Detoxing? Avoid these mistakes

Detox is always a popular topic in the health and wellness space, especially in the New Year—read this to make sure you're avoiding the classic detox mistakes...

While there’s obviously a plethora of different detox options these days ranging from the more modern-day (and arguably much-needed for us all) digital detox to an age-old dry January, the detox I’m going to discuss refers to nutrition and lifestyle strategies that facilitate liver detoxification (aka biotransformation). 

The liver is our body’s primary filtration system; it converts toxins into waste products we can excrete.  And, unless you’re living in a utopia, it’s likely you’re exposed to quite a lot of toxins on a regular basis, so our livers are busy.  However, before you rush to purchase some sort of detox/cleanse product to support your liver, there are some essentials I want you to know…

In functional medicine, we refer to ‘detox’ as the process of biotransformation because that’s actually what happens in the liver.  Your liver literally ‘biotransforms’ toxins via 2 primary phases, called Phase I and Phase II…

• Phase I, aka the activation and transformation phase, is where the liver uses enzymes, primarily the cytochrome P450 family, to initiate the breakdown of toxins. This process involves making the toxins more water-soluble, a crucial step for their eventual excretion. The enzymes in Phase I catalyze reactions like oxidation, reduction, and hydrolysis, transforming the toxic substances into intermediary metabolites.  While this transformation is a necessary step towards detoxification, it can sometimes result in more reactive and potentially harmful intermediates. To counteract this, the body moves on to Phase II.
  
• Phase II, aka the conjugation and neutralization phase, involves the conjugation of the intermediary metabolites formed in Phase I.
  The process of conjugation in Phase II reactions is dependent on sufficient levels of nutrients, including amino acids such as taurine, glycine, sulfate, glucuronic acid, ornithine, mercapturic acid, and glutamine, as well as a host of enzymatic cofactors, including Vitamin B2, B3, B6, B12 & folate.  If these nutrients are in low supply, Phase II reactions can’t keep pace with Phase I.
  The conjugation process is a sort of binding process that neutralizes the reactive metabolites (from Phase I), making them less harmful and facilitating their elimination from the body.
  These pathways work in harmony to create larger, water-soluble compounds that are easily excreted through bile or urine.
  

In summary, Phase I activates and transforms toxins, and Phase II neutralizes and prepares them for elimination. This orchestrated process ensures that harmful substances are efficiently cleared from the body without causing harm in the process.

As many of you know, I like to use analogies/metaphors to help simplify the science (where possible), so here’s my detox analogy to explain phase I & phase II:

Imagine you’re in college again and you’ve hosted a party at your house.  After everyone’s gone, all that remains is a big, smelly mess of spilled beer, cigarette butts, and other delights littered all over the place.

• Phase I is the process of tidying up the mess and gathering it into large garbage bags 
• Phase II is the process of actually removing the garbage bags from the house and putting them on the sidewalk for collection

As you can see, both Phase I & Phase II are crucial - they work together.

The first classic mistake is attempting a ‘detox’ (biotransformation) without sufficient nutrients to facilitate the function of the Phase II conjugation pathways. 
Therefore, sticking with my analogy above, the house may be getting cleaned up, but it still stinks because they can’t actually bind the toxins to facilitate Phase II. 
This explains why it's relatively common for people doing some sort of juice cleanse to report experiencing an insatiable craving(s) for some nutrient-dense protein during/after the process of their ‘cleanse’.

The second classic mistake is attempting a detox without first resolving constipation!  A detox typically expedites and exacerbates the mobilization of toxins.  Although we can eliminate toxins through sweat, the other big way we eliminate them is through stool.  Any/all nutritional detox regimens must involve making sure you’re having at least one healthy bowel movement everyday — this is often referred to as Phase III of the biotransformation process.

In the world of functional medicine, we define your total toxic load as follows:

Total toxic load = Total toxic exposure - Your ability to biotransform & excrete those toxins

So, if you’re keen to explore a nutritional detox, I recommend being mindful of the following essentials:

• Consume nutrient-dense foods to ensure your body can facilitate Phase II
  

• Optimize gastrointestinal function before initiating any sort of detox so you can eliminate toxins
  After all, we are what we eat, drink, breathe, touch, and can’t eliminate!

I hope this will help you avoid the classic detox mistakes if/when you’re tempted to do one!

As always, please don’t hesitate to reach out with questions/comments.

References:

• Hodges, R. E. & Minich, D. M. (2015).  Modulation of detoxification pathways using foods and food-derived components: A scientific review with clinical application.  Journal of Nutrition & Metabolism, 760689.  https://doi.org/10.1155/2015/760689