P3 HEPATIC SYSTEM

 

Zhou Xuehai said “The physician who knows how to harmonize the liver knows how to treat the hundred diseases.” (Reflections Upon Reading the Medical Classics (Du Yi Suibi) ca. 1895)

The liver is located in the upper right-hand portion of the abdominal cavity beneath the diaphragm and on top of the stomach, right kidney and intestines. The liver, a dark reddish-brown organ that weighs about three pounds, has multiple functions.

What are the functions of the liver?

The liver regulates most chemical levels in the blood and excretes a product called bile, which helps to break down fats, preparing them for further digestion and absorption. All of the blood leaving the stomach and intestines passes through the liver. The liver processes this blood and breaks down the nutrients and drugs in the blood into forms that are easier to use for the rest of the body. More than 500 vital functions have been identified with the liver. Some of the more well-known functions include the following:

• Production of bile, which helps carry away waste and break down fats in the small intestine during digestion
• Production of certain proteins for blood plasma
• Production of cholesterol and special proteins to help carry fats through the body
• Conversion of excess glucose into glycogen for storage (this glycogen can later be converted back to glucose for energy)
• Regulation of blood levels of amino acids, which form the building blocks of proteins
• Processing of hemoglobin for use of its iron content (the liver stores iron)
• Conversion of poisonous ammonia to urea (urea is one of the end products of protein metabolism that is excreted in the urine)
• Clearing the blood of drugs and other poisonous substances
• Regulating blood clotting
• Resisting infections by producing immune factors and removing bacteria from the bloodstream.

 

Congested Liver

Bile contains water, bilirubin, bile acids, lecithin and cholesterol. Bile acids and lecithin are both strong emulsifiers, which not only keep cholesterol in solution inhibiting the formation of gall stones, but also assist in digestion of fats. Bile acids are themselves synthesised from cholesterol by the liver, so an increase in synthesis results in a reduction of cholesterol levels. The liver is the main organ controlling cholesterol.

Hepatic production of bile is critical to the detoxification process. A compromised bile production will lead to congestion of the liver and the other eliminating channels.

Through a medical case history it is possible to tell if a congested liver would cause a problem when detoxifying the patient.

As the liver is involved in so many metabolic functions the symptoms and signs of disease could be wide and varied. Also, unfortunately, a large amount of liver tissue may need to be damaged or destroyed before customary tests of liver function reveal abnormalities. People can display a multitude of odd symptoms and complaints but may have negative liver function tests. The liver also has an amazing capacity to rejuvenate and so the symptoms could also be vague and fluctuating or they could be asymptomatic for a long time before they cause symptoms.
With congestion, the liver begins to struggle with a daily overload which interferes with its function, becoming swamped with work and progressively more congested. In such circumstances it can’t keep the blood properly filtered and cleansed as its own functioning is disturbed and deranged, giving rise to a whole host of diseases and symptoms such as;

