Unrecognized Consequence of Plant-Based Diets and a Contributor to Chronic Fatigue
By Laurie Warner, MA, CNC
A commonly reported consequence of vegetarian or vegan diets, or even diets that rely too heavily on plant foods, is chronic fatigue. Many sufferers subsequently embrace the principles enumerated by Weston Price, adopting a diet containing more nutrient-dense animal foods and fat; however, the fatigue often persists, even after considerable time on the new diet.
While Americans have been receiving a broad education on the nutritional value of plant foods, evidence has accumulated to indicate that diets that rely too heavily on plant food sources have special problems of their own. Those of us interested in traditional nutrition have become familiar with some of these, including fatty acid imbalances, B6 and B12 deficiencies, and untreated phytates in whole grains, legumes and nuts. As we continue to delve into these areas, the seriousness of these dietary imbalances continues to emerge.
Disruption of the copper-zinc ratio is an overlooked contributor to intractable fatigue that follows excessive reliance on a plant-based diet. The result is toxic accumulation of copper in tissues and critical depletion of zinc through excretion. This condition usually goes unrecognized because copper levels in the blood can remain normal. Also, most doctors are unprepared to meet with extreme zinc deficiency and its baffling effects on many systems of the body. Hair mineral analysis, competently used, is the tool which can unravel the complexities of this growing problem.
In particular, it is becoming clear that plant-based diets, and lighter diets generally, cause serious nutrient imbalances and long-term damage to digestion and cellular metabolism that are not easily corrected. This is of consequence for us in the traditional foods movement because we are asking people to return to higher density foods they may not have eaten for many years. Proper physiologic balance can be restored, but the period of transition in some cases may be longer and more difficult than we have anticipated.
An Unrecognized Danger
This article explores a major hurdle to dietary recovery, which has remained little-known, although an accessible book by Ann Louise Gittleman
, MS, introduced the topic in 1999.1 The fact is that the micronutrient copper is widely available in unrefined foods,2 but the mineral zinc, needed in larger amounts to balance copper, can only reliably be obtained in optimum amounts from land-based animal foods, in particular eggs and red meats.3 These of course are among the foods that have been most stubbornly attacked by mainstream nutrition authorities. They are also among the foods lacto-vegetarians and others who have conscientiously adopted light diets have the most difficulty in reintroducing.
It is tragic that Americans who have been inspired to adopt healthier diets have been so harmfully misled by the anti-animal foods dogma, often against their better instincts. I myself was led into this trap in the mid 1970s, and have only found my way out of it in the last few years. Although I found the Weston A. Price Foundation material when it first appeared, and benefited from many of its suggestions, I was unable to consistently expand my diet, or even tolerate any fat, until I learned to recognize and apply the lessons of the copper-zinc imbalance. In fact, this imbalance could very well have killed me.
A brief survey of copper/zinc imbalance will show why this condition can be so serious. Copper is an essential trace mineral, but it is needed only in minute amounts. It works in a paired relationship with zinc, sometimes in complement and sometimes opposing. Copper is present in most foods, and is also absorbed from the environment.4,5 When zinc is present in abundance, and when there is enough quality protein available to bind it,6 copper can be handled freely, and the excess can be readily excreted trough the bile.7,8
When the diet is lacking in zinc and protein, however—and in fats to promote bile production —use of high-copper foods, and environmental copper, primarily ingested through our water, promote buildup of copper in our tissues.9 The late Carl C. Pfeiffer PhD, MD, formerly of the Brain-Bio Center in Princeton, New Jersey, has provided us with the most comprehensive overview of nutritional problems associated with copper and zinc in his classic study Mental and Elemental Nutrients.10 As he succinctly puts it, "Deficiency of zinc accentuates copper excess."11
Here we have a classic dilemma of the medical flight from traditional diets. In lighter diets generally, and in heavily plant-based diets in particular, zinc is sharply reduced relative to copper,12 protein is curtailed, and fat is provided scantily at best. The excess copper that builds up in tissues is in unbound, inorganic form,13 highly immobile and creates a low-level toxicity that interferes with many body systems. Particularly affected are the liver and digestion,14 which are already hampered by increasing deficiency of zinc. As bile function and digestive vigor decline, difficulty with meat and fat develops. Legions of light-diet and vegetarian adherents feel justified in their choices because heavier food becomes unpalatable to them.15
The Grain Connection
We can quickly recognize a connection here that is particularly relevant to traditional foods nutrition. The copper-zinc ratio in grains is disturbed by refining.16 This ratio tends to be low in plant foods anyway,17 and is shifted further in favor of copper by the refining process.
In whole grains, as we know, phytates interfere with zinc absorption, so the net benefit from unrefined grains is always problematic, and probably very low in most cases, while copper, which is less affected by phytates than zinc,18 gains again in the copper-zinc ratio.
