The best science-based ways to help your LIVER DETOX

The liver is the main organ in charge of detoxification. It constantly “clears out” toxins that accumulate in our body, this doesn’t even have to be actual “toxins” or chemicals, it also just includes “waste products” of normal metabolic pathways.

That means our liver is always working hard, but these days with our increased toxin exposure through more processed foods, more environmental toxins through commercial skin care and cleaning products, plastic… our livers have to work harder than ever.

This leads to ever increasing numbers of liver diseases within our population, but it actually starts on a much lower level of potentially affecting our energy levels, metabolism, hormones etc. since the toxins, discarded cells and hormones and natural waste products are no longer removed from our blood and continue to circulate throughout our body...

This is where the whole detox movements have gained popularity and momentum. People recognized the stress that is constantly being placed on our liver and wanted to give it a ‘break’, by reducing the amount of work the liver has to do for some time, often in the form of a few days of juice ‘cleanses’, fasting or similar protocols.

However, in our opinion, this approach to ‘detoxification’ is similar as it often is the case to weight loss - fast and quick, BUT nothing that lasts or has a sustainable impact. Soon after the ‘detox’ most people go back to consuming the same foods they did before, the same amount of alcohol and soon they are back to square one.

In our opinion, a much better way to help the liver on a daily or at least regular basis with the detoxification process, is firstly by addressing lifestyle factors, habits and nutritional choices.

The main purpose of this article is to highlight the nutrients that have been proven to support liver function and should therefore be incorporated into our diet on a regular basis.

Before we get into the particular foods, I will briefly outline the symptoms that show that your liver needs support. I will then explain the different phases of the liver detoxification process. Next I will touch on lifestyle changes that also support a well functioning liver and finally, I will outline the most helpful foods and the reason why.

Symptoms your liver needs a little love

Bloating or constipation

When your liver is overwhelmed with handling a poor diet, prescription medications or environmental toxins that enter the body, this impacts your digestion. Your liver is like the body’s digestive control center and when it’s slowed down or damaged, you will notice digestive symptoms like bloating and constipation.

Fatigue

It is common for people with a struggling liver to experience fatigue. Research suggests that this occurs because of changes in neurotransmission within your brain. And when toxic substances build up in your blood due to a malfunctioning liver, you may also experience a number of cognitive issues like confusion and mood changes (1).

Hormonal Imbalances

Your liver is responsible for breaking down and removing excess hormones, helping to balance your hormones naturally. But when your liver isn’t functioning properly, you can experience hormonal imbalances that lead to health issues like mood swings, high cholesterol, and irregular periods. This happens, because hormones that are no longer needed are being cycled back into the bloodstream instead of being cleared out.

Skin breakouts, acne, rashes

Your skin reflects your liver. Not many of us relate the outer glow of our complexion to our liver health. But if your liver is not doing its job of breaking down toxins efficiently, they must be eliminated from your body by other means – in many cases they come out through your skin!

Dark Urine and Yellow-ish Skin (in more severe cases)

This occurs when you have abnormally high levels of ‘bilirubin’, a yellowish pigment that is made during the normal breakdown of red blood cells, in your bloodstream, which may be a result of improperly functioning liver cells. When your liver can’t metabolize your blood cells as they break down, this causes the buildup of bilirubin.

Other symptoms can include:

Disturbed sleep, muscle pain or cramps, headaches, irritability, depression, nausea, trouble breathing, fluid retention...

Chances are you know that you may have been overloading your liver with too much alcohol, lots of fatty foods or long term use of prescription drugs and it’s time to support your hardworking liver a bit more.

How does the liver detoxification process actually work?

Detoxification actually means that the liver neutralizes a wide range of toxic chemicals, both those produced internally and those coming from the environment. (2)

The toxins our body is exposed to are either:

• Water-soluble (and can be processed by the kidney and excreted through the urine)
• Fat-soluble (and need to be processed by the liver first)

The toxins include:

Biological toxins (bacterial toxins, hormonal “waste”, mycotoxins like mold, ammonia)

and

Man-made toxins (environmental pollutants, processed food, alcohol, health-care products, personal care and cleaning products, our home)

The liver filters the blood to remove large toxins, synthesizes and secretes bile full of cholesterol and other fat-soluble toxins, and enzymatically disassembles unwanted chemicals.

