conditions detoxification

RECMG7788

Detoxification

Condition:Detoxification

Naturopathic Treatments

General Recommendation
• do not overeat
• do not eat before bed
• increase exercise
• decrease intake of pollutants (e.g. smoke, food additives, perservatives, pesticides, etc)
• avoid processed foods
• avoid sugar, caffeine and alcohol
• increase water intake
• increase fiber

Foods
• cruciferous vegetables (kale, broccoli, collards)
• beets (Beta vulgaris)
• soy (Glycine max)
• onions (Allium cepa)
garlic (Allium sativum)
• ground flax seed (Linum usitatissimum)
• pomegranate (Punica granatum)

Botanical medicines
• schizandra (Schisandra chinensis)
chicory (Cichorium intybus)
turmeric (Curcuma longa)
dandelion (Taraxacum officinale)
ginger (Zingiber officinale)
• ginseng (Panax ginseng)
• Chinese skullcap (Scutellaria baicalensis)
artichoke leaf (Cynara scolymus)

Physical medicine
• sauna
• castor oil packs
• dry skin brushing

PHASE I DETOXIFICTION SUPPORT
vitamin B2 (Riboflavin)
vitamin B3 (Niacin)
vitamin B12 (cobalamin)
• glutathione
folic acid

PHASE II DETOXIFICTION SUPPORT

Sulfation - substances known to support it:
• Brassica vegetables
• alpha-lipoic acid (ALA)
selenium
• N-acetylcysteine (NAC)
• onions (Allium cepa)
garlic (Allium sativum)
taurine

Actelyation - substances known to support it:
vitamin B1
vitamin B5 (pantothenic acid)
vitamin C (ascorbic acid)

Glutamination - substances known to support:
• glutamine

Methylation - substances known to support:
methylcobalamin (active form of Vitamin B12)
folic acid
• S-adenosylmethionine (SAM-e)
• trimethylglycine (betaine)

Pathogenesis

PHASE I DETOXIFICATION
- p450 enzymes are involved in redox reaction to transform organic compounds

Note: excess stimulation of p450 enzymes without phase II support can lead to the increase production of potentially harmful reactive intermediates.

PHASE II DETOXIFICATION
- secondary compounds are added to the substrate to make them easier to excrete.
- there are several phase 2 pathways:

• Sulfation - enzymes (quinone reductase, glutathione S-transferase) transfer organosulfur compounds (e.g. glutathione, cysteine) to the following substrates:
- heavy metals (mercury)
- polycyclic aromatic hydrocarbon (benzo[a]pyrene in charred meat & cigarette smoke)
- drugs (acetaminophen)

• Glucuronidation - the enzyme UDP-glucuronyltransferase transfer a sugar (glucuronic acid) to the following substrates:
- steroidal hormones (androgens, estrogens, mineralocorticoids, glucocorticoids)
- retinoids (Vitamin A)
- bile acids
- drugs (aspirin, opiates)
- xenobiotics

• Methylation - enzymes (methyltransferases) add methyl groups to the subtrates using methyl donors (S-adenosyl methionine) to detoxify:
- neurotransmitters (dopamine, epinephrine)
- heavy metals (arsenic, mercury)
- drugs (L-dopa)

• Acetylation - various N-acetyltransferases enzymes adds acetyl groups to substrates a cofactor (Acetyl coenzyme) to detoxify:
- caffeine
- sulfa drugs (sulfonamides)
- thiazide diuretics
- glyburide

• Glycination - adds the amino acid glycine to the the following substrates:
- drugs (salicylate)
- perservatives (benzoic acid)

References

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Jones S D "Textbook of Functional Medicine" The Institute of Functional Medicine. WA 2006. p 275-298

Pu HJ, Cao YF, He RR, Zhao ZL, Song JH, Jiang B, Huang T, Tang SH, Lu JM, Kurihara H. Correlation between Antistress and Hepatoprotective Effects of Schisandra Lignans Was Related with Its Antioxidative Actions in Liver Cells. Evid Based Complement Alternat Med. 2012;2012:161062. Epub 2012 Jun 18. PubMed PMID: 22792122; PubMed Central PMCID: PMC3385912.

