Breaking Down Detox
Lisa Murray, RDN, LD
Concepts of both external and internal cleansing and purification are thousands of years old and have remained fundamental to naturopathic medicine even today. Good thing, because the number of man-made chemicals and poisonous compounds we are exposed to has steadily increased, along with an ever growing body of research identifying how acute and chronic exposure impacts our health.
Overview of detoxification
Detoxification is the metabolic process by which toxic substances are neutralized and excreted from the body. It’s also called the biotransformation system and is divided into three phases:
Phase I involves the conversion of fat-soluble toxins into water-soluble (but more toxic) molecules. Phase II binds the water-soluble toxin to another molecule making it easier to excrete. Phase III then removes this now water-soluble molecule from the cells and the body.
The difference between a cleanse and a detox
There are a growing number of misconceptions in the consumer world about the difference between a cleanse and a true detox, what each of them do and how they should be done.
Over the past hundred years or so, the understanding that the body dumps toxins into the bowels led to the idea that the bowels must be “cleansed” of their contents on a regular basis to restore health. Variations on fasting as a technique for cleansing and detoxification (for example, the Master Cleanse or juice fasting) can be helpful as an initial, short term kick-start, but certainly not for the long term.
A short 24 hour water or juice fast has the initial benefit of reducing digestive and metabolic load, while still supplying nutrients (from the day before) for detoxification. The problem here, is that a lot of people believe if a little is good, more is better – but that’s just not the case with fasting.
In reality, skimping on nutrients for more than two or three days is not helpful in supporting the body’s detoxification processes. Additionally, many toxins are fat soluble and get stuck or stored in fat tissue. Fasting mobilizes stored fat from tissue to use as energy, and thus releases the stored toxins into circulation. While this can be helpful for toxin mobilization, it can ultimately overwhelm the system and cause toxins to be reabsorbed.
This is the reason a cleanse, which focuses on fasting or drastically reducing calories, must also provide a lot of fiber to bind those toxins. Additionally, it’s common to use natural laxatives to move the toxins out faster.
In general terms, I think of a cleanse as a short term, one week program, undertaken to quickly mobilize and remove some toxins from the system to reduce overall body burden, before embarking on a new health or treatment plan.
When talking about a detox program however, practitioners are often thinking about the following things.
- The program may need to be gentle and gradual to avoid negative detoxification reactions
- The program may need to be longer term, and provide targeted nutrition support
- Compliance is important and the detox program needs to be easily incorporated into a daily routine
Compared to a cleanse that uses fibers and laxatives, a detox program may be a less disruptive way to accomplish the necessary task for patients. Typically, a detox program is undertaken for a longer term (two weeks or more) and involves nutritional support during all phases. Additionally you may recommend fiber for binding toxins and gentle motility support as needed.
Does your patient need a detox?
Detoxification is definitely questioned by mainstream medical professionals. Do the liver, kidneys, and gastrointestinal system really need additional support, over and above what is normally found in the diet? What we know, is that the enzymes that are responsible for the complex processes of detoxification do require co-enzymes and co-factors (vitamins and minerals) that may not be sufficiently present in the diet.
We also know there is a genetic influence between individuals and variation exists as a result of genetic polymorphisms, which determine how well a person’s natural detoxification system functions. Further, how a patient’s detoxification system is or has been working depends on many lifestyle and dietary factors. Looking at the total load or volume of toxin exposure, not just from water and food, but from occupational exposures, hobbies and personal habits should be part of the assessment process that helps determine the need.
Some practitioners report that for any new patient, beginning treatment with a comprehensive and nutritionally supportive detox program for a week or two, can lay the foundation for better or quicker positive outcomes.
How to choose a detox product or program
Choosing the right detox program really depends on the patient. Those who are generally healthy, without a problematic health condition, no aches or pains, who are eating a healthy, nutritious and fairly clean diet, may already have a well-functioning internal detox system. For them, perhaps just the addition of some daily detox nutrients is sufficient or a cleanse if they are interested.
Patients presenting with a myriad of health concerns, who may also be on a number of pharmaceuticals, are probably good candidates for a slow, gentle, thorough, and comprehensive detox.
For them, a cleanse could be disastrous as it would be mobilizing toxins into an already overwhelmed and overtaxed system. Instead, taking a slower, more thoughtful detox approach may be better. A slow and steady program of detox support over a few weeks or even months can be beneficial, both in the short term and in the long run.
As always, there is no substitute for the fluids, fiber and phytonutrients provided from a high-quality, plant-based diet for supporting the body’s natural detoxification system. Promoting cruciferous/brassica veggies, alliums (onions, shallots, leeks, garlic), greens of all kinds and including green herbs like parsley and cilantro and other high antioxidant foods, are critical to keeping the pathways and processes functioning efficiently after any cleanse or detox program has been completed.