by Peter Bennett N.D. and Steven
Barrie N.D
with Sara Faye. Published by Prima Health, a division of Prima Publishing.
ISBN:07615-1422-8
The Liver's Detoxification Function Your body doesn't like to keep any
molecules around for a long time. Even "good" molecules, such as
hormones, are constantly being disassembled and reconstructed to prepare them
to be recycled or eliminated.
Thanks to detoxification enzymes, the
liver is able to break tip most molecules, even toxic and
dangerous ones. Enzymes are molecules that act as catalysts in the
transformation process. There are thousands of different enzymes, each with a
unique role. Think of this detoxification process as a two-phase wash cycle.
Enzymes are like the soap that
liberates grease into little droplets, removing impurities that the water can't
remove on its own. In the first part of the wash cycle (Phase 1), enzymes break
toxins down into intermediate forms. Figure 5.2 illustrates the complicated
process of how some common toxins are broken down during Phase I
detoxification. Some toxins are ready for elimination at this stage, but others
require a second wash cycle.
In Phase 2, these intermediate
compounds are routed along one of six chemically driven detoxification pathways, where they are further broken
down, and then bound to specific types of' protein molecules which act as
"escorts" to guide them out of the body, allowing them to exit
through the kidneys (in the form of urine) or the bile (in the form of feces).
This process is called conjugation and is illustrated in figure 5.3. Of the six
pathways, three warrant special mention. One of the most important systems in
Phase 2 is the glutathione conjugation pathway, which utilizes glutathione for
the detoxification of deadly industrial toxins such as PCBs, and the breakdown
of carcinogens.
Its activity accounts for up to 60
percent of the toxins excreted in the bile. Glutathione also circulates through the bloodstream
combating free radicals. No other conjugating substance is as versatile as
glutathione and the body's supply of it, most of which is produced by the
liver, is easily depleted. Exposure to high levels of toxins exhausts reserves
of glutathione, possibly increasing susceptibility to cancer.
Chronic disease, HIV, and cirrhosis use
up reserves of glutathione. Excessive
exercise, which increases oxidative stress and ree radical production,
and alcohol consumption, which blocks glutathione production, also deplete
glutathione in the blood. The weakest pathway in most people, from a dietary
standpoint, is sulfation, the one responsible for the transformation of
neurotransmitters, steroid hormones, drugs, industrial chemicals, phenolics
(compounds derived from benzene, commonly used in plastics, disinfectants, and
pharmaceuticals), and especially toxins from intestinal bacteria and the
environment.
Intake of too little dietary sulfur, a
molecule that must come from our diets, is a cause of ineffective
detoxification. If your exposure to substances that need to be deoxified via
the sulfation pathway is high, but your sulfate reserves are low due to an
inadequate diet, you will not be able to break down these toxins. Studies have
established a strong association between the function of the sulfation pathway
and a variety of illnesses including Alzheimer's disease, Parkinson's disease,
motor neuron disease, autism, primary biliary cirrhosis, rheumatoid arthritis,
food sensitivity, and multiple chemical sensitivity.
The detoxification profile test
described in Chapter 7 identifies alterations in this pathway. The body
manufactures five different types of amino acids that form a third
detoxification pathway: glycine, taurine, glutamine, arginine, and ornithine.
Of these, glycine is the most important for the neutralization of toxins. In
some cases, the body cannot make enough glycine to keep up with its own
detoxification needs.
Though not considered an essential
amino acid because the body can make it, glycine production depends on an
adequate intake of dietary protein. Individuals who eat a protein-deficient
diet
have trouble detoxifying environmental pollutants. Glycine supplies can be
depleted by lifestyle stresses. Benzoates for example, found in soft drinks,
bind with glycine and rob the body's store of it.
One study found that people who
consumed a large number of soft drinks had problems breaking down toluene, a
common industrial organic solvent. Aspirin also slows down this detoxification
pathway because it competes for available glycine in the liver. When the diet
is supplemented with glycine, as well
as the other nonessential amino acids, there is a noticeable improvement in the
detoxification capabilities of many people. Problems in Phase I and Phase 2
Detoxification When the liver is "sluggish," Phase I of the
detoxification cycle may not be processing toxins at a normal and necessary
speed. This causes toxins to accumulate in the bloodstream. If the hormone
estrogen, for example, is not dismantled during Phase 1, the buildup can reach
potentially harmful levels. Premenstrual tension can be an expression of this.
Many factors can cause Phase I to become sluggish.
