On today’s episode of The Modern Vital Podcast, we’re going to talk a little bit about detoxification and why it might make our symptoms worse.
Our Modern Vital Fact of the Day is that sometimes, when zinc is high in our blood, it’s actually low in our cells. In other words, high zinc might indicate low zinc. We have proteins in our bodies called metallothionines, and they play a critical role in serving as a kind of reservoir for our intracellular zinc status, in other words, the zinc that is inside of our cells.
But they also protect us from things like heavy metal toxicity, and they play a crucial role in protecting us from the potential damaging effects of heavy metals like cadmium and mercury.
Metallothionines can bind to cadmium and mercury and sequester them or keep them at bay, thereby reducing their ability to induce cellular damage. And then our zinc stores can be lost in this process, because the metallothionines are sloughing the zinc or no longer binding it, and then it gets shunted out of the body And this can show up as high levels of zinc in the blood or in the hair on a hair mineral analysis.
In other words, if our metallothionines are being used up, our bodies are protecting us from oxidative stress and it could possibly be due to heavy metal toxicity, but it also could induce a zinc deficiency, and this is another reason why it’s critical to work with a highly skilled holistic practitioner or naturopathic physician.
So on today’s episode of The Modern Vial Podcast, we’re going to discuss detox. In our bodies. We have two well-known phases, Phase I and Phase II detoxification, both of which mainly take place in the liver.
In naturopathic medicine we also have five main organs of elimination, which I’ve discussed a little bit on the show. These are called emunctories and they include the liver, the kidneys, the gut, the skin, the lungs. There is also a loosely agreed upon Phase III detoxification pathway, which is basically the pathway of elimination, the pathway of excretion. It’s the process where the stuff is actually taken out, such as in the urine or in the stool.
Anyway, Phase I and Phase II detox are both quite different. The first step, Phase I, takes fat soluble toxins…most toxins are fat soluble…and makes them more water soluble. The enzymes responsible for this process are called cytochrome P450 enzymes, also known as CYP 450’s.
Basically, toxins are chemical compounds that have these functional chemical groups attached to them, and these chemical groups get transformed by various chemical processes in the body and they have fancy words like oxidation, reduction, and hydrolysis, which just means cutting with water. The cytochrome P450 enzymes use oxygen in order to catalyze their reactions and they can metabolize a wide range of substances like drugs, persistent organic pollutants, also known as POPs, toxins, etc.
And there are many nutrients that are required for this phase to function. So if we don’t have these nutrients in our bodies, this isn’t going to work very well. And these nutrients include B vitamins, particularly B2, B3, B6, B9, and B12. That’s riboflavin, niacin, pyridoxine, folate or methylfolate and methylcobalamin, and these play a role in our bodies as cofactors and in enzymatic reactions.
Free radicals are generated during this phase, adding to oxidative stress, and so antioxidants like vitamin C, vitamin E, selenium, glutathione…these are all essential to protect us from the oxidative stress that is generated during detoxification.
It’s kind of paradoxical that when we detoxify, it actually produces oxidative stress, oxidative damage, inflammation, and if our bodies don’t have what they need to combat this, it can also make us a little bit worse. We’re at higher risk of damage from oxidative stress during detoxification.
So these antioxidants that I mentioned, like Vitamins C and E, they are scavengers and they will scavenge the free radicals. I kind of think of them sometimes like Pac-Man gobbling up those little yellow balls as well as ghosts. But these antioxidants help scavenge free radicals. They protect us from potential damage caused by the reactive intermediates of detoxification. They basically mitigate for us. They are mitigators.
Also, minerals are involved…zinc, magnesium, iron. These are all critical for proper functioning detoxification pathways. For example, heme iron is a critical structural component in the cytochrome P450 enzymes. So if we’re low on iron, which we talked a little bit about last episode, that would also potentially compromise our detox pathways.
An important point is that many toxins in our bodies are fat soluble and they can hide in our fat and they could never leave, or they could leave when we least expect it, or over time they can leach out of our bodies, out of our fat, out of our tissues, into our blood and make us sick. Or they might all come out at once during, like an intensive period of fasting or weight loss due to a condition such as cancer or cachexia.
Once a toxin has been transformed in Phase I, then it’s ready for step two, Phase II, and the toxin basically is further modified by a process, another fancy biochemistry term called conjugation, which means to join, and basically it just makes the toxin more water soluble so that it can more easily be eliminated from the body through the urine, the stool, etc.
Different groups of molecules are transferred onto the activated toxins. Molecules like glutathione, glucuronic acid, sulfate, methyl groups, acetyl groups. You don’t have to remember all these. We’re kind of geeking out a little bit here.
