Topic: Detoxification Overview and Protocol with Kerri Louati
1. **Understanding Detoxification:**
- Detoxification is a continuous physiological process for eliminating toxins and waste.
- It is not a fad diet, juice cleanse, or a gimmicky supplement.
- It's a lifestyle approach to reducing toxic burden.
2. **Toxicity in Our World:**
- We live in a toxic world with unavoidable exposure to environmental chemicals, known as xenobiotics.
- Newborns have been found with an average of 200 industrial chemicals in their systems.
- Human adipose tissue shows 700 chemical contaminants.
- Persistent organic pollutants like DDT, although banned in some countries, still affect us due to global interconnectedness.
3. **Common Toxins:**
- Volatile organic compounds (VOCs), mold, solvents, phthalates, parabens, bisphenols, pesticides, heavy metals, and combustion-related products.
4. **Toxic Burden Factors:**
- The rate of toxin intake, poor excretion, detox genetics, and nutrient deficiencies affect the body's toxic burden.
5. **Health Implications:**
- Toxins can impact every system in the body, contributing to diseases like Parkinson's, Alzheimer's, osteoporosis, respiratory conditions, cardiovascular diseases, cancer, hormone imbalances, reproductive disorders, liver and kidney issues, immune dysfunction, and more.
6. **Epigenetics and Toxins:**
- Toxins can trigger the expression of genes that predispose individuals to certain conditions.
7. **Specific Toxins and Osteoporosis:**
- Heavy metals (cadmium, lead, arsenic, mercury), mold, bisphenols, phthalates, organochlorine pesticides, and PFAS are linked to osteoporosis.
8. **Detoxification Protocol:**
- Prevention: Avoid toxins by using clean water, air, food, products, and maintaining a clean home.
- Excretion: Ensure regular bowel movements and sweat to eliminate toxins.
- Support Liver and Gut: Consume foods that aid detox pathways.
- Antioxidants: Offset damage from toxic exposure with high antioxidant foods.
9. **Detoxification Steps:**
- Step 1: Prevention through avoidance.
- Step 2: Excretion via bowels and skin.
- Step 3: Support liver and gut pathways with specific foods and practices.
- Step 4: Consume antioxidants to counteract oxidative stress.
10. **Detoxification Pathways:**
- Phase 1: Adding a reactive site to the toxin, creating free radicals.
- Phase 2: Adding a water-soluble group to the reactive site for excretion.
- Nutrients like B vitamins, amino acids, magnesium are essential for these pathways.
11. **Supportive Foods and Practices:**
- Cruciferous vegetables, sulfur-rich foods, protein sources, high-antioxidant foods, probiotics, Epsom salt baths, castor oil packs, and enemas can support detoxification.
12. **Lab Testing for Toxic Burden:**
- Various tests can indicate the presence of a toxic burden, such as NutrEval, HTMA, stool tests, genetic testing, and general lab work.
13. **Action Items:**
- Limit exposure, focus on clean living, support excretion, support liver and gut, and consume antioxidants.
**Questions and Answers:**
- Bioaccumulation was explained as the buildup of toxins in the body, often stored in adipose tissue.
- Recommendations for fish intake were given to avoid high mercury levels, suggesting smaller fish like sardines.
- Sauna use was recommended 3-4 times a week for 15-30 minutes, with electrolyte replenishment suggested through products like LMNT.
- For constipation, magnesium supplements, castor oil packs, and dietary changes were recommended.
- Homocysteine levels were discussed as an indicator of methylation and detoxification efficiency.
- The importance of not letting fear hinder progress was emphasized, with a recommendation to start with simple, impactful changes.
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Kerri Louati: So today, we're going to be diving into detoxification. We're going to address what it is. We're going to talk about why it's important. And we're also gonna go over some general principles of a detoxification protocol so that you guys can leave with some actionable steps today.
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Kerri Louati: This is just going to brush the surface. And it is a lot of information. So hopefully, it's not overwhelming. But if you guys have any questions definitely jump in and feel free to ask.
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Kerri Louati: So I'm gonna start this presentation. With this arm yourself with knowledge. But don't let fear hijack your journey. And I can't emphasize this. Enough. It's important to limit toxicity and support your body. But the reality is we live in a toxic world, and there are things that we can't control. There are things that we can control.
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Kerri Louati: So as we talk about the prevalence of toxins in our society and where they're found. Let's just do our best to remove the fear. We can't live in a box but we can definitely reduce our toxic burden. So that's really my focus is giving you guys some steps of things that you actually can do.
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Kerri Louati: So. Detoxification is an ongoing physiological process by which the body eliminates toxins and waste products.
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Kerri Louati: Detoxification is not a fad diet, it's not a juice cleanse. It's not a gimmicky supplement. It doesn't mean that green juices can't be part of a healthy detox protocol, but detoxification is more than just a single week long diet of raw juices. It's a constant process, because our bodies are constantly exposed to toxins. So it's really more about a way of life, and how we can decrease that burden.
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Kerri Louati: and it is a burden. It's something that research has found. We all carry a burden of environmental chemicals which we also call xenobiotics.
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Kerri Louati: Studies have shown that in 2,004
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Kerri Louati: There were an average of 200 industrial chemicals and pollutants found in newborn babies. These were chemicals, such as pesticides, plastics coolants, other waste compounds as well. So just entering into the world. Even newborn babies are dealing with a toxic burden. And it's something that, as our you know, industry continues to
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Kerri Louati: manufacture products. And we continue to use billions of chemicals on a yearly basis. It unfortunately, is getting worse
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Kerri Louati: human adipose tissue from us residents has identified 700 chemical contaminants that haven't even be. Ca, haven't been chemically identified. And adipose tissue is where toxins tend to be stored in the body. So that's a really good source to look at where these things are found.
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Kerri Louati: and the other thing is, our world is connected. And that's really important to understand, too, because while we might not use certain toxins in our
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Kerri Louati: in our country anymore. One good example of this is Ddt. That was banned in 1,972, which is a type of toxin called a persistent organic pollutant because it persists in our body. It's really hard to detoxify, even though we don't use it in our country. Other countries still use it to eradicate mosquitoes.
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Kerri Louati: and our waters are connected. Our error is connected. And so if other countries are using different products, then that can still impact our systems today.
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Kerri Louati: So these are some examples of toxins that we're exposed to volatile organic compounds is a category that includes exposures such as carpet plasticizers, fragrances. We have exposures such as mold, which is a unfortunately very common toxin solvents like nail polish glues.
