Episode 50: Functional Detoxification with a Traditional Twist

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Welcome to Supplementing Health, a podcast presented by Advanced Orthomolecular Research. We are all about applying evidence based and effective dietary lifestyle and natural health product strategies for your optimal health. In each episode, we will feature very engaging clinicians and experts from the world of functional and naturopathic medicine to help achieve our mission to empower people to lead their best lives naturally.

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[01:45] Cassy Price: Hello friends. Welcome to Supplementing Health. For many of us spring is a season of clearing out the old and making room for the new. So, today I am joined by Amy Petrarca registered nurse, licenced acupuncturist and IFM certified practitioner to discuss the bodies form of spring cleaning more commonly referred to as detoxification. In her practice, Amy creates a structure that integrates her clinical experience from western medicine with her holistic teachings from traditional and functional medicine to help her patients reach their optimal health. Hi Amy, thanks for joining me today.

[02:17] Amy Petrarca: Hey Cassy. Thanks so much having me as your guest.

[02:21] Cassy Price: So, detoxification is a common topic especially come springtime when many of us have the urge to tidy up our lives whether that be within our home or office or our bodies and diet. For those of us that want to focus on our bodies, what are the organs and tissues that they should really be looking at?

[02:38] Amy Petrarca: Well Cassy, that’s an excellent question. Yes, spring cleaning is governed by the elements of wood actually. The liver is the custodian or general of the wood elements. The liver is one of the five organs of detoxification whether you are looking at it through any of these lenses honestly. The other organs to focus on besides the liver are the kidneys, the lungs, the skin and the large intestine.

[03:20] Cassy Price:  And if we focus on the process of detoxification itself, what happens in your body during a detox?

[03:28] Amy Petrarca: Okay, so, the word detoxification is of course a biomedical term because our bodies are always bio-transforming and detoxifying whether we are thinking about it or not. Then there is also the trendy language of “Oh, I am doing a detox.” Those are different things. I do think it is important for people to be aware of that. What is happening with the body in a detoxification process on a cellular level? The cells are getting rid of waste material. So, that happens through membrane permeability. In the liver we need to transform fat soluble substances into water soluble substances in order to have them excreted properly from the body. Then of course, even exhalation. We are exhaling carbon dioxide so cellularly at the level of the alveoli sacs there is a gas that is detoxifying.

[04:37] Cassy Price: As you mentioned, detox diets can be really trendy right now, but there are also some extreme versions out there that aren’t just about eating whole foods and supporting those organs but really trying to flush the body, shall we say. Some people tote them as the next best thing. Can you speak to the concerns that exist around those extreme detox cleanses?

[05:03] Amy Petrarca: Yes, I’d love to. This is a common topic with patients. People often times feel that doing a detox is something that is appealing to them after the holidays, after partying, some people they want to do a detoxification after medication like chemotherapy and things like that. Some of the fads, like when someone says “oh, I’m doing a cleanse. I’m doing a detox” they may or may not be actually beneficial and sometimes they can really be harmful. This is what I try to point out to patients. Our body is doing a great job of detoxification all the time. Most of the time. Sometimes we do have troubles. If a patient has maybe heavy metal toxicity or a mould exposure or something like that or even hormone changes can sometimes gunk up the detoxification pathways, if you will.

[06:15] However, I think the mistakes that people make when they are doing a fad cleanse or detox is that they don’t provide their bodies the actual nutrients that they need to push these enzymatic pathways in the body. Sometimes it causes such a stress that really what they are doing is liberating toxins that are stored in the fats, which our bodies do sometimes store some toxins in the fat or the joints or the bones if we can’t excrete them. Sometimes people will actually mobilize toxins that have been stored and then they have really bad headaches. They say they feel worse when they are doing a cleanse or a detox. It is really because they are not giving their bodies the nutrients they need to actually mobilize and literally flush out these toxins. So, sorry for the long answer Cassy but I do think that there are ways to do a proper detox thoughtfully.

[07:16] Cassy Price: And if people are to do a proper detox and make sure that they are getting the nutrients to support those organs, could anyone benefit from a detox diet or is there certain groups that would be benefitted but others wouldn’t because your natural processes can manage it?

