Many people believe that periodic 'detoxification'
provides a healthy break for organs, such as for the liver, kidney,
bladder and galbladder.
The holidays, for the most part, are a pleasant, memorable time of the year. As it is with so many things, the good is accompanied by the bad. For purposes here, excessive and unhealthy eating accompanied by consumption of alcoholic beverages results in tremendous metabolic stress on the body. Were this not enough, travel and work stress adds to the load placed on the biological system.
Preventive maintenance, in the form of a formal systemic detoxification, might be a pretty good idea, indeed.
Background
Scientific' data
is nearly impossible to obtain to support the observations of
thousands of persons over many dacades, but it is clear that there is
something to the claims that liver detoxification in particular makes
people feel better.
Without getting into the basics of phase 1 and phase
2 detoxification, which is the paradigm that outlines the manner in
which the liver, lung, kidneys, skin 'detoxify' substances, there is a
lot of good to be said for engaging in the periodic practice of 'liver
detoxification.'
- It is responsible for the
production of bile which is stored in the gallbladder and released when
required for the digestion of fats.
- The liver stores glucose in the form of glycogen which is converted back to glucose again when needed for energy.
- It
also plays an important role in the metabolism of protein and fats. It
stores the vitamins A, D, K, B12 and folate and synthesizes blood
clotting factors.
- Another important role is as a
detoxifier, breaking down or transforming substances like ammonia,
metabolic waste, drugs, alcohol and chemicals, so that they can be
excreted. These may also be referred to as "xenobiotic" chemicals. If
we examine the liver under a microscope, we will see rows of liver
cells separated by spaces which act like a filter or sieve, through
which the blood stream flows. The liver filter is designed to remove
toxic matter such as dead cells, microorganisms, chemicals, drugs and
particulate debris from the blood stream. The liver filter is called
the sinusoidal system, and contains specialized cells known as Kupffer
cells which ingest and breakdown toxic matter.
The 'poor man's liver detox-
The gall bladder functions to store bile between meals. The gall
bladder contracts when stimulated to push bile salts into the small
bowel, thereby facilitating digestion. Bile is a clear, yellow liquid,
when healthy. If the bile is allowed to stagnate, or if the galbladder
is allowed to distend or get infected, the bile thickens, stones form,
and mucous backs up. Sometimes, this leads to medical conditions that
result in the need to surgically remove the galbladder.
As it were, prevention is probably the best bet, when dealing with
the liver/galbladder system. A little bit of care, and a little bit of
prevention goes a long way.
To keep the galbladder from distending, and to keep the bile from
'going stale,' the daily administration of silymarin, taken with each
meal, will keep things moving along. The silymarin (milk thistle)
stimulates the gall bladder to 'dump, ' very much in the same way the
colon does. Both the colon and gallbladder should empty with each meal.
It gets a little sticky, however, if a person has had the gallbladder
removed, already.
The liver is the cleanser and filter of the blood stream and is of
vital importance. It is the largest organ in the body and has an
enormous amount of blood flowing through it every minute of our lives.
It is between 21 - 22.5 cm in its greatest diameter, 15 - 17.5cm in its
greatest height and 10 - 12.5 cm in its depth, weighing around 1200 -
1600 gms.
We have been attacking the symptoms of
weight excess with fad diets, obsessional high impact aerobics, stomach
stapling and toxic drugs, such as appetite suppressants, laxatives and
diuretics. We have failed to consider the underlying cause of LIVER
DYSFUNCTION and indeed we have virtually ignored the hardest-working
organ in the body, with dire consequences.
Steers
are implanted with Hormonal Growth Promotants (HGP) which is justified
by corporate statements, that tests have shown that a non-pregnant
woman produces 54,000 times the amount of estrogen found in a 500 gram
steak and that only a fraction of the amount used in human hormone
replacement therapy is used in the implants that are put into animals.
Even this additional small amount of hormone is l increasing the
workload of the liver, which over a long period of time may cause
hormonal imbalances in those who eat beef regularly. We must ask
ourselves why is the incidence of breast cancer so high, particularly
in relatively young women? Surely it is better to eat meat from animals
that roam free and happy in fresh green pastures that are not injected
with potent hormones or fed concentrated stock feed to rush their
growth?
The
use of drugs to control and treat animal disease and to promote faster,
more efficient growth of livestock is a common practice. An estimated
80 percent of U.S. livestock and poultry receive some animal drugs
during their lifetime. Improper use of animal drugs may cause residues
in the edible tissues of slaughtered animals that could be hazardous to
consumers.