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Kerri Louati: paints these have toxins, such as phthalates, Parabens, bisphenols.
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Kerri Louati: pesticides are very prevalent. We have pesticides, herbicides, fungicides that are sprayed on our food in our homes, they are ubiquitous in our society.
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Kerri Louati: We have different drugs and medications. We can get heavy metal exposures through a variety of different sources, including these cleaning agents, and combustion, related products or some other examples. Things like smoke, inhalation, industrial you know, products exhaust from cars and industry.
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Kerri Louati: So there are a lot of different areas where we're getting exposure. And there are a lot of different types of exposures that we're getting and this is really important because oftentimes we have a toxic bucket that is overflowing.
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Kerri Louati: and this is really a combination of different factors that will influence whether your toxic bucket is overflowing. The first is too many toxins coming in, and the type of toxin that's coming in is important. There are toxins such as pfas. Some of you may heard of Pfoss. This is what's deemed a forever chemical. It's a a you know, acronym for
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Kerri Louati: polyfluoral alkyl substances, and there are other compounds like I mentioned, persistent organic pollutants that are not readily detoxified, so those can tend to bio accumulate more in our systems. But the more toxins we have coming in. It's going to definitely increase our toxic buckets.
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Kerri Louati: If we have poor excretion. So if they're coming in at a more rapid rate than we're excreting them. We can definitely have more accumulation in our system.
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Kerri Louati: Detox genetics are also really important. So the rate at which our bodies capable of excreting these compounds. A lot of people have genetic snps that can impair different pathways and decrease the ability to get rid of some of these toxic compounds.
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Kerri Louati: and then nutrient deficiencies can also play a factor as well, and there are a lot of nutrients that are involved, and toxic exposure can also induce nutrient deficiencies. So you know, really, we're looking at this total toxic burden, which is how much we are accumulating and how you know how we can deal with the rate of exposure that we currently have.
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Kerri Louati: Sometimes it's a perfect storm. If somebody has all the above that can be somebody that's really symptomatic and really sensitive to a toxic exposure.
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Kerri Louati: So the question isn't, are we toxic? It's how toxic, are we? And how much is that contributing to our current health. And that's a very bold statement. But it's true. In our modern modern modern society
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Kerri Louati: there are a lot of negative implications associated with toxic exposure. It can impact every system in the body.
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Kerri Louati: So starting. And this isn't a comprehensive list. But starting with the nervous system and brain. We have conditions such as Parkinson's disease, Alzheimer's even developmental delays in children. These can be impacted by toxic exposure bones, osteoporosis. Yes, this is on the list. And I'll talk more about that on the next slide.
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Kerri Louati: Respiratory conditions. conditions such as asthma, Copd, bronchitis, cardiovascular disease. This is an interesting one, and there have been studies that have shown that there are increased cardiovascular events in highly polluted areas increase heart attacks and strokes. Hypertension is also another factor as well.
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Kerri Louati: Cancer. There are a plethora of cancers that are associated with different toxic exposure. There is a saying called the doses the poison so you know, it does really go back to what and how much of a toxin you are exposed to. But also there's this synergistic impact. We are just exposed to so many different toxins. That you know, the dose ends up being pretty high
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Kerri Louati: for a lot of people.
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Kerri Louati: Endocrine hormone imbalances. A lot of toxins can interfere with our hormones. Sex hormones, thyroid it can also interfere with conditions such as diabetes adrenal insufficiency, etc. Also reproductive disorders and fertility. That's another big one
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Kerri Louati: liver kidney. These are main organs that are associated with detoxifying a lot of compounds, so they tend to get the brunt of it. But there can definitely be impairments in that. In those organs
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Kerri Louati: immune dysfunction, autoimmunity. They can wreak havoc on our immune system. It can
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Kerri Louati: be associated with autoimmune conditions, such as Ms. Lupus rheumatoid arthritis and then there are other conditions as well that aren't listed things like skin disorders, eczema. But, as you can see, it really impacts the whole body. And whatever your weak spot is it tends to bring that out. This is a concept of epigenetics.
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Kerri Louati: There is a saying that the genes load the gun. The environment pulls the trigger. And one of the most influential environmental factors that goes hand in hand with of genetics is toxicity. So anything that we are exposed to can result in the expression of some of these genes that we are more inclined to
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Kerri Louati: to have.
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Kerri Louati: There are certain toxins that are associated with osteoporosis. Some are weak links, some are stronger links. We have some heavy metals, ones such as cadmium, lead, arsenic, mercury. These can be found in a variety of different places. These can be found in our water supply or food supply and products that we're using. In dentistry, things like mercury amalgams. That can be a source of exposure.
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Kerri Louati: Mold is another big one. Molds can wreak havoc, and a lot of different for a lot of different reasons in the body, but it has been linked to osteoporosis. And then we have other environmental chemicals, such as Bisphenols. You might have seen these referred to as Bpa.
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Kerri Louati: If you go to the grocery store and you pick up a can that, says Bpa. Free, that's what this is. Referring to the bisphenols. You have other chemicals like phthalates. These can be found in plastics and nail polish and body care products. You might notice your shampoo might have a label that says, Phthalate free. That's that's that compounds
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Kerri Louati: organocloring pesticides. So certain pesticides can increase inflammation. And that that's part of the mechanism of action is inflammation associated with a lot of these toxins that can contribute to osteoporosis. But you can also have bioaccumulation in certain areas as well as bone
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Kerri Louati: and pfas. The polyfluoro alcohol substances that is the forever chemical that I was referring to. This is this has gotten a little bit more. Attention. Recently, definitely, the past year, there have been some major headlines talking about pfas. There was a movie that came out called dark dark waters that talks about pfas. Coming from Teflon.
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Kerri Louati: which is non. So in nonstick cookware. So if you guys are interested in watching that movie, it's an unfortunate truth.
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Kerri Louati: but that will give you a little bit of insight as to what that compound is.
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Kerri Louati: So let's talk a little bit about the process of detoxification. I've ironed out 4 main steps. That are really important to focus on when looking at a detox protocol. So the first is prevention. Next is excretion. We then want to support the liver and guts, and we want to conclude with some antioxidants now.
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Kerri Louati: different protocols may be a little bit more nuanced. It depends on who you are, what you're dealing with. So you know, there definitely needs to be some variations. But this is a good general rule of thumb. For most people getting started.