This enzymatic process usually occurs in two steps referred to as phase I and phase II.

Phase I either directly neutralizes a toxin, or modifies the toxic chemical to form activated intermediates which are then neutralized by one or more of the several phase II enzyme systems.

I am elaborating on these phases/ enzyme systems to help with the understanding of WHY the compounds of the foods named below are so beneficial.

Phase I Detoxification

The liver's role in detoxification involves a two-step enzymatic process for the neutralization of unwanted chemical compounds. These not only include drugs, pesticides, and toxins from the gut, but also normal body chemicals such as hormones and inflammatory chemicals (e.g. histamine) which become toxic if they build up. Phase I enzymes directly neutralize some chemicals, but most are converted to intermediate forms that are then processed by phase II enzymes. These intermediate forms are much more chemically active and therefore more toxic.

If the phase II detoxification systems are not working adequately, these intermediates can cause substantial damage, including the initiation of carcinogenic processes, which means they have the potential to cause cancer.

Phase I detoxification of most chemical toxins involves a group of enzymes which, collectively, have been named cytochrome P450. Some 50-100 enzymes make up the cytochrome P450 system. Each enzyme works best in detoxifying certain types of chemicals, but with considerable overlap in activity among the enzymes.

The activity of the various cytochrome P450 enzymes varies significantly from one person to another, based on genetics, your level of exposure to chemical toxins, and nutritional status. Since the activity of cytochrome P450 varies so much, so does yours risk for various diseases.

In order to work, these enzyme systems need nutrients both for their activation and to provide the small molecules they add to the toxins. They also utilize metabolic energy to function and to synthesize some of the small conjugating molecules. That means, mitochondrial or cell dysfunction, which happens for example with a magnesium deficiency or when we are physically inactive, can cause phase II detoxification to slow down, allowing the build-up of toxic intermediates.

The caveat of phase 1 is that the detoxification processes produce a lot of free radicals, because the toxins are transformed--for each molecule of toxin metabolized by phase I, one molecule of free radical is generated. Without adequate free radical defenses, free radicals can disrupt cellular function and damage cells (this is why antioxidants are so important, but more on that later).

The most important antioxidant for neutralizing the free radicals produced in phase I is glutathione. In the process of neutralizing free radicals, glutathione (GSH) is oxidized to glutathione disulfide (GSSG). Glutathione is required for one of the key phase II detoxification processes. When high levels of toxin exposure produce so many free radicals from phase I detoxification that the glutathione is depleted, the phase II processes that depend on glutathione stop.

Phase II Detoxification

Phase 2 involves joining products from Phase 1 with other molecules. This makes the toxins less reactive. It also makes the toxins more water-soluble. That way they can be excreted more easily into your blood or bile for elimination.

The major Phase 2 detox pathways and some of the toxins they help with include:

Glucuronidation: This is one of the most common Phase 2 pathways. It helps clear about 1 in 10 of the top 200 prescribed drugs. It also detoxifies some chemicals, such as BPA used in many plastic containers. The end products of glucuronidation are commonly excreted via your bile.

Sulfonation: This is considered another major Phase 2 pathway. Sometimes it’s also called sulfation, but sulfonation is more accurate. It detoxifies acetaminophen and some carcinogens. Toxins that go through the sulfonation pathway are commonly excreted in your urine.

Glutathione: Glutathione isn’t “just” an antioxidant. In Phase 2 detox, it helps remove mold toxins, pesticides, and heavy metals such as mercury. You also use this pathway to detox synthetics.  

Methylation: You may know about methylation since some people have genetic variants related to this pathway. Methylation helps clear histamine. That’s produced in your body and is also high in some foods, such as fermented items. If histamine builds up, it can lead to headaches, nausea, rashes, and other issues.

