the many phases of detoxification
Written by: Dr Kevin Conners (added content by Heidi Neubauer ND)
“We are what we eat. Well, we are what we absorb. Better stated, we are what we don’t detoxify!” ~DR Kevin Conners
Phase 0 – Pulling Garbage Out of the Cells and Intracellular SpacesUnfortunately, this is where many people start when they think they need to detoxify. It’s understandable that we want to ‘get rid of the mercury from our dental fillings’ or ‘detoxify chemicals we were just exposed to,’ but starting here can be very dangerous.
We are indeed all toxic. Every day, the above phases of detoxification happen to one degree or another, and the extent they are hindered is the extent to which we become toxic.
We are what we eat. Well, we are what we absorb. Better stated, we are what we don’t detoxify!
In a magical fairyland, everything you absorb is quickly dumped into the toilet, and all is well. In real life, endless events hinder this, and cells gather poisons to store them away. Hopefully, they will stay there until they die at age 120, but this isn’t always true. If they happen to interrupt normal cell death apoptosis pathways or, worse, affect the replication rate of the nucleus, they are causes of cancer.
We pull junk out of our cells and tissues by using a chelator. A chelator is simply a nutrient that tends to grab onto toxins and escort them back to the blood, where they can circulate to the liver and start Phase 1. However, I hope you’ve come to appreciate the need to ensure Phases 6, 5, 4, 3, 2.5, 2, and 1 are working well before pulling garbage from the cells, or we will re-deposit them elsewhere!
Dr Connors believes that strong chelators should NOT be used if one has mercury fillings in one's teeth (silver fillings) or metal implants.
Phase 1 – The P450sNumerous enzymes and processes are involved in the Phase 1 family, but the 58 known cytochrome P450 enzymes are the most important. While many things happen, we could summarize the process as their ability to take a toxin from the blood and process it to get it out of the body.
For example, one P450, Cyp2C9, is involved with the metabolism of a large number of medications, including NSAIDs, warfarin, and tamoxifen. Cyp2E1 is involved with the detoxification of many industrial pollutants, as well as carcinogens. Cyp2E1 also metabolizes ethanol to acetaldehyde and acetate. Cyp2E1 is also responsible for bioactivating several carcinogens, including cigarette smoke.
Understanding one’s genetic pathway issues comes into play when supporting Phase 1 and 2 liver pathways. CYP and PON1 defects help guide product use.
Phase 2 – ConjugationA transcription factor regulates phase 2 enzymes in the liver called Nrf2 [nuclear factor erythroid 2 (NF-E2) p45-related factor 2]. Nrf2 is key to regulating the body’s detoxification and antioxidant system in other cells as well. When activated, Nrf2 dissociates from the cytosolic protein Keap1 (we talk about this when we look at a person’s genes) and “turns on” the genes associated with phase II detoxification.
Nrf2-modulation by curcumin, sulforaphane, garlic, catechins (EGCg from green tea extract), resveratrol, ginger, coffee, rosemary, blueberry, pomegranate, ellagic acid, and Astaxanthin has proven to be great nutrients for stimulating Phase 2 detoxification.
For example, Sulfur transferase is a Phase 2 enzyme that adds sulfur groups to compounds in order to make them more water-soluble and less reactive. This process is used on various toxic molecules, including phenols, amines, acetaminophen, and food dyes. Many chemicals that are able to become airborne are sulfated. Patients with autism have been found to have impaired sulfation ability, which will make these individuals more sensitive to toxins.
Paraoxonase 1 (PON1) is an enzyme that can perform paraoxonase activity on substrates. This enzyme can hydrolyze and detoxify many different types of organophosphate molecules. PON1 is one of the major pathways protecting people from these compounds. Mutations to PON1 could lead someone to be more sensitive to pesticides and increase one’s risk for cancer. Infants do not have a lot of PON1 activity.
