all posts, eczema

“how doctors think” about eczema

assorted doctors tools
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A few weeks ago I finished a book called How Doctors Think by Jerome Groopman and oh boy do I have thoughts. First off I have to say that the book had its fair share of  downer moments because it had a lot of cases of patients with cancer who struggled with doctors to find plans of care that extend their life just a bit more.

But other than that it was full of all kinds of information about different schools of thought that doctors employ to help their patients. Two specific ones it mentioned included the evidence-based and algorithm-based approaches.

With the evidence-based approach, the doctor relies on existing research, especially those that have a large amount of studies behind them. The issue with this approach is that doctors often default to using said heavily-backed solutions without inquiring or considering less numerously-backed ideas. This could become a problem, say if a new drug has tens of studies done on it, all sponsored and paid for by the company that produces the drug, while an alternative medicine or treatment may have great results but only a handful of studies supporting it, In that scenario, it’s almost more of a research field monopoly,  rather that robust results that gives the drug the good reputation, causing the doctors to favorite it more. In relation to eczema, where these ideas can be applied is in understanding how to approach doctors in a way that doesn’t cause them to default to automatically prescribe topical steroids (the long standing, most heavily-researched atopic dermatitis prescription option) as the first line of action.

With the algorithm-style approach, the doctor can follow a flowchart style of logic that’s been proven relatively effective over time. Its basically like having a graph that has arrows from each option to a few subsequent options, like:

“Does the patient have X cluster of symptoms?

  • Yes = Prescribe drug A.
  • No = Run test 1.

Is test 1 positive?

  • Yes = Give drug B.
  • No = Run test 2.”

And so on, and so forth. The flaw with this approach is that it doesn’t allow the doctor to think outside the box, which Groopman argues can result in said doctor trying to fit a patient nicely into an existing “flowchart” result, even if there are some signs or symptoms that don’t quite match up with that diagnosis. This may be the case when someone has other co-morbidities too or when someone has common symptoms of two very different diseases (like this example of a woman who was using topical steroids and found out she had lymphoma). For this problem it can be useful to ask the doctor what are the best and worst case scenarios of diseases that fit the presentation of symptoms. Asking this can help a doctor think beyond their initial conclusion and more thoroughly work to rule-out other options.

Another significant point the author makes is that for doctors to really become better, they must remember their mistakes and use that vulnerability to inform their care. He gives examples of renowned doctors who literally have binderfuls of their mistakes that they reference to maintain humbleness and act as a forcing function to always push themselves to improve. This might be a more difficult conversation to have with your doctor as I imagine no doctor enjoys being asked, “so let’s talk about all the times you royally effed up with patients”.

One last subject the book addresses that I’ll bring up is the pressure doctors implicitly face when they accept any form of samples or gifts from big pharma companies. It’s not that all pharma-marketed medicines are bad, but that you want your doctors’ reasons for choosing a specific product to come from no other influence than that they believe it works and have seen that said products have good efficacy. This is why it can be hard to decide whether or not to use samples a doctor gives you as you don’t know that they really think it works or if they just happen to have them around from a sales pitch. A question to ask in this case might be “have you seen a lot of positive outcomes from use of X product?” Another way to foray into this territory with a doctor is to ask about long-term results, as well as what are any known side effects (this could apply to eczema-related products like topical steroids to non-steroidal creams or biologics or brand-name moisturizers). If something sounds too good to be true, it’s probably fairly new to the market and so the longevity of effects haven’t been tested. A further question to ask is if there are any cheaper off-brand equivalents because those usually only come out after something has been on the market for a while.

These are just a few of the points that the book made, that I’ve tried to connect back to how to talk with your dermatologist about eczema. There are more factors involved that could make the process more convoluted or impossible in some instances, but I do think these provide a light foundation to attempt to build a stronger relationship with the right doctor.

