By Dr. Joseph Mercola
JM: Dr. Joseph Mercola
BW: Dr. Bryan Walsh JM: Welcome, everyone. This is Dr. Mercola, helping you take control of your health. Today we are joined by Dr. Bryan Walsh, who is a naturopathic physician, and really extensively trained in molecular biological pathways. We’re going to talk about detox today. But before we get into the interview, I want to give you a little background information. I had done three sets of five-day water fasts. It wasn’t until I listened to some of Bryan’s interviews that I realized that that is a very powerful detox program. You’ve got to be diligent to take care of special attention if you don’t want these toxins recirculating in your body. That’s what sparked my interest. I took his course and it’s just magnificent, so much so that I’m actually motivated to write a book on detox and really develop probably the best detox program in the world, but that won’t be for two years. Until that time, I don’t know of a better program than what Dr. Walsh has put together. It is just profoundly terrific. It really is ideal. I’m going to be incorporating a lot of his principles into what I’m doing, because he’s just put it all together in a way that’s easy to understand, which is really one of his amazing characteristics. It’s an unusual quality to be able to translate complex biochemical jargon into practical language. Dr. Walsh has done a great job on that. Welcome and thank you for joining us. Please feel free to expand on your background beyond what I did.
BW: Listen. I appreciate what you said. I’m really happy to be here. More so because this was a topic – I guess I’ll get into this – that you have heard about for a long time and I had heard about for a long time. I’ll tell you the story of what launched me into this, but it’s a topic that we need to be having different conversations about.
JM: Yes. I have reached the conclusion, and I think you would agree with this, that previously, it was an option, probably a good idea historically. But in the 21st century – this is what I would like you to expand on – it’s that we really don’t have a really pragmatic alternative, because we’re all being exposed to massive overload of toxic chemicals, upwards of tens of thousands, 80,000 chemicals. Even if you lead the cleanest lifestyle, you’re going to be exposed to them. You need some regular system to eliminate them from your body unless you want to accumulate damage. BW: Absolutely. You say living a clean lifestyle. In most people, that comes as a conscious effort later in life, which doesn’t relate to the exposures that they may have had prior to changing to a clean lifestyle. But even then, there’s evidence that this gets passed along from mom to fetus. There was a really great Canadian publication that was put out that’s called “Pre-Polluted: A Report on Toxic Substances in the Umbilical Cord Blood of Canadian Newborns.” It was referring to this very thing. That when they study newborns and they look at fetal cord blood or the first bowel movement, that they already – that’s why they called it pre-polluted, I don’t like the word toxins – have xenobiotics in their systems. You can decide that you, in your 20s, want to live this clean lifestyle and be free of toxins, but that doesn’t speak to all of the thing that may have been stored from your life even prior to you being born. They are ubiquitous. They are everywhere. And I agree, I don’t like the fist wavers and say that, “Oh, we’re all toxic.” But the reality is, I think, when you look at the literature, is everybody’s exposed. Where you live, how you live and your socioeconomic status may dictate what you’re exposed to, but everybody’s exposed to something. JM: Yes. Your entry into this field was really almost that of a skeptic. You didn’t believe that this was an effective strategy, and you set out to disprove it. Why don’t you discuss your journey and what you arrived to? BW: Thanks. I have a long history with health. I’m a naturopathic physician. I was interested in health prior to that, which is what led to that. I had been familiar with detoxification. I had read all the laypeople’s books on detoxification. I believed that we were toxic. I thought that detoxification was probably a good idea. But then what happened is that I was talking to a colleague a little while back. She was telling me about this detoxification guru in the industry and how he was describing phase III detoxification pathways. We’ll talk about the pathways if you want. It didn’t jive with what my understanding of phase III was. I thought, “Well, this guy is the guru, so he probably knows. But let me go to the scientific literature and see what really it says about what phase III is.” Three things happened. You know the PubMed rabbit hole. You go on one paper and into the next, and into the next. JM: I read the papers like that.
BW: And you’re up until 2 in the morning. In this little journey, three things happened. Number one is what I realized was he was not speaking onto what phase III was accurately. I have a problem with that, because in this industry as you know – functional medicine, nutritional medicine, whatever you want to call it – we need to be accurate with what we’re talking about. He was referring to it wrong. I thought that was a problem, that people need to know what phase III actually is. The second thing that happened was, as I was reading, there was another phase of detoxification that I have never heard about. It’s called “phase 0.” You’ve been doing this longer than I have, but I’ve been doing this long enough. I’ve never heard anybody ever refer to phase 0. I thought, “Well, wait a minute. If this is another phase of the legitimate phase of detoxification that’s in the scientific literature, how come I’ve never heard anybody ever refer to this? Because clinically, it might be valuable to know about.” The third thing that really bothered me was I read about what’s called a biphasic response for nutrients that are commonly used in detoxification programs or formulas. What the biphasic response basically says is that a low dose – choose your herb – stimulates certain detoxification enzymes or pathways, but then a high dose inhibits those very same enzymes. In English, what this means is that the amounts that are found in food generally stimulate detoxification enzymes. But the amounts that are found likely in an isolated form in a capsule in a bottle full of detoxification product might actually inhibit detoxification. And then I looked at that and I thought, “Oh my gosh. Here we go again.” We think we’re doing all these great things, but in fact, we may be doing the exact opposite of what it is that we’re attempting to do, and nobody’s questioning this. Those three things happened, and I was like, “Alright. I’ve got to start from scratch.” Just wipe out everything I thought I ever knew or have been taught about detoxification and go to the scientific literature and say, “What really is being talked about and studied?” Before even getting into detoxification, answering questions that I thought I knew. “Are we even toxic in the first place?” Everybody says that we are, but I haven’t actually looked at the literature. Another one was, “Is there a synergistic response?” If there are multiple exposures simultaneously, we’re told that there’s a synergistic response. But again, what does the science really say about this? Another one that we hear about is that the dose doesn’t matter, that a low dose that we’re exposed to, that our body has these built-in detoxification pathways to deal with these things, so therefore a low dose is inconsequential, say the detox naysayers out there. And then another one is, “Are they stored in us?” Supposedly we’re toxic, supposedly they’re stored, supposedly there’s a synergistic effect, but what does the science say? I went in and the short version is that, “Yes. We’re toxic. Everybody’s exposed. Yes. It’s stored. Yes, there’s a synergistic effect. Know that dose doesn’t