“Detox” is all over the internet with a thousand different definitions and a thousand different people telling you what to do. Detox is not just a simple process, though. Here’s how we define the three stages of metabolic detoxification and our reasons to consider a longer, more focused detox with proper nutritional support versus a simple cleanse. What is Detoxing? Detoxing is your body’s natural process of identifying, binding, and ridding the body of toxins we’re exposed to on a regular basis. Our detoxification philosophy here at Standard Process includes either a 28-day or 10-day approach with full nutritional support targeted to the three phases of detox: bioactivation, conjugation, and transport (elimination). Needless to say, supporting your body’s natural process of detoxification with adequate nutrition is not your Pinterest board’s three-day juice cleanse . Why Should I Detox? The human body is regularly exposed to environmental toxins – it’s just the way of modern life. Our bodies have a system in place to deal with these toxins, but we can support that process with whole food nutrient solutions known to help throughout the three stages of detox. The detox process is not as simple as some sources on the internet may have you believe; a longer, more focused detox as opposed to a short-and-simple cleanse will do a better job of eliminating toxins from the body. It’s vital that the body is supported with proper nutrition during a metabolic detox, paying especially close attention to the individual needs required during each of the three phases of detox. Three Phases of Detox Detoxification begins with bioactivation, continues with conjugation, and concludes with transport (before the process repeats itself as your body engages its natural mechanisms for detoxification). Your body’s natural detoxification process can be thought of as a “biotransformation” system that identifies, binds, and rids the body of toxins we’re exposed to regularly. Here are some simple ways to tell if you have toxins in your body. Read on for the three phases of metabolic detoxification accomplished with a nutritionally-supported, targeted detox. Bioactivation The first phase of detox is catalyzed by a handful of enzymes, primarily from the cytochrome P450 family (CYP450). In these enzymatic reactions, a reactive group is added to a toxin, generating a reactive site that can easily attach itself to other molecules. During bioactivation, toxins are transformed into reactive intermediates that need quick neutralization. Cruciferous vegetables like Brussels sprouts, Spanish black radish, and kale activate CYP450 enzymes needed during bioactivation. Antioxidant nutrients like vitamins A, C, and E, minerals like selenium, copper, zinc, and manganese, as well as coenzyme Q10 and several phytonutrients have antioxidant activity that may also support phase one of detox. 2. Conjugation During phase two, conjugation enzymes convert the reactive intermediates created during bioactivation into non-toxic, water-soluble molecules. Phase II conjugation enzymes include: -Sulfotransferases (SULT) -UDP-glucuronosyltransferases (UGT) -Glutathione S-transferases (GST) -N-acetyltransferases (NAT) Conjugation uses a lot of energy in the form of ATP and requires robust nutritional support in the form of B vitamins, magnesium, zinc, and other nutrients. Healthy sources of protein are also important for the conjugation phase of detox, specifically the amino acid glycine to help remove toxins. 3. Transport During the third and final phase of detox, neutralized toxins are transported, or eliminated, from the body. Transmembrane-spanning proteins are important for phase three transport and require energy in the form of ATP. Urinary pH (scale of acidity to basicity) may impact the elimination of toxins, and adequate water intake supports acid-base balance, which may also promote urinary toxin excretion.