This loss of nutrients in grains, though serious, seems to have had less effect in past generations when much of the country still lived rurally and meat and eggs were liberally used.19 Current ideology, however, has shifted the burden of the diet to grains and other phytate-bearing foods and most people concerned with nutritional values of their food today have come to believe that these foods are reliable sources of both protein20 and zinc,21 resulting in poor protein nutrition, zinc deficiencies and build up of excess copper.
Even in 1975, Pfeiffer considered zinc status in most Americans to be borderline at best.22 After twenty-five years of vegetarianism and plant-based diets, it is doubtful our status today is even that optimistic. Too many other factors also work to increase copper and work against zinc. Zinc galvanized pipes have been replaced by copper pipes in many areas, which can be etched by slightly acidic water supplies.23 Birth control pills and other medications increase the retention of copper.24 Blanching of vegetables before commercial freezing removes zinc and many trace minerals,25 while copper is added to many multivitamins.26
There are numerous other factors contributing to this imbalance, but most devastatingly zinc is lost from our bodies every day when we are under stress.27 The more stress, the higher the losses, and yet zinc is needed in large amounts by our stress-resisting adrenal glands.28 When we are zinc-deficient our innate coping resources can start to unravel, and the grind of everyday stress can seem overwhelming.
Effects on the Personality
I know now that I started life with a big zinc-deficiency liability. Four years ago, my acupuncturist put me on a copper-zinc balancing program, but it was only about a year ago that I learned about pyroluria from the Resource Tool Kit in The Mood Cure by Julia Ross, MA.29 Those of us with this condition, affecting 11 percent of the population, produce excessive amounts of a metabolic toxin called pyrroles, which requires vitamin B6 and zinc for detoxification.30 Significantly, this condition is found disproportionately in those with alcoholism,31 schizophrenia32 and mood disorders.33 It can also produce baffling physical symptoms due to heightened deficiency of these two nutrients, as well as manganese,34 a nutrient that is crucially needed to activate arginase,35 the enzyme that converts ammonia to urea for excretion from the body.
Pyroluria, like copper-zinc imbalance, was first researched at the Brain-Bio Center.36 Pyroluria patients display a range of symptoms connected with severe zinc deficiency that are familiar to me from my work with Chronic Fatigue Immune Deficiency Syndrome (CFIDS), including nausea, loss of appetite, abdominal pains and headache—all of which can be associated with food intolerance and digestive problems—as well as nervous exhaustion, emotional fragility, palpitations, depression and insomnia.37 Other complications include abnormal EEG findings38 and cognitive difficulties ranging from misperceptions and hallucinations39 to amnesia.40 Cognitive deficits such as memory, attention and concentration disturbance are widely recognized in CFIDS patients41 and can occasionally take on more serious manifestations. These observations lead me to suspect that pyroluria may also be disproportionately represented among CFIDS patients.
Certainly chronic fatigue of a baffling type is a hallmark of the copper-zinc imbalance more generally. Nutritionist Ann Louise Gittleman
discovered the importance of copper overload in her practice when results of hair mineral analysis (sometimes referred to as tissue mineral analysis) helped explain the fatigue of patients who had not responded to treatment for suspected causes of the problem.42 Among a varied population, the only common factors were fatigue and high copper analysis.43
But as she also stresses, copper overload and its accompanying zinc deficiency, are usually "more than just fatigue."44 In addition to problems already mentioned, she recognizes hypoglycemia,45 anxiety, racing mind and panic attacks,46 skin problems,47 and premenstrual syndrome.48
Racing mind, which I have experienced as a kind of desperate, circular chattering of my own thoughts that can go on for days, is a special case here because it is so specific to the copper overload problem. The cognitive deficits of chronic fatigue patients are often characterized as "brain fog,"49 and investigators have found a general slowing down of brain functions.50 For patients to complain of rushing, frantic thought processes is an anomaly that can complicate the diagnosis of chronic fatigue, unless its role as a tipoff of possible high copper is recognized.
Michael Rosenbaum, MD, has credited Gittleman with recognizing "tired bodies with overactive minds"51 as the signature of the copper-zinc imbalance.
Candida and Infection
Two other serious conditions mentioned by Gittleman deserve special consideration, because they are often involved in the more critical CFIDS form of chronic fatigue. The first of these is yeast overgrowth, termed systemic candidiasis or candida by alternative practitioners. Copper, Gittleman informs us, is "the body's natural yeast killer."53 When it is bound up in tissues, however, blood copper may be low,54 resulting in reduced white blood cell activity. High levels of bioavailable copper can also be a problem, however, in exacerbating the condition.55 As in so much of mineral metabolism, balance is necessary to permit optimum function.
