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Detox Deconstructed-
 The Saguil Approach




             Enrique Saguil, M.D.
We didn’t invent the practice of medicine….
                we’re just changing the way it’s provided.
We didn’t invent the practice of medicine….
                we’re just changing the way it’s provided.
The First Health Approach




We didn’t invent the practice of medicine….
                we’re just changing the way it’s provided.
Your Community
     of Care
      Ric Saguil, MD
    Jason Gruss, MD
     Tom Jordan, RD
 Katrina Christie, LCPC
  Jennifer Green, ND
   Joe Musolino, DC
  Emery Paredes, PT
   Yu Zhu, MD China




      You
What stops us from regular E S P
        -“Distractions”
Senate Select Committee on Nutrition
         and Human Needs

• “….During this century, the composition of an
  average diet has changed radically. Complex
  carb, fruits, veg and grain which were the
  mainstay now play a minority role. At the
  same time, fat and sugar composition have
  risen to the point where these dietary
  elements alone now comprise 60% of the total
  caloric intake…..”
Bob Dole and George McGovern

..that was from 1977!!




The McGovern Committee
Detoxification
• Found in many cultures, originally associated
  with purging impurity from the body
• With religion (Lent, Ramadan, Yom Kippur) it is
  associated with enlightenment.
• Modern proponents suggest a reset of the
  body function in addition to creating a feeling
  of energy.
• Shatkarma….the ancestor of “detox in a box”
Shatkarma
                 A process of cleansing and
 1. Neti         purifying the nasal passages.
 2. Dhauti       A series of cleansing techniques
                 divided into three
                 (1 internal (2 head (3 thoracic
 3. Nauli        Massaging and strengthening
                 the abdominal organs
                 Washing and toning
 4. Basti        the large intenstine
 5. Kapalbhati   Breathing technique for
                 purifying the frontal brain
 6. Trataka      Intense gazing at one point or
                 object to develop
                 power of concentration
Neti
• Neti pot filled with room temp water and salt
            (one tsp per 0.5 L water)
• Feet apart, lean forward, insert gently, elbow
  up and pour until ½ container is empty gently
  blow mucus.
• Repeat to other side
• Dry nostrils alternate nostril 10 breaths
  standing, leaning right leaning left, leaning
Varisara Dhauti
• Light semi liquid meal night before
• Khichari (white rice/mung dal, clarified butter
  with a little tumeric (no salt)
• Eat at the end of practice, after 45min of rest,
  again later in the day.
• 2 glasses warm salty water aqap then 8 asana
• Repeat 3x and attempt BM
• Water again aqap followed by 8 asana
The five asana activate peristalsis and enhance the cleansing process
-open the pyloric sphincter
-open the ileocecal sphincter
-open the anus
Nauli
• Madhyama Nauli



• Dakshina Nauli (right isolation)

• Vama Nauli (left isolation)
Basti
• Jala Basti-Yogic enema
• Sthal Basti-dry yogic enema
• Moola Basti-anal cleansing
Kapalbhati
• Vatkrama kapalbhati (air cleansing)
• Vyutkrama kapalbhati (sinus cleansing)
• Sheetkrama kapalbhati (mucous cleansing)
Trataka
Ayruvedic Approach
               End Result-

• Lightness of the body, clarity of the mind and
  increased energy
• Regular bowel movements with no gas or
  bloating
• A clean tongue and fresh breath
Shatkarma              Action
1.   Neti         1.   Clean out
2.   Dhauti       2.   Clean out
3.   Nauli        3.   Move
4.   Basti        4.   Clean out
5.   Kapalbhati   5.   Breath the Mind
6.   Trataka      6.   Mind
Modern Day Detoxing
What ever works!
A word on Science of our GUT




  http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.pdf
Miles of capillaries and microvilli…
…all work to constantly
absorb, filter and move.
Resting the GUT
When it works good, we feel good
When GUT is abused, it un-filters hell
When GUT is on holiday, a lot of energy frees up

  Mario says:
This is why after
 the first week,
detoxers feel so
   energetic!




                    RECHARGE!
How to choose which diet?
The Saguil Approach to
            Nutrition Change
• Has to be safe

• Take some time off (or warn others!)

