Reversing the Damage to Improve Your Mood, Turn On Your Mitochondria, and Boost Energy
Tamara had developed brain fog and had gained weight over the past few years before coming to see me as a patient. She was a smart woman but couldn’t figure out why she had these symptoms. Despite a grueling work schedule as a thirty-eight-year-old management consultant, she exercised regularly and ate well, so those lifestyle factors weren’t to blame. Her bowel function was slower, occurring every other day instead of daily, her previous norm. Tamara felt cold most of the time, wore socks to bed, and could no longer stand to ski in the winter. She would intermittently feel low in energy, like she was moving in slow motion. When I questioned her about other symptoms, Tamara added that she was retaining fluid and her skin and hair were drier than normal.
Tamara had several abnormalities appear in her lab tests. Her thyroid function was borderline: her blood work showed elevated thyroid antibodies and a suboptimal Thyroid Stimulating Hormone (TSH) that made me concerned about the potential for an autoimmune disease (see Notes for details on Tamara’s laboratory values).1 Her mercury level was significantly high, probably because of mercury dental fillings she had received as a child, even though she had them replaced in her thirties. Tamara’s blood sugar level revealed that glucose was building up in her blood instead of entering the body’s cells to be used as energy—and making her body and brain inflamed. The problem was that toxins were robbing Tamara of normal thyroid function and metabolism.
Your thyroid is a major endocrine gland in the front of your neck, and its main job is to produce and store hormones that regulate weight, energy, and metabolism (the rate at which you burn calories), like the drummer in a band. If your drummer doesn’t set the right pace for your cell’s metabolic activity, you may feel slow—physically and cognitively—and gain weight. People with low thyroid function (hypothyroidism) may experience blood sugar problems and inflammation.2
Furthermore, many of the same toxins that squeeze the life out of the thyroid affect other systems in the body—weight control, blood sugar balance, even proper brain/body function. These toxins, mostly endocrine disruptors, appear in hundreds of cosmetics, plastic bottles, metal cans, toys, and the pesticides on food that isn’t organic. They interfere with production, release, transportation, activity, and elimination of natural hormones, such as thyroid, insulin, estrogen, and testosterone—and as a result may cause a wide range of problems with the brain and body.
For instance, insulin is a hormone secreted by the pancreas that helps muscle and fat cells remove glucose from the blood. When your cells stop responding to insulin because you become out of balance, you have insulin resistance, which means glucose builds up in the blood, signaling the pancreas to produce even more insulin. When insulin resistance becomes severe enough, the rising blood sugar can have a toxic effect on the brain body by clumping proteins, damaging blood vessels to vital organs—increasing the risk of heart disease, kidney problems, decreasing blood flow to the brain, stroke, visual changes, and harm to nerve cells—and creating excess inflammation, putting a person at greater risk of dementia and Alzheimer’s disease.
I hypothesized that if we cleared Tamara’s body of the mercury and other sources of toxic inflammation, her brain fog, weight gain, and sluggish thyroid may clear up. In fact, the problems with her thyroid and blood sugar may be linked, because as TSH rises, it acts directly on insulin-making islet cells in the pancreas, causing insulin to rise along with blood glucose, indicating insulin resistance.3 Not good. Thyroid treatment, even in subclinical hypothyroidism, lowers insulin and glucose.4
Some toxins are linked to both problems—slow thyroid and higher blood sugar—especially in women.5 So we began the Brain Body Diet for Tamara. We emphasized detoxification, adding back important minerals in the appropriate ratios while removing her toxins. With my help, she used lifestyle medicine to reset insulin and rebalanced her blood sugar. She stopped using hand sanitizer or toothpaste containing triclosan because of its role as a neurotoxin and thyroid disruptor.6 We cut out diet soda, linked to a greater risk of imbalanced gut microbes, blood sugar problems, obesity, diabetes, high blood pressure, stroke, and dementia, including Alzheimer’s.7 (Yes, soda is that bad. Stop immediately!) Forty days later, Tamara’s blood work was in check, the fog lifted, and she felt more focused, not to mention she lost fourteen pounds in those forty days by lowering her body weight set point, described in the next chapter.
The Vast Experiment
We are unwitting crash-test dummies for the chemical industry. Over the past sixty-five years, Big Chemistry has created tens of thousands of chemicals with varying adverse health effects on the brain, body, and environment. Some were banned decades ago because they caused cancer or negative brain outcomes, but they persist in the environment and affect women worse than men. One example is the pesticide DDT, associated with a four-fold increased risk of breast cancer when one is exposed in utero.8 Another is lead, which the first-century Greek physician Pedanius Dioscorides noted “makes the mind give way” and has been shown to induce more oxidative stress in women and loss of balance or homeostasis.9
Toxins make you sick. They are chemicals that become poisonous even at low doses or when metabolized inside of you. You get exposed through air, food, drinks, skin, or even high stress. Toxins can be synthesized in a lab—like bisphenol A (BPA), a hormone disruptor found on receipts and reusable plastic containers.10 Or toxins can come from a plant or animal, like a poisonous mushroom or snake venom. Toxins can be made inside of your body, such as when your appendix gets swollen and bursts, releasing inflammatory toxins everywhere in your belly and bloodstream, or they can be released from imbalanced microbes (bacteria, fungi, or parasites) in your gut.
But most of the toxins that I’m referring to in this chapter are the type that you are exposed to in small amounts over the years, without knowing it. Your liver is the main organ in charge of triaging (or prioritizing the treatment of) toxins, but not every toxin is created equal. Alcohol moves to the front of the line, no matter what. Some toxins get walled off protectively in your fat (and are then released at higher levels when you burn fat and lose weight, perhaps leading to a weight-loss plateau). Other toxins don’t get triaged at all, but specifically shut down your mitochondria, the parts of your cells that produce energy. Still other toxins instigate your immune system to go into battle and start attacking your own tissue, like the thyroid.
What’s more, tiny exposures—when they accumulate, mix with other toxins, and backlog the liver—can cause serious brain/body problems. Lead is frequently present in your tap water, even though lead was banned from gas and paint. Phthalates (fake estrogens) are commonly found in your moisturizer—and women are exposed to them more than men because of our more liberal use of skin-care products.11 Toxins from fungus, like mold from the leak behind the dishwasher in your kitchen or the yeast overgrowth in your gut from eating too much sugar, cause recurrent sinus or vaginal infections and send along toxins to the brain known as neurotoxins. The list goes on, but I’ll spare you the overwhelm.
In the United States, thousands of unregulated chemicals that are foreign to the body are readily available. The Environmental Protection Agency (EPA) is required by law to test tens of thousands of these unregulated compounds currently on the market, as well as the two thousand new chemicals introduced each year. Guess how many they test each year? Yeah, not many. The EPA reviews about twenty chemicals at a time, leading to a large backlog as toxin levels rise in our environment.
Yet my aim is not to blame or get on a soapbox about how the chemical industry is like a modern version of the tobacco industry. My first goal is to be practical, to show you which toxins might trigger or be associated with your own brain/body breakdown so that you can look around your home to see which ones may be causing mischief. My second goal is to rid your body of the toxins that have set up residence in your tissues (such as in your fat and bones), perhaps as long ago as in your teenage years or twenties. My third goal is to help you understand what’s getting you into trouble with toxins. The most common reasons I see in my practice and my own body are:
You may have one or more of these tendencies and not know it. In this chapter, I will guide you through discovering why you have a problem, how you may build up either exogenous toxins from the environment or endogenous toxins from your body’s metabolic processes, and how to help boost your detoxification functions.
Is Your Brain Body Toxic?
Do you have now or have you had in the past six months any of the following symptoms or conditions?
INTERPRETATION
If you said yes to three or more questions, you may have an issue with low-level toxin exposure. Six to eight, and you probably have moderate toxicity in your brain and body. Nine or more, and you may have a severe toxic burden. The protocol at the end of this chapter will help you remove toxins, reduce future exposures, and help heal damage from neurotoxins.
