The Encyclopedia of Natural Medicine, 3rd Ed.

Detoxification and Internal Cleansing

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Introduction

Have you ever noticed that many people treat their cars better than their bodies? They wouldn’t dream of ignoring a warning light on the dash letting them know that it is time to change the oil, but they often ignore the telltale signs that their body is in dire need of cleanup or critical support. To see if you need a tune-up, answer the following questions. If you answer yes to any of them, you definitely need to pay attention to detoxification.

• Do you feel that you are not as healthy and vibrant as other people your age?

• Do you have low energy levels?

• Do you often have difficulty thinking clearly?

• Do you often feel blue or depressed?

• Do you get more than one or two colds a year?

• Do you suffer from premenstrual syndrome, fibrocystic breast disease, or uterine fibroids?

• Do you have sore, achy muscles for no particular reason?

• Do you have bad breath or stinky stools?

Is improving detoxification really an effective solution to help with all of these symptoms? In most cases, the answer is absolutely yes. Toxins can damage the body in an insidious and cumulative way. Once the body’s detoxification system becomes overloaded, toxic metabolites accumulate, and we become progressively more sensitive to other chemicals, some of which are not normally toxic.

The concepts of internal cleansing and detoxifying have been around for quite some time. In modern times, as society has increasingly been exposed to toxic compounds in air, water, and food, it has become apparent that an individual’s ability to detoxify substances to which he or she is exposed is of critical importance for overall health.

When you reduce the toxic load on the body and give the body proper nutritional support, in most cases these bothersome symptoms will disappear. Even more important, by addressing these warning signs now we can ensure better long-term health and avoid the progression of minor problems to more serious conditions.

What Are Toxins?

A toxin is defined as any compound that has a detrimental effect of cell function or structure. Obviously, some toxins cause minimal negative effects, while others can be fatal. In this chapter we address the following categories of toxins:

Heavy metals

Persistent organic pollutants (POPs)

Microbial compounds

Breakdown products of protein metabolism

This chapter will focus on enhancing detoxification primarily by promoting improved liver function. Our modern environment seriously overloads the liver, resulting in increased levels of circulating toxins in the blood, which damage most of our body’s systems. A toxic liver sends out alarm signals, which are manifested as psoriasis, acne, chronic headaches, inflammatory and autoimmune diseases, and chronic fatigue.

Just a Few of the Thousands of Chemicals Detectable in Every Living Human Being

Toxic metals (lead, cadmium, mercury, arsenic, others)

Polycyclic aromatic hydrocarbons

Volatile organic compounds

Tobacco smoke by-products (including more than 500 chemicals)

Phthalates

Acrylamides

Dioxins, furans, PBDEs (fire retardants), and polychlorinated biphenyls (PCBs)

Organochlorine by-products from chlorination of water

Organophosphate pesticides

Organochlorine pesticides

Carbamate pesticides

Herbicides

Pest repellents

Disinfectants

Types of Toxins

Heavy Metals

The toxic metals aluminum, arsenic, cadmium, lead, mercury, and nickel are often referred to as “heavy metals,” to distinguish them from nutritional minerals such as calcium and magnesium (technically, aluminum is not a heavy metal, but it is definitely toxic). Heavy metals tend to accumulate within the brain, kidneys, liver, immune system, and other body tissues, where they can severely disrupt normal function.16

The typical person living in the United States has more heavy metals in his or her body than are compatible with good health. It is conservatively estimated that up to 25% of the U.S. population suffers from heavy metal poisoning to some extent.

Most of the heavy metals in the body are a result of environmental contamination from industry. In the United States alone, industrial sources dump more than 600,000 tons of lead into the atmosphere, to be inhaled or—after being deposited on food crops, in fresh water, and in soil—to be ingested. Although we are no longer using leaded gasoline in cars (it is still used in piston engine airplanes and helicopters, however), its use for so many decades added a large amount of lead to the environment, from which it is only very slowly cleared. Other common sources of heavy metals include lead from the solder in tin cans, pesticide spray cans, and cooking utensils; cadmium and lead from cigarette smoke; mercury from dental fillings, contaminated fish, and cosmetics; and aluminum from antacids and cookware. Some professions with extremely high exposure include battery makers, gasoline station attendants, printers, roofers, solderers, dentists, and jewelers.

Toxic metals cause damage in three main ways: by blocking the activity of enzymes (for example, mercury blocks the enzyme that converts the thyroid hormone T4 to the more active T3, resulting in functional hypothyroidism), by displacing minerals (such as lead replacing calcium in bones, making them weaker), and by increasing oxidative stress, which negatively affects virtually all tissues and functions in the body.

Sources of Heavy Metals and Symptoms Associated with Toxicity

HEAVY METAL

PRIMARY SOURCES

LINKED TO THESE DISEASES

Aluminum

Aluminum-containing antacids; aluminum cookware; drinking water

Alzheimer’s disease; dementia; behavioral disorders; impaired brain function

Arsenic

Drinking water

Fatigue; headaches; heart disease and strokes; nerve disorders; anemia; Raynaud’s phenomenon

Cadmium

Cigarette smoke; drinking water

Fatigue; impaired concentration and memory; high blood pressure; loss of smell; anemia; dry skin; prostate cancer; kidney problems

Lead

Cigarette smoke; car exhaust; dolomite, bonemeal, and oyster shell calcium supplements; drinking water

Fatigue; headache; insomnia; nerve disorders; high blood pressure; attention-deficit/hyperactivity disorder; learning disabilities; anemia

Mercury

Dental amalgams (silver fillings); drinking water; fish and shellfish; air in places where coal is burned to produce electricity

Fatigue; headache; insomnia; nerve disorders; high blood pressure; impaired memory and concentration

Nickel

Air and water

Heart disease; immune system dysfunction; allergies

Early signs of heavy metal poisoning are usually vague. They also depend upon the level of toxicity. Mild cases of toxicity may be associated with headache, fatigue, and impaired ability to think or concentrate. As toxicity increases, so does the severity of signs and symptoms. A person with severe toxicity may experience muscle pains, indigestion, tremors, constipation, anemia, pallor, dizziness, and poor coordination.

Heavy metals have a very strong affinity for body tissues composed largely of fat, such as the brain, nerves, and kidneys. As a result, heavy metals are almost always linked to disturbances in mood and brain function as well as neurological problems (including multiple sclerosis) and high blood pressure (the kidneys regulate blood pressure). Numerous studies have demonstrated a strong relationship between intelligence, childhood learning disabilities, and body stores of lead, aluminum, cadmium, and mercury.712 Basically, the higher a child’s level of heavy metals, the lower the child’s IQ.

Determination of Heavy Metal Toxicity

Determining the body load of toxic metals can be difficult and is controversial. Measuring blood levels of mercury, lead, cadmium, and arsenic is good for determining current exposure. However, it is not very good for determining total body load, which better correlates with toxicity.

In the past, hair mineral analysis was considered a useful tool for measuring toxic heavy metals. Unfortunately, more recent research shows that some people have trouble eliminating heavy metals from the body, so they can show low levels in the hair even when the body levels are high.