As we age, our detoxification processes slow. Use of medications
such as anti-ulcer drugs (cimetidine) and oral contraceptives; exposure to
cadmium, lead, and mercury; and consumption of large amounts of sugar and
hydrogenated fats hinder Phase I detoxification. Substances that slow down
Phase I detoxification, setting the stage for a toxic buildup, are called Phase
I inhibitors. They affect the DNA of the liver cells, causing less
detoxification enzymes to be produced. In addition to those mentioned
previously,
Phase I inhibitors include:
Grapefruit
Turmeric
Capsicum (found in hot peppers)
Cloves
Drugs containing benzodiazepene such
as antidepressants and Valium
Antihistamines
Ketoconazole (used in antifungal
medications)
Toxins from bacteria in the
intestines
Pancreatitis and the Detoxification Bottleneck
Mainstream medicine generally does not
factor in bottleneck detoxification problems in diagnosis and treatment. Our
clinical experience, however, has shown us that when treatment focuses on
eliminating this problem, other disease conditions improve.
For example, we believe that many cases
of pancreatitis are caused by a bottleneck detoxification problem. The use of
alcohol, cigarettes, and a body-abusing lifestyle creates this bottleneck, and
the free radicals generated in this process cause inflammation in the pancreas.
We had a patient who had been in the hospital several times for acute
pancreatitis. He was always alternating between a healthy lifestyle and use of
alcohol and cigarettes. After every binge, he would end up in the hospital with
pancreatitis. We put him on a detoxification program with great success.
Patients with pancreatitis often report exposure to diesel fumes, solvents, and
trichloroethelene. These toxins also seem to accentuate the susceptibility to
alcohol-related pancreatitis. The treatment of pancreatitis with detoxification
medicine is not mentioned in medical literature. However, we believe there's
ample evidence to make it a first-line treatment consideration.
A different type of detoxification
problem develops if Phase I breaks down toxins at so
fast a rate that Phase 2 cannot keep up. In this situation, the toxic
intermediates produced during Phase I waiting to be washed out in Phase 2 flood
the system. Many of these intermediate compounds-stuck in between Phase I and
Phase 2-are more dangerous than the original toxin.
This bottleneck can become a
biochemical nightmare, damaging the liver, brain, and immune system. Some of
the substances that accelerate the breakdown of toxins in the liver by
increasing the production of Phase I enzymes, without a concurrent increase in
Phase 2 enzymes, are known carcinogens- paint fumes, and cigarette smoke.
Others are well known for their detrimental effects, such as alcohol and
steroids. Even some otherwise harmless substances such as limonene from lemons,
increase Phase I detoxification. But unlike cigarette smoke, limonene does not
create dangerous intermediate molecules.
As you read the following list, keep in
mind that it is not strictly a list of "bad" things, but of those
that increase the rate of Phase I detoxification, and that this becomes a
problem only when Phase 2 can't keep up.
Phenobarbital
Steroids
Sulfonamide medications
Foods in the cabbage family
Charbroiled meats
High-protein diets
Citrus fruits
Vitamin B1
Vitamin B3
Vitamin C
Environmental toxins (exhaust fumes,
paint fumes, dioxin, pesticides)
Cigarette smoke
Alcohol
Endotoxins from intestinal bacteria
in the bloodstream
Exposure to a toxin, when coupled with
exposure to another substance that speeds up Phase 1, is especially dangerous.
The combination of alcohol and acetaminophen provides a good example. It's not
uncommon to drink heavily, and later take acetaminophen for the headache that
follows. The intermediate compound (from acetaminophen) is an extremely toxic
substance called n-acetyl-p-benzoquinoneimine (NAPQI). Under normal conditions,
NAPQ1 is removed quickly during Phase 2, but alcohol intake forces more NAPQI into
the liver than Phase 2 can handle.
Research has shown that specific foods
and nutrients not only have a beneficial effect on detoxification capability,
but can also provide a safe and viable approach to treating a variety of immune
disorders and toxicity syndromes. If two or more detoxification accelerants are
combined, they can interact, with serious consequences. An individual on a
prescription medication who smokes, for example, actually needs higher dosages
of the medication because smoking causes the medication to be broken down
faster than it normally would be during Phase 1.
If Phase 2 can't handle the extra
burden, a detoxification bottleneck results. We predict that in the future,
medical specialists will check detoxification capabilities in order to give
more accurate drug
prescriptions.
