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Detoxing Naturally – Liver Detoxification for Dummies

February 9, 2020

Detoxing Naturally – Liver Detoxification for Dummies

Detoxing Naturally – Facts vs Fiction

There is a lot of fearmongering, straight-up lies, and generally misleading marketing within the world of “detoxing.” From companies using misinformation to sell “liver cleanses” and “detoxes,” to skinny teas & supplements, the world seems to think that detoxing is something you need to buy something in order to do! Newsflash… your body already does this for you! Your body is extremely well-equipped for detoxing naturally!

The detoxification of drugs, environmental toxins, hormones, chemicals, water, air, and even the food you eat is performed by your liver, but detoxing also occurs through your digestive tract, kidneys, skin, and lungs! You already have the machinery for detoxing naturally!

This blog post will dive into what detoxification is, how detoxification works, and hopefully by the end of reading this, you will have gained some clarity on what you can do to actually naturally detoxify your system, and help save you some money!

Detox Naturally

Let’s start with the liver. The liver plays a critical role in maintaining a healthy immune system, regulating metabolism, assisting in digestion, and plays the superhero role of detoxification. Without your liver, you can not convert food into energy, make immune system molecules, and process or eliminate medications or environmental toxins. Liver detoxification (or “detoxing” as people commonly say) is divided up into two phases, resulting in end products that are sent to other organs for excretion.

Where is my liver anyway?

The liver is in the upper right-hand side of the abdomen, snuggled up underneath the ribs. It’s actually quite large, around 3 pounds. In some cases, it can even be the size of a large football!

Doctors will typically physically examine your abdomen in the area of your liver to see if it is enlarged. This can be the first clue that there’s any true issues going on!

How exactly does the liver work?

The liver has many different functions. It produces the storage form of carbohydrates (glycogen), makes specific amino acids as needed, it detoxifies products, it produces bile and cholesterol, and it manages intermediate metabolites that need to be sent to other cells via the blood. The list goes on! For the purposes of this blog, we will be discussing the detoxification system and leave your body’s superhero other roles for a later date.

It’s important to know that the liver is extremely vascular and receives 25% of the heart’s output each time it beats. This allows the liver to gather particles from the blood. The liver can be considered a selfish organ because it actually receives ALL blood and nutrients from the GI tract before they ever make it to the brain!

Anatomy of Digestive Organs

When the liver receives blood, it filters and attracts the particles (aka “toxins”) that need to be processed. These can be byproducts of other cell processes, foreign chemicals, heavy metals, medicines, hormones, pesticides, or drugs, to name a few. These products enter our body as fat soluble particles, meaning they are dissolved only in fatty or oily substances.

It is more difficult for the body to excrete these substances in fat soluble form… so these particles (toxins) must be put through the phases of liver detoxification that make them water soluble, so that they can then be easily excreted by the body through water-like substances such as urine, bile, sweat, and CO2!

Phase II Liver Detoxification

First, particles must enter phase I detoxification, which consists of a series of oxidation and reduction reactions (cue throwback to chemistry courses). This is a series of extremely complex reactions done by many enzymes that are waiting on the wall of liver cells, called hepatocytes.

The cool thing about these enzymes is not only their name, but their function. They are called the cytochrome P450 enzyme family. You won’t find these enzymes anywhere else in the body. That’s why they are so important! There are many compounds and drugs that can increase or decrease the functioning of these P450 enzymes. Below is a table that gives a quick overview of a few.

INHIBITORS, INDUCERS AND SUBSTRATES OF CYTOCHROME P450 ISOZYMES
remember
inhibitors and substrates INCREASE the effectiveness of another drug metabolized by that isozyme
inducers DECREASE effectiveness