[07:34] Amy Petrarca: That’s also a great question. Yeah, when someone says, “Hey, would I be a good candidate for a detox?” Sometimes they have already researched a particular cleanse or plan that they want to do. There is so much information available now through podcasts and books. Patients are very educated. They often times know what they want. One of the things that a person needs to do is make sure that they are eating clean foods, nutrient dense foods, that will support a cleanse or detox. Also, hydration is key. People have to be properly hydrated. Then things as simple but easily overlooked as stress reduction and getting a good night’s sleep. These can also be really, really, helpful in integrating a successful detox. The other important variable is the length of time. Most people, they want to do a three day cleanse or even a one week cleanse.

[08:54] Those can be more detrimental or more disruptive than doing a longer and slower detox. Start low and go slow is what we say. Some of the best detox programmes are 12 weeks. Even four weeks is better than a three day cleanse for sure. Back to your question, who shouldn’t detox. Of course, everyone is always detoxifying and bio-transforming chemicals and substances in their bodies. Folks that shouldn’t do a cleanse or a detox is someone who has a known body burden of toxins or toxicants. So, if you find out that you have heavy levels of arsenic, cadmium, lead, mercury. These people need to reach out to a trained professional to help them thoughtfully do a detoxification sometimes involving chelation therapy. Other people that would not be a good candidate are folks who aren’t pooping. I tell people, “If you’re not pooping do not do a cleanse or a detox.” Because the colon is one of the organs to move things out and if you’re constipated or you are one of these people that only poops once a week, a cleanse or a detox is not a good idea. 

[10:38] Cassy Price: You had mentioned chelation therapy and it’s obviously a modality used to help with detoxification in very specific cases when you have had toxic element exposure or, like you said, a heavy burden of toxins within the body. Outside of that, what are some of the natural modalities available to help support your detoxification organs that people can consider beyond just lifestyle changes?

[11:05] Amy Petrarca: I think about healthy solutions as lifestyle changes. Of course, as an acupuncturist and herbalist, I integrate these modalities with my patients to assist with detoxification. Acupuncture and herbs can support the natural and healthy flow of chi. I mean the body is very well able to maintain its processes and equilibriums. Sometimes it does need a little boost. I like to sometimes think about acupuncture and herbs as training wheels. They give your body a little bit of a nudge to get back on track and support the natural systems. With acupuncture there are specific channels and specific acupuncture points that can be utilised to support the bodies’ natural ability to detoxify and cleanse. With botanical medicine or herbs there are so many plants that we think about, and foods or spices that we think about, to support. One of my favourite examples is ginger. How we use pickled ginger with sushi and in the Materia Medica, ginger is an herb that is able to reduce toxicity especially of seafood poisoning. That is actually as far as I know the origin of serving pickled ginger with sushi is because it reduced toxicity.

[13:05] Cassy Price: That’s interesting. I never knew that. I always thought it was for a palette cleanser or something.

[13:11] It’s also delicious, right? I mean it’s really delicious but yeah there are so many. Really many herbalists think about herbs and foods and spices as all in the same family. For example, curcumin is a really potent medicine that we…curcuminoids from turmeric root. There is so many benefits from that. If you ask someone is turmeric a spice or a food or an herb, I would really hope for an answer of all of the above.

[13:58] Cassy Price: Yeah, it can be tricky to classify things. Especially when certain components within a plant can be used, like you said, in multiple different ways it starts to muddy those lines. I wanted to step back just for a second. You were mentioning acupuncture and herbs and all of these different modalities that actually fit within traditional Chinese medicine and traditional eastern medicine practices. So, I was wondering if you could speak a little bit about the philosophy behind those practices?

[14:30] Amy Petrarca: Yes, of course, I would be happy to. Most people don’t know that going to acupuncture school to study traditional Chinese medicine is actually the longest master’s programme in the county, in the United States. It is a four year commitment. You really get to learn a lot about the history of Chinese medicine and philosophy. So, I certainly couldn’t hold a candle to my Chinese medicine philosophy teacher, but I’ll do my best. So, this is a 5,000-year-old medicine. The origins of acupuncture and herbology are something that every practitioner studies. What is important is understanding the lens of Chinese medicine. What’s different about Chinese medicine compared to conventional medicine? Well, a similarity would be that we are looking at observation.