Joanie was a forty-eight-year-old
female who had a history of hepatitis B, a disease of the liver. She had worked
for many years in the graphic arts field, and was regularly exposed to volatile
organic solvents. She came to our clinic with symptoms of chronic fatigue. We
did a comprehensive liver
detoxification screening. The test clearly showed which pathways were out of
balance. After recommending the correct nutrients, Joanie was on the road to
repairing her damaged liver function and rebuilding her health.
Problems in Phase I and Phase 2 liver
detoxification are so prevalent, and have such a major impact on health that we
believe it's a good idea for everyone to have liver detoxification tests as
part of
a standard medical workup. This lab test, described in Chapter 7, can identify
problems localized in the different detoxification pathways.
If you suffer from chronic liver and
gallbladder problems, you're probably a candidate for this test. Abnormal
results, of course, will require ruling out a liver disease before going ahead
with detoxification therapy. Assessing detoxification function makes it
possible to diagnose a problem before symptoms actually appear. Tests that
measure Phase I and Phase 2 enzymes take much of the guesswork out of
estimating the severity of liver detoxification dysfunction, and can to some
extent indicate whether a person is at special risk for cancer, neurological
disease, chemical and drug sensitivity, and immune problems.
Diet and Detoxification:
Feeding Phase I and 2 You can take
steps to keep your liver detoxification system running smoothly. Diet has a
strong effect on detoxification enzymes, and foods can help
"regulate" or balance Phase I and 2 activity. Eating foods that
support the liver can reduce your susceptibility to damage from toxins and to
conditions Such as multiple chemical sensitivity syndrome, chronic fatigue
syndrome, and cancer. Research has shown that specific foods and nutrients not
only have a beneficial effect on detoxification capability, but can also
provide a safe and viable approach to treating a variety of immune disorders
and toxicity syndromes.
Essential fatty acids are vital for
Phase I detoxification, and the standard American diet does not provide an
adequate supply of these vital nutrients. Essential fatty acid intake in the
form of cold-water fish and flaxseed oils have a demonstrated ability to
heighten detoxification. Other sources of essential fatty acids include edible oils,
such as those made from sunflower seeds, walnuts, and sesame seeds; wheat germ;
and supplements of black current seed, borage, or evening primrose oil.
Eating fresh fruits and vegetables
daily is a good way to continually replenish your body's store of glutathione,
necessary for one of Phase 2 pathways. High-quality protein nourishes both the
amino acid and the sulfation pathways. Vegetable sources of sulfur for the
sulfation pathways include radishes, turnips, onions, celery, horseradish,
string beans, watercress, kale, and soybeans. Eggs, fish, and meat are also
excellent sulfur sources. Cabbage, Brussels sprouts, broccoli, citrus fruits,
and lemon peel oils support Phase 2 activity.
Studies have shown dramatic results
from consuming broccoli sprout extract, which inhibits the activity of Phase 1
enzymes and, simultaneously enhances the Phase 2 glutathione pathway. Broccoli
sprout extracts are especially beneficial for people who have frequent or
high-level exposure to pesticides, exhaust fumes, paint fumes, cigarette smoke,
or alcohol. Anyone who is exposed to known carcinogens will benefit from
broccoli sprout extract.
Cabbage family Cold-water fish Flaxseed oil Fruits (fresh)
Garlic Nuts and seeds Onions
Safflower oil Sesame seed oil
Sunflower seed oil Vegetables
(fresh) Walnut oil
Wheat germ and wheat germ oil
Nutritional Supplements to Support Liver Detoxification
Bioflavonoids Black currant seed oil
Borage oil Carotenes Coenzyme QIO
Copper Evening primrose oil Folic
acid Iron
Lecithin Magnesium Manganese
N-acetyl-cysteine Niacin
Riboflavin Selenium Silymarin
(milk thistle) Trace minerals
Vitamin A Vitamin B6 (pyridoxine)
Vitamin B12 Vitamin C (ascorbic acid)
Vitamin D Vitamin E Vitamin K
Zinc
The gallbladder is the end of the
detoxification road that begins in the liver. Bile is the fluid into which the
liver excretes its toxins. (The other routes of elimination are the sweat
glands and the kidneys.) After bile is produced in the liver, it runs into the
gallbladder and eventually into the intestinal tract. We have found that in
many cases people with liver problems also have gallbladder problems, and vice
versa. Bile is made in the liver from cholesterol, bilirubin, and lecithin, and
is then secreted into the gallbladder. While in the gallbladder, bile is
concentrated by a reabsorption of the liquids back into the circulatory system.
A proper ratio of bile components is necessary for it to remain in solution.
