Wednesday, February 13, 2013

I'm doing a detox!

Dusten Nelson

I want to take a few minutes to provide some clarity to the whole concept of a “Detox”.  First and foremost a “Detox” is not a dance thus, one does not DO a detox. Detoxification is a process our bodies are built to perform without us ever lifting a finger, which is a good damn thing because if the body was dependant on us making the right decisions to keep it running smoothly we would have died off as a species years ago. To borrow a quote from an Italian friend of mine “When I came to America I thought to myself, ‘All the people look like little houses’.”  She’s right--we need to take better care of bodies. Thankfully, whatever created us had a pretty darn good design that is rather self-sufficient.

That being said, supporting detoxification is a beneficial and in most situations necessary step in the process of achieving optimal health. The problem is there are a number of companies out there that use the new year as an opportunity to sell us on our need to make good on the health and fitness goals that may have eluded us last year. Most of these companies lack the platform to educate the public on what detoxification is and where you as an individual may be experiencing problems. So instead, they put a bunch of fruits, veggies, and vitamins into a container and sell us a program that promotes eating lean meat (or no meat), increasing our water consumption and cutting out all the processed foods.  Folks that not a detox, that’s called eating a healthy diet and it’s been producing results since the beginning of time - food doesn’t need to come in a box or a bottle to make it work.

Detoxification is not a product that we just buy, drink and suddenly morph into the clean, lean and sexy versions of ourselves. This article will help you better understand the process of detoxification and the various techniques used in the name of “detox”. In the end, you should have a better understanding of what detoxification is, and what you can do to enhance the process.

First-things-first, we need to gain a better understanding of what detoxification is and how it works. So if you will indulge me, I will take a minute to explain the basics of the detoxification process.

The liver is the main organ of detoxification and the target of most detox programs. Its primary role in detoxification is to neutralize or remove harmful toxins in the body (though other organs including the bowel, kidney, and lymphatic system also play important roles as well). The liver achieves this by converting toxins into compounds that are excreted via sweat, stool, and urine. This process is broken into three main phases:

                Phase I: This phase is responsible for the conversion of fat-soluble toxins into water-soluble toxins. Think of this phase as a custodian gathering trash from each office in an office building and putting them in one large container in the basement of the building. This is the phase of the detoxification most packaged “Detox” products focus on.

                Phase II: This phase neutralizes the free radicals generated in Phase I. This phase is dependant on enzymes and co-factors to facilitate mechanisms including: acetylation, glucuronidation, glycine, glutathione, methylation and sulfation to form water-soluble metabolites. Think of this phase as the custodian moving the container holding all the trash into position for the garbage truck. Ideally, all toxins addressed in Phase I are efficiently moved to Phase II, but it doesn’t always work that way, as any inefficiency in these phases of detoxification can cause a build up of toxins.

                Phase III: For most people this is the easiest phase of detoxification to understand; it is simply the excretion of toxins from Phase I and Phase II in bile, feces, sweat and urine for removal. Think of this phase as the garbage company picking up the trash and moving it to the dump.

If you support phase I and fail to support phase II or III, it creates a detoxification log jam. This is one reason it is so important to make sure a detoxification program is right for you as an individual before you start.

Or is it a cleanse?
Now you may be asking yourself, “If that is detoxification then what is a cleanse?”  That’s a great question. I’ve scoured several handbooks on clinical medicine and physiology and never once found a chapter on how the body “cleanses” itself. My best guess is that somewhere along the way an individual or company began marketing a detoxification program as a “cleanse”, the term stuck and now we have a bunch of yahoo’s out there talking about “cleansing”.  A personal observation - the people most often advocating “cleanses” tend to be of the vegan-yogi persuasion. If I were walking in their flip flops I would spend less time worried about “cleansing” and more time trying to figure out why their skin and hair turns grey  (hint: it involves meat).  I rib the vegans but it’s only because they keep eating my foods food.  Did you like how I snuck a BBQ reference in there too?