[15:33] In Chinese medicine we look at the Earth. We look at the seasons. We pay attention to what is happening to the trees and the ocean and the wind. We talk about the external evils, is how its translated. Then we also look at the person and what is their constitution, right? So, there is several different lenses of not just looking at pathogenic factors and external variables, but it is really important to look at what kind of person gets a certain illness. I think that is really important especially if we get into a conversation about the pandemic. But back to Chinese philosophy. What we are looking at is a balance. A balance of elements, a balance of seasons, a balance of yin-yang. So, there is yin-yang theory is a very important theory in Chinese medicine. Also, we have size-element theory. I mentioned briefly that springtime belongs to wood elements. We have wood elements, water, fire, metal and earth. All of these are just a way to explain relationships to systems and organs in the body.

[17:02] I explain to people the reason that Chinese medicine practitioners talk about liver fire kidney deficiency and things like that. This is just a language that we use to talk about pathologies before there were cat-scans. They didn’t have cat-scans 5,000 years ago, so we needed a different language to understand the relationships between these different organs. Then of course there is the vital substances. This is an important part of Chinese philosophy, understanding that we have essence, chi, blood and body fluids usually we study it as what’s called jing. So, there is the body managing these vital substances. Then the other thing that I think is really important when talking about the philosophy of Chinese medicine. Chinese medicine is one of the only medicines that never did what I call the spiritectomy. They never removed the spirit from the person. Actually, focusing on, in Chinese medicine we call it the shong, focusing on the emotion and spiritual wellness of that person is an important concept to integrate in traditional Chinese medicine.

[18:27] Cassy Price: Now you had mentioned some of the herbs that could be used within traditional Chinese medicine but is there kind of a list that if you are going to be supporting your detox organs you should be considering to include in your diet and in your foods or cook with?

[18:42] Amy Petrarca: Yes. Herbs can be a very thoughtful way to support one’s body during a detoxification process. Most people are familiar with milk thistle, let’s say, silymarin is known to support specifically the functions of the liver with detoxification. I also really like to use frankincense or boswellia is another really wonderful herb to support the body. Of course, one of the things that I think is important to mention, whether you are doing Chinese medicine or functional medicine, the same herbs are not going to be right for every single person. Boswellia might be too warming for one person whereas for another person it is really perfect. Not only is the right herb important but also the right dosage. I like to think about herbal medicine as a recipe.

[19:53] Chinese herbalists don’t typically prescribe single herbs. There are some circumstances where that is appropriate, but we tend to put together a decoction or a recipe of herbs that are in a specific balance from the classical text to be in harmony because actually herbs when they are used together have a synergy and can potentiate each other’s benefits and they can even reduce the toxicity of other herbs in the formula. I think that is one of the beautiful things about being a Chinese herbalist is being able to know which herbs you can add. I mentioned earlier ginger, but we also sometimes use liquorish. We use a fruit called da zao. Then there are even sometimes fungal or mushrooms that can be used to decrease toxicity.

[21:12] Cassy Price: Okay, interesting. It makes sense that you would have to use multiple different herbs together. It’s kind of like foods and flavours. You don’t usually just eat one food alone. You try to mix it with other flavours and other textures to get a decadent meal, right? It makes sense you would do a similar sort of process with your herbs. You’re also a functional medicine practitioner which kind of nicely goes hand in hand with traditional Chinese medicine because it is also looking at that root cause and getting to the bottom of the ailment of the symptoms rather than masking them or just treating the symptom itself. So, how do you integrate your western experience into your practice and marry that traditional Chinese medicine experience and knowledge with your functional medicine training?

[22:09] Amy Petrarca: Okay, Cassy that is like hitting the bullseye in darts. That is a great question. It is one of my favourite questions. I think there are not a whole lot of us functional medicine practitioners that have my background. Of course, there are a lot of nurses that are functional medicine practitioners, but I think as an acupuncturist, maybe less than 1% I think are functional medicine certified practitioners are in fact acupuncturists. So, yes. I’ve done a couple of decades in critical care as a charge nurse in emergency departments and tertiary care teaching facilities all over the country which is wonderful. Since I wear many hats, I would say my first hat was being a patient advocate.

