Using Binders To Remove Toxins
When To Use Binders
Healing From Mold Protocol #4 - From the "Step By Step Protocol" To Healing From Mold
If you have not yet read the article on "Supporting The Organs Of Elimination", please read it first.
Binders work best after you have removed yourself from the exposure to the water-damaged buildings, and the belongings in that building that are also tainted with tiny bits of spores, volatile organic compounds, and other noxious toxins you can not see and may or may not be able to smell. This also works best if you make sure the individual has all their routes of elimination working well also. Binders can be constipating so the digestive tract needs to be flowing along at a good rate. They require bile to be able to move the toxins into the gastrointestinal tract where the binder can meet, and great them with a big binder hug and not let them go.
Some people will also add glutathione or n-acetylcysteine or alpha lipoic acid etc. at this time, but if the individual reacts, it is best to simply use binders for 2-4 weeks at which time the person should feel a noticeable difference, if they also removed themselves from all mycotoxin exposure. If they are not noticeably better and have been religiously taking the binders, you have to re-evaluate. Are they still being exposed? Was there a mistake in diagnosis? Do they need a different approach as they could have mycotoxins/other toxins that are not easily, or fully bindable? Is there something else going on? Are they even making enough bile to bring toxins into the gastrointestinal tract? Some mycotoxins (and other toxins) decrease bile flow.
What Are Binders
Binders, or sequestering agents, are substances that are generally used to bind cholesterol, bile acids and toxins in the small intestine. They are used by clinicians to bind toxins, but a practitioner needs to be aware that they may also bind foods, supplements, and drugs too
In relationship to toxins, binders are orally ingested material that bind either directly to the toxin in the intestine, or they bind to bile acids which may be attached to toxins. Ultimately the binder acts like a taxi giving the toxins a ride out of the body as part of the fecal matter.
Binders have a large surface area to volume ratio, giving them a large absorptive capacity. They also have ionic charges which may change what they bind to. For instance clays have a negative charge. Charcoal also has a negative charge. This means positively charged molecules will be attracted to them such as aflatoxins. Cholestyramine and chitosan have a postitive charge, so negative moleucles will be attarcted to them. Chitosan's binding research is largely in vitro.) Both cholestyramine and chitosan attach to bile acids and since bile acids are attached to toxins that the liver is attempting to remove from the body, they both can remove toxins by attaching to the bile acid with the toxin, and showing both the bile acid, and the attached toxin, the way out in the feces. If the binder does not bind the bile acid/toxin combo, the body has a good chance of reabsorbing them both through the gut, and back into the circulation again.
Characteristics Of Binders That Influence Adsorption
- The size of their pores
- Accessible surface area
- Total charge
- Charge distribution
Characteristics Of The Mycotoxin That Influence Adsorption
- Size and shape
- Charge distribution and dissociation constants
A variety of substances have shown efficacy in lowering mycotoxin, and endotoxin levels including cholestyramine, activated carbons, chlorella, clays, food fibers, glucommanans, yeast cell walls and others. These agents were once thought to be non-specific, but research is showing many of them will bind to some toxins while being useless with others. They also have the potential to bind vitamins, and nutrients as well as supplements, and medications, so they should be taken apart from these substances as a general rule.
What Is A Good Binder
- Adsorption capacity
- Irreversible binding
- In vivo studies support use for the toxin in question
Details: The binder should be able to bind most of the toxin, so it needs high adsorption capacity. The binder should be specific for the toxin, or toxins, and not bind other things like nutrients, drugs, supplements that the individual is ingesting. The binder should also stay bound to the toxin, rather than releasing the toxin before it is removed from the digestive tract. In vivo studies are important. How the binder works in vitro tells us little about how it works in vivo.
It is very important to use binders that are known to bind in the digestive tract, as opposed to a petri dish. Much of the original research on binders was completed outside of the body. It was found when tested in animals that most of the binding capacity seen in studies performed outside of the body was absent after ingestion. For most mycotoxins, we lack adequate research data as to how binders work in the body. Much of the research that is quoted is from binding capacity outside of the body.
Below is a list of binders with the mycotoxins they may bind. I list anything that looks relevant and has been shown to work in research, or clinically on animals/humans rather than outside of the body. For further details, see either the articles on the particular binder, or articles on the particular mycotoxin, or mycotoxin research that I am currently adding to this website. It is important to know there are very few binders that have studies to back up their use for specific mycotoxins. Additionally, many people are not sure what mycotoxins are bothering them. Thus, a variety of binders are often used by the individual to try to get good binder coverage. I have only included binders and the mycotoxins they are known to bind below. Please realize, just because we don't have research on mycotoxin being bound to a binder, does not mean it won't be bound by one or all of the many binders available. (there are many more types of binders than the few I mention below)
Binders May Bind Each Other
I would add that I have a concern about people ingesting a binder with a positive charge, along with a binder with a negative charge as they may actually bind to each other to some degree. This appears like it may have happened in some research studies. Will have to wait for more research on this though. Many people take a mix of various of binders, and some of them find it works well.
Other Choices When Binders Fail
Binders do not work for all mycotoxins, or at least not well enough. For instance in animal studies, binders are not as effective in preventing toxicity in relation to fusarium mycotoxins such as ochratoxins, trichotehecenes or zearalenone. For these types of toxins, biotransformation methods are used. This is the alteration of the toxins into a less toxic or non-toxic form and in the animal studies is usually accomplished with enzymes or microorganisms. This is done in the gastro-intestinal tract in these studies and given at the same time as mycotoxin-laden food. However, these methods can be used by people who use enzymes, and or appropriate gut bugs while stimulating bile movement into the gastrointestinal tract. We need more research on this. Antioxidants are also used as protection agains mycotoxins as well as the support of our own bodies biotransformation system, glutathione being a key player.