At this time, the best way of determining body load is with challenge testing. This involves taking drugs that chelate heavy metals in the body; the resulting chelation products are then excreted in the urine. The level of toxic metals in the urine after chelation correlates with the body load.

Anyone who is interested in optimal health should be evaluated for heavy metal load. This recommendation is particularly true if you have been exposed to heavy metals or have symptoms associated with heavy metal toxicity (see the table).

Persistent Organic Pollutants

This category of toxins is primarily dealt with by the liver and includes drugs, alcohol, solvents, formaldehyde, pesticides, herbicides, and food additives. It is staggering to contemplate the tremendous load placed on the liver as it detoxifies the incredible quantity of toxic chemicals it is constantly exposed to.

Symptoms of exposure to or toxicity from POPs can vary. Most common are psychological and neurological symptoms such as depression, headaches, mental confusion, mental illness, tingling in the hands and feet, abnormal nerve reflexes, and other signs of impaired nervous system function. The nervous system is extremely sensitive to these chemicals. Respiratory tract allergies and increased rates for many cancers are also noted in people chronically exposed to chemical toxins.1319 Research also shows that POPs are also especially damaging to the endocrine system. Surprisingly, high levels of POPs are more predictive of diabetes than overweight is.

Microbial Compounds

Toxins produced by bacteria and yeast in the gut can be absorbed by the body, causing significant disruption of body functions. Examples of these types of toxins include endotoxins, exotoxins, toxic amines, toxic derivatives of bile, and various carcinogenic substances.

Gut-derived microbial toxins have been implicated in a wide variety of diseases, including liver diseases, Crohn’s disease, ulcerative colitis, thyroid disease, psoriasis, lupus erythematosus, pancreatitis, allergies, asthma, and immune disorders.

In addition to toxic substances being produced by microorganisms, antibodies formed against microbial antigens can cross-react with the body’s own tissues, thereby causing autoimmune diseases. Diseases that have been linked to cross-reacting antibodies include rheumatoid arthritis, myasthenia gravis, diabetes, and autoimmune thyroiditis.

To reduce the absorption of toxic substances, we recommended a diet rich in fiber, particularly soluble fiber, such as that found in vegetables, guar gum, pectin, and oat bran. Fiber has an ability to bind to toxins within the gut and promote their excretion.

The immune system as well as the liver is responsible for dealing with the toxic substances that are absorbed from the gut.

Breakdown Products of Protein Metabolism

The kidneys are largely responsible for the elimination of toxic waste products of protein breakdown (ammonia, urea, etc.). You can support this important function by drinking adequate amounts of water and avoiding excessive protein intake.

Diagnosis of Toxicity

In addition to directly measuring toxin levels in the blood or urine, or by biopsy of fat, there are a number of special laboratory techniques useful in assessing how well we detoxify the chemicals we are exposed to. Clearance tests measure the levels of caffeine, acetaminophen, benzoic acid, and other compounds after ingestion of a specified amount. Other tests for liver function (serum bilirubin and liver enzymes) are also important but are less sensitive. Genetic testing is a newer option that can determine which detoxification enzymes are not optimal. Perhaps the best way to help determine if your liver is functioning up to par is to look over the following list. If any factor applies to you, we recommend following the guidelines for improving liver function given below:

• More than 20 pounds overweight

• Diabetes

• Presence of gallstones

• History of heavy alcohol use

• Psoriasis

• Natural and synthetic steroid hormone use

  images Anabolic steroids

  images Estrogens

  images Oral contraceptives

• High exposure to certain chemicals or drugs:

  images Cleaning solvents

  images Pesticides

  images Antibiotics

  images Diuretics

  images Nonsteroidal anti-inflammatory drugs

  images Thyroid hormone

• History of viral hepatitis

Naturopathic physicians use a number of special laboratory techniques to determine the presence of microbial compounds, including tests for the presence of abnormal microbial concentrations and disease-causing organisms (stool culture); microbial by-products (urinary indican test); and endotoxins (erythrocyte sedimentation rate is a rough estimator).

The determination of the presence of high levels of breakdown products of protein metabolism and kidney function involves both blood and urine measurement of these compounds.

How the Body’s Detoxification System Works

The body eliminates toxins either by directly neutralizing them or by excreting them in the urine or feces (and to a lesser degree through the hair, lungs, and skin). Toxins that the body is unable to eliminate build up in the tissues, typically in our fat stores. The liver, intestines, and kidneys are the primary organs of detoxification.

The Liver

The liver is a complex organ that plays a key role in most metabolic processes, especially detoxification. The liver is constantly bombarded with toxic chemicals, both those produced internally and those coming from the environment. The metabolic processes that make our bodies run normally produce a wide range of toxins for which the liver has evolved efficient neutralizing mechanisms. However, the level and type of internally produced toxins increase greatly when metabolic processes go awry, typically as a result of nutritional deficiencies.

Major Detoxification Systems

ORGAN

METHOD

TYPICAL TOXIN NEUTRALIZED

Skin

Excretion through sweat

Fat-soluble toxins such as DDT, heavy metals such as lead and cadmium

Liver

Filtering of the blood

Bacteria and bacterial products, immune complexes

 

Bile secretion

Cholesterol, hemoglobin breakdown products, extra calcium

 

Phase I detoxification

Many prescription drugs (e.g., amphetamine, digitalis, pentobarbital), many over-the-counter drugs (acetaminophen, ibuprofen), caffeine, histamine, hormones (both internally produced and externally supplied), benzopyrene (carcinogen from charcoal-broiled meat), aniline dyes, carbon tetrachloride, insecticides (e.g., aldrin, heptachlor), arachidonic acid

 

Phase II detoxification

 
 

Glutathione conjugation

Acetaminophen, nicotine from cigarette smoke, organophosphates (insecticides), epoxides (carcinogens)

 

Amino acid conjugation

Benzoate (a common food preservative), aspirin

 

Methylation

Dopamine (neurotransmitter), epinephrine (hormone from adrenal glands), histamine, thiouracil (cancer drug), arsenic

 

Sulfation

Estrogen, aniline dyes, coumarin (blood thinner), acetaminophen, methyl-dopa (used for Parkinson’s disease)

 

Acetylation

Sulfonamides (antibiotics), mescaline

 

Glucuronidation

Acetaminophen, morphine, diazepam (sedative, muscle relaxant), digitalis

 

Sulfoxidation

Sulfites, garlic compounds

Intestines

Mucosal detoxification

Toxins from bowel bacteria

 

Excretion through feces

Fat-soluble toxins excreted in the bile

   

Mercury and lead

Kidneys

Excretion through urine

Many toxins after they are made water-soluble by the liver

   

Cadmium, mercury, and lead

Many of the chemicals the liver must detoxify come from our environment: the content of our bowel, the food we eat, the water we drink, and the air we breathe. The polycyclic hydrocarbons (e.g., DDT; dioxin; 2,4,5-T; 2,4-D; PCBs; and PCP), which are components of various herbicides and pesticides, are one example. Yet even those eating unprocessed organic foods need an effective detoxification system, because even organically grown foods contain naturally occurring toxic constituents.

