Simply speaking, liver detoxification involves two steps; phase1 and phase 2, also referred to as phase I and phase II. A toxin initially enters phase1, the p-450 cytochrome system, and is reduced to smaller fragments. These fragments then progress to phase 2, where they are bound to molecules like glutathione, glycine and sulfate. This process creates a new non-toxic molecule that can be excreted in the bile, urine or stool. Some substances do not require phase I activity, being processed by phase II only.
Phase I and phase II enzymes are found in virtually all organs of the body. They are most abundant in the liver, which reemphasizes the liver's crucial role in detoxification. These enzymes are inducible by a variety of chemicals ranging from drugs to nutrients.
There are six different Phase II conjugation reactions: glucuronidation, acetylation, esterification, amino acid conjugation, sulfation and glutathione conjugation. Both Phase I (oxygenation) and Phase II detoxification enzymes are affected by the quality of the diet and specific nutritive substances within it.
If you are having trouble with addictions that are damaging your liver and need some help, many Naturopathic doctors specialize in providing the support that is needed to strengthen your liver.
One or both detoxification phases can be inefficient or over-loaded. A particularly damaging combination in an ill person is an excessive over-load of toxins coming into phase1, with an inefficient phase II. Such a person is considered a pathological detoxifier. Sometimes it is felt this combination may be the cause of marked environmental sensitivities and drug intolerances and interactions that characterize many chronic fatigue and fibromyalgia patients. As patients improve clinically, serial testing of their liver detoxification capacity shows corresponding improvement.
If a patient is very ill with severe toxic symptoms, hepatic detoxification must be done very slowly and gradually. It is always preferable first to reduce toxin exposure and any liver inflammation. Also, leaky gut syndrome should be addressed and repaired prior to liver detoxification.
Nutrients which encourage or activate Phase I include:
- Vitamin B2 (riboflavin)
- Vitamin B3 (niacin)
- Lipotrophics (cysteine, methionine, choline, and inositol)
- Vitamin C
- Milk Thistle
- Indoles from cruciferous vegetables.
- Diets adequate in protein (especially vegetable protein)
- Other things which can induce phase I activity include acetate, alcohol, barbiturates, carbon tetrachloride, charcoal-broiled meats, dioxin, exhaust fumes, high protein diets, oranges, organophosphorus pesticides, paint fumes, sassafras, saturated fats, steroid hormones, sulfonamides and tangerines
Nutrients which encourage or activate Phase II include:
- Sulfur-containing amino acids like Cysteine (or NAC), Taurine or Methionine. Meat protein has a relatively high amount of sulfur-containing amino acids, as do eggs.
- Blue green algae
- Bee pollen
- Glutamic acid
- Aspartic acid
- Cruciferous vegetables (broccoli, cabbage, brussels sprouts, cauliflower)
- Garlic, onions, leeks and shallots
- Vitamin B12
- Grapefruit juice contains naringenin, a substance which slows down Phase I enzyme activity. This increases the half life of some drugs, causing them them to remain active longer. Caution is advised when taking large doses of grapefruit juice and some drugs.
There are various combination products available to support liver detoxification with an emphasis on one phase or both phases. Because of the complexity of this issue, detoxification testing is recommended before treatment.
Amino Acid: An organic acid containing nitrogen chemical building blocks that aid in the production of protein in the body. Eight of the twenty-two known amino acids are considered "essential," and must be obtained from dietary sources because the body can not synthesize them.
Bile: A bitter, yellow-green secretion of the liver. Bile is stored in the gallbladder and is released when fat enters the first part of the small intestine (duodenum) in order to aid digestion.
Choline: A lipotropic substance sometimes included in the vitamin B complex as essential for the metabolism of fats in the body. Precursor to acetylcholine, a major neurotransmitter in the brain. Choline prevents the deposition of fats in the liver and facilitates the movement of fats into the cells. Deficiency leads to cirrhosis of the liver.
Chronic Fatigue Syndrome: CFS (Chronic Fatigue Syndrome) is a disorder of unknown cause that lasts for prolonged periods and causes extreme and debilitating exhaustion as well as a wide range of other symptoms such as fever, headache, muscle ache and joint pain, often resembling flu and other viral infections. Also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), Chronic Epstein-Barr Virus (CEBV), Myalgic Encephalomyelitis (ME), "Yuppy Flu" and other names, it is frequently misdiagnosed as hypochondria, psychosomatic illness, or depression, because routine medical tests do not detect any problems.
