Hompes MethodPractitioner Training Level II
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Lesson Twenty-Two
Supporting Phase II Detoxification
Supporting Phase II - Introduction
• Once a client/patient’s toxin exposure levels have been reduced (foods, water, skin, gut) it’s pertinent to begin supporting detoxification pathways to help the body begin reducing its toxin stockpile.
Supporting Phase II - Introduction
• As previously discussed, it’s important to support phase II pathways before jumping in and trying to up regulate phase I. There’s a myriad of products out there that can help us in this task!
Supporting Phase II - Introduction
• Remember the pathways we’re looking to support:
– Glutathione conjugation
– Amino acid conjugation
– Sulfation
– Methylation
– Glucuronidation
Supporting Phase II - Introduction
• You’re going to naturally up regulate these pathways by optimizing nutrition:
– Many people need to eat more protein (obviously you need to ensure it’s being digested effectively)
– Bone broth / powdered gelatin and collagen
– Sulphur foods (garlic, onions, etc.)
– Well cooked cruciferous vegetables (undercooked can irritate gut and may suppress thyroid)
Supporting Phase II - Glutathione
• Glutathione is one of the most powerful antioxidants known for its ability to protect the body against the damages caused by heavy metal toxicity and environmental toxins. It’s important during acute infections, inflammatory bowel conditions, autoimmune disorders and all other conditions involving free radical stress.
Supporting Phase II - Glutathione
• In humans, Glutathione is found in all tissues, with the highest levels found in the liver, eyes, spleen, pancreas, and kidneys. Research shows that glutathione is the single most protective antioxidant in virtually every tissue of the body. Glutathione Powder has a bland taste that dissolves quickly in water or other beverage for easy daily intake.
Supporting Phase II - Glutathione
• Depleted tissue GSH levels have been observed in several disease conditions. The restoration of cell GSH levels in a number of these conditions is beneficial. Thus, strategies to boost cell glutathione level are of marked therapeutic significance (in our present context of detoxification and well beyond…)
Supporting Phase II - Glutathione
• Orally, glutathione has been used for treating cataracts, glaucoma, preventing aging, treating or preventing alcoholism, asthma, cancer, heart disease (atherosclerosis and hypercholesterolemia), hepatitis, liver disease, immunosuppression (including AIDS and chronic fatigue syndrome), maintaining immune function, memory loss, Alzheimer’s disease, osteoarthritis, Parkinson’s disease, detoxifying metals and drugs.
Supporting Phase II - Glutathione
• Inhaled, glutathione is used for treating lung diseases, including idiopathic pulmonary fibrosis, cystic fibrosis, and lung disease in individuals with HIV disease. Intramuscularly: glutathione is used for preventing toxicity of chemotherapy and for treating male infertility.
Supporting Phase II - Glutathione
• Intravenously: glutathione is used for preventing anaemia in patients undergoing haemodialysis, preventing renal dysfunction after coronary bypass surgery, treating Parkinson’s disease, improving blood flow and decreasing clotting in individuals with atherosclerosis, treating diabetes, and preventing toxicity of chemotherapy.
Supporting Phase II - Glutathione
• Oral consumption may not provide optimal availability. GSH has a short life in human plasma (<3 min) and difficulty in crossing cell membranes, so administration of high doses is necessary to reach a therapeutic value.
Supporting Phase II - Glutathione
• A common mistaken belief is that glutathione is not well absorbed when it's taken orally, but significant data confirms it is efficiently absorbed across the intestinal epithelium by a specific uptake system.
http://www.ncbi.nlm.nih.gov/pubmed/2221062(study done on rats)
Supporting Phase II - Glutathione
“Plasma glutathione (GSH) concentration in rats increased from approximately 15 to 30 microM after administration of GSH either as a liquid bolus (30 mumol) or mixed (2.5-50 mg/g) in AIN-76 semisynthetic
diet. GSH concentration was maximal at 90-120 min after GSH administration and remained high for over 3 h. Administration of the amino acid precursors of GSH had little or no effect on plasma GSH
values, indicating that GSH catabolism and resynthesis do not account for the increased GSH concentration seen. Inhibition of GSH synthesis
and degradation by L-buthionine-[S,R]-sulfoximine and acivicin showed that the increased plasma GSH came mostly from absorption of intact GSH instead of from its metabolism. Plasma protein-bound GSH also
increased after GSH administration, with a time course similar to that observed for free plasma GSH. Thus dietary GSH can be absorbed intact
and results in a substantial increase in blood plasma GSH. This indicates that oral supplementation may be useful to enhance tissue
availability of GSH.”
Supporting Phase II - Glutathione
• A great deal of controversy still exists regarding the bioavailabiity of oral glutathione. Thankfully, there are a couple of other options (over and above IV, which would need to be administered by a physician).