• Precede the event with grounding (or warn others!)

• Rescue medicines or herbs (for side effects)

• Celebrate with a hallmark change in movement
  and spirit
Bottom line is the RESET




 Safe
 Cheap
 Reliable?
Knowing the facts


• Glycemic index
• Food side effects (later…)
• Calories
• Portion size
Food for Thought (bad thoughts)
GI (glycemic index) of the GI




                        Fructose heavy high GI
Insulin Dumping/Cortisol dumping
Jumpstart in a Nutshell..
Daily diet for 7-10 days
1200-1400 calories per day:
• Whole Grains
• Vegetables
• Protein
• Dairy Alternatives
• Fruit
• Fat
Whole Grains =2 cups



                          OR
1 cup cooked grain                         2 slices of bread




                     1 ½ cups dry cereal
Vegetables = 2 ½ cups


                              OR
4oz vegetable juice                        1 cup raw vegetables




                      3 cups raw lettuce
Protein = 5 ½ servings



½ cup cooked legumes
                               ½ cup tofu or tempeh
                       or



      4 oz fish             4 egg whites or 2 whole eggs
Dairy alternatives = 1 cup




      1 cup almond soy rice coconut
Fruit = 1 serving




1 piece of fruit                                 ¼ cup of dried fruit




                      ½ cup of fresh or frozen
Fat = 2 teaspoons



                          or
1 tsp oil                                 1 ½ tsp tree nut butter




              1 tablespoon chopped nuts
                   or ground flaxseed
WHOA!!!!!!
DrRic Disclaimer
•   I am not a Registered Dietician
•   I am not a “Health Coach”
•   I am not a Naturopathic Doc Sustainability Team
•   I am not a Behavioral Specialist

• I am a Yoga Teacher
• I am a Compassionate Physician
• I am an Integrative Medicine Physician
Gut-Brain Connection



When the GUT is unhappy, we are unhappy
Bottom line with Nutrition

Step away from the animal!




Hunter Gatherer Mentality
We didn’t invent the practice of medicine….
                we’re just changing the way it’s provided.
Emotion controls GUT
Sleep Cycles

           •   Insure REM
           •   Set up a conducive environment
           •   Remove distractions
           •   Rescues for 21days
           •   Don’t nap
           •   Switch macronutrient times

I don’t need much sleep- doc
The Saguil Approach to
               Restful Sleep

•   Valerian/Hops Melatonin
•   PJ/s, pillows and blanky, Temp-67, darkness
•   LCD 3m away, ear plugs, light blocker, no tech
•   Lavendar/sandalwood, SL melatonin, 4/7/8
•   Rhodiola, light box, Metallica
•   Protein day, carbs night,

                             Behavioral Therapy
Brain/GUT Relationship?




 Always have to include the mind with the diet change
    When the brain is unhappy, the GUT is unhappy
Control the Brain before the GUT



• The Limbic System controls
  gut and emotionality
• Neuroplasticity concept
• Prefrontal cortex seat of judgement and
  planning- sight of highest order cognitive activity
• Increasing connection (white matter) L prefrontal
  to amygdala yields more resiliency to adversity
The bottom line with Grounding
• Average American is very good with the
                                         stress response
• Average American is lacking the
                             relaxation response



                    Both take practice
Get Ready to Rumble!!!
The Relaxation Response
   30
• 5-10 min. at the beginning and end of your
  day

• Cultivate RR with help

   Or Try
Look familiar?
Modern Day Ashram
Caveat with diet and exercise
• Watch the increase in exercise/decrease in cal
• Performance will suffer so can be dangerous
• Consider low and slow during the fast



                 ...what in morning was truth,
                     in evening will become a lie.
                                    -Carl Jung
Bottom line with Movement
•   Change the concept of movement
•   Imbibe “brain stillness” into the endeavor
•   Warm up can be the “pause”.
•   Vigorous exercise is good…
                      ….balanced exercise is better!
Speaking of supplements…

•   Herbs for Brain –(relaxing during starvation)
•   Herbs for Sleep
•   Herbs for Liver
•   Herbs for Colon
•   Aromatherapy