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Kerri Louati: So step one is prevention, avoidance, avoidance, avoidance. This is the easiest well, not always easy, but the easiest way to get toxins out of your body is to prevent them from getting in there. In the first place. So we can do this by focusing on clean water, clean air, clean food, clean products and a clean home. So let's go one by one, taking a look at how we can clean these areas.
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Kerri Louati: So clean air studies have shown that indoor air can actually be more toxic than outdoor air, which, when I first heard this that, was very surprising to me. But one thing that we can do is we can purify our air. We can do this by getting a high quality air purifier a Hepa grade air purifier. That's one way to go about doing it.
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Kerri Louati: If you have central air, which I know we're all kind of scattered throughout the country, so everybody might not have central air. But if you do you can change your air filters and use a high merv rating air filter. This is really referring to the ability to filter out particular matter. So the higher merv rating and an air filter correlates with a higher ability to filter out particular matter. So the higher
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Kerri Louati: you go, if you can get something, you know 12 or above, that's fantastic. And change every 2 to 3 months. That would be the best way to filter your air, because air conditioning is kind of like the lungs of your home.
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Kerri Louati: So if you see anything funky with your air conditioning or your filters? That's a good sign. You might have some issues in your home. Same with air ducts. I have a good friend, actually, who just this past weekend got her air ducts cleaned, and they were filled with black mold. They were filled with dust. So that's also another important area that you can take a look at to see if you're getting clean air in your house
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Kerri Louati: outside of those things. Taking a look at certain smells and fragrances that you have in your home. A lot of those do contain environmental chemicals like phthalates.
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Kerri Louati: So if you're putting out an air freshener to try to purify your air. You're you're really not doing that. You're actually contaminating your air a little bit more so the glade Plugins. Probably not the best idea. If you de do need some support with fragrance. Doing something like a an oil diffuser with some natural oils would probably be a better option.
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Kerri Louati: You can also get air contamination through paints and fumes, dust and dander, and those are also common.
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Kerri Louati: And that was all inside the home, outside the home, you know. There's we have a little less control over what goes on outside. Unfortunately, but we do know that exposure to smoke we can limit, you know. Don't stand next to someone smoking. When you're getting gas. Don't stand next to the fumes get back in your car or stand, you know, not downwind upwind, so that you're not getting the brunt of of those fumes.
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Kerri Louati: Also vehicle exhaust, and sometimes this can be more pre prevalent. If you're exercising in a highly polluted area, you might get more exposure, not recommending not to exercise. But just maybe be aware, if you're someone that is biking, you know, on a busy street, and you're behind a lot of cars, and you're inhaling all those fumes. That would be a good example of a situation where you might get more exposure.
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Kerri Louati: clean water. So our water is pretty universally contaminated, unfortunately, and we have a lot of runoff. Our water systems are connected. So one general rule of thumb, I would say, is, don't drink tap water and one way to take a look at the quality of your tap. Water is to go to this website here, ewg.org, and they have a link called tap water database.
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Kerri Louati: You can enter in your Zip code and it will pull up your water quality and it will give you the highlights of whether your city has really bad water or just bad water. Unfortunately, those are kind of the options that we're dealing with. But tap water can have contaminants, such as lead, arsenic, pesticides, micro organisms, fluoride. There are a lot of things that can be lurking in our water, so a good general rule of thumb is, use a water filter.
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Kerri Louati: If you are able to. Get a high quality water filter. That's great. It's definitely an investment. But I do think that the things that you're doing every day matter more than the things you do once in a while, and water something that you know fuels our body. So we're made up of mostly water. So that would be a good thing to invest in.
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Kerri Louati: Brita does not really cut it, although it's better than nothing. The best option really would be a reverse osmosis system. But there are all different types of reverse osmosis options on the markets.
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Kerri Louati: I do recommend limiting plastic water bottle use as well. We do get a lot of plastics that leach into the water, and so that can be an endocrine disruptor. And that can interfere with a lot of different systems in the body, you know, if you're out and about, you need a bottle of water. Fine, but if you're relying on it every single day, I would take a look at that and definitely look for a different option.
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Kerri Louati: and then don't forget about bathing water. I think a lot of people are a little bit more conscientious of drinking water, but bathing water is also a source of exposure. We do absorb through our skin. And so if you're sitting and soaking in a water quality source that isn't great for 20 min. You know you're gonna get some of that through your skin. I do think that bathing water purification is a little bit harder. There aren't as many great options on the market.
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Kerri Louati: You know there are some shower filters. There are some bath filters. That you can take a look at for options. There are whole house water filters. But how far down the rabbit hole do you need to go? I think? Starting first and foremost at taking a look at your city water and see what is lurking there. First and foremost.
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Kerri Louati: all right, clean food. So we use over 1 billion pounds of pesticides in the Us. Annually.
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Kerri Louati: and one good general rule, thumb is to choose organic so that we do not get that pesticide and herbicide exposure if you're able to organic food is definitely more expensive. So I know that's not an option for everyone all the time. Sometimes it's just not available or not convenient, or we're dining out.
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Kerri Louati: But there is a good general rule thumb, which is to abide by the dirty dozen, which are the more Ca highly sprayed foods that tend to be more contaminated, and then the clean 15, which are typically the less contaminated options. Now, if you take a look at these lists a good general theme here is that a lot of the dirty dozen foods don't have an outer layer. They're sprayed directly
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Kerri Louati: on those foods, and then we're eating that whole food. So you know, sprayed on the spinach, we're eating that spinach.
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Kerri Louati: whereas in the clean 15 list a lot of these foods have an outer layer that we're peeling off.
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Kerri Louati: or it's grown underground, so it might not get as significant of that exposure. So that's one way to kind of look at this list. It's not a perfect list. There are foods on here like corn. That is genetically modified. And so that's a different issue for a different time, a different conversation. But this is a good list to follow. If you need to pick and choose which foods are most important. To choose organic. But if you can do all organic, that's definitely best.
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Kerri Louati: We know that herbicides and pesticides can interfere with our microbiome as well. And so, you know, it's affecting us at the gut level, and I know if you're a patient of mine, we always talk about how important. The gut is first and foremost for pretty much every single condition
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Kerri Louati: outside of choosing organic. There's some other things to pay attention to with clean food. First storing food and glass containers rather than plastic containers, so that we're not absorbing those microplastics. We're not getting those bisphenols. Anytime. You store something in plastic, and it has heat, acid, or fat. You're going to absorb more of those plastics into the food.
