Detoxification is a popular term that has been used loosely in recent times. It includes a wide range of protocols and practices. The underlying rationale is that the environment is full of toxins, chemicals, X-rays, pollutants, herbicides, and pesticides, all of which cause damage to cells, proteins, and DNA. These free radicals accelerate aging and are even linked to cancer.
It is impossible to avoid damage by toxins, but it can be reduced. To that end, the following is a general but limited overview of detoxification, or “detox.”
Types of toxins
Detoxification occurs through multiple pathways in the human body that remove unwanted chemicals and is often referred to as metabolic detoxification. This includes enzymatic reactions that neutralize toxins and send them to filter organs such as the liver and kidneys to be excreted from the human body. These toxins include xenobiotics, which are foreign chemicals, and unwanted endobiotics, which are internally produced chemicals.
Endobiotics include excess hormones, inflammatory substances, vitamins, and other compounds. These are eliminated from the body by detoxification processes that include enzymes that protect the body from environmental toxins and help excrete prescription medications. Detoxification reactions maintain homeostasis in the human body.
Poisons produced by living organisms are referred to as toxins, and man-made chemicals with the potential for toxicity are called toxicants. These toxins and toxicants can act as mutagens or carcinogens, causing DNA damage, or mutations that can lead to cancer. They can also interfere with metabolic pathways, resulting in the dysfunction of the nervous system, liver or kidneys, and other organs.
Toxins often enter the diet by way of microorganisms or toxicants from pesticides, substances from food processing, medications, and industrial waste. In addition, toxins may include heavy metals such as lead, cadmium, chromium, and mercury that find their way into the diet.
Toxins can also be found in bacteria and fungi and are ingested after contamination or improper food preparation. Some toxins result from overly high-temperature food preparation, such as nitrogen-containing compounds and meat products, which can be converted at high temperature to mutagens. For instance, smoked meats and cheeses can contain mutagenic toxins after being heated.
Respiratory exposure to toxic compounds also poses a risk of health problems, including immunological issues, hormone imbalances, kidney problems, blood disorders, bronchitis, and asthma. Non-dietary toxicants can emanate from air in the home, building materials, and toxic benzene derivatives found in disinfectants and deodorizers, as well as other cosmetics and hygiene products.
You cannot hibernate to escape toxin and toxicant exposure. But you can avoid and reduce exposure by, for instance, eliminating bisphenol A (BPA) containers and avoiding reheating food in plastic containers. You can also add organic foods to your diet.
Washing fruits and vegetables reduces pesticide exposure, as does peeling the skin off produce. In addition, limiting the number of processed foods and avoiding synthetic preservatives reduces exposure to toxic compounds. Avoiding the consumption of charcoal and overly cooked and charred foods, specifically meats, reduces toxic exposure significantly as well.
Lipid cell membranes are barriers to water-soluble compounds. But they don’t act as efficient barriers to lipid-soluble compounds. Therefore, lipid-soluble toxins can penetrate the anterior of a cell and damage or destroy it. Accordingly, in metabolic detoxification, a system converts lipid-soluble toxins into inactive water-soluble metabolites through three phases that remove undesirable or harmful lipid-soluble compounds via proteins or enzymes. The three phases include Phase I, transformation; Phase II, conjugation; and Phase III, transport.
The liver is the main organ for detoxification. It filters blood that enters the liver from the intestines and it prepares toxins for elimination from the human body. Other locations for detoxification include the lungs, brain, kidneys, and intestines.
Phase I of detoxification, known as enzymatic transformation, transforms lipid-soluble compounds into water-soluble compounds before Phase II of detoxication takes it from there. Most of the transformation in Phase I is conducted by enzymes called cytochrome P450s (CYPs).
There are several other enzymes involved in the Phase I detoxification process, such as the flavin-containing monooxygenases (FMOs) that detoxify nicotine from cigarette smoke, aldehyde dehydrogenases that metabolize drinking alcohol, and monoamine oxidases (MAOs) that break down epinephrine, dopamine and serotonin in the neurons.
Phase II detoxification is known as enzymatic conjugation. The more water-soluble toxins transformed from Phase I are dealt with in Phase II by enzymes that modify and reduce toxicity through their anti-carcinogenic and anti-mutagenic properties.