technically matter because a low dose is just as damaging as a high dose, especially with the endocrine disruptors.” Then my next question, of course, was – I’ll be honest with you, this was selfish. This was for me and my family, to be honest with you. I had no intentions. I mean, us first, then patients, and then the public at large. JM: Just like on the airplane. Take care of yourself first before you take care of someone else. BW: You’re no good to anybody else if you can’t take care of yourself and your family. So then, I said, “Well, what does the evidence really suggest as the most effective way of – since we are toxic, since it does get stored, and there are plenty of studies that support that, since there’s a synergistic effect, since these are damaging and a low dose is just as damaging as a high dose in some cases, how can we effectively get rid of these things? What is the most effective detoxification?” You know, there are footbaths, colonics, lemon juice in the morning, and all these different claims that are made, and that’s fine. Just because something’s not in the scientific literature doesn’t mean that it doesn’t exist, but I wanted to say, “Well, what is known or believed about these things?” Over time, I created this detoxification program that I’m really quite happy with. Logically, it makes a world of sense. I don’t think it’s – We like sexy. It’s not as sexy as maybe some of these fancy-schmancy things with these cute bottles, and “Drink this in the morning,” and “Drink this at night.” But it is, in my opinion, if we truly want to detox, if we really want to, then this is the type of program I believe – and we have some evidence on – that will actually do the job. [—–10:00—–]
JM: Yeah. I couldn’t agree more. I’ve looked at a lot of different programs. As I said at the beginning, yours is the best I’ve ever encountered. And not because it relies on large amounts of supplements. It doesn’t at all. But yet, you’re incorporating these massively effective polyphenolics from certain types of vegetables that are probably far more effective than the supplements. I just love that about your program. We’ll discuss the details in a moment. But first, I wanted to comment a bit on your process and applaud you for doing that, and to let everyone know that they can do that also. When I finished my residency training in – actually I extended for a year, 1984 to 1985. I took a year off and basically did research training and used PubMed. Back then, PubMed was a telephone book that was printed every month. You have to look them up in the book and then copy that down, and then go to the journal stack, and then find that article, and then copy it. It literally would take you an hour to find one article. Now, with PubMed, anyone, anyone, anyone can go on there. There is no charge. What people don’t realize, if they haven’t been on PubMed for a while, is that there is almost at least one-third to half of the articles that are free. BW: Anybody can access them.
JM: Yeah. You can download the entire article. Clearly, the jargon is going to be, if you haven’t had biochemistry or any formal training, a bit of a challenge, but you can look things up and you can get the gist and discover this yourselves.
JM: I just wanted to have that as an important side tangent. And then also emphasize the fact that the biphasic values, and the classic example of that would have been curcumin, where in highdose, it’s really bad in detox, and in low-dose, like turmeric, good stuff. There are so many components in your program. Let’s go into the fasting, because this is what really catalyzed my interest in your work.
JM: Actually I mentioned I’m writing a book. My next book is Superfuel: Ketogenic Keys to Unlock the Secrets of Good Fats, Bad Fats, and Great Health, which is out in the fall. Beyond that is Keto Fast, which I’m writing with the director of the TrueNorth Health Center, which is the largest fasting clinic in North America. They’ve fasted like 16,000 people, which is a process that you don’t disagree with. Dr. Alan Goldhamer and you would have a nice conversation. We might have you on for that, because you have two divergent opinions, and I respect both of your work immensely. But anyway, nevertheless, I’m writing that book with him. It involves fasting, which has got me on this tangent of having a little section of the book about detoxification. That little section turned into a chapter. Then after 50 to 100 pages, I realized, “This is not a chapter. This is a book.”
BW: This needs to get out there for sure. JM: Let me just finish my question. I know it was a long ramble. But the question is on the fasting. You don’t agree with regular fasting. It’s a point of disagreement between us, but that’s fine. There’s no problem. Professionals are going to have disagreements. But you have this fasting mimicking diet, which is based on Valter Longo’s work, who I’ve interviewed twice. It’s really magnificent because you’re not using his supplement program, which costs 150 dollars for clinicians, and 300 dollars if you’re a patient. But yet you use similar macronutrient ratios and calories. Why don’t you expand on that and just describe what it is? Because it’s such a magnificent innovative approach to this whole process. I really applaud your effort for it. BW: Yeah. With all due respect, I’m going to disagree somewhat. I love the concept of fasting. When you and I chatted that one time – Fasting has a really long history. There are innumerable applications for it. The more science we do, the more we learn the number of benefits that fasting actually does. My issue with it though is while it has this really long history, we live in a time now that we’ve never had ever before in human history, where we’re exposed to and store all of these synthetic chemicals. I personally believe – I love the concept of fasting, without a doubt. I love to fast myself. I’d feel great.
JM: How many days do you fast for?
BW: Over my lifetime? I’ve gone from everything from – I did a stint where I would do four days a month for multiple months in a row.
JM: Oh okay, so you’ve been through the ringer.
BW: Yeah, yeah.
JM: You’re not foreign to the concept. Because I believe that there are more people who have run marathons than did a five-day water fast.
BW: Sure. No, no. I just don’t think that we’re healthy enough to fast any longer. JM: Sure.
BW: There’s a spectrum of healthiness. But really it’s two-fold. One is – this gets into the program and some of the rationale behind it. But in every mammal study that I’ve ever looked at, when there’s significant calorie restriction or fasting, xenobiotic levels go up in the blood. Toxin levels go up in the blood every single time, no matter what mammal is being studied, which is to say that, A, it is stored, absolutely. If you’re not eating, where the heck is it coming from if it’s going up in your bloodstream? If that’s the case, we’re flooding our body with these xenobiotics. If we are at all nutrient-deficient, if we have any deficiencies in the biochemical pathways, any of them, including the detoxification ones, now we’re flooding the body with all these toxins, and we’re not excreting them. We may not be getting rid of them. There was one interesting paper that looked at yo-yo dieting in mice. What they found was when they went hypocaloric, their toxin levels went up in their blood. And then when they went hypercaloric, those toxins went into different tissues. The question is that – So we’re liberating these things. They’re probably stored as a protective mechanism, but now we’re liberating them. If we don’t take active principles to metabolize or detoxify them and then excrete them, actively try to excrete these things, then they’re more likely to cause damage elsewhere in the body. I love fasting. I just don’t think that most of us are actually healthy enough to do it anymore. And then getting to what you’re talking about, the fasting mimicking diet, I think, is just genius.
