Extracellular Matrix (ECM) and Adrenal Fatigue Syndrome

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM; Dorine Lam, RDN, MS, MPH

Adrenal Fatigue can affect your Extracellular MatrixInternal milieu is a conceptual term coined by 19th Century French physician Claude Bernard that refers to the internal environment of an organism. According to Bernard, the cells of our bodies live under optimal and thriving conditions because they are protected from the external world. Dramatic changes that can occur in the external environment that may deliver internal cellular insults include changes in temperature, acidity, ion concentrations, and nutrient levels. Physiologically, this internal milieu is composed of the water-based fluid compartments of our body, in particular the extracellular fluids matrix, blood plasma and interstitial fluids that bathe our cells.

Extracellular Matrix

The term extracellular literally means outside the cell, which explains where the matrix is located. The extracellular matrix (ECM) is a network of non-living tissues that provide support to cells. It is a three-dimensional network of proteins, glycosaminoglycans and other macromolecules. In addition to structural support, it also plays a role in other very specific functions. They include cell adhesion, migration and proliferation. The fluid of ECM initiates crucial biochemical and biomechanical signaling critical for tissue development, differentiation and maintaining homeostasis. Signals are conveyed through membrane receptors called integrins. The differential expression of extracellular matrix components, integrins and other constituents contributes to the control of pituitary hormone production and is an important player influencing adrenal function via the hypothalamic-pituitary-adrenal axis.

The constituent materials can vary widely. Animal ECM contains protein, mineral, and fiber. Plant ECM is constructed from cellulose. ECM provides the essential physical scaffolding for our seventy trillion internal cells to roam and thrive. It is a dynamic environment with ongoing cellular communications and dialog. The ECM within each tissue is unique in composition and topology. Biochemical and mechanical properties of each organ, such as its elasticity and strength is determined and protected by the ECM. For example, ligaments have special proteins within the ECM to allow movement, while bone, ECM is made primarily from collagen and mineral deposits to create a strong structure.

Once considered a kind of inert goo, the ECM has been found to consist of semiconducting liquid crystals, materials known to have a variety of properties regulating transmission, storage, and processing of information. It therefore possesses amazing properties and presents immaculate order in function and structure. The ECM is one continuous interconnected ground substance, tying every function and every process in the living body one way or another. The reason is simple: every cell in the body is nourished via the matrix, and all waste products of cellular metabolism passes through this ground substance, which is the actual milieu.

Extracellular Matrix and Alternative Medicine

The ECM has not been recognized by conventional allopathic medicine as an organ because it is so intertwined with physiological regulations that it is extremely challenging to study and research. The traditional scientific medical model to reduce one whole into smaller components for study often fails because the ECM works only as one unit and cannot be reduced. Modern medicine’s heritage comes from a linear-casual and cause-and-effect thought process. This is extremely successful in surgery and acute illness. It has largely failed in addressing chronic illness which exist in a multidimensional sphere.

It is here at the ECM where many of the alternative therapeutics exert their effect. It is in the ECM that causes and cures many of the so-called systemic and chronic illness, especially inflammatory conditions, are addressed.

The ECM can and should be considered one organ system that connects all spaces of the body. ECM provides the platform and space that acupuncture, cranial sacral therapy, qigong, and meridian highways travel within and work. It is within the ECM that much of the body’s pH is determined, and the more traditional detoxification modalities such as fasting, diet, vegetable juicing and oil flushes work. Rehabilitation of the ECM can vastly improve outcome of chronic diseases. It is within the ECM that healing begins. Major pharmacological and surgical intervention should not be embarked before ensuring that the ECM and all related immune function have been distressed ahead of time for best clinical outcome.

The long-standing confusions about the significance of holistic and complementary therapies becomes clear when proper recognition is given to the ECM as a totally pervasive system, a major organ, that alternative medicine exert its effect.

Acupuncture and Extracellular Matrix

ECM not only functions as scaffolding for surrounding tissue and organs, but also as part of a body-wide mechanosensitive-signaling network. This network is where electrical, cellular and tissue remodeling pathways are embedded. Within connective tissue ECM, for example, cell-to-cell connections in the form of fibroblast webs have been observed to be the basis of cellular communication networks.

Acupuncture may exert a mechanical distortion to energy fulcrums along meridians at specific trigger points, adhesions, and fibrotic areas when they are needled. The reaction to acupuncture needling generates an energy response at the needled point known as de-qi that includes a unique needling sensation, perceived by the patient, and needle grasp perceived by the acupuncturist. The de-qi can be felt in different ways, including a warm sensation with swirling energy; a pin prick sensation that is localized or spreads to immediate or remote areas; a sense of tissue expansion; or muscle ache described as a mixture of dull and sharp concurrently. It’s like eating a dish of sweet and sour sauce that presents with its own unique flavor. During needle grasp, the acupuncturist feels pulling and increased resistance to further movement of the inserted needle. While the exact mechanism is not known, researchers have hypothesized that the needle grasp sensation is the result of mechanical coupling between the needle and connective tissue ECM with winding of tissue around the needle during needle rotation.

Furthermore, needle manipulation at the needled point, such as an up and down motion, transmits a mechanical signal to connective tissue cells via mechanotransduction, resulting in the presence of de-qi locally as well as in remote energy fields. For example, acupuncture manipulation at the lumbar region may trigger release of de-qi locally. This energy can also travel down to the legs at times, or up the shoulders at other occasions, depending on the state the body is in at the time of needling.