Losing Our Minds to Toxins
How do toxins get to the brain, and how do we get rid of them? The reasons toxins accumulate in the body were mentioned earlier, but the main ways that toxins get into the brain are more specific: through an overtaxed liver, weak detox genes, a sluggish lymphatic system, a leaky gut, and/or a leaky blood-brain barrier. That means not only do you need to detox your body, but you also need to detox your brain. Going forward, don’t think of them separately. Treat them both together as one.
The main way to remove toxins from the brain is through the function of the glymphatic system, the trash collection that occurs while you sleep. What happens is that the cerebral spinal fluid in the brain increases substantially and washes away toxins and metabolic waste products that build up in between brain cells during waking hours.12 But certain toxins, like alcohol or general anesthesia, can slow down the glymphatic system, and may inhibit removal of toxins.13
Additionally, the immune system connects to the brain via the lymphatic system, a vast network that transports fluid throughout our bodies. The lymphatic system helps to get rid of toxins, so if yours is sluggish, you may be vulnerable to accumulating toxins.
The good news is that your brain sits behind the blood-brain barrier (BBB), that extensive filtering system of capillaries that carry blood to the brain and spinal cord and prevent the passage of specific substances that could harm your brain. The bad news is that many toxic chemicals contain characteristics that allow them to pass through the barrier and gain access to brain tissue, leading to neurodegeneration, neurotoxicity, brain fog, dementia, and cancer. The table here shows how toxins may affect biology and the ways we get exposed to them.
TOXINS OVERVIEW
TOXINS AFFECT OUR BRAIN IN A VARIETY OF WAYS:
WE CAN BE EXPOSED BY:
TAKE STEPS TO AVOID TOXINS:
Certain toxins (listed here) cross the BBB and change the very structure and function of brain tissue. Exposure is not just a problem for people who work at high-risk industrial jobs, although they have the greatest risk. Dozens of toxins fly below the radar and impact office workers, women trying to conceive, stay-at-home moms and dads, retirees in moldy homes . . . truly, all of us.
Note to Brain: Toxins Can Make You Fat and Slow
We’re just starting to understand the full spectrum of toxic threats to the brain and body. What’s clear is your body doesn’t know what to do with all of these toxins. They first clog the liver, then get stored in fat, and ultimately back up into your brain. Since the brain is almost two-thirds fat (the fattiest organ in the body), it makes sense that it’s likely the most vulnerable. Recall what I mentioned in the introduction—that the brain is the most calorie-hungry (in scientific terms, “metabolically active”) organ in the body: it is only 2 to 3 percent of body weight, but consumes 25 percent of total body glucose and 20 percent of total body oxygen. Basically, your brain is a metabolic hog. Due to the fact that the brain uses so much of your body’s resources, it is astoundingly vulnerable to any toxins that lower metabolism. These include foreign chemicals that lead to unwanted weight gain (called obesogens), which disrupt insulin and put you at greater risk for obesity. Ironically, when you burn fat or lose weight, the toxins stored in those cells can be released into your bloodstream, ready to once again tire out your mitochondria or block hormone receptors like insulin or leptin—making you hungrier and storing more fat than you burn as your liver works to recapture the freed toxins.
Let’s spend a moment on obesogens, because the link between a toxin and your weight is an important way to understand the impact of toxins on your overall brain/body health. You may get exposed while sitting in your car or favorite chair. One study in mice showed that exposure to a flame retardant found in upholstered furniture and car textiles caused 30 percent more weight gain.14 Japan banned this chemical in 2014, but it is still being produced and used in the United States and worldwide to the tune of twenty-eight thousand tons per year.15 A large study in the United States shows that exposure in adults to bisphenol A (BPA), found in canned food, thermal receipt paper, and plastic bottles, is associated with increasing body weight, higher body mass index, and general and abdominal obesity.16 How do obesogens make you fat? In rodents and humans, BPA stimulates the pancreas cells that make insulin and disturbs the insulin messaging in the liver, fat, and muscle cells, leading to pancreas dysfunction, insulin resistance, and rising blood sugar.17 That’s a recipe for storing fat. Do you really need that store receipt or plastic water bottle?
Another class of toxins is air pollution, which can constrict blood vessels and raise blood pressure, putting you at a greater risk of stroke—and once again, women seem to be at greater risk18—or asthma, attention deficit hyperactivity disorder (ADHD), dementia, schizophrenia, autism, heart attack, lung cancer, obesity, diabetes and high blood pressure in pregnancy, plus babies with short telomeres (reflecting a shorter life), small lungs for life, and a shorter life . . . to name a few.19
We need to wake up to the fact that we’re losing our intelligence, stress resilience, focus, and lean body mass to toxins. Specifically, the five categories of everyday chemicals listed below—many found in clothing, food, tap water, and furniture, most external, but some made internally in the body—are harming our brains, making us more inflamed, stressed, and fat, and creating brain trash. We need to know our enemies in order to reverse brain/body damage from toxins.
In my first decade of medical practice, I rarely thought of toxins as a cause of a patient’s symptoms. But as my thinking evolved, I went from occasionally considering the possibility to realizing it was the underlying root cause of many patients’ poor health. Now I think of those problems and other mental health issues as a sign of brain/body breakdown and possible overexposure to toxins.
So instead of going straight for the symptom diagnosis when treating a patient, I consider what else might be contributing factors from genetics and various environmental inputs, including diet, nutrients, toxins, exercise, and trauma. For example, depression becomes a nutritional-gastrointestinal-microbial-toxic-immunological-inflammatory-hormonal-detoxification-mitochondrial-environmental-structural (whew!) imbalance to resolve, not just a lack of serotonin in the brain to fix with a pill. The same can be said of many other conditions that are seemingly isolated to the brain. The goal is to restore normal set points (i.e., homeostasis) by considering all of the environmental inputs, the patient’s biological individuality, and the downstream consequences. Despite the complex roots of several of the broken seven, resolving the issue is more simple: with a proven strategy of lifestyle changes that anyone can access—including how you eat, move, think, and supplement—you can solve these problems often more effectively than you would with any prescription pill.
Your Overtaxed Liver
As I’ve described, your liver is the body’s weigh station for toxins. It tries to make most of them less dangerous through biochemical processing inside liver cells, but unfortunately that can backfire—there are some toxins that become more harmful once the liver metabolizes them. The liver sends other toxins to be stored in your fat, like when you tuck away extra junk you don’t want to deal with in the guest room closet.
As you might imagine, with the volume of toxins the liver has to triage, it can get overloaded. When that happens, fat starts to accumulate in the liver in a problem called nonalcoholic fatty liver disease (NAFLD), insulin resistance rises, and usually you suffer from impaired fat metabolism. This problem is increasingly common, affecting about 30 percent of the population, many of whom may go on to develop more serious problems like liver cirrhosis and even liver failure within ten years.20 Some medications, both prescription and over-the-counter, may make your liver more likely to suffer harm. One such medication, gastric acid blockers (known as proton pump inhibitors, including Nexium and Prilosec), has been shown to modulate the gut microbiota composition unfavorably.21
For most women, the fat accumulation in the liver occurs without their knowledge. I know it when I hear symptoms of brain/body issues and when I see liver damage on a blood test—that is, an ALT greater than 20 units/L.
The upshot is that for some women, myself included, relying on the liver to do its job against all the toxins we face may not be sufficient. Instead, we need to help out the liver by providing the nutrients it most needs to do its job, reducing the input of toxins, and accelerating the release of toxins—that includes cleaning up your food, eliminating alcohol (the liver toxin that always goes to the front of the line in liver metabolism), using only 100 percent–clean personal care products, taking inventory of what goes in your home and cutting out the red-flag products that are full of toxins, cleaning up your hormonal situation, and avoiding the red list of toxins in your home and work like asbestos, cadmium, flame retardants, and formaldehyde.22
ARE YOU LOW IN GLUTATHIONE?
When you’re low in glutathione, toxins linger in your system, potentially damaging your cells. Like me, you may run low in glutathione, the master detoxifier in the body that protects cells from toxic damage. Take my quiz and find out.