Speaking of the right doctor, I have an older post that goes more into making sure you feel comfortable and that you have a good rapport with your doctor, which was another huge point Groopman made in the book. He explained that a patient who is difficult to treat, simply by having complex issues that don’t respond to more common treatments, often ends up being resented by the doctors, and as a result gets worser care. The suggestions in the book for overcoming these kinds of doctor-patient relationship issues is to say something like, “I know my condition is difficult” or “I feel like we got off to the wrong start” to help try to make the doctor aware of their negative emotional bias.

On the flip side, a patient that the doctor likes too much may also get worse care if the doctor makes overly sympathetic emotion-based decisions like skipping tests to not inconvenience the patient or by avoiding procedures that may cause the patient pain, etc. To overcome this issue, it can be as simple as saying “please treat me like you would a patient you knew nothing about”, and hopefully that should provoke the doctor into making sure they’re as analytical and diagnostic as possible again.

I’d love to hear about any particular experiences you’ve had with your dermatologists in the comments, and whether or not you agree with my suggestions, and also from any doctors out there reading this.

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all posts, miscellaneous

thankful for eczema?

art birds business card
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Happy late Thanksgiving!! Though I thought about doing a post earlier in the day, I preferred to spend the time loafing around with some of my loved ones, so instead you’ll have to contend with me rambling on about what I’m thankful for during these last few minutes of the day.

First off, what I am most thankful for is my family and friends (who are essentially non-blood family). I love their colorful personalities and wouldn’t turn back the clock and try to change any moment in my life if it was at the risk of not having all my people here in my life. Now with that clarified, it’s onto explaining the title of the post.

Though it is currently driving me to take a daily bleach baths and use antihistamines, in some ways I do find myself thankful for having had to experience eczema. That statement alone may seem crazy given how much my skin drives me nuts, but not as mich when I de-focus my minute experiences and look deeper as to where my eczema journey as a whole is leading me.

Because in actuality what it has led to is me here in this moment thinking long-term about:

  • what plan of action to take next with my skin (when I’m done breastfeeding Fi)
  • if Jake and I will want another biological baby one day (a thought we ponder given that many newer treatments that target genes and whatnot have not been tested for long term effects), and
  • on all manner of futuristic positivity (like “this flare will pass”, “I can use this time to really focus on writing and on building up my women’s health knowledge for future career directions”).

I continue to find myself thirsty for knowledge, and subsequently scouring the world for new research studies done, as well as comparing and contrasting the results to better inform myself about options available, which I then use to create a skin plan (post on that coming soon).

But what in particular am I thankful for that eczema has “given” me? Primarily four things:

  1. Perspective. I have not only learned to be more aware when all systems are go and my skin is more functional, but also that I can understand the limits of various aspects of medicine, understand the desire of people to offer their suggestions for alleviation, and understand that I may never know my specific causes or triggers but I have to learn to deal regardless.
  2. Resilience. This has developed from having to fight for new normalcy without seeing the finish line of my efforts, as well as from having to learn to deal with visibly not looking normal but not always being able to hide away until I feel better.
  3. Flexibility (of mind). I have been forced to change my approaches and my attitude around living with a disease that is still being researched and has no known cause, and
  4. Bravery. I’ve been provoked to be seek out ways to help spread my experience and open up about my life via a medium I always wanted to pursue but was too afraid to previously.

This has been a challenging and weird journey, and continues to be so, but I am getting through as best as I can and finding new side quests along the way that almost make it feel worth it. Speaking of side quests, that reminds me of this meme:

1fl13i

What about eczema or your own battles are you thankful for today (or any day)?

all posts, eczema

“have you tried…?” survival guide

Yesterday was my 27th birthday. Yes, I know it’s not my eleventy-first birthday or anything, but I am going to impart my own bit of wisdom from my meager years of life. Also from November 1st through New Years is Tolkien season for Jake and I, so expect a lot of references.

In these 27 years I have often heard the question “have you tried…?” in regards to moisturizers and supplements and all manner of things that one might think could help me with my eczema. While all good-intended, I think there needs to be a narrowing of the question so that it is focused, and therefore more easily answered.

What I mean by that is, when someone asks, for example: “hey, I noticed your skin; have you tried using coconut oil on it?”, a potential answer on my (or any eczema-living human’s) end could be “have I used coconut oil for what purpose?”

