TOXIC SUBSTANCES AND TREATMENT

PHARMACOLOGY BLOCK OF CHEM 3 MEDICAL SCHOOL UNSOED

Aluminum
Sources: Foods Food additives AlPO4 in processed cheese, Potassium Alum to whiten flour, Sodium silicoaluminate for free-flowing salt Medicines Antacids Aluminum hydroxide Cosmetics Cookware leaching from pots, pans and foil Especially with acid foods (tomatoes, rhubarb) Increased if cooking with flouridated water Smaller amounts than in food additives Methods of Toxicity: May interfere with some magnesium functions May reduce vitamin levels or bind to DNA Associated with weakened gastrointestinal tissue Bind pepsin Astringent May block underarm lymphatics

Aluminum
Symptoms: Acute constipation, nausea, anorexia, colic, gastrointestinal irritation, skin problems Chronic muscle twitching, numbness, paralysis, fatty degeneration of kidney and liver May reduce absorption of Selenium and phosphorous osteomalacia? Alzheimers and Parkinsons disease Hyperactivity and learning disorders in children Amounts: Best measured by hair analysis 10-20ppm High Risk Population: Diets high in refined foods, flours, baked goods, processed cheeses and common table salt Those using antacids, antiperspirants or cook with aluminum foil or kitchenware Treatment: Use chelation therapy (EDTA, desferrioxamine) Support with Calcium, Magnesium and zinc Prevention: Avoid sources

Arsenic
May be functional in humans in small amounts Sources: Small amounts in food - Higher in filtering molusks Environmental toxin from burning fuel oils and coals Weed killers Methods of toxicity: May displace phosphorous and phosphates in some reactions in the body Symptoms of toxicity: Possibly hair loss, dermatitis, diarrhoea, fatigue, headaches, confusion, muscle pains, red and white blood cell problems, neurologic symptoms, and liver and kidney damage. Amounts: 7-10ppm in hair analysis High risk population: Miners, smelters and vineyard workers Treatment: Dimercaprol (given 24 hours after exposure) Can be supported with Vitamin C Prevention: Avoid sources

Cadmium
Sources: Cigarette smoke 1 mcg/cigarette, 70% exhaled Refined foods and root vegetables Water pipes - galvanised Coffee and tea Coal burning Shellfish Ceramics, dental materials, storage batteries Methods of toxicity: Competes with zinc for binding sites May catalyse oxidation reactions Symptoms: Kidney damage (concentrated storage) Hypertension and Kidney stones Cardiac hypertrophy Progressive atherosclerosis Depressed immunity Prostate enlargement Bone deformities Emphysema Anemia

Cadmium
Amounts leading to toxicity: Relative to zinc status 2ppm in hair analysis High risk population: Industrial and metal workers, zinc miners, smokers and passive smokers, coffee and tea drinkers, diets with refined flours and sugars (white rice) Treatment: EDTA chelation High intake of zinc and selenium will prevent further absorption Iron, copper, selenium and C will help elimination Prevention Minimise exposure Ensure adequate zinc levels (15-30mg/day) Strengthen kidney function

Lead
Sources: Batteries Solder Pottery Pigments - cosmetics Gasoline Paint Food grown near industrial areas Methods of toxicity Interferes with calcium, iron, copper, and zinc Interrupts erythrocyte enzymes Inactivates metalloenzymes in brain chemistry Can react with cell membranes Inactivates cysteine-containing enzymes Immunosuppressant May have some affect on gastrointestinal function

Lead
Symptoms of toxicity: Acute headache, fatigue, muscle pains, anorexia, constipation, vomiting, pallor, anemia. Agitation, irritability, restlessness, memory loss, poor coordination, vertigo and depression (lead encephalopathy) Low level affect intelligence, attention span, language and memory. Insomnia and nightmares, hyperactivity and retardation, and senility Amounts: 0-30ppm may be normal High risk population: Anyone working directly with lead Work in zinc or vanadium mining Children better absorption and smaller bodies Pregnant women

Lead
Treatment: EDTA Calcium and vitamin D and C supplementation Cysteine and methionine 250mg twice daily Prevention: Do not exercise along freeways or in heavy traffic Do not allow children to play near busy streets Do not store food in pottery Avoid soldered cans Evaluate for lead levels any questionable substances (ie water)