JM: Wait. Before we go on there, because I definitely want to expand the full length on that, the increase in the toxins when one is fasting or on a low-calorie diet is that’s because you’re burning fat as a fuel primarily. In the fat are these stored toxins. What goes up is really only fat-soluble toxins. The water-soluble toxins you’re excreting or eliminating, hopefully every day, are detoxing.
BW: Generally speaking, if it’s water-soluble, it’s all ready to be excreted. The primary modes of excretion for any water-soluble is you try to turn the fat-soluble into water-soluble. You can urinate them out. There’s water in poop, so you can poop them out. You can sweat them out obviously, which is a great way to get them out. Technically, it comes out in your saliva and even your tears. Although you’d have to cry a lot, I think, in order to be able to flush a lot of this in us. We can cry all of those toxins out. But yeah, those can be excreted, assuming that somebody is sweating and urinating and doing all these things. Yes. But the process is called lipolysis, which is the breakdown of stored fat. Anything that induces lipolysis is going to mobilize stored toxins. The more lipolysis takes place, i.e. in fasting for example or time-restricted feeding, intermittent fasting, even during exercise, is going to mobilize these and increase these levels.
JM: Alright. Why don’t you go into the fasting mimicking diet, which is a revision of Valter Longo?
BW: Again, God bless him. What a brilliant concept to be able to come up with this macronutrient ratio consumed in a relatively short period of time that the body still thinks it’s fasting. That’s brilliant, to be able to even conceptualize and to come up with this and to test it how he has is brilliant. It’s not an issue with it. But my concern is, based on the studies that show that during caloric restriction or fasting that levels go up, if you were not actively trying to support detoxification pathways, then where are those going? Are they getting metabolized? Are they just going through phase I and not phase II or phase III? All these different things. That’s my only issue with it. What I did was, in the brilliance that he had to create the macronutrient ratio, instead of just saying, “Eat these foods that fit these ratios,” is to eat foods that, according to the literature, have been shown to improve certain detoxification pathways or enzymes, like glucuronidation or glutathione conjugation. So, yeah, very heavy in the brassica vegetables, for example, Brussels sprouts, broccoli, cauliflower and cabbage. Things like garlic, onions, leeks and chives. To really focus primarily on those things – Don’t just eat rice and avocado. That’s not a diet. To do that diet, because it’s brilliant and it’s helpful and the studies on it are compelling, but knowing or at least very strongly assuming that toxins are going to go up when you do that, is to support the detoxification pathways using those macronutrient ratios that he came up with to mimic the fasting mimicking diet to support detoxification at the same time.
JM: In those vegetables that you named, a good majority of them – there are others in your work and your course, there are probably dozens if not hundreds of phytochemicals, polyphenols and flavones that support these detox pathways and will help you eliminate those toxins, which I couldn’t agree more. That is the downside. [—–20:00—–] It’s really your brilliant insights into the major problem with that. It’s that you’re not supporting detox, and you’re going to run into problems invariably. Even if you’re super [careful inaudible 20:11] it’s going to harm you, unless you’re addressing that at some point.
BW: Yeah. I don’t like quoting something that I can’t find again. This was probably 20 years ago, 20 or 25 years ago. I came across something at the time that I didn’t realize how I might use this. But it suggested that a rapid fat loss program or diet was actually a carcinogen, because of that very reason. Because if you just flood the body with these things and you’re not doing anything about them. And then here I am 20 or 25 years later, wishing I could find that reference that I had found. But that’s compelling. Here we are trying to lose weight and trying to fast to be healthy, but are we making ourselves healthier or less healthy because we potentially are flooding? Interestingly, we do have some evidence on this, that doing this program, that levels do go up. If people get tested using the blood chemistry calculator, the prediction of the toxins will go up after this detoxification program if they didn’t do the testing shortly afterwards, which makes sense. But you have to work on excretion and some of these things. JM: Well, before we go into maybe some of the details of the detox pathways, which I think is very intriguing, and you present in a way that’s relatively easy to understand, because, typically, it’s so confusing – your head starts spinning and you just checkout – you had mentioned in your work that you’re not really a big fan of testing for these toxins. Because, invariably, there are problems with the process, because many of them are stored in your tissues and unavailable for measuring. Even if they’re high, that may be a good thing. If you can expand on that, maybe that would enlighten people in regards to the testing phase.
BW: In general, I love testing. I think lab testing is a benefit, because it offers more data. I think that there a lot of practitioners who are too reliant on testing. As you know, as a practitioner, that a test should confirm what you think it’s going to find, based on your medical exam or history taking and all those signs and symptoms. I’m not opposed to testing. My problem with this testing though, is that, again, when you look at the literature, there’s just too many potential false positives and false negatives. If a toxin test is 300 dollars and it has too many variables – Let’s say you and I both do a test. Mine comes back normal and fine, and yours comes back high. Well to the average person, you’d look at that and you’d be like, “Mercola, you’re toxic. Walsh, you’re not.” The reality is that I might have more stored in me that’s not being mobilized for a variety of reasons, therefore has no bearing on my total toxic burden. You, on the other hand, because you’re following a hypocaloric diet or calorie restriction or maybe you exercised the day before the test or whatever, they’re high in your body. You have relatively lower levels than I do. Well, that test doesn’t reflect that at all. Therefore, I think it’s a huge waste of money. My problem is, is that there’s just too many inaccuracies of this. Here’s a great example. There were a couple of smaller studies that were done. They looked at blood, urine and sweat in individuals. What they found was is that in the blood and urine, specific xenobiotic or toxin would be negligible, non-existent, but in sweat, it was positive. If you did a test, a urinary test or a serum blood test, you’d say, “Well, you’re not toxic. You don’t have toxins.” But it was coming out of the sweat, which indicates that, A, it’s stored for sure, and, B, that the person does have these toxins stored in them. Testing is fine. There are a lot of tests that exist if people want to spend their money on them. Sometimes it comes back positive. It’s just not as cut and dry as, “It’s high. You’re toxic,” or “It’s normal. You’re not toxic.” That doesn’t indicate that. JM: Okay. Let’s step over into the detox pathways. It’s not that you need to understand or know this, but it helps in appreciating the value of what you’ve put together. You already mentioned phase 0, which most people – I haven’t heard about it until you mentioned it. It’s the entrance of the toxins in the cell. But then you really have I, II and III. It’s pretty simple. I’ll let you expand on it. But my understanding is, I, the liver makes it available to be water excreted, then the step III is to attach these molecules, conjugation with molecules, so it can be water-excreted. The really important phase is elimination. You have a lot of good binders that you talk about and processes. Why don’t you start there?
