Monday, January 9, 2017

Detoxification demystified


The end of year break is over, spring is coming soon. As per tradition, in this period there is a boom of articles in magazines, blog posts, offers from healthcare professionals and obviously products... about detoxification. I am a convinced follower of traditions, so why shouldn't I write something about it, too? Especially since there is so much to say.

Warning: despite the carelessness with which many people speak about the subject (not to mention the para-scientific solutions proposed) detoxification is a science. As such it has its own language and includes many difficult concepts. In this post I'll try to do my very best to convey the facts in the most simple and accessible way, all by staying scientifically correct.

Let's start as usual, by defining the problem: if we don't have a good understanding of the causes we can't evaluate the validity of a solution.

What is detoxification


Toxins and detoxification

I already spoke abundantly about toxins in a previous post. However toxins must not be intended exclusively as poisonous substances we introduce in our bodies, but also the end-product of the metabolism of other molecules that are not perforce unhealthy. I'll come back to this point later.

Detoxification is a series of processes that metabolize and eliminate toxins, drugs, hormones, dead cells and even nutrients. Detoxification occurs contiuously, just to make a simple example: adrenaline (the hormone of fear). Its action is immediate however, if the stimulus that triggered its secrection ceases, its effects last just some minutes. The half-life of adrenaline in the human body is about 2 minutes (every 2 minutes the amount of adrenaline in our blood is halved). What is happening is that our body is detoxifying it: the adrenaline is metabolized into inactive by-products and the same are eliminated through the urines. If this mechanism didn't exist, once we have been scared once we would stay scared for life.

The same happens with countless chemicals, both organic and inorganic, for example:
  • alcohol (if we didn't metabolize alcohol we would stay drunk forever)
  • caffeine (we would stay awaken for ever)
  • toxins in the food (both natural and artificial), in the air we breath or the water we drink
  • even the toxins we absorb through our skin (creams, soaps, shampoos, hand-sanitizers, ...)
  • metals (lead, aluminium, mercury, ...)
  • medicaments
This wonderful system is what allows us to survive. When the body cannot metabolize a substance, this represents a poison for us (think about deadly mushrooms).

Our body also has a limited capacity to metabolize other substances, hence the saying "the dose makes the poison":
  • drink one coffee and you'll be fine
  • drink the equivament in caffeine of 50 espressos in one go, and you're dead

Detoxification Protocols

A detoxification protocol is a series of actions taken with the intent to facilitate the naturally occurring detoxification processes.

Although in an ideal world one should not need to regularly undertake this kind of exercise, we live in a progressively more and more imperfect world, so yes: our detoxification processes need support.

It is not a coincidence that every traditional culture and religion included what effectively is a recurrent detoxification protocol, often paired with spiritual practices to underline the importance of purifying the soul together with the body (hint: detoxification is a parasympathetic process and, as such, it works better if you manage stress properly).

If our ancestors felt the need for detoxification practices, why shouldn't WE need them, since we are living in a period of unprecedented toxins exposure?

Let's start digging more into the details of detoxification, starting from...

The lymphatic system

Everybody has a basic understanding of the circulatory system in the human body (blood, heart, arteries, veins and capillares). With a huge abuse of scientific talk, one can say that our bodies have a second circulatory system: the lymphatic one.

The role of the first is to bring nutrients, oxigen, hormones to the organs, help dispose the waste, and is ativated by a pump (the heart). The heart can pump around 5 liters of blood per minute.

One of the roles of the lymphatic system is to drain the extra-cellular liquids (including toxins), to collect them in the lymphonodes and there, reintroduce those liquids into the blood stream. The lymphatic system doesn't have a pump and can generally process 3 liters of liquids per day.

Poor circulation of the lymphatic system causes swelling and water retention or Ĺ“dema. The lymphonodes is "where the magic happens", so the goal is to help the liquids travel towards them. This can be done in several ways:
  • exercise being the first: move, jump, walk, practice inversions... the movement of lymph is propelled by the action of nearby skeletal muscles, the movement of the lungs and the contraction of smooth muscle fibres
  • dry brush massage: remember that the movement is always from the extremities to the core
  • lympho-drainage massages
Many detox solutions propose soaking your feet in warm water with either some special salts or some electrodes. Others propose detox patches to be applied again under the soles of the feet. These methods are becoming quite popular in alternative health circles due to the fascination our feet elicit on our hunger for natural remedies (you know... feet, contact with the ground, rooting, mother earth, network of living-beings, healing energies, etc...).

