To detox or not to detox?
Ah, the detox. We’ve all heard it. It seems like everywhere we look, there is someone talking about detoxing, needing to detox, or going on a cleanse. But, what is a “detox” and when should you consider one??
What does it even mean?
Detoxification in our body is essentially a normal metabolic process by which toxins are excreted. In fact, detoxing is something that takes place all the time in the body, without us even thinking twice. One of the main ways our body rids itself of toxins is through the liver. The liver serves both as a defense front by limiting entry of toxic substances into the bloodstream, and as a clearance organ, by extracting potentially toxic metabolic products, converting them to chemical forms that can then be eliminated via the aid of our bowels and kidneys.1 Depending on the efficiency with which these molecules are extracted by hepatocytes (fancy word for liver cells), little or none of the absorbed substance may make it into the systemic circulation.1 But that’s not all our liver does. In addition to ridding the body of toxins, it also processes hormones, stores essential vitamins and minerals, and even produces the bile we use to digest fat. You can only imagine, if our liver isn’t functioning optimally, we won’t be either.2
These toxins, by the way, are fat soluble for the most part. This means we store them in the parts of our body that are rich in fat (for example the brain, breast, and thyroid). One of the big roles of the liver is to convert these fat soluble toxins to a water soluble format. These water soluble formats can then be eliminated via bile to the bowel and via the kidney. This basic liver detoxification process is accomplished by optimizing phase I (known as cytochrome P450 pathway) and II (known as conjugation) liver detoxification.
Phase I Liver Detox
Phase I detoxification works to provide protection from various toxins by using chemical reactions such as reduction, oxidation, hydrolysis, which create free radicals (reactive molecules that damage cells) that the body then neutralizes with antioxidants.3 The end goal of this pathway is for the end product to be water soluble and ready for urinary or bowel elimination.3
If the body is deficient in antioxidants then the attempt at phase I toxin removal can create greater toxicity. This is why it is important to maintain adequate levels of the antioxidant vitamin E, vitamin C, SOD, and carotenoids – these antioxidants are considered longevity nutrients.3
Phase I (P450) detoxification also relies on vitamin and mineral cofactors to do its job; cofactors include vitamin B3, magnesium, riboflavin, iron, and some cruciferous vegetable indoles.3
The free radicals that are not neutralized in Phase I can damage cell DNA, RNA, and protein. To protect against this the body relies on Phase II detoxification.
Some toxins (pesticides, alcohol, saturated fat, paint fumes, exhaust fumes), drugs, and metabolites can induce or cause over-activity of the P450 system resulting in high free radical concentrations that put great demand on our antioxidant supply.3,4
Phase II Liver Detox
Phase II detoxification will rely on something called conjugation to render toxic drugs, chemicals or hormones less harmful. Conjugation involves the addition of sulphur molecules, glycine, or cysteine to make toxins water soluble and ready for excretion. To conjugate, the body uses glutathione, glycine, sulphate or glucuronide conjugation.3,4 Therefore, supplemental or nutrient sources of glutamine, glycine, inositol or choline are essential to phase II detox!
Glutathione is made in the liver with the protein building blocks glutamine, glycine and cysteine. Glutathione-S-transferase (GSH-T) is the glutathione enzyme used by Phase II detox. It is a powerful antioxidant that is depleted more readily when we have a large toxic burden (e.g. drugs) or when we have a toxic release during a state of fasting or starvation.3,4 Glutathione building blocks can be maintained if we have adequate protein intake.