It is almost as if de-qi, in its infinite wisdom, has a way of moving itself to remote areas of the body where there is a call for healing. For example, needling of the right shoulder may lead to a de-qi sensation at the oral cavity where there may be a root canal pathology that is yet to be grossly observable or a tooth that is just starting to become loose and not yet problematic.

Because de-qi generated by acupuncture has no preset pattern of predictable and reproducible response consistently, acupuncture is often written off as unscientific, although there is little doubt that acupuncture produces positive results in many clinical conditions, including pain control.

As one understands how the ECM platform works, clarity of mechanism of action begins to emerge. The de-qi energy field travel appears to be a lot quicker and freer in healthy, well hydrated ECM without pathology and reaches pathological locations faster than normal areas. Pathological regions receiving de-qi also tend to react more intensely compared to normal tissue. This may explain why certain areas of the body exhibit reactions while other areas do not. Depending on the body’s unique environment at the time of acupuncture, de-qi flow can be blocked or retarded. Factors affecting de-qi movement include emotional stress, nutrition, muscular tension, mood, body constitution, internal toxin load, and hydration status, just to mention a few. Even small changes in dietary adjustment, for example, can cause disrupted ECM flow over a minute physical area. We must allow de-qi to work at its required pace and time as a self-regulatory system.

Acupuncture can therefore be seen as a mechanical way to activate the body’s internal energy or de-qi which in turn automatically travels through the ECM network to locate pathological areas of dysfunction and initiates spontaneous self-healing. Because the ECM is all encompassing within the body, a complete acupuncture program would necessarily involve the whole body. Intense and frequent acupuncture sessions addressing different parts of the body are required for optimum healing over months. A single organ focused acupuncture treatment approach carried out once a week for a few weeks usually only yields temporary relief at best and seldom leads to long-term healing.

Why study acupuncture when our concern is the extracellular matrix?

Acupuncture is but one of many alternative healing practices that exert effects through the ECM. Even though the precise mechanism of action has yet to be determined, the ECM’s role is critical and cannot be underestimated. It is clear that both mechanical and kinetic pathways are involved. By understanding how the ECM supports acupuncture function, we can deduce how ECM can be helpful in other alternative modalities, many of which also work within the ECM. They include acupressure, hyperthermia, ultraviolet light therapy, ozone therapy, and a host of unusual techniques, which we will discuss later.

In addition to mechanical and kinetic pathways working within the ECM, hormonal pathways are also involved.

Hypothalamic-Pituitary-Adrenal Axis, Cortisol, and the Extracellular Matrix

There are many hormonal highway networks within our body. One such hormonal axis, the hypothalamic-pituitary-adrenal (HPA axis), has direct influence on the ECM. The HPA axis is activated in times of stress, leading to the increased output of steroid hormones such as cortisol. They can alter target cell activities with profound effect at very small concentrations.

Much of what we know about the role of cortisol and ECM comes from studying connective tissue in athletes. Different organs have different proportions of cells in relation to ECM. In connective tissue, ECM is a predominant component. The number of cells within connective tissue is small relative to the amount of extracellular material that consists of protein fibers embedded in an amorphous mixture of huge protein-polysaccharide (proteoglycan) molecules.

Ground substance is the term we use to describe the ECM material that does not include collagen and elastic fibers. The steroidal hormone cortisol inhibits fibroblast activities within ECM’s connective tissues and reduces ground substances. When ground substance reduces, inflammation and swelling subside. Pain is diminished. Steroid medications are therefore widely used in acute athletic injury such as ligamentous strain and sprain for temporary pain relief. However, it slows soft tissue healing by masking the underlying pathology of inflammation and allows us to continue activities pain free. It is thus considered a performance-enhancing drug and universally banned in athletic competitions. It is also used in fibrosis reducing treatment caused by dense connective tissue deposits from chronic strain or trauma.

Adrenal Fatigue Syndrome and Extracellular Matrix

Chronic stress, either physical or emotional, can put the HPA axis on overdrive as mentioned previously. This leads to the adrenal glands working extra hard to put out anti-stress hormones such as cortisol. If stressors continue, the adrenal glands can become exhausted over time, leading to the condition known as Adrenal Fatigue Syndrome (AFS). There are four stages to AFS. Signs and symptoms of early stages (1 and 2) include fatigue, sugar and salt cravings, exercise intolerance and insomnia. Advance AFS (stages 3 and 4) can be incapacitating, with more severe symptoms including reactive hypoglycemia, hypotension, thyroid resistance, menses irregularity, low blood pressure, heart palpation, and low libido.

To combat AFS, the body produces more cortisol. One unintended consequence of unrelenting cortisol output is decreased ground substance mentioned previously. This usually occurs slowly. The progression is so gradual and insidious that it is often overlooked as pathological. As times goes on, reduced ECM ground matter increases internal risk of congestion with increased toxins and pollutants. The effect of long-term use of steroid medication is similar. Both stress and steroid use over time can lead to a catabolic effect on the body. Interestingly, activation of the parasympathetic nervous system by mediation or breathing has been shown to modulate the production of cortisol and thus lead to an increase in ground substance, allowing the ECM to self-heal spontaneously.