Interpretation: If you answered yes to three or more, there’s a good chance you are low in glutathione. In the first Brain Body Protocol, you will learn how to raise your glutathione levels naturally so you can protect your cells from further damage. Glutathione levels inside of your cells not only help you detoxify the brain body, but also may impact your life span.24
The Role of Genes in Your Detoxification
Your biochemical individuality makes you a lovely one-of-a-kind person but also determines the function or dysfunction of your detoxification pathways—and thus your risk of neurotoxicity. While it’s true that our bodies are designed to detoxify continuously, it’s also true that some of us (like me) have poor detoxification genes and can get overwhelmed easily by toxins. Poor detoxification shows up as being highly sensitive to physical stimuli—for example, smelling cigarette smoke or strong chemical scents sets you off—or feeling like the nervous system is delicate. Your ability to clear toxins may be impaired based on the way your genes interact with your environment. The most important detoxification genes are listed below.
If you want to read more about the detox genes, refer to the Notes, where I describe each gene and how to reduce risk if you have a variation.25 In my previous book Younger, I describe the 90/10 rule: only about 10 percent of an adult’s risk of chronic disease is genetic and 90 percent is environmental (mostly the aggregate of lifestyle factors). This rule applies especially to the brain/body connection and detoxification. Regardless of your genetic risk, the Brain Body Diet is designed to bring you back to vibrant health.
The Science of a Toxic Brain and Body
One or two small exposures to toxins aren’t so bad and your body may process them, but multiple exposures can create a combination worse than the sum, making you more vulnerable to their effects. It’s like partying like a rock star every night for a week after age forty: One night is manageable, but by the second or third night, you’re a wreck. Multiple toxins accumulate and create negative synergy: alcohol, sugar, lack of sleep, caffeine, daily hangovers. By day seven, you may feel as though you’re ready to be institutionalized.
When I started learning about the fascinating science of toxic exposure, I investigated everything in my home. I was surprised to learn that I needed to ventilate my home more (mold hides behind your curtains) and replace my water filter (my old carbon filter didn’t remove fluoride). I detox regularly to clean out the toxins that I can’t prevent exposure to (mercury and lead) and any new ones that show up (such as cadmium).
There are many delicate balances in your brain body that can be affected by subtle toxin level shifts. Your body is full of microbes, organisms too small to see with the naked eye. Think of them as part of you—bacteria, viruses, and fungi that outnumber your human cells ten to one. When the microbes in your body are in balance (when your microbiome is in homeostasis), you are far less likely to be sick or have brain problems. For example, we all have a small amount of candida, a form of yeast, that aids in our digestion and nutrient absorption. That’s a good thing. However, when you take a broad-spectrum antibiotic and wipe out both invasive and protective bacteria and/or eat too much sugar, you may get an overgrowth of candida, which leads to serious consequences. When candida breaches the intestinal barrier and enters the bloodstream, it can release toxic by-products. That’s not a good thing! Even more menacing, candida can change into its fungal form and bore through the wall of the intestine to reach other parts of the body, affecting not only the immune system, but also the liver and nervous system, giving you hangover symptoms like headache and fatigue—and possibly causing cancer. So candida can work for you when in balance or against you when external toxins disrupt the system.
While toxic exposures during pregnancy and childhood are especially risky, any exposure during your lifetime is a potential problem, and exposure in childhood may continue to harm your cognitive function later in life.26 These days almost everyone has multiple exposures. Your body doesn’t know what to do when it’s overexposed, so as I mentioned, it stockpiles the excess chemicals in your fat and bones, until you decide to go on a diet and burn fat, or you hit your forties and bone turnover ramps up. Then symptoms can become more pronounced as excess toxins are released into your bloodstream.
Maybe you think you have a “clean” life, but chances are your medical provider is not examining you for toxic chemicals, heavy metals, pesticides, or solvents in your short physical exam once per year. Our brains and bodies slowly build up poison each day from toxins in our food, water, consumable products, and air. I find in many of my patients that they have imbalanced gut microbes that produce toxic agents like ammonia and endotoxin, which stimulate more inflammation in the gut, then systemically the body, and then cross the blood-brain barrier and cause inflammation there.29
TOXIC CHILDREN
Experts at Harvard Medical School and Mount Sinai’s Icahn School of Medicine say we are experiencing a “silent pandemic” of toxins that are damaging the brains of unborn children. They point to the fact that genetic factors account for only 30 to 40 percent of neurodevelopmental disorders (whereas your overall risk of developing most chronic diseases in adulthood is just 10 percent attributable to genetics, an important concept from my last book, Younger), and assume that nongenetic or environmental exposures make up the difference.27
Their concern is that “children worldwide are being exposed to unrecognized toxic chemicals that are silently eroding intelligence, disrupting behaviors, truncating future achievements, and damaging societies, perhaps most seriously in developing countries. A new framework of action is needed.”28
Here’s a list of some of the grim statistics:
THE TOXIC AIR WE BREATHE
I never thought much about indoor air quality until I learned that parts of my home contained mold and that normal home maintenance, including changing air filters once per month, does not get rid of it. We get exposed to toxins in many other ways, too: sitting in traffic, living in or visiting urban areas, and being near construction sites. When the World Health Organization listed air pollution as one of the top ten health risks for humans, linked to seven million premature deaths per year, that got my attention!
Urban polluted air contains not just benzene and heavy metals, but also aerosolized nickel nanoparticles, which can harm the brain and the cardiovascular system.31 You breathe these toxic particles deep into your lungs, where they may cause harm. While I commuted to work in San Francisco, I was harming my brain with another nanoparticle known as magnetite, found in the human brain and associated with inflammation and Alzheimer’s disease.32
For the first time, air pollution emerges as a leading risk factor for stroke worldwide. How many strokes are attributable to air pollutants? One-third of the global burden in 2013, according to a new study, and a higher percentage in developed countries.33 This study adds to the body of evidence showing the link between climate change, higher air pollution, and more strokes.34 Higher rates of stroke were associated with specific pollutants: carbon monoxide, sulfur dioxide, nitrogen dioxide, and ozone. The problem may be that air pollution damages the cells that line the circulatory system and increases the activity of the sympathetic nervous system, leading to narrow blood vessels, restricted blood flow, and more clotting.
Surprisingly, air pollution kills ten times more people than motor vehicle accidents, according to a study in London of 3.7 million premature deaths.35 Sitting in traffic is the most deadly: pollution inside cars is up to 40 percent higher while at a red light or in traffic jams, resulting in exposure to pollution particles that are twenty-nine times more harmful than when you’re driving in free-flowing traffic. Solution: hit the recirculation button before you drive!
Let’s look at lead. Lead concentrates in the brain, liver, kidneys, and bone, and it accumulates over time. Toxic levels of lead result in lower intelligence, reduced attention span, increased antisocial behavior, headaches, lower ability to learn, a greater sense of perceived stress, digestive problems, high blood pressure, dizziness, and muscle and joint pain. People with high levels of lead in their blood experience higher cortisol levels when they wake up in the morning, so they feel stressed out even when things aren’t so bad. Lead disrupts the control system for sex hormones (the HPA axis), even at levels below the safe threshold recommended by the National Institute for Occupational Safety and Health and by the Centers for Disease Control and Prevention.38 Yet we usually assume that since lead-based paint was banned a few decades ago, we’re safe now. That’s not the case. You can ingest lead from various consumer products and from the environment: air, food, water, dust, and soil.
