Information from our book "A Natural Guide to Pregnancy and Postpartum Health "

Detoxification

The Liver Your Best Ally Against Toxins

The detoxification systems are your body's cleanup crew. Whenever a potentially harmful substance needs to be removed from the body, these systems are called upon to do the job.

Toxins originate both within and outside of the body. Some toxins are created in the natural course of metabolism; hormones and other biochemicals made by the body do not float around in your system indefinitely, but are broken down and eliminated once they have served their purpose. Chemicals with which you come in contact daily—such as cleaning solutions, medicines, car exhaust, and preservatives in foods, among many others—are also processed and eliminated by your body's detoxification systems. Even nutrients from healthy foods must be processed in the liver, a key part of the detoxification system, before they exit the body.

In an ideal world—with plenty of organic sugar- and additive-free food, a relaxed lifestyle, no need for medicines, and no pollution—your body's detoxification systems would have a reasonable workload. Unfortunately, we do not live in such a world, and we're guessing that you don't either.

Processed foods such as breads, cakes, cookies, chips, luncheon meats, condiments, and sauces tend to be loaded with preservatives, flavorings, stabilizers, and other substances that must be broken down by your body and discharged. Every time you take a medication or are exposed to a chemical, it has to be processed and eliminated from your system. This is why it is important to keep your detoxification systems running smoothly. If they cannot do their job adequately, toxins can build up in your body, effectively gumming up the works at the cellular level. Having poorly operating detoxification systems can lead to fatigue and decreased immunity by affecting the functioning of mitochondria and increasing free-radical production. Over the long term, they may increase your risk of developing cancer, neurological diseases such as Alzheimer's disease or Parkinson's disease, and other chronic disorders. For example, recent studies have shown a direct link between exposure to pesticides over the years and Parkinson's disease.

THE LIVER: YOUR BEST ALLY AGAINST TOXINS

Most detoxification processes happen in the liver, intestines, and kidneys. Like all of the systems we talk about in this chapter, the detoxifying organs require specific nutrients to do their jobs. The most active detoxification organ, the liver, is the largest solid organ in the body. If it is given the right raw materials, it does an amazing job of filtering toxins out of the blood, altering them to make them less toxic, and, eventually, sending them out of the body as waste.

Traditional Chinese medicine (TCM) and other traditional schools of medicine teach the importance of a healthy liver for overall wellness, but conventional medicine has yet to appreciate the ways in which detoxification can set the stage for true healing. In fact, conventional medicine usually treats illness by prescribing drugs, which increase the stress on the liver. This is one of the reasons why most drug therapies for chronic post partum illnesses fall short of effecting a cure.

The subtle but important differences between one person's body and another's—in other words, biochemical individuality—really show up when it comes to liver function. While one person's liver might be able to meet the detoxification demands of a highly polluted environment and a junk-food diet, another person's may be overwhelmed by ordinary everyday exposure to seemingly normal chemicals such as cleaning products. While one person may take a given medication and do just fine, another person may suffer intense side effects from the same drug. These differences can be traced back to the detoxification ability of each person's liver. Whether you find yourself at one end or the other of the detox spectrum, or somewhere in the middle, you can improve your liver's ability to detoxify by ensuring that it has all of the nutrients it needs to do its job.

Blood that has just absorbed nutrients from the intestines is channeled directly to the liver to be filtered for toxins. In the time it took you to read the last two paragraphs, roughly two quarts of blood passed through your liver. If your liver is functioning well, any drugs, foreign chemicals such as pesticides, “used-up” hormones and other biochemicals, and toxins made within the digestive tract were filtered out of that blood. Before many of these toxins can be flushed out of your body, they must undergo two distinct detoxification phases in the liver, designated phase I and phase II. Both phases have to be in good working order for detoxification to proceed smoothly, and in order for this to happen, key nutrients are needed in adequate amounts. Genetics and the lifetime toxic workload placed on your liver also affect how well your liver runs through each phase.

The following section describes the two phases of detoxification in some technical detail. The purpose of this is not to have you memorize a lot of new biochemistry, but rather to demonstrate how essential nutrients are to each step in the process of eliminating toxins from your body. If your body is not eliminating toxins effectively you are at higher risk for health problems of all kinds.

