Deprivation? Starvation? Juicing? Reset? It means something different to everyone. In this post I am going to tell you about the science of detoxification and when and how you should do it safely so that you are not weakening your body or releasing toxins into the blood with no where to go. If you really don’t want to read the background you can skip down to the where it says “what can I do” and start taking some steps to strengthen this process in your body!

Why should we care?

The body is constantly in the presence of potentially harmful agents. Environmental compounds can gain entry through the skin, the GI tract and the lungs. These are outside (or exogenous factors). Within our own bodies we produce endogenous toxins from digestion, metabolism, tissue regeneration and various cellular mechanisms that can become dangerous if not removed form the body effectively. An example would be NH3 (ammonia) that our body produces when bacteria in the intestines break down protein. The combination of these two plus any toxins produced by our microbes is our total toxic load.

In our bodies the process of detoxification is the mechanism of transforming these potentially harmful products into compounds that can be removed from our body through breath, sweat, feces and urine. When our body loses the ability to effectively do this because of weaknesses in a pathway (from enzyme deficiencies due to genetic factors or nutrient deficiencies) disease can result because these toxicants interfere with normal cellular function. So when you think of your liver, kidney or colon and you imagine this sludge of toxins built up in there, it may be a good visual but really it’s more about a process of a weakened system. People may drink olive oil and be able to poop out little stones, drink green juice for 10 days and feel lighter because they released all these “toxins” but scientifically this has not been proven to be the case, it is a matter of strengthening the mechanisms by giving your body a break and replenishing the nutrients and enzymes that aid your body in making the toxins water soluble and able to be excreted in a timely matter from the body.

What are these toxins you speak of??

Here is a short list of a few of the things that come into your body that need to be dealt with on a daily basis!

Heavy Metals – this can be as simple as small amounts of arsenic from rice or chicken to large amounts of lead from paint or battery exposure. Other examples: aluminum in deodorant, mercury in certain cuts of fish.

Xenobotics- compounds not produced in a biological system, examples would be pesticides, phthalates in food packaging and cosmetics, PCB’s in plastic.

Latrogenics – pharmaceuticals like prescription medication or OTC like acetaminophen that lowers hepatic glutathione (an important amino acid), alcohol.

Plant sources – like nicotine

Microbial – bacterial overgrowth, yeast and fungi overgrowth from high carbohydrate and sugar diets.

Endogenous – an example is AGE’s or advanced glycation end products which can be present in foods we eat, like charred barbecue meat, but the majority of these happen within the body.

How do I know if I’m toxic?

In the world we live in most humans will be carrying some toxic burden. The way our body’s handle this will differ from person to person based on what we eat, our health, our environment and our genes. (s) Children, the elderly, individuals with poor nutrition or those that are physiologically stressed will be more affected. Skeptics to detoxing will say, that’s what our liver is for! and it does a darn good job at ridding our bodies of unwanted things. And they are right…..in a perfect world. But we do not live in a perfect world, and sometimes our bodies become weakened and overloaded and this process does not work the way it should. (s) In a dysfunctional detoxification system we may see disease states like impairment on childhood development, brain disorders, cancer, heart disease, skin disorders, infertility, rapid aging, and pulmonary disease. Besides actual disease, long-term exposure to low level of toxicants can contribute to DNA regulatory interference or damage, enzyme disruption, oxidative stress, immune hypersensitivity, autoimmune diseases, brain fog and fatigue. Testing on the safety of toxins are done individually, and yes, if our bodies were exposed to one chemical in small doses one at a time our liver could easily make it water soluble and we could just pee it out but we are exposed to a multitude of things daily and it becomes more complicated than that. So in reality we could all stand to give our bodies and livers some love, so lets look at how to do that safely…..