• Jaundice in a new born (a healthy baby with a more efficient liver can normally cope with the breakdown of red blood cells and the elimination of bilirubin)
• Cradle cap may be a sign of liver congestion. The head is the only place of elimination via the skin in a small baby and will carry the load if there is liver congestion
• Recurrent tonsillitis occurs when the glands become involved resulting in infection. The final detoxification of the lymph is dependent on liver function. Recurrence indicates a toxic liver and lymph
• Fat intolerance occurs with inadequate bile production as the bile emulsifies fats
• Food intolerances may cause symptoms in the gut (indigestion, bloating, cramping, spasms, diarrhea). Bloating and flatulence is caused by undigested sugars. The by-products of pathogens and incompletely digested foods circulate to the liver and cause congestion
• Food allergies can arise from undigested protein in the gut. Chemicals present in food and food additives can also be a trigger for allergies. Wheat and dairy are the main culprits for allergic reactions. These undigested particles should be taken up by the liver and degraded before they reach the systemic circulation. However, with liver congestion, these particles escape and cause allergic reactions at the skin (eczema, hives) and mucous membranes (asthma, rhinitis)
• Constipation may also be a consequence of inadequate bile production as bile is our natural laxative
• Toxic bowel may arise because of liver congestion. If the liver fails to support digestion this will lead to stagnation in the digestive tract. Toxins will be reabsorbed by the colon and feed back to the liver. Eventually congestion will deepen and constipation will give way to diarrhea. The bowel function gets altered and irritable bowel syndrome with alternating constipation/diarrhea occurs. Colitis and diverticulitis is caused by impacted stool, which is due to the long transit time, infection and inflammation
• Skin conditions such as eczema, psoriasis and dermatitis are directly linked to liver congestion. These conditions may be caused by food allergies but additionally the liver is responsible for the manufacture and packaging of fatty acids that are circulated to the tissues. The essential fatty acid, linoleic acid, which is converted to its active form gamma-linolenic acid (GLA), by the liver. Deficiency in this essential nutrient leads to cell permeability and eczematous lesions. If adequate nutrients are supplied (C, B3, Mg, Zn) and not too many saturated fats in the diet, the liver should be able to convert linoleic acid to GLA
• Low blood sugar is associated with congested liver. Many people have inadequate blood sugar control due to liver congestion
• Hormonal imbalances also indicate liver congestion. The liver does not produce the sex hormones but it controls their activity. A healthy liver manufactures proteins (sex hormone binding globulins) that bind the sex hormones, inactivating them. Only the 2-3% that remain free are biologically active. The liver also degrades and clears all hormones. Both these activities regulate the quantities of active circulating sex hormones which controls hormonal activity, regulates menstrual cycles, improves fertility and diminishes the side effects of hormonal imbalances. Detoxification programs that relieve the toxic load of the liver have an enormous impact on hormonal regulation
• Heart disease can also develop when the liver is compromised in its capacity to convert cholesterol to bile acids for excretion
• Gall stones are another indication of faulty cholesterol metabolism. If the ratio between cholesterol and bile acids in solution is disturbed (too much cholesterol, too little bile acids) then cholesterol clumps form stones
• Glandular fever and hepatitis are common diseases that specifically involve  the liver. Any incidence of these diseases in the case history will indicate compromised liver function.
• Emotional problems, depression, anxiety, mood swings, feelings of anger, etc.
• Yellow tinge of eyes and skin, dark circles underneath eyes.
• Vague feeling of ill health.
• Frequent headaches

Factors that burden the liver and lead to congestion

• Highly refined carbohydrate foods/ sugar lead to the accumulation of liver fat causing congestion. Any excess carbohydrates are converted to triglycerides (fat) by the tissues and the liver - which is why you get fat if you eat too much sugar
• Protein deficiency from prolonged fasting, starvation, anorexia or diets lacking quality protein results in the deposition of fats in the liver. Protein is also important  for the manufacture of conjugating elements required in detoxification pathways
• Alcohol abuse
• Medical drugs. Most common ones are paracetamol, oral contraceptives, hormone replacement therapy, antibiotics
• Chemicals
• Specific nutrient deficiencies such as selenium, magnesium, vitamin E, B12, B6, folic acid, linoleic acid, and choline. Magnesium is important in the conversion of cholesterol to bile acids and the secretion of bile into the liver ducts.
• Stress causes the release of fatty acids into the circulation from the body’s own reserves , which increase the liver’s metabolic burden
• Diets that lead to loss of minerals.

Three factors are important to reverse liver congestion:

Removal of the accumulated liver fat

• Removal of the accumulated liver fat is done through a diet regime and nutrients which are required to reduce liver fat. These nutrients are known as lipotrophic factors which are required by the liver for the manufacture of the apoproteins and lecithin
• Magnesium and vitamin B6
• Lecithin; the raw ingredients to make lecithin are choline, inositol and linoleic acid. The co-factors required are vitamin B12, B6 and folic acid. If the diet is rich in these nutrients then the liver can package and mobilise fats to the tissues.

