SPOTLIGHT ON BINDERS: A CLINICALLY USEFUL TOOL WITH SOME PRECAUTIONS WITH REBECCA SNOW

Binders are a valuable addition to a functional practitioner’s toolbox. They are especially useful when clients need extra support after experiencing a Herxheimer response (herx response)—the temporary flare that occurs as microbes die and release endotoxins.

What is a binder?

A binder is a dietary supplement or food that “binds” to toxins in the gut and helps clear them from the body through the stool.

How does a binder work?

Some sources claim binders work at a cellular level, but research does not support this. Most binders carry a negative charge that attracts positively charged molecules. For example, activated charcoal has a large surface area and a negative charge, which allows it to draw positively charged molecules to its surface. This process—where molecules stick to a solid or liquid surface—is called adsorption.

Important: binders only work in the gut.

For binders to be effective, the body also needs:

• Healthy Phase 1 and Phase 2 liver detoxification

• A functioning gallbladder (bile flow carries toxins into the digestive tract)

• Regular bowel movements and good hydration

Once toxins enter the gut, binders can help escort them out via stool. Without this support, some toxins reabsorb through enterohepatic circulation (the recycling of substances between liver and intestines), raising the body’s overall toxin burden. Binders can help reduce this reabsorption and recirculation.

Different binders have different binding affinities—no single binder works for everything.

How do we use binders clinically?

I began using binders in a Lyme clinic in 2004. Many patients treated for chronic Lyme experienced a Herxheimer response with antibiotics or antimicrobial herbs. In school, I was taught to dismiss this as a “healing crisis,” but in practice I found it was a hallmark of Lyme treatment—one that binders can ease.

Over the last 20 years, I’ve found binders helpful for:

• Mast Cell Activation Syndrome (MCAS)

• SIBO

• Lyme and co-infections

• Mycotoxin illness

• Endotoxin load

• Heavy metal or persistent organic pollutant exposure

I prefer dietary fiber whenever possible, since it offers multiple benefits: supporting the innate immune system, promoting microbiome diversity, increasing short-chain fatty acid production, and lowering inflammation. In nature, fiber is found in plants, and many of these plants also provide anti-inflammatory properties that support healing.

Still, there are times when additional support is needed beyond fiber. That’s when I rely on supplemental binders.

Examples of Binders

• Activated charcoal – constipating; typical dose is 500–1000 mg/day. Poisonings require hospital care, where much higher doses are used.

• Bentonite clay – Sonne’s #7 is gentle and works well with my MCAS patients.

• Zeolite clay – must be tested for heavy metals.

• Humic and/or fulvic acid

• Modified citrus pectin

Gentler/food-based options:

• Chlorella

• Mucilaginous herbs such as marshmallow or slippery elm

• Dietary fiber such as psyllium husk, chia seeds, or flax seeds (these absorb water, so hydrate well)

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Combination formulasSome professional lines (e.g., QuickSilver, Biocidin Botanicals) add laxatives such as aloe leaf to charcoal. These are best for short-term use, since aloe leaf (not the gel) is a habit-forming laxative.

Cautions

• Drug interactions – binders can reduce absorption of oral medications and supplements. Take them 1–2 hours away from medications (erring on the side of 2). This is not a concern with topical or injected medications.

• Constipation – ensure daily bowel movements before and during binder use.

• Quality control – soil-derived binders, like zeolite, should always be tested for heavy metals.

• Sensitive clients – start low, choose gentle options (like Sonne’s #7), and increase slowly.

When to Consider Adding a Binder

• During a detox protocol, when a sensitive client reacts to otherwise beneficial support (e.g., glutathione).

• During conventional antibiotic or antimicrobial protocols for infections such as Lyme, when a client experiences a herx response or other strong reaction.

• When toxic burden is high, such as with suspected heavy metals, persistent organic pollutants, mycotoxins, or high endotoxin load.

Binders are a powerful tool. Used wisely, they can reduce toxic load, calm a Herxheimer response, and support the body’s detox pathways.

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