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Kerri Louati: So one thing that I am very cautious about is, take out containers when you're ordering something hot. So if you're ordering, let's say, like a hot tomato soup that's hot. That's acidic that probably has some fat in it. You're gonna be absorbing more of those plastics, let's say, if compared to ordering something like, you know, a salad or sandwich that's cold. That's not going to leach as much of that.
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Kerri Louati: So you know, prioritize again the things you do every day matter more than the things you do once in a while. So if this is something that you know you're ordering, take out all the time
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Kerri Louati: that might be different conversation. But one thing I'd be aware of is the plastic intake
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Kerri Louati: styrofoam containers, too. I don't think that these are as common anymore, but I know certain restaurants have gone back to Styrofoam because it's cheaper. And they're trying to cut costs. So you'll get Styrene absorption. So that's something to be aware of
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Kerri Louati: opting for non toxic cookware and being aware of teflon, or any sort of nonstick coating, just going back to the pfas. Pfas are forever chemicals. They're really hard to get out of the body. You know.
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Kerri Louati: part of the recommendations for detox for Pfos is to like donate blood because it's that hard to get out. So that's not gonna be part of the protocol that we're gonna talk about. So again, avoidance is is the most effective way to get those out of your system or not get them in your system. So choosing cookware, such as cast iron or ceramic coated pans or stainless steel pans. Those can be much better options.
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Kerri Louati: some other things to be aware of limiting aluminum exposure. If you are somebody that cooks with aluminum foil. You're putting your food on aluminum in the oven. Guess what you're getting aluminum in your food, so that is not going to be the best way to cook your food. And usually it's not necessary. There are other ways to prepare your food that doesn't require that.
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Kerri Louati: Also aluminum cans, you know, if you're using canned foods every single day. You're probably getting higher exposure to aluminum as well.
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Kerri Louati: and then, just generally speaking, limiting additives and preservatives and food as well is important.
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Kerri Louati: and this is not a comprehensive list of all the toxins that can't be in food. And again, you know, not to induce fear, but certain things that we can control. Just being cautious of high mercury seafood, you know some examples of high mercury are swordfish. Tuna there was a statistic that one serving of tuna or I think 2 for adults reaches your mercury limit for the wheat.
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Kerri Louati: So that's something you're doing very often you can still do it. There are lower mercury options like Skip Jack. Light is going to be a lower mercury form of tuna, so that might be a better option if that's something that you really like, but maybe getting a little variety with your seafood reducing arsenic by either soaking your rice, or cooking your rice, and double the amount of water, and pouring it off at the end, can reduce arsenic content.
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Kerri Louati: Oops.
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Kerri Louati: There are certain foods that tend to be contaminated more with molds. Again, you don't have to avoid these foods, but if your diet is like, you know, relying very heavily on corn and peanuts and coffee. Then you might be getting higher mold intake, and then, you know, a diet that wouldn't be
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Kerri Louati: and then just reducing animal products that are using antibiotics and hormones in meats and dairy products as well.
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Kerri Louati: And then we have clean products. So our skin absorbs what we put on it. It's one of our larger organs. And we know that. Roughly, one out of, you know, 12 people are putting potentially cancer, causing agents on their skin on a daily basis. So that website I told you about ewg
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Kerri Louati: dot org also has a section called Skincare database, and you can go in here and you can enter your body care products, and you can see the risk of toxicity associated with those products.
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Kerri Louati: They also have
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Kerri Louati: good options for cleaning supplies, mattresses and body care products that are approved in low toxicity. But this is something to, you know. Take a look at. What are you doing every day? What is your shampoo and conditioner, your lotion, your makeup?
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Kerri Louati: You know even things like toothpaste. I mean, there are things that we just do every day that we probably don't necessarily pay attention to the impact on our system. So those are things. That you can. Take into your own hands and look for alternatives. If you find something you're using is risky.
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Kerri Louati: clean home.
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Kerri Louati: top of the list for clean home is really make sure that you don't have mold if you've had water damage make sure that it's taken care of properly. If you have any suspicion for water damage, you know. Maybe take a look at whether you have any mold exposure. This is something that can definitely contribute to a lot of illness.
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Kerri Louati: systemically. And it's a big problem. I mean, there are stats that you know, 70% of homes in the country are dealing with mold. So it's a much bigger issue. I'm down in South Florida. It's wet. It's humid. I mean, there's mold everywhere. So this is a big problem where I live. If you're in a drier state, you know, you might have less issues. But anytime there's water damage. You know. You're you're looking for the molds.
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Kerri Louati: Remove your shoes when entering the house, or, you know, maybe have indoor shoes that way. You're not tracking the whole world into your home.
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Kerri Louati: That's a good way to reduce some of that toxic. Introduction.
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Kerri Louati: This is one that I I learned about from my mentor airing out dry cleaning before bringing it indoors. I don't know how many of you people do use dry cleaning but they use a lot of toxins in dry cleaning, and so the recommendation is to take off the plastic and air it out on balcony or garage and open the garage door if you can periodically. So that it's not in your home, because that can actually be a source of toxic exposure.
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Kerri Louati: And again, you don't have to do all these things. But if you, you know if any of these things are kind of checking the box for you, these are things that you can do to reduce your toxic burden.
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Kerri Louati: Avoid pesticides and herbicides. In and around your home. I'm in Florida. It's very buggy. Everybody uses pesticides to control all the bugs. I don't but you can also, if you need to do it, reduce the frequency, and you know, make it a little bit more intentional with when you are actually needing that exposure.
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Kerri Louati: If you need to paint choose low vocaints instead of high vocaints. That's one way to reduce the volatile organic compounds
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Kerri Louati: certain furniture will be higher off gassing furniture that is, using things like particle board that uses a lot of glues will have more of that voc exposure. So choosing things like solid wood, if you can, can definitely help.
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Kerri Louati: Carpet is a major source of toxins. It can also tend to hold a lot of toxins that are in the air and in the home as well. You don't need to go ripping out your carpet. But if you have a choice to install carpet versus something else that might be helpful, otherwise, you know there's certain things you can do to clean it, but definitely prevention
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Kerri Louati: and then dust often dust tends to accumulate mold spores different environmental chemicals. So if you're dusting your home often that's going to help as well.
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Kerri Louati: So those are some of the prevention and avoidance things that you can pay attention to. Next, we're gonna move on to excretion. If the toxins are not coming out, then they're staying in, and we have some systems to help with excretion. We have our bowels, our skin our kidneys, our lungs. I'm just gonna focus on the bowels and skin today.