That first clarification requires the questioner to expound upon their thoughts. Are they asking because my skin is dry? Because it’s red? Because it’s itchy? Because they think they have an idea to balance out my skin microbiome and kill potential S. aureus overgrowths? It lets the question receiver have a context to delve into to make the initial question into a conversation.

One misconception about eczema is that it’s just dry skin. If it was just dry skin, yes, using virtually any (nonalcohol-based) product probably would help alleviate the problem. However, eczema is more than its visible crocodilian facsimile. It is an autoimmune disorder, meaning there’s a underlying cause for the external appearance, and so though you can help the condition by addressing the skin issues, the idea of there being a blanket  solution in the form of a single moisturizer ends up feeling a bit naive and potentially frustrating.

So a gentler way to education about the various aspects of living with eczema is to require the questioner to be more concise. If they are thinking “oh your skin is so dry… you should try (insert moisturizer here) to help” then we can get somewhere because we can be like “yes that may help the dryness but I also suffer from other symptoms of eczema like skin sensitivity, and so I can’t use (insert moisturizer here) because my skin reacts poorly to (insert an ingredient)” or answers of that nature.

If someone asks if you’ve tried a product because of your skin’s redness/inflammation, you can respond in kind with “no, I haven’t. How does this product reduce inflammation?” and learn something new. Or you might have the opportunity to respond with “no, I haven’t tried it but I’m working on reducing inflammation via diet right now, eliminating sugar and whatnot and reducing stress”.

In a nutshell, if we can get the questioner to be more precise with why they are recommending the moisturizer (or whatever product type) for, then we have a chance to have a deeper conversation about what we’ve tried and our logic for why we tried it, and also increase everyone’s health literacy, including our own. And you know me and my love of increasing health literacy. 

So speaking of health literacy, here’s a list of common eczema symptoms that can be inserted into the question receiver’s responses to help figure out what the questioner is trying to address:

  • dry skin
  • flaky skin/peeling
  • redness (rashes)
  • inflammation
  • skin heating/flushing
  • itch (of course)
  • fissures/skin cracking
  • wrinkles
  • bumps/acne (often due to scratching)
  • excessive palmar lines (a fortune-teller’s nightmare) indicating a lack of filaggrin protein
  • sores
  • weeping (usually from the open sores)
  • insomnia
  • infection risk (again from scratching, but also just from having a compromised skin barrier)

And with that short post out of my head, I’m now off to enjoy my birthday week (as I spent the actual birthday day driving in the car 8ish hours to visit my parents).

Catch me off blasting my parent’s retro speakers and dancing around the house like:

And/or probably heading out to enjoy yet another of the Harry Potter world movies, Fantastic Beasts: The Crimes of Grindelwald. Can I just say how much I love that they come out around my birthday time, and have been since I was in second grade?

I’ll be the one sitting in the theater all giddy like:

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insomnia nights: fighting imaginary battles

Photo from wiki

Since I get insomnia a lot and end up writing a lot of blog posts between 1 and 4am, I figured I’d start a series called “insomnia nights” which will feature the weird places my mind goes during my nighttime forays. Now, with that established, let’s begin the most recent compilation of thoughts.

Sometimes I worry that Fiona will get eczema. It’s not that I worry inherently because eczema is this horrible life sentence or anything, but I worry that she’ll get pulled into a world of quick-fix medications and will end up down the road looking and feeling like me. She’s got such lovely baby skin (minus the occasional acne… did you know that babies get acne?!), that I just want to make sure she gets half a chance to keep it. 

Now this fear is also blatantly ignoring all the progress that is developing in the eczema treatment world. Like not all doctors (just all the ones I’ve seen) push steroids as their first line of defense. And naturally I would push back at anyone that tried to get me to slather creamy crack on an infant (is a 5 month old baby still considered an infant?). But at the same time, it would be nice if I didn’t have to prep for a fight.