Women are more susceptible to the immunotoxic effects of heavy metals and may be more vulnerable than men to their role as endocrine disruptors, particularly against normal estrogen and thyroid function.39 Higher levels of mercury, for example, are more common in women with “unexplained” infertility,40 and mercury correlates negatively with egg count and yield for women undergoing in vitro fertilization.41 (Additionally, elevated lead makes women 75 percent less successful at in vitro fertilization.42) Women are more likely than men to have skin symptoms like eczema, especially from elevated levels of arsenic and cadmium. Periods of increased bone turnover (old bone cells being replaced with new bone cells) occur far more often in women than in men due to pregnancy and menopause, releasing stored heavy metals like arsenic, aluminum, cadmium, and lead43 (90 percent of total body lead is stored in the bone44) from exposures dating back to childhood. Not only does toxic load increase as bone loss occurs in pregnancy, perimenopause, and menopause, some toxins may actually reduce bone density.47
SPOTLIGHT ON MERCURY
You may have heard about avoiding fish with high mercury levels or the risk of dental amalgams and exposure to mercury vapor. Mercury becomes toxic at a certain level in the body, and that level can vary depending on your gene/environment interactions. Mercury slows down your enzymes and gunks up your mitochondria so you can’t make cellular energy, called adenosine triphosphate, or ATP. The normal process produces some particles called free radicals, and ideally you want a lot of ATP and just a small amount of free radicals. But the reality I see in my practice is that about half of my patients have mitochondrial dysfunction, especially as they age past forty, so their ATP and free radicals are out of balance, resulting in a feeling of fatigue, brain fog, depression, and sometimes headaches.
In the brain specifically, mercury hurts the glutamate (NMDA) receptor, so that you lose the normal balance between the stimulating effect of glutamate and the calming effect of gamma-aminobutyric acid (GABA)—see Appendix A for the cast of characters in the brain. Mercury may cause overactivity of glutamate, so you may feel anxious and get stuck in a high-stress mode.
Mercury belongs to a class of environmental toxins that are causing imbalances and increasingly robbing my patients of normal set points—that is, control and regulation mechanisms of a specific outcome, such as stable mood, clear and calm thoughts, normal memory, rational beliefs and behaviors, a normal weight, and stress resilience. Mercury is just one toxin that might be affecting your brain, set points, and—therefore—your life. Some people, like Tamara (from the beginning of the chapter) and me, have problems with weak stress-coping genes, toxin-clearing genes, and DNA-repairing genes, all of which control your ability to revitalize the brain body. That leads to accumulation of brain inflammation and, as a result, brain trash. Nobody wants to accumulate brain trash because it can make you fat and may even give you the big “A” (Alzheimer’s disease).
The takeaway is that mercury exposure causes neurotoxicity at increasing levels, depending on your detoxification genes, environment, and other vulnerabilities.45 While there’s agreement that high levels are harmful to health, as I mentioned, there is no agreement about a safe lower level that doesn’t cause harm. Much to my relief, moderate levels of seafood consumption, even with their accompanying higher levels of mercury, are linked to a lower risk of Alzheimer’s.46 Pardon me while I go cook my opah.
Mold is another toxin that can find its way from your body to your brain and may make you lose balance, feel weird “ice pick” pains or headaches, or cause brain fog, trouble with focus, fatigue, muscle cramping, joint pain, numbness or tingling, or even weight gain. It can attack the rest of your central nervous system and thin out the lining of nerve cells, making you susceptible to symptoms similar to those of multiple sclerosis48 or even Alzheimer’s disease.49 It can cause Reye’s syndrome, a condition that causes swelling of the brain and liver. Mold can even drop your platelet count so that you bleed into your brain. Lead and mold are just two toxins that most of us are exposed to every day. Every day, people! Our environmental exposures are so common that most of us are clueless about them. You’ll learn where to find them and how to avoid them in a few pages.
Toxic Cocktails
Toxins linger for a very long time in the brain and body—the half-life (the time required for concentration of a substance in the body to decrease by half) of mercury is two months; for cadmium it’s sixteen years; for the pesticides DDT and DDE it’s two to ten years; and for PCBs, it’s three to twenty-five years! These half-lives do not account for the synergistic effects of multiple toxins, which may make half-lives shorter or longer. These toxins directly or indirectly affect your health, and may cause brain problems.50
Many of these toxins make the damage to your brain body worse when multiple toxins are present—even at low concentrations—a phenomenon known as the “cocktail effect.” Take lead. People with high levels of lead in their blood experience many brain symptoms: fatigue, muscle twitching, and balance problems, and women appear to experience more harm (more oxidative stress, like rust inside of cells that slows them down, and greater activation of genes responding to oxidative stress) than men.51 In addition to lead causing higher stress levels (cortisol) in the morning, other studies confirm the link between lead and disrupted cortisol levels.52 Since cortisol plays a crucial role in the production of new memories and brain cells (neurogenesis)—the highest concentration of receptors for cortisol is in the hippocampus (the memory center in the brain)—it’s not shocking to learn that higher levels of lead and cadmium, even below “safe” thresholds, impair working memory, the type you need to function normally day to day.53 What is important to understand is that no known level of heavy metal exposure is considered safe, especially when you consider the negative synergy of multiple heavy metals.
BRAIN TOXINS
CELL CRUSHERS
ENDOCRINE DISRUPTORS
MOTOR SKILLS
COGNITION BLOCKERS
The toxic effects of stress and its accompanying elevated cortisol—whether from toxic overload or the pressure to jam-pack your life or an unprocessed trauma—can create brain/body inflammation and trash, then send you into a brain/body failure state. Stress controls your hormones and affects your mental, physical, and spiritual health. All told, it is our greatest toxin when we don’t acknowledge it and bring it under control through the nutritional, supplement, and lifestyle repairs in the Brain Body Diet.
The worst part? Most toxic exposure is preventable—and self-imposed stress is one of the easiest to reduce immediately. Once you recognize the stressors in your life, detoxifying is essential for healthy living and a healthy brain, but you’ll find future prevention is easier. That’s where the Brain Body Diet comes in. Follow the steps outlined below to dislodge the toxins and lower the burden in your nervous system tissue and the rest of your body.
Types of Toxins, Their Effects, Where They Are Found
Here are a few highlights of the types of toxins you’re exposed to, their effects, and where they show up daily. For more details, see Appendix B.
