In Part III, I’d like to review how our body goes about the detoxification process and specifically, the liver detoxification process, in order to help the reader know how to better augment and assist this natural process.
Mary’s exam was striking but not unusual. Her hands and feet were cold and her nails had significant ridging and were brittle. Her tongue was red and slightly enlarged for her mouth causing small scallops along its edge and I noted an unusual, foul smell to her breath. Her liver was a little tender on exam as well, though not especially enlarged. Finally, her skin had an overall dusky and mottled appearance. Per her account, all of these findings began to arise five years ago.
What changes in Mary’s diet had led up to her physical and circulatory changes? Which of her past chemical and environmental exposures were contributing to her current condition? Could her sluggish bowel movements and poor urine production be augmented? Could I design a plan to assist her body in it’s ability to detox and remove the toxins she has built up over all these years?
The Process of Detoxification
There are four major processes our body must perform to remove toxins:
Defecation & Urination
The liver serves as a major filter for all of the blood coming from the large and small intestines. This blood is exposed to the cells of the liver which possess enzymes to detoxify the contents of the blood. The process of detoxification in the liver results in the production of bile that is then secreted into the small intestines. But prior to its excretion, the toxins in the bile have to be processed at the cellular level.
Phase I and Phase II detoxification occurs at the level of the cells in the liver.
Phase I & II Detoxification
Phase I detoxification is the process by which reactive metabolites naturally made in the body and toxins that enter the body are tagged for elimination by making them more water soluble. However, in this process of becoming more water soluble they also become more reactive and thus have an increased potential for harm. Phase II detoxification then takes these intermediaries, makes them less reactive, tags them for elimination by the liver cells into the bile and then they are excreted into the stool as bile and eventually out of the body.
The liver is one the major locations for the detoxification process to occur in the body, but it also occurs in the kidney and bacteria in the GI tract (both sometimes called Phase III detoxification). For the kidneys to optimally perform their Phase I and II detoxification duties, they require adequate blood pressure (through hydration with pure clean water) and minerals in addition to alkalizing substances. What this means is that if you don’t drink enough clean water, it will impede your body’s ability to excrete toxins through your kidneys. Also, if you don’t get enough of the nutrients listed in the Phase I detoxification column, your kidneys won’t work optimally. This requires eating lots of green vegetables, citrus, and mineral dense foods like bone broth.
Akalinization is a term often thrown around and often used incorrectly. It doesn’t mean you should drink soda water or eat tums (or drink alkalinizing water) but eat/drink substances that enable your kidneys to do their job, create relative alkalinity (pH >6.4), and expel toxins into the urine for elimination from the body. We will discuss the specifics of how to do this in Part IV.
Your gastrointestinal tract houses over 100 trillion bacteria that interact with the foods we eat and the secretions of our intestinal lining as well as those of the liver and pancreas. This interaction includes interacting with toxins excreted by the liver and those toxins in the unabsorbed food we eat. I could write a whole series on this, but fortunately I don’t have to, Chris Kresser has already done a nice job of this, so for the sake of time and space I’ll refer to his well-written article on this topic.
So, in the few paragraphs above, we discover the need for:
- Clean, fresh, nutrient-dense food
- Adequate hydrationa
Breathing is typically less thought of as a detoxification process, but if you were to stop expiring the carbon dioxide that your cells make during cell metabolism, you would die within minutes. Because this process is so natural and occurs literally without thought, it is often overlooked. Also breathing in—inspiration—is a potential source for toxin exposure. This is an area we all need to think about.
Air pollution can be a source for lung inflammation and respiratory disease as well as cancer. Autoimmune diseases like rheumatoid arthritis and even Alzheimer’s Disease have been associated with air pollution. The above links are great resources to learn more concerning this field of medical research. In Part IV we will discuss ways to improve the air quality of your home and minimize this risk. For our purposes here, the basic concept is that you need clean fresh air just as much as you need clean fresh water. And just as easily as we breath out and eliminated carbon dioxide made in our bodies, if the air is full of pollutants, we can breathe these into our lungs and they can enter our bodies.
Does anyone actually sweat these days? Hardly anyone has an outside job; we live in air-conditioned environments; even our gyms are conditioned for our comfort. The result is that even in work out places it’s hard to get a good sweat. This area of detoxification seems fairly intuitive; we all sweat large amounts prior to the age of air conditioning and today most of us don’t sweat enough. However, this is a controversial area because there isn’t a lot of direct research in the area. So, we will have to look at it indirectly.
First, there are substances, especially Persistent Organic Pollutants (POPs) that are preferentially excreted via perspiration. Heavy metals like mercury, lead and cadmium are also excreted more in sweat than in urine. Since we don’t know exactly how this process works, the most interesting data to me is the scientific use of Far Infra Red Saunas to treat first responders for toxin exposures. FAR-IR is an invisible form of infra-red light that heats a person’s body and makes them sweat. The technology is relatively inexpensive and a unit can be purchased at Costco (or Craig’s List for used ones). There are multiple studies looking at high exposure individuals (usually first responders or industrial workers). In these studies, the patients had severe symptoms ranging from chronic fatigue and pain to respiratory tracts diseases and hormone imbalances. The levels of certain chemicals were measured then the patients were treated with FAR-IR. The improvements in their health were spectacular and the mechanism for this, from the studies, was the detoxifying effect of the FAR-IR. The current research is compelling, but more research is needed. I never learned in medical school about the health benefits or detoxifying effects of FAR-IR because we didn’t even know about it in 1996. Today we are just beginning to scratch the surface of this field. Interestingly though, in ancient healing traditions (e.g. Mayan’s in CA, TCM in China or Ayurveda in India), sweating was commonly used to help detoxify the body and maintain balance. Ultimately FAR-IR is safe and effective, even if we don’t know all the ways in which it may be having its effect.
Defecation, urination, perspiration and expiration: the four major ways our body eliminates both metabolic toxins and environmental toxins we are exposed to. You may say this is all great info, but what now. Is this actionable data or just knowledge for the sake of knowledge?
In Part IV, I will present a complete detoxification program that will address all of the topics discussed in the previous three parts.
Since 2010, Richmond Integrative and Functional Medicine has been helping people to restore their health and hope with an integrative approach to conventional and alternative medicine that’s entirely science-backed. We at RIFM believe everyone is made for health. We offer a comprehensive, in-person patient membership program to ensure you get access to the care you need to thrive.