Have a Happy Holiday: Detox Essentials
- David S. Klein, MD FACA FACPM
- 4 days ago
- 10 min read
Understanding Detoxification in Three Easy Reads!
Many people believe that periodic 'detoxification' provides a healthy break for organs, such as for the liver, kidney, bladder and gallbladder. The holidays, for the most part, are a pleasant, memorable time of the year.
As it is with so many things, the good is accompanied by the bad. For purposes here, excessive and unhealthy eating accompanied by consumption of alcoholic beverages results in tremendous metabolic stress on the body. Were this not enough, travel and work stress adds to the load placed on the biological system.
Preventive maintenance, in the form of a formal systemic detoxification, might be a pretty good idea, indeed.
There is little scientific data on the benefits of 'Detoxification'
Scientific' data is nearly impossible to obtain in support of the observations of thousands of persons, over many decades, but it is clear that there is something to the claims that liver detoxification in particular makes people feel better. Why is there no scientific data to speak of? Simply: "There is no money in studying it."
The detoxification system is defined by three phases:
Phase I: Bioactivation.
Phase II: Conjugation.
Phase III: Transport.
Simply, the toxin is altered (usually to a safer chemical moiety, attached to another chemical (often a carbohydrate moiety,) and then transported out of the cell, gut, and out of the body.
Detoxification, often simply referred to as "detox," is a process that the body undergoes to remove harmful substances and toxins from its system. It is a fundamental physiological function that plays a crucial role in maintaining overall health and well-being. This process occurs primarily in the liver, but other organs such as the kidneys, lungs, skin, and gastrointestinal tract also contribute to detoxification.
The liver is the central organ responsible for detoxification. It breaks down and metabolizes various toxins, drugs, and waste products into less harmful substances that can be excreted from the body. This transformation often involves a series of chemical reactions that convert fat-soluble toxins into water-soluble forms, making them easier to eliminate through urine or bile. The liver also stores certain vitamins and minerals necessary for detoxification processes.
The Lungs are important organs of detoxification, as are the skin and kidneys.
Detoxification is not limited to the removal of external toxins, such as drugs and alcohol; it also involves the elimination of endogenous waste products produced during normal metabolic processes. The body continuously generates waste products, such as ammonia and carbon dioxide, which must be efficiently processed and excreted to prevent harmful accumulation. The lungs, kidneys and skin represent much of the detoxification machine.
Without getting into the basics of phase 1 and phase 2 detoxification, which is the paradigm that outlines the manner in which the liver, lung, kidneys, skin 'detoxify' substances. For a topic that gets such little mainstream support, it comes as a huge surprise to me that outside of energy expended for movement, most of the energy expended by the body is directed at DETOXIFICATION. Were it not for detoxification, we would not be able to survive outside of the sea, and even in the sea, we would be at constant peril of the environment.
The liver is responsible for the production of bile which is stored in the gallbladder and released when required for the digestion of fats.
The liver stores glucose in the form of glycogen which is converted back to glucose again when needed for energy.
The liver plays an important role in the metabolism of protein and fat, it stores the vitamins A, D, K, B12 and folate and synthesizes blood clotting factors.
In addition, the liver is as a detoxifier, breaking down or transforming substances like ammonia, metabolic waste, drugs, alcohol and chemicals, so that they can be safely excreted. These may also be referred to as "xenobiotic" chemicals.
If we examine the liver under a microscope, we will see rows of liver cells separated by spaces which act like a filter or sieve, through which the blood stream flows. The liver filter is designed to remove toxic matter such as dead cells, microorganisms, chemicals, drugs and particulate debris from the blood stream. The liver filter is called the sinusoidal system, and contains specialized cells known as Kupffer cells which ingest and breakdown toxic matter.
The gallbladder functions to store bile between meals. The gall bladder contracts when stimulated to push bile salts into the small bowel, thereby facilitating digestion. Bile is a clear, yellow liquid, when healthy. If the bile is allowed to stagnate, or if the gallbladder is allowed to distend or get infected, the bile thickens, stones form, and mucous backs up. It can become the site of chronic infection, sometimes, leading the the need to surgically remove the gallbladder.
As it were, prevention is probably the best bet, when dealing with the liver/gallbladder system. A little bit of care, and a little bit of prevention goes a long way.
To keep the gallbladder from distending, and to keep the bile from 'going stale,' the daily administration of silymarin, taken with each meal, will keep things moving along. The silymarin (milk thistle) stimulates the gall bladder to 'dump, ' very much in the same way the colon does. Both the colon and gallbladder should empty with each meal.
The liver is the cleanser and filter of the blood stream and is of vital importance. It is the largest organ in the body and has an enormous amount of blood flowing through it every minute of our lives. It is between 21 - 22.5 cm in its greatest diameter, 15 - 17.5cm in its greatest height and 10 - 12.5 cm in its depth, weighing around 1200 - 1600 gms.
