Detoxification & Adrenal Fatigue Syndrome – Part 1

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

Introduction to Detoxification

The liver is the most important organ to deal with detoxification and processing of materials from outside the bodyThere is little doubt that our environment is polluted with toxins and harmful substances. One of the keys to optimal health is to identify useful methods of detoxification to reduce 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.

What are Toxins?

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 minuscule percentage is ever tested for toxicity.

Types of Toxins

These can be broadly classified into the following categories:

Heavy metal toxins
Liver toxins
Microbial toxins
Protein by-product toxins

A. Heavy Metal Toxins

Lead, which is highly poisonous and requires detoxification to prevent serious damage to the bodyLead, 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

The 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?

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

Back pain is a sign that Detoxification is needed with Adrenal Fatigue

  • 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

Read Part 2 | Part 3

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

Dr. Lam’s Key Questions

You would have aches and pains in your body because of the inflammation caused by long-term built up of toxins. With detoxification, as the toxins slowly begin to be cleansed from the body, there should be a reduction in the aches and pains. Read my article on Detoxification and AFS.

Anything unnaturally done to the body can be stressful for the body, therefore, in the long run, weaken the adrenals.

The liver is the most important organ to deal with detoxification and processing of materials from outside the body
5 - "Thank you SO much"
Thank you SO much for this incredibly informative site!


  • Jody says:

    I have brittle nails and hair, what is the best way to start to detox?

  • Sherrice says:

    sometimes when I start a detox regimen I can get acne really bad. What does that mean?

  • Gretchen says:

    Whenever I try to detox, it makes me feel really weird like I can almost feel them moving around in my body, i become lightheaded sometimes. Is there a way to do more gently so that I am not so reactive?

  • Hiroyuki says:

    I’m not sure if this is connected but I have to ask. I’ve heard mouthwash can be harmful as it can destroy beneficial bacteria in your mouth. Is this the only reason it’s bad, or does it cause an increase in toxins from the chemicals in mouthwash as well?

  • Jenifer says:

    Talking about body detox, has anyone tried cryotherapy?

  • Gladys says:

    Understanding that there’s different types of toxins gives me better clarity as to why I may be feeling this way. Thanks!

  • Jeremy says:

    This article was very interesting to me. Thank you Dr. Lam. I wonder.. do you have an opinion on vaccinations and the heavy metals found inside of those?

    • Dr.Lam says:

      Vaccination as a public health tool has good intentions. However, not everyone can tolerate them.


  • Paul says:

    What is a safe and gentle way to detoxify?

  • Johan says:

    Even the comments are informative! I appreciate your website.

  • Jack says:


    Also as far as adrenal exhaustion –
    What throws me off about everything you say is
    Most of the symptoms one can have in completely different phases.

    The first 2 phases I get it. It makes sense. Most can relate to that… then catch on… have the common sense to rest up, perhaps make some diet changes, make healthy improvements.

    Now when you got to stages 3 and 4 is where you lost me. There’s so so many issues in those phases that you describe that are common without being as sick to the extent you describe.

    Ie: some who may go through periods of everyday anxiety or depression for a variety of reasons (kids, teens, adults) etc who also may have a hard time concentrating, or have some brain fog, crave salty food, etc for example that may even sleep alot more than usual, but then simply get over the issue quickly and are mostly fine. There’s others who’s blood sugar may dip which is very common but aren’t sick to the extents that you describe in 3 and 4… there’s many even with diabetes for most of thier whole life and they don’t get worse and worse, or have sudden loss of health to where they can’t reasonbly function, etc etc I could go on and on. So I’m totally thrown off by the explanation.

    I can respect the emphasis that you put on that one should be careful about dosing supplements as well. Especially for those who are sensitive.

    I personly am borderline low in B12 and have been sleepy, even while awake, tired, headache. Would you suggest I not take any at all and just start? Is there a basic safety plan we all can start with no matter where we are at?

    • Dr.Lam says:

      There is no one size fit all program because the body changes. The fact is that the change can be quite drastic, so people who are not on alert can make themselves worse. B12 is a stimulant. Be careful.

      Dr Lam

  • Desi says:

    Didn’t realize there were different classifications of detoxifying. Thank you for this informative and helpful article!

  • Jason says:

    Is lithium considered a heavy metal?

  • Kimberly says:

    Thanks for clarifying what type of detox is best for different toxins!

  • Nuveo says:

    I’m interested in detoxing for general health and keeping my body in prime shape. Should I start off with a light liver detox? Not looking into a major detox but just something to start off on. Thanks in advance.

    • Dr.Lam says:

      You can start with gentle detox if you are relatively healthy and strong. As far as the specific type, everyone is different, and without knowing more about your body, I am unable to tell you whether liver is the right starting point.

