September, 2005 - Nr. 9
The Importance of Liver Detoxification
by Dr. Paul Jaconello
Doctor Jaconello is the Medical Director of the Jaconello Health Centre for Nutritional and Preventive Medicine
One of the vital functions of the body is its ability to rid itself of chemical substances, which if allowed to accumulate, would poison the body or adversely effect various tissues causing their malfunction and cellular disruption.
These substances are loosely termed toxins. Even substances such as hormones, if not biotransformed so as to be removed, which a person normally produces would cause cellular disruption. These would be called endogenous metabolites.
We are constantly exposed to exogenous chemicals such as drugs, chemicals as with contaminants in foods e.g. Aflatoxin and carcinogens such as heterocyclic amines in cooked meats.
These xenobiotics, as they are called, are often stored in our lipid (fat) tissues and can be slowly leeched out especially when there is weight loss and this adds an extra burden to the body’s toxic load.
One of the major routes of biotransformation and excretion of these molecules is via the liver which is a key organ that protects us from being poisoned by the above.
This requires the proper activity of particular enzymes present in the liver and is a two step process which requires a lot of energy to function and do their jobs.
So when we are ill with conditions such as chronic fatigue syndrome, fibromyalgia and multiple chemical sensitivities which are characterized by low energy generation, one of the first functions of the body to be affected is the liver detoxification process.
This causes a feed forward effect of the sick person and accentuates all the symptoms a person already has.
So how does the liver biotransform and remove toxins from the body?
Lipid soluble toxicants are initially handled by a group of enzymes called cytochrome P450’s. These enzymes transform the toxicant to an intermediate metabolite which can often be very reactive in its own right and if not transformed efficiently by a second group of Phase 11 enzymes, can actually can cause cellular damage, such as DNA distortion and interaction with other large molecules and lipid membranes of the cell.
These Phase 11 enzymes work by tagging on a second molecule to the reactive intermediates to make it water soluble and more easily excreted into the bile and out into the gut where they are excreted in the faeces and out of the body.
Individuals may have some genetic differences in their detoxification enzymes which leads to an accumulation of the toxic intermediate and an inefficient removal of toxins.
These pathways can be normalized by foods, vitamins and phytonutrients. For instance, Phase 1 can be modulated by B vitamins, glutathione and flavonoids.
As a corollary to this, a compound in grapefruit juice can actually inhibit one of the cytochrome P 450’s that will reduce the biotransformation of certain drugs and can actually increase their blood levels. Statin drugs are one group and blood levels can go to too high a level and cause toxicity. That is why patients on this group of drugs are advised not to consume grapefruits or the juice of grapefruit.
The damaging effects of the intermediate compounds can be subdued by antioxidants such as carotenoids, vitamin C and Vitamin E
Phase 2 enzyme activity can be normalized by certain phytonutrients found in milk thistle, green tea extract, pomegranate, artichoke and watercress.
Phase 11 conjugation involves certain amino acids, specifically glycine, taurine, glutathione, N-acetyl cysteine and glutanine. Also, components of sesame can selectively inhibit one Phase 1 cytochrome enzyme to enhance levels of vitamin E and normalize hepatic function in those who have been exposed to chemicals including alcohol.
Also, rice protein, fortified with the amino acids lysine and threonine, can enhance Phase 1 detoxification. Foods such as cruciferous vegetables, onions and garlic can induce Phase 11 enzymes.
Also, dietary fibre and a good microflora in the digestive tract have advantageous effects on the detoxification pathways. So, proper intestinal restoration and recolenization of the colon with probiotics and non-digestible carbohydrate fibber may be enhancers to the detoxification enzymes.
Also, the energy required by the body to feed these biotransformation pathways is immense. Therefore conditions like chronic fatigue syndrome, fibromyalgia, chronic intracellular infections and postvirral fatigue, which produce energy deficiency in the tissues of the body will produce an adverse effect on these detoxification pathways.
Clinically, this is relevant because a big step to improve these conditions is to treat them with a metabolic nutritional programme to return these pathways to normal and reduce the toxic burden in these afflicted individuals with attendant improvement and physical well being.
Paul Jaconello, M.D.
Doctor Jaconello is the Medical Director of the Jaconello Health Centre for Nutritional and Preventive Medicine.
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