Neil Nathan’s Review of Biotoxins & Preferred Binders

Comment; We know of certain substances that we refer to as “binders” that help the body to clear biotoxins, but the question we’ve been struggling with is; “which toxin is best bound by which binder or combination of binders?” Now we have a roadmap of sorts to go by, thanks and congratulations to Dr. Nathan for this review!

    With all of the fear and paranoia that we are being bombarded with every day about the coronavirus, I have chosen not to write about that today, but rather to switch to a more positive subject: a new addition to the treatment of mold toxicity that I hope will help thousands of patients.
          For the past year, I have tried to obtain information on how, exactly, different mycotoxins are detoxified. The obvious goal here was that if we knew the more precise mechanism of detoxification, perhaps we could support that process to enhance our treatment of mold toxicity. Despite my efforts, and the best efforts of my friend and colleague, Dr. Matt Pratt-Hyatt who until recently was the head of the mycotoxin division at Great Plains, we were unable to find the information we needed.
          To my delight, when I lectured in Denver in September of this year
at Bob Miller’s First Annual Environmental Toxins & Genomics conference, I found the references and information I was looking for from three separate presenters: Beth O’Hara, on glucuronidation and acetylation, Emily Givler on sulfation, methylation, and glutathione conjugation, and Lari Young MD,  on the CYP enzymes of Phase I detoxification. Each of these women had dug deeply into their subjects and found gold.
          It seemed clear to me that if we combined their information, we could put together a wonderful reference table which would clearly tell practitioners which mycotoxins required which pathways for detoxification and further, give us treatment options to improve these.
          Several weeks later, I was studying a paper they discovered by Deanna Minich, PhD with the exciting title: Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Applications. (We are all excited by different things). As serendipity would have it, I realized that I would be speaking at the same medical meeting, two weeks later, with Dr. Minich. I immediately contacted her and we met at the meeting to go over this information and see how we could combine our data to make an even better approach, and indeed, she was all in for this project.
          The result of our little think tank is distilled into the following tables which we hope will enable practitioners to take the results of their urine mycotoxin assays (which gives us the information we need to know with precision which mycotoxins are being sequestered in our patients) and to improve our patients’ ability to detoxify by strengthening the detoxification pathways known for each mycotoxin.
           I continue to realize that the more I learn, the more complicated all of this is. In Phase I detoxification, where the liver and other organs process all toxins (not just mold toxins) by the reduction or hydrolysis of that compound, usually by an addition of oxygen, which is referred to as oxidation. This is accomplished by the P450 enzymes which in the chart are reflected by the CYP enzymes. This is usually followed by Phase II detoxification process in which those substances are made into more water-soluble substances by a variety of biochemical processes including glucuronidation, sulfation, acetylation, methylation and other noted in the table below. Given the different biochemical structure of each toxins, it should not come as a surprise that they need to be processed differently in order for us to excrete them from the body, through the organs of detoxification; namely, the liver, gut, kidneys, lungs and skin.
          What has become increasingly fascinating to me is to discover that a process that is intended to make the toxin less toxic, may in fact convert that toxin to a more toxic metabolite, which means that in our attempt to detoxify that substance, we are, at least for a while, exposing ourselves to a more toxic substance until we can convert it into something safer that can be excreted.
          As we learn more, it seems likely that what we learn will help us to help the body to do this in safer and more comprehensive ways…..hopefully shortening the treatment process and helping patients to feel better sooner. It is in that spirit that I present to you a table that we have put together, which pairs all of what is currently known about each mycotoxin, with the exact process(es) of detoxification for each, along with the nutrients that support this, and the supplements that support this as well. The (+) and (–) next to the supplements indicate (+)=upregulation and (-)=downregulation.
          To quickly give practitioners an idea about how to use this table, let’s take the most common mold toxin, ochratoxin. By looking at the table, we can see that ochratoxin utilizes the detoxification pathways of glucuronidation, glutathione conjugation, amino acid conjugation, and microbial hydrolysis. So, if we want to improve glucuronidation, we can readily see that the foods that can improve this mechanism are cruciferous vegetables, turmeric root, curry power, citrus fruits, grapes, berries, pomegranate, walnuts, black currants, algae, salmon, trout, krill, shrimp and crayfish. Supplements that can be helpful here are CBD, curcumin, quercetin, resveratrol, ellagic acid and astaxanthin.
          You can apply this same process to any of the other mycotoxins for which we have information.
          This is, of course, a work in progress. As we learn more, we will be adding other mycotoxins to this list.
          It is my hope that this will be of great value to clinicians in their efforts to treat mold toxicity. I would ask all readers that if you use this information and find it helpful (or not) to please email me with your case histories so that we can accumulate the clinical data we need to improve our treatment successes.