Other infections also play their part in CFIDS and can lead to the immune dysfunction that characterizes it. Gittleman tells us that individuals affected by chronic bacterial infections are found to have copper that's low or unavailable, while conditions of chronic viral infection are more typically connected with low zinc and high copper levels.56 Such patients often struggle on for years with little improvement, but may benefit from a copper-balancing program.57
Keynote of Poor Health
Struggling on has pretty much been a keynote of my life. In childhood I was weak and shy, always underweight. I was diagnosed with anemia and also treated with thyroid medication in early adolescence. It may have helped: always subject to frequent strep infections and earaches, I was a chronic absentee from school, but about that time I resolved to maintain regular attendance and was able to do so. But new problems appeared. I sunburned severely and was subject to stretch marks, signs of zinc-related skin fragility.58 I had my first yeast infection when only thirteen. I also experienced characteristic late-onset menarche.59
This pattern of uncertain health only worsened as I grew older. I suffered serious depression and attention problems I realize now were probably side effects of birth control pills.60 My use of these throughout my twenties was only the first of several major developments that would greatly aggravate my inborn copper-zinc imbalance.
When I first became interested in natural foods, I turned to Adelle Davis and D. C. Jarvis of Folk Medicine fame. These authors represented the natural foods movement for me and I never believed vegetarianism was necessarily the right or best lifestyle. But when I moved into a household with a vegetarian requirement, I made a fatal mistake. I accepted the premise that is was not really necessary to include meat, fish or poultry in the diet to be healthy. When I then, after a year or so of vegetarian lifestyle, acquired HHV2 infection, I was really in serious trouble, and the ominous deterioration of my health during the next few years took me decades to climb out of. Like so many immersed in the vegetarian culture, I strove to deal with my new crises by moving to more and more rigorous regimes, rather returning to the more nutritious foods I had eliminated.
My chronic infections from childhood had never let up. I had suffered constant vaginal yeast infections since my early twenties. Now to this were added, more and more frequently, headaches, painful joints and burning pain over my body in a general misery. Studying natural health seriously now, I found that these bouts, which I called "acid attacks," could be mitigated by the popular cleansing and alkalinizing regimes that so many vegetarians admire. Of course, there was no one to inform me of the vital role of high quality protein in maintaining proper pH in the body.61
Having gained some relief from my symptoms, however, I was able to sort out the pattern of these attacks more specifically, and they were centered on a cycle of liver and intestinal inflammation. It was this that I now sought to understand and unravel, and I was to pursue this quest doggedly year after year, in spite of blank looks, indifference and patronizing responses I received from practitioners across the spectrum of the healing arts. I had to do detective work on my own in those early years.
Fats and Acid Attacks
It was through careful self-testing that I first learned that fats were the source of my "acid attacks." It was a relief to find a cause, but also alarming. From my early studies, I knew very well the crucial role of fat-soluble vitamins. Was it only certain fats? I would experiment again and again over the years, trying to find ways to get a little fat into my system. All fats, even the highest quality, gave me these problems. For the present, I avoided all fats because of the price in pain and debility. It was truly ironic that everyone thought my diet was really healthy. One radio-talk nutrition expert asked me, "Why would you want to eat fats?" Even then, in the early eighties, I knew better.
At that point, things had, if possible, gotten worse. I had done an internship in iridology with a raw foods expert. I learned a great deal from this man about cleansing and retracing (a condition where old health problems resurface during the cleansing process), and I respected his program because he valued fats. He used substantial amounts of avocado and seed sauces to give his vegan regime some density, and he was not the archetypal gaunt vegetarian. But I was trying to do his program without those foods, and living on raw sprouts gave me new intestinal problems. There was no way to get enough food, let alone nourishment, from such a program. That was only the first time I nearly starved.
I had discovered I could not go back to even a more moderate vegetarian diet. I recognized that I had lost crucial digestive abilities. I now got acid attacks just trying to eat cooked food, even without fat. Dr. Paul Eck, a pioneer of mineral metabolism and hair mineral analysis was an early researcher and clearly recognized this destructive aspect of the vegetarian diet. He asserts that the vegetarian does not act freely in his choice of diet. He is forced into it by the progressive collapse of his metabolism.62 This collapse is certainly what I experienced.
Thankfully, I found two foods during this time that saved me. For years I used a seed sauce of my own design made with sunflower seeds and tofu—that is, I had finally found a substantial food I could rely on for protein and some fat. The home culturing of the sauce seemed to make it more digestible, and probably also reduced some of the problematic components of soy (of which I was unaware at the time). I was also receiving a basic source of zinc (from the sunflower seeds), a nutrient that had concerned me because I knew of its role in healing and the immune system. I did not know how extreme my zinc deficiency must have been, though I watched my nails for telltale signs. In all those years, I never developed the white-spotted or deformed fingernails linked to extreme zinc deprivation.63
Unfortunately, this sauce was also high in copper. Perhaps my second saving food helped me with this, however. Not tolerating commercial supplements, I turned to spirulina as a food supplement. I knew spirulina provided a broad range of nutrients. It was only years later that I learned how beneficial it is for the liver64 and realized it had probably helped me to reduce some of my copper load. It certainly aided my digestion, and in time I was able to return to cooked foods, though my diet was extremely limited still by my fat intolerance.