BW: Yeah. One thing is that the liver gets all of the credit about detoxing.
BW: It happens to be a fairly large organ. But the intestines have the exact same enzymes. The kidneys have the exact same enzymes. The testes have the exact same enzymes. The detoxification – and it makes sense – does not just occur in the liver. It comes in a number of organs.
JM: That’s a good point. Good point.
BW: We always think, “My liver is toxic.” But not necessarily. You might be toxic. Anyhow, the way that I oppose to this is kind of in a silly kind of analogy, but I think it helps with people. Imagine you’re in a room that has two doors. The first door is phase 0. Somebody walks in through that door. That’s the toxin. They come in. Toxins – this is interesting – aren’t inherently – they’re so many that you can’t make broad statements about these. But it’s not inherently bad. Somebody walks in that first door. That’s phase 0. They come into your room. The room is the cell. And then you start berating them. You say bad, negative things about them. You expose things about them that they didn’t want anybody to know about. That’s phase I. What phase I is in detoxification is it exposes or adds a hydroxyl group through phase I. It makes it water-soluble. But now, you just tore that person apart. They’re angry. They start throwing your desk over, throwing your chair, throwing your computer and start just wrecking your room. That’s the inside of the cell. These are all the parts of the cell that they’re now destroying, because you made them mad and you made them angry. JM: Is that the fat- or water-soluble?
BW: They are water-soluble, but they’re mad.
. BW: Then phase III is you hand them 1,000 dollars. You’re like, “Sorry. I’m sorry I just chastised you. Here’s 1,000 dollars.” Well, anybody who was mad that gets 1,000 dollars is not going to be mad anymore. That’s phase II. That’s conjugation. Conjugation is adding something to it. You’ve mentioned this. But phase II pathways are like methylation. It adds a methyl group to it. Sulfation adds a sulfur group to it. Acetylation adds an acetyl group to it. Amino acid conjugation usually will add glycine to it. Glutathione conjugation, 1,000 dollars is a glutathione molecule. Glucuronidation is a glucuronide molecule. Now, after phase II, it’s still water-soluble, but now it’s not angry. It’s not going to cause any damage anymore. But then it’s still inside the cell. This is what’s incredibly important. It needs to leave the second door. That second door is phase III. We’re inside of the cell. That’s fine. But if you block phase III, which things like curcumin does, and milk thistle. Silimarin is a mild phase III inhibitor. If you block phase III in that person who now has 1,000 dollars and can’t leave, you can take that 1,000 dollars back, and now they’re angry again. There are enzymes inside of the cell that can undo [that]. That’s like beta-glucuronidase, [which] can undo that conjugation. Now, they’re angry again. Now, they cause damage inside of the cell, so a true detoxification program. Whether somebody does mine or not, it doesn’t really matter. I’m an educator at heart. Right out of college, I even taught eight-grade inner city students in Phoenix. I’ve been teaching for a long time. My goal is to educate people. There are three principles that must be in place for it to actually be called a detoxification program. The first one we talked about is mobilization. If you’re not on a calorie-restricted diet, I don’t care what detoxification supplements you’re taking. You need to get them out of the cell first so you have to do calorie restriction, exercise for mobilization, fasting, whatever it is, but you have to mobilize these things first. You have to engage lipolysis. Step II – Again, if somebody has a detoxification program that lets you eat whatever you want but you take these fancy supplements, I’m sorry, but that’s probably not a detoxification program. The second thing then is you have to stimulate or optimize all of those phases: phase 0, phase I, phase II and phase III. I personally don’t think there are many supplements that actually optimize those pathways as we think that they do. I think that there are foods that absolutely do. In a couple of mouse studies, a couple of different types of tea has been suggested to. Exercise does, by the way. But to optimize those – But here’s the deal, if you’re not excreting – that’s great that you’ve mobilized, that’s great that you’re detoxifying these – but if they’re not being excreted, then that is not a detoxification program. Those are the three things that are necessary. Just for a quick example, is a juice fast or a juice cleanse — is that a detoxification program?. If you go through the criteria, step I isn’t hypocaloric. Yes. You’re probably mobilizing. Step II, is it optimizing detoxification pathways? It depends on what you’re juicing. [—–30:00—–] There’s evidence that things like celery, carrots and apples, things that people mostly juice actually might inhibit detoxification a little bit. It’s dose-dependent. I’m not going to say that carrots, celery or apples are bad. But anything that potentially inhibits it I don’t think has a place in the detoxification program. Are you optimizing detoxification pathways? It depends on what you’re juicing. And then the third one is, “Are you excreting? Are you really excreting?” By the way, juicing usually takes out the fiber. If you don’t have fiber, you’re not enhancing excretion from the bowels. You’re probably drinking extra fluids, so maybe you’re urinating. But if you’re not sweating, you’ve totally gotten rid of one of the major routes of excretion. So, is a juice fast, therefore, a detoxification program? I say probably not. If you’re not actively excreting or trying to excrete, and depends on what you’re juicing, that, to me, is not truly a detoxification. It’s a mobilization program, but it’s not necessarily a detoxification program. JM: Yes, indeed. Are you a fan of juicing at all? Or are there any circumstances where you would advise it or are you a smoothie advocate? BW: We do more smoothies at my house. We have a juicer, an old one. I’m not against it, but here’s my problem. I think it’s probably human nature I would imagine, although definitely in Western countries, is if something’s good, then a lot is better. With juicing, I don’t have any inherent problems with, but then people overdo it. You’ve seen the studies where people will juice excessive amounts of things like Spinach and they’ll develop end-stage renal failure, for example. Can you overdo it? Absolutely. To me, juicing is medicinal, when you really think about it. Amino acids have drug-like effects. If you treat it as a medicine, most people wouldn’t overdo a medicine. If you treat it as a medicine, I think that it’s probably fine. But within the right context, and then you have to talk about what’s actually being juiced, the quantities and the lack of fiber. Are you making it up from somewhere else? Are you putting the pulp back in? As with most things, I’m pretty low-key. I don’t have an inherent problem with it. JM: Yeah. I think most of us would agree that processed foods aren’t good. I think, on the other hand, many health advocates don’t understand that juicing