Acetylation: This pathway helps detoxify carcinogens, such as those in your diet, cigarette smoke, and car exhaust. It also helps clear histamine and caffeine. That’s why the effects of a morning cup of coffee “wear off.”

Amino acids: Certain amino acids — the building blocks of protein — can attach to toxic molecules so you can excrete them. For example, the amino acid glycine can bind with benzoate, a common food preservative.

After Phase 1 and 2, the now water-soluble toxins are shipped out of your liver cells. Some people refer to this as Phase 3 liver detoxification. But this isn’t really one of the liver phases. That’s because it involves transporting molecules rather than altering their chemical structure.

Think of this last step as liver drainage. Here’s a closer look at this.

What happens in liver drainage?

Transport proteins help carry water-soluble toxins out of your liver. They shuttle water-soluble toxins across membranes and out of your liver cells. These transporters need fuel. For energy, they use adenosine triphosphate (ATP). That’s made within your cells’ mitochondria or power houses.

Once the water-soluble toxins are moved out of your liver cells, they’re released into your bile or blood. From there:

• Toxins moved into your blood are filtered through your kidneys and eliminated in your urine.
• Toxins moved into your bile are ultimately released into your digestive tract. And bile can become bound in your stools and excreted.

Supporting your liver through lifestyle measures first

Before we get into specific liver-loving foods, it is important to address lifestyle measures. It would be hard to see improvements in detoxification with the recommended foods when your lifestyle does not support your dietary choices.

“...it might be optimal from a clinical perspective to consider how an entire lifestyle might induce or inhibit the array of detoxification enzymes. For example, addressing behaviors like smoking, physical activity, or stress. The modern clinician needs to weigh all these variables against each other. Yet, science has not fully demonstrated the individual impacts of these factors, along with all of them together. Therefore, at this time, a dietary pattern favoring whole, unprocessed, plant-based foods and the removal or reduction of toxic substances in one's environment is a two-prong approach that would seem to have the best overarching scientific underpinning.” (3)

Some of the most helpful lifestyle changes to make

Limit alcohol and quit smoking

Clearly both of these things contain toxins. One of the best ways to support your liver is not making it work so hard in the first place.

Manage stress as best as possible

Reducing time spent in a sympathetic (stressed) state, whether that is at work, home, through too much exercise or not enough food, emotional stress… Reducing stress allows oxygen to circulate better through our system and improves blood supply to ALL your cells, including digestive tract and liver, which means toxins are being cleared out more easily, as opposed to your body just focusing on survival.

Optimize sleep and sleep quality

The majority of regenerative processes in our body are increased when we sleep. That includes liver detoxification. The more consistently we get our 7-9 hours of sleep and the better that sleep quality is, the more easily the liver is able to do its job.

Exercise and sweat regularly (but not excessively)

Regular movement helps with better digestion, circulation and blood flow and therefore also supports the liver. But too much exercise also means an excess in free radicals. Remember the unstable atoms that are also produced in our Phase 1 detoxification process that can be harmful? Yes, they are a byproduct of exercise too (that is what leads to inflammation) and too much of them can damage cells, cause illness and expedited aging.

A daily sweat (can also be in the form of a regular sauna visit for example) helps the body eliminate waste through perspiration.

Support your skin

Avoid regular sunburn (again that creates an excess in free radicals), but to get some sun exposure when possible. Other ways to clear up your pores is through regular exfoliation, dry-brushing, or the occasional peeling, foot baths and so on. Supporting your lymphatic system through massages, foam rolling, lymph drainage, mobility work is also beneficial as toxins often build up around lymph nodes and these methods help increase blood flow and therefore lymph drainage.

Minimize the 3 P’s

The three P's stand for parabens, pesticides and plastic. All of which are toxins to your body and can not just mess with your liver but also with your entire hormonal profile. Parabens are most commonly found in commercial skin care and cleaning products (so try to buy organic products where possible. Plastic can be minimized by switching things like plastic bottles for stainless steel shaker bottles, tupperware for glass containers... If you want to eliminate pesticides, but you don't know what products are worth buying organic check out the Environmental Working Group's list of the 'Dirty Dozen' (list of produce that is most heavily laden) and 'Clean 15' (list of produce that is not worth buying organic). Organic food reduces your exposure to pesticides like glyphosate. This weed killer impairs cytochrome P450 enzymes you need for detox. Glyphosate also disrupts the function of mitochondria. They make energy your cells need for detox (4).