PHASE I - DETOXIFICATION
In this phase, a group of 50 to 100 specialized enzymes alter toxins to prepare them for phase II. The molecular structure of the toxin is changed in a way that readies it to be changed further during the next step of the detoxification process. We like to think of phase I as the activation step. Phase I has three basic ways to neutralize toxic chemicals:

It can change the chemical structure of a toxic molecule so that it can be dissolved in water.
It can break a toxic chemical into two or more less toxic or harmless chemicals.
It can change a toxic molecule into a different type of molecule so that other enzymes can detoxify it more easily.
Activated toxins—toxins that have been through phase I liver detoxification—are sometimes more toxic than the original compound, so it is very important that they be moved into phase II. In some instances, a substance that does not cause cancer becomes carcinogenic after activation, and is then neutralized in phase II. This is true of some hormones that must undergo detoxification to be eliminated from the body. Thus, if phase I is accelerated or phase II is slowed down, activated toxins build up and can damage the liver or pass out of the liver into the general circulation. If phase I is slowed down, the liver becomes unable to keep up with detoxification demands. You can think of this as a stream that cascades over two waterfalls, with a cold, clear pond between them. When the water flows steadily, the pond remains clear and clean. If the second waterfall is clogged, the pond becomes stagnant until it overflows, carrying debris into the stream below it. If the first waterfall becomes clogged, the flow backs up and stagnates above it as the pond below dries up.

Alcohol, tobacco smoke, and some medications (for example, the steroid drug prednisone) have the effect of speeding up phase I detoxification. So do the toxins found in charcoal-broiled meats. Many environmental toxins, including chemicals in car exhaust, paint, nail polish, and pesticides, also rev up phase I, potentially causing an accumulation of activated toxins in the body.

The key here is to maintain balance between the two parts of the detoxification system. The best ways to do that are to avoid toxic substances whenever possible and to supply your body with all of the nutrients it needs to run smoothly through both phases. As long as phase II can keep up with phase I, some acceleration may be more helpful than harmful. Some highly nutritious foods speed up phase I. The cruciferous vegetables—broccoli, brussels sprouts, cabbage, cauliflower, and their relatives—have this effect.

The most popular drug treatments for postpartum depression, including fluoxetine (Prozac) and other drugs in its class, slow down phase I detoxification. So do the benzodiazepine tranquilizers, such as alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan); many antibiotics; antihistamines given for allergies; and stomach-acid blockers such as cimetidine (Tagamet) and ranitidine (Zantac). When drugs inhibit phase I detoxification, other toxins (including other drugs) can build up to harmful levels because of the liver's decreased ability to get rid of them.

Phase I can also be inhibited by nutritious foods. Grapefruit juice contains a substance that inhibits phase I enzymes so strongly that it can cause drug overdoses. The enzymes are slowed so much that they cannot detoxify drugs fast enough, and the levels of the drug in the bloodstream climb too high. Capsaicin, the compound that makes hot peppers hot, also slows down phase I.

The common spice turmeric, found most commonly in curry powder, slows down phase I while egging on phase II, an effect that can help to move toxins more quickly through the two phases. This may explain turmeric's powerful anticancer properties.

Certain nutrients act as coenzymes to the phase I detoxifying enzymes. Vitamins B2, B3, B6, and B12 plus folic acid, bioflavonoids, branched-chain amino acids, and phospholipids are needed to keep phase I going smoothly. If some of these nutrients sound unfamiliar to you, don't worry. You will learn everything you need to know about them later on. Our goal here is to show you how nutrients keep your body systems working smoothly. We will get to specifics about those nutrients—and ways to tell whether you need more of them—later in the book.

The more detoxifying work phase I has to do, the more free radicals it produces. Liver tissues can end up being damaged by these free radicals if there aren't enough antioxidants available to handle them. Vitamin C, beta-carotene, vitamin E, coenzyme Q10 and the minerals copper, manganese, selenium, and zinc are all needed to prevent free-radical overload in the liver. Substances known as thiol compounds, which are found in garlic, onions, and the cruciferous vegetables, add to the liver's antioxidant power. Bioflavonoids and anthocyanidins are other nutrients that help to quench free radical fires.

