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IFM Environmental Health > Enhancing Detox > Flashcards

Enhancing Detox Flashcards

1
Q

Micronutrients for supporting phase 1 detox

A 
riboflavin (vitamin B2)
niacin (vitamin B3)
pyridoxine (vitamin B6)
folic acid
vitamin B12
glutathione
phospholipids
magnesium, zinc, copper
Iron: P450s
Molybdenum
flavonoids
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2
Q

Micronutrients for supporting phase 2 detox

A 
Cysteine
Sulfate
N-acetylcysteine
Methionine, serine
glycine, taurine
glutamine, proline
ornithine, arginine
Riboflavin
Vitamin A
Methyl donors
(folate, choline,
TMG, SAMe)
Phytonutrients
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3
Q

What specific phytonutrients appear to be most

useful in upregulating glucuronidation?

A

b. Quercetin, carotenes

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4
Q

sulfur amino acids that support the

phase two conjugating enzymes

A

GTG cyst meth
NAC
homo
homo

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5
Q

major botanicals for UGT

A

Milk thistle
Gingko biloba
Grape seed extract

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6
Q

think thyroid, dysbiosis, carotinoids, quercetin for…

A

Glucuronidation support

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7
Q

SAMe: B6, B12, Folate

A

SAMe is methyl donor for: –> SAH
• DNA protection
• Phosphatidylcholine synthesis
• Neurotransmitter metabolism

• Under normal circumstances, homocysteine, in the presence of vitamin B6,
vitamin B12, and folate (SAMe’s main cofactors), will eventually be converted
back into methionine, or cysteine. 1,2
• If adequate amounts of these vitamins are not present, SAMe may not break
down properly. As a consequence, its full benefits will not be obtained, and
homocysteine may increase to unsafe levels. 1

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8
Q

NASH associated with

A

high homocysteine

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9
Q

how to lower homocysteine

A

B12 plus fish oil

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10
Q

Arsenic tox correlated with

A

low beta carotene
low methionine
low glutathione

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11
Q

decreased vib sensation found in which tox?

A

Toxic Metals Pb, Hg, Cd, As;

xenobiotics

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12
Q

Methylation support

A

Folate: 5-MTHF (0.4–10 gm), folinic acid, folic acid
• B12: methylcobalamin (0.4 – 5 mg), cynacocobalamin
hydroxycobalamin and adenosylcobalamin
• B6: pyridoxine, pyridoxal-5-phosphate (10-50 mg)
• B2: riboflavin, riboflavin-5-phosphate (10-50 mg)
• Betaine (trimethylglycine) (500-2000 mg)
• Magnesium (200-1200 mg)
• Fish oil (1-5 gm EPA, DHA)
• SAMe (400-1200 mg) if clinical tolerance

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13
Q

minerals needed for glutathione cycle

A

selenium

riboflavin

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14
Q

the primary free radical cell protector

A

GSH

by maintaining mitochondrial redox potential and cell membrane stability

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15
Q

mercapturic acids

A

made in phase II detox reactions by GSH - for excretion

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16
Q

phase II metab that helps make leukotrienes - with ?

A

GSH (with AA deriv)

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17
Q

diseases with decreased GSH

A
  • Heart disease, hypertension
  • Arthritis and musculoskeletal diseases
  • Diabetes
  • Autism
  • Cancer (leukemia)
  • Macular degeneration, cataracts
  • Genitourinary diseases incl. chronic renal failure
  • Respiratory diseases like COPD, adult respiratory distress syn (ARDS)
  • AIDS
  • Hearing loss
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18
Q

what is main source of dietary sulfur/Glutathione?

A

fruits/veg

meat (only 25%)

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19
Q

why is NAC given for glutathione

A

Cysteine is frequently identified as rate-limiting for glutathione synthesis

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20
Q

mild chelators

A

NAC & GSH

NAC doesnt bind to essential metals

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21
Q

glycine

A

can be given with NAC - rate limiting step for GSH

helps with redox capacity

22
Q

How to fix age related decline in Nrf2

A

ALA

23
Q

vit that help glutathione

A

Vit D - esp brain
Vit C
Vit E

24
Q

Glutathione support

A 
N-acetylcysteine 600-3000 mg
• Glycine 4-8 gm
• Lipoic acid 200-1200 mg
• GSH 450+ mg
• Magnesium 400-1200 mg
• Vitamin D3 as needed
• Vitamin C 500- 2000 mg
• Methyl folate 400 mcg - 4 mg
• Methyl B12 1-3 mg
• SAMe 400-1200 mg
• Niacinamide 500-2000 mg
• Zinc 10-40 mg
• Vitamin E 400-800 IU
• Selenomethionine 200 mcg
• Whey Protein isolate 1-3 servings
• Milk thistle 500-1200 mg
(silymarin: silybin)
• Other: Phytonutrients – Curcumin,
Hydroxytyrosol, Sulphoraphane,
Resveratrol, berry extracts, nuts
25
Q

AA conj

A

• Glycine, Taurine, Arginine, Glutamine
• Endogenous molecules - bile acids, branched chain fatty acids
• Environmental chemicals - some herbicides
• Food preservatives - substituted benzoates
• Drugs - e.g., salicylic acid (glycine) ibuprofen (taurine), valproic acid
• For the majority of xenobiotic carboxylic acids, amino acid conjugation
is a minor metabolic pathway
• Primary role is to regulate systemic levels of amino acids that are also
utilized as neurotransmitters in the central nervous system.

