need an internal spring clean? · pesticides, toxic metals, food additives, preservatives, drugs 12...

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Nutri Ltd

Liver Detoxification

Gemma Warburton BSc (hons), MScNutritionist & Regulatory Affairs

Version: 12

Need an Internal Spring Clean?

• We are bombarded by a host of different

toxins every single day

• The body cannot always handle the overload

present in today’s environment

• Toxin overload can lead to a wide variety of

health problems

• Optimally functioning

detoxification processes

therefore essential to good health2

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Short Quiz to see if you are toxic:

1. Do you breathe air?

2. Do you drink water?

3. Do you eat food?

Answering “Yes” to one of more of the above means that you have a toxic burden.

Courtesy of; Dr Walter Crinnion N.D. Environmental Medicine Specialist.

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Functions of the Liver

• Detoxification and excretion

• Metabolic functions

• Synthesis functions

• Storage functions

• Secretory functions

• Endocrine functions

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Today - Liver Detoxification

• Symptoms associated with an under

functioning detoxification system

• The negative impact of toxins on health

• Overview of detoxification processes

• What can go wrong with detoxification

function

• Protocols to improve function of

detoxification processes

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Symptoms associated with under-functioning

detoxification systems

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Abnormal pregnancy

outcomes

Fertility problems Mineral imbalances (espec Zn

and Ca)

Atherosclerosis Fibromyalgia Multiple chemical sensitivities

Mood swings Headaches Muscle pain and weakness

Cancer Increasing sensitivities Non-responsive/recurrent

yeast infections

CFS Joint pain Panic attacks

IS depression Kidney dysfunction Parkinson's disease

Contact dermatitis Learning disorders Tinnitus

Fatigue Memory loss Unusual responses to Rx or

supplements

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What is a toxin?

• Any compound that has a detrimental effect

on cell function or structure, also called

xenobiotic

• Of the 100,000 potential environmental toxins

identified, only a proportion have been

checked out individually. Mixed

cumulative effect of these is

unknown

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Detoxification

• Any process used to decrease the negative

impact of xenobiotics or toxins on bodily

processes

• Detoxifications involve around 60% of daily

energy consumption

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Major Detoxification Pathways

The Gut:Eliminates waste, is a

detoxification organ and potentially a source of

toxicity (endotoxin)

Support with:4R programme

The Liver:

Metabolises toxins (phase I and phase II pathways) for

excretion in bile or urine

Support with:

Alkalising Metabolic Food

The Kidneys:

Toxins are sequesteredin renal tubules for

excretion in urine.

Support with:Alkaline foods.


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Where do Toxins Come from?

• Endogenous – toxins produced within the

body: end products of metabolism, metabolic

by-products released from intestinal bacteria,

free radicals generated during detoxification

• Exogenous – environmental toxins: industrial

chemicals and combustion pollutants,

pesticides, toxic metals, food additives,

preservatives, drugs

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Persistent Organic Pollutants

“These findings suggest that persistent

organic pollutants (POPs) may be associated

with type 2 diabetes risk by increasing insulin

resistance, and POPs may interact With

obesity to increase the risk to type 2

diabetes”

Lee D et al.(2007) Association between serum concentrations of persistent organic pollutants

and insulin resistance among non diabetic adults. Diabetes Care. 30:622-628

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Pollution on Your Plate

“The available information indicates that

POPs residues are present in all categories of

foods, including baked goods, fruit,

vegetables, meat, poultry and dairy products.

Residues of five or more persistent toxic

chemicals in a single food item are not

unusual, with the most commonly found

POPs being pesticides, DDT (and its

metabolites , such as DDE) and dieldrin”

Schafer KS and Kegley SE. (2002) Persistent toxic chemicals in the US food supply. J Epidemiol

Community Health. 56:813-81713 14

Environmental Obesogens

“Recent evidence from many laboratories has

shown that a variety of environmental

endocrine disrupting chemicals can influence

adipogenesis and obesity. Obesogens can be

defined functionally as chemicals agents that

inappropriately regulate and promote lipid

accumulation and adipogenesis”

Grun F and Blumberg B. (2009) Endocrine disrupters as obesogens. Mol Cell Endocrinol. 304(1-

