Blood, Sweat, and Urine: Sweating as detox
Jacob Schor ND, FABNO
April 18, 2018
Ten years ago I wrote an article on treating congestive heart failure using infrared saunas, a technique known in Japan as Waon Therapy.
When I wrote that first article about saunas I promised to write a follow-up article on using saunas for detoxification therapy, a part-2 to my original piece. The idea that saunas trigger some form of detoxification response is quite popular and my assumption was that it would be well supported in the scientific literature. However, I did not find much scientific support for the idea and delayed writing the Part-2 for the moment. That moment has stretched to a decade and it is time to return to the subject.
Greg Nigh ND of Portland Oregon recently directed my attention to the research of Stephen Genuis and colleagues Detlef Birkholz, Ilia Rodushkin , and Sanjay Beesoon at the University of Alberta in Edmonton. Since 2011 they have published at least half a dozen studies looking at the elimination of toxic substances from the body through blood, urine and sweat, collectively referred to by the acronym BUS. I keep thinking the acronym should be BUT for blood sweat and tears but alas…..
In their first 2011 paper they collected blood, urine and sweat from 20 participants, half with various health problems and half in seemingly good health. These excretions were analyzed for 120 different compounds including toxic elements. The amounts of toxic elements varied widely between blood, urine and sweat.
Many of the toxic elements appeared to be preferentially excreted through sweat.
Some elements that seemed to be readily excreted through the sweat were not even found in blood or urine. Thus sweating “…appears to be a potential method for elimination of many toxic elements from the human body.” 
In a 2012 study the authors reported that ‘induced perspiration’ was a useful method for elimination of phthalates from the body. The phthalate family of chemicals is present in many consumer products so most individuals have high exposure. Many studies have suggested significant risk of disease is associated with phthalate exposure, in particular because of the estrogenic like action of these chemicals. Most breast cancer patients are told to avoid exposure. Probably all of us should.
All study participants had phthalate compounds in their blood, sweat, and urine samples, suggesting widespread phthalate exposure. On average, phthalate excretion in sweat was more than twice as high as urine levels. Thus the authors conclude, “Induced perspiration may be useful to facilitate elimination of some potentially toxic phthalate compounds…” 
These authors also reported in 2012 that sweat appears to also be a useful way to test for and possibly eliminate bisphenol A (BPA) from the body.  BPA is an endocrine disrupter and these days the general consensus is that we want to keep levels in the body as low as possible  in general but especially during gestation, infancy and childhood  . These endocrine disrupting chemicals are now considered a risk factor for DM-2  , obesity, metabolic syndrome,  and other conditions. Attempts to reduce BPA levels in teenagers by modifying diet and eating patterns have been unsuccessful at least to date. 
These authors have reported similar finding and suggest that organochlorine pesticides and polybrominated diphenyl ether flame retardants might also be eliminated from the body via sweat. . 
At one point in my undergraduate career I was stumped when professor Roger Morse asked a lecture hall audience, “What chemical has saved the largest number of human lives in history?” The answer of course was not penicillin but instead, dichlorodiphenyltrichloroethane, better known as DDT. DDT was used with great success to control malaria and typhus around the world, saving hundreds of millions of lives. The problem is that not only did it kill mosquitoes and other insect pests it also “elicited toxic effects that harmed nontarget species, bioaccumulated in the animal food chain, and had a very slow rate of environmental degradation… ”
Keep in mind though that all of the Genuis studies are looking at sweat as a pathway to eliminating these toxins. The researchers have used saunas to elicit the sweat. One must assume for the time being that any situation that elicits sweat will eliminate toxins. Exercise also can trigger sweating. So can sitting in a hot car in Arizona. At this point we have no data that suggest saunas are more effective than any other sweat provoking situations.
Walter Crinnion ND, former professor of environmental medicine at Southwest College of Naturaopthic Medicine, wrote an article on sauna published in 2011 in the journal Alternative Medicine Review.  Dr. Crinnion focused on the cardiovascular benefits, particularly for patients post myocardial infarct, who might be suffering from hypertension, or with congestive heart failure. He also reviewed data on using sauna for treating depression, autoimmune disorders, chronic fatigue and pain syndromes.
When discussing sauna potential for elimination of heavy metals, Dr. Crinnion points out rather wisely that although sweat may contain significant amounts of these potential toxins, it does not necessarily follow that saunas will eliminate them from the body:
“While evidence is clear that some heavy metals, for example, are excreted in sweat, there is currently no definitive evidence for increased elimination of heavy metals or other impurities in sweat during a sauna.”
