The human body’s detoxification process is a chemical masterpiece in human development where removing toxins is not just a matter of physically shifting them. In fact they do not shift unless they are first altered chemically. The chemical alteration is carried out by specific enzymes which require nutrients for their action. Some of the nutrients are needed to ensure that enough of these enzymes will be formed, some are needed as co-factors for the reaction and still others are raw materials needed for the transformation of the toxins. The point is that the biochemical mechanisms are known and the nutrient requirements can be defined. This article sets out details of the nutrients required at a cellular level to put this detoxification process into effect.
“Today, those who grasp the principles of natural medicine are keener than they ever have been about the detoxifying process of the body. They are more acutely aware than past generations of the traditional naturopathic view that chronic illnesses may be promoted by a build-up of toxins in the tissues, thought to damage the delicate structures of the living cell.”
1. The Naturopathic Idea of the Detoxification Process
The early naturopaths were enthusiasts for detoxification of the body long before biochemists had any real idea of the nature of the detoxification process. Some of them even stretched back before the days when biochemists were first heard of. These naturopaths were enthusiasts for grapefruit “fasts”, out and out fasting, enemas and colonic irrigation, Epsom salt baths, internal castor oil and castor oil packs and poultices and hydrotherapy. None of this ever seemed to receive any scientific validation or, indeed, any scientific investigation.
The naturopaths were “people of insight” rather than biochemists or experts. Even the best of them undoubtedly worked on the basis of a lot of intuition supported by a considerable skill in the observation of patients, with an ability to evaluate their own results in naturopathic terms.
Science and naturopathy have often been in conflict. In particular scientists accused naturopaths of pontificating about toxins without knowing to what they were referring and talking about detoxification without any understanding of the nature of the process. Of course, the scientists were quite right - that was what was happening. But many of the naturopaths were men and women of insight and intuition, and they believed they could read into their observations of patients subtle and beneficial changes when the measures that naturopaths called “detoxifying” were put into effect. Today we can put the two fields of knowledge together and largely wipe away the conflict.
2. Popular Understanding of Detoxification Processes Today
In respect of all fields of nutrition and naturopathy, this author finds it necessary to keep reminding readers and students to focus upon the living cell. Intoxication and detoxification are essentially phenomena of each and every living cell in the body. This is the fundamental biochemical level. Too often people today have too gross and simplistic an idea of what detoxification is. Having had a bowel movement they may say “I have had an elimination”. Whilst this is bound to be true in one sense because they have eliminated some contents from the bowel, it leaves an open question as to whether or not any cellular elimination has taken place.
The true process of detoxifying begins within the living cells. Each cell of the body has to defend itself by resisting the uptake of toxic substances and by striving to detoxify and dispose of those toxins. If the individual cells of the body can do that and the main organs of elimination (liver and kidney) can remain un-compromised, then the flow of toxins to the exterior can be maintained.
Indeed, the activity of the cells of such organs as liver and kidney is crucial, for these organs must bear the brunt of the work of externalizing the toxins. Failure to envision detoxification as a cellular process is what is responsible for the common over-simplistic view.
3. Bowel Cleansing
The herbal bowel cleanse is popular among those who have gained naturopathic understanding. Many people think of a bowel cleanse as a detoxification. Naturopaths have traditionally held that this idea is not without foundation, believing the bowel can become a source of body toxicity when long-standing food residues, combined with an adverse bowel flora, are thought to generate substances that may be absorbed by the body. In this traditional view, removing such residues is considered a way of addressing a possible toxin source - though this remains a naturopathic model rather than an established physiological mechanism.
However, naturopathic theory holds that if the other main organs of elimination - the liver and kidney in particular - are already thought to be compromised, then this improvement may be less apparent, as those organs may not be able to make full use of the opportunity a bowel cleanse is believed to present.
“In naturopathic theory, achieving cellular elimination - encouraging the cells of the liver, kidney and other organs to process and release their waste products - is considered central to detoxification.”
By observing this we can see that elimination from the bowel is doing only one part of the job. In naturopathic theory, achieving cellular elimination - encouraging the cells of the liver, kidney and other organs to process and release their waste products - is considered central to detoxification. This means that although a bowel cleanse alone may often be of help, to do a full job one must take other action designed as a specific encouragement of cellular detoxification.
4. The Nature of the Cellular Detoxification Process
Detoxifying toxins usually requires two steps. The first is chemical transformation of the toxin, usually by oxidation, by which it is converted to another substance, a derivative of the original toxin. The second is conjugation, which means attaching the toxin derivative to another molecule (called a “ligand”) to render it much less toxic. The first step is conducted by enzymes known as Phase I enzymes, while the second step is conducted by Phase II enzymes.