What I recommend:If you are new to a healthy lifestyle, let's begin with the above dietary changes. Start by choosing to eat organically whenever possible. Eat more cruciferous and leafy green vegetables. Choose a salad over a hamburger. Start making smoothies with greens and whole fruits.
Strongly consider having NEXT LEVEL WHOLENESS run a full genetic profile. Phase 1 and 2 pathways are under strict supervision of specific genetic factors, and knowing if you have SNPs influencing these is very helpful. Then, you can hone in on the most appropriate nutritional approach.
Phase 3 – Support Bile Excretion from the Liver (Flow)
As you can see, we are working our way backward. Toxins enter the body through absorption through the gut, skin, or lungs, circulate through the bloodstream, and hopefully head out via the liver through the bile to the gallbladder, to the gut, and the toilet. Our purpose is to aid this process.
Bile exits the liver through the right and left hepatic ducts, forming the common bile duct. Bile leaving the gallbladder exits into the common bile duct, where the pancreas excretes enzymes. Cancers of the pancreas and/or bile duct and liver can interfere with this flow, as can sluggish liver bile production.
Phase 4 – Flushing the GallbladderThe gallbladder is a pocket where your body stores bile. Bile is made in the liver and serves several purposes. It carries the excreted toxins from the liver to the intestinal tract and is the main way we break down fat in the intestine. We have a gallbladder to hold the bile because of bile’s second function. The digestion of fats is extremely important, so bile needs to be in the intestinal lumen when fats are present. The gallbladder holds the bile until we eat fat, causing a contraction of the gallbladder, which squirts most stored bile into the first part of the small intestine.
This process does not work efficiently when we have sluggish bile or stones in the gallbladder. Less bile is present for fat digestion; worse, there is a backup of toxins exiting the liver. The liver becomes congested, and a cascade of problems can ensue, including less liver uptake of toxins from the blood that causes toxins to be stored throughout the body's cells. The liver may increase the production of lower-density cholesterol to help lubricate the process, which can contribute to other health issues.
Supporting gallbladder function is essential. One can get clues to gallbladder problems by seeing an elevated bilirubin on blood work, but functional issues can be present long before this occurs. We suggest doing a mild gallbladder flush on a regular basis and supporting its function with products like Lipo flow and liver care.
Phase 5 – Add a Gut “Binder”Binders, in nutritional-speak, are nutraceuticals that tend to bind to toxins to aid their removal. They are chelators that don’t absorb, staying in the gut to grab onto toxins and escort them into the toilet.
One major problem in clearing toxins is the fact that they tend to reabsorb in the gut and recirculate again. One reason this happens is an excessive intestinal transit time (food takes too long to get through the gut). Going back to Phase 6 helps with this. Another reason is an imbalance in hormones. Estrogens, especially “bad estrogens” (quinone estrogens, 4-hydroxy catechol estrogens), are easily reabsorbed in the large intestine, which is never good. Using DIM (must be used with caution when certain genetic SNPs are present) can help prevent this, as can one or more of the binders, Binder Pro and GI Defend.
Backwards from Phase 6 to Phase 0When we discuss the phases of detoxification, we usually discuss the three phases of liver detoxification. However, if the ultimate purpose is to remove toxins from the body, we must expand upon these steps. I want to discuss the Seven Phases of Detoxification (Phases 0 – 6) and tell patients they had better begin with Phase 6 and work backward.
Phase 6: Proper Elimination:Daily bowel movements and healthy urinary habits are the final steps in removing toxins from the body. One of our cardinal rules is that health depends on eliminating waste, and we want everyone to have regular, daily bowel movements. It is even better to be having several daily bowel movements. If this isn’t happening for you, see the steps below. These are in order of what to try first, second, and so on. It is fine to do more than one of these simultaneously. For each approach listed below, try for a day or two. If you have little or no success, add another approach:
Fiber
Magnesium and Vitamin C
Cape Aloe
Prune, fig, or Plum juice
Dynamic Intestinal Cleanse
Senna Tea
Cascara Sagrada
Coffee enemas (one of my favorites)
Colonics
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