Household Item |
Toxins |
Toxin and Brain Effects |
Air |
Ozone Particulates (dust, dirt, soot, smoke, etc.), nitrogen dioxide (NO2), sulfur dioxide (SO2) Heavy metals: arsenic, cadmium, chromium, lead, manganese, mercury, nickel Benzene57 Other: dioxin, asbestos, toluene (The EPA lists 187 toxic air pollutants.) |
Ozone activates the sympathetic nervous system (“fight-flight-freeze”) and HPA axis.54 Particulates (<10 μm), NO2, and SO2 may increase risk of ischemic stroke.55 Arsenic, cadmium, lead, manganese, and mercury escalate neurodegeneration.56 Arsenic can disrupt the HPA axis and impair executive function, processing speed, fine motor function, and memory, and is associated with depression.58 Benzene exposure occurs when you inhale petroleum products, such as gas, near gas stations, which may cause chromosome mutations and cancer.59 |
Clothing |
Pesticides: DDT, DDE Heavy metals: cadmium, lead, mercury Endocrine disruptors: perfluorinated chemicals (PFCs) |
DDT and DDE are linked to late-onset Alzheimer’s.60 Metals—see previous. Toxins in your sports bra, yoga pants, and workout gear contain endocrine disruptors that may disrupt the HPA axis and thyroid and cause cancer.61 |
Electronic devices |
Electromagnetic fields (EMFs) |
Increase free radicals, trigger the cellular stress response and breaks in DNA.62 Affect immune function both positively and negatively.63 May increase Alzheimer’s, brain cancers such as gliomas and meningiomas, and male infertility, but evidence modest at best.64 |
Kitchen |
Bisphenol A (BPA) |
BPA changes brain development; may turn off the growth of synapses in response to estrogen in certain parts of the brain.65 Altered behavior in children exposed to significant BPA has been observed.66 BPA triples the risk of autism,67 and is linked to serotonin problems.68 BPA disrupts the HPA axis, leading to problems with hormones—including changes in puberty, ovulation, and fertility. |
Food |
Arsenic in fish, shellfish, meat, poultry, dairy products, rice, and cereals Advanced glycation end products (AGEs) in charred food Fungi, including mold Nitrogens added to flash freeze food or food packaging to preserve quality Herbicides and pesticides, such as glyphosate and chlorpyrifos |
AGEs are associated with inflammation and Alzheimer’s disease.69 Nitrogen added to food may turn into toxic nitrosamine, which is linked to Alzheimer’s, diabetes, and fatty liver.70 Eating organic foods helps significantly reduce exposure to herbicides and pesticides like glyphosate and chlorpyrifos, but there are other problems that organic foods will not circumvent, like exposures to heavy metals, mold, other biotoxins, and plastics.71 |
Tap water |
Arsenic Perchlorate (rocket fuel) Fluoride Manganese Lead N,N-diethyl-meta-toluamide (DEET) |
The Natural Resources Defense Council found rocket fuel (perchlorate, a thyroid disruptor and potential carcinogen), lead, and arsenic in tap water in multiple urban areas.72 Manganese increases the risk of behavior problems, particularly in boys.73 Fluoride may cause lower IQ, cognitive impairment, and hypothyroidism.74 DEET, a neurotoxin, is found in tap water and insect repellents.75 |
Bathroom |
Skin care (lotions, shampoo, conditioner, nail polish, perfumes, deodorants) and cosmetics containing estrogen-mimicking toxins such as dioxins found in inorganic tampons, parabens (a preservative, or phenoxyethanol), phthalates, sodium lauryl sulfate, triclosan Medications and supplements: phthalates incorporated in the enteric coating Sunscreen: para-aminobenzoic acid (PABA), oxybenzone Mosquito repellent: N,N-diethyl-meta-toluamide (DEET), aluminum, formaldehyde, benzene/toluene, propylene glycol |
Estrogen-mimicking toxins, known as xenoestrogens, can be absorbed through the skin and bind to estrogen receptors on cells, thereby changing your estrogen levels and function.76 Many of these ingredients are on the Dirty Dozen list of Hormone-Altering Chemicals in skin care.77 Phthalates and other toxins may affect memory, risk of asthma and autism, and ovarian function, possibly causing infertility or diminished ovarian reserve (also known as premature ovarian insufficiency).78 Parabens may be associated with sperm abnormalities.79 Dioxins are linked to heart disease, cancer, endometriosis, and possibly diabetes.80 Formaldehyde is a neurotoxin linked to poor memory and reduced learning, and may cause cancer and liver damage.81 |
New car |
Polybrominated diphenyl ethers (PBDEs) |
PBDEs disrupt thyroid function.82 |
Under sink |
Microbes—including fungi such as mold, bacteria, actinomycetes, mycobacteria Inflammagens: endotoxins, beta-glucans, hemolysins, proteinases, mannans, and possibly spirocyclic drimanes; as well as volatile organic compounds (VOCs) |
Microbes and bacteria can cause type 3 Alzheimer’s disease, CIRS, and biotoxin illness. |
Furniture |
Flame retardants: polychlorinated biphenyls (PCBs), PBDEs*, HBCDD Phthalates |
PCBs and PBDEs alter the dopamine system and may increase risk of Parkinson’s disease;83 alter learning and memory.84 HBCDD harms dopamine signaling.85 Phthalates are tied to attention deficit disorder, autism, reduced verbal intelligence, developmental delay, and social deficits.86 |
Household cleaners and supplies |
Endocrine disruptors—phthalates Nonylphenol ethoxylates (NPEs) Fluoride in toothpaste Alcohol in mouthwash |
Phthalates, NPEs, fluoride (see previous). Alcohol is a known neurotoxin (see chapter 5). |
*PCBs and PBDEs are now banned but still exist in older furniture. |
||
The Science Behind the Protocol
The next section introduces the first steps to the Brain Body Protocol to beat toxicity, but first I want to share the science behind my recommendations.
INTERMITTENT FASTING
Intermittent fasting is when you restrict eating to a specific window of time after an overnight fast. Most animals feed this way when left to their own devices, allowing for periods of fasting that coincide with sleep. Periodically fasting creates an alternative universe with your metabolism, where you depend less on burning sugar and depend more on burning fat (known as ketone bodies). Why bother? Because intermittent fasting prevents inflammation and decelerates disease, helping you reset key metabolic and stress pathways, remove toxins, lose weight, and, ultimately, age more slowly.87 This process gives your body more time to rebuild healthy cells. Just like a baby growing from tiny stem cells, we have the ability to heal and regenerate our cells—and intermittent fasting promotes this state. By giving the body a break from constant fueling and digestion, we create a window to focus on structural needs and to heal.
Specifically, intermittent fasting has been shown to promote health in a variety of ways: in the brains of animals, it reduces neurodegeneration.88 In humans, it has been shown to improve brain function in epilepsy.89 Intermittent fasting changes circadian clock genes, since eating is associated with light/dark cycles.90 Multiple studies and reviews describe the beneficial metabolic effects of intermittent fasting.91 Specifically, intermittent fasting in humans for three to twelve weeks reduces body weight by 3 to 7 percent, lowers body fat by 3 to 5.5 kilograms (6.6 to 12.1 pounds), and lowers total cholesterol by 10 to 21 percent.92 Intermittent fasting can be one factor in lowering your body weight set point.
Finally, intermittent fasting reduces inflammation, improves biomarkers of health, counteracts disease, and potentially increases longevity and healthspan.93 We’ve known that intermittent fasting has these benefits, as first documented more than seventy years ago,94 yet most people aren’t doing it. I hope you’ll be a believer once you see the results. You’ll begin intermittent fasting this week as a way of liberating toxins that are stored in your fat, and then in the next chapter, we will delve deeper into the benefits of intermittent fasting for lowering the body weight set point.
While the data on ketogenic diet (high fat, adequate or moderate protein, low carbohydrate) are unclear regarding the benefits to the brain for most healthy individuals, I urge you to try intermittent fasting as a way to enter a fat-burning (ketogenic) state and improving metabolic flexibility. For example, finish dinner by 6 p.m. and eat again at 10 a.m. the next day (a 16/8 protocol, for sixteen hours of a fast followed by an eight-hour feeding window). This turns on longevity genes, and the production of ketones improves focus.95 Some people need to ramp up to a sixteen-hour fast more slowly—for example, beginning with a twelve-hour, then a fourteen-hour overnight fast twice per week.
GET THE RIGHT NUTRIENTS AT THE RIGHT DOSES
When it comes to removing toxins and protecting against future exposures, there are a few key scientific principles to keep in mind. Below are the highlights, and you’ll learn more about how to operationalize these principles in the Brain Body Diet. The point is to remove the obstacles to brain/body wholeness and neurogenesis, like sugar, alcohol, and hyperarousal (chapter 5), and to add in more dietary components that promote neurogenesis and detoxify, like vividly colored vegetables, polyphenols, healthy fats, sulforaphane, spices, extra dark chocolate, and teas.96
—Antioxidants are your best bet because they help counter the harmful effects of oxidative stress by inducing neuroprotection, such as the release of shielding enzymes and nitric oxide.97 Most important are vividly colored fruits and vegetables, such as carrots, tomatoes, and berries, which are rich in carotenoids.
—Another class of antioxidants that are helpful for detox are plant-based nutrients like the flavonoids (polyphenols) that may or may not be as highly colored, such as celery, onions, kale, grapes, Brussels sprouts, citrus fruit, cacao, and tea.98 It’s not just one vegetable or nutrient that is most important, but a combination of various types.
—Certain vegetables help with liver detoxification, like the cruciferous vegetables: broccoli, cabbage, and cauliflower.99 Crucifers contain sulforaphane, which inhibits Phase I and stimulates Phase II liver detoxification—that’s what most of us need for improved detoxification pathways. Sulforaphane boosts production of glutathione, the queen detoxifier that protects the brain body, may be involved in the prevention of cancer, and helps tune up mitochondria.100 The same receptor on cells that environmental toxins use for their negative effects is also used by cruciferous vegetables. That means when you eat more cruciferous vegetables, you crowd out the bad environmental toxins and strengthen your mitochondria.
—Allium vegetables (onions, garlic, leeks) are another class of vegetables that help you make more glutathione.