Girish C, Pradhan SC. Hepatoprotective activities of picroliv, curcumin, and ellagic acid compared to silymarin on carbon-tetrachloride-induced liver toxicity in mice. J Pharmacol Pharmacother. 2012 Apr;3(2):149-55. PubMed PMID: 22629090; PubMed Central PMCID: PMC3356956.

Chiu HF, Chen TY, Tzeng YT, Wang CK. Improvement of Liver Function in Humans Using a Mixture of Schisandra Fruit Extract and Sesamin. Phytother Res. 2012 May 21. doi: 10.1002/ptr.4702. [Epub ahead of print] PubMed PMID: 22610748.

Hall MN, Gamble MV. Nutritional manipulation of one-carbon metabolism: effects on arsenic methylation and toxicity. J Toxicol. 2012;2012:595307. Epub 2012 Mar 14. PubMed PMID: 22523489; PubMed Central PMCID: PMC3317163.

Sears ME, Kerr KJ, Bray RI. Arsenic, cadmium, lead, and mercury in sweat: a systematic review. J Environ Public Health. 2012;2012:184745. Epub 2012 Feb 22. PubMed PMID: 22505948; PubMed Central PMCID: PMC3312275.

Warwick E, Cassidy A, Hanley B, Jouni ZE, Bao Y. Effect of phytochemicals on phase II enzyme expression in infant human primary skin fibroblast cells. Br J Nutr. 2012 Mar 19:1-8. [Epub ahead of print] PubMed PMID: 22424477.

RodrÍguez-Fragoso L, MartÍnez-Arismendi JL, Orozco-Bustos D, Reyes-Esparza J, Torres E, Burchiel SW. Potential risks resulting from fruit/vegetable-drug interactions: effects on drug-metabolizing enzymes and drug transporters. J Food Sci. 2011 May;76(4):R112-24. doi: 10.1111/j.1750-3841.2011.02155.x. Review. PubMed PMID: 22417366.

Bak MJ, Jun M, Jeong WS. Antioxidant and Hepatoprotective Effects of the Red Ginseng Essential Oil in H(2)O(2)-Treated HepG2 Cells and CCl(4)-Treated Mice. Int J Mol Sci. 2012;13(2):2314-30. Epub 2012 Feb 21. PubMed PMID: 22408456; PubMed Central PMCID: PMC3292025.

Kim HA, Yeo Y, Jung HA, Jung YO, Park SJ, Kim SJ. Phase 2 enzyme inducer sulphoraphane blocks prostaglandin and nitric oxide synthesis in human articular chondrocytes and inhibits cartilage matrix degradation. Rheumatology (Oxford). 2012 Jun;51(6):1006-16. Epub 2012 Feb 12. PubMed PMID: 22332123.

Singh M, Sasi P, Gupta VH, Rai G, Amarapurkar DN, Wangikar PP. Protective effect of curcumin, silymarin and N-acetylcysteine on antitubercular drug-induced hepatotoxicity assessed in an in vitro model. Hum Exp Toxicol. 2012 Feb 8. [Epub ahead of print] PubMed PMID: 22318308.

Yamasaki I, Uotsu N, Yamaguchi K, Takayanagi R, Yamada Y. Effects of kale ingestion on pharmacokinetics of acetaminophen in rats. Biomed Res. 2011 Dec;32(6):357-62. PubMed PMID: 22199125.

Kantah MK, Kobayashi R, Sollano J, Naito Y, Solimene U, Jains S, Catanzaro R, Minelli E, Polimeni A, Marotta F. Hepatoprotective activity of a phytotherapeutic formula on thioacetamide--induced liver fibrosis model. Acta Biomed. 2011 Apr;82(1):82-9. PubMed PMID: 22069962.

Morsy MA, Abdalla AM, Mahmoud AM, Abdelwahab SA, Mahmoud ME. Protective effects of curcumin, α -lipoic acid, and N-acetylcysteine against carbon tetrachloride-induced liver fibrosis in rats. J Physiol Biochem. 2012 Mar;68(1):29-35. Epub 2011 Oct 11. PubMed PMID: 21986891.

Shi G, Zhang Z, Zhang R, Zhang X, Lu Y, Yang J, Zhang D, Zhang Z, Li X, Ning G. Protective effect of andrographolide against concanavalin A-induced liver injury. Naunyn Schmiedebergs Arch Pharmacol. 2012 Jan;385(1):69-79. Epub 2011 Sep 24. PubMed PMID: 21947229.