Mercury
Sources: Fungicides and pesticides Cosmetics antibacterial additive Dental fillings Medicines Coal burning Fish Methods of toxicity: Affects the inherent protein structure Inactivates enzymes Damages cell membranes Immunodepressant May interfere with selenium Symptoms of toxicity: Inhalation Acute fever, chills, coughing, and chest pain Chronic fatigue, headache, insomnia, nervousness, impaired judgement and coordination, emotional lability, loss of sex drive

Mercury
Ingestion fatigue, insomnia, irritability, anorexia, loss of sex drive, headache, forgetfulness or poor memory. Dizziness, tremors, uncoordination, and depression. May cause multiple sclerosis Amounts leading to toxicity: >5ppm hair levels High risk population: Farmers Those with amalgam fillings Treatment: Drinking milk mercury acts on protein in milk Penicillamine (potentially toxic) EDTA Vitamin C, Selenium, pectin and alginates Prevention: Avoiding contact High fibre diet Selenium 100-20mcg

Caffeine

Sources Effects on the Body Benefits Detoxification and Nutrients

Sources of Caffeine
Coffee Tea Chocolate Cocoa Guarana root Some soft drinks Kola nut Diet supplements OTC e.g. NoDoz, Awake

Toxic Effects of Caffeine

Nervousness Anxiety Irritability and Agitation Tremor/shakes Insomnia Depression Headache GIT irritation Bed wetting Heart burn Fatigue and dizziness or irregular heart rate Elevated blood pressure cholesterol Nutritional deficiencies Poor concentration Diarrhoea

Negative Effects of Caffeine

1. 2. 3. 4. 5. 6. 6. 7. 8. 9. 10. Common side effects as before Acid irritant to GIT and liver - hydrochloric acid which can irritate ulcers as well as cause ulcers Diuretic effect loss of potassium, magnesium, calcium, iron, zinc, B vitamins especially B1, vitamin C etc Relaxes the smooth muscle in the colon causing a laxative effect Fibrocystic breast disease & Oesteoporosis Cardiovascular effects - Bp and cholesterol, risk of atherosclerosis and heart disease, heart rhythm disturbance Birth defects and spontaneous abortions risk of certain cancers e.g. Bladder cancer, pancreatic cancer risk of kidney stones Adrenal exhaustion/stress/fatigue/hypoglyceamia syndrome Anxiety and panic disorders

Caffeine Interferes With These Substances

1. 2. 3. 4. 5. Lowers phenylalanine and tyrosine levels Melatonin production Testosterone levels Absorption of calcium, iron, magnesium, potassium. Phosphorous, zinc, vitamin C, B vitamins Depletes biotin, inositol, vitamin A and vitamin B1

Benefits of Caffeine
1. 2. 3. Hypochlorhydria Diuretic effect Improves athletic performance adrenergic effect, vasodilatation, BMR. Optimal level is considered 9mg/kg of body weight. (Careful of banned limit) Can aid weight loss Stimulates brain function alertness and concentration Boosts mood alleviates mind depression Stimulates respiratory system aids asthma sufferers

4. 5.
6. 7.

Bioavailability of Caffeine
Rapidly absorbed when consumed orally from intestines Significant serum levels reached 30-45 mins after ingestion Complete oral ingestion effect occurs in about 90 mins Peak plasma levels occurs in approximately 2 hours Half life = 3-5 5 hours Metabolised by the liver prior to excretion in the kidneys

Detoxification of Caffeine
Slow detoxification is recommended rather than cold turkey to withdrawal effects Aim is to support the detox with a good diet and adrenal support Alkalising the diet is helpful in detoxification Some people start by switching to lower caffeine sources e.g. tea or trying coffee substitutes e.g Eco, dandelion root

Withdrawal symptoms of Caffeine

Nutrient B vitamins Complex Magnesium Calcium Iron Zinc Vitamin C Tyrosine Potassium Dosage 1-2 tabs / day 600mg/day 800mg/day 10-20mg/day 50mg/day 2000-6000mg/day 1000-2000mg/day 600-1000mg/day

Withdrawal Symptoms of Caffeine

Headache Dizziness Cravings Drowsiness Irritability Inability to concentrate Insomnia Runny nose Fatigue Nausea Depression Vomiting Apathy Cramps Constipation Ringing in ears Anxiety Feeling hot and cold Nervousness Tachycardia Shakiness