2):19-29

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Bisphenol-A is a Major

Obesogen Candidate

“Given its prevalence in the environment,

presence in serum from humans worldwide,

suppression of adiponectin and increased IL-6

and TNFα release at nanomolar

concentrations, BPA may be a bona fide

endocrine disruptor that adversely affects

metabolic homeostasis”

(2009) Effects of bisphenol-A on adipokine release from human adipose tissue: implications

for the metabolic syndrome. Mol Cell Endoctinol. 25;304(1-2):49-54

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Diet

Metabolic

Syndrome

Genetics EnvironmentActivity

Insulin

resistance

atherosclerosis

hyperlipidaemiadiabetes

hypertension

Adapted from: (2009) Effects of bisphenol-A on adipokine release from human adipose tissue: implications for the metabolic syndrome. Mol Cell Endoctinol. 25;304(1-2):49-54

Central obesity

Bisphenol A

AdiponectinInflammatory

cytokines

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• A major source of exposure to BPA appears to

be food, especially food packaging

• An organic, fresh (no cans or plastics) food

diet dropped BPA levels by 66% in 3 days

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Bisphenol-A is a Major

Obesogen Candidate

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Toxic Metals

“The clinical consequences of mercury toxicity

include hypertension, CHD, MI, CVA,

generalised atherosclerosis and renal

dysfunction with proteinuria. Heavy metal

toxicity, especially mercury and cadmium,

should be evaluated in any patient with

hypertension, CHD, or other vascular disease”

Houston MC. (2007) Altern Ther Health Med. 13(2):s128-33

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Detoxification Systems

• Majority of toxins are fat soluble

• Water soluble toxins are excreted through urine

• Fat soluble toxins are converted to more water

soluble molecules for excretion through bile /

urine

• Phase I transforms toxins into progressively

• Phase II more water soluble substances

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Phase I Detoxification

• CYP450 enzyme system

- oxidise, reduce, hydrolyse

• Broad specificity

• Generate highly reactive intermediates, which

provide reactive sites for larger water soluble

moieties to attach

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Phase II Detoxification

• Binds highly reactive intermediate from

Phase I to another molecule converting it into

a non-toxic, water soluble molecule that is

readily excreted (conjugation)

• Conjugation steps:

Glucuronidation Sulphation

Methylation Glutathione conjugation

Acetylation Amino acid conjugation

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Water-soluble

molecule

Phase II

[conjugation pathways]

Phase II

[conjugation pathways]Phase I

[cytochrome P450 enzymes]

Phase I


Lipid-soluble

moleculeActivated

Intermediates

Serum

Kidneys

Urine

Bile

Faeces/ stool

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So What Goes Wrong?

• Imbalanced Phase I and Phase II

• Nutrient deficiencies

• Toxin overload

• Impaired gall bladder function

• Imbalanced bacterial flora

• Intestinal permeability

• Excessive oestrogen exposure / impaired

oestrogen metabolism

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Recommendations

• In any detoxification programme address

constipation first:

- Organic pureed papaya (1-3 sachets/day)

- Lactobacillus acidophilus NCFM and

Bifidobacterium lactis (probiotic) formula

(1-4 capsules daily)

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Genus Lactobacillus Bifidobacteria

acidophilus

The efficacy of probiotics is dependant

on the unique effects of individual strains:

NCFM

lactis

Bi-07

Species

Strain

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What Makes a Good Probiotic?

• Extensive scientific studies

• Clinically effective formula

• Proven delivery and survival in the gut

• Guaranteed stability and quality

• High potency for clinical effectiveness

• Capsules, powder and non-dairy options

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So What Goes Wrong?



• Toxin overload






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Water-soluble

molecule

Phase II

[conjugation pathways]

Phase II

[conjugation pathways]Phase I


Phase I


Lipid-soluble

moleculeActivated

Intermediates

Serum

Kidneys

Urine

Bile

Faeces

Nutritional support:

Niacin (NADH)

Regulated by

phytochemicals:

Silymarin (milk thistle)

Catechins (green tea)

Curcumin (tumeric)


Niacin (NADH)

Regulated by

phytochemicals:



Curcumin (tumeric)


Glutathione

Sulphate

Cysteine

Taurine

Glutamine

Methyl donors (Folate,

B6, Betaine, B12)

Enhanced by

phytochemicals:




