While there are many reasons that someone with chronic disease (Lyme, CFS, mold and other toxicity, autism, MS, etc.) may not respond to treatment (finding and addressing those issues is our main goal in most patients' first visit), there are not very many reasons that someone gets sicker with treatment. The most common one is a lack of binders, more technically called intestinal adsorbents.
The concept is this: in a detox process, practitioners use various treatments to get toxins out of wherever in the body that they are stored and into the circulation, where they can be filtered out and removed. While there are other very important detox organs, the liver filters a lot of the toxins we are most concerned about. Once the liver filters these, they are put into bile and passed into the small intestine. If there isn't something sitting there to grab and bind this material when it's squirted into the intestines, up to 90% of the bile and the toxins in it are reabsorbed. Up to 90% of toxic material is reabsorbed.
After reabsorption, the toxic material gets passed around the body again: a small amount of it being excreted by another route (sweating, exhaling, menses, etc.) and most of it lodging elsewhere in the body: sometimes somewhere relatively safe (maybe uncomfortable, but not fatal) like the fat (and then it becomes harder to lose weight because the body doesn't want to mobilize the fat/toxin combo and redistribute the toxins again) or the skin (leading to conditions like eczema) or somewhere very unsafe: the brain, heart, blood vessels, kidneys, etc.
That is not effective detox.
The clear answer is to prevent reabsorption, and the way to do that is to consume material that is especially good at doing this: binders.
We use around 12 different types of binders (specific types of clays, chlorella and other seaweeds and algae, activated charcoal, pectins, silica formulas, and others), depending on the patient, their particular physiology, and what toxins are most key to their symptoms and illness, because different binders have different levels of efficacy and pros/cons to them. Even quality ones aren't universally interchangeable.
Sourcing and brands in clays and chlorellas in particular have to be chosen carefully because of how common it is for sources to be contaminated. Seaweeds and algae contain the toxins of the water that they grew in. Terms like "bentonite" and "zeolite" are almost blanket terms: they are the names for groups of clays that have a same basic similarity with one another, but the zeolite from each of it's 60+ mines, for example, has a different chemical makeup and physical structure, and many of them are not safe for consumption. Further, because the industry is not highly regulated, not only can unsafe zeolite be on the shelf next to a safe one, but also, a company can call their product "zeolite" when it really has only a small percent of zeolite in it - the rest being other pulverized rock with no required comment on the label about what it really is. Low quality binder-like material like this can add to a patient's toxic burden or ill health instead of having a detox function.
Two big categories of binders, to anthropomorphize them, are: "intelligent" vs. "unintelligent". Activated charcoal is an example of an unintelligent binder, in that it binds almost anything, without discernment. This is good in acute or temporary situations, like food poisoning where it's key to bind large quantities of bacteria and their toxins and get them out as quickly as possible. The problem with it is that it binds nearly everything else in the gut too, potentially causing significant nutritional problems in patients who take it long term. Intelligent binders, like the silica based Enterosgel (available in the US through Amazon and other sellers) while they are not perfect, have the capacity to intensely bind some heavy metals, pathogenic bacteria, and other toxic material while less strongly binding to nutrients.
Binders also need to be taken in a particular way to be effective: throughout the day (once per day is not enough if someone is severely ill) and away from food and other supplements. While it's easy to forget to take these at the right time, this is one routine that's worth making an effort to create. Creating routine effectively often depends on making it as easy as possible for yourself in big and little ways. Some recommendations below:
1. Daily dose in a water bottle: get a small to medium sized water bottle, fill with water, and add your daily dose of powdered binder to it. Carry the water bottle with you and drink as recommended throughout the day. Example: if you are on 1 scoop of clay 3x/day, add 3 scoops to the water bottle in the morning and drink 1/3rd of the bottle away from food throughout the day.
2. Drop your idea of perfectionism: while in a general sense, all of the above rules need to be followed, it's more important that you get the binder in consistently and frequently than it is to take every dose perfectly. Forgot to take your binder and now you're out at lunch? Sincerely try to remember next time, but take it anyway and eat lunch without guilt.
3. Stash bottles where you spend the most time or where you know you're going to be at a certain time. Get a separate bottle for your car so that you can take a dose when stuck in traffic, or at your desk at work, etc.
4. Strategize timing: if it takes you 30 minutes from the time that you wake up to get ready, shower, etc. before having breakfast, then take the binder right when you get up and by the time you have breakfast, it's been 30 minutes without any other planning. Or create other healthy routines, if you're able, by having a daily walk in the afternoon and evening. Take a dose, go for a 30+ minute walk or other exercise, and come back to prepare dinner.
The material above is not complete enough by itself to make accurate or wise treatment decisions. Please talk with an appropriately trained healthcare provider before choosing and using binders.
Photo credit: Andrés Canchón