Most countries will have set MRL or
Maximum Residue Limits. This is the amount of pesticide residue, heavy
metals, hormone residues and natural toxins that the food ( eggs, meat
or milk) are allowed to have and still be sold to the public for
consumption. The MRL in Australia are set by the National Registration
Authority for Agricultural and Veterinary Chemicals. In the USA they
are set by authorities under the Food and Drug Administration. The key
point is, just because a food substance complies in relation to the MRL
, does not mean that the food is free from ALL contamination - just
that it is at, or under, the level set by the particular authority
deemed to be safe. MRLs are often set on a national basis to meet the
requirements of a particular country. However, pests and pest pressure
can vary between countries, as can chemicals used and agronomic
practices. The lists of MRL values applying in different countries can
therefore be quite different.
There is also the
point that despite the existence of these laws, it does not guarantee
that all farmers and growers comply 100% . Principle causes of
excessive drug residues are failure to observe drug label withdrawal
periods before slaughter or processing, or failure to withhold milk
after dosing of herds with drugs such as the treatment of bovine
mastitis with large doses of penicillin which requires a withholding
period before the residues in milk are reduced to acceptable levels.
Other causes may include failure to follow other drug label directions,
poor feed manufacturing practices, and human negligence.
There
are many chemicals (e.g., trace metals, industrial chemicals, and
mycotoxins) that may be inadvertently present in animal tissues yet
have no established safe concentrations. This of course does not mean
that these substances are not harmful.
It is a
fact of life that pesticides, herbicides and hormones are used in food
production. Although the regulatory levels set by authorities provide
some control over residues - it is not the 'be all and end all'. The
liver is again highlighted as vital, as it is the organ that
metabolizes these substances and excretes them from the body.
The
liver is the gateway to the body and in this chemical age its
detoxification systems are easily overloaded. Thousands of chemicals
are added to food and over 700 have been identified in drinking water.
Plants are sprayed with toxic chemicals, animals are injected with
potent hormones and antibiotics and a significant amount of our food is
genetically engineered, processed, refined, frozen and cooked. All this
can lead to destruction of delicate vitamins and minerals, which are
needed for the detoxification pathways in the liver. The liver must try
to cope with every toxic chemical in our environment, as well as
damaged fats that are present in processed and fried foods.
Phase One - Detoxification Pathway
Human
liver cells possess the genetic code for many isoenzymes of P-450 whose
synthesis can be induced upon exposure to specific chemicals. This
provides a mechanism of protection from a wide variety of toxic
chemicals.
To put it simply, this pathway
converts a toxic chemical into a less harmful chemical. This is
achieved by various chemical reactions (such as oxidation, reduction
and hydrolysis), and during this process free radicals are produced
which, if excessive, can damage the liver cells. Antioxidants (such as
vitamin C and E and natural carotenoids) reduce the damage caused by
these free radicals. If antioxidants are lacking and toxin exposure is
high, toxic chemicals become far more dangerous. Some may be converted
from relatively harmless substances into potentially carcinogenic
substances.
Excessive amounts of toxic chemicals
such as pesticides can disrupt the P-450 enzyme system by causing over
activity or what is called 'induction' of this pathway. This will
result in high levels of damaging free radicals being produced.
Substances that may cause overactivity (or induction) of the P- 450 enzymes:
Caffeine, Alcohol, Dioxin, Saturated fats, Organophosphorus pesticides, Paint fumes, Sulfonamides, Exhaust fumes, Barbiturates
The
family of P-450 enzyme systems is quite diverse, with specific enzyme
systems being inducible by particular drugs, toxins or metabolites. It
is this characteristic that has allowed the development of special
tests to check the function of the various pathways - see liver tests.
The substrate is the substance that is acted upon by the enzyme.
Substrates of cytochrome P-450 enzymes:
Theophylline, caffeine, phenacetin, acetaminophen, Lidocaine,
erythromycin, cyclosporin, ketoconazole, testosterone, estradiol,
cortisone, Alprenolol, bopindolol, carvedilol, metoprolol, propranolol
, Amitriptyline, clomipramine, desipramine, nortriptyline , Codeine,
dextrometh- orphan, ethylmorphine, 4-methoxyamphetamin Family
Phenytoin, ibuprofen, naproxen, oxicam drugs, S-warfarin, Diazepam,
hexobarbitone, imipramine, omeprazole, alcohol, chlorzoxazone,
enflurane.
Phase Two - Detoxification Pathway
This is called the
conjugation pathway, whereby the liver cells add another substance (eg.
cysteine, glycine or a sulphur molecule) to a toxic chemical or drug,
to render it less harmful. This makes the toxin or drug water-soluble,
so it can then be excreted from the body via watery fluids such as bile
or urine.
Major Phase II pathways include
glutathione, sulfate, glycine, and glucuronide conjugations. Individual
xenobiotics and metabolites usually follow one or two distinct
pathways. Again, this makes testing of the various pathways possible by
challenging with known substances.