But as neither of these things has happened yet (Fi getting eczema or me fighting her future dermatologists for less reactionary medicines), essentially this post is all about me and my imaginary battles. It’s good to know I am firmly rooted in reality in my day to day (or should I say night to night) insomnia life.

Continuing on about imaginary battles, I have a really weird way of going about reading books. I still have a library pile that has looming due date deadlines that I hope to meet, but I am being slowed by the amount of health-related books I got that I just can’t get myself to chug through. There are certain styles of writing that I really enjoy consuming, but lately all the books I’ve gotten in the health-esque field are not of that style. They are often overly repetitive, which drives me nuts. If I have to read page after page where you are going to say the same thing, I should just commit to the first paragraph of each chapter and move on! But of course I can’t actually do that; I pigheadedly must finish them thus, there we have the the “imaginary battle” bit.

At the moment I am stuck with this one book on obesity, but have started seeing another book on the side. Yes, I know that’s cheating but I need to find some pleasure in reading here! I just finished this book called Worlds of Childhood: The Art and Craft of Writing for Children, and it features the commentary of six children’s authors who talk about why they write, how they got into writing about said book topics, and just generally gives a taste of their process and their mentalities. It’s AWESOME. It’s quite inspiring and makes me want to write children’s books but I’ll table that idea for another day because lord knows I am already too easily inspired by what I read.

Also the power went off last night. I know this because Fi woke me up during the outage and then I had to make sure to put her in more layers as we didn’t know how long the heat would be off. That thought then made me realize I may not be able to take a bath/shower when I got up, which was a terrifying thought. I rely on such morning methods to help remove the newest skin exoskeleton I have acquired over night and to help wet the skin so applying moisturizer does something besides lotion-coat dead skin. It’s crazy how much eczema requires me to be dependent. I need central heat control and access to hot water plumbing and places to curl up in a ball from insomnia exhaustion. Not to mention the large amount of products I try out and go through. So then I had to plan out my battle strategy for having no shower/bath, which basically came down to me asking Jake if he thoughts power would be back on by the time I “woke up”.

Speaking of products, as my hands have been cracking quite badly overnight, I decided to try out liquid bandaids (because regular ones won’t adhere to my dry skin, and they certainly can’t stick to my skin if I’m covered in moisturizer). So there I am trying out these bandaids and oh my frick do they burn. I mean they smell like acetone (think nail polish remover), so I don’t know why I’m surprised, but holy hellabore they are not fun to apply. They basically act like glue and pull the skin back together, which is great, save for the fact that most of the cuts are on my knuckles, so bending my fingers pops the glue seal. Oh well. At least I felt a little less dried out today (…or yesterday. Time is a relative thing when you insomnia blog but don’t post actually get around to posting anything until a day or two later). If these liquid bandaids lead to great healing, well then the momentary application pain is worth it. I can firmly say, having continued this post the next night, that the bandaids did not lead to great healing. Oh well.

Well here I am again writing at 2am. Fi woke up to feed around 1am and now my mind is still trudging along. It’s not randomly snowing tonight so instead of having that magical snow-covered lightness about the world, I’m over here like this guinea pig (on the right). That video cracks Jake up every time. In fact I’ll know if he reads my post tomorrow because I’ll hear hysterical laughter-induced coughing if so. No pressure, Jake. I’ll just be low-key waiting for that as proof that you read my posts. 

Anyway tonight I’m trying an experiment where I just keep on re-applying moisturizer whenever Fi wakes me up, especially to my hands. So far my hands do feel softer, but it’s not stopping them from drying the evergreen out, or from the skin of my knuckles cracking like the grand canyon did long ago. But I’ll persevere and assess the progress in the morning. Later morning I mean. Until then I’ll continue to battle my overnight fissuring skin tendencies. It’s me versus moisture-loss.  Who will win? Place your bets in the comments below! 

 

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cultivating simple pleasures

pexels-photo-92612.jpeg
Photo by Matthias Zomer on Pexels.com

Today’s post is silly and short.