Extracellular Matrix Regulation and Breakdown

Adrenal Fatigue affects your ECMThe regulatory role played by ECM is a key factor in determining the success or failure of all biomedicine and therapeutics. To put it simply: a healthy ECM leads to a healthy body. Breakdown of the ECM therefore is a threat to good health. Disturbances of ECM regulation can simultaneously compromise homeostasis and efficacy, leading to eventual depletion of nutritional reserve leading to cellular dysfunction and ultimate organ failure.

When microbes attack the body, one of the things they assault is the extracellular matrix. Toxins secreted from bacteria and virus breaks down the ECM components. When the scaffolding of the body is damaged, cellular survival is at risk.

The ECM also serves as a backup garbage dump and septic tank for the body. The lymphatic system runs within, and when congested, as is normally the case in those with advanced Adrenal Fatigue Syndrome (AFS), toxins and metabolites diffuse throughout the extracellular space. Having a clean and healthy ECM forms the foundational base within which all cells can thrive. Unpolluted ECM optimizes organ function by facilitating cellular transport, intercellular signaling, detoxification, and rebuilding. Having a clean ECM is akin to taking a bath in a tub of clean water.

Without a continuously healthy ECM environment, few organs are allowed to function optimally. Having a healthy ECM is critical in achieving homeostasis at the most foundational level, bar none. Good health is simply not possible otherwise. When the homeostasis is disturbed, the body is susceptible to infectious agents. That is why despite having billions of microbes and bacteria cohabiting within our bodies, we do not get sick all the time unless our immune system is weak and our ECM is congested. Only when our ECM is polluted can microbes assert their toxic effects. Organisms already present in the body of a normal individual in fact cause many microbial diseases, such as candida. They become the cause of disease when a disturbance arises which upsets the equilibrium of the body to their favor.

When the ECM is congested, cellular breakdown is inevitable. The basic mechanism for decongesting the ECM is to open up and drain out pollutants and toxins so that the entire body has less toxic burden. Along the same lines, the manual bodywork techniques such as lymphatic drainage work on the same principal to release toxic burden.

Alerts, Signs and Symptoms of Extracellular Matrix Congestion

The ECM signals it is polluted and needs cleansing with subtle signs. They include:

  • Aches and pains of unknown origin
  • Migratory muscle pain
  • Increasing sensitivity to medication
  • Inability to tolerate nutritional supplements, even at low dose
  • Paradoxical reactions to nutritional supplements and medications
  • Bloating and indigestion
  • Long term unresolved headaches despite normal workup
  • History of gallbladder removal
  • History of liver infection such as hepatitis
  • History of excessive alcohol or cannabis use
  • Psoriasis and skin rash of unknown origin
  • Chemical sensitivities to shampoo nail polish, perfume, etc.
  • Food sensitivities, especially to corn, wheat, and diary products
  • Sensitivity to florescent lights and computer screens
  • Frequent yawning for no reason
  • Startles and agitates easily
  • A non-specific sense of something is wrong within the body
  • Increased in hyperpigmentation or hypopigmentation spots on skin that can come and go
  • Fatigue that fail to improve despite medications and rest
  • Unexplained dizziness
  • Feeling “wired and tired”
  • Eczema
  • Feeling worse during days of ovulation or menses
  • Muscle twitches
  • Water retention
  • Migraine headache
  • Unable to fall asleep after using a computer monitor or watching TV
  • Sense of nervousness under fluorescent lighting
  • A feeling of heaviness in the lower extremities without edema or structural defects
  • Frequent yawning, especially when outdoors or traveling

You need to determine your EMC health when dealing with Adrenal FatigueThere is no single definitive diagnostic sign or symptom. There is no definitive laboratory test. Microscopic examination of blood under dark field microscopy provides some hints of internal terrain. Stacking of red blood cell in “rouleau” formation, for example, can point to ECM pollution and pH imbalance. Generally speaking, the more symptoms present, the higher the probability of ECM congestion. They point to a body in a state of fragile balance at best. The key to determining ECM health is a detailed history taken by an experienced clinician on the lookout for subtle sign of internal disarray.


Consider the following typical history from a 45 year old female with ECM congestion:

“For the last few years, I have been maintained on 5 mgs of Cortef 3 times day along with Armor thyroid and Cytomel. It has given me some energy, but the feeling is not very smooth but “hyper” at times. I am barely able to make it through most workdays, and am very tired at night and on weekends. Some days are better than others, but I get fatigued and anxious easily. Overall, I seem to be going downhill.

I tried to eat a healthy diet but that does not seem to be enough. I developed food sensitivities to dairy and gluten. Almonds give me stomach discomfort, and too much eggs or sugar make me anxious. Every time I eat something wrong, my body punishes me. It takes me days to recover from my fatigue and anxiety. I have to eat frequently, once every 2-3 hours, in order to avoid crashes. I am now much more sensitive and restrictive on what I can and cannot eat.

I used to be an active person, but not anymore. Most of the time when I am at home, I lie on the coach and try to rest. Taking a long walk, soaking in a hot bath, having an emotional argument, or even being in the sun for a few minutes can induce my body to crash. My recovery time from these crashes are now getting longer compared to before. Even when I recover, I don’t feel like my body has returned back to baseline.

