We live in a toxic world and as Alan Gaby, MD, in Nutritional Medicine states “In modern times, humans, are exposed to tens of thousands of harmful or potentially harmful compounds, including pesticides, herbicides, solvents, petrochemicals, heavy metals and plastics” [1]. Most of these substances are fat soluble and are found throughout the body in the adipose tissue. The Environmental Protection Agency in 1982 reported that 20 toxic compounds were found in 76%-100% of the adipose tissue samples taken from cadavers and elective surgery patients from throughout the United States [1].

Reduction of adipose tissue releases these compounds into the systemic circulation, which can be detrimental to neurological function. Continued exposure to toxin release throughout bariatric surgery weight loss could play a role in the pathogenesis of autoimmune disorders like systemic lupus erythematosus, dementia, Alzheimer’s, and Parkinson’s disease. Reduction of the toxic load can also lead to chronic fatigue, thyroiditis, rheumatoid arthritis, other connective tissue disorders, and multiple sclerosis [1—3].

A number of commercial laboratories offer testing for toxic body burden levels of pesticides, polychlorinated biphenyls (PCBs), solvents, heavy metals, and other toxins [4]. Environmental medicine denotes that toxic chemicals contribute to chronic illness and a detoxification regime can enhance well-being by stabilizing or reversing disease through a program of exercise and low-grade hyperthermia (sauna) to stimulate the release of toxic chemicals from storage in fat tissue [5]. Some chemicals are removed through sweat and others are transported to the liver for conversion to water-soluble compounds that exit the body in the feces and urine. Further information is available at the Walter Crinnion, ND, website [6].

The study of detoxification processes in the body and influences on health is a young field of science but research is helping clinicians understand the complexities of cytochrome P450 in Phase 1 and conjugation during Phase 2. In the 1970s cytochrome P450 was found in the liver and researchers discovered it was responsible for converting lipophilic (fat stored) toxins into intermediates that were water-soluble. As research continued into the 1980s and 1990s, investigators uncovered the enzymes in the liver, called con- jugases, that allowed drugs and xenobiotics to be excreted from the body [7].

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