Detoxification Circuit Dysfunction – Part 2

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM; Carrie Lam, MD

Read Part 1

The Clinical Picture of Detoxification Circuit Dysfunction

Failure to help the body regain its footing and relieve the reactive metabolite overload can lead to worsening systemic signs and symptoms of detoxification circuit dysfunction. Detoxification circuit dysfunction symptomsSubtle signs include an increase in food sensitivities, gastric bloating, constipation, exaggerated responses to drugs, paradoxical reactions to medications, insomnia, brain fog, migrating pain of unknown origin, anxiety, psoriasis, autoimmune flare-ups, tingling, dizziness, burning sensations in the mouth when under stress, fatigue, heart palpitations, stress intolerance, and electrolyte imbalances. Unfortunately, most of these symptoms are ignored and passed over as a normal part of the aging process until severe. On closer examination, however, it is clear that the symptoms are deep rooted, well beyond what any single condition can encompass.

Because of the level of complexity in clinical presentation, physicians are often overwhelmed and left with little choice but to patch symptoms as their patient’s complaint list grows. Aggressive physicians may start the patient on a battery of medications, including the following:

  • Antidepressants and sleep medications for mood
  • Thyroid replacement for energy
  • Beta blockers for heart palpitations
  • Anti-inflammatory drugs
  • Proton pump inhibitors for gastric discomfort
  • Bio-identical hormone replacements including testosterone, DHEA, and pregnenolone
  • Methylation enhancement products to correct genetic abnormalities
  • Immune suppressant drugs and peptides
  • Intravenous infusions of IgG, vitamin C, vitamin B, and glutathione
  • High dose steroids including hydrocortisone or prednisone

While transient symptoms may improve initially, most medications fail over time because of side effects, intolerance, or resistance.

After extraordinary and heroic efforts, physicians usually give up. Looking from afar, the body seems to be very irritable. Unfortunately, the root cause cannot be found by the allopathic approach. Something is wrong, but all medical workups continue to be largely normal. It’s like walking down a street and seeing smoke coming out of multiple windows of a house that it is not supposed to. You know something is wrong, but the source of the problem cannot be located.

The Rare Perfect Storm

Detoxification circuit dysfunction represents a perfect storm with excessive reactive metabolites, liver congestion, ECM pollution, and an immune state on full throttle, resulting in a fragile body that is often housebound and bedridden. The body is weak, and daily function is marginal at best. The clinical picture is serious, as it reflects a system-wide malfunction of the detoxification circuit. This is very different from healthy people who are low in energy but live a normal life and feel revitalized after a liver flush, a detoxification fast, or a coffee enema. The difference comes down to the degree of damage and resulting clinical incapacitation. A body can recover more easily and on its own if only one of the three aspects of the detoxification circuit is dysregulated. Giving the body a few days of rest by fasting may be all that is needed. When the perfect storm hits, however, the entire detoxification circuit can be affected and severely damaged. The clinical picture is much more severe. Any attempt to detoxify the body can actually make matters much worse.

Detoxification circuit dysfunction can result a fragile body that is often bedriddenBecause conventional and even naturally oriented physicians are seldom exposed to such a perfect storm, with convoluted clinical presentations in a body that is very brittle and fragile, many mistakes are made by well-intentioned doctors. They do not fully realize that invasive investigation and trial-and-error symptoms patching during this time may easily make the sufferer much worse. The reason is simple. Without a clear idea of what the root issue is, heroic attempts by well-intentioned physicians to patch symptoms invariably lead to even more reactive metabolites being introduced to the body at a time when it is already overloaded. This includes introduction of radioactive dyes needed for diagnostic tests such as MRIs and CT scans, medications to help stabilize mood, antimicrobials for co-infections such as candida and H. Pylori, immunosuppressants for autoimmune flare-ups, bio-identical hormones to increase energy, proton pump inhibitors for gastric discomfort, and sleep meds for insomnia, just to mention a few. The more metabolites are introduced, the more toxic and sensitive the body becomes. Any attempt to reduce toxicity only adds to the existing ECM and liver congestion. A marginally weak body may crash under such insult.

Classic History of Detoxification Circuit Dysfunction

Physicians need to be on clinical alert in order to detect detoxification circuit dysfunction. The typical history involves:

  1. An unknown trigger sets off the avalanche of decompensation, with low energy and fatigue at the outset. A detailed history may reveal preexisting, systemic problems such as stealth infections, heavy previous antibiotic use, gastric disturbances, over exercise, severe stress, or hormonal imbalance.
  2. A severe energy crash. The body recovers slowly but is unable to maintain a sustained recovery over time.
  3. Common relapses. Gradually, other symptoms unrelated to fatigue begin surfacing. Numerous detoxification processes may be tried, including enemas, flushes, colonics, and fasts. These attempts usually fail. Sufferers become more sensitive with each failed attempt to feel better. A retoxification reaction may occur as the body deteriorates gradually. Nutritional supplements may produce temporary benefit, but improvement is unsustainable, and measures backfire over time.
  4. An extraordinary medical workup and effort to find the cause. Trying to find the ‘smoking gun’ results in a barrage of tests, from functional studies to genetic investigations.
  5. Laboratory test results that are usually normal or borderline. There may be elevated rT3, white blood cell count, or anti-TPO antibodies. Sed Rate and ANA titers are generally unremarkable or borderline high. Genetic testing may show positive MTHFR gene mutation and pyroluria. It’s very important to note that, when enough tests are run, some abnormalities may be found. Not every abnormality needs to be addressed. Often times, aggressive maneuvers to normalize test results may produce more harm than good. Unfortunately, this holistic perspective is often ignored by well-intentioned physicians.
  6. Therapy for what appear to be presumptive causes. Therapies include steroids, hormones for thyroid and bioidentical hormone imbalance, antibiotics for stealth and chronic infection, peptides to the boost immune system, and toxic metal chelation. Some transient improvement may be experienced, but usually it is short lived.