—Organic food beats out nonorganic every time, especially for the dirty dozen (strawberries, spinach, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes, and sweet bell peppers). Genetically modified organisms have negative effects on the microbiome and sex hormones.101 Even one week of eating an organic and mostly plant-based diet will improve dozens of measures of health and measurably lower your toxic burden, according to a study of pesticide residues in people eating a mostly vegan diet with some fish and eggs, but without gluten, caffeine, dairy, or alcohol.102 Imagine what forty days will do for you!
—Cacao or extra dark chocolate (85 percent cacao or higher) contains methylxanthines, another polyphenol, which are proven to enhance the brain body, reverse insulin block, lower blood pressure, and protect the nervous system.103
—Liberal spice use reduces inflammation and inflammatory toxins.104
—Alcohol consumption impairs mitochondria.105
—Grains tend to be moldy and laced with arsenic, cadmium, and/or lead.106
—Glutathione and precursors help you detoxify.
Liposomal glutathione or the precursor, N-acetyl cysteine (NAC), is shown to lower inflammation and mercury levels.111 NAC helps remove lead and mercury,112 and breaks down biofilms,113 which are protected niches of bad microbes such as candida that release toxins and affect the brain body.114
(R)-alpha-lipoic acid reverses the age-related loss in glutathione, but the data in humans are not yet as strong as for NAC.115 NAC and alpha lipoic acid improve mitochondria function.116
—Selenium protects you against metal toxicity. It’s a natural antagonist against the harmful effects of mercury and lead.117 Selenium works best when your body levels are low, and may contribute to metabolic syndrome if you are replete or consuming excess amounts beyond your body’s need.118
—Berberine moderately lowers blood glucose, reduces blood markers of fatty liver, and decreases adipokines.119 It has better efficacy combined with milk thistle.120 Mild weight loss is seen at higher doses.
—Curcumin fights inflammation, including neuroinflammation or brain trash, and may help protect you from toxins such as lead, among others.121 Studies show that it can help reverse nonalcoholic fatty liver disease.122
—Probiotics are anti-inflammatory and protect the brain body from heavy metals and mycotoxins (toxins from mold).123 They lower body burden of BPA in rats.124 They support mood and probably decrease depression and anxiety, although data are still emerging.125 Probiotics may prevent and possibly reverse harm to the liver such as nonalcoholic fatty liver and subsequent brain effects.126
—Though gingko may improve liver and gallbladder function (the gallbladder stores bile, which helps the body break down fat from the diet) and gingko has also been shown to improve blood flow to the brain, cognition, speed of cognitive processing, and memory, the data are mixed.127 Because of risk of cancer in animal models, the lack of consistency in study results, and its classification as a possible human carcinogen (Group 2B) by the World Health Organization’s International Agency for Research on Cancer, I do not recommend it.128
PUMP YOUR LYMPHATICS
The lymphatic system functions as a network of tissues, nodes, and organs—like the spleen, tonsils, and thymus—that help rid the body of toxins, waste, and other undesirable debris. The main function of a normal lymphatic system is to transport lymph, a fluid containing immune-boosting and infection-fighting white blood cells, throughout the body and upward to the neck, where the lymph empties into your subclavian veins. When it’s not working, you feel puffy, like you’re retaining fluid, and may be more prone to infection.
Think of the lymphatic system as the waste clearance system for the whole body. It took my traumatic brain injury to realize just how important the lymphatic system is, because it ferries toxins and waste products out of the body. Not only that, but the lymphatic system is also responsible for keeping the fluid between cells (the extracellular fluid) in homeostasis, helping proteins stay in balance, providing immune surveillance, and combating infection.129 As I lay in bed recovering, my swollen body provided evidence of accumulated toxins that I couldn’t get rid of. My lymphatics needed attention to help clear my brain/body toxins.
Various problems of modern life conspire against normal lymphatic flow: gaining weight, underhydrating, and underexercising, among others. At the time of my head injury, my lymphatics had been neglected for decades. I had a habit of not drinking enough water, established during my medical training when I didn’t have time to urinate, and leading up to the day of my fall, when the bathroom was too far away. I went twelve hours without a sip of water.
How is the brain involved? In 2015, a landmark discovery was published in the prestigious scientific journal Nature: the brain connects to the immune system via lymphatic vessels, located in the sinuses of the head.130
Brain injury of any kind, whether it’s gradual (eating too much sugar and the resulting neuroinflammation) or traumatic like my injury, impairs the lymphatic system in the nervous system, which means you are more likely to experience sleep difficulties, and less likely to remove toxins efficiently.131 So to keep your lymphatic system doing its job and disposing of toxins, drink more water, keep your weight at a healthy set point (more on that in the next chapter), sleep more, exercise more to keep your circulation moving, and sit less.132 Jump on a rebounder (a small trampoline), for example. One of the best ways to improve your lymphatic circulation and aid in the removal of toxins is with resistance exercise. Even just ten to fifteen minutes of brief muscle contractions increases lymph flow by 300 to 600 percent.133
KUNDALINI YOGA FOR DETOXIFICATION
Kundalini is based on hatha yoga but with a different format, and in my opinion it is better suited to the removal of toxins. In kundalini, postures are just one part of a continuous movement called a kriya—breathing, chanting, and flexing/extending the spine—to permit the kundalini, or life force, to circulate in the body and brain. Kriyas last three to eleven minutes, and there are thousands of them. Best of all, you don’t need to be flexible or to have practiced yoga for years in order to benefit: even the earliest beginners benefit immediately.
I began practicing kundalini about fifteen years ago after learning hatha yoga from my great-grandmother as a child and practicing alongside my mother. Honestly, though, it took multiple reconstructive breast surgeries in 2017 for me to slow down enough to make kundalini part of my rehabilitation. After my surgeries, I couldn’t make it through a tough vinyasa yoga class because my pectoralis and serratus muscles could no longer hold Downward-Facing Dog, so I resorted to the more gentle kundalini practice. Along the way, I rediscovered a very subtle yet powerful way to rebalance body and brain.134 Perhaps that’s why kundalini is growing in popularity and was named a top-ten fitness trend by the Washington Post.135
On a mechanistic level, the movements of your physical and energetic bodies pump specific muscles as well as deeper internal systems, flushing capillaries and gently stimulating the lymph system so it can pick up toxins and get them out of your tissues, as well as rebalancing your endocrine system. Practitioners say other benefits are weight loss and stress and blood pressure reduction. Scientifically, kundalini improves anxiety, depression, diastolic blood pressure, resilience, perceived stress and cortisol levels, homeostasis, obsessive-compulsive disorder, and executive function, and may reverse mild cognitive impairment.136 Kundalini yoga can also help by removing toxic thoughts and stuck emotions. Kundalini helps to move the toxins from your field of awareness metaphorically, as well as from your blood, fat, and bones physically. We all need a better technique to clear the toxins from our subtle energetic anatomy, and kundalini is a great one.
Psychiatrist Carl Jung, MD, considered kundalini to be a blueprint for higher consciousness, which can flow only from robust brain/body health. Jung described kundalini as a method of psychic hygiene, something we lack in Western thought—a redefinition and reintegration of self. This is not something that exists outside of you, but rather is latent within you and every person, and is even your birthright. In the lore of kundalini, it’s an activity that reignites capacities that could be dormant by stimulating the brain and endocrine system, reestablishing balance in the left and right brain hemispheres. After practicing kundalini after my brain injury, I got to the point where I stopped digging in an endless inventory of all the problems that exist in life, and instead started focusing on the solutions—truly a redefinition, reignition, and reintegration for me. Kundalini can be a solution to many of my problems and yours.