           -Then return back to the usual
           O3, Vit D3, MVI and DrRic’s personal picks
DrRic fav’s for colon
•   Slippery Elm –lube and antiinflam
•   Marshmallow Root –” “
•   Ginger - prokinetic
•   DGL –protects the stomach
•   Magnesium – constipation/spasm
•   Probiotic – diarrhea/immunity
•   Digestive enzymes - +/-
•   Mucosagen by Orthomolecular
                                        Read your box labels
DrRic fav’s for liver


• Milkthistle –(Natures Way purple top)
  “Thisilyn” 200m/d
• SAMe
• Vitamin AA –(no alcohol)



                                          Read your box labels
DrRic fav’s for brain

•   SAMe
•   St Johns Wort
•   5HTP
•   Valerian with Lemon Balm
•   Magnesium
•   O3

• Kava kava / Ashwaganda
                                    Read your box labels
Aromatherapy
•   DiGize
•   Ocotea
•   Sandalwood
•   Lavendar
•   Sage



                  To induce release of oxytocin and serotonin
The Reveal
The Saguil Approach to
  Sustainable Change
            Embark (set the date)

            Enlighten (read)
            Enlist (get help)
            Empower (ground)
            Encourage (share)
Knee Pain in the Outdoor Athlete

          REI Schaumburg
         5/23 Wed 7-8pm
           1209 E Golf Rd
          Schaumburg, IL
       Phone: (847 )619-6729

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DrRic -Detox Deconstructed (slide share edition)