INHIBITORS INDUCERS SUBSTRATES INHIBITORS INDUCERS SUBSTRATES
CYP1A2 CYP3A4
cimetidine
ciproflxacin
enoxacin
erythromycin
***fluvoxamine
grepafloxacin
isoniazid
mexiletine
norfloxacin
tacrine
zileuton
barbiturates
carbamazepine
charcoal-broiled foods
lansoprazole
omeprazole
phenytoin
rifampin.
smoking
    amitriptyline
caffeine
clomipramine
clozapine
cyclobenzaprine
grepafloxacin
imipramine
mirtazapine
olanzapine
propranolol
riluzole
ropinirole
R-warfarin
tacrine
theophylline
zileuton
amiodarone
amprenavir
clarithromycin
cyclosporine
danazol
delavirdine
diltazem
efavirenz
erythromycin
ethinylestradiol
fluconazole
fluvoxamine
grapefruit juice
indinavir
itraconazole
ketoconazole
nefazodone
nelfinavir
quinine
***ritonavir
saquinavir
Synercid
troleandomycin
verapamil
zafirlukast
barbiturates
carbamazepine
dexamethasone
efavirenz
ethosuximide
griseofulvin
modafinil
nafcillin
nevirapine
oxcarbazepine
phenytoin
primidone
rifabutin
***rifampin
rifapentine
St. John’s wort
     alfentanil
alprazolam
amiodipine
amprenavir
atorvastatin
bepridil
buspirone carbamazepine
cerivastatin
cisapride
citalopram
clarithromycin
clomipramine
corticosteroids
cyclophosph-amide
cyclosporine
dapsone
delavirdine
diazepam
diltiazem
disopyramide
dofetilide
donepezil
doxorubicin
efavirenz
erythromycin
ethinylestradiol
etoposide
felodipine
fentanyl
finasteride
ifosfamide
imipramine
indinavir
isradipine
itraconazole
ketoconazole
lansoprazole
loratadine
losartan
lovastatin
methadone
midazolam
mirtazapine
montelukast
nefazodone
nelfinavir
nicardipine
nifedipine
nimodipine
nisoldipine
paclitaxel
pimozide
quetiapine
quinidine
quinine
repaglinide
refabutin
ritonavir
saquinavir
sertraline
sibutamine
sildenafil
simvastatin
sirolimus
sufentanil
tacrolimus
tamoxifen
testosterone
tolterodine
toremifene
triazolam
troleandomycin
verapamil
vinblastine
vincristine
R-warfarin
zaleplon
zileuton
zolpidem
zonisamide
CYP2C9
amiodarone
cimetidine
cortrimoxazole
fluconazole
***fluvoxamine
isoniazid
ketoconazole
metronidazole
zafirlukast
barbiturates
carbamazepine
rifampin
rifapentine
St. John’s wort
    carvedilol
celecoxib
diclofenac
flurbiprofen
fluvastatin
glimepiride
ibuprofen
irbesartan
losartan
montelukast
naproxen
phenytoin
piroxicam
tolbutamide
torsemide
S-warfarin
zafirlukast
CYP2C19
felbamate
fluoxetine
fluvoxamine
modafinil
omeprazole
oxcarbazepine
None.     amitriptyline
citalopram
clomipramine
diazepam
imipramine
lansoprazole
phenytoin
omeprazole
R-warfarin
CYP2D6
amiodarone
chloroquine
cimetidine
clomipramine
diphenhydramine
fluoxetine
fluphenazine
haloperidol
paroxetine
perphenazine
propafenone
propoxyphene
quinacrine
quinidine
ritonavir
sertaline
terbinafine
thioridazine
None amitriptyline
carvedilol
chlorpromazine
clomipramine
clozapine
codeine
desipramine
dextromethorphan
dihydrocodeine
donepezil
flecainide
fluoxetine
haloperidol
hydrocodone
imipramine
loratadine
maprotiline
methamphetamine
 metoprolol
mexiletine
mirtazpine
nortriptyline
oxycodone
paroxetine
perphenazine
propafenone
propanolol
risperidone
ritonavir
thoridazine
timolo
tolterodine
tramadol
trazodone
venlafaxine

Foods and dietary components, including teas and supplements, can also influence this enzyme.

Foods that affect liver detoxification

Chart with Liver Detoxification Pathways. Toxins are fed into phase 1, then phase 2, then are eliminated through urine, sweat, and bile.

