowed into the environment at one time. Thus if there is a relapse, one is able to spot the exact excitant responsible and a new policy of avoidance, once instituted, should restore the better state of health.
The Future of Detoxification
Until relatively recently, endogenously-stored chemicals in the body's fat have been a "hidden variable" in clinical ecology. Knowledge of their presence and their effects can only bring more certainty to diagnosis and treatment.
The task of defining the relationship between exogenous and endogenous chemicals in particular patients remains. At this time, we can say that reducing endogenous accumulations of toxic chemicals appears vitally important to the effective treatment of some environmentally ill patients; and the development of a safe and effective method for reducing these burdens gives us a welcome new tool for treatment.
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