I remember the reoccurring theme in the French movie Amélie when the narrator tells us what each of the characters likes and dislikes. Because the protagonist Amélie grew up with no friends, she was said to have learned to cultivate an appreciation for the finer things in life, like collecting smooth stones for skipping, sliding her fingers into large burlap sacks of dried beans, and cracking freshly made crème brulée.

Well I too have devised my own version of weirdly satisfying simple pleasures for one living with eczema that I will share with you all so you can all be tantalized by these delicious (and mostly improbable) thoughts. Sorry if some of them are gross; I have a weird mind.

And so, without further ado, my current running list of cultivated simple eczema pleasures:

  • Dipping eczema flaky feet into those ponds of fish that lightly nibble dead skin.
  • Getting Elmer’s white glue all over the top of the hands and then pulling off the dried result (like we did as kids to our palms), and watching the dead skin pieces go with it.
  • Getting a Korean exfoliation skin massage and watching the bits of skin slew off (if this didn’t entail probably wrecking eczema-afflicted skin).
  • Having a lint roller for dead skin that can just roll the excess skin away.
  • Going into a mud bath equivalent of what was in the movie Spirited Away, and coming out all silky smooth as the mud deeply moisturized the skin cracks.

Then I have ideas for all these even more so crazy impossible scenarios, like a skin cheese peeler that only goes as deep as the dead cells and doesn’t hurt any new skin growth, and other weird things like that.

Clearly I’m feeling flaky these days. I’ve started to identify the fall season time as being when I identify most with a bear. I alternate between just wanting to roll up in blankets and hibernate for months and wanting to emerge to rub my itchy body on trees.

pole-dancing-bear.gif

Yeah, that’s me in a nutshell. Bears get me.

all posts, miscellaneous

sometimes i personify my eczema

pexels-photo-987585.jpeg
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When I haven’t had a real flare in a while (flare in my case depicted by aggressive heating up randomly due to pressure or any prolonged skin contact, or when my skin develops a hot red undertone color), its timely arrival always knocks me down a few notches. Sometimes I liken my eczema to being some kind of monster that continues to hunt me movie after movie sequel, or I hear its irritating voice cutting through a crowd. This most recent flare comes across like a socially unaware drunk, and I like to lighten my mood by pretending it would act like Sheldon from The Big Bang Theory:

tenor.gif

Ugh. At any rate, I’m taking it day by day, and the good news is when I do fall asleep (and Fiona doesn’t wake me up) I can really sleep, thankfully. It’s strange, I don’t really remember what it’s like to naturally wake up anymore. In the immortal words of country singer Thomas Rhett, “ain’t it funny how life changes”.

But, when I am first in bed, sandwiched between the time before I can succumb to the depths of the dream world and the time before Fi wakes me up again, my head is filled with thoughts that I have to process.

It’s during this time that I find that I tend to blame myself for my flares. I’ll think back to things I ate and worriedly wonder if it was sunflower oil in the crackers causing me to develop a sensitivity to my moisturizers that have sunflower in them. Or I’ll berade myself because I had the fruit covered in dark chocolate. I’ll panic that I’m secretly allergic (but not anaphylaxically) to almonds and just never knew, or that it’s because I had too many calories and ate too many legumes and so I slugged my digestive system down and now I am paying the price. Or maybe I had a Polar Seltzer and who knows what those natural flavors are made of! Or I had a probiotic drink and maybe it was the wrong kind of probiotics. What if it was the coconut!? At any rate, the result is always the same, fearing food and feeling blue about myself.

This type of stress gets compounded by my clingy eczema, as it lingers over me constantly reminding me that there is a cause to each flare-up, so what was it this time? I also find that I scratch my hands a lot more at night from a combination of the heating up moments laying under the blankets along with the constant drying out (and literally nothing keeps the moisture in at this stage!).

What I’ve learned is that when I get super tired in the middle of the night, as I’m pawing away at my paws, I tend to have thoughts zoom around my head that make no sense but seem so logical in the moment. If I just scratch here then you know that assignment will get done. And random nonsensical thoughts like that. I honestly have no idea what I’m talking about when I wake up in the morning and looking at my picked scabs and scratch marks.