Supporting Phase II - Glutathione
“Acetyl-glutathione is orally active, unlike plain glutathione, and is stable in the intestine and plasma when absorbed
and delivered directly to the cells for natural de-acetylation intracellularly. Plain glutathione delivered to the plasma by
precursors, liposomal products or intravenously must be broken down by enzymes to the basic amino acid
components for absorption into the cell and require more energy expenditure to be re-constructed back to rGSH.”
http://www.nleducation.co.uk/resources/reviews/oral-glutathione-equivalent-to-iv-therapy/#_ftn6
Supporting Phase II - Glutathione
“It is known that disease states can block the re-assimilation of components into rGSH. Therefore, it is a better dietary/therapeutic decision to provide the orally
active and absorbed. Acetyl-glutathione which increases intracellular rGSH directly and naturally
without increased energy expenditure and without being compromised from disease states.”
http://www.nleducation.co.uk/resources/reviews/oral-glutathione-equivalent-to-iv-therapy/#_ftn6
Supporting Phase II - Glutathione
• In his thyroid book, Dr. Datis Kharrazianrecommends the use of a transdermal form of glutathione, via a product called Oxicell. He states that the transdermal delivery system is superior to the oral route.
Supporting Phase II - Glutathione
• In his more recent book on brain function entitled Why Isn’t My Brain Working, he also discusses acetyl-glutathione. Here’s what he has to say…
Supporting Phase II - Glutathione
“In the thyroid book I recommend a liposomal glutathione cream because oral glutathione is difficult
to absorb…Now we have access to a new form of glutathione known as s-acetyl-glutathione, which the
gastrointestinal tract can efficiently absorb. Oral doses can start at 300mg/day and go up to several thousand
milligrams if necessary with certain inflammatory conditions. I suggest about 1000mg/day in most cases.”
Dr. Datis Kharrazian: Why Isn’t My Brain Working? P.426.
Supporting Phase II - Glutathione
• Oxicell is a the glutathione cream recommended by Dr. Kharrazian at 1-2 pumps per day, rubbed into the skin on the underside of feet and inside the wrist and elbows. Good for people with compromised guts.
Supporting Phase II - Glutathione
• Acetyl-Glutathione is a novel oral glutathione formulation that is stable in the stomach and gastrointestinal tract, well absorbed, and able to enter the cells directly and present to the cytosol for mitochondrial entry.
Supporting Phase II - Glutathione
• AC-Glutathione is Apex’s version of s-acetyl-glutathione - well absorbed, and able to enter the cells directly and present to the cytosol for mitochondrial entry.
Supporting Phase II - Glutathione
• Absorption of oral glutathione can be affected by stomach acid or enzymes in the duodenum. However, the sustained-release properties of Glutathione-SR protect it from stomach acid and digestive enzymes, allowing slower release and a more steady level in the blood of this essential nutrient.
Supporting Phase II - Glutathione
• Reduced glutathione is offered by many companies, including Vital Nutrients and DFH. It’s available in both capsule and powder form.
Supporting Phase II - Glutathione
• Glutathione Recycler provides compounds that aid in glutathione activity, support glutathione peroxidase and super oxide dismutase enzyme activity, helps support favorable reduced:oxidizedglutathione ratios. 1 capsule contains NAC, Cordyceps, Gotu Kola, Milk thistle, L-glutamine and ALA.
Supporting Phase II - Glutathione
• N-Acetyl Cysteine provides several benefits, most notably its ability to support glutathione production (DFH product available in the US from Moss Nutrition).
Supporting Phase II - Glutathione
• Milk thistle (Silymarin) has been shown to increase the liver's content of glutathione. Silybin, one of the primary constituents of milk thistle, supports the liver's efforts to remove chemicals, drugs, alcohol, and other exogenous toxins.
Supporting Phase II - Glycine
• Glycine plays a key role in CNS function, phase II liver detoxification (direct effect on toxin elimination or via its effect on increasing glutathione). Glycine is necessary for the healthy DNA and RNA – it plays an important role in ensuring healthy cell function throughout the body.
Supporting Phase II - Glycine
• Bone broths and collagen supplements contain a rich array of amino acids (non-inflammatory). Glycine is a primary constituent and arginine is also present (ammonia clearance).
Supporting Phase II - Methylation
• Trimethylglycine (TMG) is an effective methylation enhancing agent. After TMG converts toxic homocysteine into methionine and SAMe, it becomes DMG (dimethylglycine).
Supporting Phase II - Methylation
• SAMe supports methylation and is found naturally in every cell in the human body. It increases levels of neurotransmitters such as serotonin and dopamine, and helps protect the liver from fat infiltration (expensive).
Supporting Phase II - Methylation
• Vitamins B12, B6 and folic acid can be helpful in up-regulating the methylation pathways. Because of poor cephalic response and damage to parietal cells (gluten, H. pylori, etc.) there may be a lack of intrinsic factor, which will impact B12 absorption even when high dose oral supplements are used.
Supporting Phase II - Methylation
• Methyl Factors from Biogenesis is a liquid form that can be used sublingually to deliver:
– B6 2mg
– B12 1000mcg
– Folic acid 400mcg
Supporting Phase II - Methylation
• Sublingual B6 liquid by Designs For Health offers improved bioavailability for people whose digestion is compromised.
