Liver detoxes may be trendy. But do they really work? Are they safe? Evidence shows that there are quite a lot of myths out there about liver detoxes, so how can we know what is necessary to do for liver health?

For example, it’s true that our livers already detox every day without our help. This would lead us to believe that "detoxes" are unnecessary. On the other hand, our modern chemical-ridden environment bombards our livers with excess toxins daily. This would lead us to believe that "detoxes" are necessary.

The answer to whether or not detoxes are safe and necessary likely lies somewhere in the middle. While an intense "liver detox" can be potentially harmful if done incorrectly or without medical supervision, those practicing functional medicine unanimously agree that healthy, gentle liver support is vital to optimal health.

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What is the Liver's Role in the Body?

The liver is an organ that plays a lot of vital roles in the body. All of our blood must pass through the liver to get processed and detoxified before journeying throughout the body. Over 500 liver functions have been identified, but here are the most notable:

Production & Processing

• Produces bile, which assists digestion by breaking down fats
• Produces proteins for blood plasma
• Produces cholesterol and particular proteins that help transport fats throughout the body
• Processes hemoglobin from old red blood cells and stores the iron
• Produces immune factors to reduce infections
• Converts poisonous ammonia to urea, which gets excreted in the urine

Regulation & Clearing

• Assists blood sugar balance by converting excess glucose to glycogen and can also break down the glycogen back into glucose when needed
• Regulates amino acid levels
• Regulates blood clotting
• Clears bilirubin coming from old red blood cells
• Clears bacteria from the bloodstream
• Metabolizes and clears the blood of toxins

What is a Liver Detox?

Detoxification (also known as biotransformation) occurs in three phases to process toxins, hormones, and other metabolites.

Phase 1 uses specialized cytochrome P450 enzymes to convert toxins, hormones, and metabolites into intermediary byproducts. Unfortunately, many of these byproducts are more toxic than the original product and must be further processed.

Phase 2, the "conjugation" phase, further converts the byproducts into water-soluble forms for easier excretion into the blood or bile, ultimately leaving the body via urine or stool.

Phase 3 is the elimination of toxic waste products from the body and occurs outside of the liver in the colon (via the stool), kidneys (via the urine), skin (via the sweat), and lungs (via the breath). Most elimination occurs through the colon, so gut health is essential for overall detoxification.

Genetic variability can impact the effectiveness of Phase 1 and Phase 2 enzymes, ultimately determining an individual's sensitivity to toxic substances and ability to detoxify thoroughly.

A "Liver Detox" is typically a strict diet and supplement regimen that quickly cleanses the liver of toxins. While a medically supervised liver cleanse may be warranted by some individuals, at-home "detox kits" are frequently marketed as a "cure-all" solution though they may cause more harm than good.

Since our livers are already detoxifying every day, a "liver detox" isn't something we necessarily have to actively "do" to our bodies. Instead, supporting our liver in its various jobs can be crucial for optimal health, ultimately helping reduce its burden.

Nutrition and supplements provide the nutrients necessary for liver enzymes to function correctly. Studies show that cruciferous vegetables (i.e., watercress, garden cress, and broccoli), allium vegetables (i.e., onions, garlic, and leeks), apiaceous vegetables (i.e., carrots, celery, and parsley), and grapefruit and supplements such as resveratrol, fish oil, quercetin, daidzein, and lycopene can have a positive impact on the effectiveness of the detoxification enzymes.

The addition of liver-supportive herbs is also essential for a liver-supportive lifestyle. Milk thistle (Silybum marianum) is the most highly researched plant in treating liver disease. It has been shown to reduce the build-up of various heavy metals, environmental pollutants, alcohol, and prescription drugs leading to lower liver toxicity. Curcumin (the bioactive portion of turmeric) has also been shown to support liver functions and positively affect liver enzymes.

Signs & Symptoms Your Patient May Need a Liver Detox

According to conventional medicine, if you have overt liver dysfunction, you may experience the following symptoms:

• Yellowish color in the eyes or skin
• Excess fluid in the abdomen (known as ascites)
• Pain in the abdomen
• Itchy skin
• Bruising easily
• Low blood pressure
• Excessive fatigue
• Tremors (shaking)
• Swelling in the legs or ankles
• Loss of balance or weakness
• Confusion

*These symptoms would suggest proper testing and a referral to a specialist.

However, a Traditional Chinese Medicine (TCM) perspective also includes the following symptoms when discussing a "sluggish liver":

• Hormonal imbalance, PMS, or fibroids
• Weight and cholesterol issues
• Headaches
• Teeth grinding
• Eye issues (specifically in the right eye)
• Mood issues - feeling irritable, angry, or impatient
• Regularly waking up between 1:00 AM and 3:00 AM
• Toenail discoloration
• Frequently feeling hot
• Thyroid issues
• Prostate inflammation
• Hip pain

*Many times when a Liver Detox is prescribed its based off "sluggish" liver symptoms.

Functional Medicine Labs to Help Determine if a Liver Detox is Right for Your Patients

If your patients have known or suspected toxic exposures, this could affect their liver's function. The Total Tox-Burden panel evaluates potential environmental toxins, heavy metals, and mycotoxins (mold/fungal toxins). These results will help practitioners understand how efficiently the liver is functioning.

The Chemical Immune Reactivity Screen (Array 11) test is unique because instead of evaluating toxic exposures, it measures antibodies to chemicals to measure how the body reacts to them. This test can help determine health risks from chemical exposures.

Lastly, the Hepatic Function Panel is a great test for analyzing the health status of the liver and screening for any overt liver diseases that could be impacting detoxification.

Signs the Liver Detox is Working

When focusing on a liver detox or liver-supportive lifestyle, you should see marked improvements in certain areas of health. For example:

1. There is a connection between liver health and brain health. So as the liver heals, patients may have healthier brain function and reduced brain fog.
2. Fatigue is a significant symptom of liver disease. The connection between liver health and energy suggests that as liver health improves, energy will also improve.
3. Pain is a common symptom for those experiencing liver diseases due to liver inflammation. As inflammation decreases with liver support, the pain will likely decrease.
4. Often, skin symptoms are the first sign of a liver issue. As the liver heals through gentle support, the skin may also improve.
5. Liver function tests (bloodwork) will also likely improve when liver health improves.

How Often Can a Patient Do a Liver Detox?

Caring for the liver can be a daily lifestyle choice. Choosing a healthy diet to support liver enzymes and adding liver-supportive herbs and supplements, as well as exercising and increasing hydration, are all gentle choices.

When it comes to heavier detoxes, they should only be done with the support of a health practitioner and are recommended individually. However, typically those detoxes are recommended twice per year.

Who Should Not Do a Liver Detox?

Evidence shows that many toxins pass through the placenta while pregnant and through breast milk. So, while eating a liver-supportive diet is beneficial for all, attempting a more intense "liver detox" would not generally be recommended to those trying to conceive, who are already pregnant, or who are breastfeeding.

Those with overt liver disease should also seek the care of a qualified physician and should not attempt to resolve their condition on their own through a detox protocol.

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Summary

The liver is a vital organ that plays many roles, and one of its most famous roles is detoxification (or biotransformation). With all of us living in an increasingly toxic world, it's no wonder why so many "detox" protocols are out there. While a medically supervised liver detox may be appropriate in certain situations, most people would be better off incorporating daily liver-supportive lifestyle choices.

Functional medicine can help evaluate the current toxic load and liver function. Using nutrition, supplements, and herbs can provide gentle solutions to keep the liver in optimal shape.