NEUROSPIRITUALITY
One of the best ways to detoxify stress is something that grew out of kundalini for me. After a few decades of practicing yoga and still feeling dogged by stress, I realized that I could use my basic understanding of neuroscience to grow and enhance my experience of spirituality. Before I get too metaphysical on you, look at it this way: you can use your connection to something greater, no matter what it is, to improve your brain/body connection. (In more scientific parlance, you can use your beliefs along with the basics of neuroscience to improve spiritual neuroplasticity and build a better, healthier brain/body connection.) You could use a walking meditation, prayer, or other spiritual practices to detoxify stress from the brain in just a few minutes per day. These are simple and easy shifts that lead to important change. Even further, they change the structure and function of the brain, as documented in brain scan studies. The important part of creating and strengthening new pathways in the brain is repetition. As Rick Hanson, noted author and lecturer on neuroplasticity, says, whatever holds your attention has a special power to change your brain. So find a practice that suits you and stick with it.
To enhance neurospirituality, I began a daily practice that increases blood flow to the brain, grows the gray matter (you want more!), reduces the focus on self-centeredness, and creates a connection to something greater—through a process of empowered surrender that helps me let go of my ego. This practice has measurable effects on the brain, especially the limbic or emotional system, parietal lobe, and frontal cortex—brain regions that you’ll get to know intimately and learn to love in the coming chapters. These new practices improve brain/body physiology while clearing out old traumas and providing a shield against the normal stress of daily life. You’ll learn the specifics in the first protocol below.
The Brain Body Protocol: Removing Toxins
Now you get the basics of how toxins damage brain and body cells, disrupt hormones, and trigger the type of inflammation that leads to brain fog, weight gain, hormonal imbalance, and brain trash, among other life-depleting symptoms. It’s time to lighten up your toxic load. You may think you’re safe because you live far from a freeway or coal-burning power plant, but as you’ve read, the dangers lurk in your dry-cleaned dress, restaurant food, and probably your favorite workout clothes. As a physician taking care of women who don’t know that toxins are causing many of their symptoms, I can tell you there’s a good chance that they are—by harming your liver, mitochondria, brain, or all three. The bad news? Almost none of my patients are free of toxins, and it costs a small fortune to test for them. If your symptoms are particularly severe and you think you may need testing for a particular metal, see the Advanced Protocol or Appendix B for suggested labs. The good news is that you can start removing the worst toxins today by starting with just one or two steps below.
Our focus of the first part of the Brain Body Diet is to clear the toxins you’ve been exposed to via your lifestyle, from the time of conception until now. Most of us have toxic issues that need to be cleared with positive influences like sprouts, more fiber, and glutathione-boosting foods that help you build up a reserve for detoxification. We will optimize detoxification starting with the Basic Protocol. If you feel inclined or are especially toxic, add in one item or more from the Advanced Protocol. I urge you to follow the Toxin Protocol for forty days, adding protocols in the chapters that follow based on your self-assessments at the beginning of chapters 3 through 8.
BASIC PROTOCOL
Step 1: Lighten the load on your liver.
Your liver and mitochondrial activity have a direct impact on brain function, hormone levels, and detoxification of external environmental toxins as well as internally made toxins. Throughout the forty days of the Brain Body Diet, the following are your food rules.
Consume liver-supportive and brain-boosting foods and drinks to detox your brain body.
Include in that count bitter vegetables and herbs at every meal for their liver benefit: arugula, dandelion leaves, endive, radish, sage.
To raise glutathione (the master detoxifier in the body), eat allium vegetables: onions, garlic, leeks.
Eat cruciferous vegetables because they trigger cleanup in your liver and immune system: broccoli, Brussels sprouts, cabbage, cauliflower, kale, radishes.
Include both nonstarchy and starchy vegetables. Limit starchy vegetables to one serving twice per week if you are trying to lower your body weight set point. Replace grains like rice with tubers: sweet potatoes, potatoes, yams.
Eat the rainbow. You’ve heard it before, but in my practice, people get lazy about eating at least five colors of whole foods each day. Do it to help your detoxification genes and prevent micronutrient deficiency. Examples are provided in the Notes to help you accomplish this important task daily.137
Add prebiotic fiber. Feed the good bacteria in your gut ecosystem and remove toxins like BPA. Include asparagus, burdock root, Jerusalem artichoke, jicama, garlic, onion, leeks, unripe (green) bananas, flaxseeds, seaweed, konjac root (you can find this prebiotic source in shirataki noodles), and yacon root.
Spice it up. Extensive research over the last ten years has shown that some spices target inflammatory pathways, and thereby may prevent neurodegenerative diseases: turmeric, red pepper and chili, black pepper, licorice, clove, ginger, garlic, coriander, cardamom, fenugreek, cumin, rosemary, anise, cinnamon.
Make sure your vegetables are organic—that is, free of glyphosate, the herbicide found in a lot of genetically modified food.
Add in four to five forkfuls of probiotic foods per day: sauerkraut, kefir, and kimchi.
Commit to intermittent fasting. Limit your eating to a specific window of time, after an overnight fast, for all of the remarkable benefits listed in the Science section, but most of all, for the way it helps you burn fat, free up toxins, and then have an opportunity to remove them. I recommend a fourteen- to sixteen-hour window for men and a sixteen- to eighteen-hour window for women. For example, finish dinner by 6 p.m., and eat again at or after 10 a.m. the next day.
Avoid foods that destabilize your blood sugar, introduce heavy metals, and hurt your mitochondria.
Step 2: Take brain botanicals.
Step 3: Detoxify your body with sweat, heat, and circulation.
Extensive studies now indicate that one of the best ways to remove toxins is to sweat them out.138
YOGA FOR DETOXIFICATION: BREATH OF FIRE
This energizing kriya from kundalini yoga is designed to free up the diaphragm and pump your core so that your lymphatics work better.
ADVANCED PROTOCOL
If the Basic Protocol doesn’t lower your toxic burden enough or you are still experiencing symptoms after forty days, try one or more of the advanced items for another forty days.
Step 4: Perform a basic detox of your environment at home and in your car.
Clean up your bathroom, kitchen, and car to reduce your exposure to the most common everyday chemicals and endocrine disruptors:
Step 5: Supplement to reduce toxin levels.
If you are on prescription medications, talk to your pharmacist about any drug interactions first.
Step 6: Test your toxin levels.
I routinely use several tests for patients who have symptoms of exposure, including but not limited to allergies, gut problems, asthma, autoimmune conditions, brain fog, heart disease, cancer, fatigue, frequent infections, hypertension, learning challenges, mood disorders, and obesity. We can measure toxic metals in the blood and urine and organic acids in the urine. In the blood, we can measure toxic by-products like homocysteine and other inflammatory markers like high-sensitivity C-reactive protein.
The tests that I commonly recommend (see Appendix B) are the following:
—Visual Contrast Sensitivity test to look for mold and other biotoxin exposures.147
—Quicksilver Scientific to measure toxic metals like arsenic, cadmium, cobalt, lead, mercury, silver, and strontium.148
—Genova Toxic Effects CORE to assess levels of bisphenol A (BPA), chlorinated pesticides, organophosphates, PCBs, phthalates and parabens, and volatile solvents.
—Genova NutrEval to find micronutrient deficiencies and heavy metals in the blood and urine.149
—Viome is an in-home stool and metabolic test that provides personalized food and nutrient recommendations based on comprehensive analyses of your gut microbiota and RNA messages (transcribed by the microbial genes), also known as metatranscriptomics.150
—Gastrointestinal Microbial Assay Plus (GI-MAP) by Diagnostic Solutions Lab offers PCR Stool Technology to map your microbiome. It screens for pathogenic bacteria, commensal bacteria, opportunistic pathogens, fungi, viruses, and parasites.151
—Great Plains Organic Acid Test (OAT) to check the biochemical machinery of the body—this is one of the tests that I use to look at overall metabolism in a single snapshot with over seventy markers, including dysbiosis, fungal overgrowth, vitamin and mineral levels, oxidative stress, neurotransmitters, and oxalates.152
—Great Plains Toxic Non-Metal Chemical Profile (GPL-Tox) to screen for 172 different environmental pollutants using eighteen different metabolites, all from a single urine sample.153
Step 7: Draw toxins out of the body.
There are many ways to remove toxins from the body, some proven and some unproven.
—Low stomach acid can induce toxins by causing imbalanced gut microbes. One way to help is to take betaine (trimethylglycine), 1 to 1.5 grams two to three times per day before meals, either anhydrous (which is better for estrogen metabolism) or betaine HCl (which is better for digestion).