Navigating your transition through menopause may feel like a right of passage, or you may feel like your body is betraying you. It is different for everyone. Menopause is the halt of menses due to the decrease in ovarian function. Our hormones, cycles, and mood are meant to ebb and flow in life, but transitions can come with challenges. We’ll review some of our specially formulated herbs for menopause remedies to help you embrace this change in life and all that you may experience in this new phase. Honoring this natural shift into the “wisdom years” when you care less about what people think and expand into speaking your truth. What Is Menopause? Whether you have arrived at menopause by right of age in your 40s and 50s or medical reasons brought it early, it is a time of great emotional and physical adjustments. Estrogen and progesterone hormones are declining, and a host of symptoms may be rising. Crossing over the threshold into “menopause” is considered official once you have been period-free for a year. However, there are often several years of symptoms leading up to the menopause milestone. This approaching phase is called perimenopause. Symptoms During Menopause Perimenopause and Menopause symptoms may vary from mild to severe. If you have taxed adrenal health or are underweight, your symptoms may be more difficult. Common symptoms include headaches, hot flashes, mental fog, moodiness, night sweats, sleep issues, reduced muscle tone and bone strength, urinary symptoms, vaginal dryness and thinning, weight gain and more. While many of these usually resolve on their own, they may last years, causing disruptions to a woman’s quality of life. Natural Strategies For Menopause Get nutrition to work in your favor daily. Food is medicine. Nutrition can decrease or prevent symptoms. Increase your fiber, which keeps bowels moving, microbiome happy and inflammation in check. Turn to more vegetables and flax seeds (1-2Tbsp fresh ground daily), supporting healthy estrogen levels. Eat more high-quality fats like avocado, olive oil, walnut oil, coconut oil, butter or ghee at each meal to maintain hormone synthesis. Take essential fatty acids, especially evening primrose and fish oil. Keep blood sugar balanced with adequate protein, eat every few hours and minimize the sugar and empty calories. Fish rich in omega-3s is invaluable for brain and vascular health. Emphasize a plant-based diet rich in phytoestrogens. Increase cooked leafy greens like kale, broccoli, collard greens, Napa cabbage, and legumes like garbanzo beans and lentils. Keep moving. Exercise is powerful in protecting health, reducing symptoms and preventing weight gain. Nourish your adrenals and build stress resilience with adaptogen herbs like Ashwagandha . It can be helpful for anxiety, sleep, libido and reducing cellular damage. As much as it seems like a good time for a glass of red wine, skip the alcohol for now, which is a common symptom trigger, especially for hot flashes. Treat yourself to massages which have also been shown to improve symptoms, sleep and mood. Herbal remedies can help you start feeling better so you can enjoy an improved quality of life. Modifying your supplements should always be done with the guidance of a trusted healthcare provider. Menomorphosis (or Women’s Menocaps if you prefer capsules) brings comfort to the uncomfortable menopause symptoms, especially cooling symptoms with heat mentioned above. In addition, this balancing blend brings whole-body support for women’s health through PMS and menopause. This is accomplished through the wise synergy of burdock, long used by midwives as a uterine tonic, dong quai, known as the female ginseng, and licorice, which contains a phytoestrogen called glabrene. In combination, the black cohosh, chaste tree is also known as vitex, and motherwort, are a trio of relaxing herbs that have an affinity for supporting normal healthy hormone levels, balancing mood and managing symptoms of stress. Bittersweet elixir offers digestive, muscle, and vaginal support through gentian, dandelion (root), fennel and elecampane. The value of a healthy functioning digestive system allows for proper absorption of the healthy nutrients you are striving to consume. Additionally, a normal inflammatory response is supported by turmeric, ginger and slippery elm promoting healthy cognitive, cardiovascular and bladder functions. Women’s Cycle Comfort is our new release! Contains a mix of relaxing nervines great for supporting a balanced mood while promoting ease and comfort through the menstrual cycles and into menopause. This balanced blend of black cohosh, chaste tree, skullcap, kava, wild yam and ginkgo produces an impressive synergy for the body. It encourages healthy circulation, a calm nervous system, a relaxed musculoskeletal system, thus reducing inflammation, symptoms of restlessness, tension and tenderness. Using nourishing herbs to support your health while keeping a healthy diet and a positive attitude will support a more balanced mind-body connection. These herbs for menopause may also increase the transformational power and ease of your experience. Try framing menopause as a liberation, leaving something behind to become something new. Embrace this natural biological process, a rebirth into your authentic wise woman. There is a traditional Native American saying: “At her first bleeding, a woman meets her power. During her bleeding years, she practices it. At menopause, she becomes it.”  This blog was written by Meg Ramirez, please click here to learn more about the author.