      Dr Lam

    • Dr.Lam says:

      If you are strong, light liver detox is generally well tolerated if your doctor is ok with it.

      Dr Lam

  • Natally says:

    I have brain fog, really bad anxiety, derealization, depersonalization, AF, super tired, emotionally numb, no libido obsessive thoughts some inappropriate,

    My tests showes

    IgA high
    Low dopamine
    Low serotonin
    High candida

    I tried many supplements and i am not getting better

  • Juan says:

    Can feeling jittery be a sign of a liver that’s in trouble? I take supplements but they always seem to push me to the edge, and I was wondering if it’s because they hit my liver too hard.

    • Dr.Lam says:

      Its possible, but also can be the intrinsic characteristics of the supplement concerned. A detailed history is needed to sort it out.

      Dr Lam

  • Junior says:

    Any supplements to help with this?

  • Nick says:

    first off, great article! also what are some detox a person with constant headaches and allergies is able to do?

    • Dr.Lam says:

      In a setting of AFS, one has to be very careful. What works for one person can worsen another. The stage of AFS a person is in plays a big part. There is not “gentle” as what is gentle for one may not be for another.

      Dr Lam

  • Nury says:

    Even if you do everything in your power to restore GI health, it’s still possible to experience some side effects as a result of the antibiotics treatment.

  • Jeff says:

    I suffer from constant allergies, esp. in the face area. is there any specific kind of detox i should try?

    • Dr.Lam says:

      Detox in the setting of AFS needs to be very carefully considered as even the most gentle ones can trigger adrenal crashes if the body is weak. Best you talk to an AFS practitioner. I am therefore cautious without knowing more about your body.The simpliest is just to drink more water with some lemon.

      Dr Lam

  • Hank G. says:

    I notice that my tongue is kind of grey-ish, what kind of detox does that indicate ?

  • Nicole says:

    Under Protein By-Product Toxins, you mention that a drastic reduction in protein can cause a crash, What is considered a “drastic reduction”?

  • Stephanie says:

    After reading this article i feel like i have many of the signs that a detoxification is needed for my body.I am a bit overweight, have a lack of energy, dome depression, headaches, and joint pain among other things. What is the best way to start a detox? how often should i detox my body?

    • Dr.Lam says:

      The most gentle way to start the process is to simply drink more water and let the body naturally get rid of toxins. Juice fast is also good but you have to be very careful especially if you have AFS as crashes can be generated.

      Dr Lam

      • Jack says:

        Do you have a general guideline for the amount of water you should drink and for how long should you drink if your not improving – like say in the instance of having brain fog with AF, etc. thanks

        • Dr.Lam says:

          Usually at least 64 onces a day is needed. But everyone is different and some may need a lot more.

          Dr Lam

  • Joe says:

    EDTA is not a very good chelator of mercury. It is however a good chelator of lead. This being said, someone chelating lead with edta should make sure they are not mercury poisoned to begin with before using edta as this approach would move mercury around causing worse health to occur. The safest chelation method for mercury seems to be cutler chelation using ala, dmsa or dmps.

    • Dr.Lam says:

      That is correct, on a relative basis. Also not to be forgotten is glutathione, green foods such as chorella can be added to your list.

  • Melissa Gold says:

    Is psilocybin considered a toxin? Or just a regular fungus, like a mushroom you would eat at salad bar?

    • Dr.Lam says:

      It is not considered a toxin in and of itself. it can become a toxin if your body reacts negatively or you are unable to breakdown this compound properly.

  • Melissa Gold says:

    Is psilocybin considered a toxin?

  • Mxm says:

    I have the begining stage 2 of AF, leaky gut, kidney and liver are overloaded, and I have high level of chemicals in my bloodstream. Do you recommend healing af before i start any kind of detox? Also Do you think TCM os able to heal AF?

    • Dr.Lam says:

      In general, the weaker you are , the more careful you need to be with detox. Without knowing your severity , I cannot begin to give you any accurate recommendation. TCM has its place for short term use, but it does not heal the underlying problem. Click Acupuncture, TCM, & Adrenal Fatigue Syndrome for more information.

  • Kenneth Martinez says:

    Is it better to use detoxifying foods over detoxifying supplements ?

    • Dr.Lam says:

      They both have their places. Its not necessarily one or the other. The key is knowing how to use food or supplements properly.

      Dr Lam

  • help says:

    I have severely congested liver that is causing histamine to constantly release. What is the gentlest way to detox and avoid crashing.

  • Irving Stephen Bradley says:

    I grew up living in houses with lead paint and some mold. Im glad I’ve read this article, makes a lot of sense. Thank you Dr Lam.