is processing the food significantly and removing maybe one of the most beneficial aspects, for instance the fiber. I’ve become progressively disenchanted with juicing. I’m a far more larger fan of the smoothies, churning the whole vegetables in there. BW: Absolutely. JM: As you mentioned, the fiber is massive. That really is an important component of your binder program that you have people implement. Why don’t you talk about the binders? And then also touch on – you kind of did a bit – your strong endorsement and belief that it is what I would call “BF,” and I think you would agree, “beyond foolish,” to even think about detoxing without the use of an infrared sauna to facilitate the excretion of the toxins through your sweat. BW: Yeah. Regarding the sauna, what’s interesting, I think a couple of years ago, I would have agreed with the far-infrared. We have a far-infrared sauna. I’ve sort of retrofitted it with some near-infrared bulbs, which just took it up so many notches. It’s incredible. But when you look at some of these papers, it’s just sweating. No, really. In one of the papers, they just told the participants just to collect your sweat. They didn’t tell them how. Some people did it during exercise. Some people did it during a sauna. They had xenobiotics in their sweat. I also don’t like to split hairs too much about things. If people want to talk about the different types of sauna, radiant heat versus far-infrared versus near-infrared, that’s totally cool. I’m against steam primarily, just because of the water source. If it’s not filtered, purified water, then all that stuff is becoming airborne, all the volatile organic chemicals. But to me, it’s just sweat. You’re probably going to sweat more in the sauna. Far-infrared saunas seem to have some additional benefits. But if somebody says, “Well, I don’t have a far-infrared sauna, so I’m not going to detox.” I don’t care. Heat up your house. Do something. Just sweat.
BW: So, the binders. The binders that I apply –
JM: Before we go to the binders – that’s a long discussion – let me just give my insights on that too. I agree. How could you possibly disagree with what you just said? My fine-tuning of that would be that I’ve really become progressively disenchanted with far-infrared saunas, primarily not because they don’t work, but they’re associated with pretty high electrical fields. BW: Electromagnetic fields (EMFs).
JM: When we say EMFs, there’s a lot of low-EMF saunas, and even some of the best ones that cost 8,000 dollars that are advertised as low-EMF, and they’re not. They’re low magnetic fields, but they’re not low-electric. When you use very sophisticated meters, I mean meters that cost thousands of dollars, you’ll find you may have up to 60,000, 70,000, 80,000 millivolts of electricity in these things. I haven’t seen a far-infrared sauna yet that was electromagnetically free. But the near-infrared, the one that you have, congratulations, that is, in my view, the absolute best. You can make them pretty inexpensively yourself and put it on the market for a few hundred bucks. These far-infrared bulbs are just less than 10 dollars. You put four of them in there and you’ve got to get containers for them. It not only gives you the heat, but you get photobiomodulation from 800 to 1,500 nanometers, and you’re improving your mitochondrial function.
BW: No. It took our sauna to the next level. [My wife and I,] we make it a point to try to get in there. It’s so great now.
JM: I do it every day when I’m home for 30 minutes. I love it. Now, you can go into the binders. I just wanted to give my two cents on that.
BW: So, the binders. That’s the third phase of it. Again, you have to mobilize. You have to optimize these four detoxification pathways. By the way, these exhaust has been shown to inhibit phase 0. Concentrated amounts of some citrus fruits inhibits phase 0. You need to open up door 1. You need to get phase 1 and phase 2. You’ve got to open up door 3. When it goes out, you have to excrete this stuff. You can do it via, like I said, urine and sweat. But I have specific binders that I’ve included in the program, some with meals, and some away from meals. Also with the fasting mimicking diet, I also utilize time-restrictive feeding. Just try to eat in the smallest window of time to maximize lipolysis, not maximize mobilization. There were a couple – You know, you read papers sometimes, and you just go, “Oh my gosh. I cannot believe that I read this and that this occurs.” There are a couple of papers where they injected a toxin. They inject it. This is important. They injected a xenobiotic or toxin into mice. It wasn’t oral. And then a few hours later, they looked in their gastrointestinal tracts and there was quite a bit – and that’s because of phase 0 and phase III incidentally – of the toxin in their gastrointestinal tract. If we think about this, if you are in the time-restricted feeding period where you’re not eating for 16 hours and you’re in the fasted state, you’re undergoing lipolysis and you’re getting this flood, depending on how toxic you are, of toxins, according to those few papers, those are getting into your gastrointestinal tract on an empty stomach. So how are you going to excrete those if you’re not eating as much bulk or food as you were prior? There are some binders that, it turns out, work better on an empty stomach, and then some, like five of them, that work better with food. I have a lot of binders that were covered in the science too, like zeolite. Some people love zeolite. I couldn’t find any papers really that substantiate its use. I’m not saying that that’s bad. I didn’t include it. I use things like chitosan and charcoal, for example, and different types of fibers, because there’s evidence of modified citrus pectin. There’s evidence that it actually decreases or increases excretion, which is what we’re after, of xenobiotics. But it’s critical that somebody not only does that with fiber when they’re eating, but in their fasted state to consume these binders. Because according to those papers, if your levels of xenobiotics go up in the blood, some of that is leaking into your gastrointestinal tract. If you don’t have the bulk that you normally eat in terms of just total calorie content, you’re not going to be moving that stuff along as well. That, to me, is a critical piece of this. It’s not just sweating. It’s not just drinking enough fluids. But they’re leaking into your gastrointestinal tract, even in the fasted state. You have to bind those things up for excretion. JM: That really is a strong endorsement for your perspective on the fasting mimicking diet as opposed to just regular fasting. Really, one of the weaknesses of a true water fast is that you don’t have these binders in your stomach. As you said earlier, you’re definitely going through lipolysis. You’re excreting these toxins. If you don’t have the capacity to bind them in your stool, they’re recirculating frequently back into your body, which is not a good thing. I’m coming around to your point of view. I think that for the vast majority of people, probably upwards of 90 percent, the fasting mimicking diet, with all these cruciferous vegetables and fiber additions, is probably the ideal way to engage in a fasting program.