The more we learn about immunology, the more we realize that practically all the patterns seen commonly in a functional medicine practice have a fundamentally immunological basis. Sam Yanuck, DC, FACFN , FIAMA + , is a renowned Functional Medicine instructor and practitioner, with a focus in immunology, and is an advocate for prioritizing immune system balance as a crucial first step for many of patients. He states “the more you learn about immunology, the more you realize how many of the patterns you see in your patients have a fundamental immunological basis. It’s essential that you have a systematic plan to address the immunological basis for these patterns and the right tools to implement the plan.” The immune system plays a central role in protecting and maintaining homeostasis in the body by distinguishing between self (your cells) and non-self (pathogens, bacteria, viruses, etc.). The robustness of this process depends on appropriate activation of T helper cell types, as well as balanced cytokine expression. The relevance of the immune system goes far beyond natural defenses. Immunology is at the root of many common clinical objectives, including: Tolerance of self-tissue Digestive health Cytokine balance Brain function, mood and cognition Joint function Glucose homeostasis Sinus and respiratory health Cardiovascular function It is important to have a plan in place to address the immunological basis of your patients’ concerns and the right tools available to implement the plan. SELF-TISSUE RESPONSE: A THREE-STEP APPROACH Each step described below supports a key aspect of the immune system and cumulatively helps promote a balanced immune response: STEP 1. PROMOTE T-HELPER CELL BALANCE T-helper cells are a class of lymphocyte that help the immune system respond appropriately to different types of threats faced by the body. They begin as naive T-cells and become, when activated, unique T-helper cell types. Which type they become depends on cytokines and other factors in their micro-environment at the time of their activation. Here is a list of different T-helper cells and their role in maintaining immune system balance: Th1 cells: Support cell-mediated immune defenses Th2 cells: Help activate eosinophils and mast cells Treg cells: Modulate the effects of other T cells Th17 cells: Respond to the extracellular microbial environment A balanced profile of T-helper cells is crucial for immune defenses and tissue homeostasis. Unfortunately, many factors commonly seen in patient cases, such as stress, diet, environment, glucose metabolism, and age, can drive an imbalance in T-helper cell types. Often, this occurs as an increase in the number and activity of Th2 cells (Th2 response) and a decrease in the number and activity of Th1 cells (Th1 response). In turn, this imbalance leads to the expansion of Th17 cells, which, through a cascade of effects, can make the patient more susceptible to developing an immune response directed at self-tissue. Supporting and maintaining a balance of less Th2 cells and more Th1 cells, will help to moderate Th17 responses to help maintain immune homoeostasis in tissues. STEP 2. MODULATE CYTOKINE ACTIVATION This step supports immune system balance by modulating the activity of NFkB, a major driver of cytokine expression. This step also supports a healthy T-cell repertoire and tissue health. But first, it is crucial to first support a balanced T-helper cell profile (Step 1). Cytokines are messenger molecules that orchestrate immune system function. NFkB is a protein complex that induces gene expression of a mixture of cytokines that initiate immune activation, which can increase self-tissue response. Persistent NFkB can decrease Th1 response, while other factors can increase Th2 response. Decreased Th1 response and increased Th2 response can increase Th17 response, which can contribute to development of a self-tissue response. The patient factors mentioned in Step 1 can drive cytokine and NFkB activation, which in turn can influence cytokine activation in the brain, and self-tissue response throughout the body. Cytokine activation also decreases Th1 response, which we learned in Step 1 will increase Th2 response and therefore drive Th17, which impacts self-tissue response. Figure 1. Step 2 of the PureResponse Self-Tissue Response Protocol STEP 3. PERSONALIZE YOUR PLAN OF CARE Functional medicine is personalized medicine, which means tailoring your plan of care with ingredients and formulas to address unique circumstances of your patient’s case. Remember, the interconnectedness of elements in the immune system is often bidirectional. In some patients, progress depends upon addressing factors you would normally think of as downstream from the mechanisms discussed in steps 1 and 2. For instance, G.I., sinus, lung, or bladder mucosal function, or mast cell activation can affect T cell polarization or cytokine activation. Therefore, modulating mast cell activation or supporting GI mucosal health can also contribute to a healthy T-helper cell profile. BRINGING IT ALL TOGETHER The immune system must distinguish between self and non-self to protect and maintain homeostasis in the body. To help your patients experiencing self-tissue response, you must understand how to balance T-helper cells (Step 1) and modulate cytokine (NFkB) activation (Step 2). Keep in mind each patient is different, so personalization will be essential in supporting immune system balance and homeostasis (Step 3). Want to learn more about the products that can support self-tissue response in your patients every step of the way? Be sure to check out the complete protocol and guide, exclusive to Pure Encapsulations and developed by leading functional immunology expert Sam Yanuck. Check it out here. ‡ WORKS CITED Zhu J, Paul WE. Blood. 2008 Sep 1;112(5):1557-69. Miossec P, Korn T, Kuchroo VK. N Engl J Med. 2009 Aug 27;361(9):888-98. Barnes PJ, Karin M. N Engl J Med. 1997 Apr 10;336(15):1066-71. O’Shea JJ, Plenge R. Immunity. 2012 Apr 20;36(4):542-50. Maddur MS, Miossec P, Kaveri SV, Bayry J. Am J Pathol. 2012 Jul;181(1):8-18. Steinman L. Nat Med. 2007 Feb;13(2):139-45. Akdis M, Burgler S, Crameri R, et al. J Allergy Clin Immunol. 2011 Mar;127(3):701-21.e170 + Dr. Samuel Yanuck is a retained advisor for Pure Encapsulations®.

