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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

    INHIBITORSINDUCERSSUBSTRATESINHIBITORSINDUCERSSUBSTRATES
    CYP1A2CYP3A4
    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
    Noneamitriptyline
    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!

    Redbeets, tomatoes, cherries, cranberries, raspberries, strawberries, red bell peppers, red apples
    Blue/Purpleeggplant, grapes, blueberries, plums, pomegranates, purple potatoes
    Orange/Yelloworanges, bananas, guavas, peaches, yellow squash, carrots, sweet potatoes
    Greenkiwi, collard greens, swiss chard, celery, green beans
    Whitecauliflower, 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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    Love- Lacey: Team “Let Your Liver Detox -Not Your Wallet”

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