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Kerri Louati: So the first recommendation is to move your bowels. What happens is toxins are packaged in the liver shuttled through the bile, and they're supposed to leave through the intestines. And so, if you have constipation, you're not having daily bowel movements. You're not moving those toxins out on a consistent basis. And what happens is if if they're sitting in the gut, they can get reabsorbed through and tara hepatic recirculation.
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Kerri Louati: So you have. You know the chance of becoming even more toxic. So move your bowels. Otherwise it's kind of like a clogged toilet that's not flushing.
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Kerri Louati: There's another saying, that is very appropriate for toxic exposure, which is the solution to pollution is dilution. And so the more you dilute that toxic exposure, the less toxic you'll be, and what I'm referring to with that is, since our bodies shuttle a lot of toxins out through bile. Then we can help to dilute that plan
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Kerri Louati: process by eating more healthy fats to make sure that we have good bile flow, and bile is just, you know, kind of flowing out and diluting some of the that toxicity. So you can support bile with healthy fats, bitter foods different herbs like, you know, dandelion tea or dandelion greens, other bile supporting foods or ones like beats.
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Kerri Louati: artichoke arugula. Anything really bitter is going to support that
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Kerri Louati: the possible role of binders. You guys may have come across binders. The role of binders partially is to bind to toxins in the gut so that they can actually get excreted from the system. They're not always necessary. I mean, if you're on a you know, an actual detox protocol they could be recommended. They include supplements, such as zeolites, pectins, charcoal, humicin, acid. Those are some common examples.
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Kerri Louati: But again, if they're just sitting in the gut, and they're able to get reabsorbed. Then you're not really detoxing effectively.
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Kerri Louati: and then next sweat it out. Toxins can be excreted through sweat, and one of the best ways to increase that excretion is by using something like a sauna which uses heat. You can get you know, different forms of Sauna to get the benefits of, you know different light therapy as well. But this is a really effective way to help support detoxification.
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Kerri Louati: especially if there are any other systems that are impaired like if you're having issues with your gut, if you're having constipation, you know, something like a sauna can be a good intervention. So if you go to a gym, you have access to a sauna, you know, pop in there. And that can be really supportive. You also get a good cardiovascular workout from Sauna. It kind of pumps your heart the same way you get from a cardiovascular workout. So you get other benefits as well.
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Kerri Louati: You can sweat through exercise. But if you are sweating a lot definitely, stay hydrated and replace those electrolytes.
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Kerri Louati: Okay, I'm I'm a big biochemistry nerd. I love to know the pathways, and I wanted to share the pathways with you, because I I think it's helpful to understand what detoxification actually is. So when we have toxins entering our system, a lot of them are fat, soluble toxins and they have to go through different phases to actually get excreted from the body. So we have the first phase which we call phase one detox.
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Kerri Louati: And what that is is, it's adding a reactive site to the toxin.
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Kerri Louati: But when they do that it actually creates a lot of free radicals. And I'll explain free radicals. In a minute. So you have that phase one, it adds a reactive site. And then you have phase 2 which needs to add a water soluble group to the reactive site. And so these water, soluble groups are things like sulfur, which is a pathway called sulfonation, glucuronic acid, which is a pathway called glucuronidation
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Kerri Louati: glutathione con glutathione for glutathione conjugation. I know. There are many patients in the program that are on glutathione. So this is one of the ways that that's actually supporting you. Methylation. You're you're supporting with methyl groups through that pathway called methylation.
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Kerri Louati: One way to actually know if your methylation is impaired is by looking at one of the markers that we commonly test for, called homocysteine. And if your homocysteine is elevated, that's a sign that you have impaired methylation, and if you do have impaired methylation, you know, you really wanna support with with methyl support, you can get that through a methylated foliate methylated B 12 and other compounds
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Kerri Louati: to like. Colon can also be really helpful to support methylation and get that homocysteine down
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Kerri Louati: you need acetyl groups for acetal acetylation and amino acids for amino acid conjugation. And this is what is really interesting for me, because a lot of the typical detox programs that you come across don't have actually a lot of amino acids in the program, and you need those amino acids to be able to
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Kerri Louati: add that water soluble group so that it can be excreted. If you don't, then you're dealing with a very high level of even more toxic compounds after phase one. The compounds become more toxic to your system. So you want to get this phase, 2 going as much as possible so that you can get them out of your body.
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Kerri Louati: And then you need other nutrients to support these pathways as well, like B. Vitamins, amino acids, magnesium, and and a few more. So, you know, just focusing on nutrient density is also helpful.
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Kerri Louati: I have another visual here to kind of explain this. I'm a visual person. So hopefully, this is helpful for you. But you have the toxin here. And what you're doing for phase one is you're adding this reactive site. But now this compound becomes more toxic. So you really want to rush into phase 2.
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Kerri Louati: Which is adding this water, soluble group. And again, this water soluble group can be glutathione, it can be sulfur, it can be methyl groups, it can be gluchronic acid. But when you're adding this water soluble compound.
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Kerri Louati: now, it can get excreted from the body. If you don't have this water soluble compound. It's going to persist in the body, and it's going to induce more damage. Now, the interesting thing is a lot of the genetic snps that people have that can impair detoxification are revolved around this phase. 2 process where they just aren't working, that
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Kerri Louati: that capability isn't as rapid. And so this process is a little bit slower. So people are dealing oftentimes with a more toxic compound, and they're not getting them out of the system as quickly.
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Kerri Louati: So let's talk about what you, what you can actually do about that. So what we want to do is really support phase 2. So we're going to talk about some general recommendations to do that.
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Kerri Louati: And the first is talking about some foods that are really supportive for detoxification. I think top of the list. One of the best categories of detoxification foods are your cruciferous vegetables. They have a rich source of glucharonic acid, so they'll support that glucraridation. They also contain sulfurs, so they'll support Sulfon Sulfan of them also contain glutathione, like broccoli sprouts, can contain glutathione so supporting glutathione conjugation.
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Kerri Louati: But your cruciferous vegetables are very powerful. So
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Kerri Louati: broccoli, cabbage, cauliflower, Brussels, Bok, choy. Those are really great to incorporate into your day into your week, and rotate as well
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Kerri Louati: sulphur rich foods. So you're getting a a source of sulfur from food such as onions, garlic, eggs. Again, your cruciferous animal proteins that sulfur is really important for that sulfenation, so that you can help get those toxins out of the system.
