If you follow experts and influencers in the health space, there is always a lot of discussion on the role of detoxification in our health. You’ll see extreme ideas and very restricted programs for detox including the “master cleanse” where you commit to only having lemon, maple syrup and cayenne pepper for a week or longer. Or, you might be familiar with various juice cleanses, raw food diets and fasting programs marketed with the goal of detoxification. In addition, there are thousands of detoxification supplements on the market, each with its own spin on why it’s the best tool for detoxification.
No wonder there is so much confusion around detoxification. Are we really that dirty that we need to take extreme measures, invest in expensive programs or take handfuls of supplements? Should I buy the next “artichoke liver cleanse” that enters my inbox?
What exactly is liver detox – and is it all hype? Or not?
This is exactly what I’m going to dive in to today, providing my expertise as a functional medicine practitioner.
In this article, you will learn:
Let’s start with - what is detoxification?
Detoxification is a natural body process of removing waste products and toxins. The body needs to remove normal products of cellular waste, excess hormones (like estrogen) along with the toxins that enter our bodies through the environment, food and personal care products. If the body doesn’t need it and can’t reuse it, it needs to get out of the body. This is the work of your detoxification system.
There are 5 organs that are important for detoxification:
Whereas the liver often gets the most attention, and it is what we will focus on today, these other aspects are important for removing waste. If you liver does a great job of transforming toxins so they can move out of your body, but you aren’t peeing, pooping or sweating, those toxins recirculate and wreak havoc on your system.
Let’s talk about estrogen for a moment because one of my passions as a clinician is helping women with hormone balance. One of the most common hormone imbalances for women is estrogen dominance, or having extra estrogen. (Sometimes estrogen dominance goes hand-in-hand with PCOS that you can read more about here and here.)
The liver works to transform this estrogen into metabolites that can leave the body, and I’ll go into the details on this in a moment, but in order to leave the body the colon plays a major role in terms of microbiome balance and regularity. Think of your colon as the drain in the bathtub, if it’s clogged, you can’t drain the dirty bathwater. The same is true for estrogen, if your colon is clogged, the excess estrogen can’t leave and might stick around causing PMS, heavy periods, headaches or even contribute to certain cancers.
It’s also important for the kidneys to filter out toxins so they can leave via urine, the lungs to help you exhale toxins and the skin releases toxins via sweating. The whole system is important.
In simple terms, the role of the liver in detoxification is to transform fat soluble molecules into water soluble molecules. It’s water soluble, it can enter the bloodstream and be removed by the body. In addition, through this process, toxins become bound up, and therefore, less harmful.
Liver detoxification happens in two phases, known as Phase 1 and Phase 2. Phase I uses cytochrome P450 enzymes to transform the toxins, and often what is produced here, called intermediates, are incredibly toxic to the body so an additional transformation is required. Phase 2 offers a variety of processes (methylation, amino acid conjugation and sulfation) to bind to these toxic intermediates and neutralize them.
Here is a helpful visual, originally from the Textbook of Functional Medicine:
Enter this visual, or similar:
What is so striking to me about this visual is how incredibly important nutrition is for both phases. A variety of vitamins, minerals, amino acids (from protein) and plant compounds are critical for a well-functioning liver detoxification process.
So when it comes to detoxing the liver and the question I get all of the time about “how to detox your liver?” my answer is that you need to feed this process with an abundance of nutrients. Extreme restriction and fasting likely won’t give your liver what it needs to do its job and may actually work against the detoxification process we are talking about.
The next question I often get is, “how long does it take to detox your liver?” The truth is that detoxification isn’t something that happens in the timeframe of a program or cleanse. Detoxification happens all the time, without you having to give it much thought. In fact, your body is detoxing for you right now!
Now that isn’t to say that we don’t have to think about detoxification because we do. In today’s world we are exposed to more toxins than ever before. The burden on our detoxification systems is huge and only becomes greater with stress, poor diet, inactivity and other factors of a modern lifestyle. Many people benefit from ongoing detoxication support and specific protocols if there was a known exposure or health issue related to toxins.
One way to support the liver is with glutathione. Glutathione is known as the body’s master antioxidant, it’s critical for protecting cells from oxidative stress and the damage caused from toxins and enhances the immune system, which is one reason glutathione is getting a lot of attention in regard to COVID-19. The effect of glutathione on the liver is twofold: glutathione supports both phase 1 and phase 2 detoxification.
The body synthesizes glutathione on its own, from the amino acids glycine, glutamate and cysteine. For good glutathione production and balance, riboflavin (vitamin B2), vitamin C, vitamin E and selenium are also required. This is another reason that eating protein and many plant foods helps to support detoxification and why nutrition becomes a key way to provide this glutathione and liver function support in an ongoing way.
Glutathione is also frequently used as a supplement, which may be particularly beneficial for those with genetic changes that inhibit their own production or who have a greater need for glutathione to support detoxification. Choose the liposomal form of glutathione for optimal absorption or use NAC for liver support. NAC, or n-acetyl-cysteine, provides the cysteine component of glutathione and helps to raise levels in the body.
Alpha lipoic acid (ALA) is another supplement that you might hear of in regard to detoxification. ALA helps to protect cells from free radicals as well as to regenerate antioxidants, including glutathione.
It is relatively easy to pop some pills for detox support; however, even with these high quality supplements that I’ve recommended, it is important to lay the foundation of health with nutrition and lifestyle practices. Here are some steps you can take today, and every day, to support your body’s detoxification systems.
While we may think that American’s are eating too much protein, many of the patients I work with have a hard time getting enough, and it can be even more challenging for those eating more of a plant-based diet. Getting enough protein looks like including a 3-5 ounce serving (or 20-30 grams of protein) with each meal and including protein with snacks as needed. Or an easier way to think about it is to take your goal weight in pounds and that’s your total protein need for the day. If your ideal healthy weight is 130 pounds, your protein intake is 130 grams. While that seems higher than you’re likely accustomed to hearing, the science on longevity, ageing and staving off chronic disease trends towards maintaining lean muscle mass and increased protein needs. Try it out for a day and compare how you feel with higher protein intake versus lower intake. For many people, the better energy, decreased cravings, improved sleep, decrease bloating and other pesky symptoms speaks for themselves! And yes, you can eat enough protein following a plant - based diet – it just tends to require more thought, planning and education.
A variety of colorful plant foods, eaten daily, helps to support your body in this modern environment. Whether you are an omnivore or vegan, plant foods in their whole form are key. Beets, berries, carrots, artichokes and broccoli are just some of the magical, liver supportive options!
Glass or stainless steel water bottles are great for refilling.
My hope is that this information helps to transform your views about detoxification, so you can ignore the gimmicks and hype, but still benefit from very foundational detoxification support that easily fits into your healthy lifestyle. Here at The Fork Functional Medicine, I often say it begins with the fork because what you put on your fork each day is medicine on so many levels, including liver detoxification.
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