After a good fight between the particles and the enzymes, these particles (AKA toxins) come out modified and partially water soluble. These new products are called toxic intermediates and sometimes can do more damage to the cells than they can do in their original state.

If not excreted and put through phase 2 detoxification, these toxic intermediates can create free radicals that cause oxidative damage and oxidative stress which leads to inflammation, premature aging, and ultimately increases the risk for chronic diseases. This is where antioxidants are VERY important! They help combat the toxic intermediates.

Speaking of antioxidants, there are a variety of nutrients that are extremely important for the enzyme processes to continue. If you are lacking in these nutrients, phase I liver detoxification cannot run at full speed. This means any toxic products can build up and cause damage to the body. If one was to try and “detox” without these nutrients, they may do more harm than good.

The nutrients that are of importance for phase I detoxification processes are:

  • B2, B3, B6, B12
  • Folate
  • Glutathione
  • Flavonoids

Liver Detoxification Pathway and Nutrients needed for each step

(photo sourced from https://wildcraftmedicine.com/21-day-detox-program/)

Phase II Liver Detoxification

After phase I comes phase II of your liver detoxing the body naturally. This is the final step in transformation of the toxins, where they go from being less lipid soluble to becoming more water soluble through what is known as conjugation – which includes sulfation, glucuronidation, and more (see the above image!). Depending on the molecules, they undergo these 1-or more- of 6 reactions that conjugate (aka ADD another substance such as sulfur, cysteine, or glycine) to the particle or “toxin” to make it less harmful and be able to be excreted.

It’s important to note that phase II pathways require different nutrients than phase I. This is why variety in the diet is so important! If the body lacks of any of these nutrients,  the process will slow down immensely, just like in phase I. This can cause a reduction in your body’s ability to detoxify! This also explains why those who consume poor diets and have micronutrient deficiencies may actually see benefits from “detoxes”- they finally get the nutrients they need, so they start to feel better and see reductions in inflammation and free radical damage! Plus, they may get a large bowel movement… “detox” teas tend to stimulate the GI tract and are really just a laxative – yes I said it!!!

Nutrients that are important for Phase II Detoxification include:

  • Glutathione
  • B5, B12
  • Multiple Amino Acids- including taurine, glutamine, cysteine, methionine, glycine
  • Sulfur Containing Compounds like MSM & Sam- E
  • Magnesium
  • Vitamin C
  • Choline
  • Carnitine

The Last Step: Final Excretion of Toxins

After phase 2, finally, these the transformed particles & “toxins” are excreted. Some are returned to the blood to go to the kidneys and eventually out of the body through urine. Other products are attached to bile, which then go into the intestines and are passed through the stool. Others leave your body via sweat or breathing out of CO2.

Along with getting in all the required nutrients to go through each phase, it’s important to stay hydrated and to have regular bowel movements to rid your body of the final form of toxins- FOR GOOD! A happy poop life can mean a happy detoxification life!

Critical factors for final excretion include:

  • Adequate fiber intake
  • Adequate water intake

Lack of excretion or alterations in phase 1 & 2 detoxification can lead to a build up in the body of some particles- which is commonly seen when drugs are not metabolized correctly can be seen in estrogen dominance or high sex hormone binding globulin levels.

What does the liver store?

Your liver is a very crafty organ. As we mentioned before, the liver receives most of the blood and nutrients first. This allows for swift processing and storage. It stores many of the fat-soluble vitamins and minerals. Specifically, it stores the fat soluble vitamins A, D, E, K, along with water soluble vitamin B12. In addition, two minerals (iron and copper) have their stores in the liver.

Many animal livers store the same vitamins and minerals, which makes animal liver an extremely nutrient-dense food. It’s important not to eat too much liver though, because the fat-soluble vitamins themselves can become toxic at high doses.

Even though the liver stores all of these vitamins and minerals, it does not store many of the critical nutrients mentioned above that are needed for the detoxification pathways. Many of these are protein (stored in muscle) or water-soluble vitamins (which get directly excreted if they are not utilized). Therefore, having a wide variety of foods in the diet should be first priority.