The claim is that the salty water (or the special patch) pull toxins from your body, the proof is that they become brown. However, considering that the natural flow of lymphatic fluids is from the extremities to the core, this claim is very corageous (my politically correct way to say quackery). There are several causes that explain the browning of the detoxifying support, none of them are actually associated with the action of pulling toxins through the skin.

If a pediluvium helps you feel relaxed and gives you pleasure, feel absolutely free to do it. Don't expect to detoxify any better that you would have done with a good sweat. Sorry... you have to move!

Detoxification pathways

Ok, the toxins are in the blood, the extra-cellular toxins have been collected through the lymphonodes and those too are in circulation again. Let's detox them!

Phase I

Phase I happens in the liver, it uses enzymes (such as cytochrome P450) to break down toxins into intermediate metabolites. Some toxins, at this point, can already be eliminated from the organism, this is the case for example of caffeine, a molecule that impact enormously Phase I detoxification.

For most toxins however, a second Phase is required. Often intermediate metabolites are even more toxic than the original molecule.

Phase II

There are six different pathways within Phase II detoxification. They are required to complete the breakdown of chemicals, hormones and toxins, thus completing the job of Phase I. They do so by binding the intermediate metabolites to specific type of proteins and molecules that "escort" them out of the body.

I won't go into the details however, the list is the following:
  • Glutathione conjugation, 
  • Sulfation
  • Peptide Conjugation
  • Glucuronidation
  • Acetylation
  • Methylation

Enzymes and nutrients: you need to be well nourished!

We need nutrients to manufacture those enzymes that are needed for detoxification. Without the proper nutrients our body won't be able to produce enzymes and molecules to bind toxins to, and we won't therefore be able to properly detoxify.

Diets low in nutrients as well as periods of intense use of nutrients (detox protocols, or long periods of stress) deplete our resources. Often those deficiencies are chronic, that's the reason why, if we decide to start a serious detoxification protocol, we need to follow a properly individualised plan: just like overeating slows down detoxification, ingestion of proper macro and micro nutrients play an important role in our body's ability to detoxify.

Fundamental nutrients for detoxification are, for example, vitamins C and B2. Minerals like magnesium, molybdenum and manganese, which are required to activate metabolic and detox enzymes. Chelation of bad minerals may dispose good minerals at the same time, hence the need for replacement.

It is important to mention that amongst the macro nutrients required for proper detoxification, we also find amino-acids and hence proteins. Food for thought to rethink the food for detox.

Elimination pathways: how toxins leave our body

Once the toxins have been metabolised and transformed, it is necessary to eliminate them from our body.

Digestive system

Our digestive system does way more that breaking down and absorbing food. For example it:
  • scans the food for invaders
  • detoxifies poorly digested food and fermented toxins
  • filters food and intestinal bacteria
  • receives the toxins detoxified by the liver through the gallbladder
  • ... and obviously eliminates toxins and unusable substances from the body through the faeces
Being constipated is not a good starting point for a detoxification diet: if toxins and their metabolites cannot leave the body they will be reabsorbed and reput in circulation. When prioritising the issues, a healthy digestive system always takes the precedence and this includes having regular bowel movements.

I mentioned the gallbladder, such an important and yet underestimated organ: it is through the bile that the liver eliminates some of the toxins it processes. Having a congested gallbladder (often because of low-fat diets) or having a thick, viscous, poor quality bile (usually this is caused by bad fats in the diet) incapacitates the liver to eliminate them.

Bile also stimulates peristalsis, and so elimination of solid waste from the intestine. We often think that when somebody is constipated, the solution is to eat more fiber. That would be the equivalent to try to gush-out the drain pipe of the kitchen sink... by throwing-in a cup of chopped salad. Adding some healthy fats and food that supports the gallbladder may be way more efficient, this is in neat opposition to typical detox diets which recommend instead to eliminate fats...

