We live in a world where we are exposed to hundreds of toxins each day, but there’s a lot we can do to minimize those exposures and support the body’s natural detoxification systems. Certain nutrients and phytonutrients from foods improve the body’s ability to process toxins and lower the total body burden. While a plant-heavy diet is important, there’s a macronutrient my patients are often missing that is critical to detox. High-quality, lean protein is a must. A protein-deficient diet impairs detox pathways in the liver (called phase II conjugation), and it’s the reason a juice fast might actually leave you worse off.

Detoxification refers to your body’s ability to get rid of waste. If that is impaired, or if we are bombarded with too many toxins, we get sick. The liver is central to metabolic detoxification. It works through a series of enzymes, via pathways referred to as phase I and phase II detoxification. This system is dependent on adequate nutrients, phytonutrients, antioxidants, and protein. These pathways in the liver transform chemicals, hormones, and toxins into water-soluble metabolites that can then be excreted by the intestines, kidneys, and skin.

Phase I is the first line of defense against toxins in the liver. Phase I reactions occur primarily by cytochrome P450 enzymes, which help transform fat-soluble toxins into less harmful chemicals that can be metabolized by the phase II enzymes. This process produces free radicals, which are quenched by antioxidants (like vitamins C and E). However, if antioxidants can’t meet the demands of excessive toxin exposure, too many free radicals can actually cause damage to the cells in the liver. The danger is if these reactive intermediates build up because they are too numerous to be metabolized by the phase II pathways.

Phase II detoxification makes these intermediate metabolites water-soluble via a process called conjugation. This process involves specific pathways that conjugate (attach) molecules to toxins so they can be excreted by the body. There are six major pathways:

. Glutathione conjugation (more on this to come)
. Methylation (we’ll touch on this below, too)
. Sulfation
. Glucuronidation
. Acylation/Glycination
. Acetylation

Glutathione, our master antioxidant, is the most integral part of detoxification. It prevents damage caused by free radicals and makes toxic chemicals more water-soluble, so we can excrete them. Glutathione is made up of three amino acids (cysteine, glutamine, and glycine), and our body needs to regenerate it all the time. Our body makes glutathione through a process called methylation. This is an important biochemical process (involved in many functions) that depends on adequate levels of vitamins B6, B12, folate, and trimethylglycine. Taken together, methylation and the production and recycling of glutathione may be the most important biochemical processes our cells perform.

Finally, phase III detoxification transports the transformed, conjugated toxins into bile or urine for excretion by the intestines, kidneys, and skin. As a whole, a well-functioning digestive system—including the liver, gallbladder, and gut—is hugely important to healthy detoxification.

Christine Maren, D.O., is the founder of a high-tech, functional medical practice in Colorado, Michigan, and Texas. Her upbringing inspired an interest in holistic medicine at an early age, but it was her own personal health challenges with chronic digestive issues, hypothyroidism, gluten intolerance, and recurrent pregnancy loss that motivated her to study functional medicine. Using the functional medicine model, she works with patients to identify and treat the root causes of chronic disease. Her approach to patient care is individualized and personalized, with an emphasis on the ways our environment, food, and lifestyle choices interact with our genes. Dr. Maren is board-certified by the American Board of Family Medicine and is an Institute for Functional Medicine certified practitioner.


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