What I had not yet faced was a threat just becoming known.65 In my raw food years I had relied excessively on fruit and fruit juices for "alkalinizing," and just to get enough food. As I read the emerging literature on candidiasis, I was horrified to realize I had built up a massive systemic yeast problem. And yeast, we remember, is a hallmark of the copper-zinc imbalance. There would be no resolving one without dealing with the other.
In 1988, I began treatment with my acupuncturist, Theresa Vernon, and benefited from Chinese tonic herbs. Chinese medicine is a godsend for cases like mine because it can work at once by strengthening and balancing the system based simply on presenting conditions. Its cumulative effects are slow however, and I was by now very ill, and could not withstand further shocks to my system. I was then going through a prolonged relationship breakdown that I would have to call the most excruciating stress of my not unstressful life. And in 1990, I suffered a severe adverse reaction to Nizoral, an antifungal drug then being use for candida. This caused serious new liver damage and intestinal damage as well. I had now developed an acute colitis-like condition that would stay with me many more years, and the liver pain was back with a vengeance. Once again my diet collapsed to a handful of foods.
In the fall of that year I went into total breakdown, a process that is most devastating because it just keeps on getting worse. Gittleman talks about adrenal burnout in zinc deficiency as a total exhaustion of the adrenal capacity to respond to stress.66 Deep burnout produces a bone-shuddering, unrelenting fatigue that is beyond anything I would have imagined. I only hope that by sharing this information I can spare others that experience.
Burnout was only part of what was going on. There were also waves of a kind of feverish delirium that made it very hard to focus on my surroundings or communicate with others. Pfeiffer might have called it an "intensifying of disperceptions."67 In Chinese medical terms it is referred to as "deficiency fire."68 In energetic form, it can be described as a fast-burning brushfire in dry grass; when the system becomes too depleted, it can only consume itself. It is a complete exhaustion of yin, the reserves and nourishing fluids of the body.
The Chinese regime treats this with a "purge fire" and yin-restorative herbal tonic program. By pouring on these herbs for weeks, we cooled down to where the outbreaks of fire were less intense and less frequent. But I remained in a free-floating kind of fugue state for years. It is part of the disorientation of the condition that I don't know now exactly when I came out of it. I see a lesser version of this frequently in the ill persons I assist through our support network; there is such a high level of confusion, distractibility and anxiety in certain people today that they frequently cannot focus on the information that could help them. Such observations lead me to look into the area of zinc deficiency and adrenal burnout in their situations.
With all this we were trying to fight the candida too. We frequently had to go beyond the available information to make progress. In straight forward cases of flora imbalance, the basic programs generally presented may suffice. But attention must always be given to the problem of die-off. When antifungal supplements begin to kill yeast in the system, toxins are released which can aggravate symptoms unless care is taken.69 These symptoms can be mitigated by moderation in the approach, but I found I was struggling constantly with erratic and unpredictable flare-ups. What we gradually realized was that in more severe cases, the body can be so saturated with the toxic by-products of candida that these can cause "die off" responses with anti-fungal products, but also by anything with a cleansing effect on the system, even salads and beverage teas in a case as severe as mine.
I also felt that nourishing and strengthening agents, such as vitamins and tonic herbs, stirred up symptoms, perhaps simply because they aided my body in its own efforts. The toxicity of yeast and yeast byproducts is a serious concern and I have seen yeast-control efforts collapse again and again when this factor is not understood. The impulse is to throw everything available at the overgrowth, but we discovered that in many cases it can be eliminated only in minute increments, over an extended period of time.
I believe Theresa's treatment during those years saved my life. Using care in handling die-off, I was able to progress beyond the phase where nearly everything I did seemed to cause flare-ups. By the late 1990s, I had rebuilt my diet yet again and regained some strength, but I was living mostly on chicken soup and still rarely went out of the house.
Theresa and I have both found Chinese herbs and food therapy always helpful for those with chronic fatigue. Neither of us personally know anyone who has recovered from the condition without the help of Chinese medicine.