Atta AH, Elkoly TA, Mouneir SM, Kamel G, Alwabel NA, Zaher S. Hepatoprotective Effect of Methanol Extracts of Zingiber officinale and Cichorium intybus. Indian J Pharm Sci. 2010 Sep;72(5):564-70. PubMed PMID: 21694986; PubMed Central PMCID: PMC3116299.

Matveev AV, Koniaeva EI, Kurchenko VP, Shchekatikhina AS. [Hepatoprotective properties of silymarin]. Eksp Klin Gastroenterol. 2011;(2):130-5. Review. Russian. PubMed PMID: 21560654.

Cay r K, Karadeniz A, Sim ek N, Y ld r m S, Karaku E, Kara A, Akkoyun HT, SengÜl E. Pomegranate seed extract attenuates chemotherapy-induced acute nephrotoxicity and hepatotoxicity in rats. J Med Food. 2011 Oct;14(10):1254-62. Epub 2011 May 6. PubMed PMID: 21548807.

Robbins MG, Andersen G, Somoza V, Eshelman BD, Barnes DM, Hanlon PR. Heat treatment of Brussels sprouts retains their ability to induce detoxification enzyme expression in vitro and in vivo. J Food Sci. 2011 Apr;76(3):C454-61. doi: 10.1111/j.1750-3841.2011.02105.x. PubMed PMID: 21535814.

Lee IS, Park S, Park K, Choue R. Hepatoprotective Activity of Scutellariae Radix Extract in Mice Fed a High Fat Diet with Chronic Alcohol Exposure. Phytother Res. 2011 Feb 21. doi: 10.1002/ptr.3370. [Epub ahead of print] PubMed PMID: 21341335.

MÜller T. Catechol-O-methyltransferase enzyme: cofactor S-adenosyl-L-methionine and related mechanisms. Int Rev Neurobiol. 2010;95:49-71. Review. PubMed PMID: 21095459.

Mohamed ME, Frye RF. Effects of herbal supplements on drug glucuronidation. Review of clinical, animal, and in vitro studies. Planta Med. 2011 Mar;77(4):311-21. Epub 2010 Nov 3. Review. PubMed PMID: 21049395.

Bardag-Gorce F, Oliva J, Wong W, Fong S, Li J, French BA, French SW. S-adenosylmethionine decreases the peak blood alcohol levels 3 h after an acute bolus of ethanol by inducing alcohol metabolizing enzymes in the liver. Exp Mol Pathol. 2010 Dec;89(3):217-21. Epub 2010 Sep 7. PubMed PMID: 20828554; PubMed Central PMCID: PMC3319153.

Carvalho CM, Lu J, Zhang X, ArnÉr ES, Holmgren A. Effects of selenite and chelating agents on mammalian thioredoxin reductase inhibited by mercury: implications for treatment of mercury poisoning. FASEB J. 2011 Jan;25(1):370-81. Epub 2010 Sep 1. PubMed PMID: 20810785.

Joshi D, Mittal DK, Shukla S, Srivastav AK. Therapeutic potential of N-acetyl cysteine with antioxidants (Zn and Se) supplementation against dimethylmercury toxicity in male albino rats. Exp Toxicol Pathol. 2012 Jan;64(1-2):103-8. Epub 2010 Aug 4. PubMed PMID: 20688495.

Genuis SJ, Birkholz D, Ralitsch M, Thibault N. Human detoxification of perfluorinated compounds. Public Health. 2010 Jul;124(7):367-75. Epub 2010 Jun 19. PubMed PMID: 20621793.

Lii CK, Liu KL, Cheng YP, Lin AH, Chen HW, Tsai CW. Sulforaphane and alpha-lipoic acid upregulate the expression of the pi class of glutathione S-transferase through c-jun and Nrf2 activation. J Nutr. 2010 May;140(5):885-92. Epub 2010 Mar 17. PubMed PMID: 20237067.

