Toxic Overload Begins in the Gut

The centrality of the Gut!  It’s a key principle in the clinical application of Functional Medicine (FxMED):  All disease can begin in the gut or be exacerbated there, through a host of mechanisms, including toxic overload.  

Detoxification is the biotransformation and clearance of chemicals and waste products from the body, those of both endogenous and exogenous origin.  Collectively, the many pathways by which the body does this are critical for maintaining optimal health.  Many chemicals are cleared via the gut and stool, often involving a complex 4-phase process. The liver is a central player, but it cannot act alone. 

Check out this clinical tip video to learn more!  Other often-overlooked gut functions are also required, in ways that might surprise you. Let’s dive in to just a few of them:

• Digestion
• Absorption
• Motility
• Hepatic-Biliary health

Digestion and absorption are the vehicles through which the body receives the nutrients it needs to carry out all of its functions.  At SAFM we often say, “No Lettuce, No Salad.” By this, we mean that biochemical “ingredients” are essential for results. Detoxification presents a heavy nutrient demand!  Requiring a steady supply of B vitamins, amino acids, minerals, and more – learn specifics here. Insufficient micronutrient levels hinder detoxification. This overtly contributes to overall toxic burden, taxing immune function and increasing oxidative stress. You can learn to master resolution of these upstream disease-promoting dynamics, e.g. 

• Hypochlorhydria – suboptimal stomach acid – is more common than you might think (hint: many patients are taking drugs that create it, on purpose!). B12 and amino acid availability may especially suffer. 
• Pancreatic enzyme insufficiency is also prevalent, especially in your clients with Diabetes (all types!), and may limit the body’s access to many nutrients, including essential fatty acids and fat-soluble vitamins

And this is just the beginning. 

Motility – when excessively fast or slow – is another major player in toxic overload.  Ideally, GI motility overall is a good balance of slow enough to allow for optimal nutrient absorption, but fast enough to not expose our intestines to prolonged periods of toxicity. 

• Slowed motility / constipation sets the stage for toxic buildup (and thus, chronic inflammation) in the intestines and possibly allows “retoxification”, where toxins are reabsorbed through the intestinal wall and recirculated through the body. Wreaking negative effects and requiring another wave of nutrients for clearance. Again!  
• Fast motility / diarrhea can impede the transfer of nutrients in chyme across the intestinal wall and into systemic circulation for cellular use, depriving the body of the nutrients it needs. It’s also a common cause of subclinical dehydration. There is so much nuance here that you can learn to confidently navigate. Consider, for example, the link between SSRI use and IBS that often involves dysregulated motility. Constipation with hypothyroidism is a well-known association, but it’s often overlooked because so much subclinical hypothyroidism remains hidden and untreated.  The wake-up call is this: both SSRI use and hypothyroidism are extremely prevalent in the populations we serve and are often at play in gut dysfunction. This is one of hundreds of clinical wisdom details you need to thoroughly understand to do your best work with chronic disease. 

Hepatic-biliary health is a major player in toxic overload. Not only must functional hepatocytes carry out key Phase I and II biotransformation, but they also aid in excretion as part of Phase III detoxification. Given our typical toxic exposure in modern life, imagine how toxic our gallbladder contents are and why it’s important that they empty readily (are you monitoring this with GLP-1 agonist use?). Our current epidemics of fatty liver and gallbladder disease (and removal), as well as thick, sluggish bile (do you know what causes this?) all impair the body’s detoxification. Here’s a good exploration of “gut-liver” axis nuances, including the role of microbiome composition (are you seeing the interconnectedness here too? antibiotic use figures heavily). 

Toxic overload is a powerful way in which disease begins in the gut or is exacerbated there. However, it’s actually just one of many common mechanisms you can learn to master. Powerful know-how for medical and wellness professionals of all modalities. Whether your expertise is metabolic health/weight, pain syndromes, autoimmune disease, thyroid function, or longevity and healthy aging.  Learn more here! 

We must help our patients and clients to minimize exposure to exogenous toxins in this increasingly toxic world. The problem is ubiquitous, though, and requires that we become experts at supporting their bodies’ sustainable detoxification capacity. GI functional balances must be central to this work if we are to be clinically effective!