BW: Well, again. With all due respect to him for having created this, I feel like what I’ve done is taken this brilliant concept and just tweaked it so that it’s a little bit more effective and a little bit better. And quite honestly –
JM: And less expensive.
BW: Well, yeah. Of course.
JM: Not of course. It is. [—–40:00—–]
BW: But if one’s perspective is not that of toxins and it’s more of lifespan, autophagy and all of these benefits of fasting, you wouldn’t necessarily think of that. But then when you look at the literature, it’s very clear that that happens again in every single mammal study that I’ve ever looked at, including humans, that levels go up when you fast or you calorie restrict. To take his idea and say, “Alright. That’s great. Let’s use those same macronutrient ratios, but apply these vegetables,” – I use sprouted mung beans when applicable – “to get the fiber, first of all, but also to get these nutrients that, according to the studies, increases certain, specifically, phase II detoxification enzymes.”
JM: I think you have broccoli sprouts in there too, didn’t you?
BW: Yeah. Sprouts are good.
JM: Yeah. Broccoli sprouts are loaded with sulforaphane, which is an nuclear factor erythroid 2- related factor 2 (NRF2) upregulator, which is another magnificent support for detox.
BW: Yeah. But again, food-based.
JM: Yes, yes. Of course. BW: I don’t know if you’ve looked into some of the dark side of NRF2, but as with most things, if it sounds too good to be true, it probably is.
JM: Enlighten us with some of the dark sides. That’s one of my favorites.
BW: No, no. It’s the same thing with anything. That’s like what I just said, “If a little is good, then more is better,” or, “If a little bit is bad, then try to reduce the amount.” But in reality, the takeaway is that it seems to be stimulating NRF2, the antioxidant enzymes and the detoxification enzymes it’s associated with. There are some interesting papers on NRF2 and atherosclerosis and a couple of other things. But when you do it – I come to this. Listen, right out of college, my supplement cabinet was insane. I did what everybody does. You read about a new supplement. You think, “Well, why am I not taking that?” You add that but you never take one away. Next thing you know, you have 30 bottles of supplements and you’re taking all these random things.
JM: Thirty would be a low number.
BW: Yeah, right. But from food, you can’t argue with that. It’s hard to overstimulate a pathway with food. You’re right. We talked that one time and you asked me why I didn’t have any specific NRF2 activators in there. It’s because that in the foods that I include, that’s embedded in there.
JM: Yeah. It’s just brilliant. Absolutely brilliant. I’m wondering, we’ve not had this discussion yet. One of the reasons why I believed that the program we’re going to come up with is really optimized is that it’s customized for the individual. Yours is a generic program. You make the same program for everyone. It can’t be, because you’re not doing any testing for some of the reasons you mentioned. But I was wondering about your thoughts about individualizing a program based upon pretty aggressive screens from genetic polymorphisms and the detox pathways that can recognize specific malfunctions you have because of your parents or grandparents. As a result of those, identify them and compensate for them with certain nutrients. And then also, perhaps even more importantly, is to understand that there are certain nutrients and supplements that are commonly regarded as beneficial, like methyl folate, classic for detox pathways. But in many people, you know, a significant number, maybe 10 percent, it’s a disaster if you go on it. I’m thinking that’s the next step. It’s to individualize it and have some software program that customizes the recommendations based on your genetics.
BW: Yeah. If I were to do some [inaudible 43:32] customizing, which I thought about doing, I would start with basic blood chemistry testing, because you can make some inferences into some pretty basic markers as to what may be going on with somebody. For example, there are some studies that show that gamma-glutamyl transferase (GGT), when it’s high-normal may indicate glutathione deficiencies, specifically hepatic glutathione deficiency. Just to correlate, it can also be slightly elevated in people who have xenobiotic exposures. But those may be the same thing, that your GGT is high because you have some xenobiotics.
JM: There’s another reason. It could be high-iron, which can actually cause those issues.
JM: That’s another screen for that. BW: Absolutely. With the good iron studies panel as well, Ferritin total iron-binding capacity (TIBC), you could rule in or rule that out for sure. But so, in that case, for example, let’s say somebody had a high normal GGT, that maybe, while doing this program, they might want to add some N-acetyl cysteine to try to support glutathione. On the other hand, if somebody has low normal bilirubin, they maybe have excess lipid peroxidation. Maybe they will need to take some things that will mitigate lipid peroxidation. So starting there. Now, with the genetic testing, I like genetic testing. But I’m not a very early adopter with technology or much of anything. I’m conservative in that way, and I’m happy for it.
JM: Well, that’s not necessarily true, because you’re involved in a project with Chris. His last name escapes me.
JM: Kelly. Chris Kelly, who is a software engineer and pretty interested in deep learning and artificial intelligence (AI) technology. You’re combining the lab testing to some pretty impressive stuff, which you probably don’t have time to go into today.
BW: No, no.
JM: I know you’re impressed as hell with it. It takes a lot to impress you. You’re not an early adopter.
BW: No. That was just too cool not to be, but in general. You’ve been around the business long enough. You’ve seen tests come and go. A test comes out. It’s the next big thing. Or pathway, vitamin D deficiency, or, like you said, methylenetetrahydrofolate reductase (MTHFR) or whatever the next big thing is. The Human Genome Project – that’s what that was. We’re going to map the human genome and solve all the world’s problems, including global warming and deforestation, all at the same time. And then they did, and then they found out that it didn’t. So then, what’s next? The microbiome. Well, the genome, that didn’t do it, but the microbiome, that’s going to be it. Really, if history does repeat itself, we keep doing these very things. New tests have come out. New supplements have come out. They are exciting, and then they just disappear, because they didn’t pan out the way people liked. I like genetic testing, but having looked into it pretty deeply and talked through it as yourself has as well, I don’t know that we know as much as we think we do in the application. We can test these things and take a look at them. The literature that I’ve looked at is not as robust as I would like in terms of what to do. To answer your question in a long, winded way, I think something like that totally makes sense. Of course. If you have somebody who has polymorphisms and superoxide dismutase (SOD), they may. The question is, “Has it expressed itself of has it not? Will they benefit from supporting SOD pathways?” But it’s worth a shot. JM: Yeah. You’ve got the complexity of epigenetics influencing the genes too. You might have some of them turning them on or off. If you’re not integrating that into the evaluation, then you’re definitely not getting the full picture. BW: Well, in signs and symptoms in medical history. You know, I had a patient recently who – just to keep it short – has POTS. She was talking about sort of the cognitive issues and how all of her sisters have it and now their mom has it.
