Many of us are aware of the concept of a ‘meme,’ an idea that spreads from person to person within a culture as some sort of phenomenon. Memes are sticky, like that song you can’t get out of your head no matter how hard you try.
‘Detoxification’ is one such meme; as a concept it has meaning to almost everyone, but the significance of that meaning may be quite different from person to person. On its most basic level, detoxification implies the removal of ‘toxins’ and again, this word can mean different things to different people. For example, one might see toxins as things made via improper metabolism or internal microbial over-activity. These are usually considered ‘auto-toxins’ in the sense that they are generated out of the internal environment. Others might focus on the ever-increasing amounts of external toxins that are the result of chemical industrialization. These are usually termed ‘environmental toxins’ or ‘xenobiotics,’ chemical compounds such as drugs, pesticides or carcinogens not normally found in living organisms. There is little doubt about their penetration into human physiology. For example, a toxic component of rocket fuel has been found in breast milk of women in 18 states. The chemical, perchlorate, leaches into groundwater from various military facilities.
If you think this is all just a curse of modern living, you might be surprised to know that a lot of the genetic variation in our ability to effectively detoxify substances such as hydrocarbons is the result of our attempt to deal with the combustion byproducts of a very long history of crowding around smoky campfires.
Science or Commerce?
Detoxification has become big business. There is no shortage of products and nostrums that claim to ‘flush out toxins.’ Most of the time these are simply harmless ways of wasting money, except when they delay proper analysis and treatment of a more serious medical condition. More insidiously, they perpetuate the notion that the body is a helpless accumulator of all things malevolent, and desperately needs our help to do what it is incapable of doing itself.
Nothing could be farther from the truth. Detoxification is a well-understood biochemical process and there is no shortage of science behind it. Let’s take a look at how it works and what you can intelligently do to support it. I promise to keep things simple.
Most chemical detoxification occurs in the liver, the basic chemical powerhouse of the body. Toxins might come in via respiration, the digestive tract or some other means, but if they get into the blood, they’re going to the liver. There, they trigger a series of reactions that have been grouped into two ‘phases.’
In order to better understand the detoxification process, I will be discussing Phase I and Phase II separately, but actually, both of these occur simultaneously; like an automated car wash, where one car might be getting air-dried while another has just gone under the soap; at any given point in time, various toxins will be in either phase of detoxification, although all will eventually go through both phases.
Phase I - Metabolism and Breakdown of Toxins
Phase I detoxification enzymes are intimately involved with drug metabolism and breakdown, which is why one has to be aware that foods, herbs and supplements can influence cytochrome activity and why, if you are using them and taking prescription medicines, you should be monitored by a physician who is skilled in their combination. If I feel a generalized boost to Phase I detoxification is in order, I’ll often recommend these natural products in various combinations:
Phase I detoxification is often not very gentle. Conversion of these compounds involves sending a lot of free oxygen and hydrogen around and, in their high energy states, they can be very reactive and irritable. The end products of Phase I detoxification can sometimes be even more problematic than the molecule they started with. The only ‘improvement’ is that, at the very least, they are now on the way out.
Phase II - Preparation of Metabolites for Excretion
After a toxin finishes Phase I, it passes on to the second stage of its processing, Phase II detoxification. Phase II involves picking up the toxin from where it was left off by Phase I and twiddling it so that it can be safely be excreted from the body. Because the products of Phase I can be very reactive, having our Phase II detoxification mechanism in sync is very important.
Think of it like this: a toxin is similar to a baton used in a relay race. Phase I and Phase II are the runners running the race. Phase I takes its lap around the track, does its job on the toxin and then passes the baton to Phase II so that it can do its job on the toxin. However, Phase II has to be able to very quickly determine whether Phase I has passed it a real baton or lit stick of dynamite. If Phase II gets it wrong, the very effectiveness of Phase I instead becomes a problem; or as one of my patients, a choreographer, once explained modern dance to me: ‘40% of every dance is the ending.’
To be able to effectively handle the pass-off from Phase I, Phase II can call on a bevy of deactivation pathways that can pin all sorts of things on the baton to tone it down. The two most amenable to lifestyle modification are known as conjugation and glucuronidation. I know I promised to keep it simple, so let me describe these as best as I can. Like marriage, conjugation involves wedding an antioxidant known as glutathione to the baton. Glutathione is made from the amino acid NAC (n-acetylcysteine) and is about as close to a ‘metabolic currency’ as you’ll find in biochemistry. There are genetics involved, and some people make it better than others. However, having ample NAC is critical. I might also add that an extra level of attention can be provided by supplementing NAC with the herb milk thistle (silymarin), as this herb has been shown to help increase the level of glutathione inside the cells, which is where you want it.
This doesn’t necessarily pertain to detoxification, but there is a strong and emerging evidence basis for using NAC for the treatment of psychiatric disorders. NAC appears to reduce the negative symptoms of schizophrenia and also appears to be effective in reducing craving in substance use disorders, especially for the treatment of cocaine and cannabis use among young people, in addition to preventing relapse in already abstinent individuals. NAC has also show some benefit in obsessive-compulsive and related disorders, as well as on mood disorders. (Biomed Res Int. 2018; 2018: 2469486.) All of this has been speculated to be the result of its ability to increase glutathione.
Glucuronidation is a very long word used to describe plunking a molecule known as glucaric acid (or its stable form, calcium glucarate) onto the Phase I baton. During Phase II liver detoxification, certain hormones and various fat-soluble toxins will undergo glucuronidation and be excreted through the bile or urine. Calcium glucarate helps this elimination process occur without interruption. Apples, grapefruits, bean sprouts, and cruciferous vegetables like cabbage, broccoli and Brussels sprouts tend to be high in calcium glucarate.
So, which phase should you try to maximize? In most situations, you’ll want to assist both Phase I and Phase II at the same time. However, if you smoke, are drug sensitive or are caffeine sensitive, you might want to emphasize enhancing Phase I. Phase II detoxification involves the synthesis and secretion of bile, a carrier in which many toxic substances eventually are passed into the intestines. If you notice delayed reactions to foods, problems with digesting fats or a simple ‘sick feeling’ after eating certain heavy foods, you might want to work on optimizing Phase II.
These are supplements I’m fond of using to aid in the overall detoxification process:
General Phase I Enhancement:
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Finally, a word of encouragement. We are not biochemical bubbles who need to be protected from the big bad world out there. We’re designed to handle environmental challenges and even metabolize them. In fact, the process of learning how to master these challenges is part of the process of engineering health itself. Eating right, exercising, sweating a little, expressing yourself, spending time in Nature, and limiting your exposure to toxic media and toxic people gives the innate wisdom of your body time to do what it does best: sort things out over time.