Stimulation of bile production

• Magnesium remains a key mineral in both the production and secretion of bile
• Elevated levels of the natural sex hormones and also synthetic sex hormones such as estrogens, progesterone, and testosterone are known to affect bile salt metabolism adversely either by inhibiting the secretion of bile into the bile ducts or inhibiting its propulsion along the ducts and out of the liver
• Nutrient deficiencies, diets that promote triglyceride synthesis, abuse of alcohol and stimulants, the pill, HRT, and specific antibiotics all lead to liver congestion and a compromised bile production
• Dietary changes and supplementation of nutrients are fundamental. One important aspect is the increase of soluble fibre
• Soluble fibre binds and carries bile salts and toxins via the colon to the outside. Under normal conditions, 95% of the bile salts (along with the toxins) are reabsorbed from the digestive tract and recycled by the liver, so hepatic synthesis contributes only 5% daily to the total bile acid pool. By promotion of reduction of the recycle pool the liver is encouraged to increase production of bile acids by the liver
• The inclusion of foods high in soluble fibre is critical to the detoxification process.

Sources of soluble fibre:

• Oatmeal, oat cereal, oat bran
• Lentils, beans
• Apples, oranges, pears, strawberries, blueberries
• Nuts
• Flaxseeds
• Psyllium husk seeds.

Obtained from the seed husks of plantago psyllium, psyllium helps normalise bowel movements, preventing both constipation and diarrhea. A study of 125 people with type 2 diabetes found that psyllium supplements led to significant reductions in blood sugar, total cholesterol, LDL cholesterol, and triglycerides. Other studies have yielded similar results. A recent article in the International Journal of Pharmaceutics noted that psyllium likely plays a role in preventing inflammatory bowel disease and ulcerative colitis.

• Inulin

Not to be confused with the hormone insulin, inulin is both a soluble fibre and a prebiotic, meaning that it is a food source for beneficial intestinal bacteria. As a prebiotic Inulin is helping to support the growth of certain beneficial Lactobacillus species, especially the Bifidus species. Bifidobacteria digest inulin to produce short chain fatty-acids, such as acetic, propionic, and butyric acids. The first two fatty acids can be used by the liver for energy production and detoxification, while butyric acid has been shown to have cancer-preventing properties within the intestine. Inulin can be extracted from chicory root and used as an additive to increase the fibre content of some foods, or for supplementation. However, perhaps care must be taken when suggesting its supplemental use to clients who have known bacterial overgrowth of pathogenic bacteria particularly Klebsiella, a bacteria implicated in AS and with leaky gut; or with people with a known overgrowth of Candida. Recent studies suggest that inulin may also encourage the growth of these two unfriendly species. So instead of supplementation of inulin, foods that naturally contain inulin should be eaten to start with. Or if supplementing, we should test for unfriendly overgrowths first.

Inulin can be found in many fruits and vegetables, such as chicory, root vegetables, garlic, onions and globe artichokes. Like other types of soluble fibre, inulin functions as a natural stool softener and can reduce constipation. A study in The Journal of Nutrition noted that it may reduce the severity of inflammatory bowel disease.

• Glucomannan

This type of soluble plant fibre has several positive effects, according to a recent overview of the research in The American Journal of Clinical Nutrition. After daily consumption for several weeks, glucomannan can lead to a modest reduction of blood sugar levels. In a couple of studies, supplements promoted modest weight loss, which was enhanced when glucomannan was combined with a low-calorie diet. Other research has shown that glucomannan decreases total cholesterol, ‘bad’ LDL cholesterol, triglyceride levels and blood pressure.

Additional help in releasing liver congestion is done with:

• The coffee enema

The use of coffee in enemas for liver detoxification purposes is well-known. It is a common herbalogical remedy that has been suggested by holistic and alternative medicine professionals for many years. It is a low-volume enema that remains only in the sigmoid colon. The colon has the ability to absorb water with water soluble matter. Water absorbed is carried from the colon to the liver by the hepatic portal vein. Almost all of the blood coming from the digestive system drains into this special venous circulation called the portal circulation. This is, because it contains all the nutrients and toxins that have been absorbed along the digestive tract from ingested food. Before these absorbed substances can go into the systemic circulation (the main blood circulation in the body), it must be filtered first to remove or "detoxify" toxins first. This filtering and detoxification is one of the functions of the liver.
So, any liquid (not just coffee) introduced into the colon by enema, if absorbed, will be carried directly into the liver in almost no time. Now, once coffee reaches the liver, it stimulates production and excretion of bile, including excretion of bile from the gallbladder. When the coffee reaches the liver, the liver excretes bile into the duodenum (through common bile duct).
That bile goes from the duodenum through the whole small intestine, and through the colon, and some of it, together with enema, leaves the body (depends on how long time the enema is retained and many times the enema is repeated per day.)
Releasing the toxins in the liver ducts makes room for toxins from the body to enter the liver for detoxification. The alkaloids in the caffeine stimulate the production of glutathione-S-transferase, which is an enzyme that facilitates the liver detoxification pathways. Coffee enemas will not waste minerals and electrolytes because they have already been absorbed in the previous sections of the intestines. The coffee enema is safe even for people who are sensitive to caffeine because the coffee remains in the sigmoid colon where it will not be absorbed, provided the proper amount is used and the enema bag is not placed too high.