Results of a study that characterized the relationship between physical activity, sedentary behavior, and how they interact with cardiometabolic health were recently published in the journal Medicine and Science in Sports and Exercise. This study helps to chip away at some of the questions that remain around sedentary behavior and physical inactivity, and if there is a difference between the two . Inactivity is typically defined as not meeting the recommended guidelines for physical activity, while a sedentary individual may meet the requirements and simultaneously spend a lot of time with very low energy expenditure. Key questions remain regarding the requirements of exercise needed, such as the sufficient intensity and duration to improve cardiovascular risk and compensate for periods of sedentary behavior, or if sedentary behavior carries its own risk independently of other periods of physical activity. Does sitting in front of a computer for 10 hours have a negative impact on people that also meet or even exceed requirements for moderate-to-vigorous physical activity (MVPA)? Does the amount of light intensity physical activity (LPA) also influence risk? Is there a threshold at which MVPA or LPA can negate the detrimental effects of being sedentary? In this study, nearly 4,000 46-year-old participants from the Northern Finland Birth Cohort (1966) wore an accelerometer during waking hours, which collected data for 7-14 consecutive days. Cardiometabolic variables were also collected, including BMI, body composition and visceral fat, plasma lipids, glucose, and insulin, and in some cases oral glucose tolerance testing. Cardiorespiratory fitness was determined by a submaximal 4-minute single-step test, and several variables were self-reported, including sleep duration and lifestyle behaviors, such as smoking and alcohol consumption. Physical activity was characterized both by total time as well by cluster, which helps to acknowledge the interrelationships between each level of activity. Among the 4 clusters described, the unhealthiest were classified as “active couch potatoes”; they had the most sedentary time (defined as <1.5 metabolic equivalents [MET]), and the least time in LPA (1.5–3.0 MET) and MVPA (3+ MET). Roughly 1/3 of the cohort, these individuals averaged over 600 minutes of sedentary time per day, and less than 220 minutes of LPA per day. Importantly, however, they did participate in approximately 35 minutes of MVPA per day, meeting the recommendation of at least 150 minutes MVPA per week encouraged by most professional and governmental organizations . The other groups were comprised of “sedentary light movers” and “sedentary exercisers” who spent less time being sedentary than the active couch potatoes (between 480-600 minutes per day), but more time in LPA or MVPA, respectively. “Movers,” about 17% of the cohort, spent the least time being sedentary, and more time in LPA and MVPA (>350 and >60 minutes per day, respectively). Even after adjusting for potential confounders, including cardiorespiratory fitness and sleep duration, active couch potatoes had the least favorable cardiometabolic profile. For example, even sedentary light movers had lower 2-hour and fasting insulin levels (11.4% and 9.3% lower, respectively), triglycerides (5.3%), and other adiposity measures. Sedentary exercisers and movers had even greater reductions in 2-hour insulin (22.7% and 18.3%), triglycerides (9% and 10.9%), LDL/HDL (9.3% and 9.9%), as well as improvements in body fat, fat mass, visceral fat area, and waist circumference. The findings of this study suggest that large amounts of time spent in sedentary behavior (such as 10 hours per day or more) are associated with poorer cardiometabolic health, even when basic recommendations for MVPA are met. Additionally, the more time spent in LPA vs. sedentary the better – there was a clear advantage of increasing the proportion of time in LPA even if the gains were not as large as if that time were spent in MVPA. Other useful studies help to consolidate thinking in this area; a very large meta-analysis found that greater amounts of time spent sitting were associated with increases in overall mortality risk, but the hazard ratios only start to increase significantly around 