Each of these groups of enzymes has specific co-factors required for the enzymic reaction to proceed and many of these are available only through good nutrition. For Phase II you need a supply of the ligands that have to be attached. If one wants to take action to encourage these detoxifying enzymes then the way forward is to put together all the principal nutrients that these enzymes need and to make sure to consume enough of each type.
5. The Myth of Fasting
Fasting is a method that was popular among the older naturopaths for inducing the body’s detoxification process. By fasting one means complete withdrawal of food while continuing to supply as much water as required. It was thought that fasting would accelerate detoxification because it was a way to interrupt the inflow of fresh toxins from the environment.
The logic of this approach seems compelling at least until one realizes that detoxification requires nutrients and there has to be a balance between the benefits and the inevitable depletion of nutrients that marks the onset of starvation. Certainly it seems that any fast that one undertakes in order to encourage detoxification should be strictly limited in its duration. The main reason is the depletion in anti-oxidant nutrients that starts to occur as soon as food is withdrawn. The price we pay for that is that the cell structure and cell enzymes are at once at increased risk from free radical damage.
6. Diets to Facilitate the Detoxification Process
In nutritional practice it has become clear that effective detoxification can and does take place while continuing to eat. It is very important that this should be so, because naturopaths consider that supporting the body’s natural detoxification pathways is a gradual process rather than something to be achieved quickly. Rather it takes place successfully only through assiduous attention given to the matter over the medium to longer term.
The most profound errors and imbalances of the British diet should be addressed and eliminated. That means excluding or at least minimizing added salt and sugar, keeping fat intake to not more than 20% of calorie intake, avoiding frying and other sources of fat that has been heated in air and keeping protein intakes adequate but modest, ensuring adequate amounts and balance between Omega 6 and Omega 3 fatty acids. For a period of detoxification lasting, say, three months, a vegan diet that is wholly or mainly organic vegetables, pulses and rice, taking into account the effects of food types on detoxification,, with the pulses not exceeding 60g/day, will provide an excellent background intake.
7. You Do Not Have to Use a Special Diet to Benefit
One of the points naturopaths make about the nutrients discussed in this article is that ensuring an adequate intake of them is considered good general nutritional practice for most people. From a naturopathic standpoint, anyone eating a typical British diet may wish to pay particular attention to these nutrients as part of a balanced diet.
Naturopaths would nonetheless recommend that improving overall dietary habits remains the foundation of good nutrition, with nutrient supplementation considered, where appropriate, as a complementary measure rather than a substitute for dietary change.
8. The Naturopathic View: Detoxification and Chronic Health
According to the old naturopaths, detoxification failure was considered by them to be a common contributing factor across many forms of chronic ill health. This is a traditional naturopathic hypothesis, not an established medical fact, and it should not be read as implying that any specific disease is caused, prevented, treated or cured by dietary detoxification. Anyone experiencing symptoms of chronic illness should always seek assessment from a qualified medical practitioner.
9. Detoxification Ability and Genetics
Many of the detoxification enzymes are said to be “polymorphic”. This term means that they exist in different versions, some of which work better than others. Evidence to date suggests that there are about 35 genes in the human genome that affect detoxification adequacy. If you have a genetic disadvantage that affects your ability to detoxify, there is nothing you can do to alter that situation. But you can make allowance for it.
10. How to Compensate for Genetic Disadvantage
Given that genetic disadvantage exists, then the other factors that affect detoxification performance are environmental and dietary. Environmentally, one should minimize toxin exposure. That calls for attention to the quality of drinking water, the use of organic food and minimizing exposure to chemicals of all types. Dietary precautions, apart from eating from organic sources, include reduction of protein and fat levels within an adequate range and eating a combination of foods and supplements that will provide the specific nutrient requirements for detoxification. Obviously your disadvantaged enzymes will work better if the cells are encouraged to produce more of them and if they are well supplied with their co-factors and substrates.
12. How Should One Develop a Detoxification Strategy?
- The main thesis of this article is that one’s detoxification ability should be augmented by nutrients that support the detoxifying enzymes. Whether these are in a composite formulation or taken as separate nutrient supplements, this action should be the first plank in the strategy.
- Modify the diet. Get away from the worse excesses and imbalance of the UK or western diet. It would be better still to obtain professional help from a well trained, holistic nutritional practitioner.
- Consider using a herbal bowel cleanse either before or at the same time as using the special nutritional supplements recommended.
- Use a good quality bowel flora preparation comprising acid-producing species, especially Lactobacilli and/or Bifidobacteria.
