II. Reduction of Bioaccumulated Compounds

While we still do not fully understand the bio-active mechanisms or the kinetics of many toxic substances, physicians have known for centuries that health problems can ensue as a result of accumulations of xenobiotics (foreign chemicals) and have looked for ways to safely and effectively reduce body burdens.

Ramazzini, in his 1713 work, Diseases of Workers, notes that writers of works on poisons at that time "advise, in general, remedies that have the power of setting the spirits and blood mass in motion and of provoking sweat" (12), a recommendation which aligns well with current knowledge of the kinetics and metabolism of foreign compounds.

Approaches to handling bioaccumulation of harmful chemicals depend on increasing the rate of removal of these compounds. This is accomplished by either altering the compound to a non-toxic form or by enhancing the rate of elimination.

This philosophy has been applied in many ways. In acute poisoning, purging is a key means of removing the toxic compound before adverse effects arise. For this reason, a strong purgative is included in the highly toxic pesticide, paraquat.

Ingestion of compounds known to bind to the contaminating compound has been used in some cases. This increases the rate of removal of the toxic compound because it cannot be reabsorbed as it passes through the intestine. In this manner, cholestyramine was successfully used to reduce levels of Kepone (13), and Prussian blue was used to reduce levels of radioactive Cesium (14).

A fasting technique has been used to enhance the mobilization of fat-stored compounds. This approach resulted in improved symptoms in 16 PCB-exposed Taiwanese patients (15), although the levels of PCBs in the blood of these patients increased.

Ethylenediaminetetraacetate (EDTA) has been used for many years in the treatment of lead toxicity. EDTA binds to lead and other compounds in the blood, the resultant complex then being eliminated. (16,17)

Reduction of fat-stored chemicals must be aimed at mobilizing chemicals from fat stores, distributing the mobilized chemical to routes of elimination, and increasing the rate at which these routes are utilized. This is the design behind the detoxification procedure developed by Hubbard.