When I do have some skin healing downtime, I like to map out how I’ll treat myself later. I know it’s a pretty divisive option, but I love tattoos. I think there is something about knowing my skin gets all wrinkly and cracked and flaky that makes me not have those “well imagine how bad it will look when you are old and wrinkly” thoughts. I’m already wrinkly, and age has nothing to do with it. Me and this cat are basically identical:

giphy

At any rate, I like to find cleared spots and think about what kind of tattoo I would get there. Lately I’ve been thinking about lotuses. They have a lot of symbolism for women’s health which I really like. That and I really want to get a tattoo of a open book at some point. Generally I like dreaming this up a lot more than I actually execute action, but who knows what will happen after this flare passes.

 

 

all posts, eczema, nutrition

do you detox? (or fast? or supplement?)

sliced lemons
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“Hello darkness my old friend”… today’s post was started during the witching hours of the night, not because of insomnia (yay, progress!) but because of Fi-somnia… aka my 4.5 month old baby, Fiona. She’s a much cuter reason to have a disturbed REM cycle.

Anyway let’s talk about the health elephant in the room: detoxing. I have heard more and more talk about various detoxification methods and I am just not sure what it all means, so today’s post is about clearing my system (pun intended) of these questions.

First off, what are the theories around detoxification? One theory I have heard for those who have eczema goes as followed: our organs (specifically the liver and kidneys) become over-taxed by our modern diets and exposure to heavy metals and other toxins, and at some point it becomes all too much and our bodies cannot flush-out said toxins, so instead, the build-up of toxins show off their toxic love by wrecking our skin.

Now going by that theory, let’s quickly delve into the soup to nuts details of how detoxification works in the body in general by addressing (very quickly) specific organs.

  • Liver: works by changing toxins into less harmful substances and/or helping the body flush out toxins
  • Kidneys: remove waste and acid build-ups from blood into our urine to be flushed out of the body
  • Intestines: helps to remove toxins via waste or vomit
  • Lymph system: transports its white blood cells throughout the body
  • Respiratory tract: the lungs remove gases from our bodies
  • Skin: (when intact) prevents some toxins from penetrating into the body

So from there, let’s address some specific detox methods I’ve heard about including the watermelon detox, the lemon detox, etc. My internet researching first led me to a review done in 2014, which reported that there wasn’t much evidence to show that detox diets actually work. It indicated that studies that said otherwise usually had flaws in their methods or too few people tested (aka small sample sizes, which is a problem because then you can’t reasonably assume the results will work for a much larger group).

I then looked more for studies, but before I talk about them, let’s backtrack and talk about studies that investigated how detoxification naturally works in the human body (and/or animal bodies). First I wanted to figure out what organs have been studied to hold toxins. A study done in 2007 on African catfish showed how the livers, kidneys, and hearts of the fish ended up storing high concentrations of heavy metals (zinc, lead, arsenite, cadmium, and copper) presumably from pollution entering the water nearby. I’m not sure if the same organs are seen to hold toxins in the case with humans, but given how often we hear livers talked about in the same sentence as detox diets, I’d venture to say yes. I then actually looked up via the CDC, about organs and toxic exposures for humans, and apparently all organs can be affected. Well then, how do our bodies avoid full spectrum toxicity?

Well, bodies have some ability to create compounds out of heavy metals, to bind them chemically to make them less dangerous to the body (which is the function of the liver, remember?), as was supported in a study in 2004 on seals, porpoises, and albatross. Generally heavy metals can end up in cells in the body: in the cell’s fluid, mitochondria, nucleus, etc (in the case of the study, they were talking about liver cells). But how specifically do bodies deal with heavy metals; or in other words, what gets the liver to start neutralizing these toxins? A study done in 2004 on mice looked at something called the metal responsive transcription factor 1 (or MTF-1)Side note: a transcription factor is a protein that helps turn on/off genes. The study’s results showed that a developing fetus that lacks Mtf1 (the gene that MTF-1 can turn on/off) will die because its liver won’t be able to form properly, but an adult that lacks Mtf1 will have difficulty handling heavy metals and will have low lymphocytes (the cells that help clear bad germs and materials out of our blood). This MTF-1 also is used to deal with when the body has hypoxia (not enough oxygen) or oxidative stress (too many free radicals in the body). What this all means is that our liver is able to function properly because it has this protein that turns on whatever genes are needed to get the liver to deal with toxins (metals and free radicals).