—For Tamara’s high mercury, I prescribed a daily dose of 2,3-Dimercapto-1-propanesulfonic acid (DMPS) at a dose of 125 mg every night, along with a mineral supplement. We paid attention to keeping her bowels moving every day so that she would not reabsorb the mercury she was removing. After twelve weeks, her mercury level was in the normal and nontoxic range. Now she periodically tests her mercury level, about once per year. She uses liposomal glutathione, 250 mg twice per day, as needed if her mercury starts to climb. (See Appendix B for recommended labs.)
—For details about additional over-the-counter158 and prescription medications159 for binding and chelation, see Notes.
Step 8: Diagnose and treat brain/gut problems.
Depending on your gut function and symptoms, you may benefit from a more extensive gut assessment and repair of the gut/brain axis. First you want to identify the gut issues that cause or worsen the gut-derived toxins affecting the brain body, including loss of gut integrity, maldigestion, partially digested food, food additives, the wrong bacteria (or bacteria in the wrong place), the wrong microbes (such as fungal overgrowth or parasites), toxins from normal bacteria (such as lipopolysaccharides from gram negative bacteria), loss of normal liver detoxification, and inflammation. Many of the tests mentioned in Step 6 will uncover these problems. Based on your results, in functional medicine we follow the “4R” program of four stages—remove, replace, reinoculate, and repair—designed to address underlying root causes of symptoms affecting the brain body. If eating the foods and taking the supplements recommended earlier in the protocol are not helping you feel better in terms of gas, bloating, and other gastrointestinal symptoms, consult a functional medicine practitioner. Depending on the severity of your issues, it may take up to six to twelve months to heal your gut.161
Step 9: Increase your neurospiritual practices.
Spiritual practice helps to reset the brain body, particularly the overactivation of the stress caused by toxins.162 My daily practice is to get up in the morning, make hot water with lemon or green tea, and sit down in a comfy chair in the living room to review my day. I start by measuring my heart rate variability as I described in my previous book Younger. I have a wristband that measures my heart rate variability continuously, alerting me on my smartphone when high cortisol is once again hijacking my calm (see Appendix B for the current wearables that I’m using). Instead of amplifying stress with coffee or indulging thoughts about the problem or shutting it off with addictions, I measure and tame it. Today I was 50 percent stressed (probably because my house is on the market), and after a thirty-minute guided visualization, I was 18 percent stressed.
When I’m tired, a guided visualization suits me best, or a few yin yoga practices. When I have more energy, I perform centering prayer. Studies show that word-based centering prayer stimulates the prefrontal cortex, plus the language part of the brain (the frontal lobe, the area behind the forehead) and the limbic areas, and makes you less self-centered.163 It also activates the brainstem, which is how the brain connects to the body, and thereby translates calm not just into the brain but into the viscera of the rest of the body. Finally, studies show that meditation, including centering prayer, decreases sense of self as shown by reduced blood flow to the parietal lobe, the seat of self-orientation.164 Centering prayer is the form of active surrender that I mentioned earlier. Here’s how to do it.
If sitting in a comfy chair every morning, measuring your heart rate variability and visualizing a recent beach vacation, sounds like too much work, here’s an alternative: take yourself on a mindful walk. Recently I’ve begun a daily walking meditation with my dog. It takes ten to thirty minutes, and you don’t need a dog to reap the benefits. See the sidebar below for how I do it, adapted from Jon Kabat-Zinn.165
WALKING MEDITATION
This is not a hike or workout. Instead, it’s an intentional form of walking slowly and meditatively, where you walk ten to thirty small and natural steps, then retrace your steps.
Last Word
An unhealthy environment creates an unhealthy brain body. At our essence, we are self-regulating biochemical machines with complex metaphysical qualities, but toxins impair the function of the machine. A friend’s grandfather was a fruit farmer in the Central Valley of California. The chemicals he used to spray his fruit trees included DDT, which very likely may have contributed to his diagnosis of dementia late in life. What was surprising were his doctor’s words of solace to his wife and family, including my friend: “His brain stopped telling his body to heal.” In the throes of dementia, his brain forgot to activate the healing response. The brain helps the body heal, but sometimes that signal gets interrupted. Please don’t let that happen to you.
DETOXIFICATION
What |
Why |
How |
Detoxifying food |
Antioxidants crowd out environmental toxins and rebalance liver detoxification pathways. |
Consume more foods containing antioxidants, including cruciferous, bitter, allium, and vividly colored vegetables. Add tea and probiotic food like sauerkraut, kefir, and kimchi to your daily regimen. |
Sauna |
Saunas remove toxins like arsenic, cadmium, lead, and mercury.166 |
Sit in a sauna for twenty to sixty minutes, four times per week. Replace electrolytes and trace minerals after you emerge. |
Copper in balance with zinc |
You want enough copper, but in balance with zinc. High copper is neurotoxic and causes many of the same symptoms as mercury toxicity—anxiety, and even criminal behavior. |
Make sure you have approximately 100 mcg/dL copper and zinc; an optimal ratio is >1.3 (copper to zinc); >1 is normal. |
Glutathione |
It protects cells by cleaning up excess free radicals, the enemy agents with unpaired electrons that damage DNA, cell membranes, and proteins. |
Take liposomal glutathione 250 mg twice per day for a goal glutathione (GSH) level of 5.0–5.5 μm. |
Restore mitochondria |
Your mitochondria’s job is to make energy in the form of ATP. In the process, there’s free radical production. You want a lot of ATP and just a small bit of free radicals. |
Avoid sugar, mold and other biotoxins, heavy metals (in grains, amalgams, and personal-care products), and stabilize your blood sugar. Measure your methylation activity and genes; if needed, take methylators. |
Keep selenium in balance |
Selenium should be known as the “mercury-fighting” mineral. Selenium deficiency causes a sluggish thyroid and extra toxicity from mercury, so keep your levels optimized. |
Maintain serum selenium levels of 110 to 150 ng/mL. When you eat fish, choose fish using the new selenium-based standard, meaning with more selenium than mercury, such as the types listed:167 albacore tuna yellowfin tuna skipjack tuna bigeye tuna spearfish swordfish wahoo opah |
Even when you’re trying to detoxify, life can get in the way and interrupt the biochemical machine. While writing this book, I had two trips back to back. One was to New York. I stayed in a hotel on the waterfront with organic mattresses and sheets, clean filtered air, and filtered water in every room. The restaurant served organic food. I felt normal upon my return to San Francisco, because the hotel was much like my home environment. A few days later, I went to Sacramento for my daughter’s volleyball tournament. We stayed in a hotel on the freeway, in a room that reeked of toxic cleaning products. I opened the sliding glass door and noticed smokers on the deck next door and the freeway fifty yards away, and promptly shut it. I sat in an upholstered chair to write, but then got to thinking about how it contained flame retardants, and shut my laptop. My sinuses became congested, my eyes were itchy, and I felt hungrier than normal—in fact, intermittent fasting felt close to impossible. As I drove home, I noticed in the mirror that my eyes were rimmed in red and the whites of my eyes were bloodshot. My weight increased four pounds. I was inflamed.
My experience was hardly a controlled experiment, but sometimes anecdotal self-experimentation in your own body (the n-of-1 study) can be as important as the latest large clinical trials. Find out what happens in your own brain body when you are exposed to toxins and healing begins to slow down. Start to notice how you feel when you are one week into the Brain Body Diet. Attune to the signs that you’re reversing toxicity, liver stagnation, and inflammation—your face looks less puffy, you feel less stiff in the morning, and the whites of your eyes look brighter, more white. Maybe you’re less angry or anxious.
Just as Tamara was able to remove mercury and other inflammatory toxins—and to optimize her self-regulating biochemical machine—you can similarly remove toxins that may be blocking normal function, disrupting homeostasis, and creating a brain/body failure state. The Brain Body Diet helps you reverse the damage by allowing the brain to help the body heal again.