We have been attacking the symptoms of weight excess with fad diets, obsessional high impact aerobics, stomach stapling and toxic drugs, such as appetite suppressants, laxatives and diuretics. We have failed to consider the underlying cause of LIVER DYSFUNCTION and indeed we have virtually ignored the hardest-working organ in the body, with dire consequences.
The use of drugs to control and treat animal disease and to promote faster, more efficient growth of livestock is a common practice. An estimated 80 percent of U.S. livestock and poultry receive some animal drugs during their lifetime. Improper use of animal drugs may cause residues in the edible tissues of slaughtered animals that could be hazardous to consumers.
There are many chemicals (e.g., trace metals, industrial chemicals, and mycotoxins) that may be inadvertently present in animal tissues yet have no established safe concentrations. This of course does not mean that these substances are not harmful.
It is a fact of life that pesticides, herbicides and hormones are used in food production. Although the regulatory levels set by authorities provide some control over residues - it is not the 'be all and end all'. The liver is again highlighted as vital, as it is the organ that metabolizes these substances and excretes them from the body.
The liver is the gateway to the body and in this chemical age its detoxification systems are easily overloaded. Thousands of chemicals are added to food and over 700 have been identified in drinking water. Plants are sprayed with toxic chemicals, animals are injected with potent hormones and antibiotics and a significant amount of our food is genetically engineered, processed, refined, frozen and cooked. All this can lead to destruction of delicate vitamins and minerals, which are needed for the detoxification pathways in the liver. The liver must try to cope with every toxic chemical in our environment, as well as damaged fats that are present in processed and fried foods.
Phase One - Detoxification Pathway
Human liver cells possess the genetic code for many isoenzymes of P-450 whose synthesis can be induced upon exposure to specific chemicals. This provides a mechanism of protection from a wide variety of toxic chemicals.
To put it simply, this pathway converts a toxic chemical into a less harmful chemical. This is achieved by various chemical reactions (such as oxidation, reduction and hydrolysis), and during this process free radicals are produced which, if excessive, can damage the liver cells. Antioxidants (such as vitamin C and E and natural carotenoids) reduce the damage caused by these free radicals. If antioxidants are lacking and toxin exposure is high, toxic chemicals become far more dangerous. Some may be converted from relatively harmless substances into potentially carcinogenic substances.
Excessive amounts of toxic chemicals such as pesticides can disrupt the P-450 enzyme system by causing over activity or what is called 'induction' of this pathway. This will result in high levels of damaging free radicals being produced.
Substances that may cause overactivity (or induction) of the P- 450 enzymes: Caffeine, Alcohol, Dioxin, Saturated fats, Organophosphorus pesticides, Paint fumes, Sulfonamides, Exhaust fumes, Barbiturates
The family of P-450 enzyme systems is quite diverse, with specific enzyme systems being inducible by particular drugs, toxins or metabolites. It is this characteristic that has allowed the development of special tests to check the function of the various pathways - see liver tests. The substrate is the substance that is acted upon by the enzyme.
Phase Two - Detoxification Pathway
This is called the conjugation pathway, whereby the liver cells add another substance (eg. cysteine, glycine or a sulphur molecule) to a toxic chemical or drug, to render it less harmful. This makes the toxin or drug water-soluble, so it can then be excreted from the body via watery fluids such as bile or urine.
Major Phase II pathways include glutathione, sulfate, glycine, and glucuronide conjugations. Individual xenobiotics and metabolites usually follow one or two distinct pathways. Again, this makes testing of the various pathways possible by challenging with known substances.
The conjugation molecules are acted upon by specific enzymes to catalyse the reaction step. Through conjugation, the liver is able to turn drugs, hormones and various toxins into excretable substances. For efficient phase two detoxification, the liver cells require sulphur-containing amino acids such as taurine and cysteine. The nutrients glycine, glutamine, choline and inositol are also required for efficient phase two detoxification.
Eggs and cruciferous vegetables (eg. broccoli, cabbage, Brussels sprouts, cauliflower), and raw garlic, onions, leeks and shallots are all good sources of natural sulphur compounds to enhance phase two detoxification. Thus, these foods can be considered to have a cleansing action. The phase two enzyme systems include both UDP-glucuronyl transferase (GT) and glutathione-S-transferase (GSH-T). Glutathione is the most powerful internal antioxidant and liver protector. It can be depleted by large amounts of toxins and/or drugs passing through the liver, as well as starvation or fasting. Phase II reactions may follow Phase I for some molecules or act directly on the toxin or metabolite.
Substrates of the glycine pathway Salicylates and benzoate are detoxified primarily through glycination. Benzoate is present in many food substances and is widely used as a food preservative. Many other substances are detoxified as well via the glycine conjugation pathway. Patients suffering from xenobiotic overloads and environmental toxicity may not have sufficient amounts of glycine to cope with the amount of toxins they are carrying.
Substrates of the sulfation pathways Neurotransmitters, steroid hormones, certain drugs such as Acetaminophen (also known as paracetamol) ,and many xenobiotic and phenolic compounds.