My doctor and I tried all kinds of supplements, and nothing has worked long-term. Herbs, glandulars, vitamin C, Bs, amino acid, and minerals all seem to backfire after a while. Some work for a short time at the beginning, but then stop working. Others I cannot tolerate from the start. Still others, I get too stimulated. I am now unable to tolerate many of them. I am scared to take anymore supplements because I have had such bad experiences over the years. My doctor and I could not figure out why. It seems that my body is getting more and more sensitive. The harder we try, the worse it gets.

Despite many attempts to adjust my thyroid and steroid medications, my energy level seems to be stuck at the same low level and not improving. I am holding steady with medicine now, but I don’t know how long that can last and how I can continue in the future as I am still young. I have seen so many specialists, and no one can tell me what is really going on inside my body. My doctors all focus on the laboratory results. I don’t think they really understand how I feel inside. Some days I don’t feel like I need my Cortef and some days it does not seem like enough. I just keep doing it, afraid to get off, yet unwilling to stay on.

I have tried to kick start my methylation process by taking methyl folate but that only makes me more anxious. I take betaine hcl and ox bile with every meal but still feel bloated with occasional gastric cramps and diarrhea. I have to take Ambien to fall sleep because nothing else works. I continue to wake up in the middle of the night with heart palpitations and night sweats. It takes me a long time to fall back to sleep, and I wake up unrefreshed. I am also taking Xanax to assist me with the high anxiety that can come randomly for no apparent reason. On top of that, I have muscle pain, brain fog, eczema, lightheadedness on standing up, and joint pain. My menstrual cycle is irregular with no help from natural hormone replacement.

I am unable to tolerate stress. I get energy slumps almost daily, and crash easily. I have been to the Emergency Room multiple times and I hate to go back there because I know they will tell me there is nothing wrong with me and send me home.

I know something is very wrong with my body. It seems like I am in a slow motion train wreck. There is a slow fire burning inside me and I know that one day it will blow up. I am scared because I do not know what I would do then. I have lost my zest for life, am socially withdrawn, and feel depressed. I am frustrated at my doctors, disappointed at myself, and angry at those around me for not understanding my plight. My integrative doctor does not know what else to do for me.”

Extracellular Matrix Cleanse Principals and Approaches

By the time ECM congestion is suspected, most people are already on a battery of nutritional supplements and medications yet not improving clinically. Many are in a state of worsening moderate to severe fatigue. If ECM congestion is suspected, a key principal to remember is that the extracellular cleanse should always precede intracellular detoxification by micronutrients.

Always start by taking a step back to make sure the internal ECM is unpolluted and flowing smoothly at the most foundational level of body function. The reason is simple: regardless of how good nutritional support is, limited benefit will be derived if the body is unable to assimilate and get rid of the metabolic by-products.

Due to an already fragile body by the time ECM decongestion is contemplated, it is important that the overall approach is comprehensive, gentle, slow going, and most importantly, nurturing to reduce toxic overload without triggering adrenal crashes.

Dietary Action

From a diet perspective, increase clean water intake orally. This should be done concurrently with electrolyte replenishment to avoid imbalances. The more water taken in, the more the movement of the ECM is effected. The more movement, the more toxins transferred to the kidneys and liver for processing and excretion. Bear in mind that electrolytes also need to be balanced, especially sodium and potassium. Ice-cold water should be avoided. Room temperature or warm water consistent with body temperature is preferred. Avoid sugary or caffeinated drinks.

Food choices should focus on organic and non-hormone components. Hydrogenated foods high in sugar should be avoided to reduce oxidative stress and the resulting EMC pollution. Corn, diary, gluten, and wheat must be curtailed to reduce genetically modified substrates and hard to digest proteins that can be pro-inflammatory. Nuts are generally encouraged provided they have been pre-soaked for at least 10 hours. Refrain from almonds. It is not necessary to be a vegetarian. Eat sensibly according to your blood type is helpful in about 70% of the cases. Always make room for exceptions to fit each body’s need. Those in a catabolic state should place priority on easy to digest food such as soups and blended food. Vegetable and fruit juice should be avoided.

Cooking methods should be simple. Avoid deep fried foods that can change the hydrogen bond structure within lipids, turning good fat into bad fat, triggering inflammation and histamine release that pollutes the ECM. Focus on steaming and boiling methods to ensure maximum nutrient retention and easy digestion. The exact food choice should match the person’s constitution. Raw foods may or may not be well tolerated. If the GI tract is strong, raw food can be very helpful. However, if the GI tract is weak, damaged, or if one is in a catabolic state raw food may not be very tolerated and can make things worse. Every person’s diet should be customized to blood type, metabolic needs, and foundational constitution.

Lifestyle Actions

From a lifestyle perspective, stress reduction is key. Stress increase oxidative stress which in turn breaks down ECM components. Meditation and gratitude practice are all positive contributors to a healthy mental outlook.