So what is a Flush?
It is possible to “flush” most bowls and some organs that contain ducts. For example:

Liver:  The liver is essentially a filter responsible for cleaning the blood. If the liver gets congested with fatty deposits that block the ducts it can theoretically inhibit the bodies ability to detoxify. In response to this potential disruption of the detoxification process, it is possible to dilate (open) the ducts in the liver and move the fatty deposits through into to the intestinal tract for excretion. The same can be said of the ducts of the gallbladder. Depending with whom you speak, there can be any number of ways to determine if a flush is needed and how best to perform the flush (None of these important steps are outlined in juice bar literature, on the backs of “flush” products or in programs that recommend you drink lemonade, maple syrup and cayenne pepper). The system I have found most successful for determining an appropriate herbal formula for a “flush” is Traditional Chinese Medicine or TCM.

TCM commonly utilizes diagnostic techniques involving the pulse and tongue, both of which are believed to be holographic representations of the homeostatic balance within the body. Depending on where a licensed Acupuncture and Herbalist (LA.c) finds an imbalance, they can make an herbal remedy to dilate or open the appropriate duct work and “flush” any fat, cholesterol, etc that has become an obstruction.

“A little bit of knowledge is a dangerous thing” – Alexander Pope
I am not going to turn this post into an Essay On Criticism but I might add some witticism (If you don’t get the reference you should read more) Pope must have been referring to the world of detoxification programs when he penned those words. We live in a copy cat world built upon provisional information and if someone can take an idea and make it better we want it. But as my friend Derek Woodske says: "The one thing he can’t live without used to be his gym clothes, now its his cell phone – Not all changes are good."  (more on this in an  upcoming interview)

The same can be said about the current trend of non-licensed herbalist “borrowing” classic Chinese herbal formulas for use in liver detoxification programs. Most of the herbal formulas I see being marketed were not created for use in liver detoxification programs. Though it is common to find multiple uses for the same products (i.e; baking soda) any self-respecting herbalist will tell you that though in some situation these formulas may be helpful, in most situations they will do little to support detox and can create adverse effects. If you truly want to use herbs to support your bodies’ ability to detoxify, work with a licensed herbalist and have them design a custom formula for your personal constitution. – If you have a problem with your car you don’t go to the dentist. If you want to use herbs to support detoxification, speak to an herbalist.

Colon: Colons are the most common organ associated with flushing. It requires less skill and has fewer negative outcomes but they are also the least effective. I am not saying they are worthless – they can do a nice job of moving impacted waste in the bowl.  However, they are often marketed as the key to being lean and that’s simply not the case. Most of the aesthetic changes from a colon flush result from the flushing of impacted waste product in the intestines.  Simple flush remedy’s include a brief (24-72 hour) period of fasting combined with a stool softening medicinal such as Epsom salts (mang xiao) or an over the counter teas such as Traditional Medicinal “Smooth Moves”. These techniques can be very effective in ridding the intestinal track of impacted waste but if used incorrectly can also result in the crapping of once pants or worst - so it best to consult a licesensed herbalist before trying these thing on your own.

Is fasting a form of detoxification? Fasting, though not involved in the detoxification process, can be used to improve health. Fasts are probably the easiest technique of the three we have discussed to use at home because fasting is simply not eating solid food for a period of time. Despite their simplicity, fasts can actually be useful. Fasting alleviates the stress on the digestive system and engages a primal defense system to improve metabolic activity and cellular defense. Research suggests that fasting creates an environment of deprivations causing the response of a genetic factor known as SIRT1. SIRT1 increases activity in fat cells, moving them into the blood stream for energy. Increases in SIRT1 has also been shown to inhibit a protein that promotes inflammation (NF-B). This is important because inflammation is beginning to gain traction in the medical community as the base cause behind a laundry list of degenerative disease processes. (See the February 23rd 2004 issue of TIME magazine).

Fasting for as little as 16-hours, one to four times per month may be enough to activate the SIRT1 gene and see results in reduction of body fat and inflammation. So why don’t we hear more about the benefits of fasting?  First, the only product associated with a fast is water, making it a difficult product for companies to market and sell.  Second, fasting can cause destabilization of blood sugar and increased adrenal stress, so it may not be right for you. That doesn’t mean we should avoid fasting but rather respect it for what it is, a tool to be used in a specific situation to enhance a detoxification program.