PHASE II- DETOXIFICATION
During phase II detoxification, activated substances from phase I—other wise known as intermediates—are altered further. Seven different major biochemical reactions occur in this phase, known as glutathione conjugation, amino acid conjugation, methylation, sulfation, acetylation, glucuronidation, and sulfoxidation. Each of these reactions works on specific types of intermediates and needs specific nutrients in order to proceed to successful completion. Basically, these reactions work by adding a molecule to the intermediate from phase I, making it less toxic and soluble in water. Then the final product can be flushed out of the body in either the urine or the bile, another product of the liver. Bile leaves the body as part of solid waste.

The nutrients required for phase II fall into two categories. The first are the amino acids, which donate molecules that are attached to phase I intermediates. These include the sulfur donors, among which are the amino acids methionine, taurine, cysteine, and N-acetylcysteine. Other, non-sulfur-containing amino acids are also required: glycine, taurine, glutamine, ornithine, and arginine. The antioxidant amino acid glutathione is also required for phase II detoxification.

Following is a brief summary of the individual phase II processes, the types of toxins they are used to eliminate, and the nutrients required for them to be carried out properly:

Acetylation is a phase II liver detoxification pathway that attaches acetyl co-A to toxins to make them far less harmful and easy to excrete. This process requires vitamin B pantothenic acid, and vitamin C to function properly.

Amino acid conjugation helps the body to rid itself of many toxic chemicals, called xenobiotics, from the environment. The amino acids glycine, taurine, glutamine, arginine, and ornithine must be available for this liver detoxification pathway to function properly. Amino acids are available in protein-rich foods if they are eaten in adequate amounts.

Glucuronidation helps to detoxify many prescription drugs and, to some extent, the reproductive and adrenal hormones. Glucuronidation requires magnesium and vitamin B

Glutathione conjugation helps to detoxify and eliminate poisons in the liver, lungs, intestines, and kidneys. Glutathione is one of the most important antioxidants and anti carcinogens in the body. Its synthesis requires adequate amounts of the amino acids cysteine, glutamic acid, and glycine. Nutrients that help to raise glutathione levels include vitamin C, alpha-lipoic acid, whey protein, and the amino acids glutamine and methionine.

Methylation helps to detoxify many of the steroid hormones, including estrogen. The methylation pathway begins with the amino acid methionine, and needs vitamin B folic acid, choline, and vitamin B to function properly. Methylation eventually yields usable sulfate with the help of the trace mineral molybdenum.

Sulfation is the main liver detoxification pathway that neutralizes the stress hormone cortisol, as well as many environmental toxins, food additives, microbial products, and some commonly prescribed drugs. Usable sulfur is needed for sulfation to run unimpeded. Sources of sulfur include the sulfur-bearing amino acids methionine and cysteine, and the nutritional product methylsulfonylmethane (MSM).

Sulfoxidation transforms toxic sulfite molecules into sulfate with the assistance of the mineral molybdenum. This is the last part of the methylation process (see above). Sulfites are compounds that are added to some foods to preserve freshness. For example, they are often found in wine, dried fruit, dehydrated foods, seasonings, and salad dressings. Many restaurants use them on salad bar foods. Ironically, sulfites, which can be highly allergenic and can interfere with breathing in those who are sensitive to them, are also added to some asthma medications.

A diet low in protein—all too common in women who are trying to lose weight with a low-fat diet—can dramatically slow phase II detoxification. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (found in Advil, Nuprin, and other products), also slow phase II detoxification.

Does even the smallest bit of caffeine keep you wide awake at night? You could have sluggish phase I detox. Can you guzzle two cups of coffee in the afternoon and sleep just fine? Your phase I enzymes might be over active. Does garlic make you sick? Does your urine have a strong smell after you eat asparagus? Did you suffer from toxemia during your pregnancy? Any of these symptoms may indicate problems with phase II. Specially targeted nutrients can do wonders for your liver's detoxifying ability. (See Figure 3.2 in the book for an illustration of the liver detoxification pathways and the nutrients needed for them to operate properly.) We will explain how to support liver detoxification with diet and supplements will be discussed in Chapters 5 and 7.

Figure 3.2 LIVER DETOXIFICATION PATHWAYS AND SUPPORTIVE NUTRIENTS The diagram above summarizes the major liver detoxification pathways and the nutrients required for them to be completed successfully.

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