For the most part, Phase II enzymes are produced and controlled by a protein called nuclear factor (erythroid-derived 2)-like 2 (Nrf2). It also controls genes in the production of detoxification molecules, such as glutathione and superoxide dismutase (SOD). It significantly affects heavy-metal detoxification and recycles CoQ10, which is a strong antioxidant.
Dietary sources from broccoli and hops may also directly activate Nrf2 and the enzymatic activity in Phase II. Other Phase II enzymes include UDP- glucuronosyltransferases (UGTs), which attach glucuronic acid to toxins to make them more water-soluble. Clinical drugs and dietary supplements are metabolized by UGTs.
Other enzymes in Phase II include glutathione S-transferases (GSTs), which transfer glutathione, a significant antioxidant, to Phase I products. GSTs are involved in the metabolism of endobiotics, such as steroids, fat-soluble vitamins, bilirubin, prostaglandins, bile acid, and thyroid hormone. GSTs also detoxify free radicals.
Another enzyme in Phase II is sulfotransferase (SULT), which connects sulfates to acceptor molecules that are important in detoxification reactions and is involved in detoxification of drugs and xenobiotics as well as the metabolism of thyroid and adrenal hormones, steroids, vitamin D, ascorbate, retinol, and serotonin.
To a lesser degree, an enzyme involved in Phase II called methyltransferase is involved in methylation using S-adenosyl-L methionine (SAMe), which eliminates excess dopamine or adrenalin. Other less-used enzymes in Phase II include arylamine N-acetyltransferases (NATs) as well as amino-acid conjugating enzymes such as glycine and glutamine that attach to xenobiotics.
The last phase of detoxification is Phase III, called transport, which occurs in the kidneys, brain, liver, and intestines, and moves xenobiotics and endobiotics in and out of cells. It also excretes the products of Phase II detoxification out of cells.
Phase III transporters require energy in the form of ATP. Drug-resistant cancer cells often use these as protection against chemotherapy drugs. Also, Phase III transporters move glucuronide sulfate and glutathione conjugates out of cells into the bile for excretion.
There is a delicate balance between Phase I and Phase II levels of detoxification, and the products of Phase I metabolism tend to be more toxic than the initial molecule. If Phase II enzymes are functioning at a sufficient rate to neutralize Phase I products, then toxicity from Phase I isn’t a problem. But if Phase I activity is faster than Phase II, upsetting this balance, harmful metabolites can form faster than they can be detoxified, damaging cells.
Some foods and supplements increase Phase I enzyme activity in the diet as well as smoking and alcohol consumption. Men and postmenopausal women tend to produce lower levels of Phase I enzyme activity, and genetics and disease can be factors, too.
Clinically speaking, the No. 1 goal of a detox plan is long-term sustainable change. This includes cutting out processed and inflammatory foods, refined sugar, alcohol, and certain other foods and beverages that are a part of the standard American diet.
Ideally, an organic, chemical-free, plant-based detox diet without toxic foods and that controls cravings can significantly help in changing a person’s eating habits in the long run. Regular detoxing helps flush toxins out of the body and strengthens the immune system, increasing the ability to fight off infections.
There are various dietary protocols for detoxing, which include intermittent fasting, or bone-broth and vegetable-broth cleanses. It is critical to manage each patient’s chemical and metabolic systems through the gold standard of blood, hair, urine, and fecal testing.
Over time, conduct retests to evaluate whether the patient is moving in a healthy direction. During a detoxification protocol, the patient should avoid nutritional supplements and drink plenty of water—preferably half their body weight in ounces. They should buy organic as much as possible, follow your meal plan as suggested, and encourage a family member or friend to join them.
Steven Nickels, DC, NMD, DACBN, DCBCN, has practiced as a board-certified nutritionist and chiropractor for over 32 years. He is currently owner/director of Science Based Wellness in Ponte Vedra Beach, Florida, where he offers nutrition and wellness programs for people of all ages. He is considered a “concierge care doctor,” managing patients’ health for a desired period. He is also a diplomate of the American Clinical Board of Nutrition. He can be contacted through sciencewellness.net.