The liver plays several roles in detoxification. It filters the blood to remove large toxins, synthesizes and secretes bile full of cholesterol and other fat-soluble toxins, and enzymatically disassembles unwanted chemicals. This enzymatic process usually occurs in two steps referred to as Phase I and Phase II, with Phase I chemically modifying the chemicals to make them an easier target for one or more of the Phase II enzyme systems. The liver also plays a critical role in the excretion of metal toxins such as mercury.

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The Liver’s Detoxification Pathways

Proper functioning of the liver’s detoxification systems is especially important for the prevention of cancer. Up to 90% of all cancers are thought to be due to the effects of environmental carcinogens, such as those in cigarette smoke, food, water, and air, combined with deficiencies of the nutrients the body needs for proper functioning of the detoxification and immune systems. Our exposure to environmental carcinogens varies widely, as does the efficiency of our detoxification enzymes. High levels of exposure to carcinogens coupled with sluggish detoxification enzymes significantly increase our susceptibility to cancer.

The link between our detoxification system’s effectiveness and our susceptibility to environmental toxins, such as carcinogens, is exemplified in a study of chemical plant workers in Turin, Italy, who had an unusually high rate of bladder cancer. When the liver detoxification enzyme activity of all the workers was tested, those with the poorest detoxification system were the ones who developed bladder cancer.20In other words, all were exposed to the same level of carcinogens, but those with poor liver function were the ones who developed the cancer.

Fortunately, the detoxification efficiency of the liver can be improved with dietary measures, special nutrients, and herbs. Ultimately, your best protection from cancer is to avoid carcinogens and make sure your detoxification system is working well in order to eliminate those you can’t avoid.

Filtering the Blood

One of the liver’s primary functions is filtering the blood. Almost two quarts of blood pass through the liver every minute for detoxification. Filtration of toxins is absolutely critical for the blood that is coming from the intestines, because it is loaded with bacteria, endotoxins (toxins released when bacteria die and are broken down), antigen-antibody complexes (large molecules produced when the immune system latches on to an invader to neutralize it), and various other toxic substances.

When working properly, the liver clear 99% of the bacteria and other toxins from the blood before it is allowed to reenter the general circulation. However, when the liver is damaged, this filtration system breaks down.

The Bile

The liver’s second detoxification process involves the synthesis and secretion of bile. Each day the liver manufactures approximately one quart of bile, which serves as a carrier in which many toxic substances are effectively eliminated from the body. Sent to the intestines, the bile and its toxic load are absorbed by fiber and excreted. However, a diet low in fiber means these toxins are not bound in the feces very well and are reabsorbed. Even worse, bacteria in the intestine often modify these toxins so that they become even more damaging. Another example of the problem with a low-fiber diet is toxic metal excretion. The liver normally clears through the bile about 1% of the body load of mercury every day. However, 99% of what is excreted in the bile is often reabsorbed, due to insufficient dietary fiber intake. Besides eliminating unwanted toxins, the bile emulsifies fats and fat-soluble vitamins, improving their absorption in the intestine.

Phase I Detoxification

The liver’s third role in detoxification involves a two-step enzymatic process for the neutralization of unwanted chemical compounds. These include not only drugs, pesticides, and toxins from the gut but also normal body chemicals such as hormones and inflammatory chemicals (such as histamine) that would become toxic if allowed to build up. Phase I enzymes directly neutralize some chemicals, but many other toxins are converted to intermediate forms that are then processed by Phase II enzymes. Unfortunately, these intermediate forms are often much more chemically active and therefore more toxic, so if the Phase II detoxification systems aren’t working adequately, these intermediates hang around and are far more damaging.

Phase I detoxification of most chemical toxins involves a group of enzymes that collectively have been named cytochrome P450. Some 50 to 100 enzymes make up the cytochrome P450 system. Each enzyme works best in detoxifying certain types of chemicals, but with considerable overlap in activity among the enzymes. In other words, some may metabolize the same chemicals, but with differing levels of efficiency. This fail-safe system ensures maximum detoxification.

The activity of the various cytochrome P450 enzymes varies significantly from one individual to another based on genetics, the individual’s level of exposure to chemical toxins, and nutritional status. Since the activity of cytochrome P450 varies so much, so does an individual’s risk for various diseases. For example, as highlighted in the study of chemical plant workers in Turin, Italy, discussed above, those with underactive cytochrome P450 are more susceptible to cancer.20 This variability of cytochrome P450 enzymes is also seen in differences in people’s ability to detoxify the carcinogens found in cigarette smoke and helps to explain why some people can smoke without too much damage to their lungs, while others develop lung cancer after only a few decades of smoking. Those who develop cancer are typically those who are exposed to a lot of carcinogens and/or those whose cytochrome P450 isn’t working very well.21

Even among healthy adults, the level of activity of Phase I detoxification varies greatly. One way of determining the activity of Phase I is to measure how efficiently a person detoxifies caffeine. Using this test, researchers have found a surprising 5- to 15-fold difference in the detoxification rates of apparently healthy adults.22

When cytochrome P450 metabolizes a toxin, it tries to either chemically transform it into a less toxic form, make it water-soluble, or convert it to a more chemically active form. The best result is the first option, that is, simply neutralizing the toxin. This is what happens to caffeine. Making a toxin water-soluble is also effective because this makes it easier for the kidneys to excrete it in the urine. The final option is to transform the toxin to more chemically reactive forms, which are more easily conjugated by the Phase II enzymes and made water-soluble.

While ultimately very important for our health, this transformation of toxins into more chemically active toxins can cause several problems. One is the production of free radicals as the toxins are transformed. For each toxin metabolized by Phase I, a free radical is generated. Without adequate free radical defenses, every time the liver neutralizes a toxin to protect the body, it itself is damaged by the free radicals produced.

The most important antioxidant for neutralizing the free radicals produced as Phase I by-products is glutathione, a small molecule composed of three amino acids—cysteine, glutamic acid, and glycine. In the process of neutralizing free radicals, however, glutathione is oxidized to glutathione disulfide. Glutathione is also required for one of the key Phase II detoxification processes, and so when high levels of toxin exposure produce so many free radicals from Phase I detoxification that all the glutathione is used up, Phase II processes dependent upon glutathione stop.

Another potential problem occurs because the toxins transformed into activated intermediates by Phase I are even more toxic than before. Unless quickly removed from the body by Phase II detoxification mechanisms, they can cause widespread problems. Therefore, the rate at which Phase I produces activated intermediates must be balanced by the rate at which Phase II finishes their processing. Unfortunately, due to genetic variations or nutritional deficiencies, some people have a very active Phase I detoxification system but very slow or inactive Phase II enzymes. The end result is that these people suffer severe toxic reactions to environmental poisons.