The castor oil pack

• Pour approximately 1-2 tablespoons of castor oil to a cotton flannel and apply onto the upper right quadrant of your abdomen, just under the ribcage (location of liver)
• Place an old towel or t-shirt over the flannel to keep any excess oil from touching your sheets.  Note:  Castor Oil will stain sheets so be careful!
• Place heat source on top of the towel.  Temperature should be high enough for you to  feel the warmth on your skin but not get burned. Use a hot water bottle or heating lamp
• Relax for 30-45 minutes while your skin absorbs the oil.

This is a nice ritual to do before going to sleep while reading or relaxing in bed.  You can keep a container next to the bed so that when you are ready to go to sleep it is easy to drop all materials into the container without getting out of bed.

It is generally recommended that a castor oil pack be used for three days in a row and then four days off to treat a health condition or for detoxification.

Safety precautions: Castor oil should not be taken internally. It should not be applied to broken skin, or used during pregnancy, breastfeeding, or during menstrual flow.

 

Revitalisation of liver detoxification pathways.

The liver filters the blood volume every three minutes. Its job is to neutralise and eliminate all chemicals, both endogenous and exogenous. These toxins will either be eliminated via the kidneys or the bile.

When toxins enter the liver most will undergo a two phase process. Phase 1 takes up toxins and will either directly neutralise it (such as caffeine), make it water soluble for excretion by the kidneys, or modify it; preparing it for entry into the phase 2 pathways. Phase 1 activity generates free radicals and modified toxins (intermediate metabolites), both of which are highly reactive. Phase 1 metabolites can create much damage through oxidative stress in the liver unless they are inactivated.

A significant side effect of phase 1 detoxification is the production of free radicals as the toxins are transformed. For each molecule of toxin metabolised by phase 1, one molecule of free radical is generated. Without adequate free radical defences, every time the liver neutralises a toxin exposure, it is damaged by the free radicals produced.

The most important antioxidant for neutralising the free radicals produced in phase 1 is glutathione. In the process of neutralising free radicals however, glutathione (GSH) is oxidised to glutathione disulfide (GSSG). Glutathione is required for one of the key phase 2 detoxification processes. When high levels of toxin exposure produce so many free radicals from phase 1 detoxification that the glutathione is depleted, the phase 2 processes dependent upon glutathione.

Having a plentiful supply of the antioxidant vitamins and minerals (A,C,E, the bioflavonois, magnesium, selenium and zinc) will neutralise the free radicals, while the speedy transfer of reactive metabolites to the phase 2 enzyme pathways will ensure that any potentially damaging activity will be short-lived.

Problems will occur when phase 1 produces more reactive metabolites than phase 2 can detoxify. This may be due to an overactive phase 1, an underactive phase 2 or a combination of both.

Liver detoxification capacity is depending on:

• The required nutrients for the liver to power its detoxification pathways
• Placing a toxic burden on the liver that is greater than its capacity to detoxify and eliminate
• Enzyme deficiencies in our detoxification pathways due to genetic polymorphism.

Recent research shows that the cytochrome P450 enzyme systems are also found in other parts of the body, especially the brain cells. Inadequate antioxidants and nutrients in the brain result in an increased rate of neuron damage, such as seen in Alzheimer's and Parkinson's disease patients. As with all enzymes, the cytochrome P450s require several nutrients to function, such as copper, magnesium, zinc and vitamin C. A considerable amount of research has found that various substances activate cytochrome P450 while others inhibit it.