Tobacco

Toxic effects Interference of Substances Detoxification and Nutrients

Toxic Effects of Tobacco

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. risk of atherosclerosis risk of abnormal blood clotting risk of CVD Can cause cerebral insufficiency risk of hypertension risk of intermittent claudation risk of ischemic heart disease risk of stroke Can cause halitosis Impairs hearing risk of age-related macular degeneration risk of risk of cancers e.g. Lung, cervical, bladder, oesophagus etc Can cause leukoplakia (pre-cancerous lesions in the mouth) number of free radicals risk of oesteoporosis Can impair taste and mental function Can cause coughs, bronchitis and emphysema risk of infertility and genital problems

Tobacco Interferes with these Substances

1. 2. 3. 4. 5. 6. 7. 8. Carotenoids Testosterone Calcium Selenium Vitamin A Vitamin E

fibrinogen levels Can cause cross linking of DNA mutations 9. homocysteine 10. cholesterol

Symptoms Associated with Tobacco

Heart burn Surgical complications Allergies Nutritional deficiencies Angina pectoris Stains on teeth and fingers Hoarseness pregnancy risk Coughs caffeine use Headaches alcohol use Memory loss Higher insurance rates Anxiety Fatigue Lowered immunity Low sexuality Cold hands and feet Leg pains

Cigarettes and Appetite

Cigarettes suppress appetite Interferes with hunger response in brain Supplementation with zinc required especially if they suffer from eating disorders as well

Nutrients and Foods that help Decrease Damage from Cigarettes

1. 2. 3. 4. 5. 6. 7. 8. Arginine inhibits the adhesions of monocytes to the endothelium Cysteine precursor to glutathione which helps prevent damage to the bronchial tubes Selenium counteracts many toxic effects Zinc strengthens the mucus membranes of lungs and boosts levels depleted from tobacco Vitamin A strengthens mucus membranes Vitamin C - oxidation Vitamin E counteracts many toxic effects B vitamins aids nervous system

Withdrawal symptoms of Tobacco

Aggressiveness Anxiety appetite Poor concentration Impatience Insomnia Irritability Cravings

Suggestions for Cessation of Smoking

Cut down on other addictive substances e.g. Caffeine, sugar, alcohol Get a partner or another smoker to stop with them Work on psychological factors first e.g. Dont smoke at the normal times like after dinner so change daily patterns A smoker wont quit unless they definitely really want too Learn stress management techniques Start exercising or exercising more Stay busy to prevent boredom Set small goals along the way Get plenty of rest Keep a positive attitude Find oral substitutes use quitting substitutes When cravings arise, develop a behaviour to counteract them

Alcohol

Toxic effects on the Body What it Interferes with Detoxification Processes Nutrients to assist Detoxification

Alcohol Interferes with:

1. 2. 3. 4. Amino acids SAMe Carbohydrates tolerance to Galactose Carotenoids Enzymes acetylcholine production and fat breakdown Hormones
i. ii. hGH and prolactin melatonin and testosterone

5.
6. 7.

Lipids interferes with the absorption of Cetyl Myristoleate (CMO) Minerals:

i. ii. iii. iv. v. calcium magnesium Excretes potassium selenium zinc Inhibits acetylcholine Reduces GABA receptor sites Inhibits Nitric Oxide Prevents vasopressin release

8.

Neurotransmitters:
i. ii. iii. iv.

Alcohol Interferes with:

9. 10. 11. 12. 13. 14. 15. 16. Organic acids: lactic acid & uric acid Peptides - glutathione Polyphenols - rutin Quinones Second messengers cyclic AMP Sexual hormones - testosterone Micro-organisms: destroys gut bacteria Vitamins decreases/destroys
i. ii. iii. iv. v. vi. vii. viii. ix. x. xi. xii. xiii. xiv. Biotin Choline Folic acid Inositol PABA Vitamin A Vitamin B1 Vitamin B2 Vitamin B6 Vitamin B12 Vitamin C Vitamin D Vitamin E Vitamin K

Sugar Response and Alcohol

There is a theory that involves 3 parts: 1. Reactive blood sugar 2. Low serotonin 3. Low beta endorphins These factors can be seen in alcoholics and siblings of alcoholics. All can lead to cravings for sugar, depression, mood swings and low impulse control.