Abnormal ratios promote the formation
of cholesterol crystals or stones in the gallbladder. During a meal, bile is
secreted by the gallbladder into the intestines to promote the digestion and
breakdown of oils and fats. After the intestines absorb them, these
bile-digested fats are used in the body to build cells, hormones, and
prostaglandins (a group of chemicals that act like hormones). When constipation
occurs, bacteria in the intestines split the toxins that are bound up in the
bile, in turn causing reabsorption of these already detoxified poisons.
A diet high in vegetables will prevent
constipation. Beta-glucuronidase is an intestinal bacterial enzyme that
releases compounds for reabsorption. To prevent this reabsorption of toxins, an
adequate
supply of calcium d-glucarate, a natural ingredient in vegetables that inhibits
beta-glucuronidase activity, is necessary. Charcoal will also bind up the bile
and prevent toxins from being reabsorbed into the bloodstream. Gallstones-a
common complaint in North America-easily disrupt the flow of bile.
They are found in sixteen to twenty
million Americans and are twice as common for women as men. Usually the stones
are a mixture of cholesterol, calcium, bilirubin, and lecithin. Occasionally,
however, the gallbladder also forms a stone consisting mainly of calcium with a
little bit of cholesterol. If you have gallstones, observe the following
instructions:
1.
Take lecithin daily. Cholesterol stones
are caused when your liver excretes more cholesterol into the gallbladder than
it does lecithin and bile acids. The cholesterol tends to
"supersaturate" and form stones. A daily supplement of 500 mg of
lecithin with meals keeps the bile flowing smoothly.
2.
Limit dietary sugar. Sugar intake correlates with gallstone
formation, suggesting that sugar stimulates cholesterol synthesis.
3.
Take 5 g of soluble fiber (pectin in fruits, beans, or oat bran)
daily with meals.
4.
Eat a low-fat diet to prevent obesity.
5.
Eat small meals to ensure proper digestive capacity.
6.
Avoid food allergens, which are notorious for provoking acute
attacks of gallbladder inflammation. Eggs are considered the worst offender.
7.
Take 500 mg of bile acids with every meal; this is usually 50
percent effective in reducing the size of the cholesterol variety of
gallstones.
8.
Take supplements of the amino acids methionine and taurine.
Because women's bodies make less taurine than men's, this might be the clue to
their twofold increased risk for gallstones. The dose is 1 g of each, between
meals, twice daily.
9.
Take dandelion root (Taraxacum officinalis) extract. It's a superb
cholegogue (releases stored bile), gentle in action, and safe to use. The dose
of the solid extract is 1 teaspoon, 3 times a day. The solid extract is hard to
find in the store, but the next best thing is to use the powdered root. The
dose is 8 g as a tea, 3 times a day.
A family history of estrogen-related
breast cancer, smoking-induced lung cancer, and other types of cancer can be
related to inherited weaknesses of detoxification capability. These genetic
differences are a result of the wide variance in how detoxifying enzymes in the
liver express themselves. The term to describe this is metabolic polymorphism.
This means that there is a variety (poly) of forms (morphism) that humans have
in detoxifying their environment (metabolic). In the book entitled Genome,
authors Jerry E. Bishop and Michael Waldholtz, propose that genetic
susceptibility factors should be the major focus of medicine in
the future. This, they suggest, would make it possible to modify the
environment appropriately to protect individuals against diseases related to
genetic polymorphism.
Yet hereditary variations in the
biochemical breakdown and transformation of toxins is still one of the most
undervalued and under-utilized areas of prevention and treatment. Medical
doctors could be individualizing health care plans and minimizing risks using
laboratory tests (described in Chapter 7) to assess detoxification functions.
This screening process would identify
those individuals who have very strong detoxification abilities as well as
those who require special help to discourage the onset of disease. Not taking
genetics and detoxification abilities into consideration sets the stage for
illnesses that are preventable. It is possible to minimize the impact of our
biological weak links.
The "Achilles' Heel" that's
encoded in our DNA that makes each of us more susceptible to certain stressors
can be countered by our daily lifestyle choices and compensated for with
nutritional medicine and detoxification support. Naturopathic doctors have many
ways to stimulate the liver, for example, using herbs, special diets,
physiotherapy, and homeopathic medicines.
Treatment of gall bladder disease
frequently includes the same herbal medicines that are used for liver
detoxification problems. If you have an inherited weakness in these organs, the
EcoTox program will help. It is designed to stimulate the liver and gall
bladder, as well as the proper digestion of foods and nutrients necessary for
their activity. In the following chapter, you'll learn more about the sources
of toxins that place such a heavy burden on the liver, and the toll they take
on your health.
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