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Kerri Louati: Protein you need amino acids for that amino acid conjugation pathway. So making sure you're getting enough protein if you're in the program, the 12 month program. This is always something that we're working to optimize is getting protein levels up to. You know your specific needs. But some other foods bone broth and collagen are really rich in glycine, which is an important amino acid for detoxification.
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Kerri Louati: Any animal proteins that you're getting from a clean source. Legumes. These are just some options. It's not a comprehensive list. Whey protein is also another good option, because this can increase glutathione levels. So you know, incorporating whey protein can help detox as well.
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Kerri Louati: We have a lot of other foods that are supportive. You have foods like berries and pomegranate grapes, walnuts, dandelion black currents. These contain different compounds to support detoxification. But all of these are whole foods. So you know, sometimes you need some supplements if you're dealing with the toxic burden. But you can do a lot with eating in organic whole food diet to help support your detox pathways.
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Kerri Louati: You also have different teas like Roy's Tea, honey, bush, tea, green tea. These are also wonderful options as well.
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Kerri Louati: Outside of foods. There are some other things that you can focus on improving the gut microbiome through probiotics, either through food like fermented foods. Or if you're taking a probiotic, that's fine, too. Probiotics or bacteria in your microbiome can actually help to degrade and break down different toxins. They can help with excretion. But they play an important role in toxic exposure, and
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Kerri Louati: the more balanced your microbiome the you know better. You're able to deal with that burden. You have options like Epsom salt bass which contain magnesium sulfates where you can absorb that sulfate through the skin, and that can provide a source of sulfur for detoxification.
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Kerri Louati: Castor oil packs to reduce inflammation in in the liver, gallbladder. Even in the guts
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Kerri Louati: enemas, I mean, I'm not sitting here promoting enemas, but it is an option for people that are looking to optimize detoxification, and a lot of people do use it, but to each their own.
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Kerri Louati: So we talked about avoidance. We talked about excretion, talked a little bit about supporting the liver and the guts. And then the last step is really like offsetting some of that toxic exposure. So you've dealt with the toxic burden. You know. We know that it causes a lot of damage to different organs and systems. So one of the things that I recommend is increasing your antioxidants because oxidative stress is something that can contribute to a lot of damage in the body.
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Kerri Louati: As I showed you in that liver. After that phase, one. You have a lot of free radical production. And so I wanna explain what free radicals are. This is a free radical free radicals are produced from a variety of different processes. Detoxification is one basic metabolism, even high intensity exercise. You have a lot of different reasons for free radical production. But toxicity is a big source.
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Kerri Louati: and they Ca, they cause a lot of damage. And so what they are. It's it's a very unstable compound, all of these little red things. Here are electrons. And you can see that this free radical is missing an electron.
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Kerri Louati: And so when you have a high amount of free radicals, what what we say is that you're dealing with oxidative stress, and the way to deal with this is to increase your antioxidant intake because antioxidants are
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Kerri Louati: 8 electrons to balance out free radicals in your system. Because if antioxidants are not available for this process, what happens is these free radicals go around your body and they start stealing electrons from anywhere. And so that causes a lot of cell damage organ damage contributes to aging. So and this is something that's a you know, a root factor and osteoporosis as well as
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Kerri Louati: there's a lot of other conditions. So we we do not want free radicals. But the equation is really what's the ratio of antioxidants to free radicals in your system. So the more we can support antioxidants, the more we can offset that oxidative stress induced from that toxic exposure and our basic detox pathways.
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Kerri Louati: There are a lot of antioxidants. These are vitamins, such as vitamin, c vitamin, EA. Glutathion co Q. 10 alphaic acid. Some of you may have these in your protocol. If you're working with us in in the program. But you don't necessarily have to take these vitamins, you can get a lot of antioxidants through foods as well.
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Kerri Louati: So we have high antioxidant food sources. These are high orac foods or act stands for oxygen, radical absorption, absorpence, capacity. And this is not a comprehensive list. These are just some options. But getting variety from a lot of plant based foods can be really supportive. Foods like kidney beans, are really high and antioxidants. Pomegranate.
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Kerri Louati: dark chocolate, yes, dark chocolates on the list, artichokes, pecans. A lot of foods that have like a deep, rich, dark color. That can be a really good sign of antioxidants.
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Kerri Louati: A lot of your berries are very high antioxidants, so elderberry, gochi berries, cranberries, blackberries, blueberries, A lot of your berries are really good, so if you can incorporate those that can boost your antioxidant capacity. You also have other things like Amla Berry. That's another good one.
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Kerri Louati: and then spices are also really rich in antioxidants as well. Usually we're only using a small amount of spices. So you know, they depending on how much you're using, they might not contribute a whole lot to your antioxidant status, but I mean, flavor your food. Use these spices. There are a lot of other spice spices that are rich in antioxidants as well, but these are some of the higher ones. So these can be great to incorporate.
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Kerri Louati: And then, as we spoke about earlier, a lot of these toxins can induce damage. So you know, if you do have evidence of toxic exposure, you know, we know it impacts the gut. It impacts the mitochondria and your cellular health, it can induce nutrient deficiencies.
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Kerri Louati: So these are things that if you have signs of dysfunction in these areas toxicity could be playing a role but also, if you have a known toxic burden, then we should also give a little Tlc to these areas. And that's something that if you're working with us we can provide support as well.
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Kerri Louati: There are some lab testing options. That can give you some insight as to whether you're dealing with a toxic burden. These are some that we commonly work with. One is a neutral eval which is a blood urine test that has certain markers like glutathione status. It has a few different
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Kerri Louati: toxic elements that are included as well. So we can see if that's something that you're dealing with with the toxic burden. Hma is a hair tissue mineral analysis. By analyzing your hair we can look at different heavy metals.
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Kerri Louati: Stool test will look at the health of your microbiome. But also there's a marker there that if it's elevated it shows that you are, you know, reabsorbing. Likely a lot of toxins in your system. This is called Beta Glucuronidase. And so, if you have that high, you know, you might be one of those people that's recirculating those toxins genetics. This is a really good way to see, are you someone that has impaired genetic pathways?
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Kerri Louati: And then just general lab work. If you're dealing with high inflammation, it's always a possibility. It doesn't always mean that you're dealing with with toxins. But it's a possibility.
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Kerri Louati: So just to summarize. Some of the action items to focus on limit exposure as much as possible. Control what you can, don't stress about what you can't clean water, clean air, clean food, clean products, clean home.
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Kerri Louati: excrete the toxins. Don't let the sewer get clogged. Sweat and poop.