Substrates of glucuronidation
Polycyclic aromatic hydrocarbons, steroid hormones, some nitrosamines, heterocyclic amines, some fungal toxins, and aromatic amines. It also removes "used" hormones, such as estrogen and T4 (thyroid hormone), that are produced naturally by the body.
Toxic Overload If the phase one and two detoxification pathways become overloaded, there will be a buildup of toxins in the body. Many of these toxins are fat soluble and incorporate themselves into fatty parts of the body where they may stay for years, if not for a lifetime. The brain and the endocrine (hormonal) glands are fatty organs, and are common sites for fat-soluble toxins to accumulate. This may result in symptoms of brain dysfunction and hormonal imbalances, such as infertility, breast pain, menstrual disturbances, adrenal gland exhaustion and early menopause.
Many of these chemicals (eg. pesticides, petrochemicals) are carcinogenic and have been implicated in the rising incidence of many cancers.
Rarely does anyone think about the liver, which seems incredible to me because it is such a powerful organ and is easily improved. Indeed the simplest and most effective way to cleanse the blood stream and thus take the load off the immune system is by improving liver function. An example of the phase one pathway is the Cytochrome P-450 mixed function oxidase enzyme pathway. These enzymes reside on the membrane system of the liver cells (called Hepatocytes).
Specific Detoxification Recommendations
1. Begin with ensuring rapid transit through the colon. Without this, waste materials can be reabsorbed, and benefit is minimized.
CLA 1250 mg taken three times daily. This should be started first, and maintained throughout the detoxification period.
Silymarin/curcumin combination. This should be started simultaneously with the CLA. Dosage is different for men and women. Men should take it three times daily, women take one capsule at bedtime, only.
This combination should be maintained for 4 weeks or more. Many patients feel much better when the take it, and simply stay on it indefinitely. (This is what I do for myself, actually)
3. Maintain colonic function with Flax Seed Oil and cape aloe.
Maintaining healthy colonic function is a very, very good preventative health approach. It costs very little and it is an important factor in stimulating weight loss.
NOTE: This should be initiated soon after Thanksgiving and maintained through the holiday season.
In recent years, there has been a growing interest in detox diets and programs that claim to enhance the body's natural detoxification processes. While these programs often emphasize dietary changes and the consumption of specific foods or supplements, their effectiveness and scientific validity are a subject of debate. The human body is well-equipped to detoxify itself without the need for extreme diets or supplements, and it is essential to approach any detox regimen with caution and consult a healthcare professional for guidance. The use of simple, inexpensive and readily available natural products may be all that is necessary.
In conclusion, detoxification is a vital physiological process that helps the body rid itself of harmful substances and waste products. The liver, along with other organs, plays a central role in this process by transforming toxins into forms that can be safely eliminated. While there is ongoing debate about the effectiveness of various detox programs, it is generally advisable to support your body's natural detoxification mechanisms through a balanced diet, regular exercise, and a healthy lifestyle rather than relying on extreme or unproven detox methods. Consulting with a healthcare provider is essential for anyone considering significant dietary or lifestyle changes related to detoxification.
References
Ross D, et al. The role of the cytochrome P450 system in detoxification. Pharmacol Ther. 2019;197:41-52.https://pubmed.ncbi.nlm.nih.gov/30293648/
Lu Y, Cederbaum AI. NAC and hepatoprotection: mechanisms and clinical outcomes. Toxicology. 2020;430:152339.https://pubmed.ncbi.nlm.nih.gov/31412208/
Abenavoli L, et al. Milk thistle in liver disease: clinical evidence and mechanisms. Dig Liver Dis. 2018;50(10):10-17.https://pubmed.ncbi.nlm.nih.gov/30086050/
Jacobs MM, et al. Taurine and hepatic metabolism: implications for bile synthesis and detoxification. J Nutr Biochem. 2019;63:1-8.https://pubmed.ncbi.nlm.nih.gov/30429265/
Tu W, et al. Kupffer cells and their role in detoxification pathways. Hepatology. 2020;72(3):843-857.https://pubmed.ncbi.nlm.nih.gov/31737865/
Wallace C, et al. Colon transit time and toxin reabsorption: a mechanistic review. J Gastroenterol Hepatol. 2018;33(7):1241-1248.https://pubmed.ncbi.nlm.nih.gov/29533019/
Rahman TM, Hodgson HJ. Nutritional cofactors required for Phase II detoxification. Clin Sci. 2020;134:1521–1534.https://pubmed.ncbi.nlm.nih.gov/32300505/
Tang H, et al. Free radicals and oxidative stress generated during Phase I detoxification. Free Radic Biol Med. 2021;169:145-155.https://pubmed.ncbi.nlm.nih.gov/33845123/
Šimíček V, et al. Environmental xenobiotics and hepatic clearance mechanisms. Environ Health Perspect. 2022;130(5):560-571.https://pubmed.ncbi.nlm.nih.gov/35532747/
Roman BL, McMullen PD. Functional evaluation of cytochrome enzyme pathways in detoxification. Toxicol Appl Pharmacol. 2018;356:116-125.https://pubmed.ncbi.nlm.nih.gov/29129628/
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