How our body detoxifies itself:

 Barriers like skin protect us, but if something gets in, the body will mobilize than excrete the toxin. This happens in two phases. Phase I is an oxidation step where molecules are converted to substrates for Phase II by enzymes like Cytochrome P450 (CYP). Phase II is called the conjugation pathway and the liver adds another substance (like glycine) to make it less harmful and makes it water-soluble so it can be excreted. Endogenous toxins, diet-derived or pharmacological compounds are converted primarily by liver enzymes to more water-soluble forms in order to be removed from the body. Detoxification involves mechanisms that can make your body more tolerable to exposure, increase the conversion rate of the toxin and/or induce the excretion of the toxin. Each of these steps can be addressed by clinical interventions.

Do I need to do testing?

If you are having major symptoms and want to see what your recent exposures may have been, or to find out what your response is to a toxin and the ability of your body to handle the exposure to know what nutrients to focus on, then yes. Hair, blood and urine testing (all with different pros and cons) can show toxic metals because these metals bind to many tissue proteins and tend to accumulate with repeated exposure. The half-life of metal-binding proteins is somewhat slow, so testing done even months after exposure can reveal elevated tissue levels. It does not show what is stored in your adipose tissue or bone and the only way to find this out is to have a fat biopsy. On the other hand organotoxins (like phthalates) are a challenge because these toxins are removed promptly from body fluids, converted to derivatives and stored in adipose tissues. So only recent exposure will show on a test. One way to circumvent this is to measure urinary products of liver detoxification that can reveal the level of trapped compounds still being processed through the liver long after the first exposure. One thing to remember is that the heavier you are or the more body fat you have the more stored toxins you have in your adipose tissue and when losing weight or detoxing for obese individuals the risk of a reaction to released circulating toxins is greater. (s)

Types of testing:

A few simple blood tests that your doctor runs on you at your yearly check-up can be used as a start. (My ranges will be different than those on your lab slips. Ranges for functional blood tests are a little different than for acute-care medicine. The acute-care model ranges are set to identify and diagnose disease and to fit 95% of the population. Clinically normal ranges are very large and have little practical value except for extreme cases. I look at optimal ranges that reduce the range in which you are declared normal. Functional ranges are used to identify conditions before they become a full-fledged problem.)

Blood urea nitrogen or the marker called BUN (optimal range 10-16 mg/dl) shows the detoxified form of ammonia, so if this is elevated you may have increased ammonia loading and conversion in the urea cycle.

Bilirubin (optimal range 0.1-0.9 mg/dl) will be elevated if impaired glucoronidation (Phase II metabolism of drugs, pollutants, bilirubin, androgens, estrogens, mineralcorticoids, glucocortocoids, fatty acid derivatives, retinoid and bile acids)

Creatinine (optimal range 0.8-1.10) mg/dl Increased creatinine can indicate kidney damage due to an autoimmune disease, congestive heart failure, atherosclerosis or complications in diabetes, even slightly raised should be a major consideration for evaluating toxins because this is a major route of removal.

ALT/AST/GGT (10-26 u/l) – if high may indicate impaired liver detoxification capacity.

Other tests usually run by an N.D. , nutrition professional or functional medicine M.D. if needed:

To show exposure:

Heavy metal testing via hair, urine or blood

Oral cavity mercury vapor (to test fillings)

Metabolites in urine – organic acids test

Microbial products – organic acids test

Porphyrinurias in urine (This pathway to heme is highly active and any disturbance will cause a fast and large accumulation of these intermediates, these enzymes are also widely distributed inhuman tissue and are highly sensitive to many different toxins. These porphyrins can serve as biomarkers of the toxic effects of heavy metals and some drugs).

Assessment of detoxification capacity:

Amino acids and organic acids test

Challenge test (given in high doses to challenge pathway) of caffeine, salicyluric acid, sulfate, cystiene or glucuronide

Assessment of nutrients protective in detox pathways

Sulfur amino acids

Glycine (amino acid)

Minerals – magnesium, zinc, copper, selenium, manganese

Antioxidants – A,E, beta caroteine, COQ10,

B-vitamins

Genetic testing – CYP, UGT, GSTP, NAT and SULT genes (to name a few) can show if you have a possible reduction in the clearance of various toxins or if you have reduced ability of clearing a certain type of drug. These abbreviations represent an enzyme used in the pathway to clear a specific toxin. You can read more here about DNA testing.