An imbalance between Phase I and Phase II can also occur when a person is exposed to large amounts of toxins in a short period or lower levels of toxins for a long period. In these situations, so many toxins are being neutralized that the critical nutrients needed for Phase II detoxification get used up, allowing the highly toxic activated intermediates to build up.

Recent research shows that cytochrome P450 enzyme systems are found in other parts of the body, especially the brain cells. Inadequate antioxidants and nutrients in the brain result in an increased rate of neuron damage, such as that seen in Alzheimer’s and Parkinson’s patients.

As with all enzymes, the cytochrome P450 enzymes require several nutrients for proper functioning. A deficiency of any of these means more toxins floating around doing damage.

Inducers of Phase I Detoxification. Cytochrome P450 is induced (that is, activated) by some toxins and also by some foods and nutrients. Obviously, it is beneficial to improve Phase I detoxification in order to get rid of the toxins as soon as possible. This is best accomplished by providing the needed nutrients and nontoxic stimulants while avoiding those substances that are toxic. However, stimulation of Phase I is not a good idea if your Phase II systems are not functioning properly.

Substances That Activate Phase I Detoxification

Drugs

• Alcohol

• Nicotine in cigarette smoke

• Phenobarbital

• Sulfonamides

• Steroids

Foods

• Cabbage, broccoli, and brussels sprouts

• Charcoal-broiled meats (due to their high levels of toxic compounds)

• High-protein diet

• Oranges and tangerines (but not grapefruits)

Nutrients

• Niacin

• Vitamin B1 (thiamine)

• Vitamin C

Herbs

• Caraway seeds

• Dill seeds

Environmental toxins

• Carbon tetrachloride

• Exhaust fumes

• Paint fumes

• Dioxin

• Pesticides

All of the drugs and environmental toxins listed above activate P450 to combat their destructive effects, and in so doing, not only use up compounds needed for this detoxification system but contribute significantly to free radical formation and oxidative stress.

Among foods, those in the brassica family (for example, cabbage, broccoli, and brussels sprouts) contain chemical constituents that stimulate both Phase I and Phase II detoxification enzymes. One such compound is a powerful anticancer chemical called indole-3-carbinol. It exerts a strong stimulant effect on detoxifying enzymes in the gut as well as the liver.23 The net result is significant protection against several toxins, especially carcinogens. This helps explain why consumption of brassica vegetables protects against cancer.

Oranges and tangerines as well as the seeds of caraway and dill contain limonene, a phytochemical that has been found to prevent and even treat cancer in animal models.24 Limonene’s protective effects are probably due to the fact that it is a strong inducer of both Phase I and Phase II detoxification enzymes that neutralize carcinogens.

Inhibitors of Phase I Detoxification. Many substances inhibit cytochrome P450. This situation is perilous, as it makes toxins potentially more damaging because they remain in the body longer before detoxification. For example, if you are taking statin drugs or others metabolized by phase I enzymes, or you are exposed to elevated levels of toxins, don’t eat grapefruits or drink grapefruit juice. Grapefruit contains a flavonoid called naringenin that can decrease cytochrome P450 activity by 30%, slowing the elimination of many drugs and toxins from the blood.25

Inhibitors of Phase I Detoxification

Drugs

• Benzodiazepines (e.g., Halcion, Centrax, Librium, Valium, etc.)

• Antihistamines (used for allergies)

• Cimetidine and other stomach-acid-secretion blocking drugs (used for stomach ulcers)

• Ketoconazole

• Sulfaphenazole

Foods

• Naringenin from grapefruit juice

• Curcumin from the spice turmeric

• Capsaicin from red chili pepper

• Eugenol from clove oil

Other

• Aging

• Toxins from inappropriate bacteria in the intestines

Curcumin, the compound that gives turmeric its yellow color, is interesting because it inhibits Phase I while stimulating Phase II. This effect is also very useful in preventing cancer. Curcumin has been found to inhibit carcinogens such as benzopyrene (the carcinogen found in charcoal-broiled meat) from inducing cancer in several animal models. It appears that the curcumin exerts its anticarcinogenic activity by lowering the activation of carcinogens while increasing the detoxification of those that are activated. Curcumin has also been shown to directly inhibit the growth of cancer cells.26

In particular, if you smoke or are regularly exposed to secondhand smoke, we recommend eating a lot of curries (turmeric is the key component of curry). Most of the cancer-inducing chemicals in cigarette smoke are carcinogenic only during the period between activation by Phase I and final detoxification by Phase II, and so the curcumin in turmeric can have a dramatic impact. In one human study, 16 chronic smokers were given 1.5 g turmeric per day while six nonsmokers served as a control group.27 At the end of the 30-day trial, the smokers receiving the turmeric demonstrated a significant reduction in the level of mutagens excreted in the urine. This result is quite significant, as the level of urinary mutagens is thought to correlate with the systemic load of carcinogens and the efficacy of detoxification mechanisms.

The Phase I detoxification enzymes are less active in old age. Aging also decreases blood flow though the liver, further aggravating the problem. Combined with lack of the physical activity necessary for good circulation and the poor nutrition commonly seen in the elderly, these factors add up to a significant impairment of detoxification capacity. This helps to explain why toxic reactions to drugs are seen so commonly in the elderly—they are unable to eliminate drugs fast enough, so toxic levels build up. Another reason is that many elderly people take so many drugs that they are overloading their detoxification systems.

To ensure Phase I is working well, we recommend that you eat plenty of foods from the brassica family (cabbage, broccoli, and brussels sprouts), foods rich in B vitamins (nutritional yeast, whole grains), foods high in vitamin C (peppers, cabbage, and tomatoes), and citrus fruits (oranges and tangerines, but not grapefruits).

Phase II Detoxification

Phase II detoxification involves a process called conjugation, in which a protective compound binds a toxin by adding a small chemical to it. This conjugation reaction either neutralizes the toxin or makes the toxin more easily excreted through the urine or bile. Phase II enzymes act on some toxins directly, while others must first be activated by the Phase I enzymes. There are essentially six Phase II detoxification pathways: glutathione conjugation, amino acid conjugation, methylation, sulfation, acetylation, and glucuronidation. Some toxins are neutralized through more than one pathway.

In order to work, these enzyme systems need nutrients both for their activation and to provide the small molecules they add to the toxins to bind them. In addition, they need metabolic energy to function and to synthesize some of the small conjugating molecules. If the liver cells’ energy-producing structures, the mitochondria, are not functioning properly (malfunctioning can be caused by aging, magnesium deficiency, or lack of exercise), Phase II detoxification slows down, allowing the buildup of toxic intermediates. The first table below lists the key nutrients needed by each of the six Phase II detoxification systems. The second table lists the activators, and the third lists the inhibitors of Phase II enzymes.

