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
- Magnesium
- Iron
- 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:
- Glycine
- 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
- Glutamine
- Glutamic acid
- Aspartic acid
- Cruciferous vegetables (broccoli, cabbage, brussels sprouts, cauliflower)
- Garlic, onions, leeks and shallots
- Vitamin B12
- Molybdenum
- 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.