 

 

Phase 1 liver detoxification

The phase 1 detoxification can be grouped in an underactive phase 1 and an overactive phase 1:

Symptoms of an underactive phase 1:

• Caffeine, alcohol and nicotine
• Food sensitivities to certain foods such as cheese, nuts, chocolate, red wine, and oranges. These foods contain “amines” which under normal conditions are oxidised and inactivated by the phase 1 cytochromes, the mono-amine oxidase enzymes and diamine oxidase
• Food allergies
• Chemical sensitivities to environmental toxins such as exhaust fumes, paints, strong odours and perfumes
• Increased sensitivity or toxic reactions to drugs
• Poor stress tolerance
• Drowsiness and fatigue after eating.

How to support an underactive phase 1 detoxification:

Recommendations:

• Ensure quality of protein as protein deficiency decreases phase 1 activity, but equally high protein may exhaust this pathway
• Reduce toxic exposure to chemicals and foods that are known to aggravate the condition
• Nutrient cofactors for phase 1 enzymes: B vitamins (B3 niacin), vitamin C, bioflavonoids, co-enzyme Q10, magnesium, iron, copper
• Cruciferous vegetables (broccoli, cauliflower, sprouts, cabbage, bok choy) contain indoles, which enhance phase 1
• The herbs dill, caraway and citrus peel
• Liver regenerating herbs like St.Mary’s thistle, licorice, schizandra and globe artichoke (licorice and schizandra increase P450 activity)
• Fresh organic vegetables and fruits for their antioxidant value
• Prebiotic and probiotic if there are gut problems

Be aware some drugs such as benzodiazepines, antihistamines and stomach-acid secretion blocking drugs will inhibit phase 1 activity. St. Johns wort will induce Phase 1 enzymes and therefore should not be taken in conjunction with medical drugs as it may accelerate the drug's clearance and thus reduce its effectiveness. 

Symptoms of an overactive phase 1:

In general, an overactive phase 1 is determined when the production of intermediate metabolites exceeds the rate of clearance by the phase 2 pathways. People with this imbalance are called pathological detoxifiers. This means intermediate toxins are only slowly taken up by and conjugated by the phase 2 pathways. The liver cells are therefore exposed to free radicals and reactive chemicals for too long, which poisons the liver causing inflammation, scarring (cirrhosis), liver disease and increased susceptibility to liver cancer.

Symptoms:

• Environmental chemical sensitivities
• Abnormal liver function tests
• Liver damage; cirrhosis
• Increased susceptibility to toxin induced diseases such as cancer
• Rapid clearance of caffeine, alcohol and nicotine.

How to support an overactive phase 1 detoxification:

Recommendations:

• Reduction of toxic exposure to chemicals and food
• Don’t exceed protein requirements. High protein increases phase 1 activity and may eventually exhaust this pathway
• Antioxidants to curb free radical damage to liver cells: selenium, magnesium, zinc, vitamin A, C and E, bioflavonoids and alpha lipoic acid
• Protection of glutathione level. With an overactive phase1 is a potential depletion of glutathione. Glutathione is known as a ‘suicide substrate’ as it conjugates directly with some P450 reactive metabolites and may therefore be used up. As one of the main phase 2 pathways is dependent on glutathione, it is imperative that these stores are maintained or this pathway will be slow
• St. Mary’s thistle, schizandra, alpha lipoic acid, vitamin C and  N-acetylcysteine will help to regenerate glutathione
• Cruciferous vegetables are a good source of glutathione
• Grapefruit juice, turmeric, clove oil, quercetin, chilli peppers and calendula suppress phase 1 activity
• Regenerate and protect your liver with green tea, schizandra, turmeric, St.Mary’s thistle and globe artichokes
• Stimulate the phase 2 uptake of toxins with coffee enemas, schizandra and tumeric. Cruciferous vegetables stimulate the enzyme glutathione S transferase, which transfers toxins for conjugation in the phase 2 glutathionation pathway.

 

Phase 2 liver detoxification

To find out if phase 2 and phase 1 are working properly, an FDLP test (functional liver detoxification profile) and a Nutrigenomic DNA test are a good option.

In phase 2 all toxins which went through phase 1 ( P450 cytochrome oxidase enzymes) are transported as quickly as possible to the six main conjugating pathways. These pathways inactivate the toxins, made water soluble and eliminated via the bile.