Nutrients Needed by Phase II Detoxification Enzymes

PHASE II SYSTEM

REQUIRED NUTRIENTS

Glutathione conjugation

Glutathione, vitamin B6

Amino acid conjugation

Glycine

Methylation

S-adenosyl-methionine

Sulfation

Cysteine, methionine, molybdenum

Acetylation

Acetyl coenzyme A

Glucuronidation

Glucuronic acid

Inducers of Phase II Detoxification Enzymes

PHASE II SYSTEM

INDUCER

Glutathione conjugation

Foods in the brassica family (cabbage, broccoli, brussels sprouts), limonene-containing foods (citrus peel, dill weed seed, caraway seeds)

Amino acid conjugation

Glycine

Methylation

Lipotropic nutrients (choline, methionine, betaine, folic acid, vitamin B12)

Sulfation

Cysteine, methionine, taurine

Acetylation

None found

Glucuronidation

Fish oils, cigarette smoking, birth control pills, phenobarbital, limonene-containing foods

Inhibitors of Phase II Detoxification Enzymes

PHASE II SYSTEM

INHIBITOR

Glutathione conjugation

Deficiency of selenium, vitamin B2, glutathione, or zinc

Amino acid conjugation

Low-protein diet

Methylation

Deficiency of folic acid or vitamin B12

Sulfation

Nonsteroidal anti-inflammatory drugs (e.g., aspirin), tartrazine (yellow food dye), molybdenum deficiency

Acetylation

Deficiency of vitamin B2, vitamin B5, or vitamin C

Glucuronidation

Aspirin, probenecid

Glutathione Conjugation. Many toxic chemicals, including heavy metals, solvents, and pesticides, are fat-soluble. This situation makes it very difficult for the body to eliminate them. The primary way the body eliminates fat-soluble compounds is by excreting them in the bile. Remember that the problem with excreting toxins in the bile is that as much as 99% of the bile-excreted toxins can be reabsorbed due to inadequate fiber in the diet. Fortunately, with the help of glutathione the body is able to convert the fat-soluble toxins into a water-soluble form, allowing more efficient excretion via the kidneys. The elimination of fat-soluble compounds, especially heavy metals like mercury and lead, is dependent upon an adequate level of glutathione, which in turn is dependent upon adequate levels of methionine and cysteine. When increased amounts of toxic compounds are present, the body draws upon its stores of methionine and cysteine to produce more glutathione, thus protecting the liver.

Glutathione is also an important antioxidant. This combination of detoxification and free radical protection means that glutathione is one of the most important anticarcinogens and antioxidants in our cells. Consequently, a deficiency of glutathione can be devastating. When glutathione is used up faster than it can be produced by the body or absorbed from the diet, we become much more susceptible to toxin-induced diseases, such as cancer, especially if our Phase I detoxification system is highly active.

A deficiency can be induced either by diseases that increase the need for glutathione, by deficiencies of the nutrients needed for synthesis, or by diseases that inhibit its formation. For example, people with idiopathic pulmonary fibrosis, adult respiratory distress syndrome, HIV infection, hepatic cirrhosis, cataracts, or advanced AIDS have been found to have a deficiency of glutathione, probably due to their greatly increased need for glutathione, both as an antioxidant and for detoxification. Smoking increases the rate of utilization of glutathione, both in the detoxification of nicotine and in the neutralization of free radicals produced by the toxins in the smoke. The same is true of alcohol, with glutathione production directly proportional to the amount of alcohol consumed.

Glutathione is available through two routes: diet and synthesis. Dietary glutathione (found in fresh fruits and vegetables, cooked fish, and meat) is absorbed well by the intestines and does not appear to be affected by the digestive processes.28 However, the same is probably not true for glutathione supplements.29

There are other ways to increase glutathione. For example, in healthy individuals, a daily dosage of 500 mg vitamin C may be sufficient to elevate and maintain good tissue glutathione levels.30 In one double-blind study, the average red blood cell glutathione concentration rose nearly 50% with 500 mg per day of vitamin C.30 (However, increasing the dosage to 2,000 mg raised RBC glutathione levels by only another 5%.) Other substances that can help increase glutathione synthesis include N-acetylcysteine (NAC), whey protein (which is high in cysteine), glycine, and methionine, but vitamin C appears to offer greater benefit in raising glutathione levels at the least cost even in severe glutathione deficiency.31

Over the past 5 to 10 years the use of NAC and glutathione products as antioxidants has become increasingly popular among nutritionally oriented physicians and the public, but is this use valid?

There is a biochemical rationale for this practice. It is thought that NAC acts as a precursor for glutathione, and that taking extra glutathione should raise tissue glutathione levels. While supplementing the diet with high doses of NAC may be beneficial in cases of extreme oxidative stress (e.g., AIDS, cancer patients going through chemotherapy, or drug overdose), it may be an unwise practice in healthy individuals. The reason? One study indicated that when NAC was given orally to six healthy volunteers at a dosage of 1.2 g per day for four weeks, followed by 2.4 g per day for an additional two weeks, it actually increased oxidative damage by acting as a pro-oxidant.32 On the other hand, many studies have shown NAC to effectively raise blood cell levels of glutathione, and long-term safety studies, some lasting several years and enrolling thousands of patients, show that it is very safe.

To ensure that glutathione conjugation is working well, eat plenty of glutathione-rich foods (asparagus, avocado, and walnuts), vegetables in the brassica family (such as cabbage and broccoli), and limonene-rich foods, which stimulate glutathione conjugation (orange peel oil, dill and caraway seeds). In addition, we recommend taking extra vitamin C (1,000 to 3,000 mg per day in divided dosages). Those with exposure to toxic metals such as mercury will find NAC particularly beneficial, as it both increases glutathione levels and directly chelates methyl mercury out of the body.

Amino Acid Conjugation. The body uses several amino acids (glycine, taurine, glutamine, arginine, and ornithine) to combine with and neutralize toxins. Of these, glycine is the most commonly utilized in Phase II amino acid detoxification. People suffering from hepatitis, alcoholic liver disorders, carcinomas, chronic arthritis, hypothyroidism, toxemia of pregnancy, and excessive chemical exposure are commonly found to have a poorly functioning amino acid conjugation system. For example, using the benzoate clearance test (a measure of the rate at which the body detoxifies benzoate by conjugating it with glycine to form hippuric acid, which is excreted by the kidneys), the rate of clearance is half in those with liver disease compared with healthy adults, so in these people all the toxins requiring this pathway stay in the body doing damage almost twice as long.33

Even in apparently normal adults, a wide variation exists in the activity of the glycine conjugation pathway. This is due not only to genetic variation but also to the availability of glycine in the liver. Glycine and the other amino acids used for conjugation become deficient on a low-protein diet and when chronic exposure to toxins results in depletion.

To ensure that amino acid conjugation is working well, simply make sure that you are eating adequate amounts of protein-rich foods. When additional protein is required, whey protein has the highest biological value.

Methylation. Methylation involves conjugating methyl groups to toxins. Most of the methyl groups used for detoxification come from S-adenosyl-methionine (SAM-e). SAM-e is synthesized from the amino acid methionine. This synthesis requires the nutrients choline, vitamin B12, and folic acid.