Yoga is a gentle exercise that increases blood flow to the liver. Certain liver decongestion poses can be very helpful if tolerated. Excessive exercise should be avoided. Most with severe liver congestion are in advanced stages of AFS. They are invariably bathed in a sea of adrenaline caused by an over activated nervous system in a state known as reactive sympathetic response. Symptoms include rapid heart rate, anxiety, dizziness, sub-clinical postural orthostatic tachycardia (POTS), heart palpitations, and severe insomnia. Adrenaline is a powerful hormone that causes an increase in hepatic blood flow. In the AFS setting, its over-release is usually compounded by a concurrent presence of high histamine levels when the body is inflamed and under stress. Both are high in advanced stages of AFS. Histamine produces arterial dilatation. The combination of adrenaline and histamine leads to higher blood flow into the liver, carrying more toxins to be processed, which needs metabolization. The liver workload is increased, and with that, a higher risk of ECM congestion if the metabolic breakdown machinery is not working at optimum levels. When the body is flooded with adrenaline, some leak and diffuse from the cell and is retained in the ECM. Extracellular fluid volume has been shown to increase. This can destabilize the membrane potential and acid base balance in the ECM.

Not to be forgotten is the use of Adrenal Breathing Exercises (ABE) to reduce sympathetic nervous system overtones. ABE enhances the parasympathetic nervous system, which leads to a reduction in sympathetic tone. Adrenaline is replaced by its weaker chemical mother, nor-epinephrine, which has been shown to decrease hepatic blood flow slightly. Liver congestion is reduced. ABE can lead to a sense of calm and serenity with peace of mind, reduced heart palpations, and decreased liver ache. Suffice to say that clinically this is a very powerful and positive tool when done properly. However, improperly carried out, ABE, can trigger excess adrenaline release and worsen liver congestion along with increased fatigue.

Nutritional Supplementation and Medication Considerations

Your lifestyle may need to change with Adrenal Fatigue

From a nutritional supplementation perspective, a comprehensive approach should be detailed in accordance to the level of congestion present. Supplements that may be good for liver and adrenal function is usually not well tolerated when ECM is congested. Sensitivities to vitamin C, B, herbs, and glandular compounds as well as medications are common. It may be necessary to temporarily reduce nutritional supplementation load carefully so as not to send the body into a crash or a state of withdraw.

Draining the ECM of pollutants therefore should be the primary focus, or else the release of toxins from micronutrients’ action on the cell (including vitamins, enzymes, minerals, etc.) will stimulate negative symptoms, such as skin eruptions, anxiety, aches and pain, fatigue, fever, malaise and skin rashes. Most of these are the result of inflammation.

Because most sufferers need some form of nutritional support, abrupt cessation is not recommended and should be avoided. Providing a gentle delivery system of nutrients with easy assimilation and cellular absorption without over stimulating and over burdening the liver workload should be the guiding principles. For example, gel caps or liquids and encapsulated powders should be considered for better absorption.

A thorough review of supplementation should be undertaken. In severe congestion, even relatively harmless compounds such as digestive enzymes and probiotics may be too much for the body to handle. Selected supplements can be considered, provided they are given at the right time, along with the proper delivery system and dosage. Slow drip delivery is preferred to bolus. The right nutrient at the wrong time or wrong dose will easily backfire given a fragile body with limited reserve.

Avoid traditional detoxification approaches such as liver flushes, cleanses, and enemas, vegetable juicing, and fasting. These approaches can generate a significant amount of toxins that can overwhelm the liver and pollute the ECM. In other words, they can be “too strong” for the ECM. Intensive exercise can lead to excessive oxidative stress that can damage the ECM as well. Both should be avoided until the body is well healed and stable.

Avoid medications as much as possible because invariably they all have to be metabolized by the liver. This includes all steroidal hormones such as cortisol, testosterone, estrogen, and progesterone. Those who already on such medications should not discontinue abruptly. Antibiotics can be insulting to hepatic cells, and statin drugs commonly prescribed for lipid abnormality can damage the cytochrome P450 detoxification pathways over time, leading to sub-optimal liver function. Exposure to environmental toxins including fumes and chemicals should be curtailed. These toxins accumulate within the ECM over time. Live in a clean and unpolluted environment with plenty of sunshine, fresh air, and clean water are sound principals to be adhered to whenever possible.

Eight Remedies to Cleanse Extracellular Matrix

There are no conventional medical tools to optimize ECM function. Here are eight out of the box techniques that are clinically proven helpful from our experience.

A. Charcoal. Charcoal is an excellent gentle binder and remover of toxins from the ECM if administered properly. The activated form of charcoal can be ingested, though it tends to be too strong for most people in advanced stages of AFS due to its direct toxin binding properties that can lead to a retoxification reaction. A more gentle transdermal delivery system can be considered. For example, charcoal can be incorporated into poultices, wraps, braces, lotions, soaps, and garments. Clothes made out of charcoal cloth are particularly useful when used at locations away from key organs, which helps the body gently rid itself of excessive unwanted pollutants from ECM without exciting a retoxification response. Side effects can include constipation, abdominal cramps, bloating, and headache.

B. Germanium. Germanium is a gray-white semiconductor element that may help relieve inflammation if applied externally. It has two important distinguishing factors that bring about healthy functioning effects in the human body. These traits are its inherent ability to balance the body’s ions, also known as bioelectricity, and its ability to penetrate far infrared rays into the human body.

Our modern lifestyle frequently exposes the body to harmful positive-charge ions, usually generated from mobile phones, computers, various other electronic equipment, chemicals and ultraviolet or UV rays. The presence of more positive-charge ions within the ECM causes the body to operate more slowly and much less efficiently. The cells within the human body start to weaken, making it more susceptible to aging and illness. This process commonly accelerates due to a lack of oxygen reaching blood cells with a now reduced carrying capacity. Germanium atoms attract harmful positive-charge ions from the body and help balance the ions within the body. The ECM is made more orderly.