JM: For those who don’t know what’s POTS.
BW: Postural Orthostatic Tachycardia Syndrome. When she stands up, her heart goes way up. It has so since she was a young girl. But anyway, there seems to be a genetic component to her. Because of that, I think genetic testing can be really helpful with her. But for the average person who may feel okay and then does some tests, there was a paper that you probably saw as well that suggested that some of these direct-to-consumer lab tests for genetic tests may have a significant amount of fall positives. I like it.
JM: We actually did an article on that. The accuracy was in question. The number of snips they test for is relatively small. I mean I’m working with companies now that test 600,000 snips.
BW: And then there’s the full genome versus the snip. There’s a lot more to be learned from. It’s initially very cool. I just think we don’t know enough to know what to do about it, is my own humble opinion. JM: Yeah. Your humble opinion is worth a lot. Thank you for your thoughts on that. I guess if someone was interested in this program, what’s the best way to do that? BW: I did two versions of it. Briefly, they can go to DrWalsh.com/Detox. Initially, it’s a 9-hour plus video program, like the one that you saw, for practitioners. I went deep into the science. “What really are cytochrome P450 enzymes and how really do they work?” for example. “How do we make glucuronic acid in the first place to even use it for glucuronidation?” Deep into the science. But then, there were people kind of wanting the watered-down version for the sort of nonpractitioners. If you go to DrWalsh.com/Detox, there are two links. There’s one for practitioners. There’s one for non-practitioners. The non-practitioner one was the one that you saw. It’s about four hours. It’s watered-down. It goes into the science a little bit, because I’m an educator and I want to teach people why they’re doing something, not just tell them what to do. If people get the practitioner version though, they get the non-practitioner version for free as well. JM: Perfect. I think it’s a few hundred dollars but it’s money well spent if you really want to understand this process. Once you have that foundation, then you can actually do your own independent research on PubMed, but it’s a really great start. I know it catalyzed my interest in this whole area. I greatly appreciate the opportunity to review it, and really understand it at a pretty foundational level. [—–50:00—–] I was always confused about detox. I just thought it was something your body did naturally. I didn’t understand it at the level that you really delved into. BW: I totally felt the same way. If there’s time, there’s one other thing that I don’t know is in the version that you watched, but it’s such an important piece. You may appreciate the complexity of this because, inevitably, when you start talking about this, somebody will raise their hand, “Well, I heard someone say that green tea is good for detox.” This is why, I think, we don’t know as much as we think we do when it comes to what actually supports detoxification. It’s when you look at the research, first of all, was it a cell study? Was it a rodent study? Or was it a human clinical trial? This was fascinating. They mapped the rodent genome as well. Not surprisingly, it suggested that rodents, mice and rats have more robust detoxification pathways than we do, because of where they live and what they eat. They have to. If something does well in a mouse study, it doesn’t mean that it’s going to do well in us. Another one is how they measure detoxification. Most of the time, as you know, it looks at enzyme activity or looks at what’s called messenger RNA (mRNA), how much of a cell is making a detoxification protein. There was this really fascinating study. It was an in-vitro study that looked at cells and they applied quercetin to it. The mRNA went down for certain detoxification enzymes, which suggests what? That quercetin inhibited detox.
JM: Inhibited it. Right.
BW: But in the same cells, they also added some toxins to it and quercetin increased the toxin excretion. Even though the suggestion was that it inhibited it to some degree, that it still aided in the excretion of this chemical.
JM: I think I know why. You know why? Because it inhibits cluster of differentiation 38 (CD38). CD38 consumes loads of nicotinamide adenine dinucleotide (NAD). Essentially, it indirectly increases NAD.
BW: Sure. They didn’t talk about it, but that could very well be. JM: Yeah. That’s the mechanism. BW: Then what’s really interesting is there are other papers that show that this is fascinating. Certain detoxification compounds – green tea, I’ve mentioned that before. Green tea may increase detoxification in liver cells, and the same enzyme will be decreased in kidney cells, and then the same enzyme in the enterocytes in the gut cells has no change at all. And then there’s one more fascinating one. It’s acute versus chronic dosing. In most studies, as you know, they look at acute dose. They take a cell. They apply green tea, and then they look to see what those enzymes do. I forget honestly if it was resveratrol or pomegranate. I think it was pomegranate. But pomegranate acutely inhibited certain detox pathways, but given over a period of two weeks increased those same pathways. Saying all those things together, choose your nutrient of the month and say, “Does it help with detox? Well, was it done in a cell, a rodent or on a human clinical trial? Did they look at it with mRNA or enzyme activity? What cell tissue were they looking at and does it have different effects? What dose was it, meaning biphasic effects?” Or the last one was, “Was it an acute or chronic dose?” Because of all that, you have to be an expert in looking up the research and interpreting the research to say irrefutably that milk thistle is a detoxification nutrient. I can’t say that. Because of that, because of what I’ve read, and you’ve seen that in the program. I don’t have curcumin, green tea –
BW: – and pomegranate, or any of those things, because if you really want to detox, you have to mobilize. You have to open up phase 0, I, II and III, and you have to excrete. Anything that can inhibit any one of those things, I think doesn’t have a place in the detoxification program.
JM: Which is exactly what I stated when we opened it up. I said, “There are very few supplements in your program.” It’s mostly food-based. How could you possibly, possibly argue with that as being one of the most strategically pragmatic, safe and relatively inexpensive ways to detox. I’m wondering – You had mentioned there are chronic exposure to these novel chemicals that never existed in really mitigating or suggesting that we all would benefit from a regular detox. I’m wondering if you have a recommendation as to the frequency that most people would benefit from it. From my perspective, it seems that this is a relatively rational strategy to do once a month, four or five days once a month.