SAM-e is able to inactivate estrogens through methylation, a fact that supports the use of methionine in conditions of estrogen excess, such as PMS. Its effects in preventing estrogen-induced cholestasis (stagnation of bile in the gallbladder) have been demonstrated in pregnant women and those on oral contraceptives.34 In addition to its role in promoting estrogen excretion, methionine has been shown to increase membrane fluidity, which is typically decreased by estrogens, thereby restoring several factors that promote bile flow. Methionine also promotes the flow of lipids to and from the liver in humans. Methionine is a major source of numerous sulfur-containing compounds, including the amino acids cysteine and taurine.

To ensure that methylation is working adequately, eat foods rich in folic acid (green leafy vegetables), vitamin B6 (whole grains and legumes), and vitamin B12 (animal products or supplements). Methionine deficiency is not likely to be a problem because methionine is widely available in the diet.

Methylation also has other very important functions in the body. For example, it is used to detoxify homocysteine, an intermediate metabolite that damages the brain and heart if not eliminated, and it binds to arsenic, helping excrete it in the urine.

Sulfation. Sulfation is the conjugation of toxins with sulfur-containing compounds. The sulfation system is important for detoxifying several drugs, food additives, and toxins.

Sulfation, like the other Phase II detoxification systems, results in decreased toxicity and increased water solubility of toxins, making it easier for them to be excreted in the urine or sometimes the bile. Sulfation is also used to detoxify some normal body chemicals and is the main way we eliminate steroid hormones (such as estrogen) and thyroid hormones so that they don’t build up to damaging levels. Since sulfation is the primary route for the elimination of neurotransmitters as well, dysfunction in this system may contribute to the development of some nervous system disorders.

Many factors influence the activity of sulfate conjugation. For example, the diet needs to contain adequate amounts of methionine and cysteine. A diet low in these amino acids has been shown to reduce sulfation.35 Sulfation is also reduced by excessive levels of molybdenum or vitamin B6 (over about 100 mg per day).36 In some cases, sulfation can be increased by supplemental sulfate, extra amounts of sulfur-containing foods in the diet, and the amino acids taurine and glutathione. Another key nutrient is the trace mineral molybdenum, which is required for most of the enzymes involved in sulfur metabolism.

To ensure that sulfation is working adequately, consume adequate amounts of sulfur-containing foods, such as whey protein, eggs, red peppers, garlic, onions, broccoli, and brussels sprouts.

Acetylation. Conjugation of toxins with acetyl coenzyme A (acetyl-CoA) is the method by which the body eliminates sulfa drugs (antibiotics commonly used for urinary tract infections). This system appears to be especially sensitive to genetic variation, with those having a poor acetylation system being far more susceptible to sulfa drugs and other antibiotics. While not much is known about how to directly improve activity of this system, it is known that acetylation is dependent on thiamine (vitamin B2), pantothenic acid (B5), and vitamin C.37

To ensure that acetylation is working adequately, eat foods rich in B vitamins (nutritional yeast, whole grains) and vitamin C (peppers, cabbage, citrus fruits).

Glucuronidation. Glucuronidation, the combining of glucuronic acid with toxins, requires the enzyme UDP-glucuronyl transferase (UDPGT). Many commonly prescribed drugs are detoxified through this important pathway. It also helps to detoxify aspirin, menthol, vanillin (synthetic vanilla), food additives such as benzoates, and some hormones. Glucuronidation appears to work well in most of us and doesn’t seem to require special attention, except for those with Gilbert’s syndrome—a relatively common syndrome characterized by a chronically elevated serum bilirubin level (1.2 to 3.0 mg/dl). Previously considered rare, this disorder is now known to affect as much as 5% of the general population. The condition is usually without symptoms, although some patients do complain about loss of appetite, malaise, and fatigue (typical symptoms of impaired liver function). The main way this condition is recognized is by a slight yellowish tinge to the skin and white of the eye due to inadequate metabolism of bilirubin, a breakdown product of hemoglobin.

The activity of UDPGT is increased by foods rich in limonene (citrus fruits and the seeds of dill and caraway). Eating these foods not only improves glucuronidation but also has been shown to protect us from chemical carcinogens.

To ensure that glucuronidation is working properly, eat sulfur-rich foods (see above) and citrus fruit (but not grapefruit). If you have Gilbert’s syndrome, be sure to drink at least 48 fl oz water per day. Also, methionine administered as SAM-e has been shown to be quite beneficial in treating Gilbert’s syndrome.38

Sulfoxidation. Sulfoxidation is the process by which the sulfur-containing molecules in drugs (such as chlorpromazine, a tranquilizer) and foods (such as garlic) are metabolized. It is also the process by which the body eliminates sulfite food additives used to preserve foods and drugs. Various sulfites are widely used in potato salad (as a preservative), salad bars (to keep the vegetables looking fresh), dried fruits (sulfites keep dried apricots orange), and some drugs (such as those used for asthma). Normally, the enzyme sulfite oxidase metabolizes sulfites to safer sulfates, which are then excreted in the urine. Those with a poorly functioning sulfoxidation system have an increased ratio of sulfite to sulfate in their urine.

When the sulfoxidation detoxification pathway isn’t working very well, people become sensitive to sulfur-containing drugs and foods containing sulfur or sulfite additives. This is especially important for asthmatics, who can react to these additives with life-threatening attacks.

Dr. Jonathan Wright, one of the leading holistic medical doctors in the country, discovered several years ago that providing molybdenum to asthmatics with an elevated ratio of sulfites to sulfates in their urine resulted in a significant improvement in their condition. Molybdenum helps because sulfite oxidase is dependent upon this trace mineral. Although most nutrition textbooks believe molybdenum deficiency to be uncommon, an Austrian study of 1,750 patients found that 41.5% were molybdenum deficient.39

To ensure that sulfoxidation is working adequately, eat foods rich in molybdenum such as legumes (beans) and whole grains.

Practical Applications

The activity of and interplay between Phase I and Phase II reactions is possibly the single most important factor that determines our biochemical individuality. Genetic factors are clearly important. One illustration of this is the strong odor in the urine that some people experience after eating asparagus (the odor is a function of variability in liver detoxification). While this phenomenon is virtually unheard of in China, it is estimated that almost 100% of the French experience such an odor; about 50% of adults in the United States notice this effect).

While sophisticated laboratory tests are necessary to prove that a specific liver detoxification system is dysfunctional, several signs and symptoms can give us a good idea of when the liver’s detoxification systems are not functioning well or are overloaded. In general, anytime you have a bad reaction to a drug or environmental toxin you can be pretty sure there is a detoxification problem. The table below lists symptoms that are directly tied to a particular dysfunction.