Now let me also quickly talk about oxidative stress, which is important to note because heavy metals can cause oxidative stress. That may be why and where the idea of some detox diets came from: if you want to detox from free radicals in the body, doesn’t it seem logical to consume antioxidant-rich foods and nothing else for a few days to cleanse? And what foods are known to have good supplies of antioxidants? Watermelons, lemons, and many fruits and vegetables that we see juiced into detox juices. So using that line of thinking I now move on to trying to better understand the support behind specific cleanses.

First I searched for the lemon detox. There’s a study that was done in 2015 on overweight Korean women that tested the lemon detox drink (a lemon, maple syrup, and palm syrup combo) versus a placebo drink versus a normal diet for 7 days followed by 4 days of food transition. According to the abstract of the study (which was all I could access freely) both the placebo and lemon drink resulted in improved BMI, body weight and body fat, as a well as improved serum insulin levels and insulin resistance scores. Hemoglobin and hematocrit levels were unchanged for those on the lemon diet, while a protein called serum high-sensitive C-reactive protein (hs-CRP) was reduced. What I am unsure of, is if the hematocrit and hemoglobin levels were within a normal range to start for the participants (which is important to know because too low indicates issues like anemia/low iron in the blood; too high can be a signal of dehydration among other things). The researchers concluded that going on a lemon drink detox for 7 days improves body fat and insulin resistance. The reasoning behind why however, they said was because the lemon detox drink is low-calorie, so essentially you are just burdening your digestive system less. So it’s more likely the fasting component that helps rather than the lemon drink having a cleansing effect.

What about watermelon? A study done on rats in 2015 indicated that a diet of watermelon helped reduce the effects of laboratory-induced type 1 diabetes. The procedure involved the rats fasting for 24 hours before being injected with a solution (alloxan) to induce diabetes, and then being fed watermelon extracts for a week. The rats given the watermelon extract had improved weights and reduced blood glucose concentrations, among others changes that caused the watermelon-fed rats to more closely resemble the control (healthy) rats, than the diabetic rats.

Thus my overall concluding thoughts on detoxing so far, are that:

  1. If you are consuming fewer calories, innately you are taxing your digestive system less so you’ll have a natural “detox” effect,
  2. With fewer things in your digestive system, the effects of consuming foods that are rich in antioxidants probably does help remove free radicals. It also probably therefore lets your liver bind toxins and your kidneys remove waste more effectively, and
  3. If detoxing is therefore being used synonymously with fasting, then there is a lot of evidence that it works. Fasting has been studied to, when done safely, be beneficial for everything from diabetes and obesity to other autoimmune disorders.

The reason I brought up point number 3 is because there are studies done on lemon juice and other popular detox foods that don’t include fasting, but rather just adding said food to a person’s existing diet. One such study done in 2016 tried such an experiment, by adding lemon juice and garlic to participants diets, and their results included decreased cholesterol, reduced blood pressure, and reduced BMI. In Jason Fung’s book Obesity Code, he mentions how drinking two tablespoons of apple cider vinegar in water before bed helps lower your blood sugar levels while you sleep. So then one can beg the question of, are we seeing improvements to health more so because fasting allows our bodies to “catch up” and get rid of toxins, or because we are lacking nutrients and so when we supplement them we see positive outcomes to our health?

Backtracking for one last comment on juicing and raw vegetable/fruit detoxing. A study done in 2017 looked at the effects of a raw juice diet of 6 drinks a day for 3 days, varying the juices throughout, and saw a lot of positive results in changes to the gut microbiota, increasing microbiome species correlated with weight loss and other aspects. The issue still stands of whether or not it’s the food types themselves that are included in the juices, or the fasting aspect (as one consumes a lot fewer calories when juicing), that provokes said positive results.

