Gut Check – Laying the Groundwork for Detox
With detox becoming much more popular in the last decade, it’s likely that some of your patients have come to you asking for a “good detox”; however, it’s not generally advisable to have that be your starting point. Jumping first into a detox can be like putting a new, whole-house water filtration system in your basement and not first replacing the old, grime-covered pipes that deliver the filtered water to your kitchen, shower, and faucet.
Adequately preparing your body to handle the increase of toxins that will be mobilized during a detox often requires a bit of preparation in terms of making sure the gastrointestinal system is functioning optimally with healthy GI flora.
We each have nearly 10 pounds of bacteria in our gut that serve to support the digestion of food, synthesize B vitamins and Vitamin K, produce ATP from non-digestible carbohydrates, convert T4 to active T3, inhibit non-beneficial bacteria, deconjugate bile acids, enhance lactose tolerance and glucose balance, stimulate and modulate the immune system (balance TH1/TH2 responses), maintain mucosal barrier integrity and metabolize xenobiotics. These are just some of the activities of healthy gut flora.
Non-beneficial gut bacteria may release endotoxins that have multiple effects: impairing optimal immune function, impeding nutrient absorption, turning nutrients into toxins, weakening the gut barrier and central to this discussion, significantly increasing the toxic load that the liver must metabolize. Elevated lipopolysaccharides/LPS levels lead to a reduction in glutathione production as well as a significant reduction in function of cytochrome P450 enzymes; reducing Phase 1 detoxification. Phase 2 detox is also compromised with elevated LPS as it down-regulates glutamate-cysteine ligase and reduces the synthesis of SAMe and the methyl groups available for methylation.
Lab testing can help identify imbalances in the GI tract, which may need to be addressed prior to embarking on detoxification. Ensuring the integrity of the gut is optimized can improve the efficacy of a detoxification program, by decreasing the overall body burden of toxins and decreasing the avenues for toxin reabsorption.
- Morgan, ET. Suppression of constitutive cytochrome P-450 gene expression in livers of rats undergoing an acute phase response to endotoxin. Mol Pharmacol. 1989 Nov;36(5):699-707.
- Ko, K. et al. Changes in S-adenosylmethionine and GSH homeostasis during endotoxemia in mice. Lab Invest. 2008 Oct;88(10):1121-9.