BW: Yes. That’s what I said. It kind of depends on where somebody is – I mean not physically – with regards to health. Some people, they probably could use multiple programs every month doing this, but the reality is that, as good as the program is, that some people who have multiple chemical sensitivities might need to modify the program. It’s just too much for them. Maybe they need to take more binders. Maybe they need to sit in the sauna at a lower temperature for a longer period of time type of things. Maybe the calorie restriction shouldn’t be as restrictive necessarily. The program, as it’s outlined, is 10 days, as you saw. My recommendation is to do the 10-day program. The first six days are calorie restriction, but high-protein. The last four are that modified fasting mimicking diet. What I recommend to people is to do the full 10-day program one month. And then depending on how they do, the next month, to do the full 10-day program or just do the four- to five-day modified fasting mimicking diet. That, for people who are relatively healthy, I think is a good way to go. That’s four to five days a month of the fasting mimicking diet portion of it only – all the supplements, all the sauna and all the exercise. But I think that that’s a really great way to go. Yeah. For a period of six months or so, doing that once a month is probably not a bad idea for most people, because of the accumulation that we have.
JM: Yeah. I’ve forgotten that there was a 10-day program. I was just remembering the last four or five days of it. That was what I was referring to when I mentioned that once a month would be a good strategy, because it’s a relatively small component. It’s literally 85 percent of the month that you’re not doing it.
BW: I’ll even say this, if people want to be somewhat aggressive with this, I would say do two of the four-day fasting mimicking diets a month.
BW: Put one in week 1 of the month, and then do another one in week 3, and then the following month. You can do two of those a month if you really wanted. You mobilize a lot during that.
BW: If somebody wanted to be aggressive with it, I’d say you can do two a month.
JM: Can you share with us how long you have developed this and have been using it clinically, and what are some of the more astonishing anecdotes that you’ve observed?
BW: That’s a really good question. I’m always developing it. JM: It’s never finished. BW: Which is to say I’m kind of not. In fact, I was going to be adding a video to the program. Anybody who’s purchased it will get an email saying that, “Here’s a new video.” But there are some really compelling – here’s why – papers that suggest that a urine pH of 7.5 or above greatly increases the excretion of many, not all – depends on the acidic or alkalinic nature or basic nature of the xenobiotics. But many of them are acidic. To use a urinalysis strip at home, to track their urine, and to add sodium bicarbonate during the fasting mimicking diet portion until their urine pH is above 7.5. Because what we’ve found is, in some people, this works. Their level, depending on the blood chemistry calculator, their predicted levels go up. In those cases, perhaps they have a genetic mutation, and they’re not excreting these things as well. I’m not a big fan of the acid-alkaline thing, but it’s in the literature that alkalizing the urine to above 7.5 or above greatly enhances the excretion of a number of toxins and xenobiotics. In addition to the fact, like adding N-acetyl cysteine to it, I don’t think would be a bad idea because that’s not a pathway, but that’s supporting glutathione. Or something like, you have to take a load of it, but calcium D-glucarate to help augment glucuronidation for example, in some people might be helpful as well. In terms of stories, you know what? I don’t know. I mean I’ve had people, I’ll be honest with you, they didn’t do real great. I think that just kind of spoke to the toxicity. It’s a healthy program. Why would somebody feel worse? No, really. Eating less calories, sitting in the sauna, doing a little bit of exercise and taking some non-aggressive supplements, a bunch of binders, and the food that they’re eating is whole food and a lot of vegetables. The fact that they feel worse, it’s an assumption that their levels are going up and that’s causing a problem. I don’t know in terms of any really – I’m trying to think. That was a good question. A lot of people just feel better. They feel better during. They feel better afterwards. They notice some sensitivities that they might have had afterwards. One of my favorites is a woman said that her husband was nicer. I don’t know if it was actually the husband who was nicer, but maybe it was her actually feeling better herself.
JM: Yeah. Perception is everything. I’m wondering, in your alkalization strategy, if you consider potassium bicarbonate instead of sodium bicarbonate. [—–1:00:00—–]
BW: Yeah, yeah. Of course, of course. I like that quite a bit more, but in terms of something that somebody might already have sitting around that they could use, absolutely. I think that would be a better option than sodium bicarbonate. But again, trying to do what’s evidence-based, the studies, you actually have to use sodium bicarbonate to alkalize the urine of the people in the study to increase or enhance the excretion. I would assume that it’s the alkalization of it. When you know about the physiology of the kidneys and how the relative pH of the urine actually misses, it’s an important piece. The pH of the urine dictates whether a xenobiotic on its way out gets reabsorbed or gets excreted.
JM: That’s pretty fundamental.
BW: Yeah. You know what? I went into the details of that process in the practitioner version. It’s an incredibly important piece that we never talked about. That if it’s too acidic, you tend to reabsorb the acidic xenobiotics that have been conjugated and are on their way out, but they tend to get reabsorbed. Conversely, the more alkaline it is, you’ll tend to reabsorb alkaline xenobiotics of which I think that there’s less of. Anyway, the potassium bicarbonate and sodium bicarbonate are potentially important strategies for people during that fasting mimicking diet portion. JM: Terrific. I can’t thank you enough for compiling this and being the perpetual student you are and a really magnificent teacher to explain some complex chemistry and biochemistry into terms that people can fully understand and appreciate. Your program is outstanding and highly recommended. You can get it at DrWalsh.com/Detox. If you’re not a professional, you don’t want to get the professional version. The other one is fine. It’ll give you the basics and pretty much what you need. Thanks again. Is there anything you want to add before we leave?
BW: No. I just appreciate it. You provide a venue for people to get information out that needs to get out. Like I said, I’m not saying that my program is the best program ever.
JM: I am.
BW: Well, thank you. As science comes out and more comes out, then we can probably modify certain things. But the main point is we need to be having this. Because there’s so much misinformation out there about detoxification that I believe we need to bring this forward to people so that, at the very least, we can be having better conversation. So that conventional doctors, who generally don’t think in detox is real or worthy – the science says that it is – so that they say, “Okay. Well, maybe we should be looking at this.” And to all the functional medicine [practitioners] to say, “Maybe we’re doing this wrong. We know we should be doing this, but we’re not doing it in the best, most effective way possible.” To get this information out to a wide audience, I want to thank you for having that platform, enabling people to do that. I appreciate it.
JM: Okay. Great. Alright. I’m sure we’ll be in touch again, especially as I develop my program in the next two years. We’ll be working together to help create even better ones. Thank you. You’re an inspiration. You really, truly are.
BW: Sounds good.