Detoxification and Adrenal Fatigue Syndrome

By: Michael Lam, MD, MPH; Dorine Lam, RDN, MS, MPH


detoxification juiceThere is little doubt that our environment is polluted with toxins and harmful substances. One of the keys to optimal health is to identify useful ways to detoxify our exposure to toxic surrounding elements including our air, water and food. The reason is simple—the more toxins you have in your body, the faster you age. Toxin overload can burden our liver, triggering Adrenal Fatigue Syndrome (AFS) and retard its recovery.

The concepts of internal cleansing and detoxification have been around for centuries. Detoxification of the body refers to the cleansing of the bowels, kidneys, lungs, the liver and the blood since these are the organs involved in the detoxification of chemicals and toxins from the body.


A toxin is defined as any compound that has a detrimental effect on cell function or structure.

Toxins can damage the body in an insidious and cumulative way. Fortunately, the body has a built in detoxification process working 24/7. However, once the internal detoxification system becomes overloaded, toxic metabolites begin to accumulate within. It is this accumulation of toxins over a period of time that can wreak havoc on our normal metabolic processes because the body has to work extra hard to get rid of it. As our body’s workload increases, we can then become progressively more sensitive to other compounds, including nutrients and drugs, some of which are normally non-toxic.

Toxins include industrial chemicals and their polluted by-products, pesticides, additives in our foods, heavy metals, anesthetics, drug deposits, environmental hormones, and secondary smoke. More than two million synthetic substances have been identified and 25,000 new toxins are added each year. About 30,000 are produced on a commercial scale. Unfortunately, only a miniscule percentage is ever tested for toxicity.

Types of Toxins

These can be broadly classified into the following categories:

  1. Heavy metal toxins
  2. Liver toxins
  3. Microbial toxins
  4. Protein by-product toxins

A. Heavy Metal Toxins

Lead, mercury, cadmium, arsenic, nickel, and aluminum are included in this category. These metals tend to accumulate in the brain, kidneys and immune system.

Up to twenty-five percent of the US population suffer from heavy metal poisoning especially from lead, mercury, and aluminum. Over 600,000 tons of lead is released into the atmosphere from industrial processes and leaded gasoline. The toxins can then either be inhaled or ingested after being deposited on food crops, fresh water and soil.

Heavy metal toxicity has been linked to several diseases including Alzheimer’s disease, Parkinson’s disease and severe neurological disorders.

Other common sources of heavy metals include lead from pesticide sprays and cooking utensils; cadmium and lead from cigarette smoke; mercury from dental fillings, contaminated fish, and aluminum from antacids, cookware, and soda cans.

The early signs of heavy metal poisoning are vague or often attributed to other diseases. The early symptoms of heavy metal poisoning include headaches, fatigue, muscle pain, indigestion, tremors, constipation, anemia, and indigestion. Mild toxicity symptoms include impaired memory and distorted thinking ability. Severe toxicity can lead to death.

The most accurate measurement of toxins in the body is by blood analysis of actual toxin levels of each toxin within the red blood cells. Many toxic metals have a tendency to accumulate inside the cell where most of the damage is done. Serum toxic metal levels do not correlate well with intracellular toxic metal levels.

For those who are healthy, a good detoxification program includes chelation therapy using EDTA to bind toxic metals, high potency multiple-vitamin and mineral supplementation, sulfur containing amino acids (methionine, cysteine, and taurine), and high sulfur-content foods such as garlic, onion and eggs and water-soluble fibers such as guar gum, oat bran, pectin and psyllium seed. Natural component such as barley grass, spirulina, chlorella, and sea vegetables also have good chelation property and can be considered. Note that those who have AFS generally do not do well on such programs. The more advanced the AFS, the less effective this is and the higher probability of failure. In some cases, such detoxification programs can trigger adrenal crashes because the body is too weak to tolerate such an approach.

B. Liver Toxins

liverThe liver is the major detoxification center of the body. It acts as an in-line filter for the removal of foreign substances and wastes from the blood. Toxins that are cleared by the liver include alcohol, solvents, drugs, binders and fillers from nutrition supplements, formaldehyde, pesticides, herbicides and food additives. Despite varying chemical toxicities, the liver has the function of reducing toxins into compounds that the body can safely handle and remove through the kidneys (as urine), skin (as sweat), lungs (as expelled air) and bowels (as feces). Optimal liver function is therefore essential for good health.

The symptoms of a compromised liver include psychological and neurological symptoms such as depression, headache, mental confusion, fatigue, anxiety, joint pain, mental illness, brain fog, abnormal nerve reflexes and tingling in the hands.

The solution is to take compounds that support the liver’s detoxification mechanism. Such compounds include milk thistle extract, choline, methionine, glutathione, N- acetyl cysteine, and lipoic acid. Again, those with AFS need to proceed with care, as the body may not be able to tolerate these compounds, even though they are natural. The right compounds, timing, and delivery system is key to avoid unexpected symptoms of retoxification from this attempt to rid toxins from the liver.