In Chinese medicine, proper food is a major treatment modality. According to Michael Tierra in Planetary Herbology, "Deficiency conditions are regarded as the root or radical cause of most diseases."70 Foods are analyzed according to the five flavors71 of sour, bitter, sweet, pungent and salty, and applied as a kind of supplement for the primary energies of yin, yang, chi and blood.72 In Chinese System of Food Cures, Dr. Henry C. Lu recommends chicken for underweight, poor appetite, diarrhea, edema, frequent urination, vaginal bleeding and discharge, shortage of milk secretion after childbirth and weakness after childbirth73—all symptoms of yin deficiency. He describes its characteristics as warm and sweet and its action as a tonic for the spleen. In Chinese medicine, digestion is a function governed by the spleen meridian system.
Dr. Lu gives recipes helpful for fatigue, neurasthenia and memory. His remarks indicate it would be a food of choice for any case of malnutrition, burnout or digestive debility. Theresa describes chicken soup as "healing for everything!"74 She has nursed many patients through this chicken soup phase.
My personal chicken soup was made with carrot, cabbage and potato. I had arrived at this combination by trial and error when the die-off reactions made everything problematic. I was able to eat it day after day and still find it delicious, strengthening and satisfying. As I learned about Chinese food therapy, I could see why it was so helpful. The root vegetables carrot and potato provided me some mild tonic benefit at a time when most herbal tonics were too strong for me. The cabbage had a cooling effect, promoted urination75 and nourished my digestion. I used only boneless, skinless chicken breasts at this time, (only later was I able to tolerate soup made with bones), but the slight amount of fat they provided was a godsend. I was also able to make soups with lowfat whitefish some of the time.
Ups And Downs
During this time I would improve greatly with this protocol and be able to add more foods for a time, even butter, but then my old problems would return. I understand now that my steady regimen was aiding my zinc deficiency and allowing me to eliminate copper. My tolerance for other foods would go up and I would improve again when I added eggs, but when I added other foods I would soon be in trouble again, and then the eggs would be too rich again. I realize now that when I could, I would go straight back to copper-rich foods.
Ironically, copper excess can lead to a craving for copper in some individuals. "Although it's a bit difficult to understand," Gittleman writes, "many people who have high copper in their tissues have difficulty utilizing that stored copper. As a result, they become somewhat deficient in copper in their blood. Because of that deficiency, they often crave high-copper foods to give them a temporary energy high."76 My copper fixes of choice were nuts, cereals and avocado.
Thus we can find ourselves simultaneously in excess and deficiency of copper. This paradox can complicate any program of copper-zinc balancing. When in 2002 Theresa began incorporating hair mineral analysis into her practice, she recognized my problem with high-copper foods and urged me to begin to detoxify. I had avoided zinc supplements along with so much else when everything gave me a problem. When I reduced high-copper foods, my liver pain reappeared; when I tested zinc supplements, my liver pain also reappeared. I began to realize this copper thing could have been a part of my problem for some time. But I didn't have a handle on it yet, and my efforts were erratic. When I read Gittleman's book, all my years of struggle finally fell into place. The key point: copper is normally eliminated in the bile.77
The Bile Connection
Liver pain is debilitating and frightening. When tested, my blood panels had been normal. The usual hepatic herbs gave me fits. Without knowing what I was doing, I had always opted for protecting myself and avoiding flare-ups. Now I set out to restore my gall bladder function. The more I learned, the more I was sure copper must be part of my problem. I came to understand that by reducing copper foods, I was allowing copper elimination. By beginning zinc supplementation, I was mobilizing copper elimination. I reasoned that my gall bladder function had shut down from years of nearly fat-free eating. I knew that my old mentor, Adelle Davis, had much to say on the subject, information I hadn't been able to use until now.
Ms. David won my heartfelt gratitude when she described the life of a gall bladder sufferer: "Individuals who have suffered acutely while passing a gall stone or when the gall bladder has been inflamed often become so fearful of food that they frequently live on self-imposed, severely restricted diets free from all fats without realizing that they are making their condition continually worse."77 Here I read the only description I ever found of my plight. My suffering had been caused by passing of copper, not gall stones, but I had repeatedly been given the same advice she criticizes—avoid fats to reduce digestive discomfort.78 Her program uses peanut oil79 to increase bile acids80 and recommends whole milk, cream and butter.81
I had long since recognized the epigastrium-gall bladder area just below the ribs on the right flank as the focus of my pain, and had for some time been using a Chinese formula "to clear damp heat"82 from the area. I got hold of some zinc supplements and some bile capsules containing 500 mg, and was ready to face peanut oil and butter. There was considerable discomfort from the copper elimination, and some digestive upset to mark the transition, but understanding now what I was doing I was able to modulate the process. Within a few days I was eating soft boiled eggs with butter and salad dressing with buttermilk and flax oil; by the end of the week, I was experimenting with chicken skin and bits of well-marbled roast beef. Talk about learning things the hard way!