Coffee should also be included as one of the items most heavily laden with pesticides and is worth buying organic when possible.

Fast every night for 10-12 hours minimum

Again, this rest time will allow your gut and liver to do its “recalibrating” and clearing out processes better than if you constantly ‘feed’ it more things to clean out…

The most helpful foods for liver detoxification

Phase 1

The overarching theme here is Antioxidants: Remember that Phase 1 liver detox generates free radicals that could damage your cells.

“Antioxidants are molecules that in low concentrations can prevent or delay the oxidation of an oxidizable substrate. Antioxidants are present in our body and exist in several foods. Antioxidants have a high affinity for free radicals and scavenge these molecules to protect our health. Compounds with antioxidant properties donate electrons to free radicals to reduce their reactivity and maintain the cellular pro-oxidant/antioxidant balance. “ (5)

• Naringenin: grapefruit, bergamot, sour orange, tart cherries, tomatoes, cocoa, Greek oregano, water mint, as well as in beans.
• Curcuminoids: turmeric
• Allium Sativum: garlic
• Polyphenols: coffee
• Lutein: broccoli
• Catechins: green tea.
• Quercetin: apples, honey, raspberries, onions, red grapes, cherries, citrus fruits, and green leafy vegetables.
• Silymarin: milk thistle.
• Resveratrol: peanuts, pistachios, grapes, blueberries, cranberries, and even cocoa and dark chocolate.

These are some of the main antioxidants supporting liver health, but this is far from being an inclusive list.

In addition to that:

• B vitamins: Some Phase 1 enzymes need the help of B vitamins, including riboflavin (B2) and niacin (B3). If you avoid dairy products — a top source of riboflavin — seek other sources. Riboflavin is in almonds, eggs, and quinoa. Niacin is found in meats, poultry, and sunflower seeds.
• Zinc: You need this vital mineral for Phase 1 detox, as it’s required for cytochrome P450 activity. Some good sources of zinc are meat, chicken (mainly dark meat), pumpkin seeds, cashews, and oatmeal.
• N-acetyl cysteine (NAC): This is made from the amino acid cysteine. NAC can act as an antioxidant by neutralizing free radicals directly. But it also helps your body make more glutathione, a potent free-radical quencher. That helps protect your liver.

Phase 2

• Amino acids: In Phase 2, enzymes attach amino acids to some Phase 1 detox products to enable you to excrete them. Examples of such amino acids are glycine, taurine, cysteine, and methionine. Top sources of amino acids are protein foods, such as meat, poultry, eggs, and nuts. If you consume a good variety of animal proteins and 0.8-1.2g per pound of bodyweight, you should have this covered.
• Magnesium: This mineral may increase your glutathione production. As you read above, glutathione provides antioxidant protection and Phase 2 detoxification. Magnesium also supports methylation enzymes. Top sources of magnesium include almonds, pumpkin seeds, sesame seeds, and amaranth. In most cases it is worth supplementing with 300-400mg of magnesium per day.
• B vitamins: Several B vitamins — including folate, B6, and B12 — support methylation enzymes, as well as other aspects of liver detox. Folate is found in spinach, sunflower seeds, and avocados. Good sources of vitamin B6 are meat, nuts, and seeds. And vitamin B12 is found in meat, poultry, and eggs. If you avoid all animal products, you’ll need a supplemental source of B12. In general, it might be worth supplementing with a Vitamin B complex supplement.
• Broccoli sprouts: These are a top source of sulforaphane. This phytochemical increases your production of glutathione. And it promotes the action of Phase 2 liver detoxification enzymes.
• Flavonoids: One key flavonoid is ellagic acid, which is abundant in pomegranates. Ellagic acid promotes the activity of Phase 2 enzymes while decreasing Phase 1 activity. This encourages a better balance between the activity of these two phases. And that could help keep damaging intermediate products in check. Berries are a great source of flavonoids, too.