The main pathways are:

• Methylation
• Sulphation
• Glutathionation
• Glucuronidation
• Acylation ( glycine and taurine conjugation)
• Acetylation.

Problems arise in phase 2 when there is a shortage in actual conjugating compounds used in each pathway. The compounds are normally supplied by dietary proteins and glucose.

• Methionine (essential amino acid) supplies methyl groups for methylation
• Sulphur for sulphation
• Cysteine as a building block for glutathione production - glutathionation
• Glutamic acid, glycine, taurine and cystein supply for acylation
• Glucose supplies the glucuronidation
• Acetic acid supplies Acetylation.

Methionine is a major lipotrophic compound and with estrogen dominance the body will require more methionine. Estrogen reduces bile flow through the liver and will increase cholesterol levels. Methionine helps deactivate estrogens and at the same time affect the levels of glutathione and other sulphur containing compounds that enhance liver function and protect against toxic damage.

If there are enough enzyme co-factors, B vitamins, most importantly vitamin B5, B6, B12, folic acid and choline, magnesium, selenium and zinc, and the enzyme activity is not defective, then these pathways should run smoothly.

Main indicators for phase 2 deficiencies:

• Fat intolerance and or gall stones. This indicates a slow glycination or taurine conjugation pathway. Bile acids are conjugated with either glycine or taurine to form bile salts, which have an important role in the emulsification of cholesterol and dietary fats. Any deficiencies in either the conversion of cholesterol to bile acids, or in their subsequent conjugation may result in gall stone formation and intolerance to dietary fats.
• High homocysteine. High homocysteine indicates deficiencies in either the methylation pathway or the glutathionation and sulphation pathways.
• High bilirubin. The breakdown of red blood cells into bilirubin takes place via the glucuroidation pathway where an enzyme is responsible for its conjugation. Either the pathway is generally slow, which leads to Gilbert’s syndrom, or the pathway is being used as a supplementary pathway for the removal of toxins that would ordinarily be conjugated by the sulphation, methylation or glycination pathways.
• Estrogen dominance. In order to protect against the formation of the more dangerous 4-OH and 16-OH estrogen metabolites, phase 1, 2-OH pathway with DIM or indole 3 carbinole  needs to be supported as well as the phase 2 methylation pathway for conversion to the anti cancer estrogen metabolites.  Estrogens are ultimately detoxified and eliminated via the glucuronidation and sulphation pathways.
• Food sensitivities and allergies. Most of our food sensitivities and allergies implicate deficiencies in the phase 2 pathways, specifically the methylation and sulphation pathways.

We have two main classes of immune globulins which are associated with food intolerances; IgG and IgE.

If IgE is triggered by contact then endogenous histamine from mast cells is released and leads to the development of hives, eczema, conjunctivitis, rhinitis, sinusitis and asthma.

Histamine is detoxified by methylation so it is very important to support this pathway with adequate dietary vitamin B12 and folate, and the reduction of the known triggers. The food groups to watch out for are dairy, wheat, nuts, soy and eggs. In an allergic individual, mast cells can spontaneously release histamine to other triggers such as heat, sudden cold, alcohol, paints, fumes, colourings, additives, salicylates, bacteria, plant toxins etc.

There are many substances which can trigger a IgG response. Chemical sensitivities, naturally occurring food chemicals, partially digested protein (especially from wheat and diary), gluten and certain foods.

 

Heavy metal toxicity

Heavy metals such as mercury, lead, cadmium, copper and aluminium can tie up the sulphation and glutathione pathways and exacerbate any existing health problems linked to poor sulphation, such as food and chemical intolerances, inflammatory disease and behavioural disorders.

It is very important to reduce the heavy metal load before any improvement can be seen. Oral chelating agents are used over a prolonged period of time, however, that will not fix a poor sulphation pathway. It is highly advised at the same time to support this pathway with NAC, garlic, cilantro, chlorella, zinc.

By embarking on any kind of treatment which draws heavy metals out of the tissues, it is important that there is enough chelating agent or cysteine (as NAC) to bind the metals. If not there will not only be an increase of load for the sulphation pathway but also the risk of redistributing the heavy metals into the central nervous system if they cannot be eliminated.