Sugar can act like a drug addiction Affects same area in brain as heroin and morphine Drug detox increases sugar cravings as it gives them a similar high or feeling fills a gap Withdrawal symptoms blood sugar drops so they crave either the drug (e.g. alcohol) or sugar Biochemistry of sugar sensitivity is very similar to alcoholism

Baby steps Drugs & Sugar

Allow sugar for the first 2 days After 2 days start to the amount of sugar consumed

Suggestions: 1. Frozen yoghurt instead of ice-cream 2. Can still have Milo, drinking chocolate, AktaVite 3. Mineral water or natural cordial instead of soft drink 4. Use raw sugar 5. Helgas white bread, turkish bread, bagels,wholemeal muffins etc 6. No lollies/sweets

Effects of Illegal Drugs on the Body

Teenage Community Drug Abuse

Drug and Demographics 1995 Users % Tobacco males 14-19 Tobacco females 14-19 Regular alcohol male 14-24 Regular alcohol female 14-24 Marijuana male and female 14-24 Barbituates male and female 14-24 Heroin male and female 14-24 Amphetamines male and female 14 - 24 Cocaine male and female 14-24 14.5 13.2 55.1 33.3 32.8 0.1 0.6 5.6 1.8 1998 Users % 16.3 15.8 48.7 34.1 37.9 0.5 1.3 9.8 1.9

Toxic Effects of Amphetamines

Nervous System 1. Depression 2. Excessive stimulation of dopamine D2 receptors 3. Drug dependence 4. A decrease in intelligence 5. Impairs memory Immune System Interferes with thymus gland via norepinephrine deficiency Metabolism Lack of energy, motivation and willpower.

Amphetamines Interfere with:

1. 2. Enzymes - tyrosine Neurotransmitters:
(I) Inhibits dopamine (ii) norepinephrine and vasopressin

3. 4.

Metabolism increases it Nervous system:

(I) Suppresses emotion (ii) Increases alertness temporarily (iii) Used in ADD treatment (iv) Alleviates fatigue temporarily (v) Improves intelligence temporarily (vi) Improves learning, attention span and memory temporarily

Substances that Increase Potency 1. Amino acids tyrosine prolongs life of drug 2. Smart Drugs

Substances Counteracts the toxic Effects 1. Tryptophan counteracts the cravings for amphetamines 2. Tyrosine corrects norepinephrine deficiency

Toxic Effects of Methamphetamine

e.g. Speed more potent effects than amphetamines

Nervous System 1. Depletes dopamine 2. May damage neurons in the brain

Bioavailability Rapidly absorbed. 60% slowly metabolised by liver and excreted via kidneys along with unmetabolised drug.

Toxic effects of Cocaine Cardiovascular System: hypertension

Nervous System 1. Depression 2. Drug dependence 3. Increased dopamine levels 4. A lack of motivation 5. Impairs short term memory Metabolism: Leads to fatigue Interferes with:
1. 2. Hormones: lowers serum testosterone Neurotransmitters: dopamine, vasopressin and norephedrine within the brain but over time depletes them

Toxic Effects of Marijuana

Eyes/Vision Can cause persistent blood shot eyes Immune System 1. Can cause cancer e.g. long term use can cause testicular cancer 2. Suppresses T-lymphocytes Respiratory System Can cause emphysema-like changes in lung Nervous System 1. Anxiety 2. Unpaired coordination 3. Hallucinations 4. Decreased learning abilities Marijuana temporarily and reversibly causes: 1. Short-term memory loss 2. Mental retardation in offspring 3. Paranoia 4. Can trigger or exacerbate psychotic episodes (trigger for schizophrenia)

Toxic Effects of Marijuana

Sexual systems Female: suppresses lactation (prolactin-blocker) Male: Infertility by decreasing sperm count and testosterone

Marijuana interferes with: 1. Hormones testosterone 2. Neurotransmitters suppresses vasopressin 3. Nucleic acids interferes with synthesis of DNA and RNA

Health Benefits of Marijuana

Digestive system can prevent vomiting from chemotherapy Eyes/Eyesight alleviates glaucoma by lowering intraocular eye pressure Nervous system stimulates the appetite, sedates the CNS and alleviates pain by influencing the pain receptors in the brain

Toxic Effects of Ecstacy

1. 2. Excretory system: can cause urinary retention Nervous system: produces amphetamine like feelings of euphoria with fewer hallucinations and less sense of disembodiment. Can cause hyperpyrexia.

Ecstacy Interferes with: Neurotransmitters causes release of large amounts of serotonin so therefore subsequent depletion
Ecstasy. The happiest diet pill on earth?
Romano, J. Muscular Development. 37(12):158-162, 2000

Serotonin levels are significantly lower in animals given the equivalent quantity of ecstasy as that found in one pill of MDMA. This occurs because the cells that produce ecstasy are unable to keep up with demand (as serotonin is released in large amounts by ecstasy). Ecstasy users have fewer serotonin receptors compared to non-users.