I have never again had to fall back on my frugal chicken soup diet, though I still make soups several times a week. Now I prefer turkey to chicken, because it's richer, and I also make soups with beef, pork, lamb and seafood. Yes, seafood is very high in copper, but after a period of detox and after digestive recovery to restore a hearty appetite for red meat, copper just isn't a major bugaboo any longer.
In teaching traditional foods and working with chronic fatigue advocacy, I am now meeting people frequently who complain of fat intolerance or gall bladder pain, or queasiness after rich meals. People are hearing the new information about good fats and are eager to enjoy salmon and butter, olive oil and coconut milk. It is startling to them to find they can't easily go back to more traditional habits. I see this pattern in people who haven't yet developed the multiple problems of lowfat plant-based diets and copper-zinc imbalance. After all, that was my first problem, too. We need to take this incipient digestive upset as a warning sign and find our way back to the foods of our ancestors.
I feel that digestive recovery is the beginning, whether a person is coming from the standard American diet or some version of a light or fat-restricted diet. As in my case, the particular nutritional dilemmas a person has gotten into can tell a lot about the struggles developing in his or her body. Gittleman, who had studied the work of Paul Eck, develops his point made above: "Many people switch to a lighter diet because red meats and other types of animal protein feel ‘heavy' in their system. Ironically, this feeling can develop from copper excess, or zinc deficiency, or adrenal insufficiency. Individuals with copper-zinc imbalance have trouble digesting and absorbing fat and protein in particular, so they often opt for diets that avoid foods rich in these nutrients."83
Farther down the spiral from lighter diets to adrenal burnout, copper buildup becomes almost unavoidable. Adrenal burnout can lead to copper buildup in and of itself. Protein synthesis, especially the copper-binding protein ceruloplasmin, slows down and liver detoxification falters.84 This can lead to, in Chinese terms, liver heat, or in more extreme form, liver fire, with symptoms of dizziness, headache and red eyes.85 Recall the headaches that marked my first problems, which were "cooled" by alkaline foods and cleansing herbs. In the full-on deficiency-fire state, waves of dizziness were constant, and my eyes were so sensitive I wore dark glasses in dimly lit rooms.
The most easily available herb Tierra recommends for liver fire is yellow dock.86 Its energy is bitter and cool, it functions as an "alterative, chologue, astringent, aperient and blood tonic," and he recommends it for skin disorders and as a purgative for bile congestion.87 With skin disorders, think zinc deficiency, and with skin disorders of liver fire, think of the widespread incidence of adult acne. Yellow dock's action as a purgative, he tells us, is similar to rhubarb but milder in action.88 This combination of action is especially valuable in our present context, since constipation and lower intestinal problems can be a direct consequence of reduced bile flow89 and low-fat diets.90 Tierra recommends 3-9 grams daily, in capsules.91 This is probably too high when copper is being cleanses. In these cases, I recommend any new herb be introduced carefully. Very small amounts may provoke a reaction, but the portion can be gradually increased as cleansing occurs. Yellow dock is recommended as a digestive aid only. No single herb can clear such a complex condition as liver heat.
It is because of this pervasive liver heat that many of our light dieters on the way down became avid salad and fruit eaters, or raw-food vegetarians, as I did. To go for all this cold food without understanding what it is doing can create new digestive problems. In Chinese medicine, the spleen meridian system, governing spleen, pancreas and stomach, is easily damaged by cold, a condition called deficiency of spleen yang. With this deficiency comes poor digestion, fluid retention and tendency towards mucus.92 A clear sign of this type of digestive damage is a tongue that is bloated and very pale, frequently heavily coated as well. This condition is frequently associated with candida overgrowth.93
The vegetarian with a cold spleen condition may be worried about "mucus-forming" foods and yet crave cooling dairy products that worsen the condition because of liver heat or hot spots elsewhere in the system. The Chinese medical approach allows addressing liver heat with cooling liver herbs and cold, damp spleen with herbs and foods that warm and protect the stomach. My chicken soup, although I did not fully understand it, fulfilled these functions very well. Tierra recommends mildly warming stomachic herbs like cardamom, caraway and dill, which by aiding the circulatory function of the spleen system, benefit the liver as well.94
Dairy products can also worsen problems with zinc deficiency, according to Gittleman. Calcium can slow metabolism, already sluggish from poor digestion and excess copper, and if foods high in phytates are eaten with dairy foods, ". . . this combination of foods dramatically decreases the body's absorption of copper-antagonistic zinc."95
When I needed to improve digestion and transition to foods with higher nutrient density, I relied on non-gluten grains, vegetables, poultry and fish. Just by cutting out the glutinous grains, I avoided substantial amounts of copper and zinc-binding phytates. Although my program was very low-fat, it greatly improved my digestion and my very cold spleen condition. The way I ate then was very similar to the program Gittleman recommends, and I feel her guidelines can be helpful for those wishing to transition to richer traditional foods.