NAC, alpha lipoic acid, sulphur rich foods and chlorella are very good binders.

 

Depression

Circulating toxins such as food by-products, if not detoxified by the liver can enter the brain and create havoc. The brain has both methylation and sulpahtion pathways so there is a backup mechanism for the detoxification of these toxins. But in the genetically predisposed, where these pathways may be down-regulated, we see depression.

Depression is related to either an underproduction of the feel good brain chemicals serotonin, dopamine and noradrenalin or poor transmission capacity. Antidepressant medications will boost levels of these chemicals by either increasing their output or reducing their rate of breakdown. This means that higher levels of chemicals remain in the brain for a longer period of time.

The parent molecule for neurotransmitter synthesis are the amino acids tryptophan and tyrosine. Both pathways require vitamin B6 and magnesium. Tryptophan is the direct precursor for seretonin synthesis and tyrosine the direct precursor for dopamine, noradrenaline and adrenaline synthesis. So B6 and magnesium deficiencies can directly lead to depression. Estrogen dominance can suppress dopamine production, which also leads to depression.

 

Recommendation to support phase 2 detoxification pathways:

Methylation:

Symptoms: Allergy, estrogen dominance, homocysteine, depression, anxiety, ADHD, ASD, fatty liver, alcoholism, multiple chemical sensitivity.

Supplements: Methionine, magnesium, vitamin B12, folate, choline, carnitine, TMG, SAMe.

Foods/Herbs: Sulphur containing foods; broccoli, Brussel sprouts, cauliflower, red/green cabbage, watercress, onions, garlic, leeks, quality protein.

Sulphation:

Symptoms: Allergies, drugs (aspirin, paracetamol, NSAIDs), estrogen dominance, thyroid hormone imbalance, inflammatory disease, anxiety/high adrenaline, heavy metal accumulation, candida, clostridia, ADHD, ASD, gall stones.

Supplements: Methionine, cysteine, taurine, vitamin B12, vitamin B6, folate, magnesium, zinc, iron, NAC, alpha lipoic acid, taurine.

Foods/herbs: Sulphur containing foods, fresh coriander and chlorella will assist in heavy metal detoxification.

Glutathionation:

Symptoms: As for the sulphation pathway plus: liver toxicity, cirrhosis, hepatitis, cancer, abnormal liver function tests, drug sensitivity to penicillin, tetracycline, paracetamol.

Supplements: As for the sulphation pathway plus: selenium, glutathione, glycine, glutamine, vitamin B2, B3, B6, Aplpa lipic acid, NAC (N-acetyl-cysteine).

Foods/herbs:  As for sulphation plus: turmeric, schizandra, milk thistle

Glucuronidation:

Symptoms: Elevated bilirubin, Gilbert’s syndrome, jaundice, estrogen dominance, anxiety/high adrenaline, drugs: a wide range including aspirin, paracetamol, diazepams, steroids.

Supplements: Calcium D glucarate, SAMe.

Foods/herbs: broccoli, oranges, Brussel sprouts, kombucha tea, green tea, rosemary leaf extract.

Glycination:

Symptoms: Allergy to benzoates, salicylates/aspirin, gall stones, jaundice.

Supplements: Magnesium, zinc, vitamin B3,B6, glycine.

Foods/herbs: Glycine is widely available in foods.

If there is a problem with a genetic variance and down regulation of enzyme pathways then supplementation with an intermediate nutrient will bypass the impaired step.

• It is estimated that ca. 35% of the population may have a impaired folate metabolism. Activated folate in the form of 5-methyltetrahydrofolate (5-MTHF) is more easily assimilated into the folate metabolism than its synthetic form folic acid and therefore the better choice to supplement

Cyanocobolamin vitamin B12 is metabolised by the liver to its active form methylcobolamin. This is the only form which can be utilised by the brain and nervous system. People with an impairment in their vitamin B12 pathway will benefit from the active form.

 

Further reading recommended: 

Article: Six lifestyle & Dietary Habits for healthy liver and gallbladder functions 

https://www.trulyheal.com/six-lifestyle-dietary-habits-for-healthy-liver-gallbladder-functions/