In the endless list of detox protocols, we also find coffee enemas. My rule is that digestion is a process that works from-north-to-south, not the other way round, so I prefer not to waste time with them. The subject would even be fun if it weren't for the cases of deaths associated to it (hint: fix the causes, not the symptoms).

To resume the paragraph: it is fundamental, before attempting a detoxification diet, to make sure that the stomach, intestines, the liver and the gallbladder are working efficiently.

Kidneys

The primary role of the kidneys is to filter the blood to remove cellular wastes, such as water, bile pigments and obviously toxins that had been processed by the liver.

Kidneys have literally the ultimate task in the elimination of many toxins from the blood, it is fundamental to support them with nutrients and proper hydration.

Once again, it is non-sense and potentially harmful to initiate a detoxification diet if this main elimination pathway is not working properly.

Skin

Skin, or better the sweat glands, can be considered a second kidney, although not as efficient. Some toxins can be eliminated through perspiration and in fact many cultures acknowledged the importance of it.

A very popular mean to have a good and deep sweat going, especially in the winter period, is to regularly spend some time in a sauna or steam room. During summer the best solution is probably to exercise outdoors.

Respiratory system

Last but not least, the respiratory system.

The lungs eliminate a variety of waste products in particular, but not limited to, carbon dioxide. They also play a major role in maintaining the correct pH of the blood: I'll speak more about this in a future article about alkaline/acidic diets.

And now the big question...

What happens when any of these steps is not working? What if we can't metabolise toxins or if we can't eliminate their by-products?

Where and how toxins are stored

In an healthy and well nourished body, toxins are eliminated through the pathways mentioned above. If not, our body's first action is to remove them from circulation: poison should not circulate freely. It decides to stock them in tissues that are not very metabolically active.

Body fat

Fat tissue can store toxins such as metals, petroleum, fat soluble chemicals and other organic and inorganic compounds. Toxins can accumulate in the fat tissue for years, this is a well know issue when eating meat and fats from animals raised in non-organic ways: they are themselves toxic (exposure to toxins, hormones, anti-biotics, stress, etc).

This should also make the reader aware of the potential risks associated to weight-loss programs, especially when a lot of stubborn body-fat is lost in a short period of time. Some toxins that have stayed silent for years are now massively pulled back in circulation, maybe at a pace we cannot keep-up to.

A properly designed weight-loss diet must always take this into account: the detoxification pathways must be working and elimination open. An initial detox protocol can make a tremendous difference between a generic weight-loss diet and a healthy one.

P.S. The brain is estimated to be composed of 60-80% from fat. Fat also wraps our nerves in the form of myelin, meaning that the same toxins that are stored in body fat can be stored in our nervous system as well. An additional reason to choose wisely how to approach the problem of weight-loss...

Soft-tissues, connective tissues, lymphs, joints

This is the second favourite place for our body to store toxins. The good news is that it is also the place from where it is easier to remove them... provided one follows the correct steps.

Bones

Because of its chemical affinity with calcium, bones are the preferred stockage area for lead. Bones are the most long-lasting tissue in our body, but they are not eternal neither. A complete renewal of our skeleton takes from 7 to 10 years.

If you have a history of lead exposure, you may have to cope with it for another decade.

Detoxification diets

Please note that our metabolism is not stupid, it is not storing toxins because it is masochist, it is trying to save our lives: PCBs are better in our belly that in our blood.

As frustrating as it is, once again we cannot blame our body: the sole responsibles are ourselves who introduced toxins and didn't take care of the good functioning of our own detoxification mechanisms.

Detoxifying body tissues takes a lot of time, even years as we saw. This will immediately ring a bell and cast some doubts on some very popular miracolous 7-day detox diets.

The best that can be done in such a short periods is:
  1. to re-open the elimination pathways (first and foremost)
  2. to initiate to support the detoxification phases (Phase-II first, then Phase-I)
That said... most typical protocols of 7-day detox diets are indeed good starting points for a bigger and more in-depth detoxification program. With obvious counter-indications of course (one example for all, juice fasting is not recommended to people with blood sugar regulation issues).