Basically, the idea is that several different enzymes are involved and we have all of these different attached groups that are changing the structure and the function of these toxins so they can be excreted by the body. Enzymes come along, enzymes like GSTs, UGTs, SULTs, sometimes called SULTs, and NATs, sometimes called NATs. The GSTs involve glutathione, the UGTs involve glucuronic acid, the SULTs involve sulfate. So each thing is kind of named after the most critical compound in it.
Some of these conjugates, such as the ones processed by the UGTs and SULTs, can be excreted in the bile. Now remember, the bile is made by the liver and it is stored in the gallbladder and then it’s secreted into the lumen of the gut. The lumen is just the opening, the space in the gut to emulsify fats, that is, to break down the fats and extract the fat soluble vitamins like vitamins E and A and so on. Pretty important.
And so people who’ve had their gallbladder removed, a process known as cholecystectomy, are at higher risk of environmental toxicity, because when these conjugates have been ready to be excreted in the bile and there’s no gallbladder present, then it’s not going to happen as well. Right?
And it’s estimated that 20 to 25 million people in the US alone have gallbladder disease and a significant fraction of those have had their gallbladder removed.
Now the nutrients involved in Phase 2, there’s many of the same characters, but one important point is that amino acids are particularly important here. Cysteine, glycine, methionine, these are the amino acids that make up our master antioxidant, glutathione. It’s interesting, I don’t usually think about this very often but another reason to eat protein is to make glutathione and to make antioxidants in your body.
So in other words, protein also plays a huge role in supporting our detox pathways. Antioxidants, essential in Phase 2, we already mentioned most of them…glutathione, vitamin C, vitamin E, selenium. And then we also have the B vitamins…B6, B9, B12, particularly, again, those are pyridoxine, methylfolate and methylcobalamin. And then the minerals magnesium and zinc also act again as essential minerals cofactors and play a role in enzymatic reactions.
As a side note, sulfur-containing compounds, like the ones we find in cruciferous vegetables… broccoli, kale, cabbage, and also in onions and garlic, also greatly support Phase 2 detoxification.
And it’s interesting because there’s a disease or a condition called Gilbert’s and it’s where we see elevated bilirubin on a comp metabolic panel. Now, bilirubin is a breakdown product that’s got a yellowish pigment and it’s a breakdown product from red blood cells and we see it in our blood on a comp metabolic panel. When it’s abnormally high, that usually indicates the person has what’s called Gilbert’s’ disease and there’s no morbidity or mortality associated with Gilbert’s. It’s a benign condition. However, to us naturopathic physicians, it does indicate that the detoxification pathways aren’t working as well, and oftentimes just by adding a bunch of extra cruciferous vegetables to the diet, vegetables containing sulforaphane, which is an active compound found in them. Oftentimes this will correct the elevated bilirubin.
Now we already mentioned some practitioners refer to Phase 3 detoxification as elimination or the actual removal of the toxins by way of urine, stool, etc. The point I want to make is that if the organs of elimination are not functioning properly and this is very common the organs of elimination, like the liver, the kidneys, the genito-urinary tract (which really comprises the kidneys), the gut, the skin…we see a lot of conditions where there’s constipation, where there’s urinary retention, where the pores and the skin are clogged. If these organs of elimination are not functioning properly and we aggressively go on a robust detoxification protocol that moves Phase 1 and Phase 2 pretty quickly and rapidly, we’re likely to get sick and get worse if we haven’t also nourished and supported and brought back online, so to speak, the organs of elimination, also known as the emunctories. Very key point, and this is the one reason you should never really try this at home. You really need to be working with somebody who understands detoxification.
Toxins can end up in the blood or the urine or the stool during detoxification. Think about it. These substances are being made more water soluble, but they’re still in the body. But if there’s no way to move out, the blood and the urine are going to become more toxic. That’s going to make us sick. If our liver and kidneys and gut aren’t moving the fluids and the materials properly, if our lymphatic system, the drainage system…I like to think of it as the sewer system of the body…if our lymphatic system is not working properly, if it’s all clogged up, then we’re going to become more toxic during detoxification and we’re likely going to experience adverse reactions and symptoms of just feeling like crap. Malaise, headache, fatigue, joint pain, feeling like we’re coming down with a cold or a flu, constipation, brain fog, and this is another reason why we really never want to do this too fast and we need to do it with someone who understands the process.
So that concludes today’s episode of The Modern Vital Podcast. We would love to hear from you. We really value your feedback. If you have any questions or suggestions, please reach out to me at firstname.lastname@example.org. Also, please leave us a review if you enjoyed this episode and we look forward to having you join us next week for another exciting episode of The Modern Vital Podcast.