  • 1. Detox Deconstructed- The Saguil Approach Enrique Saguil, M.D. We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
  • 2. We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
  • 3. The First Health Approach We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
  • 4. Your Community of Care Ric Saguil, MD Jason Gruss, MD Tom Jordan, RD Katrina Christie, LCPC Jennifer Green, ND Joe Musolino, DC Emery Paredes, PT Yu Zhu, MD China You
  • 5. What stops us from regular E S P -“Distractions”
  • 6. Senate Select Committee on Nutrition and Human Needs • “….During this century, the composition of an average diet has changed radically. Complex carb, fruits, veg and grain which were the mainstay now play a minority role. At the same time, fat and sugar composition have risen to the point where these dietary elements alone now comprise 60% of the total caloric intake…..”
  • 7. Bob Dole and George McGovern ..that was from 1977!! The McGovern Committee
  • 8. Detoxification • Found in many cultures, originally associated with purging impurity from the body • With religion (Lent, Ramadan, Yom Kippur) it is associated with enlightenment. • Modern proponents suggest a reset of the body function in addition to creating a feeling of energy. • Shatkarma….the ancestor of “detox in a box”
  • 9. Shatkarma A process of cleansing and 1. Neti purifying the nasal passages. 2. Dhauti A series of cleansing techniques divided into three (1 internal (2 head (3 thoracic 3. Nauli Massaging and strengthening the abdominal organs Washing and toning 4. Basti the large intenstine 5. Kapalbhati Breathing technique for purifying the frontal brain 6. Trataka Intense gazing at one point or object to develop power of concentration
  • 10. Neti • Neti pot filled with room temp water and salt (one tsp per 0.5 L water) • Feet apart, lean forward, insert gently, elbow up and pour until ½ container is empty gently blow mucus. • Repeat to other side • Dry nostrils alternate nostril 10 breaths standing, leaning right leaning left, leaning
  • 11. Varisara Dhauti • Light semi liquid meal night before • Khichari (white rice/mung dal, clarified butter with a little tumeric (no salt) • Eat at the end of practice, after 45min of rest, again later in the day. • 2 glasses warm salty water aqap then 8 asana • Repeat 3x and attempt BM • Water again aqap followed by 8 asana
  • 12. The five asana activate peristalsis and enhance the cleansing process -open the pyloric sphincter -open the ileocecal sphincter -open the anus
  • 13. Nauli • Madhyama Nauli • Dakshina Nauli (right isolation) • Vama Nauli (left isolation)
  • 14. Basti • Jala Basti-Yogic enema • Sthal Basti-dry yogic enema • Moola Basti-anal cleansing
  • 15. Kapalbhati • Vatkrama kapalbhati (air cleansing) • Vyutkrama kapalbhati (sinus cleansing) • Sheetkrama kapalbhati (mucous cleansing)
  • 17. Ayruvedic Approach End Result- • Lightness of the body, clarity of the mind and increased energy • Regular bowel movements with no gas or bloating • A clean tongue and fresh breath
  • 18. Shatkarma Action 1. Neti 1. Clean out 2. Dhauti 2. Clean out 3. Nauli 3. Move 4. Basti 4. Clean out 5. Kapalbhati 5. Breath the Mind 6. Trataka 6. Mind
  • 21. A word on Science of our GUT http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.pdf
  • 22. Miles of capillaries and microvilli…
  • 23. …all work to constantly absorb, filter and move.
  • 24. Resting the GUT When it works good, we feel good
  • 25. When GUT is abused, it un-filters hell
  • 26. When GUT is on holiday, a lot of energy frees up Mario says: This is why after the first week, detoxers feel so energetic! RECHARGE!
  • 27. How to choose which diet?
  • 28. The Saguil Approach to Nutrition Change • Has to be safe • Take some time off (or warn others!) • Precede the event with grounding (or warn others!) • Rescue medicines or herbs (for side effects) • Celebrate with a hallmark change in movement and spirit
  • 29. Bottom line is the RESET Safe Cheap Reliable?
  • 30. Knowing the facts • Glycemic index • Food side effects (later…) • Calories • Portion size
  • 31. Food for Thought (bad thoughts)