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Kerri Louati: support the liver and gut pathways, eat more foods that provide the compounds to help detoxification and offset the risk from toxic exposure by eating high antioxidant foods.
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Kerri Louati: Do you guys have any questions for me?
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Breta, RDN, OBH TEAM: We sure do have questions. So I
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Breta, RDN, OBH TEAM: going to hold on, I will remove your spotlight.
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Breta, RDN, OBH TEAM: Okay? Awesome.
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Breta, RDN, OBH TEAM: So several questions here. I wanna start with bio accumulation. This will tie into a few things. But could you explain bio accumulation and like a little bit more depth on like what's going on, or what that really means.
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Kerri Louati: Sure. So bio accumulation, or is really referring to toxins that are persisting in your body. So bioaccumulation can happen with different varieties of toxins. But toxins can get stored in your system. Oftentimes they're stored in your adipose tissue. Some people we've seen this with weight loss when people lose weight, and they're breaking out of post tissue cells. Adipose cells, and they can release toxins. And
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Kerri Louati: and that can, you know, kind of flood the system. But the bio accumulation is just referring to a high level of toxins that are accumulating and being stored in your body. Fat tissue is not the only area you can have toxins stored and different organs. As well.
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Breta, RDN, OBH TEAM: Yeah. And so I think so. One of our other questions was about the mercury and fish intake, too. And I think that's another really good application of like understanding by accumulation that the smaller the animal, the less bio accumulation we have. So what are your recommendations for, like around mercury and fish intake, as it relates to like some of those things like sardines and anchovies that are really good for bone health as well.
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Kerri Louati: Yeah, no great question. So when you look at the larger carnivorous fish that are eating all the smaller fish they are bio accumulating more of that mercury. So that's where some of the bigger fish tend to have higher mercury levels, whereas the smaller fish tend to be lower in mercury. So sardines are a great option, because they're smaller. They don't have that mercury impact the way that you know the large tuna does.
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Kerri Louati: So you know, I think just being just looking at the frequency, you know again, it's not that you have to avoid these things. You know, permanently. But if you do like tuna. I do recommend skipjack light that has been shown to be lower in mercury, but also, if you do have certain conditions that are high risk for mercury. Then I would maybe move to just more fish like salmon, sardines, anchovy.
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Kerri Louati: herring, and you can find a list of low mercury and high mercury fish. I didn't give you a comprehensive list but there are lists available that we can share. To give you a little bit more information about what's safer.
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Breta, RDN, OBH TEAM: Awesome. Yeah, and
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Breta, RDN, OBH TEAM: just onto the onto the next on it. There, we're all over the place on topics here, so I'll try
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Breta, RDN, OBH TEAM: as possible. But I want to get people's questions answered too. Ha! Are you familiar with like the hydrogen water bottles?
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Breta, RDN, OBH TEAM: And do you have thoughts on those.
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Kerri Louati: Water bottles and plastic, not the hydrogen systems.
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Breta, RDN, OBH TEAM: No, they're the like the ones where they like. You push a button, and it like infuses hydrogen into them, like, I think, like Gary Breca recommends them. And if you don't have any thoughts that's totally fine.
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Kerri Louati: I don't really know a whole lot about the hydrogen water system, so I don't really have a strong opinion on that so unless unless you know much about that, Brett, I'm gonna pass on that question. But I can.
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Breta, RDN, OBH TEAM: Was good.
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Kerri Louati: After researching it.
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Breta, RDN, OBH TEAM: I think we can go back to them because I think Ashley, who presented with us a few weeks ago. She might have some details on that. So we'll circle back on the hydrogen water bottles.
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Breta, RDN, OBH TEAM: Cause? Yeah, I think those are a newer thing on the market, and I
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Breta, RDN, OBH TEAM: would wanna make sure that, you know we have some good evidence and good research before recommending anything for sure. So on the cooking side of things, then what do you recommend for cookware? That
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Breta, RDN, OBH TEAM: is, things won't stick to or like. What should people be, you know, if we're aiming for the best quality cookware for like low toxins, how can we also make that convenient.
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Kerri Louati: Cookware is a little tough. If you if you don't have that non stick, it's not gonna be perfectly non stick but I I still recommend the ceramic coated. If you can get like a ceramic coated cast iron, it does have a layer that you know, helps with that also, just using your pans properly can go a long way to make sure things aren't sticking as much.
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Kerri Louati: So you know, that's where using like a stainless steel pan properly. There's certain ways to, you know. Wait until your pans heated, and add your oil before adding your egg. That will help decrease the egg sticking to the pan. If you don't, it's gonna increase the risk of sticking. So there are just certain things that you can you know, I guess, follow certain practices you can follow to decrease that. But it's not perfect. I mean, yeah, not having that nonstick is not as convenient. But it's definitely less toxic.
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Breta, RDN, OBH TEAM: Yeah.
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Breta, RDN, OBH TEAM: no, for sure. And even with like a cast iron like making sure it's well seasoned and it's, you know, you're not scrubbing it with soap and things like that to those things can all be really helpful?
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Breta, RDN, OBH TEAM: So when it comes to Sauna, I know you talked about sweating. Do you have any recommendations around Sauna use and frequency? And how can people optimize that.
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Kerri Louati: So I do recommend with everything. If if you're my patient, you know low and slow is the way to go. So you know, you can start with 15 min. You can go anywhere from 15 to 30 min is a good range of time for Sauna. Use 3 to 4 times a week is a really good amount of use. So it doesn't have to be crazy amounts of times. You know, if you're going to the gym 3 times a week after your workout. You pop in Asana for 1520 min, I mean, that's that's a really good frequency.
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Kerri Louati: Yeah.
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Breta, RDN, OBH TEAM: Awesome. We love Sonas over here. I wanna, okay. So then onto
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Breta, RDN, OBH TEAM: Rgi issues with detoxing. So if specifically for constipation, I wanna wrap this into like the castor oil packs as well. So you think well, we can kill 2 birds with one stone here. But what do you recommend for natural ways to increase bowel movements. That also help support Detox.
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Kerri Louati: Though.
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Kerri Louati: anything that's gonna increase excretion is also gonna help improve bowel movements, and detox. So I like to start it. It depends.
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Kerri Louati: Constipation is difficult, because there are a lot of factors that go into it. You know we always start with the basics. Are you getting enough water? Are you getting enough fiber? And then you move on to what does the microbiome look like, you know? Are you dealing with organisms that are overgrown that are more constipating in nature. Is there any issue with motility? Do you have nutrient deficiencies that are impairing neurotransmitter synthesis that play a role in motility? So it gets a little nuanced. But, generally speaking.