Supporting Phase II - Methylation
• B12 Boost Spray offers a neat little delivery system that allows oral absorption of B12.
Supporting Phase II - Methylation
• “B12 may be absorbed by an alternate mechanism without reliance on intrinsic factor when high amounts of 1,000 mcg or more are taken. Thus, individuals without adequate intrinsic factor can still obtain adequate amounts of B12 if extra amounts are ingested.”
Supporting Phase II - Methylation
• HomocysteX Plus:
– B2
– B6
– B12
– Folic acid
– TMG
Supporting Phase II - Methylation
• Standard B-complex formulas are readily available:
– B-Supreme (DFH)
– Ultra-B Complex (Biogenesis)
– B Complex number 5, 6, etc. (Thorne)
Supporting Urea Cycle
• L-arginine is the product of choice when the urea cycle needs to be supported. Gelatin products do contain quite good levels of arginine, so individual arginine supplementation may not be needed in some cases.
Supporting Phase II - Estrogen
• Calcium D-Glucaratelowers blood and tissue levels of Beta-glucuronidase and supports detoxification of estrogens, androgens, "used" T4, some steroids, bilirubin, bile salts, certain drugs, xenobiotics, environmental toxins.
Supporting Phase II - Estrogen
• Diindolylmethane (DIM)is an indole - plant compounds in cruciferous vegetables such as broccoli, cabbage, cauliflower & Brussels sprouts. It pushes estrogen into more of the protective 2-OH rather than the proliferative 16-a-OH.
Supporting Phase II - General
• Liver Nutrients provides several key phase II nutrients:
– Milk thistle
– NAC
– ALA
– L-methionine
– L-cysteine
– Taurine
– TMG
Supporting Phase II - General
• Amino-D-Tox does not contain botanicals:– Glutamine 500 mg
– Glycine 500 mg
– Methylsulfonylmethane 400 mg
– N-Acetyl L-Cysteine 250 mg
– Taurine 250 mg
– Alpha Ketoglutarate 200 mg
– Glutathione 200 mg
– Methionine 200 mg
– Ornithine 200 mg
– Calcium-D-Glucarate 200 mg
Supporting Phase II - General
• Support Liver: – Vitamin C 9 mg
– L-Methionine 300 mg, Lemon Pure Form Bioflavonoid Complex 345 mg
– N-Acetyl-Cysteine 150 mg,
– Taurine 75 mg
– L-Glutathione (reduced) 75 mg
Supporting Phase II – Organic Acid Results
• The Metametrix, Genova and US Biotek organic acids profiles all come complete with specific supplement guidelines and recommendations, which makes your programme design task much easier. Let’s look at an example…
Supporting Phase II – Organic Acid Results
2-Methylhippurate
• If you see high 2-methylhippurate:
– Indicates xylene exposure, so see whether exposure levels can be reduced.
– Glycine is the intervention option.
Glucarate
• High glucarate indicates general liver stress and exposure to higher levels of pesticides, etc.
– Organic food / fix gut
– General detoxification “treatment” - gently introduce phase II then phase I:
• Amino Dtox, Liver Nutrients, Support Liver
• Then consider adding phase I and support such as LV/GB Complex,
a-Hydroxybutyrate
• If high a-hydroxybutyrate, support glutathione production:
– Glutathione products
– Glycine (bone broth and consider collagen hydrosylatepowder as well as glycine supps)
– NAC
– Milk Thistle (Silymarin)
– Support Liver, Liver Nutrients, etc.
Pyroglutamate
• If high pyroglutamate shows up it’s because of glutathione wasting:
– Remove exposure, reduce sources of toxicity, inflammation and oxidative stress
– Glutathione products
– Glycine
– NAC
– Milk thistle
– Support Liver, Liver Nutrients, etc.
Sulfate
• Sulfate imbalances indicate either excessive phase II activity or depletion:
– Glutathione products
– Glycine (bone broth and consider collagen hydrosylatepowder as well as glycine supps)
– NAC
– Milk Thistle (Silymarin)
– Support Liver, Liver Nutrients, etc.
Orotate
• If orotate is high:
– L-arginine
– Bone broth and collagen/gelatin also contain quite a lot of arginine per unit mass.
– Note: other organic acid markers can indicate ammonia toxicity – to be discussed when we cover other sections of the organic acids tests.
Methylation
• If methylation (methylmalonate / FIGLU) markers are elevated:
– B12
– Folic acid
– B6
– TMG
– SAMe
– May be advisable to check SNPs.
Supporting Phase II - Summary
• As I keep stating, it’s generally appropriate to support phase II prior to up-regulating phase I. This can be done very effectively by using individual products such as NAC, glutathione in the correct form, glycine, milk thistle and others. Compound products such as Support Liver, Amino D-Tox and Liver Nutrients can also be used.
Thank You!
• Thanks a million for tuning in – I hope this lesson was informative and helpful. In lesson 13, part 3, we’ll look at supporting phase I, antioxidant support and general liver-support products that up-regulate both phases.
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