C. Microbial Toxins

Toxins produced by unwanted bacteria and yeast in the gut can be absorbed which can cause a significant disruption of bodily functions. Examples of such toxins include endotoxins and exotoxins from bacteria, toxic amines, toxic derivatives from bile and many carcinogens. These toxins have been implicated in many diseases including Crohn’s disease, IBS, leaky gut, ulcerative colitis, psoriasis, lupus, pancreatitis, allergies, asthma, immune disorders, and delayed food sensitivities.

In addition, antibodies formed against microbial molecules (antigens) can cross-react with the body’s own cellular structure. This in turn causes autoimmune diseases such as rheumatoid arthritis, myasthenia gravis, diabetes and autoimmune thyroiditis.

The solution is to follow a diet rich in fiber, particularly water-soluble fibers such as those found in vegetables, guar gum, pectin and oat bran. Fiber has the ability to eliminate toxins from the gut and promote their excretion. The replacement of healthy bacteria such as acidophilus is also helpful.

D. Protein By-Product Toxins

The kidneys are mainly responsible for the elimination of toxic waste products from protein breakdown such as ammonia and urea.

For those who are healthy, detoxification of the body involves cleansing the kidneys with adequate amounts of water (at least 8 to 10 glasses a day) and a reduction in protein intake (such as red meat) to avoid overloading the body with urea, which is a result of the breakdown of protein. Those with AFS may need to add salt to the water to aid electrolyte balance. Excessive protein reduction may make matters worse in advanced cases of AFS where the body is already in a catabolic state.

Do You Need Detoxification?

is detoxification for you?Most of us cannot escape to a safe haven, free from toxins and pollutants. The air that we breathe is polluted, the water that we drink is full of chlorine, the clothing we wear is made of artificial fabrics and chemicals, the lotions and shampoos that we use all contain chemicals. Once these chemicals are inside us, we can never fully eliminate them unless we undergo a detoxification process. As a result, most of us need some form of detoxification.

Our bodies are clearly designed to be self-cleansing and self-healing. The internal detoxification process is an automatic daily procedure by the major detoxification organs.  In the past, detoxification was for reformed alcoholics and drugs addicts, people with severe allergies, cancer patients. Nowadays healthy individuals wishing to maintain the most pristine of conditions within their body’s systems adopt this process.

A weekly, monthly or even quarterly detoxification program can make a big difference in optimizing the bodily functions. In fact, it might even help prevent chronic opportunistic diseases such as cancer, diabetes, chronic fatigue and arthritis.

Signs that Detoxification is Needed

  • If you have unexplained headaches or back pain
  • If you have joint pain or arthritis
  • If your memory is failing
  • If you are depressed or lack energy
  • If you have brittle nails and hair
  • If you have abnormal body odor, coated tongue or bad breath
  • If you have an unexplained weight gain
  • If you have psoriasis
  • If you have frequent allergies
  • If you have a history of heavy alcohol use
  • If you have a history of natural and synthetic steroid hormone use
  • If you have an exposure to cleaning solvents, pesticides, diuretics and certain drugs

Benefits of Detoxification

  1. Digestive tract is cleansed of accumulated waste and fermenting bacteria, reducing food allergies and unwanted organisms such as candida.
  2. Liver, kidney, and blood purification can take place. This is not possible during routine eating patterns.
  3. Mental clarity is enhanced as chemical and food additive overload is reduced, diminishing brain fog.
  4. Reduced dependency on habit forming substances such as sugar, caffeine, nicotine, alcohol and drugs.
  5. Facilitates Adrenal Fatigue Syndrome recovery

Major Detoxification Centers of the Body

detoxification massage

  1. Skin – excretes toxins such as DDT, heavy metals and lead through sweat.
  2. Liver – filters blood to clear bacteria, bile secretion to eliminate cholesterol, hemoglobin breakdown products and extra calcium. It also purges prescription drugs due to amphetamines, digitals, nicotine, sulfonamides, acetaminophens, morphine and diazepam.
  3. Intestines – mucosal detoxification to rid toxins from bowel bacteria and excretion through fe1ces of fat-soluble toxins excreted in the bile.
  4. Kidneys – excretion through urine of toxins after they are made water-soluble by the liver.

Detoxification for AFS Sufferers

The more advanced the adrenal fatigue, the more care should be considered before embarking on any form of detoxification therapy. The reason is simple. The weaker the body (as in advanced stages of AFS), the more congested the detoxification organs. These include the liver, kidneys, and the skin. Too aggressive a detoxification program can lead to massive release of internal toxins that the body is unable to excrete on a timely basis. This can lead to a variety of unpleasant side effects, including fatigue, anxiety, brain fog, heart palpitations, fever, dizziness, hypoglycemia, insomnia, feeling wired, joint pain, ringing in the ears, nausea, vomiting, diarrhea, chills, and tingling sensations, just to mention a few.