Shim JY, Kim MH, Kim HD, Ahn JY, Yun YS, Song JY. Protective action of the immunomodulator ginsan against carbon tetrachloride-induced liver injury via control of oxidative stress and the inflammatory response. Toxicol Appl Pharmacol. 2010 Feb 1;242(3):318-25. Epub 2009 Nov 11. PubMed PMID: 19913046.

Pall ML. Do sauna therapy and exercise act by raising the availability of tetrahydrobiopterin? Med Hypotheses. 2009 Oct;73(4):610-3. Epub 2009 Jul 5. PubMed PMID: 19581054.

Lee SB, Kim CY, Lee HJ, Yun JH, Nho CW. Induction of the phase II detoxification enzyme NQO1 in hepatocarcinoma cells by lignans from the fruit of Schisandra chinensis through nuclear accumulation of Nrf2. Planta Med. 2009 Oct;75(12):1314-8. Epub 2009 May 18. PubMed PMID: 19452436.

Wiegand H, Wagner AE, Boesch-Saadatmandi C, Kruse HP, Kulling S, Rimbach G. Effect of dietary genistein on Phase II and antioxidant enzymes in rat liver. Cancer Genomics Proteomics. 2009 Mar-Apr;6(2):85-92. PubMed PMID: 19451092.

Yan F, Zhang QY, Jiao L, Han T, Zhang H, Qin LP, Khalid R. Synergistic hepatoprotective effect of Schisandrae lignans with Astragalus polysaccharides on chronic liver injury in rats. Phytomedicine. 2009 Sep;16(9):805-13. Epub 2009 Apr 2. PubMed PMID: 19345075.

El-Kamary SS, Shardell MD, Abdel-Hamid M, Ismail S, El-Ateek M, Metwally M, Mikhail N, Hashem M, Mousa A, Aboul-Fotouh A, El-Kassas M, Esmat G, Strickland GT. A randomized controlled trial to assess the safety and efficacy of silymarin on symptoms, signs and biomarkers of acute hepatitis. Phytomedicine. 2009 May;16(5):391-400. Epub 2009 Mar 19. PubMed PMID: 19303273; PubMed Central PMCID: PMC2733865.

Wu JW, Lin LC, Tsai TH. Drug-drug interactions of silymarin on the perspective of pharmacokinetics. J Ethnopharmacol. 2009 Jan 21;121(2):185-93. Epub 2008 Nov 8. Review. PubMed PMID: 19041708.

Bolling BW, Parkin KL. Phenolic derivatives from soy flour ethanol extract are potent in vitro quinone reductase (QR) inducing agents. J Agric Food Chem. 2008 Nov 26;56(22):10473-80. PubMed PMID: 18956872.

Chen Y, Huang C, Zhou T, Chen G. Genistein induction of human sulfotransferases in HepG2 and Caco-2 cells. Basic Clin Pharmacol Toxicol. 2008 Dec;103(6):553-9. PubMed PMID: 18715236; PubMed Central PMCID: PMC3108497.

MehmetÇik G, Ozdemirler G, KoÇak-Toker N, Cevikba U, Uysal M. Effect of pretreatment with artichoke extract on carbon tetrachloride-induced liver injury and oxidative stress. Exp Toxicol Pathol. 2008 Sep;60(6):475-80. Epub 2008 Jun 25. PubMed PMID: 18583118.

Ahmed B, Khan S, Masood MH, Siddique AH. Anti-hepatotoxic activity of cichotyboside, a sesquiterpene glycoside from the seeds of Cichorium intybus. J Asian Nat Prod Res. 2008 Mar-Apr;10(3-4):223-31. PubMed PMID: 18335337.

Faria A, Monteiro R, Azevedo I, Calhau C. Pomegranate juice effects on cytochrome P450S expression: in vivo studies. J Med Food. 2007 Dec;10(4):643-9. PubMed PMID: 18158835.

Nishinaka T, Ichijo Y, Ito M, Kimura M, Katsuyama M, Iwata K, Miura T, Terada T, Yabe-Nishimura C. Curcumin activates human glutathione S-transferase P1 expression through antioxidant response element. Toxicol Lett. 2007 May 15;170(3):238-47. Epub 2007 Mar 24. PubMed PMID: 17449203.

Crinnion W. Components of practical clinical detox programs--sauna as a therapeutic tool. Altern Ther Health Med. 2007 Mar-Apr;13(2):S154-6. Review. PubMed PMID: 17405694.

