Doctor, I want to detox..." is not an uncommon patient request in my office, especially after a long winter of limited exercise, indoor activity, and not-so-fresh food. But just how does one "detox," and is it a good idea?
To begin, it is important to understand the difference between being ill or medically toxic, and being in need of a self-care clean-up. Significant toxicity is obvious -- skin changes, hair loss, allergic reactions, memory loss, diarrhea, abdominal pain, and difficulty breathing include some of the physiological signs of considerable toxic exposure. If you have such episodic symptoms, you should see a doctor.
There are also diseases with symptoms similar to those associated with true toxicity; viruses, such as' hepatitis, mononucleosis, and Epstein-Barr, weaken the body, particularly the liver, creating symptoms such as fatigue, changes in appetite, skin, digestion, and sleep patterns. Today, hepatitis, particularly hepatitis C, is a serious public health concern; about 30,000 new hepatitis C infections are diagnosed each year in the United States, and almost 4 million Americans are currently diagnosed with the disease. If you have been exposed to one of these viruses, or have suspicious symptoms, ask your healthcare practitioner for a diagnosis.
On another level, everyone alive during this last year of the 20th century has had, and will continue to have, some level of toxic exposure; it is simply unavoidable. Things like pesticides, herbicides, radiation, preservatives, and untold toxic residue exist in all parts of the world. Chemical by-products are in our water, our food, and our air. Exposure damages the body, and places a high demand on our bodies' natural detoxification mechanisms.
Reducing the toxic burden
Accumulation of chemicals and metals can overload the body, making it more sensitive to all sorts of things -- foods, plants, scents -- and decrease healthy body function. Many experts surmise that toxic exposure may well be responsible for the increase in chronic diseases (e.g., cancer, arthritis, chronic fatigue syndrome, depression, and attention deficit disorder). If this is the case, all of us need to keep our natural "detox" mechanisms in high-functioning condition.
Our bodies' detox systems -- on and below the surface The skin, the kidneys, the bowels, and the liver are the best known of the body's detox organs. Daily elimination, plenty of water, skin brushing (using a brush on dry skin prior to showering), regular physical exercise, and good nutrition are essential to keeping these systems intact -- giving them the ability to efficiently and effectively eliminate toxins from the body.
But what happens when we fall off the proverbial wagon, when we invariably slip into drinking too much caffeine, eating sweets several times a day, and skipping our daily work-out? The skin changes, it may get rough, or oily, with acne or eczema; we gain weight, bowels act up, and energy becomes sluggish; odd pains in the joints, the neck, and the abdomen may appear. In addition, premenstrual syndrome (PMS), irritability, sinus drainage, or headache remind us that it's time to clean up our act. Our detox systems tell us that they help best those who help themselves.
'Detoxing' herbs: our bodies' support team
When embarking on a cleansing phase of dietary and lifestyle improvement, it is often advisable to also use one or more of a variety of herbs that have a beneficial effect on liver and digestive function. The liver plays a key role in detoxification: it neutralizes chemicals from the external environment, filters the blood, manufactures bile, and goes through a variety of enzymatic processes to both break down, and create, compounds necessary for human life -- cholesterol (the "good" kind), glutathione, and various hormones.
Many herbs are helpful for the liver and gastrointestinal (GI) tract. My favorites are the tonic herbs, plants like dandelion, burdock, and garlic, which are good food for the body and safe to consume regularly -- incorporated into meals and/or beverages and taken in daily supplement form. Milk thistle and the Indian herb, Picrorhiza, are also powerful medicinals for treating liver disease. Ayurvedic practitioners also use Phyllanthus amarus and Triphala to maintain liver and GI health.
Our 7 "toxic avengers"
Though "hunted" voraciously and annually with millions of gallons of toxic weed killer, the resilient dandelion (Taraxacum officinali) carries on, nonetheless. Each Spring it pops up, sporting a cheeky yellow cheerfulness that defies all human attempts at eradication. Like echinacea, dandelion is a member of the Compositae, or daisy, family. Both the root and the leaves are used as medicine; the plant is rich in bitters, vitamin C, potassium, and enzymatic-like substances which stimulate the liver and kidneys.
Dandelion is known as a cholegogue, or a substance which stimulates the production of bile in the liver, and the secretion of bile from the gallbladder. Bile has a laxative effect on the gastrointestinal tract, and it helps in proper fat digestion. For this reason, cholegogues are frequently used in cases of constipation and liver congestion.
Dandelion also has diuretic properties, meaning it stimulates kidney function. I often prescribe this plant medicine to patients who require a diuretic, in conditions like high blood pressure or edema. Dandelion is widely available in a variety of forms: dried leaf and root are sold in tea, capsule, and tincture form.
Another member of the Compositae family, Arctium lappa, or burdock, also has good "clean-up" properties, particularly where there are dry scaly skin conditions, such as psoriasis or eczema. Like dandelion, burdock is a bitter, stimulating the secretion of digestive enzymes, particularly bile. It is often combined with yellow dock, milk thistle, and dandelion in specific liver preparations.
Arctium has also long been known as a medicine for premature baldness, rheumatism, arthritis, and acne. The fibrous root is thought to be protective against toxicity and even cancer. It is most commonly used as a tincture or a tea, though the raw, fresh root is also available in grocery stores and can be sliced thinly and added to soups or salads.
Just about everyone knows that garlic (Allium sativum) packs not only a strong scent, but tremendous vitality into a single clove. Antiviral, antiseptic, bile-stimulating, hypotensive, and blood cleansing garlic finds itself in the group of herbs which R.F. Weiss calls the "gentle herbal remedies" -- herbs which have broad therapeutic action and are safe to take over a long period of time.