Phase 3

• Fiber: Some types of fiber you consume in foods may also help bind bile in your gut. So, fiber is another way to encourage toxin excretion in your stools. This includes soluble fiber, such as found in oatmeal, legumes, and prunes. But be careful not to overdo it, causing constipation...
• Intestinal-moving herbs: Herbs such as aloe vera and ginger gently stimulate your gut to help prevent constipation. Ideally, you should move your bowels at least once a day to support toxin elimination.
• Good hydration: You need to consume enough water to support the elimination of toxins through your urine and stools. Good hydration helps your kidneys work better. Being well-hydrated also helps reduce your risk of constipation.

So to sum it up, the foods MOST helpful for detoxification are:

(This is not an exclusive list, there are plenty of others that have still some positive impact)

Allium Vegetables - onions, garlic, leeks, scallions, chives, and shallots

Apiaceous Vegetables - carrots, celery, celery root (celeriac), fennel, parsnips, including seeds of anise, caraway, coriander, cumin, chervil, cilantro, dill, lovage, and parsley

Cruciferous Vegetables - arugula, bok choy, broccoli, brussel sprouts, cabbage, cauliflower, collard greens, cress, horseradish, kale, kohlrabi, sprouts

Starches and grains - sweet potatoes (especially purple), oats, quinoa, amaranth

Beans - soybean, black soybean and legumes in small amounts in general

Berries - black raspberry, blueberry

Fruit - citrus fruit, pomegranate, dark grapes, apples, tart cherries, tomatoes, prunes

Nuts/ seeds - peanuts, pistachios, cashews, almonds, sesame seeds, sunflower seeds, pumpkin seeds

Teas/ coffee -  milk thistle, black tea, chicory tea, chamomile tea, dandelion tea, honeybush tea, peppermint tea, green tea, rooibos tea

Roots - ginger, turmeric

Herbs - rosemary, Greek oregano, water mint, bergamot, aloe vera

Others - Fish oil, ghee, MCTs, honey, cocoa

And consuming plenty of good quality animal proteins (such as red meat for vitamin B, eggs for niacin, or dark chicken meat for zinc)

As you can see, if you follow a whole foods diet that consists of a good amount of these foods you are already doing a lot of good for your liver and therefore maximizing your full potential and elevating your wellbeing and longevity.

I want to leave you with a citation from a 2015 research review.

“Studies have revealed that exposure to and accumulation of toxins play a significant role in cardiovascular disease, type 2 diabetes, and obesity. Thus, one's dietary intake and environmental influences may have a large bearing on the incidence of chronic disease. Therefore, it would seem that designing clinical recommendations to maximize the effects of food and reduce the impact of toxins is essential.” (3)

Now it’s time to act. Are you adding more toxins for your liver to clear out or are you supporting it as best as you can?

Resources:

1. Swain M. G. (2006). Fatigue in liver disease: pathophysiology and clinical management. Canadian journal of gastroenterology = Journal canadien de gastroenterologie, 20(3), 181–188. https://doi.org/10.1155/2006/624832
2. Grant D. M. (1991). Detoxification pathways in the liver. Journal of inherited metabolic disease, 14(4), 421–430. https://doi.org/10.1007/BF01797915
3. Hodges, R. E., & Minich, D. M. (2015). Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application. Journal of nutrition and metabolism, 2015, 760689. https://doi.org/10.1155/2015/760689
4. https://microbeformulas.com/blogs/microbe-formulas/phases-of-liver-detox-what-they-do-how-to-support-them
5. Casas-Grajales, S., & Muriel, P. (2015). Antioxidants in liver health. World journal of gastrointestinal pharmacology and therapeutics, 6(3), 59–72. https://doi.org/10.4292/wjgpt.v6.i3.59

Other links:

EWG’s Dirty Dozen

EWG’s Clean 15