A far infrared ray is an element of sunlight, a type of energy wave. These rays contain an incredibly low amount of energy that subsequently provides no detrimental effects to human bodies. It’s also not considered a radioactive ray. The human body is naturally considered organic. It’s also a source of far infrared rays. This fact relates to the ancient Chinese art of chi, which implies humans harbor their own internal life force, which works much like the previously mentioned rays.

Far infrared rays, although not considered radioactive, have similar characteristics to sources of light with radiation elements. Light energy, in general, doesn’t require additional mediums or conductors to transmit energy to objects. The light from the Sun, as an example, travels to Earth incredibly long distances without other mediums.
Far infrared rays do share different traits apart from normal visible light. Far infrared rays can travel or penetrate through objects. These rays can travel as deep as four to 10 centimeters from the top layer of human skin into the body, essentially warming the body from the inside out.
Studies have been conducted on the effects of far infrared therapy or stimulation to improve blood flow, which as a result may affect wound healing, or patients undergoing hemodialysis.
Germanium can emit a certain amount of far infrared rays, measuring around four to 14 microns. When both the body and germanium emit the same nine-micron wavelengths, this overlapping causes the water molecules within the body to warm, facilitating the circulation of blood throughout the body. As the body contains over seventy percent water in weight, this process essentially reactivates the body’s water cells, which in turn, improves blood circulation.
When far infrared rays get absorbed into other parts of the body including the ECM, it potentially revitalizes, improves and strengthens them. This process also increases the temperature underneath the skin, in addition to promoting micro-circulatory flow throughout the body, improving overall health.

Germanium therefore helps the body’s muscles relax, reducing fatigue and tiredness while increasing circulation and enhancing the body’s anti-inflammatory defense system.

Germanium apparel may be a gentle option to help rebalance the positive and negative-charge ions within the body that has been thrown off by its own equilibrium and improve circulation to the ECM at the same time. Side effects can include weakness, dizziness, and anxiety, among others. This is usually dose dependent.

C. Detoxification Water and Cream. Chelating unwanted minerals and microbes out of the ECM can be accomplished by ingesting water that is higher in electrical resistance conductivity relative to normal water. Water has been around for so long that few take the time to fully understand its hidden qualities. There are many characteristics to water that most are unaware of that can affect how it interacts with our body, such as: the natural angle between the two hydrogen and one oxygen atom, the direction of it’s spin (to be in harmony with the body it should be spinning clockwise), it’s movement (how it interacts with other substances it comes into contact with), the size of the dissolved water particles (that is the ions, electrical and protonic particles), it’s weight (spring water is lighter than other forms of water), the pH level, hardness (due to the mineral content such as calcium), total dissolved solids, boiling point (which can vary based on altitude and level of salt content).
Water exists in three states: gas, liquid and solid. Regardless of what state it is in, water still consists of the same molecules, that is, H2O (one oxygen and two hydrogen atoms). What creates the varying states is the distance and strength of the bond between the atoms and thus the density of the molecule.

Water at freezing temperature is more dense than liquid, and thus it naturally solidifies into ice. The opposite occurs at high temperature, when water turns into vapor as density reduces. In recent years, progressive physicists and scientists have come to discover the possible existence of a fourth state, where the molecular structure and density is between that of liquid and solid. The water molecule at this state tends to present in groups. It is noted that these specialized water molecules attached to bacteria when put in the same environment, ultimately making it impossible for the bugs to live. It appears that some form of signaling is in process, which has a positive impact on the immune system. As the level of microbes goes down, healthy ECM returns. As well, due to their higher resistance to electrical conductivity relative to regular water, there is a very gentle detoxification effect, binding unwanted toxins, minerals and heavy metals from the body’s ECM, thereby reducing the overall toxic load of the internal terrain.

The precise mechanism of action is still not known and will not be know for decades. Positive effects include increased immune function, reduced brain fog, gradual increase in energy, and a sense of calm over time. The process is slow and no immediate positive effect should be expected. Side effects, however, can include headache, brain fog, generalized and muscular pain, and fatigue, among others. They usually arrive at the start of the program. Tremendous fine tuning is involved.
D. Essential oils. Essential oils of various kinds have been used as a tonic and detoxification agent since ancient times. They can be ingested, vaporized through a diffuser or topically applied. Popular oils with internal cleansing effect include rosemary, chamomile, peppermint, juniper, lemon and thyme. Using the right blend of oils and right potency is important, because the combination of oils provides synergistic effects single oils cannot achieve. Oil of the highest purity and strength may be good for those who are healthy, but not necessary so for those in advance AFS. A more gentle blend is preferred because we only want the oil to emulsify toxin from the ECM and not intracellularly. The requirements are thus different. Special rotational and location specific protocols need to be followed to allow the body time for localized ECM cleanse without built up. Those who have multiple chemical sensitivities and a fragile body may not do well with essential oils and indeed may feel nauseated, with headaches and dizziness. Oils may seem harmless on the surface, but they can be very powerful once inside the body in ways that science has yet to understand fully.
E. Oil pulling. Oil pulling is an ancient Indian practice that can be considered as well. Oral application can emulsify toxic compounds from the mouth gently over time. Care must be taken to select the right oil and duration. Overly aggressive oil pulling can trigger adrenal crashes. The proper oil is important. Sesame oil appears to be well tolerated and not too intense.
F. Earthing. There is a tradition in some European countries of walking barefoot in the early morning when the ground is still wet with dew, or if you are fortunate enough to live on the coast, walking barefoot along the sandy shores of a beach. The scientific understanding behind this tradition is based upon the knowledge that our bodies are made up of cells that communicate with one another via their own electrical signals. Furthermore, our bodies (which are largely made up of water in the form of blood and body fluids) are also relatively conductive. As mentioned earlier, this signaling process is largely carried out in the ECM. When the body makes contact with the Earth (which is a natural source of electrons) there is a transfer of the Earth’s electrons into our body, thereby charging it with the same negatively charged electrical potential as the Earth, which is essentially grounding oneself. Earthing or grounding has enjoyed the support of emerging scientific research, that is, it is believed that the Earth’s electrons are capable of inducing physiological changes such as reduced pain, improved sleep, and a shift from sympathetic to parasympathetic mode in the autonomic nervous system. Side effects are minimal, but many may not be used to this in the beginning so it is important to start slow.