  • 32. GI (glycemic index) of the GI Fructose heavy high GI
  • 34. Jumpstart in a Nutshell.. Daily diet for 7-10 days 1200-1400 calories per day: • Whole Grains • Vegetables • Protein • Dairy Alternatives • Fruit • Fat
  • 35. Whole Grains =2 cups OR 1 cup cooked grain 2 slices of bread 1 ½ cups dry cereal
  • 36. Vegetables = 2 ½ cups OR 4oz vegetable juice 1 cup raw vegetables 3 cups raw lettuce
  • 37. Protein = 5 ½ servings ½ cup cooked legumes ½ cup tofu or tempeh or 4 oz fish 4 egg whites or 2 whole eggs
  • 38. Dairy alternatives = 1 cup 1 cup almond soy rice coconut
  • 39. Fruit = 1 serving 1 piece of fruit ¼ cup of dried fruit ½ cup of fresh or frozen
  • 40. Fat = 2 teaspoons or 1 tsp oil 1 ½ tsp tree nut butter 1 tablespoon chopped nuts or ground flaxseed
  • 42. DrRic Disclaimer • I am not a Registered Dietician • I am not a “Health Coach” • I am not a Naturopathic Doc Sustainability Team • I am not a Behavioral Specialist • I am a Yoga Teacher • I am a Compassionate Physician • I am an Integrative Medicine Physician
  • 43. Gut-Brain Connection When the GUT is unhappy, we are unhappy
  • 44. Bottom line with Nutrition Step away from the animal! Hunter Gatherer Mentality
  • 45. We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
  • 47. Sleep Cycles • Insure REM • Set up a conducive environment • Remove distractions • Rescues for 21days • Don’t nap • Switch macronutrient times I don’t need much sleep- doc
  • 48. The Saguil Approach to Restful Sleep • Valerian/Hops Melatonin • PJ/s, pillows and blanky, Temp-67, darkness • LCD 3m away, ear plugs, light blocker, no tech • Lavendar/sandalwood, SL melatonin, 4/7/8 • Rhodiola, light box, Metallica • Protein day, carbs night, Behavioral Therapy
  • 49. Brain/GUT Relationship? Always have to include the mind with the diet change When the brain is unhappy, the GUT is unhappy
  • 50. Control the Brain before the GUT • The Limbic System controls gut and emotionality • Neuroplasticity concept • Prefrontal cortex seat of judgement and planning- sight of highest order cognitive activity • Increasing connection (white matter) L prefrontal to amygdala yields more resiliency to adversity
  • 51. The bottom line with Grounding • Average American is very good with the stress response • Average American is lacking the relaxation response Both take practice
  • 52. Get Ready to Rumble!!!
  • 53. The Relaxation Response 30 • 5-10 min. at the beginning and end of your day • Cultivate RR with help Or Try
  • 56. Caveat with diet and exercise • Watch the increase in exercise/decrease in cal • Performance will suffer so can be dangerous • Consider low and slow during the fast ...what in morning was truth, in evening will become a lie. -Carl Jung
  • 57. Bottom line with Movement • Change the concept of movement • Imbibe “brain stillness” into the endeavor • Warm up can be the “pause”. • Vigorous exercise is good… ….balanced exercise is better!
  • 58. Speaking of supplements… • Herbs for Brain –(relaxing during starvation) • Herbs for Sleep • Herbs for Liver • Herbs for Colon • Aromatherapy -Then return back to the usual O3, Vit D3, MVI and DrRic’s personal picks
  • 59. DrRic fav’s for colon • Slippery Elm –lube and antiinflam • Marshmallow Root –” “ • Ginger - prokinetic • DGL –protects the stomach • Magnesium – constipation/spasm • Probiotic – diarrhea/immunity • Digestive enzymes - +/- • Mucosagen by Orthomolecular Read your box labels
  • 60. DrRic fav’s for liver • Milkthistle –(Natures Way purple top) “Thisilyn” 200m/d • SAMe • Vitamin AA –(no alcohol) Read your box labels
  • 61. DrRic fav’s for brain • SAMe • St Johns Wort • 5HTP • Valerian with Lemon Balm • Magnesium • O3 • Kava kava / Ashwaganda Read your box labels
  • 62. Aromatherapy • DiGize • Ocotea • Sandalwood • Lavendar • Sage To induce release of oxytocin and serotonin
  • 64. The Saguil Approach to Sustainable Change Embark (set the date) Enlighten (read) Enlist (get help) Empower (ground) Encourage (share)
  • 65. Knee Pain in the Outdoor Athlete REI Schaumburg 5/23 Wed 7-8pm 1209 E Golf Rd Schaumburg, IL Phone: (847 )619-6729