What can you do? 

1. Nutrition plays a key role in toxin management. Detoxification pathways are metabolically demanding! If you are deficient in various nutrients, your body may have a hard time with toxicant clearance. Your nutrition status will dictate your response to exposures. (s) Clinical tests can guide nutritional interventions, but if you want to make sure your body is primed and ready to get rid of toxins that enter your body this is a list of the most essential nutrients it will need:

Vitamin C-antioxidant protection (Phase 1)

 B-complex vitamins for liver enzyme cofactors and methylation (Phase 1 & 2)

Lipoic acid for liver protection and antioxidant regeneration (Phase 2)

N-acetylsysteine (NAC) – for formation of glutathione (a key amino acid in detoxification Phase 2)

Cystiene-a sulfur amino acid to be used in sulfation reactions (Phase 2)

Methionine- methyl donor and sulfur supply (Phase 2)

Glycine –  used in liver conjugation (Phase 2)

Essential amino acid mixtures – mitochondrial energy production (Phase 2)

Calcium (Don’t forget you need Vitamin D to absorb calcium) – protection from lead (Phase 1)

Magnesium-liver and other effects (Phase 1)

Selenium – glutathione regeneration and protection from mercury (Phase 1)

Manganese, copper – glutathione regeneration (Phase 1)

Zinc – glutathione regeneration and cadmium protection (Phase 1)

Milk Thistle – supports normal liver function, liver cell regeneration and glutathione production

Curcumin – promotes activity of glutathione s-transferase (an enzyme in Phase 2)

There are many different liver support formulas. This and this (search for Protocol for Life Liver Detox) are two of my favorites.

2. Avoid and remove xenobotics (pharmaceuticals, plastic, cleaning supplies, mold, cosmetics, lotions, perfume ect ect), this may mean modifications of home and work environments.

3. Remove and repair microbial overgrowth like small intestinal bacterial overgrowth, see my post here to read more.

4. An elimination diet can provide a period of absence of food-based and endogenous  toxin exposures. (s) This could be a water fast or a juice fast, but remember those with high body burden must be very careful with fasting. The absence of food can increase mobilization of stored toxins and this heightened detoxification will demand extra nutrients (including protein!). Get your nutrient levels high and your overall health in check (including pooping!) before attempting various juice diets.  I would rather see someone do a fast that includes a healthy diet (like intermittent fasting) rather than juicing alone. This can limit the number of new food-based toxins entering your system and help you shed weight.  Fasting may have some mental health benefits, and of course, fasting can have spiritual benefits; it is often a religious practice.  But you need to be careful.

5. While reducing our toxic load you must remember that eliminating the toxins is just as important, if they are left to float around in the blood they will cause damage. Use of dietary oils may stimulate bile flow (especially olive oil) and help with gall bladder emptying.

6. High fiber diets can help speed intestinal transit time and assist toxin removal through the feces. This may help avoid re-acquisition via hepatic recycling. If you are not regular, a detox diet is probably not for you as you will not be able to eliminate the toxins appropriately. Magnesium citrate before bed can help move the bowels.

7. You can eliminate toxins through the skin! Exercise, sauna and massage can help stimulate toxin loss the increased blood flow and sweat.

8. Alcohol detoxification is a whole other blog that I will be writing soon stay tuned!! But remember alcohol inhibits a lot of the enzymes we discussed above and can weaken the body’s detoxification capacity. Limit to 1 drink per day for women and 2 drinks per day for men.

Do I think you should do chelation therapies, extreme juice fasts, coffee enemas, gall bladder cleanses ect ect? Before attempting any extreme measure do your research, talk with a nutrition professional and look at the pros and cons. Can you achieve the same (or better and safer) results by first attempting to clean up your diet, reduce your exposures, add in some nutrients, lose some weight? That is for you to decide. I’d like to do a post on the scientific research behind these modalities (although there is not much) but that is for another time….for now work on your overall health so your body can do what its suppose to (and wants) to do!