Antioxidants and biotransformation pathway support are always a good bet for decreasing mycotoxin affects on the body. As we learn more about mycotoxins and the pathways used for their removal, this adds to our knowledge on how to transform and remove them.
Binders Known To Bind Particular Mycotoxins Well
Aflatoxins are bound by clays such as montmorillonite, Sodium and Calcium bentonite, (lots of studies with the calcium montmorillonite clay called Novasil™ that is fed to animals in their feed) and clinoptilolite. Gliotoxins may also be bound by bentonite clay.
Ochratoxin is bound directly to cholestyramine.
Zearalenone appears to bind to cholestyramine.
Fumonisins have been shown to bind to cholestyramine (85%) better than activated charcoal (62%) or bentonite (12%) or celite (0) in vitro. However, petri dish testing does not always equate to what happens in the body. The in body testing for binders of fumonisins has not been very fruitful. In a study of rats fed fumonison there was a significant reduced effect from treatment with cholestyramine. Enzymes are currently being used in farm animals for fumonisin with good success, and antioxidants should also be of use along with biotransformational pathway support.
Zearalenone affect was shown to be remediated by diatmoaceous earth (clay) in an experiment wtih piglets and rats, however it does not appear in most research to work very well.
Next, Read about "Supporting The Biotransformation/Detox System".
How To Use Binders
I wrote an extensive article on how to use cholestyramine, and precautions for using it as it was the first binder I used back in the beginning. Although most people think "natural" binders do not have the same possible side effects, in reality they do to one degree or another. Also, some binders people think are natural, are actually altered. Many clays are being altered now to enhance binding capability. Pretty much everything I wrote in the cholestyramine article relates to other binders as far as when to take them and safety precautions, so please read about cholestyramine. The only thing that is different is the amounts. I find some people have trouble with binders and to be honest they may need to take such extremely small doses of them, that you would think they will not help, but they do. They simply have to be consistent and increase the dose over time. For instance, the dose for charcoal could be 1/8th of a cap to as much as 8 capsules. So, I hesitate to give you exact doses. When I wrote the cholestyramine article, I gave the dosage in there that is given as a higher dose to anyone who can handle it. However, some people can not take that much. I also found really fast that 4 times a day (the original dose used by Dr. Shoemaker) is too hard for people, and most folks still got better using it 3 times per day. What I am trying to convey is that binder doses vary. You need to take as much as necessary to bind the toxins, but you don't want to cause constipation, or bind nutrients, or drugs etc. So, please read the cholestyramine article even if you plan to use clay, or charcoal, or water soluble fibers etc. The same directions and precautions will be applicable.
Always take binders 30-60 minutes prior to a meal with some fat in it, as you need to stimulate the production of bile. You want to be sure that binder is ready, and waiting, when the bile dumps into the intestine.
Problems With Binders
- Can decrease absorption of medications
- Can decrease absorption of nutrients in food
- Can decrease absorption of supplements/vitamins/minerals/herbs etc.
- Can lower thyroid hormones
- Gastrointestinal irritation or pain
The main issue I find with binders is that they slow down the digestion. I think this is induced by binding with bile, but probably has other causes. What I note in people is a slowing down of the digestive tract. There is decreased bile, decreased pancreatic enzymes and many of these people have low stomach acid. I don't know how much of this is due to the binder binding with bile, as well as other digestive juices, and how much might be from releasing mycotoxins, chemicals, or even heavy metals during the process which negatively affect digestion. I have even wondered about the possibility of releasing pathogens from biofilms or disrupting our own good floras biofilms. Although, I am not sure of all the causal factors, I do see that people have decreased digestive capability that results in reflux, slowed digestion (food feels like it is sitting in stomach and not moving very fast), gas, burping, flatulence, bloating, pain and constipation. There are ways to deal with this however. The binders can be helpful at removing mycotoxins, so stopping them is not the solution desired. Plus many of these people will continue to have issues after stopping the binders. By the way, these people have the symptoms of what is now being called small intestinal bowel overgrowth or SIBO. Rather than testing, I simply use a mix of ox bile, pancreatic enzymes, HCL and pepsin. Additionally, I use prokinetic herbs and supplements. Vitamin C, magnesium or herbs for constipation can be used as needed. Most of these people are low in magnesium, so this is often used. Vitamin C in small amounts of 500 mg can increase glutathione and is a great antioxidant to help protect against the oxidative damage all mycotoxins cause. There are a variety of other things that can be used to support bile production, enzyme production, enhancing HCL, bile conjugation, gut dysbiosis or SIBO etc. as needed for each individual person. The point is that this is something that happens all too often and should be remedied as soon as it rears its head. Not everyone has this issue. Those who have had digestive issues in the past will probably react at some point and in this case you may want to be proactive with these patients and start them on digestive assistance during the binding process. You can also start them on a binder dose that is really low. It is more important to use it 30-60 minutes before each meal than it is to have the full amount. So, don't give a bunch of binder once per day and none the rest of the day as a way to decrease the dosage. Give a decreased dose for each time it is used, but use it at least with each meal and hopefully 3 times per day. You want to keep the process of removing the mycotoxins in question at a constant, steady process. If you don't there will be periods where the mycotoxins (and often other toxins) will not be removed, and this gives them a chance to cause additional irritation as they are reabsorbed into the body and settle out some place else in a person's tissues. This is why binders are often given 3-4 times per day. You are trying to keep it as constant as possible. I find 3 times per before meals is usually enough, and try to keep it spread out from early to later as much as possible.
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