Dysfunctional Liver Detoxification Systems

SITUATION

SYSTEM MOST LIKELY DYSFUNCTIONAL

Adverse reactions to sulfite food additives (such as in commercial potato salad or salad bars)

Sulfoxidation

Asthma reactions after eating at a restaurant

Sulfoxidation

Caffeine intolerance (even small amounts keep you awake at night)

Phase I

Chronic exposure to toxins

Phase II glutathione conjugation

Eating asparagus results in a strong urine odor

Sulfoxidation

Garlic makes you sick

Sulfoxidation

Gilbert’s disease

Phase II glucuronidation

Intestinal toxicity

Phase II sulfation and amino acid conjugation

Liver disease

Phase I and Phase II dysfunction

Perfumes and other environmental chemicals make you feel ill

Phase I

Toxemia of pregnancy

Phase II amino acid conjugation

Yellow discoloration of eyes and skin, not due to hepatitis

Phase II glucuronidation

The Importance of Bile Flow

Once the liver has modified a toxin, it needs to be eliminated from the body as quickly as possible. One of the primary routes of elimination is through the bile. However, when the excretion of bile is inhibited (a condition called cholestasis), toxins stay in the liver longer. Cholestasis has several causes, including obstruction of the bile ducts and impairment of bile flow within the liver. The most common cause of obstruction of the bile ducts is the presence of gallstones. Currently, it is conservatively estimated that 20 million people in the United States have gallstones. Nearly 20% of women over 40 and 8% of men over 40 are found to have gallstones on biopsy, and approximately 500,000 gallbladders are removed in the United States each year because of gallstones. The prevalence of gallstones in this country has been linked to the high-fat, low-fiber diet consumed by the majority of Americans.

Impairment of bile flow within the liver can be caused by a variety of agents and conditions (listed below). These conditions are often associated with alterations of liver function in laboratory tests (serum bilirubin, alkaline phosphatase, SGOT, LDH, GGTP, etc.), signifying cellular damage. However, relying on these tests alone to evaluate liver function is not adequate, since laboratory values may remain normal in the initial or subclinical stages of many problems. Among the symptoms people with cellular damage to the liver may complain of are fatigue, general malaise, digestive disturbances, allergies and chemical sensitivities, premenstrual syndrome, and constipation.

Causes of Cholestasis

• Presence of gallstones

• Alcohol

• Endotoxins

• Hereditary disorders such as Gilbert’s syndrome

• Hyperthyroidism or thyroxine supplementation

• Viral hepatitis

• Pregnancy

• Natural and synthetic steroidal hormones

  images Anabolic steroids

  images Estrogens

  images Oral contraceptives

 • Certain drugs

  images Aminosalicylic acid

  images Chlorothiazide

  images Erythromycin estolate

  images Mepazine

  images Phenylbutazone

  images Sulfadiazine

  images Thiouracil

Perhaps the most common cause of cholestasis and impaired liver function is alcohol. In some especially sensitive individuals, as little as 1 fl oz alcohol can produce damage to the liver, in the form of fatty deposits. All active alcoholics demonstrate this fatty infiltration of the liver.

SAM-e has been shown to be quite beneficial in treating two common causes of stagnation of bile in the liver: estrogen excess (due to either oral contraceptive use or pregnancy) and Gilbert’s syndrome.40

Putting It All Together

A rational approach to aiding the body’s detoxification involves (1) decreasing exposure to toxins; (2) eating a diet that focuses on fresh fruits and vegetables, whole grains, legumes, nuts, and seeds; (3) adopting a healthful lifestyle, including avoiding alcohol and exercising regularly; (4) taking a high-potency multiple vitamin and mineral supplement; (5) using special nutritional and herbal supplements to protect the liver and enhance liver function; and (6) going on a 3- to 7-day nutritional cleansing at the change of each season.

Diet and Liver Function

The first step in supporting proper liver function is following the dietary recommendations given in the chapter “A Health-Promoting Diet.” Such a diet will provide a wide range of essential nutrients the liver needs to carry out its important functions. If you want to have a healthy liver, there are three things you definitely want to stay away from: saturated fats, refined sugar, and alcohol. A diet high in saturated fat increases the risk of developing fatty infiltration and/or cholestasis. In contrast, a diet rich in dietary fiber, particularly soluble fiber, promotes increased bile secretion.

Special foods rich in factors that help protect the liver from damage and improve liver function include high-sulfur foods such as garlic, legumes, onions, and eggs; good sources of soluble fiber, such as pears, oat bran, apples, and legumes; vegetables in the brassica family, especially broccoli, brussels sprouts, and cabbage; artichokes, beets, carrots, and dandelion; and many herbs and spices such as turmeric, cinnamon, and licorice.

Drink alcohol in moderation (no more than two glasses of wine or beer or 2 fl oz hard liquor per day for men, half that for women), and avoid alcohol altogether if you suffer from impaired liver function. Alcohol overloads detoxification processes and can lead to liver damage and immune suppression.

Follow the Recommendations for Nutritional Supplementation

The recommendations given in the chapter “Supplementary Measures” for nutritional supplementation are quite useful in promoting detoxification. A high-potency multiple vitamin and mineral supplement is a must in trying to deal with all the toxic chemicals we are constantly exposed to. Antioxidant vitamins such as vitamin C, beta-carotene, and vitamin E are obviously quite important in protecting the liver from damage as well as helping in detoxification mechanisms, but even simple nutrients such as B vitamins, calcium, and trace minerals are critical in the elimination of heavy metals and other toxic compounds from the body.4143

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DRINK WATER!

Low fluid consumption in general and low water consumption in particular make it difficult for the body to eliminate toxins. As a result, low water consumption increases the risk for cancer and many other diseases. Drinking enough water is another basic axiom for good health that you’ve probably heard a thousand times. But it’s true: you need to drink at least six to eight glasses of water (48 to 64 fl oz) each day. That means having a glass of water every two waking hours. Don’t wait until you’re thirsty; schedule regular water breaks throughout the day instead.

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Special Nutritional Factors

Choline, betaine, methionine,44,45,46 vitamin B6, folic acid, and vitamin B12 are important. These nutrients are lipotropic agents, compounds that promote the flow of fat and bile to and from the liver. In essence, they have a decongesting effect on the liver and promote improved liver function and fat metabolism. Lipotropic formulas appear to increase the levels of two important liver substances, SAM-e and glutathione.

Formulas containing lipotropic agents are very useful in enhancing detoxification reactions and other liver functions. Nutrition-oriented physicians recommend lipotropic formulas for a wide variety of conditions, including a number of liver disorders such as hepatitis, cirrhosis, and chemical-induced liver disease.

Most major manufacturers of nutritional supplements offer lipotropic formulas. In taking a lipotropic formula, the important thing is to take enough of the formula to provide a daily dose of 1,000 mg choline and 1,000 mg methionine and/or cysteine. Alternatively, SAM-e can be used at a dosage of 200 to 400 mg per day.

Plant-Based Medicines and Liver Function

There is a long list of plants that exert beneficial effects on liver function. However, the most impressive research has been done on the extract of milk thistle (Silybum marianum), known as silymarin. Silymarin contains a group of flavonoid compounds that have a tremendous protective effect on the liver and also enhance detoxification processes.

