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Detox diets have had a bad rap, and for a good reason as most of them either oversimplify a very complicated process or offer a solution entirely out of context.
What is a detox diet?
The body will naturally detox its self without any aid what so ever, if it stops you die very quickly. The notion that you need a special diet to detox is absurd but what we can say is that the speed of certain aspects of the bodies detox process can be influenced. The detox process has 3 phases and involves multiple organs and systems. It requires specific molecules to act as co-factors, genetics, metabolic functions, diet and environmental factors all impact the bodies detox efficiency.
The liver is the key organ of the detox process, but other organs such as the spleen, kidney’s and GI tract also have considerable implications.
- The spleen is involved in the turnover of red blood cells which impact bile production, a crucial part of the 3rd phase of the detox process.
- Kidney’s filter blood to produce waste urine and are vital in the control of hydration and blood pressure that both impact the detox process directly through phase 1 and indirectly via liver congestion.
- The GI tract houses 50% of the bodies lymphatic tissue which communicates the systemic immune need to the liver directly via the portal vein.
The detox process is broken down into 3 distinct phases, modification, conjugation and elimination. Modification is an oxidative process which means it uses REDOX (reduction and oxidation) molecules to alter the number of electrons in the chemical structure of the metabolite being processed. The enzyme cytochrome P450 is the predominant player in this detox phase. It uses water and number of co-factors most critically NADH, NADPH, B6 & Magnesium to biotransform toxic compounds into water-soluble compounds ready for elimination or into less toxic compounds to go through conjugation. Some drugs enter the detox process via the liver, but other are activated first by the liver, so changes in modification speed can have a significant impact on drug metabolism. There is a lot of scientific literature on which genes control which subgroups of the P450 enzyme and how genetics can be used to personalise drug prescriptions. Speed of modification is predominantly controlled by genetics but can be altered by both environmental and dietary changes.
- Alcohol, Nicotine & Steriods
- Cruciferous vegetables (high in indol)
- High protein diets
- Citrus fruits other than grapefruit
- Vitamin B1, B3 & C
- Pesticides, car fumes, paint fumes
- Carroway, dillseed
- Specific medications (such as antihistamines and oral contraceptives)
- Heavy metals
- High levels of sugar and transfats
- Grapefruit juices, turmeric, curcumin, cloves and capsicums
- Toxic compounds from the GI tract due to pathogenic bacteria and undigested/poorly food
As mentioned above, the modification detox stage is an oxidative process. As a result, it will create free radicles, which are molecules that can cause damage to surrounding tissues. So while increasing the speed of this phase may seem like a good idea and is suggested in many scenarios, it comes with additional considerations such as our capacity to deal with the extra strain brought with it.
Conjugation means to join, and that is what this detox phase does. It takes the metabolite being processed and adds a specific molecule depending on which pathway is used to prepare it for elimination via urine or bile. Conjugation has six main pathways.
- Amino acid pathway (Glycine, Glutamine, taurine, arginine and ornithine)
- Glutathione pathway
- Acetylation pathway
- Methylation pathway
- Glucuronidation pathway
- Sulfation pathway
Each conjugation detox pathway has specific metabolites it deals with, but some are more important than others. The glutathione pathway mainly processes fat-soluble toxins into water-soluble compounds ready for elimination, and around 60% of the toxins eliminated by bile are processed by the glutathione pathway. Each Detox pathway in phase 2 has its unique parts to play in keeping the body healthy. Shortages in the key nutrients or the co-factors needed to run these pathways efficiently can not only lead to problems in the liver itself but also in the systems distal to the liver.
Elimination of toxins is precisely what detox diets claim to do, and many of them use botanicals that act as diuretics (increase urination) or cholagogues (stimulate bile release). While these supplements or nutrients may increase liver drainage that may be utterly useless if phase 1 or 2 are not optimally functioning and similarly if there is no point in increasing the speed of phase 1 or 2 if elimination is not in sync. Outside of stimulating a detox by increasing liver drainage, we must also consider if the kidneys can deal with the increased load, if we are hydrated enough to dilute the toxic waste and if we are creating bile well enough to coupe. Hydration sounds simple but involves amino acid availability and electrolyte balance inside all the cells of the body. Stress, poor diet, low nutritional diversity and minimal water intake may all have adverse effects on the detox process. The liver filters around 1.82 L of blood per day, most of which comes via the portal vein from the intestines. It not only filters the blood removing toxins but breaks down old red blood cells as part of a recycling process. It breaks red blood cells down into globin, heme and iron. Iron is transported via ferritin back to the bone marrow to be used in the creation of new red blood cells, but heme is broken down into biliverdin which eventually becomes bile. Changes in red blood cell health will impact elimination as will hydration, methylation and glucuronidation due to their involvement with producing bile.
Evaluating the interconnection of the detox process
For those with a keen eye, they may have noticed a few overlaps within each pathway. The first thing we need to address is the fact that phase 1 of the detox process creates free radicles. The bodies primary coping mechanism for dealing with this is using nutrients such as glutathione, vitamin C and other antioxidants that play a role in phase 2 of the detox process. Therefore increasing the speed of modification may deplete nutrients needed for conjugation and ultimately cause stagnation of the detox process. Phase 3 of the detox process elimination, also relies on sufficient bile production, which is reliant on methylations impact on red blood cell health and glucuronidation to create the final product of bile. No amount of diuretics or cholagogues to increase liver drainage will aid the detox process if bile production is stalled and dehydration is occurring. One final point to make is the function of the intestines; the speed food travels through the GI tract has a large impact on the potential for toxic re-absorption. If the intestinal walls are damaged, leaky or motility is stalled, the chance of toxic laden bile being re-absorbed increases. No matter what speed the liver can process toxins if they are re-entering hepatic circulation your detox plan will fail.
How do we know which system to target?
The above may seem a little daunting and difficult to know where to start; it is essential to understand which phases need the most help when looking to improve one’s personal detox process.
Symptoms of excessive modification
- Rapid caffeine metabolism – people who can drink caffeine at night with no impacts on sleep
- Anxiety or nervousness
Symptoms of slow modification
- Sensitivity to chemicals – perfumes, cleaning products etc. make you irritable or tiered
- Coffee intolerance – makes you feel terrible
- Liver disease
Above are a few symptomatic considerations for modification, but the best way to reveal which detox phase needs most help is blood chemistry analysis. Below I will list a few considerations of standard blood markers used in determining detox process functionality, bare with the test acronyms it’s not so important you understand what they are but more that they exist. Unfortunately, a full explanation of each biomarker may be a little outside of the scope of this article.
- Liver enzymes can tell us a lot, when ALT is elevated above AST & GGT issues may be occurring inside the liver
- When the liver enzyme GGT is elevated above AST & ALT issues may be happening outside of the liver but in the biliary tree (gall bladder & bile issue)
- Elevations of ALT may lead to hydration issues due to the depletion of glutamate
- Low GGT may indicate a need for more glutathione
- Elevated ALP, also a liver enzyme, may indicate either biliary insufficiency or a need to support the drug conjugation in phase 2
- Decreased vitamin B12, B9, total red blood cell count, haemoglobin & hematocrit may indicate methylation issues
- Increased MCV, MCH, MCHC, RDW also indicate methylation issues
No one strategy will improve the detox capacity of the body; you need to specifically support the part of the detox system that is under strain to make any real headway. In conclusion detox diets do work when you have the right information to support the right systems.
Want a free symptom analysis questionnaire to reveal which organ systems are under the most strain click here.
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