Dr. Crinnion goes on to describe the results of a cleansing program that he used with patients for many years at his Seattle clinic. If this topic is of interest to you I suggest you make the effort to read the full details in the full text paper: http://archive.foundationalmedicinereview.com/publications/16/3/215.pdf
A Cannadian colleague Wendy Davis, ND, writing in 2008 described an interesting study: “In a small, placebo-controlled pilot study, Canadian doctors Sat Dharam Kaur, ND and Gordon Ko, MD set out to demonstrate whether environmental chemicals and heavy metals can be effectively eliminated from the body through perspiration induced from regular use of an infrared sauna.
Numerous environmental chemicals and heavy metals were evaluated via blood and urine before and after the study, and a regimented supplement program was instituted as part of the pilot study.
Participants underwent sauna treatments for 1-1.5 hours at a time for a total of 50 hours over the course of the study.
At the end of the study, it was shown that the mean plasma toxicology (pesticides, PCBs, total toxins) decreased by 15%-25% after 50 hours and mercury levels decreased by 35%. Lead levels increased after 50 hours, but in a subsequent study in which sauna therapy was maintained for 100+ hours the lead levels decreased significantly (Kaur, 2006). See the accompanying graphs.”
There is a problem though. I can’t find this study. [This study is not listed on PubMed and I have not been able to locate where (or I suppose if) it was published.]
Bottom line: It sounds as if saunas may be useful for eliminating at least some of the toxic burden in the body. The evidence is neither as strong nor as compelling as one might think after reading the many online advertisements from sauna vendors. While the marketing claims suggest strong evidence, the fact is that the data are still wanting. A regular exercise program that induced sweating might have a similar effect. For those too debilitated to exercise vigorously, perhaps inducing sweat via sauna might be a preferable strategy. There appears to be little evidence to suggest that regular saunas will pose health risk. So why not?
1. Genuis SJ, Birkholz D, Rodushkin I, Beesoon S. Blood, urine, and sweat (BUS) study: monitoring and elimination of bioaccumulated toxic elements. Arch Environ Contam Toxicol. 2011 Aug;61(2):344-57. doi: 10.1007/s00244-010-9611-5. Epub 2010 Nov 6.
2. Genuis SJ, Beesoon S, Lobo RA, Birkholz D. Human elimination of phthalate compounds: blood, urine, and sweat (BUS) study. ScientificWorldJournal. 2012;2012:615068. doi: 10.1100/2012/615068.
3. Genuis SJ, Beesoon S, Birkholz D, Lobo RA. Human excretion of bisphenol A: blood, urine, and sweat (BUS) study. J Environ Public Health. 2012;2012:185731. doi: 10.1155/2012/185731. Epub 2011 Dec 27.
4. Shafei A, Ramzy MM, Hegazy AI, et al. The molecular mechanisms of action of the endocrine disrupting chemical bisphenol A in the development of cancer.
Gene. 2018 Mar 20;647:235-243. doi: 10.1016/j.gene.2018.01.016. Epub 2018 Jan 6.
5. Braun JM. Early-life exposure to EDCs: role in childhood obesity and neurodevelopment. Nat Rev Endocrinol. 2017 Mar;13(3):161-173.
Free PMC Article
6. Ehrlich S, Lambers D, Baccarelli A, Khoury J, Macaluso M, Ho SM. Endocrine Disruptors: A Potential Risk Factor for Gestational Diabetes Mellitus. Am J Perinatol. 2016 Nov;33(13):1313-1318.
7. Le Magueresse-Battistoni B, Labaronne E, Vidal H, Naville D. Endocrine disrupting chemicals in mixture and obesity, diabetes and related metabolic disorders.
World J Biol Chem. 2017 May 26;8(2):108-119.
8. Galloway TS, Baglin N, Lee BP et al. An engaged research study to assess the effect of a ‘real-world’ dietary intervention on urinary bisphenol A (BPA) levels in teenagers. BMJ Open. 2018 Feb 3;8(2):e018742.
9. Genuis SK, Birkholz D, Genuis SJ. Human Excretion of Polybrominated Diphenyl Ether Flame Retardants: Blood, Urine, and Sweat Study. Biomed Res Int. 2017;2017:3676089.
10. Crinnion WJ. Sauna as a valuable clinical tool for cardiovascular, autoimmune, toxicant- induced and other chronic health problems. Altern Med Rev. 2011 Sep;16(3):215-25.
11. http://ndnr.com/dermatology/use-of-infrared-sauna-therapy-to-improve-clinical-symptoms-of-chemical-toxicity/ December 2008 NDNR Wendy Davis, ND