What's the truth about diet "detoxes" and functional gut assessments?
Quick Summary: The world of nutrition and gut health is a smudgy gray area. Constantly bombarded with influencers and biohackers telling you dogmatic, black-and-white ideas can make this "gray area" idea hard to remember. In this post, we will broadly tackle detoxes and functional gut tests. (This post will be more conversational and less "heady" or academic)
#1: Let's start with detoxes.
Detoxes are a touchy subject for some reason. I'm going to drop three "truths" into the conversation early:
Your body can and does remove toxins from itself all the time.
We will never be free of toxins in today's world.
Actual clinical toxicity is a nightmare of an experience for the patient suffering - and challenging to treat clinically.
"So, wait? Are we always detoxing? We don't need a special kit of supplements and coffee in our butts to detox?" - Reader.
Our bodies are so good at constantly detoxing that it is one of the more significant obstacles when creating a medication. We need to know that the drug can be absorbed and survive your liver's "first-pass metabolism," coming out the other side pharmacologically active. (When someone tells you that your vitamins end up in your pee, remind them that so do their pharmaceutical drugs. thanks to background detox mechanisms.)
Your body is ALWAYS working to eliminate environmental and endogenous ("self-produced") toxins. The main ways that "stuff" can leave our bodies: breath, sweat, urine, and feces.
We breathe out volatile organic compounds (VOCs).
We sweat out all sorts of stuff.
We urinate out all sorts of stuff.
We defecate out all kinds of stuff.
We are constantly detoxing. Rather than spending 4, 8, or 12 weeks on a crash diet and pills:
"Eat food, mostly plants, not too much." - Michael Pollan
Aim to consume 2-3L of clean water each day.
Try and break a sweat through exercise each day.
Make sure that you have at least one bowel movement per day.
What will this lifestyle ensure? This ensures that you consume adequate fibers and phytonutrients known to bind and remove toxins (e.g., chlorophyll). We know that sweating is an effective means of eliminating toxins (e.g., heavy metals). If we can sweat through exercise, it may be more effective than a sauna. During exercise or sauna, core temperature increases, and we may volatilize compounds for exhalation. Finally, a daily bowel movement indicates good overall health and a means of the excretion of bound-up toxins.
Depending on your situation, there are times to consider liver-supportive supplements like N-acetylcysteine or Milk Thistle. However, this is a conversation for you and your doctor. And remember, you cannot out-supplement a garbage lifestyle.
#2: Now, let's chat about functional gut tests.
Testing "for gut health" is arguably one of the more confusing - and controversial - things in medicine right now. While I run a couple of these tests in my office, I only use professional lab companies. Currently, there are more commercial labs and tests than any doctor could adequately evaluate for legitimacy.
So, what are we testing for in the functional gut space?
IgG Food Intolerances
Microbiome Composition & Diversity
Digestive Sufficiency
Inflammatory Markers
Each of these bullet points could be a post, or series of posts, by themselves. What I will say about them at large:
Most people do not need these tests (at least in 2023). For a couple of glaring reasons:
Implicit in these being "functional" tests, they do not provide any diagnostic value to your assessment.
Most importantly - More often than not, the results of these tests will not change the treatment plan.
Why does it matter if the tests are diagnostic or not? Well, there is some context to be added to that question. There is the element of time and the questions of which therapies you have tried along your journey for improvement. I use the "thinking outside of the box" analogy for patients. We romanticize thinking outside the box, but we need to know and have explored the box before we can safely know when to step out of the box.
It's not always a bad thing to find something in the box! After all, it's in the box - we know what it is. That is a much more robust starting point for discussing conventional and integrative treatment options (e.g., further work-up/imaging, lifestyle, nutrition, medication/supplementation, surgery, etc.).
Let's say you've been to your GP, who referred you to gastroenterology. You've done all the tests and had all of the imaging performed. You've been chasing answers for weeks, months, or years. You're still struggling with gas, bloating, abdominal pain, diarrhea/constipation, etc... This is when we can safely say that we've thoroughly explored the box, and it's time to step outside. Even still, it's not a free for all testing extravaganza. There should be a rhyme and a reason for why you commercially, or your provider professionally, orders which tests.
And no matter which tests you run or what the results say, here are some everyday "foundational gut health" practices that end up being big needle movers even in complex cases:
Eat slowly and mindfully. Really? Yes. It takes approximately 15-20 minutes for your stomach to tell your brain, "hey, there's food down here!" Suppose we don't take the time to sit down (away from a screen), chew, and breathe. In that case, we can easily overeat our way into symptoms by bypassing satiety mechanisms. Remember that digestion is a parasympathetic activity (opposite of "fight/flight").
"Eat food, not too much, mostly plants." - Michael Pollan. Again, really? Yes. While there are common food intolerances and allergens (e.g., dairy, soy, corn, shellfish, etc...), most people will do better by eating more "foods" and fewer "food products." The way to remember this is that "food" is the/an ingredient. A "food product" has many ingredients, many of which are not food. Food has fiber, vitamins, minerals, phytonutrients, and zoonutrients. Food has goodies to support your microbiome and a healthy metabolism. Food is good stuff.
Drink 2-3L of clean water each day. That's 8-12 cups of water daily for us American folks. I will not exhaust the importance of water in this post, but you can read more about it here if you like.
Wrap-up & Summary
If you've read this far, I applaud you. The information contained in this blog is not sexy, possibly even "triggering," and requires effort on your part to practice. If you're to walk away from this with anything, keep these three things in mind.
Your body is always resiliently battling environmental and endogenous toxins for you.
Most functional gut tests, for most people, are a distraction from putting in the actual lifestyle work it takes to be healthier.
There are times and places for detox protocols and functional gut testing. However, these cases are far fewer than social media would have you believe.
In my practice, I offer in-person care here in Arizona and virtual concussion/PCS programs for folks outside the state and abroad. Over the course of three visits, we dive deeply into autonomic, metabolic, visual/vestibular, cervical, and psychological assessment and screening. By completing this comprehensive assessment in a matter of 2-3 weeks, patients are provided with a comprehensive rehab plan that can shave months off their recovery times.
Request an appointment below for your consultation to begin working together.