DETOXIFICATION OF MYCOTOXINS

TABLE I
Detoxification By Pathway

Mycotoxin              Detox Pathway        Dietary Supplement       Food

Ocharatoxin            Glucuronidation       Quercetin                   Cruciferous veg
Sterigmatocystin                                         Curcurmin                  Turmeric root
T-2 toxin (trichothecene)                          Reserveratrol               Curry powder
Zearalenone                                                 CBD                               Citrus fruits
Alternaniol                                                  Ellagic acid                   Grapes, berries,
DON (deoxynivalenol)                              Astaxanthin                 Pomegranate
                                                                                                            Walnuts, black
                                                                                                            currants, algae,
                                                                                                            salmon, trout,
                                                                                                            krill, shrimp,
                                                                                                            crayfish
_______________________________________________________________________________

Trichothecene              Acetylation               Quercetin              Processed meats
                                                                      Garlic                      Grilled meats

______________________________________________________________________________

DON                            Sulfation             Retinoic acid                   Fish, arugula,
T-2 Toxin                                                 Caffeine                            artichoke,
                                                                                                          green & black tea
______________________________________________________________________________

Ochratoxin A               Glutathione         GSH Assist                 Berries, grapes,
DON                              conjugation       Genistein                 Pomegranate,
                                                                                                          walnuts,
                                                                                                          fermented soy,
                                                                                                          black currants
______________________________________________________________________________

Aflatoxin B-1                 CYP 3A4           Curcurmin                   Tumeric root
                                                                Resveratrol (-)             Curry powder
______________________________________________________________________________
Aflatoxin B-1                 CYP 1A2           Resveratrol (+)            Cruciferous veg
                                                                Quercetin (-)                 Green tea
                                                                Curcuminm (-)             Chicory root
 ______________________________________________________________________________

Aflatoxin B-1                 CYP 1B1             Resveratrol (-)            Cruciferous veg
                                                                  Curcumin                   Turmeric root                                                      
Aflatoxin G-1                                             Indole-3-carbinol      Curry powder
Sterigmatocystin
______________________________________________________________________________

Ochratoxin A      Amino acid conjugation  Glycine              Turkey, pork
                                                                            Taurine Chicken
                                                                            Glutamine   Pumpkin seeds
                                                                            Ornithine
Arginine
______________________________________________________________________________

Ochtatoxin A                 Microbial hydrolysis (gut)

______________________________________________________________________________

Alternariol                     Methylation conjugation
______________________________________________________________________________

TABLE II
Detoxification By Organ System

Mycotoxin              Organ System for Detox           Supplemental Support

Ochratoxin A                 Renal (Urinary)                           Renelix
Zearalenone                                                                          Increased fluid intake Citrinin
AFB-1                           
Patulin
______________________________________________________________________________

Ochatoxin A                  Gastroinestinal (Fecal)                  ToxEase GL or caps
Zearalenone Chicory inulin
T-2 Toxin (trichothecene)
AFB-1
DON
______________________________________________________________________________

Ochatoxin A                  Enterohepatic Circulation              Bitters
Zearalenone                                                                              Ox bile
                                                                                                     Globe artichoke
                                                                                                     Phosphatidyl choline
______________________________________________________________________________

Table I and II have not been proofread yet. Thanks for your patience. Any typos will be corrected shortly.