Tsai CW, Chen HW, Yang JJ, Sheen LY, Lii CK. Diallyl disulfide and diallyl trisulfide up-regulate the expression of the pi class of glutathione S-transferase via an AP-1-dependent pathway. J Agric Food Chem. 2007 Feb 7;55(3):1019-26. PubMed PMID: 17263507.

Krylova SG, Efimova LA, Vymiatina ZK, Zueva EP. [The effect of cichorium root extract on the morphofunctional state of liver in rats with carbon tetrachloride induced hepatitis model]. Eksp Klin Farmakol. 2006 Nov-Dec;69(6):34-6. Russian. PubMed PMID: 17209462.

Broderick KE, Potluri P, Zhuang S, Scheffler IE, Sharma VS, Pilz RB, Boss GR. Cyanide detoxification by the cobalamin precursor cobinamide. Exp Biol Med (Maywood). 2006 May;231(5):641-9. PubMed PMID: 16636313.

Agarwal M, Srivastava VK, Saxena KK, Kumar A. Hepatoprotective activity of Beta vulgaris against CCl4-induced hepatic injury in rats. Fitoterapia. 2006 Feb;77(2):91-3. Epub 2005 Dec 20. PubMed PMID: 16376022.

Lee CH, Wettasinghe M, Bolling BW, Ji LL, Parkin KL. Betalains, phase II enzyme-inducing components from red beetroot (Beta vulgaris L.) extracts. Nutr Cancer. 2005;53(1):91-103. PubMed PMID: 16351511.

Tsai CW, Yang JJ, Chen HW, Sheen LY, Lii CK. Garlic organosulfur compounds upregulate the expression of the pi class of glutathione S-transferase in rat primary hepatocytes. J Nutr. 2005 Nov;135(11):2560-5. PubMed PMID: 16251611.

Lee HU, Bae EA, Han MJ, Kim DH. Hepatoprotective effect of 20(S)-ginsenosides Rg3 and its metabolite 20(S)-ginsenoside Rh2 on tert-butyl hydroperoxide-induced liver injury. Biol Pharm Bull. 2005 Oct;28(10):1992-4. PubMed PMID: 16204963.

Lee HU, Bae EA, Han MJ, Kim NJ, Kim DH. Hepatoprotective effect of ginsenoside Rb1 and compound K on tert-butyl hydroperoxide-induced liver injury. Liver Int. 2005 Oct;25(5):1069-73. PubMed PMID: 16162168.

Iciek M, Bilska A, Ksiazek L, Srebro Z, W odek L. Allyl disulfide as donor and cyanide as acceptor of sulfane sulfur in the mouse tissues. Pharmacol Rep. 2005 Mar-Apr;57(2):212-8. PubMed PMID: 15886420.

Walters DG, Young PJ, Agus C, Knize MG, Boobis AR, Gooderham NJ, Lake BG. Cruciferous vegetable consumption alters the metabolism of the dietary carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) in humans. Carcinogenesis. 2004 Sep;25(9):1659-69. Epub 2004 Apr 8. PubMed PMID: 15073045.

Fukao T, Hosono T, Misawa S, Seki T, Ariga T. The effects of allyl sulfides on the induction of phase II detoxification enzymes and liver injury by carbon tetrachloride. Food Chem Toxicol. 2004 May;42(5):743-9. PubMed PMID: 15046820.

Pari L, Murugavel P. Protective effect of alpha-lipoic acid against chloroquine-induced hepatotoxicity in rats. J Appl Toxicol. 2004 Jan-Feb;24(1):21-6. PubMed PMID: 14745843.

Ram VJ. Herbal preparations as a source of hepatoprotective agents. Drug News Perspect. 2001 Aug;14(6):353-63. PubMed PMID: 12813598.

Speroni E, Cervellati R, Govoni P, Guizzardi S, Renzulli C, Guerra MC. Efficacy of different Cynara scolymus preparations on liver complaints. J Ethnopharmacol. 2003 Jun;86(2-3):203-11. PubMed PMID: 12738088.

