What do Naturopathic Doctors do to Treat Toxic Exposure?

What is Environmental Medicine?

Environmental medicine (EM) is a relatively new branch of medicine that explores how the environment interacts with the human body – especially the physical, mental, and emotional responses to environmental factors. Environmental medicine dovetails with other branches of medicine including toxicology, industrial medicine, and public health. EM uses a holistic, systems-wide based model to evaluate how various toxins, pollutants, chemicals, and microbes may be compromising the body.

Those working in environmental medicine leverage the concept of cumulative toxic load – low-level exposure and interaction with various substances in food, water, air, homes, and communities – over time that may compromise fundamental systems which maintain overall wellness and support healthy aging. This field explores the link between the environment and the documented rise in chronic illnesses like cancer, metabolic, neurological, and endocrine disorders. 

Where do toxins come from?

In the age of industrialization and modern society, pollutants, chemicals, and toxins are commonly encountered in daily life and range from pollutants that come through the atmosphere to packaging and consumed food. Several examples of chemicals and pollutants are listed below.

FoodPersistent organic pollutants (POPs)
Organophosphates (OCPs)
Pesticides: various herbicides, glyphosate
Xenobiotics: plastics, bisphenol A (BPA)
Metals: Aluminum, arsenic, cadmium, mercury
Alcohol
WaterMicroorganisms
Disinfectants: Chlorine
Metals: Lead
Organic Chemicals 
AirMold Mycotoxins
Polycyclic aromatic hydrocarbons (PAHs)
Perfluorocarbons (PFCs)
Volatile organic compounds (VOCs)
Particulate matter
Ozone
Carbon monoxide
Sulfur and nitrogen oxides
ProductsParabens
Phthalates
Metals: aluminum

Naturopathic doctors understand that no two people are alike due to genetic biochemical individuality. Based on this principle and utilizing a patient-centered approach, naturopathic doctors evaluate how each person’s environmental exposure may be influencing their foundations of health. In addition to toxic load, an ND evaluates genetic variations, nutrient deficiencies, stressors, dietary choices, microbiome status, vitality, and associated conditions that may influence how a patient responds to toxins.     

Given that chronic illness is typically caused by many factors, it is important to identify which toxins or elements in the environment are interacting within the body. Many of the above-named chemicals have a direct effect on a variety of tissues, leading to a potential cycle of oxidative stress inflammation. A number of environmental toxins have also been associated with endocrine disruption.  Research to date alludes to the inflammation as the key driver of metabolic, neurologic, endocrine, and cellular malfunction leading to a rise in obesity, neurodegenerative disease, autoimmune conditions, reproductive disorders, and cancer.

How do naturopathic doctors evaluate a patient who has many symptoms of toxic exposure?

While assessing if the environment is contributing or causing a specific illness, a naturopathic doctor (ND) begins with a thorough case history, sometimes using a comprehensive environment – a targeted questionnaire that helps identify signs of toxic overload. Several questions are asked to help identify what chemicals are involved in the timing of exposure is consistent with symptom development, and what systems in the body are compromised by the possible exposure. For example, if a patient began complaining of an increase in allergies, brain fog, headaches, and skin rashes upon moving into an old modular home located in a humid area, a naturopathic doctor may be suspecting mold contamination and compromised lung, immune, and neurological function.

In addition, there are various specialty laboratory tests available to practitioners. To identify toxic load, advanced laboratory testing may be necessary, including serum or urine testing, which assesses for metals, mold derivatives, solvent metabolites, and organophosphate metabolism. To work up specific systems implicated by environmental exposure, a doctor may explore microbiome testing, hormone testing, organic acid testing, micronutrient panels, genetic panels, and oxidative stress markers before implementing a targeted treatment plan.

What treatments are available in environmental medicine?

Naturopathic doctors work through the therapeutic order while treating patients. Given environmental medicine can be so complex and multi-modal, the primary factor in treatment is to identify the source and remove it. Avoidance alone can make a notable difference in a patient’s symptoms. Next, targeted therapeutics depends on the individual’s genetic make-up, biochemical, and metabolic needs. Treatment may include:

Supporting functional genetics with added vitamins, nutraceuticals, and lifestyle changes.

  • Certain genetic variations in our detoxification pathways have been shown to require added support in their function with specific minerals or stimulation through botanicals that influence antioxidants.
  • Single Nucleotide Polymorphisms (SNPs) are also continuously being transcribed through our DNA, and new research has found that moderate exercise is capable of controlling the genetic expression of unfavorable genes.