This program is fairly neutral from the Chinese warm-cold point of view, avoiding excess cold foods. Fish is neutral from the copper-zinc viewpoint as well, as it does not contain great amounts of either copper or zinc.
While fish is valuable for its rich nutritional profile, especially essential fatty acids, and is especially digestible for those first adding more protein to their diet,96 it is important to begin using small amounts of land-based proteins as one becomes able to do so. It is in part the mildly warming nature of chicken that makes it so good for digestion. Although eggs contain only .7 mg zinc per egg, their ratio of 7 to 1 zinc to copper is nearly ideal,97 and properly raised eggs are rich in many accessory nutrients needed to aid detoxification. And red meats are among the most warming foods, with mutton and pork being especially recommended for the spleen.98 These land-based proteins are our richest and best-assimilated sources of zinc. Dark meat poultry and red meat contain the most fat in this group, and also significantly more zinc.99
Restoring Fat Metabolism
We know that vitamins A and D in animal fats are essential for the absorption of minerals.100 Although Gittleman recommends use of enzymes and hydrochloric acid to aid digestion for those who have lost finction,101 she does not provide an affirmative program for restoring fat digestion, such as the use of bile salts, nor does she recommend cod liver oil. She states that reversing copper overload will boost both fat digestion and fat metabolism,102 but I found I had to improve my fat digestion to begin to eliminate copper. Thus, her program stops short: to fully restore our mineral metabolism, we must get past the stage of careful fat restriction she advocates103 and embrace the full range of healthy natural fats, especially fats that will provide the all-important fat-soluble activators.
In 1997, a significant article appeared in the Health Journal of the Price-Pottenger Nutrition Foundation, discussing "systematic acidosis resulting from glandular deficiencies that impair fat metabolism."104 The author, a dentist, discussed how this acidosis was the cause of calculus (scale) deposited on teeth, and could be reversed by supplementation of bile salts. The article provides careful and detailed information on bile supplementation which must be adjusted to individual need. Two tablets of 5-grain ox bile are to be taken with each meal, to be reduced to one if diarrhea occurs, and discontinued if diarrhea continues, indicating another source of fat disturbance is likely. It is interesting that, while I benefited greatly from bile supplementation, I never was subject to dental calculus; thus, a trial of bile salts is desirable in cases of liver or gall bladder congestion whether or not calculus is present.
Some elimination of copper can begin as soon as a shift towards a more balanced diet is taken, and is likely to cause some discomfort. As with the candida process, changes should be made slowly, backed up by digestive support. If copper release is higher than can comfortably pass through the liver and gall bladder, copper levels in the blood can rise, with an increase in digestive discomfort, anxiety, headaches and other symptoms.105
To minimize these episodes of copper discharge, Gittleman recommends emphasizing nutrients which have an antagonizing action to copper, that is, they reduce its absorption or aid in binding it for excretion from the body.106 The most important of these, of course, is zinc itself, as obtained from the land-based proteins mentioned above. Manganese and iron act to displace copper from the liver; vitamin B6 and niacin promote reversal of copper overload; molybdenum and sulfur, which act in the intestines, facilitate its excretion; and vitamin C, very importantly, chelates copper in the blood to facilitate its removal.107 By emphasizing food sources of these nutrients, inorganic copper can be mobilized and circulated out of the system with minimum disruption.
A diet providing ample animal protein, dark leafy greens, a variety of other vegetables and fruits, fish, small amounts of legumes and plentiful natural fats can meet these needs. If cold foods worsen your digestion, stick with soups, cooked vegetable dishes and stewed fruits, and take digestive enzyme supplements.
To perform this kind of metabolic work, supplementation is very helpful. For copper overload of long standing, or to obtain more immediate relief, it really becomes necessary. Readers of Wise Traditions are accustomed to using food-based supplements, and I always encourage these for the rich matrix of associated factors they provide, but to address serious conditions like copper toxicity, liver congestion, candidiasis and adrenal insufficiency, Theresa has found clinical supplementation to be essential.108
Gittleman recommends supplements in the following amounts, to be taken with a copper-free multiple vitamin: zinc, 10-25 mg; manganese, 5-15 mg; vitamin B6, 50-200 mg and vitamin C, 500-3,000 mg.109 To this would be added pantothenic acid, 600 mg to support the adrenals.110 Not mentioned by Gittleman, but of course very important, is a good quality cod liver oil.
I have taken these supplements for years, and still do. I also take, and recommend, a natural trace mineral supplement (see the Resource section, below) as a source of antagonists too often depleted from our soils. The product I use contains a mixture of sea bed and volcanic montmorillonite. The minute amounts of copper such products contain, perhaps because imbedded in a mineral substrate, generally do not interfere with a copper-balancing program.