Hinweis der Redaktion

  1. Basic existence boils down to 3 things E S PIf these 3 are intact, survival, love, reproducing, community will flourishAs is demonstrated in my medical clinic and emergency rooms, hospitals and pharmacies around the world…..the above 3 characteristics of a happy life are all screwed up. Just look at the symbol for eat…..a hamburger(processed food) and a beverage (plastic container)Sorry, just being critical but this will justify the concept of detoxing.
  2. US sentate select committee on nutrition and human needs = the McGovern CommitteeTitled Dietary Goals for the United States, but also known as the "McGovern Report",[10] they suggested that Americans eat less fat, less cholesterol, less refined and processed sugars, and more complex carbohydrates and fiber.[11] (Indeed, it was the McGovern report that first used the term complex carbohydrate, denoting "fruit, vegetables and whole-grains".[12]) The recommended way of accomplishing this was to eat more fruits, vegetables, and whole grains, and less high-fat meat, egg, and dairy products.[2][11] While many public health officials had said all of this for some time, the committee's issuance of the guidelines gave it higher public profile.[11]The committee's "eat less" recommendations triggered strong negative reactions from the cattle, dairy, egg, and sugar industries, including from McGovern's home state.[2] The American Medical Association protested as well, reflecting its long-espoused belief that people should see their doctor for individual advice rather than follow guidance for the public as a whole.[11] Some scientists also thought the committee's conclusions needed further expert review.[2] Others felt that the job of promulgating recommendations belonged to the Food and Nutrition Board of the National Research Council.[9] Under heavy pressure, the committee held further hearings, and issued a revised set of guidelines in late 1977 which adjusted some of the advice regarding salt and cholesterol and watered down the wording regarding meat consumption.[2]
  3. In sanskrit , shat means six, karma means actionShatkarma translates to the 6 purification practices
  4. There is also vatsaradhauti (cleansing the intestines with air)Vamandhauti (regurgitative cleansing)Vastradhauti (cloth cleansing)
  5. Tadasana works on the stomach and stretches the colonTiryakatadasana acts on the small intestine and colonKatichakrasana massages the small intestineTiryakabhujangasana and udarakarshanasana squeeze and massage the caecum, sigmoid colon and rectum and also stimulate the urge to defecate
  6. Practiced when completely empty, 5-6 hours after meals. (before breakfast ideal)Helps to rotate, aggitate entire abdomen in efforts to generate heat, stimulate appetite, assimilation, absorption, secreation, excreation.
  7. In sanskrit , shat means six, karma means actionShatkarma translates to the 6 purification practices
  8. Detoxing nowadays is more to the point of moving bowels restricting intake and losing weight
  9. To the non medical side To the medical sideHerbalists MDNaturopathes DOYogi’s ChiroNutritionistsRD’s (some)ChiroTrainersSome diets are dangerous!!!1kidney stones, muscular wasting/digestion, dehydration, ketoacidosis
  10. Triglycerides are the chemical forms in which fat moves through the bloodstream. They are mostly derived directly from fats in your diet, but some are also made in the body from carbohydrates. When the calories you consume are not used immediately, they are converted to triglycerides, transported through the bloodstream, and stored in fat cells. Hormones then regulate their release to meet energy needs. Whenever your LDL ("bad") cholesterol is measured, triglycerides are also checked. Levels lower than 150 milligrams per deciliter (mg/dL) are considered normal, and levels above 200 mg/dL are considered too high…..bottom line is this takes a lot of energy to accomplish 3 times a day +
  11. Virus cancer bacteria parasite heavy metal….Holiday is when the gut doesn’t have to work….like in a detox diet!!!
  12. Going below BMR will cause deficit in caloric function ok for young and healthy?Get a physical to look for disease ...bipolar ds, thyroid, diabetes, kidney disorder, gout/arthritis cause choking down on calories and inducing starvation environment can unleash hell
  13. On the flip side….our food industry is also profiting at the GUT expense by making tasty food that is bad for you. Sure they can be responsible for the way people eat but no one is telling the buyers you have to be in charge……FDA regulation of twinkies!!!!Thus you will have to self-educate and you may need to enlist help
  14. Don’t forget water I like reverse osmosis, theres also gravity flow microfiltration units and water distilling systems for contaminants….watch BPA in bottled water Bisphenol A
  15. What western medicine is good at…..science based health.What its poor at…practical application to the individual and teaching self care
  16. The best studies of longevity all point to a mostly plant based diet with fish/chicken Mediterranean, Japanese….ornish, HCG, South beach, modified, atkins, are non sustainable in my opinion, if you are going to try something, research the hell out of it and or get some help to weight the odds of success in your favor
  17. One of the basic things grounding can help is sleepWith the stress of lifestyle change comes erratic sleep…or maybe it was there already?This is what happens with stress (visible or invisisble)
  18. The brain/mind can control the function of the gutParasympathetic system (Gandhi) increases digestive juice, motility and relaxing sphincterSympathetic system (Godzilla) the opposite So if just nutrition is changed, there may be a temporary response but the gut/brain interface will push the previous chaos back into life
  19. Amygdala snaps to attention involved in negative emotion and stress1Left prefrontal inhibits?(as per Richie Davidson)Another way to calm the amygala (reduce activation in the amygdala) – 2increase oxytocin!Or laying the groundwork for a socially intuitive brain….3love and compassion can also increase oxytocin (supposedly)
  20. Yoga is not just flexibility…in fact, my classes are more for breathwork and meditation than the poses. One can just stay in easy pose like Julia and listen to my voice for 60 minutes and get close to the same benefit as others in the class
  21. The knowledge of our youth aintgonna work now (didn’t work then either!) Enlist help
  22. Change during the fast as decreased calories can translate to decreased attention and injuryTry a non vigourous movement like basic pilates yoga, tai chi forest bathingI like the idea of sweating during the fast but very careful not to push an already taxed body with low calories….could be pass out time. Consider a low intensity exercise like above for the fast then afterward 7-10 days….reintroduce a new exercise paradigm (sustainable!)
  23. Mucosagen –l glutamine, milk thistle, NAC, L glucosamineChlorella….caprilic acid, pau d arco
  24. Used in the 50’s and 60’s for death cap mushroom poisoning, studies up to 16-22 weeks but have to suggest 10days
  25. Empower for success