While critics might argue that garlic's taste is anything but gentle, it is indisputable that garlic is an excellent cleansing and health-maintaining medicine. Studies show that the long-term use of garlic and garlic-derived extracts protects the arteries against plaque build-up and works to lower elevated cholesterol. It also has anti-microbial activity, assisting in keeping our gut flora healthy. While I personally enjoy the taste of garlic, both raw and cooked, it is also widely available in supplement form (powdered and aged), in a variety of single and combination formulations.
4. Milk Thistle
Silybum marianum, or milk thistle, is an undeniable giant in the field of liver-supportive herbs. An array of re search studies reveals that silymarin, a flavonoid extracted from milk thistle, has a substantial protective effect on the liver. This flavonoid protects the liver through several means: it acts as an antioxidant, protecting the liver from free-radical damage; it increases the liver's rate of tissue regeneration; and it increases the synthesis of glutathione, an anticarcinogen and an antioxidant. Studies carried out with laboratory animals have shown milk thistle to be protective against such liver-damaging substances as carbon tetrachloride and Amanita mushroom.
Human studies have found milk thistle to be useful in treating hepatitis, cirrhosis, and alcohol-induced fatty liver. In my naturopathic medical practice, I find this thistle to be of great value in cases of gallbladder and bile-duct inflammation. Because it increases the flow of bile from the gallbladder, it should be introduced gently to avoid overstimulation of the liver and gallbladder. Overstimulation can lead to intestinal irritation and loose stools.
5. Picrorhiza kurroa
Like milk thistle, the Indian herb Picrorhiza kurroa proudly claims a coveted role in liver protection. Studies using noxious chemicals, such as carbon tetrachloride and alcohol, and the infectious agents aflatoxin B1 and Leishmania donovani, show that Picrorhiza is able to protect the liver against damage from these substances. Picrorhiza has also been shown to be effective against hepatitis B and parasitic infections.
The antioxidative activity of the bitter roots and rhizomes of this plant have long been a traditional part of Ayurvedic medicine. In that medical system, Picrorhiza is also known for its benefit in illnesses such as asthma, bronchitis, and malaria.
6. Phyllanthus amarus
Heads turned in 1988 when the renowned Lancet published a study showing the Indian herb Phyllanthus amarus to be remarkably effective in eliminating the "carrier" status in patients who were hepatitis B carriers. In this study, carrier subjects took 600 mg daily of dried, powdered Phyllanthus for 30 days. When tested 20 days after treatment, 59 percent of the study participants were no longer hepatitis B carriers.
Unfortunately, studies following this one have failed to confirm Phyllanthus's effectiveness in similar cases of hepatitis, and the research "jury" on Phyllanthus is still out.
However, experts in the field of Ayurvedic medicine argue that it is the research, not the herb, which is flawed. They point to thousands of successful clinical cases, and a long traditional use of this herb in all manner of liver disease.
Given the serious and devastating nature of liver disease, my vote is for continued, thoughtful use, observation, and discussion of Pyllanthus amarus. We have not yet solved many concerns related to liver disease; it may well be that Phyllanthus is part of the solution.
Triphala, also known as Trifal, is actually a combination of three herbs: Terminalia chebula, Terminalia bellerica, and Phyllanthus emblica. It is an ancient Ayurvedic remedy; experts date references to this formula back as far as 5,000 years ago.
Traditionally, triphala was used as a digestive, a mild laxative, and externally to speed wound and burn healing. In modern times, it is referred to as an intestinal "cleanser," improving both digestion and elimination. Practitioners report that triphala is mild, gently encouraging elimination without irritating the bowels.
So, whatever your understanding of or need for "detoxification" may be, there are some cleansing helpers from the plant world that are certainly worth a try. Patients with existing liver and gallbladder disease should consult their healthcare practitioners before using any of these liver-supportive botanicals.
PHOTO (COLOR): Dandelion
PHOTO (COLOR): Burdock
PHOTO (COLOR): Milk Thistle
PHOTO (COLOR): Garlic
PHOTO (COLOR): Jamison Starbuck
Leelarasamee, A., et al. "Failure of Phyllanthus amarus to eradicate hepatitis B surface antigen from symptomless carriers," Lancet 335:1600-1, 1990.
Mittal, N. "Protective effect of Picroliv from Picrorhiza kurroa against Leishmania donovani infections in Mesocricetus auratus," Life Sci 63(20):1823-34, 1998.
Pizzorno, J. and Murray, M. "Detoxification: A Naturopathic Perspective," Natural Medicine Journal 1(4):6-17, 1998.
Rastogi, R., et al. "Picroliv protects against alcohol-induced chronic hepatotoxicity in rats," Planta Med 62(3):283-5, June 1996.
Santra, A., et al. "Prevention of carbon tetrachloride-induced hepatic injury in mice by Picrorhiza kurrooa," Indian J Gastroenterol 17(1):6-9, January 1998.
Thyagarajan, S.P., et al. "Effect of Phyllanthus amarus on chronic carriers of hepatitis B virus," Lancet 2(8614):764-6, October 1, 1988.
Weiss, R.F. Herbal Medicine. Beaconsfield, England: Beaconsfield Publishers, 1988.
By J. Jamison Starbuck, J.D., N.D.
Adapted by J.D., N.D.
Jamison Starbuck, J.D., N.D., is a licensed naturopathic and homeopathic physician. Her Missoula (Montana)-based family practice treats the whole person via constitutional homeopathy, botanical medicine, nutrition, counseling, and other natural modalities. Dr. Starbuck is also a consulting editor for Time-Life Books.