Toxic Effects of LSD

Cardiovascular System Increases blood pressure Nervous System 1. Extreme anxiety (temporary) 2. Extreme confusion (temporary) 3. Impairs coordination 4. Potent hallucinations 5. Inhibition of acetylcholine serotonin 6. Temporary panic disorder

LSD interferes with:

Neurotransmitters causes hallucinatory effects by functioning as a general 5-HT antagonist: blocks serotonin receptors, thereby inhibiting its function and allowing acetylcholine to cause excessive stimulation. Also causes release and destruction of vasopressin. Reduces Detrimental Effects: Vitamin B3

Toxic Effects of Inhalants

Long term Effect The most toxic type of drugs that young people can abuse, as it can cause irreversible damage. Nervous System 1. Brain damage resulting in movement disorders and possible intellectual impairment (esp toluene) 2. Peripheral nervous damage: arms and legs trembling uncontrollably, numbness, weakness and muscle paralysis 3. Gasoline toxicity lead poisoning causing dementia and muscle paralysis 4. Tinnitus Kidneys 1. Severe kidney damage kidney failure 2. Serious electrolyte imbalances muscle weakness, nausea, vomiting and mental confusion 3. Glomerulonephritis Liver: Abnormal liver function

Toxic Effects of Inhalants

Lungs Lung inflammation Pneumonia and other infections Asphyxia = death

Heart & Blood Vessels 1. Abnormal rhythms of the heart 2. Sudden sniffing death syndrome if individual exercises or gets excited
Bone Marrow & Blood 1. Benzene can cause severe anemia and leukemia 2. Methylene chloride is converted to carbon monoxide resulting in brain damage. Heart patients and cigarette smokers have an increased risk if use simultaneously.

Aim of Nutrition in Detoxification of Drugs & Alcohol

Assist the body to detoxify the drug(s) out of the body as quickly as possible which lessens the severity and length of withdrawal Repair some of the damage done to their body by the drugs, bad eating habits and lifestyle Alkalise the body and reduce acidity

Educate people on proper nutrition

Nutrients that counteract Drug Dependence

1. 2. SAMe (S-Adenosylmethionine) counteracts anxiety and depression Tryptophan counteracts cravings for amphetamines, decreases physical pain Lipids reduces withdrawal symptoms Vitamins vitamin C reduces withdrawal symptoms

3. 4.

Beneficial Foods for Alcohol & Drug Detoxification

Beneficial Foods for Alcohol and Drug Detoxification

1. 2. 3. 4. Water Especially filtered, helps to flush out toxins Fibre aids in absorption and removal of toxins Fresh vegetable juices alkalises the body, contains natural antioxidants and helps liver and kidney detox functions Protein foods contains tryptophan, tyrosine, glutamine, methionine, cysteine, and taurine etc. These are precursors to neurotransmitters and detox processes. Fresh fruit and vegetables excellent form of fibre, nutrients and help to alkalise the body Whole grains contain essential nutrients for detox. Also required for serotonin production. Garlic blood cleanser, lowers blood fats and is a natural antibiotic Ginger natural anti-inflammatory, reduces nausea, stimulates circulation and sweating

5. 6. 7. 8.

Beneficial Foods for Alcohol and Drug Detoxification

9. 10. Raw foods increases number of nutrients in foods Glutamine foods assists alcohol withdrawal e.g. GABA receptors, also heals mucous membranes and decreases cravings for CHO and sugars. Foods that assist kidney function e.g. asparagus, watermelon, parsley, wheat grass, beetroot, fennel etc Foods that assist liver function lemons, pears, grapes, cherries, wheat grass, artichokes, dandelion tea, turmeric, broccoli etc

11.

12.

Essential Nutrients and Supplements

Glutamine Magnesium Glutamine 2-3 grams a day (empty stomach) Magnesium 600mg per day

B complex (esp B3)

Vitamin C

B complex - 1 tablet every 4 hours

Vitamin C 250 mg every 3 hours

Alcohol
Alcohol Dehydrogenase (B3 Dependant Enzyme)

Acetaldehyde Aldehyde Dehydrogenase (B3 Dependant Enzyme)

Acetate

Essential Nutrients and Supplements

Zinc Essential fats Carnitine Lipotropenes 30mg a day EPA/DHA 3g per day after food Carnitine & Acetyl-L-Carnitine 400mg 1g per day Liver Tablets including taurine, methionine, choline, vitamins, St Marys Thistle, Globe artichoke etc