Wettasinghe M, Bolling B, Plhak L, Xiao H, Parkin K. Phase II enzyme-inducing and antioxidant activities of beetroot (Beta vulgaris L.) extracts from phenotypes of different pigmentation. J Agric Food Chem. 2002 Nov 6;50(23):6704-9. PubMed PMID: 12405765.

Hultberg B, Andersson A, Isaksson A. Lipoic acid increases glutathione production and enhances the effect of mercury in human cell lines. Toxicology. 2002 Jun 14;175(1-3):103-10. PubMed PMID: 12049840.

Zhang Y, Callaway EC. High cellular accumulation of sulphoraphane, a dietary anticarcinogen, is followed by rapid transporter-mediated export as a glutathione conjugate. Biochem J. 2002 May 15;364(Pt 1):301-7. PubMed PMID: 11988104; PubMed Central PMCID: PMC1222573.

Wu CC, Sheen LY, Chen HW, Kuo WW, Tsai SJ, Lii CK. Differential effects of garlic oil and its three major organosulfur components on the hepatic detoxification system in rats. J Agric Food Chem. 2002 Jan 16;50(2):378-83. PubMed PMID: 11782211.

Appelt LC, Reicks MM. Soy induces phase II enzymes but does not inhibit dimethylbenz[a]anthracene-induced carcinogenesis in female rats. J Nutr. 1999 Oct;129(10):1820-6. PubMed PMID: 10498753.

Munday R, Munday CM. Low doses of diallyl disulfide, a compound derived from garlic, increase tissue activities of quinone reductase and glutathione transferase in the gastrointestinal tract of the rat. Nutr Cancer. 1999;34(1):42-8. PubMed PMID: 10453440.

Zafar R, Mujahid Ali S. Anti-hepatotoxic effects of root and root callus extracts of Cichorium intybus L. J Ethnopharmacol. 1998 Dec;63(3):227-31. PubMed PMID: 10030727.

Khanum F, Anilakumar KR, Sudarshanakrishna KR, Viswanathan KR. Effects of feeding fresh garlic and garlic oil on detoxifying enzymes and micronuclei formation in rats treated with azoxymethane. Int J Vitam Nutr Res. 1998;68(3):208-13. PubMed PMID: 9637953.

Krop J. Chemical sensitivity after intoxication at work with solvents: response to sauna therapy. J Altern Complement Med. 1998 Spring;4(1):77-86. PubMed PMID: 9553837.

Hu X, Benson PJ, Srivastava SK, Xia H, Bleicher RJ, Zaren HA, Awasthi S, Awasthi YC, Singh SV. Induction of glutathione S-transferase pi as a bioassay for the evaluation of potency of inhibitors of benzo(a)pyrene-induced cancer in a murine model. Int J Cancer. 1997 Dec 10;73(6):897-902. PubMed PMID: 9399673.

Gebhardt R. Antioxidative and protective properties of extracts from leaves of the artichoke (Cynara scolymus L.) against hydroperoxide-induced oxidative stress in cultured rat hepatocytes. Toxicol Appl Pharmacol. 1997 Jun;144(2):279-86. PubMed PMID: 9194411.

Hatono S, Jimenez A, Wargovich MJ. Chemopreventive effect of S-allylcysteine and its relationship to the detoxification enzyme glutathione S-transferase. Carcinogenesis. 1996 May;17(5):1041-4. PubMed PMID: 8640910.

Hassoun BS, Palmer IS, Dwivedi C. Selenium detoxification by methylation. Res Commun Mol Pathol Pharmacol. 1995 Oct;90(1):133-42. PubMed PMID: 8581338.

Zhang Y, Talalay P, Cho CG, Posner GH. A major inducer of anticarcinogenic protective enzymes from broccoli: isolation and elucidation of structure. Proc Natl Acad Sci U S A. 1992 Mar 15;89(6):2399-403. PubMed PMID: 1549603; PubMed Central PMCID: PMC48665.

Stauber JL, Florence TM. A comparative study of copper, lead, cadmium and zinc in human sweat and blood. Sci Total Environ. 1988 Aug 1;74:235-47. PubMed PMID: 3222694.

Skvortsova RI, Pozniakovski VM, Agarkova IA. [Role of the vitamin factor in preventing phenol poisoning]. Vopr Pitan. 1981 Mar-Apr;(2):32-5. Russian. PubMed PMID: 6972670.

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