In order to develop a more comprehensive program, if it is to match your own metabolism, it is necessary to seek out hair mineral analysis, and obtain a metabolic profile based on the mineral ratios presented. Unfortunately, most laboratories offering hair analysis services provide nutritional programs based simply on apparent deficiency of minerals in the hair, and perhaps levels of toxic metals. I had tried such a program early in my search for health, and found it offered little beyond supplementation I was already using.
Pioneer mineral researcher Paul Eck, mentioned above, found that supplementation must be applied to correct critical mineral ratios, such as the ratio of copper to zinc in the tissues of 1:8. He had found that giving a particular mineral just because it showed up low on an analysis rarely succeeded in raising that mineral, but when he adjusted mineral ratios first, mineral levels would then rise.111 Gittleman's work is based solidly on Paul Eck's research, and Theresa is also seeing excellent results by affiliation with a laboratory that uses his methods. This kind of metabolic rehabilitation is a long-term project, and requires using a group of supplements that are modularly interlocked to match each person's pattern.
In the case of copper overload, copper which is found in hair tissue may not initially give a high reading, but telltale patterns of mineral ratios can reveal the likelihood of hidden copper.112 The laboratory we have used is listed in the Resources section below.
I have been using a metabolic mineral balancing program since I began to address my own copper issues several years ago. My hair is retested several times a year and the supplement program adjusted accordingly. The program includes a supplement specifically intended to increase digestive elimination of copper. I also use zinc and B6 in higher-than-normal levels to address my pyroluria. Based on Pfeiffer's research, I supplement manganese and zinc in a 1:20 ratio to facilitate urinary excretion of copper.113
When I was ill, my underweight condition at times approached emaciation, and for years all I could do was prepare my soups, eat them and return to bed. My digestive recovery five years ago has changed all that. With a steady diet of bone broths, meat, turkey, butter, eggs, cod liver oil and raw cheese since that time, I am today stout, active and happy for the first time in my life. I have the musculature to take regular exercise and—most astonishingly—have lost the frail frame I had struggled with all my life. Today at sixty years of age, I have the sturdy bones and rosy peasant cheeks of my Irish and German ancestors. And I have optimism and enthusiasm to bring a friendly word about real food to others who have been starving from the lack of it.
To find a practitioner in your area who utilizes hair mineral analysis (also referred to as tissue mineral analysis) according to the methods of Dr. Paul Eck, you may call Analytical Research Labs, Inc. at (602) 995-1580. Their website is
They are located in Phoenix, Arizona.
ARL is the provider of Endomet brand supplements. The copper-eliminative supplement Theresa recommended for me is called GB3, which contains 112 mg ox bile, hydrochloric acid, enzymes and black radish. Black radish is recommended by Gittleman for liver congestion and as a source of sulfur.114
Supplements provided directly to the consumer are generally lower in bile salts. When my stomach was still very cold, I could not use hydrochloric acid, and I searched for months to find a product that contained only ox bile and enzymes. I could only find one, designed by Dr. David Beaulieu of Kansas City, Missouri. It contains 65 mg ox bile and enzymes in a two-stage tablet. Multiple tablets can be used to give a comfortable bowel elimination. Since bile salts are resorbed from the small intestine,115 effects of bile supplementation are cumulative and the dose would change over time. Dr. Beaulieu's company, called Preventics, also makes the Mont-Min 74 trace mineral supplement I use. Preventics can be contacted at (800) 888-4866 or
I generally recommend zinc be taken in chelated form. Ethical Nutrients, however, has a liquid zinc sulfate product called Zinc Status. Since zinc deficiency affects the sense of taste, you can test yourself at intervals with this product until your zinc-restoring efforts bring you up to speed. As long as your zinc status is deficient, the product will remain tasteless; if it takes on a characteristic obnoxious sulfur taste, you know that you are making progress.116 The product is available in health food stores or from
Herbalist Andrew Gaeddart is the genius (in Theresa's opinion) behind Health Concerns Chinese herbal products. These products adapt traditional Chinese formulas for problems of American patients. They are at the heart of Theresa's success with chronic illness. Quiet Digestion, containing magnolia bark, citrus peel and other herbs, promotes long-term digestive recovery and provides immediate aid for digestive distress. GB6 is the product which helped me reduce liver and gall bladder pain, used over time. Phellostatin is an outstanding candida regimen, which supports all affected systems as it eliminates yeast.117 Yin Chiao Jin aids all those "flu-like symptoms" from yeast or copper detox. Nine Flavor Tea is a superlative yin tonic formula of the old school, used to overcome the extreme weakness and insomnia that go with burnout and inflammatory conditions. To find a practitioner using Health Concerns products, call (800) 233-9355 or visit