Overcoming the poisons around us (and in us)
We live in a toxic world. Sources of toxins seem endless: pesticides in food and water, alcohol, pollutants in the air, bacterial metabolites in the gut. Even our own neurotransmitters and hormones must be constantly recycled; a build-up can poison the body. Because of this constant assault on our bodies, it is essential for our detoxification systems to be functioning optimally. Detoxification is carried out by the kidneys, lungs, skin, and gastrointestinal tract; but the major pathway is the liver.
Just what is "toxicity"? If one's cleansing systems are not up to par, the resulting overload can manifest as a variety of syndromes. Bacterial by-products can penetrate an incompetent gut wall, causing cross-antigenic reactions that can lead to rheumatoid arthritis or other autoimmune conditions. Inadequate liver function can lead to dermatologic disorders, chronic fatigue, chemical sensitivities, and in severe cases, certain types of cancer.
The liver is the great filter of the body. Endogenous toxins are carried through via the systemic circulation; the portal circulation brings in exogenous toxins from the GI tract that have penetrated the frontline defenses. Like the GI tract, the liver has mechanical and immunologic defenses, in the form of bile flow and Kupffer cells, respectively. The major function of the liver, however, is biochemical processing.
This processing can be divided into two phases. Phase I involves dozens of enzymes, collectively known as cytochrome P450. These enzymes can alter a molecule in one of three ways. They can: 1) make it more water-soluble, so it can be eliminated by the kidneys; 2) neutralize the substance, to prevent damage before eventual excretion; or 3) make the molecule more reactive, so it can be processed by Phase II enzymes.
In general, Phase II enzymes carry out the function of conjugation. They attach carriers such as glutathione, glycine, and glucuronic acid to reactive, hydrophobic substances, so they may be more easily excreted from the body. Of these pathways, glutathione conjugation is the most prevalent.
Diagnosis of toxicity is usually made by examining the clinical presentation of the patient. For example, intolerance of fatty foods and the colicky pain of gallstones indicate cholestasis, or inadequate bile flow. For the hepatic biochemical pathways, "challenge" tests using substances such as caffeine and acetaminophen narrow the possibilities of deficient enzymes.
After determining the area or areas of weakness, treatment is targeted to those systems. There are many foods, nutrients, and herbs that assist liver function. Cruciferous vegetables offer antioxidant protection against the free radicals produced during chemical detoxification, as well as specifically stimulating many Phase I and II enzymes. Other functional foods that share these properties are oranges, tangerines, caraway, and dill. Grapefruit should be avoided by patients in need of detoxification; a component called naringenin inhibits many Phase I enzymes.
Sulfites are an ingredient of many food and drug additives. The patient who reacts strongly to these (e.g., lettuce at a salad bar) may have an inefficient sulfoxidation system. This is carried out by sulfite oxidase, which converts sulfites to harmless sulfates. This Phase II enzyme is molybdenum-dependent; therefore, extra molybdenum may prove useful. This may take the form of supplementation, or consumption of molybdenum-rich foods such as dairy, legumes, and whole grains.
Herbs such as dandelion root (Taraxacum oficinale), artichoke leaves (Cynara scolymus), and turmeric (Curcuma longa) promote the flow of bile, moving toxins out of the liver and into the intestines for excretion.
One of the most important herbs for the liver is milk thistle (Silybum marianum); the actions of its main component, silymarin, have been thoroughly researched. It has antioxidant activity, and prevents depletion of glutathione and glucuronic acid. Additionally, it promotes regeneration of the hepatocytes themselves, by preventing decomposition of membranes, and stimulating protein synthesis. On the research horizon is an herb called Picrorhiza kurroa. Its active ingredient, picroliv, has functions similar to, yet more potent than, silymarin.
We face an ever-increasing load of toxins--in our air, food, and water. Rather than a quaint, vague concept from the past, detoxification is a vital tool to use every day in practice.
This overview of hepatic detoxification is by no means comprehensive. For an in-depth treatment of the topic, start with the book Total Wellness by Joseph Pizzorno, ND. Check out the NCC Natural Alternatives folder, on reserve in the LRC, for more resources.
Reprinted from The Synapse, August 1997.
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