What we should take from this?
We are designed to execute the phases of detoxification without even thinking about it…in fact, your body is detoxifying right now. So does the liver need our help? Theoretically no, but practically yes.

Where do we go from here?
We live in a toxic world filled with environmental toxins, toxins in make-up, lotions, cleaning products, water, food, etc (even organic food still has some level of toxins, though significantly less in most situations) Get the point? We are inundated with toxins, and though they body is designed to get rid of toxins, we don’t always give the body the raw materials needed to exist in our overly toxic world.  So here are the top two strategies you will want to include in your detoxification support program:

#1: Reduce the toxic load:
  • Eat clean, organic, unprocessed food.
  • Replace make-up and beauty products (hair care, skin care, etc) with natural, non-toxic alternatives.
  • Replace toxic cleaning products with natural, non-toxic alternatives.

#2. Give the body the raw materials it needs to execute phase I, II and III detoxification.
Phase I – This phase requires significant antioxidant consumption, so eating fruits and vegetables is crucial. Berries, especially blueberries are incredibly high in antioxidants and a great support to phase I detoxification. In every country of the world you will find an indigenous berry that is easily grown, harvested and consumed. The exotic goji berry and acai berry, though heavily marketed and said to do everything including sealing cracks in the concrete are no better as a nutritional source than the blueberry - you can bet that the good ole Buddhist in the Himalayan mountains are getting a good chuckle over the amount of money we spend marketing this exotic cure-all berry from their mystical land.  Nutrient support for this phase often includes Folate (B5), B3, B6, B12, Vitamins A, C ,D & E, Quercetin and N-Acetyl-Cystine.

Phase II – This is where things get tricky. If a detoxification program or product has a weak spot this is typically where you will find it. Phase II detoxification pathways often get log jammed and require specific nutritional support to “un-jam them”. Here are a couple supplements to consider when supporting phase II detoxification:
  • Glycinaton Nutrients - Including glycine, a sweet amino acid.
  • Methylation Nutrients – Including Folate (B5), B6 and B12.
  • Glutathione Nutrients –Including Glutathione spray, N-Acetyl-Cystine, Selenium, Milk Thistle.
  • Sulfur metabolites - Found in cruciferous vegetables, MSM, Calcium D-Glucerate and additional amino acids including Lysine, Carnitine, and Taruine.

For those of you looking for a little more explanation, I picked a few nutrients involved in phase II detoxification and discuss them a little more in-depth at the end of the post.

Phase III – This one is a little less technical, as sweating is probably the most effective way we can support our phase III detoxification. Exercising for 30-60 minutes, four to six days per week will significantly move blood, lymph and sweat and aid in the third phase of detoxification. Clinically three to five percent of sweat from exercise is identified as toxins. Infrared sauna can also be a great tool to support this phase of detoxification. Sweat resulting from an Infrared Sauna, which utilizes heat and infrared light to stimulate the blood, lymph and sweat has been shown clinically to contain as much as 35 percent toxin.

Side note – Despite popular belief, January in the Northern Hemisphere (especially north of 40 degrees of latitude) is not a great time of year to detox. This is a time to boost the immune system and protect the body from getting sick. As the days get longer and warmer with the presence of spring and summer, the body is better equipped to handle a detoxification program. Regardless, people are more likely to start health and fitness resolutions in January than March.

Though I do recommend working through this process with a qualified health care professional, here are the steps I use when designing a detoxification support program that you might find useful in your own program design.

How to select a program to support your detoxification:

Step 1: Goals
I like to start by identifying a detoxification goal(s). A few common goals include:
                Improving Digestion
                Increasing Energy
                Expediting Fat loss (Metabolic detox)
                Reducing Musculoskeletal Pain
                Improving Sleep
                Decreasing Stress

Step 2: Techniques
Decide what combination of detoxification support is best for your goals and constitution. This process often involves selecting which nutritional program, supplementation, herbs, acupuncture, infrared sauna and exercise will best support these goals.