G. Electro Magnetic Field Reduction. Living in the modern world is no easy task. We are constantly bombarded by subtle energies in and around our bodies, whether or not we are aware of them. Electromagnetic Fields (EMF) are energy waves with frequencies below 300 hertz or cycles per second. They come from every day things such as power lines, radar and microwave towers, cell phones, television and computer screens, fluorescent lights, microwave ovens, house wiring and numerous other common electrical devices from blenders to battery chargers. Excessive EMFs trigger vibratory fluid movement and turbulence within the ECM. This can negatively affect cellular signaling. Silver is a metal with good EMF deflective properties. Functional wear incorporating strands of silver fibers can be worn to reduce EMF exposure. The more commonly worn garments include hoodies, sweatshirts, neck wraps, headgear and socks. Those who are extremely sensitive may need to sleep under a silver fiber incorporated bed canopy. These garments can be particularly useful when worn during your work in front of computers and laptops, or in an office building where it is inevitably decked out in wireless devices. Side effects can include anxiety, increased fatigue, headache, vomiting, bloating, and upset stomach.

H. Reduce oral cavity bacteria load. Our oral cavity is filled with microbes that secrete toxins slowly that eventually find their way to the ECM, which they call home. Poor dental health has been associated with heart attack, cancer, and a host of chronic diseases. While proper brushing of teeth reduces tooth decay, it is not specifically focused on reducing bacterial load. The Bass brushing technique helps. Here is how:

  • Gently position the head of the toothbrush horizontally with the bristles part way on the gums and part on the teeth.
  • Tilt the brush head to about a 45-degree angle. The bristles should be pointing towards the gum line.
  • Move the toothbrush in very short horizontal strokes so the tips of the bristles stay in one place, but the head of the brush waggles back and forth very gently 20 cycles per tooth. Overly aggressive motions can cause gum bleeding.
  • For the insides of your front teeth, hold the brush vertically instead.
  • To clean the chewing surfaces of the teeth, the bristles should be facing straight down and move in tiny circular motions instead, one tooth at a time.

This technique is more powerful than it looks. Always start and progress very slowly to avoid flooding the oral cavity with excessive microbes and toxins that can trigger anxiety, headache, heart palpitation, muscle and joint pain, fever, and adrenal crashes.

How Do I know If It Is Working?

The above provides an array of tools and remedies for consideration. Additional alternative medicine modalities that can be considered include bamboo salt, meditation, magnet therapy, biofeedback, guided imagery, vibrational therapy, cranial-sacral therapy, and others.

Bear in mind that healthy people generally will not feel any significant effect when these tools are applied. This is to be expected. A healthy body has ample local compensatory response mechanisms that automatically activate to rebalance internal energy and ECM flow disruptions from these tools on application. As a result, no clinical difference is observed. Those who are fragile and weak lack this internal reserve. The body therefore has insufficient energy to launch a local rebalancing response. Perceived as a threat to survival, the body’s immediate reaction to external stimuli is to activate the central emergency alarm system. This leads to the release of emergency hormones, norepinephrine from the brain and adrenaline from the adrenal glands, as a compensatory response of last resort. Heart palpitations, anxiety, fatigue and adrenal crashes are unintended consequences of such activation.

With each failed trial and error effort, the body’s emergency alarm is unnecessarily activated repeatedly. Over time, the threshold for such sympathetic activation is lowered, and the body becomes more and more “sensitive” to even the smallest stimuli from any of the above mentioned tools, not to mention medications and nutritional supplements. A state of reactive sympathetic response exists where the body is constantly bathed in a sea of adrenaline. This is why most people who do not understand the underlying physiology fail in their self-navigation effort to recover with alternative therapy and instead, worsen their overall condition over time.

The key to understanding how to use these tools and remedies rest with the ability to modulate and adjust the intensity, frequency, dosage and delivery system to match the body’s state of energy reserve and ECM congestion at every moment in time. This will provide the body positive benefit without negatively overwhelming the already weakened and fragile state. Over time, as the ECM is optimized, a sense of calm will return. The body will be able to handle stress better. Anxiety will go down, sleep will improve, and energy level will gradually increase. Patience is required because the progress can take some time.