26
Q

sweetener in smoothies

A

glycine (conjugator supp)

27
Q

L-Taurine

A

• Highest concentration in brain and heart
• Second most abundant amino acid in blood (free form)
• Sulfonate group: electrophile center/reducing agent
• Membrane-protective against hypochlorous acid
• Crosses blood brain barrier: long term potentiation in
striatum/hippocampus neurons
• Membrane stabilization
• Calcium homeostasis
• Protects against glutamate excitotoxicity**

28
Q

Clinical Applications of L-Taurine

A
  • Hyperactivity, anxiety, sleep disturbance
  • Seizures, autism
  • Cholestasis, Hypercholesterolemia, diabetes
  • Cardiomyopathy, retinal degeneration
  • Alzheimer’s disease, hepatic disorders
  • Cystic fibrosis, growth retardation
  • Alcoholism
29
Q

Applications of Glutamine

A

• Inflammatory bowel diseases, especially of the small intestine
(e.g., Crohn’s disease)
• Increased intestinal permeability
• Persons with wounds that are still healing (e.g., burns, injuries,
surgeries)
• Persons with low muscle mass and chronic immune weakness
revealed by frequent infections
• All wasting syndromes
• Cancer patients undergoing chemotherapy

30
Q

glutamine contra-indication

A

• Current neurodegenerative diseases: ALS, MS, PD
• Glutamine conversion to glutamate in neurons can be
excitotoxic

31
Q

chemically sensitive people - metab defect

A

think slow acetylators.

• Acetylation is used to eliminate excess histamine, serotonin, sulfa drugs

32
Q

Acetylation support

A 
pantothenic acid, 
Vitamin C, 
B1, B2, 
Mg and 
lipoate
33
Q

Poor conjugators clinical syndromes

A

Possible ‘poor conjugators’

• Chemical sensitivity: MCS: perfumes, sulfites, preservatives, dyes,
colors, MSG, salicylates, etc.
• Autoimmune disorders: Lupus, RA, MS, thyroiditis, Sjogren’s,
scleroderma, etc.
• Neurological: ASD, ADD, depression, anxiety, neurodegeneration, migraine, restless legs, neuropathy, “brain fog”, memory loss,seizures.
• Metabolic: Diabetes, metabolic syndrome, obesity
• Structural: Fibromyalgia, osteopenia/osteoporosis
• SNP: Predisposition consideration

34
Q

• Glucuronidation support focus

A 
Carotenoids, 
quercetin
glucuronidase support
 thyroid,
dysbiosis
35
Q

• Sulfonation support focus

A

• Sulfur amino acids, sulfate/MSM

36
Q

Methylation support focus

A

• Folate, B12, B6, TMG, EPA-DHA

37
Q

• Glutathione conjugation support

A 
NAC
Lipoate, 
GSH, 
Mg, 
D3, 
phytonutrients
38
Q

fat free diets

A

Fat-free diets in animals have a dramatic reduction in
cytochrome P450 and glutathione S-transferase
concentration and activity

39
Q

high GGT

A

Serum GGT >40
Reflects Persistent Organic Pollutants burden1
High GGT: increased glutathione catabolism / depletion

40
Q

Pantothenic acid

A

supports glutathione synthesis through its role in ATP production

41
Q

B12 deficiency is associated with

A

lower glutathione levels1

42
Q

Zn deficiency and immune function

A

impairs development of acquired immunity

• Compromises B lymphocyte development and antibody production(IgG). Adverse affect on macrophages.

43
Q

could see zn def in

A

celiac
diarrhea
veg

44
Q

see Low alkaline phosphatase

lack of sour, bitter taste in…

A

zinc deficiency

45
Q

mineral that helps with mercury detox

A

selenium

46
Q

minerals that helps with lead detox

A

calcium and iron

47
Q

mineral required for all CYP

A

iron

48
Q

cadmium affected by

A

iron def

49
Q

lipoates effect

A

activate Nrf-2/Antioxidant Response Element to increase phase II enzymes

50
Q

lipoates and toxic metals

A

protective

IFM Environmental Health (6 decks)

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