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Kerri Louati: you know there are different fibers that you can incorporate. Magnesium can be a great start which also supports detoxification because you need a little bit of magnesium, so something like a mag oxide or a Mac citrate can definitely help with bowel movements. But castor oil packs can also help, and that's something that you know. You apply topically. You soak a like a cloth panel, a flannel in castor oil, and you put it on topically.
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Kerri Louati: They have packs that you can buy that can reduce inflammation that can also help promote bowel movements as well. So that's something that you don't have to ingest you can do topically, and that can be helpful. But it it looks a little different for everybody. So I would say there's some element of needing to be personalized if it's if it's not kind of cut and dry. If if the basics don't, you know improve the situation.
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Breta, RDN, OBH TEAM: Yeah, on cast or oil packs. Is there a brand that you typically recommend.
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Kerri Louati: No.
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Kerri Louati: there's not. But I would just look for an organic wool cloth, and on Amazon they're they're pretty ubiquitous.
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Breta, RDN, OBH TEAM: I'm gonna share a link to Queen of the thrones.
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Kerri Louati: Yes. Okay.
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Breta, RDN, OBH TEAM: Do you.
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Kerri Louati: Here.
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Breta, RDN, OBH TEAM: Okay, as long as you're good with that. So I put the link for queen of the thrones for castor oil packs and things and castor oil in there. If anybody's interested in exploring that a little bit more so when it comes to as well, we have a question about saunas and electrolytes. So before I get too far away from the Saunas, what do you recommend for replacing electrolytes when doing saunas.
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Kerri Louati: So typically something like an element can work really well for electrolyte replacement therapy if if that works for you and and you tolerate it. Well, I mean, that's a good electrolyte replacement. We have others that we recommend as well. But
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Breta, RDN, OBH TEAM: and the back end of this question is products with no sugar. None of these have sugar in them, and it really depends on what your goals are. If you want sugar in your electrolytes or not. But Lmnt, they have a their flavors have artificial sweeteners in them like. It's just Stevia. But if you don't tolerate Stevia, they have an unflavored one that doesn't have Stevia in it, so that could definitely be an option for you.
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Breta, RDN, OBH TEAM: and those are gonna be really heavy on the sodium component. So if you need to replace your salt after sauna, that's gonna be your best option. If you're looking at other electrolytes, ultimize like what I'd call like a broad spectrum like electrolyte, where it has, like a lot of different micronutrients in it.
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Breta, RDN, OBH TEAM: but
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Breta, RDN, OBH TEAM: it's not gonna have as many of any like one thing, and it also doesn't have sodium, and that also has stevia in it so? Those might be some good suggestions for you guys. And then I also think to like something like a be minerals. Replacement could also be a good option. If you guys haven't explored that as well, I don't know, Carrie, do you have any other thoughts on like the mineral.
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Kerri Louati: Well, there is one that I've used. It's not very potent in dosing, so it kinda depends on how much support you need, but there is a company bio, a body bio that has an elite. It doesn't have any artificial sweeteners. It comes in a liquid. I just add a little bit of that to my water. And it gives, you know, a little salty but that works really well, and it's just it's very mild. So if you know.
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Kerri Louati: if you need something a little stronger that might not work. But if you just need something with a little bit of a mild replacement, and you don't want any of the additives. That might be a good option.
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Breta, RDN, OBH TEAM: Yeah, awesome great recommendation. And then, as far as teas go, do the t's that you mentioned are they gonna have a big impact on like Gerd. If somebody is trying to avoid higher acid foods.
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Kerri Louati: not
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Kerri Louati: not. Generally speaking, I mean the teas that you would actually want to use for detox can sometimes be supportive for good cause you're using those bitter herbs like dandelion, for example, and that can help to promote digestion, and that can help to support acid reflux. So I would actually argue that it might be more supportive.
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Breta, RDN, OBH TEAM: Yeah, and then onto homocysteine really, quickly. So I know we touched on that. And that's like a lab that you know, we recommend people get, how connected do you feel like homocysteine levels are with detoxification? And is that something that you factor in into the detoxification process?
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Kerri Louati: I think it's a piece of the puzzle. I mean, as as I showed you in the liver pathways, there are a lot of different pathways. Methylation is just one. But you know, when we look at the methylation cycle, homocysteine can actually go down to eventually form glutathione, too. So I think it is a really important marker. And it does give you some insight as to where some where you need support and where certain things are clogged in your pathways.
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Breta, RDN, OBH TEAM: Yeah. And there's I, you know, commonly we'll talk about B vitamins there, which are obviously also helpful in detoxification, too. So sometimes we can get some like bonus support there and then, just you know, it's not all about the Vp vitamins all the time. There's other things that we need to look at, too, if it's not driving down your home assisting. So okay, with our last minute. And then if any.
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Kerri Louati: Polline is really a powerful one, too, for detoxification and for methylation. So that's another good one. If, like the B vitamins aren't cutting it. Colon is really supportive.
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Breta, RDN, OBH TEAM: Yeah, that's a great addition. I think that gets overlooked a lot. And it's one of the reasons why we rarely have people exclude eggs so they can get extra colon in their diet, too, so awesome and then this is like a lot of info. And I know we talked about like. Don't let fear hijack progress, but with people maybe going. Oh, my gosh! There is a lot for us to do. If all this information like, what do you recommend? Like people's next steps are to manage all of the all of the info.
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Kerri Louati: So stop, just start with things that are impacting your day to day. You know, if you're not a lot of these things are not gonna affect everybody every day, but something like water. We're drinking every day, you know, something like our home. We're breathing every day. So I would say, just start with simple things that might make a big difference. You do not have to do all of these things.
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Kerri Louati: At all. But start with what's simple for you and what's gonna make a big impact.
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Breta, RDN, OBH TEAM: Yeah.
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Breta, RDN, OBH TEAM: definitely pick pick one thing, go with it, and you know, see? See where that gets you to start with goes go slow.
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Breta, RDN, OBH TEAM: Awesome. Well, that is the time that we have for today. So we're gonna go ahead and wrap up I'm going to take. I know there's a couple of questions that we didn't get to, so I will just get Kerry to type up a short little response, and I'll drop all of those in slack as well. So you guys can have the answers that you want. If you don't have access to slack, please reach out at Hsn. support@ohm.com, so we can make sure you get set up