Cobalamin: Vitamin B-12. Essential for normal growth and functioning of all body cells, especially those of bone marrow (red blood cell formation), gastrointestinal tract and nervous system, it prevents pernicious anemia and plays a crucial part in the reproduction of every cell of the body i.e. synthesis of genetic material (DNA).
Cysteine: A nonessential amino acid but may be essential for individuals with certain diseases or nutritional concerns. Cysteine is a sulfur-bearing amino acid with antioxidant properties. It is important for keratin synthesis, a protein found in skin, hair and nails and is a component of coenzyme A and glutathione.
Enzymes: Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Fibromyalgia: (FMS): Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.
Glutamic Acid: Involved in the synthesis of DNA, glutathione and some amino acids. Helps remove excess ammonia from the body. Interconverted by the body into glutamic acid and gamma-amino-butyric acid (GABA).
Glutamine: A non-essential amino acid, glutamine is considered to be a brain fuel. Glutamine has been used therapeutically for alcoholism, mild depression and to reduce the craving for sweets. Glutamine is very important in the functioning of the metabolism and muscle maintenance. Glutamine supplementation can help prevent muscle and other tissue breakdown by providing the body with nitrogen and fuel.
Glutathione: A natural sulfur-bearing peptide formed from the linking of three amino acids: glutamic acid, cysteine and glycine. Glutathione acts as an antioxidant and detoxicant and is involved with the selenium-containing enzyme glutathione peroxidase. Glutathione is also involved in amino acid transport across cell membranes.
Glycine: The simplest amino acid which is a constituent of normal protein and an inhibitory neurotransmitter, used as a dietary supplement. A natural antacid and sweetener, it is involved in the syntheses of DNA, phospholipids and collagen.
Hormones: Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Inositol: Usually considered part of the vitamin B complex. It is thought that along with choline, inositol is necessary for the formation of lecithin within the body. Involved in calcium mobilization.
Iron: An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.
Magnesium: An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.
Methionine: Essential amino acid. Dietary source of sulfur and methyl groups. Important for proper growth in infants, nitrogen balance in adults, healthy nails and skin and the synthesis of taurine, cysteine, phosphatidylcholine (lecithin), bile, carnitine and endorphins. It is an antioxidant nutrient and lipotropic agent which promotes the physiological utilization of fat.
Molybdenum: An essential trace element. It helps regulate iron stores in the body and is a key component of at least three enzymes: xanthine oxidase, aldehyde oxidase and sulfite oxidase. These enzymes are involved with carbohydrate metabolism, fat oxidation and urine metabolism. The average adult has about 9mg of molybdenum concentrated mostly in the liver, kidney, adrenal glands, bones and skin. Molybdenum deficiencies are associated with esophageal cancer, sexual impotency and tooth decay.
NAC: (N-acetyl-l-cysteine): A sulfur compound that is a precursor of glutathione.
Naturopathy: Medical practice using herbs and other various methods to produce a healthy body state by stimulating innate defenses without the use of drugs.
Niacin: (Vitamin B-3): A coenzyme B-complex vitamin that assists in the breakdown of carbohydrates, fats and proteins. Essential for the health of the skin, nerves, tongue and digestive system. It is found in every cell of the body and is necessary for energy production. Niacin is also needed for DNA formation.
Protein: Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Riboflavin: (Vitamin B-2): A B-complex vitamin that acts as a coenzyme that activates the breakdown and utilization of carbohydrates, fats and proteins. It is essential for cellular oxidation and necessary for healthy skin and eyes.
Saturated Fat: A type of fat that is readily converted to LDL cholesterol and is thought to encourage production of arterial disease. Saturated fats tend to be hard at room temperature. Among saturated fats are animal fats, dairy products, and such vegetable oils as coconut and palm oils.
Steroid: Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.
Taurine: A nonessential amino acid but may be essential for individuals with certain diseases or nutritional concerns. May be needed for the proper development and maintenance of the central nervous system. Taurine's role in bile formation is important for fat metabolism and blood cholesterol control.
Vitamin C: Also known as ascorbic acid, Vitamin C is a water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.