Step 3: Timing
Pick an appropriate time of year to execute the program. As I mentioned earlier, winter is not the best time to embark on a life altering detoxification program. During the cold and flu laden months of the winter, the body is allocating its resources to bolster immune functions and thus we do not want to circulate excess toxins and impair the immune function of the body.  Empirically I have found that performing detoxification programs in January does increase the occurrence of cold and flu. I prefer to run detoxification programs late in February through September.

Step 4: Results
Evaluate results. Detoxification is a process unique to the individual and works best with clearly outlined goals, processes and tracking.

Keep these thoughts in mind as we approach the beginning of detoxification season (in the northern parts of the northern hemisphere) and contact me if you would like to try our detoxification programs for yourself.

Yours in health,


As always, Statements on this blog are intended for educational awareness and do not replace the recommendation of your medical professional. Before beginning any exercise, nutrition or supplementation programs speak with a qualified medical professional and decide which programs are right for you.

A little more info on the nutrients involved in phase II detoxification:

The acetylation process is responsible for metabolizing a plethora of toxins (pharmaceuticals, beauty products, cleaning products, etc).  This process is dependant on B vitamins and Vitamin C to maintain proper function.

A laundry list of amino acids including arginine, cystine glutamine, glycine, and taurine, are involved with various detoxification processes. Consuming significant amounts and varieties of amino acids is crucial to successfully supporting detoxification.

Glucuronidation is a critical detoxification process where the acid (glucuronic acid) binds with drugs, hormones and other toxins. Research has shown that calcium-D-glucarate can inhibit beta-glucuronidase  (referred to as BG from now on) and support phase II detoxification. Milk thistle – and its chemical constituent silymarin not only boost glutathione levels but also inhibits BG. Elevated levels of BG are associated with an increased risk for hormone-dependent cancers, primarily the estrogen driven cancers breast, prostate and colon.

A major antioxidant that aids in phase II detoxification and is a major contributor to the detoxification of xenobiotic compounds. Supplements including milk thistle, vitamin c, N-acetyl cystine, and SAMe have been shown to increase glutathione levels in addition to providing the raw materials of glutamine, cystine and glycine which are amino acids from which glutathione is synthesized.

Methylation is a hot topic these days as an increased percentage of the population is demonstrating inhibited methylation. And requires adequate levels of SAMe, methionine, choline, vitamin B12 and folic acid for synthesis. Methylation is important for the metabolism of several pharmaceuticals as well the production of neurotransmitters

A follow up comment on methionine – when methionine is broken down in the blood it produces a compound known as homocystine. Elevated levels of homocystine (know clinically as hyperhomocysteinemia) can lead to atherosclerosis, heart attack or stroke. Elevated levels of homocystine are often found in people suffering from kidney disease, low thyroid levels, low Vitamin B and low Folate. Additionally, there is an increasing percentage of the population presenting with a genetic variant called Methylenetetrahydrofolate reductase – pronounced just like its written –for those of you that don’t speak a Slavic based language, its simply known as MTHFR –or referred to by a pneumonic that involves coitis with ones mother – but I digress. This little genetic variant impairs ones ability to process folic acid –and thus elevated levels of homocystine and a decrease in the methyl donor SAMe – which is crucial to detoxification.

So here is my point, this is very basic overview of the process of methylation, highlighting the potential implications for detoxification in the liver. If a person has an MTHFR mutation, takes a prepackaged detoxification product that doesn’t address the inhibited methylation ability and uses folic acid instead of a folate blend in their supplementation, not only will the person not support their detoxification ability as intended, but the unprocessed folic acid can create a log jam in the methylation process in the phase II liver detoxification pathway.  Not an effective way to support methylation.

Sulfur containing compounds are used to eliminate hormones, neurotransmitters and several medications including acetaminophen. You can get a significant amount of sulfur from foods including garlic, onions, and cruciferous vegetables (broccoli, cauliflower and watercress) or supplement with sulforaphane.

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