“For the first time in the history of the world, every human being is now subjected to contact with dangerous chemicals, from the moment of conception until death.”
– Rachel Carson, Silent Spring (1962)
Rachel Carson’s Silent Spring exposed the hazards of the pesticide Dicholorodiphenyl Trichloroethane (DDT) and eloquently questioned our faith in certain areas of technological progress and in doing so set the stage for the environmental movement.
Five decades later, research into the biotransformation and elimination systems of the body continues to evolve.
We all know that detoxification is the body’s normal process of first neutralizing (Phase 1) and then eliminating (Phase 2) “toxins” through different organ systems (colon, kidney, lungs, lymph, skin).
We also know that “bioaccumulation” refers to the accumulation of absorbed “toxins” at a faster rate than our detoxification systems can handle. So let’s step through the enhanced modulation of detoxification pathways using supplemental components.
Before we look at the functional capacity of the liver, gut function must be addressed. Why? The gut excretes most of what the liver packages for elimination. The gut is arguably the third dimension of detoxification. The first step in any detoxification process should be to heal the gut, reduce inflammation and make sure that your patient has consistent intestinal motoric function (ie., they have a bowel movement daily).
Here are some basic detoxification perquisites:
Effortless bowel movements, at least once a day, are required to reduce the potential for toxins being resorbed back into systemic circulation.
- 30 grams of fiber a day
- Hydration: roughly eight, 8 ounce glasses of water a day.
- Consider following an elimination diet for two weeks to reduce potential immune mediated inflammation.
- Supplemental compounds to consider for enhanced gut excretion/repair: L-Glutamine, Ca-D-Glucarate, DGL, Aloe Vera Extract, Slippery Elm, Marshmallow root, Citrus Pectin, omega-3 fatty acids…
Biotransformation occurs during Phase 1 liver function (aka CYP450 enzymes). This is where a fat-soluble compound is transformed into a water-soluble compound. A reactive site is formed on the substance identified to be eliminated with the addition of an oxygen molecule. This is an oxidative process, producing free-radicals. There is variability in the number and efficiency of our CYP450 enzymes, therefore supplementing with anti-oxidants, like these listed below, can address the potential oxidative load imparted upon our body during this phase:
- Vitamin C, Alpha Lipoic Acid, N-Acetyl Cysteine, Zinc, Green Tea (EGCG), Curcumin, Resveratrol, Garlic, Fish oils.
- Dietary inclusions: Cruciferous vegetables
Phase 2 is the liver’s elimination stage: After toxins have gone through the process of becoming water-soluble (hydrophilic) through Phase 1 CYP450 enzymes, their reactive site can be conjugated ( “to link together” in Latin) to a number of similarly hydrophilic compounds leading to enhanced excretion in bile and urine (i.e. glucuronidation, sulfation, acelylation, methylation, glutathione conjugation, amino acid conjugation.
Listed are a few possible enhancers of phase 2 conjugation:
- Glutathione, Curcumin, SAMe, Milk thistle
- Dietary inclusions: Adequate protein intake, Alliums such as onions and scallions, cruciferous vegetables
The most efficacious detoxification approach must evaluate current health status and the patient’s readiness for a detoxification program. This should include but not be limited to:
- Type and number of symptoms
- Patients individual capacity to metabolically detoxify
- The total toxic burden
- Consideration for the relevance of assessing the particular toxins for which a patient has been exposed.