[23:12] That is what I feel the nurse is. A fierce patient advocate at that because to work in the emergency department you have to be able to reprioritise quickly, watch for signs and symptoms, use your skillset and really speak out for what that patient might need because you don’t have a diagnosis to work with right away. So, I am fortunate enough that I have been working with patients in a western setting for so long that when I am looking at my patient’s lab work or I am looking at their MRI report, or what have you, I have a lot of experience with being able to integrate those findings and even see what I call the missing labs. What labs are missing? In conventional medicine they are really focused on being able to manage an acute process and treat a disease whereas in functional medicine and Chinese medicine there is a bit of a greater focus on prevention and function. Sometimes we really expand that palette of diagnostics to get a wider lens to really capture some of these more subtle indicators of imbalance in the body.

[24:42] Cassy Price: Awesome. Now you’ve touched on acupuncture a few times throughout our conversation, and I would love to dive a little bit deeper into that modality of treatment just to better understand the ins and outs of it. I was curious. You have mentioned that there are specific acupuncture points within the body to help it to be proficient in its detoxification process. Can you share what some of those points are and why they are important?

[25:11] Amy Petrarca: Yes. I would love to. As much as I love functional medicine and being a detective, I really love being an acupuncturist as well. It’s a beautiful medicine. So, in Chinese medicine and in acupuncture specifically, I touched briefly on these concepts of yin and yang and also the size elements and meridian theory. In Chinese medicine three of the key organs in detoxification belong to metal elements. I think this is really important. Those organs are the lungs, the colon, and the skin. If you think about it these are three really important organs to be able to access and support a proper detoxification. So, why grasshopper, we would say? Why grasshopper does metal have this responsibility? Metal is sharp and cuts things away. We can think about metal as a surgeon’s knife that is skilfully able to remove a malignancy from the body. So, metal has this skilful clarity. We can think about cutting out poisons or toxins, let’s say. So, in acupuncture, often times we will use the metal channel for detoxification support.

[26:51] One of my favourite points on a metal channel is lung 8. Lung 8 is a metal point on the metal channel, so it is what we call a horary point. It is almost like a double metal point. This happens to be a ditch point. Some of the points in Chinese medicine have a translation of being a ditch point or a gutter point and so it is like you imagine cleaning out the gutters. It is literally able to remove toxicity from this channel. I have been using lung 8 a lot, especially in the pandemic, to help support the lungs specifically and the lung channel in clearing toxicity. Another important point that I would like to include with supporting detoxification, I mentioned before about including the spirit and the person’s mind. If their mind or their spirit is in harmony, then things are moving more fluidly.

[28:04] There is a wonderful point on the body called zhu bin and it translates typically as guest house or ghost house. Westerns refer to this point as kidney 9. So, what is this guest house and ghost house about? Well, the guest or the ghost is the spirit. This point is about clearing the body of toxicity or negative energies, so the spirit has a safe and clean place to reside. So, I will credit one of my mentors and teachers, Mary Elizabeth Wakefield, with this one. She called kidney 9 Botox-detox because she always uses it on her patients after they get Botox. It can also be used for patients after chemotherapy. It is incredibly useful for purging negative energy. So, if you ever got into a conversation, like a fight with your boss or an argument with your best friend or even a stranger and you feel kind of like you want to purge that energy, kidney 9 is an excellent choice.

[29:30] Cassy Price: Very cool. So, does acupressure have the same effects as acupuncture and do you use the same points in both treatments?

[29:39] Amy Petrarca:  That’s also a good question. Acupressure and acupuncture are two ways to stimulate chi at certain points or on certain channels. Acupressure is a tool that is more accessible and portable, right? I mean not everybody carries acupuncture needles with them especially if you are not an acupuncturist. Just anyone could learn acupressure. You don’t have to have a licence to do acupressure. So, I think it an easier accessible tool. So, absolutely you can stimulate chi with acupuncture and acupressure. The way that I was talking about the herbs, it is really a recipe, you are not really just choosing just one herb, you want to put together this thoughtful blend of herbs. The same thing as an acupuncturist.

[30:51] You want to put together a thoughtful point prescription as well. It is like a symphony. Maybe I am going to choose lung 8 which happens to be on the arm, and it is a metal point and it is on the yin channel. If I’m choosing kidney 9, that’s on the leg and it is a yin channel. If I really want this point prescription to be in balance. I am going to choose some other points. I am going to choose some points that are yang. I am going to choose some points that are different elements based on what my treatment modality is. So, unlike acupressure, with acupuncture you can actually stimulate several points at the same time, and it creates a synergy and a harmony inside the body so those points actually can communicate together. I think about it like a symphony.