Silymarin prevents damage to the liver by acting as an antioxidant as well as by other important mechanisms demonstrated in a number of experimental studies. In animal research, silymarin has been shown to protect against liver damage from extremely toxic chemicals such as carbon tetrachloride, amanita toxin, galactosamine, and praseodymium nitrate.47,48

One of the key ways in which silymarin enhances detoxification reaction is by preventing the depletion of glutathione. As discussed above, glutathione protects the liver from oxidative damage and is critically linked to the liver’s ability to detoxify. The higher the glutathione level, the greater the liver’s capacity to detoxify harmful chemicals. Typically, when we are exposed to chemicals that can damage the liver, including alcohol, the concentration of glutathione in the liver is substantially reduced. This reduction in glutathione makes liver cells susceptible to damage. Silymarin not only prevents the depletion of glutathione induced by alcohol and other toxic chemicals but also has been shown to increase the level of glutathione in the liver by up to 35%.49 Since the ability of the liver to detoxify is largely related to the level of glutathione in the liver, the results of this study seem to indicate that silymarin can increase detoxification reactions by up to 35%.

In human studies, silymarin has been shown to have positive effects in treating liver diseases of various kinds, including cirrhosis, chronic hepatitis, fatty infiltration of the liver (from chemicals or alcohol), and inflammation of the bile duct.5054 The standard dosage for silymarin is 70–210 mg three times per day.

Fasting

Fasting is often used as a detoxification method, as it is one of the quickest ways to increase elimination of wastes and enhance the body’s healing processes. Fasting is defined as abstinence from all food and drink except water for a specific period of time, usually for a therapeutic or religious purpose.

Although therapeutic fasting is probably one of the oldest known therapies, it has been largely ignored by the medical community despite the fact that significant scientific research on fasting exists in the medical literature. Numerous medical journals have carried articles on the use of fasting in the treatment of obesity, chemical poisoning, rheumatoid arthritis, allergies, psoriasis, eczema, thrombophlebitis, leg ulcers, irritable bowel syndrome, impaired or deranged appetite, bronchial asthma, depression, neurosis, and schizophrenia.

One of the most significant studies regarding fasting and detoxification appeared in the American Journal of Industrial Medicine in 1984.55 This study involved patients who had ingested rice oil contaminated with polychlorinated biphenyls (PCBs). All patients reported improvement in symptoms, and some observed “dramatic” relief, after undergoing 7- to 10-day fasts. This research supports past studies of PCB-poisoned patients and indicates the therapeutic effects of fasting as an aid to detoxification.

It is important to point out that caution must be used when fasting. Please consult a physician before going on any unsupervised fast.

If you elect to try a fast, we strongly advise supporting detoxification reactions while fasting, especially if you are carrying a particularly heavy toxic load or have a long history of exposure to fat-soluble toxins like pesticides. The reason is that during a fast, stored toxins in our fat cells are released into the system. For example, the pesticide DDT has been shown to be released from body fat during a fast and may reach blood levels toxic to the nervous system.56

The best way to support detoxification during a fast is to choose a 3-day fresh vegetable juice fast (instead of a water fast or a longer fast). Longer fasts require strict medical supervision at an inpatient facility, while a short fast can usually be conducted at home.

For a three-day juice fast, each day you will consume three or four 8–12-fl-oz juice meals spread throughout the day. During this period your body will begin ridding itself of stored toxins. Drinking fresh juice for cleansing reduces some of the side effects associated with a water fast such as light-headedness, tiredness, and headaches. While on a fresh juice fast, individuals typically experience an increased sense of well-being, renewed energy, clearer thought, and a sense of purity. Be sure to use vegetable juices (preferably fresh and organic), not fruit juice, as the high level of sugars in fruit juice can cause widely fluctuating blood sugar levels.

To further aid in detoxification, follow these guidelines:

1. Take a high-potency multiple vitamin and mineral formula to provide general support.

2. Take a lipotropic formula to provide a daily dose of 1,000 mg choline and 1,000 mg methionine and/or cysteine. Alternatively, SAM-e can be used at a dosage of 200 to 400 mg per day.

3. Take 1,000 mg vitamin C three times per day.

4. Take 1–2 tbsp of a fiber supplement at night before retiring, preferably a soluble fiber such as powdered psyllium seed husks, guar gum, or oat bran.

5. If you are carrying a particularly heavy toxic load, take silymarin at a dosage of 70 to 210 mg three times per day.

Other Tips on Fasting

Although a short juice fast can be started at any time, it is best to begin on a weekend or during a period when adequate rest can be ensured. The more rest, the better the results, as energy can be directed toward healing instead of other body functions.

Prepare for a fast by having only fresh fruits and vegetables as the last meal on the day before the fast begins. (Some authorities recommend a full day of raw food to start a fast, even a juice fast.)

Only fresh vegetable juices (ideally prepared from organic produce) should be consumed for the next three to five days. As noted above, have four 8- to 12-fl-oz glasses of fresh juice throughout the day. In addition to the fresh juice, drink pure water. The quantity of water should be dictated by thirst, but it should be at least four 8-fl-oz glasses every day during the fast.

Do not drink coffee; bottled, canned, or frozen juice; or soft drinks. Herbal teas can be quite supportive of a fast, but they should not be sweetened.

Exercise is not usually encouraged during fasting. It is a good idea to conserve energy and allow maximal healing. Short walks and light stretching are useful, but heavy workouts tax the system and inhibit repair and elimination.

Rest is one of the most important aspects of a fast. A nap or two during the day is recommended. Less sleep will usually be required at night, since daily activity is lower. Body temperature usually drops during a fast, as do blood pressure, pulse, and respiratory rate—all measures of the slowing of the body’s metabolic rate. It is important, therefore, to stay warm.

When it is time to break your fast, reintroduce solid foods gradually by limiting portions. Do not overeat. It is also a good idea to eat slowly, chew thoroughly, and eat foods at room temperature.

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QUICK REVIEW

• The ability to detoxify is a major determinant of a person’s level of health.

• It is conservatively estimated that up to 25% of the U.S. population suffers from heavy metal poisoning to some extent.

• Exposure or toxicity to food additives, solvents (cleaning products, formaldehyde, toluene, benzene, etc.), pesticides, herbicides, plasticizers, and other toxic chemicals can give rise to a number of psychological and neurological symptoms.

• Toxins produced by bacteria and yeast in the gut can be absorbed, causing significant disruption of body functions.

• The liver is a complex organ that plays a key role in most metabolic processes, especially detoxification.

• The liver’s detoxification mechanisms include:

  images Filtration of the blood

  images Formation of bile

  images Phase I detoxification reactions

  images Phase II detoxification reactions

• Glutathione is an important detoxification compound; vitamin C supplementation is the most cost-effective method to raise glutathione levels.

• Silymarin, the flavonoid complex from milk thistle, is a well-researched way to improve liver function.

• Fasting is one of the quickest ways to increase elimination of wastes and enhance the healing processes of the body.

• We strongly advise support of detoxification reactions during fasting, especially if you are carrying a particularly heavy toxic load or have a long history of exposure to fat-soluble toxins such as pesticides.