Glycine is useful for detoxifying benzoate food preservatives, salicylate drugs, environmental toxins/agents, carcinogens, drugs, insecticides, and naturally occurring foreign compounds.3 Foods high in glycine include fish, meat, dairy, beans, spinach, cabbage, kale, cauliflower, cucumber, pumpkin, soybean, kiwi , and banana. Glycine can also be formed in the body by using amino acid protein building blocks readily available when you maintain a high quality protein diet.6
Sulphation is essential for the elimination of steroid hormones, neurotransmitters, drugs (e.g. acetaminophen), xenobiotic, and phenolic compounds. Sulphur foods or sulphur amino acids (taurine, cysteine) can stimulate Phase II detox.3 Sulphur-containing foods considered to have a cleansing action that stimulates phase II conjugation include eggs, cruciferous vegetables (cabbage, broccoli, cauliflower and brussel sprouts), onions, garlic, shallots and leeks.5
Glucuronidation is essential in the detox of steroid hormones, some fungal toxins, some nitrosamines, and aromatic amines, among other things.3,4 Glucuronidation also helps to get rid of thyroid T4 hormone and estrogen after they have been utilized by the body. Foods that can assist in glucuronidation include those that contain limonene, so for example citrus peel.5
To detox or not to detox?
Unfortunately, our environment can play a major role in contributing to our toxic load. From industrial pollution in the great outdoors, to the things we eat and drink, and to what we put on our bodies, most of us will be bombarded with loads of pollutants everyday. For that reason alone, if you’ve never done one, then it might be wise to consider a liver cleanse at some point.
What should you be looking for?
A liver that is not functioning optimally will allow for toxic buildup, resulting in a number of signs and symptoms seen in both physical and the mental sphere.2
- Hormonal imbalance (menstrual irregularities, infertility, early menopause)
- Headaches
- Sluggishness, fatigue, brain fog
- Dizziness
- Weight gain and inability to lose weight
- Issues with digestion (stomach pain, bloating and gas, acid reflux, nausea, poor appetite)
- Constipation, dark urine
- Skin and/or eyes that are yellowish (a symptom of jaundice)
- Bruising easily
- High blood pressure
- Excessive sweating
- Moodiness, anxiousness, or depression
- Rosacea and other skin issues (ie acne)
How to go about it
Fortunately, you can improve your liver’s functioning with a liver cleanse, which can have you feeling better in a couple of weeks
- Start with diet
A diet high in processed foods, refined sugars, and hydrogenated fat, can be toxic to your system. Replace these foods with healthy choices, which include whole foods, organic and GMO free when possible. Fresh foods such as leafy greens packed with magnesium, chlorophyll, Vitamins A and C, along with fresh vegetables and fresh fruits are best. Of note, organic fruits and vegetables also contain higher amounts of Vitamin A, Vitamin C, and sulfur, which all boost liver detoxification and cleansing. Broccoli, brussels sprouts, kale, collards, apples, onions, garlic, and squash are all great choices.
The liver as we mentioned is also responsible for producing bile that breaks down fats. Eating healthy fats like almonds, coconut, walnuts, hemp, chia, and flax, along with pumpkin and sunflower seeds, olives, and avocado are all the best sources of fat for your diet. Avoid saturated fats and trans fats (aka hydrogenated) which can lead to inflammation in your body and hinder liver health.
Ditch the alcohol
You might be sad to hear it, but alcohol is a toxin in any form and your liver will have to use a deal of energy getting rid of it. During this process, metabolic energy used up, and quite a bit of it, so consequently this can actually lead to weight gain, fatigue, and even sleepiness.
The lemon water fix
Lemon and all citrus fruits contain vitamin C and other minerals that can boost your body’s ability to sweep away waste, as well as minerals that boost bodily functions and enhance the cleansing process. Aim to drink as many glasses a day as you possibly can.
Raw Vegetable Juicing
If you’re finding it difficult to get in your 4-5 servings of vegetables per day, you might want to consider juicing a variety of raw vegetables. Even vegetables that don’t peak your interest can be enjoyed in a fresh vegetable juice. With impaired liver function, juicing vegetables has the added benefit of making the vegetables easier to digest, and more readily available for absorption. Vegetables ideal for a liver cleanse include cabbage, cauliflower, and brussels sprouts. Remember, you can also add fresh herbs including mint, parsley, and others to make the juices tasty.