In Health, Michelle

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23andMe is a saliva-based direct-to-consumer personal genome test. It’s a fun way to learn about your ancestry and genetic traits that explain why you are the way you are! What is a genome? A genome is an organism’s complete set of genetic instructions. These instructions tell our body how to make proteins and molecules essential for growth, development and health.

Although the data 23andMe gives you is very interesting, you probably already knew that you have blue eyes or that your pee smells when you eat asparagus (you will find this out if you get the $199 test). Some interesting things you might not know is whether you have slow or fast twitch muscles. As a former marathon runner I guess I instinctively knew that I wasn’t really cut out for 26 miles and that all my running friends seemed to have greater success on the same running plan. It was nice to confirm that my muscles are more suited for sprinting! You can also find out if you metabolize caffeine fast or slow…don’t you hate those people that can drink coffee at 9pm and have no problem falling asleep! Or how about whether you are more likely to move in your sleep and even if you are more prone to be lactose intolerant!

There are 41 carrier status reports, which could be useful if you are planning on getting pregnant. From the website: “Carrier status tests detect genetic variants that can cause inherited conditions. These variants are often found primarily in certain ethnicities. Being a carrier means you have one variant for the condition. Carriers typically don’t have the condition but can pass the variant to their children”.

The ancestry section is pretty cool and gives you a good breakdown of your ancestry composition. If your mom and dad get the test too, you can merge your data to see how much of your ancestry composition came from each parent. I gave both of my parents the kit for Christmas and am looking forward to reviewing their results. Overall for $199 (sometimes on special for $149) it is a pretty interesting test, especially if you are a data nerd like me. If you want to just find out ancestry and still get the raw data file just pay $99!

Buy a 23andMe test here.

The Basics

DNA contains instructions for how your body works; it is made up of 23 chromosomes in pairs of two, one from each parent. It is made up of smaller units or building blocks (usually seen as A, T, C or G) when you combine these units into sequences they are called genes. One DNA sequence might tell your body how to make protein; these proteins might go on to build muscle fiber. In humans most of our DNA sequences are the same. It’s the 1-2% that makes us different. These differences are called variants or SNP’s (single nucleotide polymorphism) and this is what a DNA test shows, the differences that affect our ancestry, traits and health.

Let’s talk about limitations

The information on 23andMe is put together in neat reports, but beyond the limited data they present to you on-line, you enter more of the unknown. In 2013 the FDA shut down 23andMe because they were giving too much health/medical information. In 2015 they came back and the data they now give is useful but limited. But…you can download your raw data file with thousands of results to many websites that will interpret your data for you (you get the raw data file with the $199 and $99 test). But here’s the thing, just because you have a specific abnormal trait does not automatically mean anything is wrong with you. It may mean that there is a greater likelihood that the enzyme that gene produces won’t function as well but it is not a given. I see people bringing their genetic SNP reports they got on-line to their doctor convinced that this is what is wrong with them. I also see practitioners supplementing based just on one SNP. Take our Methylation pathway for example, the MTHFR SNP has gotten a lot of press lately as approximately 40-60% of the population (I see differing statistics everywhere) has at least one gene that contains a polymorphism. Practitioners are loading their patients with folate and B vitamins to help the pathway, which will help some people but if you don’t look at the big picture and some of the other related genes and environmental factors you may be affected negatively. It’s a new science and I believe it’s the future, but it’s newish and we need to proceed with caution. Find someone with experience and a working knowledge of metabolic pathways in the body to work with before jumping to conclusions. Having said all that, it is really fun to run these reports (for data nerds and people who can handle it.) If you are prone to being a hypochondriac proceed with caution!

How to read most reports you can run on-line:

There are two copies of each gene in your genetic profile, one copy from each parent. When both copies have a specific polymorphism it usually reads +/+ and is called homozygous (red in a lot of reports). If you have one copy from only one parent it will read +/- and is called heterozygous (yellow in a lot of reports). The + and the – specification refer to whether the gene has a change from what the report determines is the norm (and why occasionally reports/labs will vary depending on what reference database they use). If you see -/- (green in a lot of reports) then that means your DNA for that particular SNP is deemed “normal”. In some cases having a +/+ will actually increase the strength of the enzyme that gene produces and is considered abnormal but good and in some cases it decreases the efficiency of that enzyme and will be considered bad (not all reports make this designation and hence why some are hard to read unless you know what you are looking at).