The
conjugation molecules are acted upon by specific enzymes to catalyse
the reaction step. Through conjugation, the liver is able to turn
drugs, hormones and various toxins into excretable substances. For
efficient phase two detoxification, the liver cells require
sulphur-containing amino acids such as taurine and cysteine. The
nutrients glycine, glutamine, choline and inositol are also required
for efficient phase two detoxification. Eggs and cruciferous vegetables
(eg. broccoli, cabbage, Brussels sprouts, cauliflower), and raw garlic,
onions, leeks and shallots are all good sources of natural sulphur
compounds to enhance phase two detoxification. Thus, these foods can be
considered to have a cleansing action. The phase two enzyme systems
include both UDP-glucuronyl transferase (GT) and
glutathione-S-transferase (GSH-T). Glutathione is the most powerful
internal antioxidant and liver protector. It can be depleted by large
amounts of toxins and/or drugs passing through the liver, as well as
starvation or fasting. Phase II reactions may follow Phase I for some
molecules or act directly on the toxin or metabolite.
Substrates of the glycine pathway
Salicylates and benzoate are detoxified primarily through glycination.
Benzoate is present in many food substances and is widely used as a
food preservative. Many other substances are detoxified as well via the
glycine conjugation pathway. Patients suffering from xenobiotic
overloads and environmental toxicity may not have sufficient amounts of
glycine to cope with the amount of toxins they are carrying.
Substrates of the sulfation pathways
Neurotransmitters, steroid hormones, certain drugs such as
Acetaminophen (also known as paracetamol) ,and many xenobiotic and
phenolic compounds.
Substrates of glucuronidation
Polycyclic aromatic hydrocarbons, steroid hormones, some nitrosamines,
heterocyclic amines, some fungal toxins, and aromatic amines. It also
removes "used" hormones, such as estrogen and T4 (thyroid hormone) that
are produced naturally by the body.
Toxic Overload
If the phase one and two detoxification pathways become overloaded,
there will be a build up of toxins in the body. Many of these toxins
are fat soluble and incorporate themselves into fatty parts of the body
where they may stay for years, if not for a lifetime. The brain and the
endocrine (hormonal) glands are fatty organs, and are common sites for
fat-soluble toxins to accumulate. This may result in symptoms of brain
dysfunction and hormonal imbalances, such as infertility, breast pain,
menstrual disturbances, adrenal gland exhaustion and early menopause.
Many of these chemicals (eg. pesticides, petrochemicals) are
carcinogenic and have been implicated in the rising incidence of many
cancers.
Rarely
does anyone think about the liver, which seems incredible to me because
it is such a powerful organ and is easily improved. Indeed the simplest
and most effective way to cleanse the blood stream and thus take the
load off the immune system is by improving liver function.
An example of the phase one pathway is the Cytochrome P-450 mixed
function oxidase enzyme pathway. These enzymes reside on the membrane
system of the liver cells (called Hepatocytes).
Specific Detoxification Recommendations
1. Begin with ensuring rapid transit through the colon. Without this, waste materials can be reabsorbed, and benefit is minimized.
a. CLA 1000 mg taken three times daily. This should be started first, and maintained throughout the detoxification period.
b. Silymarin/curcumin combination. This should be started simultaneously with the CLA. Dosage is different for men and women. Men should take it three times daily, women take one capsule at bedtime, only.
c. After 2 weeks of the CLA/Silymarin/Curcumin consumption, begin one of the following:
Ortho DTX- one capsule three times daily (orthomolecular products, inc.)
or, Ultraclear pH- (metagenics, inc.)
Choose one or the other, but they should be taken for a period of about 3 weeks.
2. When the Ortho DTX or UltraClear pH is finished, begin the following:
a. NAC 500 mg three times, daily
b. Taurine 500 mg three times, daily
c. Hawthorne 450 mg, once daily.
This combination should be maintained for 4 weeks or more. Many patients feel much better when the take it, and simply stay on it indefinitely. (This is what I do for myself, actually)
3. Maintain colonic function with Flax Seed Oil and capsular aloe.
Maintaining healthy colonic function is a very, very good preventative health approach. It costs very little and it is an important factor in stimulating weight loss.
NOTE: This should be initiated soon after Thanksgiving and maintained through the holiday season.
Given the individual nature of detoxification, I am willing to customize a regimen for persons interested in sending me an e-mail.
Information should include: age, sex, brief medication list and medical conditions.
The anticipated cost for a complete package will depend upon the specifics of the situation. The supplements will be taken over a 6-8 week period.
I am willing to put together a custom regimen, with home-shipping of the products. E-mail me if you are interested in this seasonal service.
[email protected]
David S. Klein, MD, FACA, FACPM, FACMIMS
Director, Pain Center of Orlando
www.suffernomore.co