Honestly, in my humble opinion, it doesn’t actually matter which answer is correct because if you are safely fasting on occasion (and/or reducing calories), and consuming healthy options with lots of vitamins and minerals while doing so, does it really matter which aspect is to praise for the good results?

Ending note: I hope this was apparent, but, the intention of this post isn’t to target people who do or don’t do detox diets but merely to satisfy my curiosity. I had heard a lot of anecdotal experiences on the matter and so I was curious to hear about the results from more formal studies as well. Whether or not you choose to detox is your own prerogative.

 

REFERENCES

Aslani N, Entezari MH, Askari G, Maghsoudi Z, Maracy MR. Effect of Garlic and Lemon Juice Mixture on Lipid Profile and Some Cardiovascular Risk Factors in People 30-60 Years Old with Moderate Hyperlipidaemia: A Randomized Clinical Trial. Int J Prev Med. 2016; 7: 95.

“Detoxification.” Partnership for Environmental Education and Rural Health, https://peer.tamu.edu/curriculum_modules/OrganSystems/Module_3/index.htm. Accessed 7 Nov 2018.

Farombi EO, Adelowo OA, Ajimoko YR. Biomarkers of Oxidative Stress and Heavy Metal Levels as Indicators of Environmental Pollution in African Cat Fish (Claris gariepinus) from Nigeria Ogun River. Int J Environ Res Public Health. 2007; 4(2): 158-165.

Henning, SM, Yan J, Shao P, Lee R, Huang J, Ly A, Hsu M, Lu Q, Thames G, Heber D, Li Z. Health benefit of vegetable/fruit juice-based diet: Role of microbiome. Scientific Reports. 2017 May 19; 7.

“How does the liver work?” Informed health Online, Institute for Quality and Efficiency in Health Care, https://www.ncbi.nlm.nih.gov/books/NBK279393/. Accessed 6 Nov 2018.

Ikemoto T, Kunito T, Tanaka H, Baba N, Miyazaki N, Tanabe S. Detoxification Mechanism of Heavy Metals in Marine Mammals and Seabirds: Interaction of Selenium with Mercury, Silver, Copper, Zinc, and Cadmium in Liver. Archives of Environmental Contamination and Toxicology. 2004 Sep; 47(3): 402-413.

Kim MJ, Hwang JH, Ko, HJ, Na, HB, Kim JH. Lemon detox diet reduced body fat, insulin resistance, and serum hs-CRP level without hematological changes in overweight Korean women. Nutrition Research. 2015 May; 35(5): 409-420.

Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. Journal of Human Nutrition and Dietetics. 2015 Dec; 28(6): 675-686.

Oseni OA, Odesanmi OE, Oladele FC. Antioxidative and antidiabetic activities of watermelon (Citrullus lanatus) juice on oxidative stress in alloxan-induced diabetic male Wistar albino rats. Niger Med J. 2015 Jul-Aug; 56(4): 272-277.

“Taking an Exposure History: Which Organ Systems Are Affected By Toxic Exposure(s)?” Agency for Toxic Substances & Disease Registry: Environmental Health and Medicine Education, https://www.atsdr.cdc.gov/csem/csem.asp?csem=33&po=6. Accessed 6 Nov 2018.

“Transcription factors.” Khan Academy, https://www.khanacademy.org/science/biology/gene-regulation/gene-regulation-in-eukaryotes/a/eukaryotic-transcription-factors. Accessed 7 Nov 2018.

Wang Y, Wimmer U, Lichtlen P, Inderbitzin D, Stieger B, Meier PJ, Hunziker L, Stallmach T, Forrer R, Rülicke T. Metal-responsive transcription factor-1 (MTF-1) is essential for embryonic liver development and heavy metal detoxification in the adult liver. The FASEB Journal. 2004 Jul 1; 18(10). 

“Your Kidneys & How They Work.” National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work. Accessed 6 Nov 2018.