Glutathione

Sulphate

Cysteine

Taurine

Glutamine

Methyl donors (Folate,

B6, Betaine, B12)

Enhanced by

phytochemicals:



Antioxidants:

Vitamin A, C, E

Cysteine

Lipoic acid

Glutathione

Hepatoprotectants:

Silymarin (milk

thistle)

Antioxidants:

Vitamin A, C, E

Cysteine

Lipoic acid

Glutathione

Hepatoprotectants:

Silymarin (milk

thistle)

Faecal

elimination

supported by:

4R Programme

Dietary Fibre

Faecal

elimination

supported by:

4R Programme

Dietary Fibre

Renal

elimination

supported by:

Alkalization

(Potassium

Citrate, Fruits

and

Vegetables)

Renal

elimination

supported by:

Alkalization

(Potassium

Citrate, Fruits

and

Vegetables) 28

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So What Goes Wrong?



• Toxin overload




• Excessive Oestrogen Exposure / impaired


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Toxin Overload

• Exposure to high amounts of toxins on a daily

basis can overload the detoxification systems

and lead to impaired detoxification capacity

and chronic health problems

• Association between toxic exposure and the

aetiology of a number of chronic conditions

such as chronic fatigue syndrome (CFS),

multiple chemical sensitivities (MCS),

fibromyalgia and atherosclerosis

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Recommendations

• Colourful, nutrient dense whole food

diet

• Remove food and drinks that are likely to

contain toxins, food allergens or antigenic

challenge

• Adequate hydration – bowel regularity

• Adequate protein

• Alkalising metabolic food for enhanced liver

support31 32

An Alkalising Approach

“Increasing evidence suggests that persisting,

low grade acidosis can cause a number of

chronic health concerns such as osteoporosis,

kidney disease, muscle wasting and metabolic

disorders Including energy deficient disorders”

Minich D and Bland J. (2007) Acid-alkaline balance: Role in chronic disease and detoxification.

Altern Therapies. 13:62-70

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Acid/Alkaline forming foods

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Alkalising Metabolic Food for

Detoxification and Chronic Fatigue

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For enhanced liver support:

• Low-reactive rice protein

• Blend of macro nutrients, vitamins, minerals,

amino acids and phytochemicals to support

detoxification

• Supports gut health and repair

• Promotes kidney and liver detoxification

capacity

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• Enhances the excretion of toxins out of the

body by promoting an alkaline urinary pH

status with potassium citrate

• Protects against potentially damaging reactive

oxygen compounds generated during the

hepatic detoxification process

• Dose: 1-3 serves daily

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Nutrient profile per serving:

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“These results suggest that a supplemental

medical food programme may provide an

important adjunctive therapy for the

management of many complex symptoms

associated with the chronic fatigue and

fibromyalgia patients. Results also suggest that

many chronic symptoms are the result of the

adverse metabolic impact of toxin accumulation

from both exogenous and endogenous sources”

Bland J, Bland K and Reedy G. (1995) A medical-food supplemented detoxification

programme in the management of chronic health problems. Altern Therapies.

1:62-70

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Case Study

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Case study: Fatigue and Muscle Tension

Patient’s Presentation and History

A 60-year-old Caucasian female presented with fatigue, muscle tension, and pain in her shoulder. She was also borderline hypertensive. The patient consumed a relatively healthy diet, avoided fats and fast foods, and did not drink coffee or alcohol. She reacted strongly to sugar in her diet, which caused tiredness, and was sensitive to car fumes. The patient had a history of obesity, metabolic syndrome (borderline diabetic), and gallstones.

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Patient’s Objective Information

• BMI*: 35.5; BP: 130/83

• MSQ† score 45

• 10-hour (overnight) urine pH: 5.75

• Results of CBC/chemistry tests: Within reference ranges

• Prescriptive medications and supplements included a combination formula comprised of chromium, green tea, cinnamon, and alpha-lipoic acid

• Assessment: Fatigue, muscle tension, sensitivities to specific environmental influences, obesity, insulin dysregulation, borderline hypertension.

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Plan

In addition to continuing prescriptive medications and

supplements, the patient was placed on the following

protocol:

• Days 1-7: American Heart Association Diet (low-fat, low-

cholesterol)

• Days 8-28: Elimination Diet and Alkalizing metabolic food

for enhanced liver support, 1 serving daily

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Follow-up (two weeks):

As soon as 15 days after starting the programme, the patient’s subjective clinical symptoms were noticeably improved.