Links to sites I liked and a short review

Again proceed with caution if you do this alone! Research your butt off before you draw conclusions or find someone to help you interpret, and remember it is for educational and informational purposes only unless you work with a genetic counselor, but have fun, this is some really interesting data to dig into!

https://athletigen.com – Exercise and athletic characteristics, free! Here is an article in USA today about how the Baylor Football team is using this genetic information to create individualized training programs for their players.

https://codegen.eu – Tons and tons of information, easy to use, Loads directly from 23andme, free!

http://www.compass.dna.land – easy to load file, takes awhile to process up to 24 hours, once loaded you must download a VCF and TBI file on to your computer. There is a lot of data but a little cumbersome to use, you have to know what you are looking for! Free!

https://www.dnafit.com -Nice website, you can sign up to get 14 daily emails about various genetic topics. Personalized fitness and nutrition genetic reports, cheapest report is $159. I did not buy one.

https://www.foundmyfitness.com Connects directly to 23andMe. Small amount of information but its good info. Free or you can make a donation. Report has most of the common single nucleotide polymorphisms that Dr Rhonda Patrick likes to talk about in podcasts and during presentations, a lot of relevant videos/news on the website.

https://www.gedmatch.com/ Easy to load, takes a few days to process. Data matches you to people with similar traits and/or genealogy. You can be public or private.

http://www.geneheritage.com All reports are $2. Only presents 8 genes, can compare to family members.

http://geneticgenie.org Only gives information on methylation and detox SNP’s so if you just want to know if you have the MTHFR SNP use this. Easy and free!

https://genoomy.com I like this report, they have a sample to look at. It color-codes your traits so you know if it’s good or bad and gives references. $19 for one report. (did not order)

http://www.impute.me Easy to load, decent report categories but hard to decipher what is bad and good. Free!

https://www.infino.me Easy to load, this is a project to try and understand the relationship between genetics and obesity, you can also connect a fitness tracker to join the study. The gene reports are presented in graphs. It’s a lot of info but need to know what you are looking for; association reports are presented if they exist.

https://knowyourgenetics.com One of my favorites, easy to use, supplement info on your methylation pathway. Also books and lectures available about genetics written by Dr. Amy Yusko.

https://livewello.com $19.95 for a gene variance report, paid subscription for more in depth nutrition reports. One of the more popular user-friendly sites.

https://www.nutrahacker.com Good methylation and detox plus supplemental recommendations, free. 4 other paid reports. Easy to load data.

https://opensnp.org For sharing and finding people with similar SNPs

https://promethease.com A lot of free information, report is $5. Information pulls form Snpedia. This site was recommended to me as the best by someone with genetic experience.

https://www.selfdecode.com Great reports, selfhacked.com is the founders website full of great information on genetics and health. $19.99/month but cancelable

https://seekinghealth.org/product/strategene/ The website of Dr. Ben Lynch. He does a lot of training in gene education to practitioners and the public. This report mostly focuses on a few main pathways with drawings. $45 for one report. (I did buy this $45 report)

Let me know if you have found any other sites you like. Don’t forget, you only have to run this report once your DNA will never change. The way it expresses itself though is up to you. The field of epigenetics has shown that lifestyle factors: what you eat, where you live, how much you exercise ect. can influence the way your genes are expressed. You can actually change the way your genes are expressed without actually changing the underlying DNA sequence. It is never to late to improve your health and teach your cells to read your genes in better ways. Don’t let a history of heart disease or Alzheimer’s in your family create your destiny. Find out the genes that might influence these disease states and whether yours are active and use nutrigenomics (how food and supplements effect gene expression) to optimize your nutrition based on your genotype. Genes are cool!

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