Foods that Detox Your Body Naturally

While no food alone will detox your body, your liver needs support from specific nutrients in order to successfully complete its detoxification role. A healthy liver requires a well-rounded diet that includes a variety of fruits, vegetables, and proteins.

In this case, remembering to eat the rainbow will help you get all the nutrients you need for a healthy liver!

Red beets, tomatoes, cherries, cranberries, raspberries, strawberries, red bell peppers, red apples
Blue/Purple eggplant, grapes, blueberries, plums, pomegranates, purple potatoes
Orange/Yellow oranges, bananas, guavas, peaches, yellow squash, carrots, sweet potatoes
Green kiwi, collard greens, swiss chard, celery, green beans
White cauliflower, garlic, turnips, potatoes, onions, mushrooms
Don’t forget your protein!* legumes (beans), poultry, beef, eggs, soy products, pork

*Protein provides essential amino acids needed for liver detoxification.

 

Liver Cleanses are Unnecessary – The Bottom Line

There are so many companies out there trying to sell things like liver cleanses, detox teas, or supplements they claim will support the liver. They are sold under a false pretense that your liver stores toxins. As we learned earlier, the liver can temporarily store these toxins in excess fat outside the liver, because many of these toxins are fat loving molecules.

However, this only happens if the detoxification phases are not running at optimum efficiency.  If, through diet and lifestyle, the toxic load is more than the liver can handle even at optimum capacity – toxins will get stored in fat until the liver can process them.

So, contrary to popular belief, your liver does not directly store toxins. Therefore, you do not need a liver cleanse! What you DO need to handle toxins is to be physically active, poop daily, ensure optimal nutrients required for each pathway, and to sweat!

The body never stops working and neither does the liver! Through all these miraculous enzymes and nutrients, the body can keep running at an optimum level, without any need to purchase detox products. It’s just important to maintain a consistent dietary intake of all the required nutrients in order to support the liver!

Unless you have specific medical conditions that are inhibiting absorption or digestion of nutrients, the best way to make your liver happy and continue processing properly is to eat the rainbow! Taking supplements that help provide the body with required phase nutrients MAY help if someone is deficient, has a compromised liver, or has a genetic mutation that has affected detox pathways… but unless you work with a health care provider, it is best to avoid any supplements that claim to “help detox” because some of these may do more harm than good!

Authors: Lacey Dunn, MS, RD, LD & Chelsea Macias, Dietetic Intern

References:

Ballantyne S. What Does Our Liver Do Anyway? Detoxification Explained. The Paleo Mom. https://www.thepaleomom.com/what-the-heck-does-our-liver-do-anyway-detoxification-explained/. Published July 8, 2019. Accessed January 31, 2020.

Cline JC. Nutritional Aspects of Detoxification in Clinical Practice. Alternative Therapies. 2015;21(3).

Lautt WW. Overview Hepatic Circulation. Hepatic Circulation: Physiology and Pathophysiology. https://www.ncbi.nlm.nih.gov/books/NBK53069/. Published January 1, 1970. Accessed January 31, 2020.

Percival M. Phytonutrients and Detoxification PDF. 1997.

Speller J. Storage Functions of The Liver – Carbohydrates – Vitamins. TeachMePhysiology. https://teachmephysiology.com/gastrointestinal-system/liver/storage-functions-liver/. Published June 3, 2018. Accessed January 31, 2020.

Tucker I. Your Body’s Detoxification Pathways. The Great Plains Laboratory, Inc. https://www.greatplainslaboratory.com/gpl-blog-source/2016/6/6/your-bodys-detoxification-pathways. Published June 6, 2016. Accessed January 31, 2020.

Additional resources:

www.ncbi.nlm.nih.gov › pmc › articles › PMC4488002Modulation of Metabolic Detoxification Pathways Using Foods …

www.ncbi.nlm.nih.gov › pubmedNutritional aspects of detoxification in clinical practice. – NCBI

www.ncbi.nlm.nih.gov › pmc › articles › PMC4014033Pharmacological strategies for detoxification – NCBI

www.ncbi.nlm.nih.gov › pubmedAntioxidant and detoxifying enzymes in the liver and … – NCBI

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