P.S. You may wonder why we need to work "backwards" when reactivating the detoxification pathways (elimination, Phase-2, Phase-1). The reason is that every step requires the following to be working in order not to get stuck in the process. Now... how many detoxification specialists have you met that take this into account?

You are what you eat, literally

Sometimes toxins literally become you. I am speaking of the use of unhealthy nutrients as building blocks of your body, if this doesn't interest you I don't know what will.

Every cell of our body is enclosed by a membrane, this is self-evident. What is less evident is what that membrane of made of.


The membrane is made of a double layer of:
  • phospholipids (fatty acids containing phosphorus),
  • cholesterol,
  • glyco-lipids (fatty acids attached to carbohydrates).
Contrary to popular belief, they are not made of proteins: they are made fat, cholesterol and fat again.

Long story made short, fats are not just a source of concentrated calories like we have been brought to believe. They are fundamental structural bricks of our cells, and therefore our tissues, our organs, and finally our body. They become you.

Now, imagine your body patched with plaques of
hydrogenated palm oil and oxydized cholesterol

How long does it take to rebuild our cells?

In my opinion, the tissue that is more interesting in a detoxification protocol is the blood, since it is the "organ" that links all the other organs together.  Let's not forget that one of the roles of the blood is to deliver toxins to the liver and by-products to the kidneys, the skin and the lungs. For this reason it is also the tissue that is more susceptible to stay in contact with toxins like metals, chemicals, hydrogenated fats, drugs, and such.

Let's take red blood cells: the average lifespan of red blood cells is ninety days, this means that it takes 90 days to make a whole new set of red blood cells.

When I am asked how long a detoxification protocol should last, the unpleasant truth is that one should do it for at least three months. This is very different from the common belief according to which one can eat junk food 51 weeks per year and then detox everything with a 7-day juice fast (if only...).

It also put into a different perspective the frequency with which we should eat clean, and consequently the frequency of exceptions.

Things that may slow down detoxification


Additional toxins

It goes without saying that if one is following a detoxification protocol, the first thing to stop doing is to introduce more toxins into the body. This includes also non-food sources like smoke, chemicals, exposure to radiations and unsurprisingly: stress. Actually, wilful intake of toxins and chronic stress are better avoided all year long.

Caffeine

As mentioned before, caffeine has precedence on Phase-I detoxification. Heavy coffee drinkers may in fact be sabotaging the correct functioning of their detoxification pathways.

In the other hand, because of the fact that caffeine is metabolised only in the first phase, it may be a good ally in case Phase II needs some initial support before it can be fully engaged.

Everything is very subjective and there is not a single answer for everybody.

Nutrients that engage the detoxification phases

I was once at a table speaking with some people I just met. A man mentioned that during a trip to India he followed a detoxification program, and one of the recommendations was to avoid spices during the treatement. He joked on how weird it was to spend time in India and not be allowed to eat their tasty recipes.

I wondered why that should have been the case and immediately recalled my nutrition classes and how phytonutrients, anti-oxidants are indeed processed by our liver to be eliminated. And herbs and spices are great sources of these kind of organic compounds.

Some nutrients support detoxification, others may work against it. While not toxins themselves, they anyway provide additional job to our Phase-I, Phase-II and elimination pathways, with the potential risk to deplete the nutrients that are required for the correct functioning of this complex, yet wonderful, mechanism.

Conclusions

Thanks for reading until the end, and sorry if sometimes in this article I had to digress to complex concepts: I know why you are here, you'd like to read simple and possibly reassuring answers, like:

Alright... so that’s 2 carrots, 1 head of broccoli,
10 grapes, a couple slices of ginger, and some celery

The fact is that our bodies are complicated. I felt it was necessary to be a bit more precise to avoid writing another generic article on detoxification that wouldn't have provided much added value compared to the countless articles that are already on-line.

I hope that this post didn't discourage anybody from attempting a detoxification diet. On the contrary, my expectation is that you maturated awareness of its importance and decide to initiate one, maybe with the support of a qualified expert.

And stay tuned! More exciting stuff coming very soon!

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