Supporting liver detoxification with botanicals, protein, and vitamins.

  • Phase 1 and phase 2 detoxification require a broad series of B vitamins, bioflavonoids, sulfur metabolites, protein, and fat-soluble vitamins.
  • Botanicals such as milk thistle have been shown in various clinical studies to increase cellular glutathione, the body’s primary antioxidant, in addition to strengthening antioxidant defense systems.
  • Dietary modification including the increase of cruciferous vegetables such as Brussels sprouts, broccoli, and kale.
  •  Increasing system-wide antioxidants with green tea, N-acetyl cysteine, anthocyanins, polyphenols, and citrus bioflavonoids.

Supporting elimination pathways through the gut and skin.

  • Stimulating the liver in detoxification can become troublesome without focusing on elimination pathways, so optimizing bowel and kidney function is key to a successful detoxification program.
  • Focus on adequate water intake for proper kidney elimination may be recommended along with therapeutics that address overall gut health such as colonics, castor oil packs, and/ or high fiber diets.
  • Sauna/infrared saunas are found to stimulate detoxification and clearance of toxic metals through the skin.

Facilitating environmental change in the home.     

  • Water filtration systems for drinking and shower water.
  • Air purification filters (such as HVAC or house plants), especially for those in urban areas.
  • Reduction in carpet surface area. Carpets are known to store various pollutants from the air in homes.
  • Clean paint to prevent lead off-gases from being absorbed through the respiratory tract.

Preventing other toxic exposures from impacting the body in the future.

  • Strengthening the microbiome with broad-spectrum probiotics, fermented foods, and stress modification.
  • Improving the gut epithelial lining with proteins and minerals such as glutamine or zinc carnosine, which are shown to maintain a healthy inflammatory response, support the gut immune system, and prevent “leaky gut.”
  • Exchanging personal and household care products to be paraben and phthalate free.
  • Opting for organic, cleanly washed produce and either wild caught or grass fed, hormone free meat/fish.

With modern advancements in biotechnology and advanced therapeutics, many naturopathic doctors are trained and specialize in and promote detoxification in a controlled setting. Such treatments are done under medical supervision.     

As society continues to evolve, the care for nature and our environment is becoming more popular. There are now many ways patients can be proactive about their environment using resources from the Environmental Working Group and understanding the Dirty Dozen, downloading apps like Think Dirty, and following health blogs that educate about DIY tactics for creating a healthy home environment.

While our environment is ever changing and nearly impossible to avoid complete exposure to pollutants, chemicals, and toxins, seeking out the advice of a licensed naturopathic doctor can help you understand the way your body is responding to your environment and lifestyle, and help support your system in order to maintain optimal function and prevent chronic disease.

A service for consumers from the American Association of Naturopathic Physicians (AANP) and the Institute for Natural Medicine (INM). The INM and AANP would like to acknowledge Tess Marshall, ND, for her contributions to the content of this FAQ.

Additional References:

  1. Murray MT, Pizzorno JE. The encyclopedia of natural medicine. Rev. 3rd ed. New York: Atria Books; 2012. x, 1219 p. p. 109-130.
  2. Pizzorno JE. Total wellness: improve your health by understanding the body’s healing systems. Rocklin, CA: Prima Publishing; 1996. xi, 419 p. p. 87-162. Crinnion W, Pizzorno JE. Clinical environmental medicine: identification and natural treatment of diseases caused by common pollutants. St. Louis, Missouri: Elsevier Inc.; 2019. p. p.
  3. Bijlsma N, Cohen MM. Expert clinician’s perspectives on environmental medicine and toxicant assessment in clinical practice. Environ Health Prev Med. 2018;23(1):19.
  4. Nasri H, Baradaran A, Shirzad H, Rafieian-Kopaei M. New concepts in nutraceuticals as alternative for pharmaceuticals. Int J Prev Med. 2014;5(12):1487-1499.
  5. Herr C, Otterbach I, Nowak D, Hornberg C, Eikmann T, Wiesmuller GA. Clinical environmental medicine. Dtsch Arztebl Int. 2008;105(30):523-531.
  6. Lampe JW. Diet, genetic polymorphisms, detoxification, and health risks. Altern Ther Health Med. 2007;13(2):S108-111.

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

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Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.