- Use botanicals
Milk Thistle
Milk Thistle is considered one of the best detoxifying herbs, and so it’s not wonder it’s ideal for a liver cleanse. Milk thistle helps to eliminate the buildup of heavy metals, prescription medications, environmental pollutants and alcohol in the liver. The active ingredient, silymarin, has been proven to help strengthen the liver cells, while also supporting healthy regeneration!7
Dandelion Root
A powerhouse of a flower and is packed with vitamins and minerals. In addition, dandelion root has a natural diuretic effect, allowing your liver to actually eliminate toxins more quickly. In addition, it is a great botanical to help strengthen the immune system, balance blood sugar and soothe digestive upset. 8
Turmeric
Also, another powerhouse, tumeric works on many fronts. In addition to supporting healthy liver tissue and metabolism, it is also a great overall anti-inflammatory.9
- Consider coffee Enemas
Coffee enemas are thought to help aid in liver detoxification. During the enema, organic coffee is retained in your bowel, allowing the fluid to enter the liver through the intestinal wall.10 This has a stimulating effect which will increase bile flow, contributing to revving up your liver and gallbladder. This sparks the production of the chemical glutathione, a strong cleansing compound that helps to release the build up of toxins in your system.10
Now that you know the ins-and-outs of liver detoxification remember, before thinking of beginning your detox, it is essential you come up with a strategy how best to proceed. Although it has amazing benefits in the long run, the process of stimulating the body’s natural detox systems may cause feelings of fatigue, irritability, soreness, mood swings, and even the onset of cold or flu symptoms. Work with a qualified professional who can assist you during your first detoxification so that you can begin to understand the processes you are undergoing.
In addition, if you can significantly reduce the level of pollution in your home, choose the best quality food you can, and be wise about the products you use on your body, half the battle is already won … but I suppose that is a conversation for another day….
To your liver,
Dr. Afrouz
References
- Koeppen B, Stanton BA. Berne and Levy Physiology. Published January 1, 2018
- Wedro B. Anatomy and Function of the Liver. Retrieved from http://www.medicinenet.com/liver_anatomy_and_function/article.htm
- Hodges R, Minich D. Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application. J Nutr Metab. 2015; 2015: 760689. doi: 10.1155/2015/760689
- Bradshaw G. The Liver & Detoxification (Part 2). 2013. Retrieved from http://www.inl.asia/resources-main-navigation-bar/the-liver-a-detoxification-part-2.
- Kharrazian, D. Liver Detox Pathways and Vitamins and Foods that Support These Pathways. Retrieved form https://www.hashimotoshealing.com/wp-content/uploads/1Liver-Detox-Pathways-and-Vitamins-and-Foods-that-Support-These-Pathways.pdf
- SelfNutritionData. Foods highest in Glycine. 2014. Retrieved from http://nutritiondata.self.com/foods-000094000000000000000.html
- Loguercio C, Festi D. Silybin and the liver: From basic research to clinical practice. World J Gastroenterol. 2011; 17(18): 2288–2301. doi: 10.3748/wjg.v17.i18.2288
- National Center for Complementary and Integrative Health. Dandelion. September 2016. Retrieved from https://nccih.nih.gov/health/dandelion
- RE, Muriel P. Pharmacological actions of curcumin in liver diseases or damage. Liver Int. 2009;29(10):1457-66. doi: 10.1111/j.1478-3231.2009.02086.x.
- Gerson Institute. Scientific Basis of Coffee Enemas.
Retrieved from https://gerson.org/pdfs/How_Coffee_Enemas_Work.pdf
Hello Dr.Demeri, I recently enjoyed a webinar by you and Nick Polozzi. I am in my 60’s, overweight, and ready for healthier changes but do not know where to begin. Im on the east coast (NH),Do I seek out a functional medicine provider, herbalist? Wush u coukd visit you in Cali, but afraid to fly…another issue. Thank you for your response.
Thank you Christine – I see most patients virtually. Hope to see you in the program!