7-8 hours (they reported a 34% higher mortality risk for adults sitting 10 h/day, after taking physical activity into account). This suggests that some degree of sedentary behavior may not be harmful, but certainly higher amounts are. A second meta-analysis published in The Lancet may offer the most insight. Over 1 million individuals were included, leading to a number of important takeaways. First, compared to the group that exercised the most (>35.5 MET-hours per week) and spent the least time sitting (<4 hours per day), groups that spent more time sitting and less time exercising had a 12-59% higher mortality rate. However, there was no increase in the mortality risk among those who sat for more than 8 hours/day but who also reported >35.5 MET-hours per week of activity. Thus, a very high portion of time spent in MVPA may negate the effects of sedentary behavior, but it requires a lot – 4-5 times the amount of time spent in MVPA than current guidelines recommend, a difficult goal for most people. This study and others also suggest that time watching TV (or screen time) may be different from other sedentary activities, and that MVPA does not seem to negate its effects, particularly above specific thresholds (such as 5 or more hours watching per day).  Bottom line: move frequently and regularly, avoid being sedentary, and opt for moderate to vigorous activity as much as possible.

Vitamin D is an essential nutrient for both adults and children. In kids, vitamin D is critical for healthy bone growth and the development of a healthy immune system. Recent research suggests that it may also support other aspects of health in the growing child.  Vitamin D helps support healthy bone mineralization and calcium homeostasis regulation, and it is essential for the formation of bone during childhood development . Vitamin D also helps support both innate and adaptive immune health . Vitamin D receptors (VDRs) are present on some immune cells including lymphocytes and monocytes. Calcitriol, or 1,25[OH]2D, is a form of vitamin D that has been shown to modulate antimicrobial peptide transcription, the secretion of interleukin (IL)-10, and the production of certain pro-inflammatory cytokines in monocytes and macrophages through VDR signaling . VDR signaling in dendritic cells has also been associated with certain aspects of T-cell differentiation . Vitamin D status has been associated with the incidence of microbial illness in the pediatric population. A population study reported that newborns with lower levels of serum calcidiol, or 25[OH]D, had a greater prevalence of otitis media and upper respiratory infections at 3 months of age and wheezing at 15 months. A randomized control trial explored the potential role of supplementation with 1,200 IU of vitamin D during the winter months in the prevention of influenza A. More than 300 children participated. The treatment arm was shown to have a 58% lower likelihood of contracting influenza A as compared to a placebo. The incidence of certain autoimmune disorders associated with juvenile onset such as juvenile idiopathic arthritis (JIA) has been associated with serum 25[OH]D deficiencies or insufficiencies. JIA and other autoimmune disorders are associated with an atypical involvement of the immune system and inflammatory mediators . A meta-analysis found vitamin D insufficiencies in 82% of participants with JIA. Vitamin D deficiency has also been associated with a greater incidence of atopic pathologies and certain allergies , including food allergies. Deficiencies in vitamin D are common in both pediatric and adult populations. In the pediatric population, they may be a result of inadequate nutritional intake , decreased absorption, darker skin pigmentation, certain pathologies, lifestyle changes, and genetic conditions. Other factors related to vitamin D deficiency include living in higher latitudes and having restricted sun exposure. Evidence suggests that supplementation with vitamin D3 can be more effective at raising and maintaining vitamin D levels in the body when compared with vitamin D2 supplementation. Research indicates that supplementation with vitamin D may help promote bone development and a normal immune system in pediatric populations . By Colleen Ambrose, ND, MAT