‘Liver detox’ usually makes people think of things like juice cleanses, liver flushes, or intensive fasts. The reality, however, is that the process of liver detoxification is much more nuanced. (Read: there may be more targeted, effective ways of supporting liver detoxification that don’t involve starving yourself for weeks, depleting your lifetime lean muscle mass, or risking an emergent gallbladder condition.)
Our bodies have multiple physiological means to process and dispose of chemicals and waste, which is why understanding the liver’s innate detoxification process can be helpful. Check out the following process to learn ways you may need more support.
Sequence is Key
The important thing to know about liver detoxification is that it occurs in stages and that it is very individualized. Like doing a deep clean of your own home, it wouldn’t make sense to start gathering up a bunch of waste to throw out or recycle if you weren’t sure about whether or not the garbage and recycling trucks are available for pick up (or whether or not you can even open the doors to the house). So whether we are talking about the body’s own mechanisms for detoxification, or a supported ‘cleanse’, having functional resources at each stage along this process is key. If not, you could end up with a bigger mess than when you started.
Phase 1 Detoxification: Redox Reactions
The first step in our body’s innate liver detoxification involves breaking toxins down and transforming them into less harmful, water-soluble molecules.
This process involves oxidation, reduction, and hydrolysis reactions and creates reactive oxygen species (free radicals). Free radicals—if allowed to persist—can lead to inflammation, DNA damage, unwanted immune activation, and tissue damage.
Therefore, it’s important to move out of this stage as quickly as possible via PHASE 2 and PHASE 3. This also why eating a diet rich in antioxidants (vitamin C, E, and A), phytopigmentation (eat the rainbow), and minerals (zinc, copper, selenium).
It’s also one possible explanation for why folks may feel horrible if they engage in activities that promote PHASE 1 detoxification when PHASE 2 or PHASE 3 aren’t working properly. Substances that promote PHASE 1 detoxification include: weight loss/nutrient deprivation, consuming alcohol or coffee, excessive amounts of circulating hormones or medications, and several industrial chemicals.
Phase 2 Detoxification: Conjugation
PHASE 2 involves conjugating (which means linking) specific molecular groups to the products from PHASE 1 DETOXIFICATION to make them less harmful. This process prepares them for discharge into the blood or bile for excretion.
There are six main types of molecules that can be conjugated in this step:
Glucuronidation
Glutathione conjugation
Sulphation
Methylation
Acetylation
Glycination
Each conjugation pathway supports the detoxification of different kinds of chemicals and each requires a different set of nutrients and cofactors.
Impaired Phase 2 Detoxification
In an ideal scenario, each of these complex detoxification reactions takes place naturally in the body — especially when there are enough nutrients, minerals, and enzymatic activity to do so. However, in reality, each individual person may have a specific difficulty with one or more conjugation pathways due to nutrient deficiencies, chemical exposures, specific health conditions, or genetic defects in the enzymes that code for the conjugation pathway.
Phase 3 Detoxification: Drainage
Next, specific transport proteins remove the newly water-soluble toxins formed from PHASE 2 CONJUGATION pathways and are released from the liver into the bile or bloodstream.
Toxins that made their way into your bile are eventually released into your digestive system. And bile can be excreted through your stool.
Toxins that enter your bloodstream are filtered by your kidneys and excreted through urine.
Start with Phase 3 and Work Backwards
People who have any measure of impairment in the intestines, bladder, or kidneys may have difficulty keeping this detoxification process operating smoothly. For this reason, it’s important to stay hydrated as well as treat the root cause of any chronic digestive or urinary tract dysfunction.
In addition, liver detoxification is also dependent upon unimpeded fluid flow, including the venous blood it receives from the digestive and pelvic organs. Interestingly, the liver is able to expand up to 40% to absorb additional fluid. So, people who have excessive swelling in the abdomen or uterus may experience congestion, swelling, and tension in the right side upper back as part of their digestive or hormonal pattern. Other people may have physical structures impeding fluid flow (e.g. fibroids, endometriomas, or contusions from past surgical procedures or accidents) and these blockages can curtail detox rates.
Your Body is An Ecosystem
Finally, while there is plenty of emphasis in elimination, purification, and ‘cleansing’ within wellness spheres, it’s important to know your own body’s constitution (individual tendencies). Does your body tend towards robust energy and a tendency towards accumulation? Or, do you tend to be easily depleted and exhausted? Either set of circumstances may influence how you approach liver detoxification support. Do you need to focus on reducing exposures? Or work towards nourishing yourself consistently and more thoroughly? Or, is it a combination?
Supporting liver health can impact baseline health levels, but you may want support or guidance in determining the best next steps for your unique set of conditions.