The patient commented on having double her usual energy, and her MSQ score decreased from initial score of 45 to 5.

Her blood pressure had fallen dramatically to 105/68. The diet diaries and questionnaires indicated compliance with the programme.

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Follow-up (three weeks):

After 3 weeks on the programme, the patient reported no evidence of muscle pain and noted a dramatic improvement in her subjective symptoms overall. The patient also commented on having a notable increase in energy and ability to handle stress better. Her 10-hour urine pH at the final visit was increased from 5.75 to 6.5.

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After 3 weeks, the patient’s

Medical Symptoms

Questionnaire score

decreased from 45 to 2

(reference range: <30 =

few or low intensity

symptoms).

The result suggests a distinctive clinical improvement

and noticeably fewer symptoms.

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The 10-hour (overnight) urine

pH of the patient

increased from 5.75 to 6.5

(reference range: 4.5 to

8.0).

This result suggests that the recommended nutritional

protocol featuring an Alkalizing metabolic food for

enhanced liver support may influence urine alkalinity.

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10-Day Express Detox

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The 10-Day Express Detox

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The 10-Day Express Detox

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The Alkalizing Metabolic

Food Step Plan

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Alkalizing Metabolic Food




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Recommendations

Chronic fatigue / fibromyalgia

•Alkalising metabolic food for enhanced liver

support

•High-strength powdered magnesium and malic

acid formula (1 teaspoon twice / day)

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Recommendations

Heavy Metal Toxicity:

•In addition to alkalising metabolic food for

enhanced liver support, consider:

Gastrointestinal support formula with

psyllium husk and natural apple fibres

(4 capsules 1-3 times / day)

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So What Goes Wrong?



• Toxin overload






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The Gall Bladder

• Liver produces up to 1 Litre bile each day

- this is stored in the gallbladder

• Bile has two functions:

- aids in fat digestion

- enables excretion of excess cholesterol and

toxic lipophilic waste products

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The Gall Bladder

• Principle components of Bile:

- bile salts – ‘the detergent’ dissolving and

enabling the absorption of dietary fats and

fat soluble vitamins

- bilirubin – responsible for the yellow colour

of bile

- cholesterol – bile represents only excretion

route

[- water]56

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Recommendations


- Gall bladder support formula with ox

bile and black radish

- 1-3 tablets daily

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So What Goes Wrong?



• Toxin overload






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Imbalanced Bacterial Flora

• Pathogenic bacteria can produce toxins that

become absorbed into the circulation and

increase toxic load

• Some also have ability to remove conjugation

molecules

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Intestinal Permeability

• ‘Leaky Gut’ allows increased numbers of

toxins to enter circulation leading to toxic

overload of detox systems

• Also associated with malabsorption

• A double whammy – higher levels of toxins

and fewer nutrients available to

support the detoxification

processes

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Recommendations

• Remove food and drinks that are likely to

contain toxins, food allergens or antigenic

challenge

• Consider 4R programme (remove, replace,

inoculate, repair)


- Lactobacillus acidophilus NCFM and

Bifidobacterium lactis (probiotic) formula

(1 capsule daily)61 62

Recommendations


- Consider intestinal permeability test

- High strength L-glutamine powder with

DGL liquorice & aloe vera

(1-3 teaspoons / day) or:

- L-glutamine with NAG & gamma

oryzanol for intestinal support

(1-3 capsules / day away from food)62

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So What Goes Wrong?



• Toxin overload






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Recommendations

• Multi nutrient support for healthy oestrogen

metabolism (1-3 tablets / day)

Or:

• Metabolic food for healthy oestrogen

metabolism (1-2 servings / day)

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A Word on Water Fasts

• Over induces CYP450 enzymes

• Results in catabolism of muscle over fat

• Results in reduced intake of necessary co-

factors

• Causes reduced Glutathione levels

• Thus slows Phase II and retains reactive

intermediates in body longer

Liska D. (2002) The Role of detoxification in the prevention of chronic degenerative diseases.

Applied Nutritional Science Reports.

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need an internal spring clean? · pesticides, toxic metals, food additives, preservatives, drugs 12...

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