[31:46] Cassy Price: Okay, so it is more holistic in that sense that you get the whole picture all at once rather than individual pieces?

[31:54] Amy Petrarca:  Well, I think they are just really different tools. So, for example if I have a patient that is really suffering with headaches, I can teach her how to use acupressure on her large intestine 4 on the hand and she can easily do that for herself and possibly relieve her pain. Like I said it is a very portable tool. That might be a better tool for her, whereas if you want to help someone with detoxification I think that going to see an acupuncturist and getting a thoughtful integrated point prescription treatment would be superior to acupressure in that case.

[32:47] Cassy Price: Okay, that makes sense for sure. I can see where each piece would make the best difference and be more impactful. So, for acupuncture are there different sizes of needles used in treatment depending on location or depending on what the ailment is that you are trying to address?

[33:08] Amy Petrarca:  Yeah. That’s a great question as well. Many patients, especially those that are acupuncture naïve would like to know some information about these needles. I have this wish that acupuncture needles were actually called acupuncture implements because so many people are needle phobic and they associate needles with hypodermic needles and the gauge, when you are talking about a needle gauge, that’s a size but it has to do with the circumference. So, hypodermic needles are the same gauge as acupuncture needles however with hypodermic needles we are using needles like a 21 gauge, a 23 gauge, maybe a 25 gauge to get an injection to a child or something like that. People don’t like those needles because they hurt. With acupuncture we have gauges 40, 38, 36. The higher the number the smaller the circumference. It is a much thinner needle, and they are about the width of human hair.

[34:33] In fact, they are pretty wimpy. It is almost like a little wet noodle. The first time I saw an acupuncture needle I said “Do your best, you are not going to hurt me with that thing. That thing is tiny.” So, the first answer to the question is that the gauge is different and is much thinner. Then you want to look at the length of the needle. Acupuncture needles vary from a few millimetres in length to I think some acupuncture needles are in excess of three inches long, some are probably five inches long. So, you are choosing the gauge and you are choosing the length based on the point that you are going to needle and that person’s body.

[35:28] So, everyone in the state of California, had to sit for the California acupuncture licencing exam and be able to answer questions about needling depth and technique for every point. For example, zhongfu lung 1 is needled obliquely lateral, I think it is 0.7 to 1.21 which is a measurement we use in Chinese medicine that we call a body inch. So, really the insertion and the depth and the angle and the technique that you use is different for each and every acupuncture point on the body and licenced acupuncturists have to memorise all of those details to be able to pass the state board exam and practice acupuncture in the state of California.

[36:30] Cassy Price: I remember the first time I had acupuncture and that sensation. You’re fully ready for a needle prick in the sense of when you get an IV or a vaccination but it nothing like that. It is definitely more of I would describe it as a tingly sensation for a lack of a better description. It is almost calming, right? It is a nice tingle on your skin.

[36:56] Amy Petrarca:  It is. I’m so glad that you have had that experience Cassy. I am also glad that you are sharing it because there are so many people that really have a negative association with it.

[37:09] Cassy Price:  Awesome. Well thank you so much for sharing all this information. I really appreciate it and I think it is a great topic to explore.

[37:15] Amy Petrarca:  Well great yeah, I think so too. It is a beautiful lens to be able to integrate what’s happening throughout the body with functional medicine and with traditional Chinese medicine.

[37:31] Cassy Price:  If any of our listeners wanted to work with you or get a hold of you how could they go about doing that?

[37:35] Amy Petrarca:  Well Cassy, thanks so much for asking that question as well. I am currently operating in San Francisco, California. I have patients who can reach out and give me a call in the U.S. It’s area code 415-846-0963 or you can head to my website which is actually going to be revised very soon so I do apologise to anybody who lands on my antiquated website. It is pretty cutting edge in 2013 but that address is www.biaohealth.com. You can actually click onto my online scheduler and get a complimentary 15 minute consultation with me. It’s been an honour and a privilege to spend this time with you today.

[38:34] Cassy Price: Honestly, it’s been our pleasure. Thank you so much for taking the time to join me today.  

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Thank you for listening to Supplementing Health. For more information about our guests, past shows, and future topics, please visit AOR.ca/podcasts or AOR.us/podcasts. Do you have a topic you want us to cover? We invite you to engage with us on social media to request a future topic or email us at marketing@aor.ca. We hope you tune in again next week to learn more about supplementing your health.

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