13. Reviewing the Detoxifying Enzymes
As mentioned above, detoxifying a chemical toxin usually involves two phases. The first phase is most often an oxidation. Where toxic molecules are concerned, the most common reaction is one that adds an oxygen-containing group, the (-OH) group, called the hydroxyl group. These reactions are usually carried out by enzymes of a special class called the “P450 cytochromes”. These are by far the most important Phase I enzymes in the body. These enzymes contain haem, the same pigmented material that colours the blood red. Haem contains iron as a component and this fact gives us the first nutritional connection with detoxification - without iron you cannot have P450 cytochromes.
In Phase II the Phase I product is chemically bonded to another molecule and that bonding almost always results in a significantly less toxic derivative. This “joining” reaction at Phase II is distinguished by the term “conjugation”. The substances joined to the Phase I product are called “ligands”. There are several of these, among which are the amino acid glycine, the sugar derivative glucuronic acid and sulphate.
There are distinct nutritional strategies that enhance Phase I mechanisms and other nutritional strategies that enhance Phase II. It would be counter-productive to follow a strategy for stimulating Phase I only, as this could leave us exposed to highly toxic Phase I products that are ready to be conjugated and detoxified in Phase II.
15. The Effects of Nutrition upon Cytochromes P450
There are many interactions between diet and nutrition and the activity of the P450 system. The cytochromes P450 need to be regenerated after the reaction by co-enzymes that are in part derived from nicotinamide, and therefore from Vitamin B3. These work together with a flavoprotein enzyme that requires riboflavin (Vitamin B2).
Rogers & Newberne (1975) showed that detoxification of foreign toxins in the endoplasmic reticulum of the cell required lipotrophic nutrients: choline, glycine, folic acid, Vitamins B6 and B12, polyunsaturated fatty acids and phosphate. Vitamin C is also essential for the oxygenation of foreign toxins by cytochrome P450. Vitamin E too plays an essential role by protecting the membrane of the endoplasmic reticulum from peroxidation. Vitamin A was also shown to have a strong effect upon P450s. Magnesium is another mineral that enhances P450s and their associated reductase enzyme.
17. Detoxifying Toxins by Conjugation - Nutritional Requirements
Phase II detoxification reactions occur by conjugation - a “joining together”. These linkages are made primarily to glucuronic acid, sulphate, acetyl, glutathione or the amino acid glycine.
Vitamin C has been shown to play a very significant role in glucuronide conjugation. The glucuronyl transferase enzymes apparently provide quantitatively the most important single route for detoxification of environmental chemicals in mammals. Hence it would be hard to put forward a nutritional detoxification programme that did not include Vitamin C.
A conjugation reaction of huge importance in detoxification is the one with glutathione (GSH). Glutathione has three separate roles in detoxification: the glutathione peroxidase route, the conjugation route and a key role in regenerating Vitamin C. Nutritionally, the importance of glutathione further emphasizes the essentiality of the dietary sulphur amino acids, cysteine and methionine.
18. Practical Action
The benefits of a detoxifying diet and avoidance of environmental toxins have been stressed already. Other practical action depends upon the use of nutritional supplements to supply the substrates and co-factors for the detoxifying enzymes. Such supplements should include realistic levels of:
- Vitamin E, Co-enzyme Q10, Vitamin C, Vitamin A
- Glutathione, Selenium, Nicotinic acid
- Choline, Glycine, Folic acid
- Vitamin B6, Vitamin B12, Riboflavin, Thiamine
- Magnesium, Sulphate, Zinc
- Cysteine, Methionine, Glutamic acid
- Manganese and Copper
In view of the special properties of carotenoids in free radical quenching, it is also recommended that naturally sourced beta-carotene, alpha carotene, lutein and lycopene be included at levels that make a genuine difference.
19. How to Use This Article
This article is not intended as individual medical advice to the reader, but is provided more generally for information. Individual patients wishing to detoxify often do undertake self-designed programmes on their own responsibility. The best route, however, is to opt for the advice of a fully trained nutritional practitioner and that is to be recommended.
If you’d like to go deeper into this topic without committing to a full diploma, our short course Understanding Detoxification covers the naturopathic model, Phase I & II biochemistry, and eliminative foods in five self-paced modules.
20. References
Blake, D.R., Allen, R.E. & Lunec, J. “Free radicals in biological systems - a review orientated to inflammatory processes”, British Medical Bulletin, 43 (2) 371-385 (1987).
Colin, C., Narbonne, J.F., Migaud, J.L., Grolier, P., Cassand, P. & Pellissier, M.A. “Lipid peroxidation and benz(a)pyrene activation to mutagenic metabolites” Mutation Research 246 159-168 (1991).
Institute for Functional Medicine Inc., “Detoxification: A Clinical Monograph”, Gig Harbour WA USA (1999).
Parke, D.V., Ioannides, C. & Walker, R., Eds., “Food, nutrition and chemical toxicity” Smith Gordon, Chapter 39 419-426 (1993).