Which Tool to Use?

Questions for dealing with Adrenal FatigueOne should always exercise prudence in choosing any alternative methodology. Remember in this discussion, we are dealing with an extremely weak and fragile body at a time when extensive medical workup and laboratory tests are normal. Clinically, the picture is convoluted and defies conventional medical logic. Symptoms include fatigue, insomnia, heart palpitation, anxiety, food and supplement sensitivity, low blood pressure, dizziness, and hypoglycemia, just to mention a few. With the lack of understanding of the root cause of AFS to start, and not knowing the underlying mechanism of action of these tools, it comes as no surprise that these techniques, though clinically proven useful when properly deployed to the right subject, are universally rejected by conventional medicine. Once the stimulatory approach of conventional medicine, using tools such as hydrocortisone, testosterone, estrogen, thyroid replacement, anti-depressant, and sleeping pills has run its course, sufferers are abandoned. Sufferers at this point should not be discouraged, but instead should get educated and start “thinking out of the box”. Remember that modern medicine of the past 150 years does not hold a monopoly to the collective medical knowledge of 5000 years of civilization.

Not one tool mentioned above is superior to another because all are designed, when properly used, to cleanse the ECM in the background, subtly and slowly. The body is in control of how fast this can go. Our job is to facilitate that process by providing the body the necessary tools for self-healing. For best results, a personalized program using multiple tools to harness the collective synergistic effect is recommended. Proper design of such a program requires the clinician to thoroughly understand not only AFS but also each of these tools in detail as to their pros and cons. Some trial and error is necessary, even in the best of hands.

Tools To Avoid

When an ECM cleanse is being contemplated, it is important to remember that not all alternative tools and techniques are suitable for those in advanced AFS, especially when the body is very fragile. They should be avoided unless conducted under close supervision by an experienced clinician. These include skin brushing, moxibustion, ice therapy, tui na therapy, body manipulation, certain forms of yoga and breathing exercise, lymphatic massage, ultra violet light therapy, deep tissue massage, far infrared therapy, rifle therapy, hyperbaric oxygen therapy, hyperthermia, and ozone therapy. Needless to say, traditional detoxification techniques such as fasting, enemas, castor oil packs and flushes should be avoided during ECM optimization because they are difficult to titrate when the body is fragile and can decompensate quickly.

Science vs. Snake Oil

It is likely these techniques enhance ECM function by removing ECM toxins gently and slowly without upsetting the rest of the body. The exact mechanism is not known. For skeptics and those conventionally aligned with allopathic medicine, the demand for hard science prior to embarking on these time-tested modalities is reasonable.

These modalities do appear on the surface to even be off-the-wall to alternative heath care practitioners that are not used to and experienced with dealing with advanced stages of AFS. We have yet to develop a full logical explanation that meets current definitions of an evidence-based scientific model. Those who are logically minded would be disappointed. Just because we don’t know why it works does not mean that it dose not work, and thus is the case here. We were also skeptics at first. Through the years, we are fortunate to have observed first hand the positive clinical effects when deployed properly. For AFS sufferers whose goal is simply to feel better and regain vitality, these tools should not be rejected outright without careful consideration.
We are not recommending that anyone try any of these, but one should know that clinically they do work for many in advanced AFS whose liver and ECM is severely congested. The key lies in understand the body’s state and matching it with the proper technique along with careful monitoring. These techniques may not work for everyone. Usually the failure lies with the operator rather than the modality. Indeed, we have to plan properly as part of a comprehensive total body approach to make the best use of these tools.
Conventional medicine has nothing to offer hypersensitive sufferers of AFS with EMC congestion. In fact, sufferers at this point are universally abandoned. As healers of the body, our mandate is to help the sufferer improve. No modality should be deprived of a properly planned clinical trial as long as there are no negative side effects. That is good clinical science. The key is to have a protocol that is customized for the body’s condition at each moment in time and to make adjustments along the way. The body will change as these modalities exert their effect. A lot of fine-tuning is needed, especially on the intensity and frequency of application. Everyone is different, and for this reason, a personalized approach and close monitoring works best. What works for one person may not work for another. For example, wearing a germanium-laced garment may be more effective than oral ingestion of activated charcoal for some. For others, topical essential oils mixed with the adrenal breathing exercises are best if not overdone. In addition to assessing the level of liver congestion, to be effective attention has to be paid to associate symptoms that exhibited prior to choosing the right combination and protocol.
Regardless of which special modality is used as a standalone or in combination, bear in mind that the body can be quite fragile and adrenal crashes can be triggered easily. Even in the best of hands, some trial and error is unavoidable.


The extracellular matrix is part of the internal milieu that bathes our cells. It provides the proper scaffolding for cells to thrive within our body. Pullulated and congested ECM is evident in advanced stages of AFS, where concurrent liver congestion and hypersensitivity to supplementation is common. The task of optimizing ECM function should be considers as foundational priority in preparing the body for AFS recovery. Indiscriminate use of natural compounds to enhance energy and reduce fatigue without optimizing the ECM first is a common clinical mistake in the recovery process of those in late stage AFS. Multiple tools are available, though most lack evidence based data in the conventional medical model. Fortunately, they do provide positive clinical outcomes with no negative effects when properly supervised.
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© Copyright 2015 Michael Lam, M.D. All Rights Reserved.