How the detoxification circuit reacts to medications

  1. Aggressive stepping up of medications and supplements to fight symptoms. This continues over time, from first-line to last-resort drugs, without long-term positive clinical outcomes. Most medications are met with failure or abandoned due to side effects as the body’s sensitivity grows and resistance develops.
  2. Some temporary relief is often experienced with natural modalities such as IV therapy, immune boosting, methylation, enzyme therapy, chiropractic manipulation, cranial sacral adjustments, and acupuncture, but results are usually unsustainable.
  3. Sufferers continue to feel worse as one medication after another fails, and one modality after another fails. There is no smoking gun found. This can take years.
  4. The body becomes more sensitive over time to food, medications, and natural compounds. Energy levels continue to decline. The threshold needed to trigger an energy crash lowers, and the intensity of crashes increases. Eventually sufferers become housebound or bedridden.
  5. After all possible tests have been exhausted and all meds have been tried at their maximum dosage, sufferers are ultimately abandoned by their physicians as side effects mount and fatigue worsens.

Detoxification Circuit Dysfunction Recovery

The failure to recognize signs and symptoms of detoxification circuit dysfunction is common. Few conventional physicians are knowledgeable or have enough clinical experience in this matter to be on alert. The lack of laboratory tests that are sensitive enough to detect such a condition compounds the confusion. Patients are generally told all is well, or nothing can be done. Some are told they have autoimmune disease, but the outcome of remediation is more often than not blunted at best. Over time some may become dependent on steroids, thyroid replacement, and bioidentical hormone replacement. Others are told to take antidepressants and sleep medications for symptom relief as well. Physicians eventually abandon most patients.

One should not jump to the conclusion that there is indeed detoxification circuit dysfunction without taking the time and patience to piece the history together. Also required is a careful examination of whether the clinical puzzle can be explained based on sound physiological and medical logic from a functional perspective. This can be a painfully slow process lasting months. Piecing together complex history takes time and multiple encounters with a knowledgeable physician before a detoxification circuit dysfunction is suspected. Most sufferers have seen multiple doctors and taken a myriad of failed supplements and medications at one point or another. Many are incapacitated.

To fully understand the degree of detoxification circuit dysfunction, qualitative challenges need to be issued to evaluate in real time the body’s detoxification capability, reserve, sensitivity, immune state, and constitution. Only with close, continuous follow-up and monitoring over a period of time will a clinical picture of the detoxification circuit dysfunction emerge. A qualified physician on the lookout for this clinical scenario is therefore the first step in recovery.

Once ascertained qualitatively, common sense would dictate that it can only be resolved by one solution long-term. You must reduce the overload that triggered the dysfunction. This involves steps to reduce reactive metabolites, decrease liver congestion, depollute the extracellular space, and prevent excessive immune excitation.

However, this is easier said than done. Most attempts by inexperienced clinicians fail as the condition of patients worsens because:

What conventional medicine says about the detoxification circuit

  • The patient is not well informed of the recovery path and has inappropriate expectations. Many demand quick results. A focus on finding the ‘smoking gun’ seldom works, if ever.
  • Fast track solutions often backfire and make things worse, because the body is not ready or is too fragile.
  • The removal of harmful agents, whether medications or natural compounds, can carry significant risk of withdrawal and may worsen symptoms.
  • Lack of accurate laboratory tests to guide clinical management causes problems. Conventional serum liver function, immunoglobulin studies, and autoimmune studies are normal to marginal at best. Genetic testing may shed some light, but remediation often makes matters worse. Advanced testing such as salivary interleukin-1 beta, alpha amylase, C-reactive protein, and IGA can be helpful, but proper clinical interpretation is needed.
  • A weak body that changes frequently is a clinical nightmare. It is like a moving target. What works one day may not work the next. Few physicians have enough clinical experience.
  • There is no set protocol possible, as everyone is different. Heavy reliance is placed on a clinician’s expertise, which must be built from handling a large number of cases over decades.
  • The process can be very long, taking more than a few years in severe cases.

Only generalized conceptual approaches can be offered here because each person is different and what works for one may indeed make another person worse. There is no one-size-fits-all protocol possible.

A holistic functional perspective, coupled with clinical experience and a systematic plan, is the key to recovery. With close monitoring, patience, and persistence, recovery can be affected and sustained. Roller coaster rides or relapses may be experienced from time to time, but the intensity and frequency usually reduces over time under capable hands. It is constantly surprising to find that the body possesses such an amazing recovery and self–healing ability, if given the right natural tools and time. On the flip side, the wrong approach can worsen the clinical situation.

Read Part 1

© Copyright 2017 Michael Lam, M.D. All Rights Reserved.

Detoxification circuit