Detoxification Demystified – The Science

The latest trend in alternative medicine is a “cleanse” or a “detox”. While most of us have an understanding of the definition of detoxification, the process in the body is usually unknown and often misunderstood by the general public.

The confusion is compounded by differing opinions on the viability of such approaches. The truth is the science behind detoxification is real.

All organisms are exposed to unavoidable external toxins (known as xenobiotics) in our environment, as well as internal toxins (endotoxin) as the by-products of metabolism.

By design, our bodies are capable of handling these toxins through complex systems of detoxification, thereby decreasing the negative impact of these toxins on our bodies.

However, the real story is a little more complicated than that. The majority of these toxic products are fat-soluble, especially those more resistant to breakdown, which enables easy penetration into our cells but also makes their elimination much more difficult.

Detoxification: Phase One

The process of detoxification in the body is one of biotransformation. Through a series of steps, toxins are made increasingly more water-soluble and subsequently more easily excreted from the body. Biotransformation occurs primarily in the liver, and here, detoxification occurs in two phases.

Phase I is the body’s first defence against harmful substances. Through a series of oxidation, reduction, and hydrolysis reactions, functional groups such as hydroxyl (OH), carboxyl (COOH) or amino (NH) are added to a toxin molecule. This is carried out by the action of many different enzymes; the most common is the Cytochrome P450 superfamily of oxidases (enzymes that oxidise). This diverse group of enzymes (several hundred varieties) is responsible for the biotransformation of many xenobiotics, drugs, steroids, environmental pollutants, and carcinogens. The biotransformation of a molecule can occur in two ways: bio-inactivation (neutralisation) or bio-activation.

Phase I detoxification is a predominantly bioactive process in which the intermediate metabolites produced are more reactive and, as a result, are more toxic than the original. While this seems counter-intuitive, it is necessary in order for the second phase of detoxification to occur.

Phase II detoxification reactions decrease the reactivity and, thus, the toxicity of a molecule with the addition of a hydrophilic (water-loving) compound that allows for rapid removal by the kidneys through urine or by the bowel through faeces.

Ultimately, the function of detoxification is to minimise the potential damage to the body as a result of toxicity. Dysfunction occurs when the system is overloaded or if one phase is out of balance with the other; it is this dysfunction or imbalance that has been linked to a number of disease processes, in particular, multiple forms of cancer and other chronic illnesses.

If Phase II reactions are inhibited or Phase I reactions are initiated without a concomitant increase to Phase II, the optimal balance is compromised, and detoxification results are imbalanced. The intermediate metabolites of Phase I reactions are more reactive and toxic than the initial substance; dysfunction in the system can cause damage to other cells of the body. The process of oxidation creates free radicals, which results in oxidative damage to surrounding cells. This creates an excess demand for antioxidants, which leads to the depletion of antioxidant defences of other cells; these reactive molecules have an affinity for proteins, lipids, and nucleic acids, especially DNA and RNA. Oxidative damage to these cellular components causes structural changes that can lead to malfunction and carcinogenesis in the body. Since Phase II reactions involve the use of dietary cofactors that are used up in the process of detoxification, it is essential these be replenished. Nutritional deficiencies, therefore, can result in an impaired capacity of the liver to perform detoxification.

Detoxification: Phase Two

The detoxification process does not end with the liver. The conjugated metabolic products of Phase II are then transported to the kidney for excretion through urine. The kidney’s ability to properly excrete these substances is greatly affected by hydration levels; dehydration has serious consequences for the body’s ability to detoxify and excrete toxins due to decreased urinary output.

As the final organ of detoxification, it is imperative that the kidney is functioning optimally. Without the ability to excrete the conjugated metabolites of detoxification, a system-wide “back-up” of toxins can result, leading to ill health and disease. The unique composition of each organism results in a normal range of variability in one’s susceptibility to toxins and the subsequent ability of the body to detoxify. Theoretically, the fat-soluble nature of xenobiotics makes those with greater fat distribution more vulnerable to toxic build-up.

This is especially true of women, who are naturally prone to an increased percentage of fat mass over men. The inevitable exposure to toxins in the air, water, and food is compounded by the high rates of exogenous hormone consumption from various birth control interventions and, later, hormone replacement therapies. This makes detoxification for women of particular importance.

Naturopathic medicine is unique in its ability to target these differences in toxin metabolism by tailoring treatment plans suited to each individual. It is essential that any detox or cleanse be appropriately supervised to ensure proper balance and function of appropriate detoxification pathways. Through the elimination of toxicity, our bodies operate at their best, reducing disease risk and laying the foundation for a happier, healthier future.

Detoxification Support

It is important to recognise what type of toxins you are exposed to and offer a detox protocol. Cellular detoxification from Dr Christopher Shade and the whole-body cleansing protocol from Global Healing are a few examples we use. Functional tests are available to measure glucotoxicity, biotoxins (bacteria, mould, yeast, Lyme), oxalate, heavy metals, and environmental toxins.

Ref: Association for Nutrition and Naturopathic Practitioners (2019)