Vegetable Juicing Program For AFS Sufferers

Fruit juices are very different from vegetable juices. Fruit juices should be avoided as the high sugar content of fruit juice raises blood sugar and insulin levels. This can lead to insulin resistance and ultimately diabetes in the long run. Many AFS sufferers have subclinical reactive hypoglycemia. Fruit juices can worsen the condition.

Vegetable juices are not as pleasant-tasting as fruit juices. The beginner should begin by gulping the juice, as this is probably the best way to get started. This process will ensure that the juice is in minimal contact with the taste buds. Start slowly by drinking only one or two ounces and finally up to 12 ounces each time. Too much vegetable juicing may trigger adrenal crashes. Always consult your doctor before you start.

Other Detoxification Modalities

Other time tested modalities include acupuncture and acupressure to open the meridian, lymphatic massage and stimulation to increase toxic excretion, various forms of baths and soaks, gallbladder and liver cleanses or flushes to clear out heavy metals, parasites, and internal toxins; pulse electromagnetic field therapy to rebalance internal energy flow, various forms of hyperthermia modalities including the use of far-infrared rays, intravenous ozone and hydrogen peroxide therapy.

Each specific modality has its benefits when deployed at the correct time with the proper intensity. In general, these modalities are best used when adrenal fatigue is in the early stages. They can provide short-term energy boosts without side effects because the adrenals are stable with enough reserve to cushion against sudden influx of toxic metabolites from such a detoxification process. But there lies the paradox – people in early stages of AFS seldom seek such treatment.They usually ignore the warning signs of fatigue and compensate with caffeinated drinks and sugary food for instant energy.

For those who are in advanced stages of Adrenal Fatigue Syndrome, these seemingly harmless and widely touted beneficial modalities can in fact backfire and worsen their condition. Adrenal crashes can be triggered easily since the body is already in a hypersensitive state from toxic overload. Any sudden increase in toxic metabolites from the detoxification process would throw the body over the edge, so to speak. Fortunately, such negative consequences are usually only prevalent in those who are well entrenched in advance stages of AFS and not a common occurrence in those in mild stages.

vitamin C helps detoxificationSuch adrenal crashes have serious repercussions symptomatically. Existing hypersensitivity can quickly worsen, along with exaggerated paradoxical reactions. With each insult, the threshold of triggering a crash is lowered and the longer the crash the slower the recovery process. In severe cases, one can be homebound and bedridden for weeks or months. This hypersensitivity applies also to previously tolerated nutritional supplements, as they are rejected by the body during such crashes and thereafter. For example, those who can tolerate 500-2000 mg of vitamin C previously may find the tolerable level reduced to 50 mg or lower, with a sense of fatigue, anxiety and being wired with any attempt to increase the intake. Herbs that are adaptogenic can become stimulatory. Calming compounds like magnesium can trigger anxiety. Most are at a loss at this point and are usually abandoned by their physicians.

As you can see, adrenal crashes resulting from improper detoxification can be very debilitating.Forcing more nutrients, no matter how good they are, into the body at this time will only make things worse. However, a body without any nutrients at all may be drained and devoid of basic energy for daily living. Navigating through this internal territory is delicate and treacherous; as any slight mishap can potentially throw, the body into another dreaded crash.

A body in this state needs help, but at a more foundational and orthomolecular level. To reach each cell without over stimulation, the amount of nutrients and the delivery system needs to be scaled accordingly. There is little room for error, and a slow and steady comprehensive approach is needed for best results. Detoxification should not stop, but be reduced to a more gentle level that focuses on the internal foundational terrain, starting at the extracellular matrix.


Almost everyone needs detoxification especially people who are exposed to industrial or environmental toxins. Those with Adrenal Fatigue Syndrome need detoxification even more as the body’s natural detoxifier organs are performing suboptimally.  The cornerstone of detoxification includes fasting, vegetable juicing; nutritional supplementation and a proper maintenance diet once the body has been detoxified. This can be supplemented with special herbs, antioxidants, probiotics, and enzymes to help the detoxification process.

The degree of detoxification tolerated varies from person to person. Those with advanced AFS need to be especially careful. The more advanced the AFS, the higher the risk of detoxification failure unless properly supervised. Inappropriate or overly aggressive detoxification is a common trigger of an adrenal crash and a common mistake in adrenal fatigue recovery failure. They will need a different set of detoxification tools including carbonized functional garments and specialized therapeutic water designed to cleanse the extracellular matrix as condition precedent to regular detoxification modalities.

Always consult your health care practitioner before embarking on any detoxification program.

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© Copyright 2013 Michael Lam, M.D. All Rights Reserved.