Portal circulation — this is how detox really works
The liver is the central metabolic organ in the human body, and in addition to metabolism is responsible for a number of other functions such as immunity, detoxification and vitamin storage. It accounts for about 2% of an adult’s body weight and is located just below the diaphragm largely in the right upper abdomen. Microscopically, the liver is composed of structural elements about 1–2 mm in diameter — the hepatic lobules. Because of the dual blood supply through the portal vein (about 75%) and the hepatic artery (about 25%), the liver is a unique organ.
Normally, organs have an arterial, oxygenated blood supply and a venous, deoxygenated blood drainage. The liver, however, receives nutrient-enriched blood directly from the intestine via the portal vein in addition to the arterial supply. This is the fastest and most direct way to ensure that all nutrients can be absorbed and processed directly before the blood flows back to the heart. In addition, the liver has large storage capacities to store various nutrients, such as glucose in the form of glycogen, fat-soluble vitamins and the trace elements copper and iron.
The liver plays a particularly important role in sugar metabolism. Through various mechanisms, it ensures that blood glucose levels are kept constant within narrow limits during periods of hunger (with the help of gluconeogenesis). Another important function of the liver is detoxification and the focus of our article today: in the course of so-called biotransformation, both endogenous and exogenous lipophilic (insoluble in water) substances are coupled to hydrophilic (soluble in water) substances and thus made excretable. The liver thus enables the body to rid itself of substances that would not “find their way” out of the body on their own. The breakdown products are released into the small intestine via the bile and excreted via the intestines.
Are you only interested in the facts? Everything you need to know about the liver!
- The liver is the central metabolic organ in the human body, and in addition to metabolism is responsible for a number of other functions such as immunity, detoxification and vitamin storage.
- The liver accounts for about 2% of an adult’s body weight.
- Because of its dual blood supply through the portal vein (about 75%) and the hepatic artery (about 25%), the liver is a unique organ.
- The liver enables the body to rid itself of substances that would not “find” their way out of the body on their own.
- Milk thistle has been a well-known “liver cleanser” for decades because of its antioxidant and anti-inflammatory properties.
- According to experimental animal studies, turmeric powder shows significant liver-protective effects.
- Algae, especially chlorella, are powerful chelators and can bind and eliminate heavy metals and other toxins that might otherwise burden and besiege the liver. Laboratory studies showed that chlorella can absorb 40% of the heavy metals in a test solution within seven days.
- Sweating helps take some of the detox burden off the liver. The skin is our largest organ and important for detoxification via sweating.
- Detox products are now available over-the-counter everywhere, but most, if not all, have not been tested in human clinical trials.
- Those who maintain a balanced diet rich in fiber and nutrients, keep their weight stable through exercise, and consume alcohol in moderation are supporting the liver in the most effective way.
- The liver is a unique organ because it can regenerate damaged tissue completely and without scarring.
What are the detox mechanisms in the liver?
More than ever, our bodies are bombarded with stressors, from pollution to chemicals in skin care products to preservatives in foods we eat. These can build up in the liver, blocking space for actual nutrient stores. A buildup of dangerous substances in the body, such as heavy metals or molds, can lead to chronic inflammation, fatigue, and indigestion — and give our liver a whole lot of extra work. So detox is not about detoxifying or cleansing the liver itself — because that’s not possible. Rather, it’s about supporting the liver in its natural work and protecting it from external stressors.
The bile produced by the liver helps to eliminate substances that cannot be excreted through the kidneys or sweat. Bile is produced by hepatocytes — liver cells — and consists mainly of water, electrolytes, bile salts, bile acids, cholesterol, bile pigment, bilirubin and phospholipids, among other substances.
What substances can support liver function?
Milk Thistle: Milk thistle has been a well-known liver cleanser for decades because of its antioxidant and anti-inflammatory properties. By reducing inflammation, milk thistle creates a better environment in the liver, allowing enzymes to work more effectively and substances to be detoxified and eliminated more efficiently.
Turmeric: According to research, the curcumin contained in the root — the anti-inflammatory substance that also provides the characteristic color of the spice — has an effect as high as ibuprofen and aspirin. Because of its anti-inflammatory properties, turmeric, has long been used in Ayurvedic medicine. Turmeric has also shown surprising results in non-malignant precancerous conditions. According to experimental animal studies, the yellow powder produced from the root of the turmeric plant also exhibits significant liver-protective effects. In a Korean study, a significant decrease in elevated liver enzymes was observed after twelve weeks of taking turmeric powder. However, as with all nutrients and supplements, one should not overdo it: an overdose (between 8 and 12 grams per day) can lead to irritation of the stomach lining.
Chlorella: Algae, especially chlorella, are powerful chelators and can bind and eliminate heavy metals and other toxins that might otherwise burden and clog the liver. Laboratory studies showed that chlorella can absorb 40% of the heavy metals in a test solution within seven days. In animal studies, it was observed that chlorella could remove toxins such as mercury from the body. Chlorella also contains several nutrients with antioxidant properties, including vitamin C, chlorophyll, beta-carotene, lutein and lycopene.
Activated Charcoal: Like chlorella, activated charcoal can help bind toxins that circulate freely in the body and eliminate them through the intestines. However, activated charcoal can also bind important minerals and vitamins, so it should be taken between meals and separately from other supplements. Furthermore, there are no studies on the long-term safety of activated charcoal, which is why it should currently be taken rather short-term and with caution.
What else can be done to promote liver detoxification?
Sweating helps take some of the detoxification burden off the liver. According to Wendie Trubow, M.D., a gynecologist, detoxification depends on two critical factors: Avoiding additional exposure to toxins and eliminating toxins that are present in the body. Ridding the body of toxins occurs through two main pathways. The first is improving liver function, and the second is sweating. “The skin is our largest organ and an important detoxification organ through sweating”, she says. Exercise also boosts the body’s production of glutathione, which likewise helps with detoxification (see below for more on glutathione). In addition to at least 30 minutes of exercise per day, she recommends infrared saunas, steam baths or Epsom salt baths to really work up a sweat.
Stay away from “detox teas”
Detox products are now available over-the-counter everywhere. However, most, if not all, have not been tested in clinical trials and are not regulated by the U.S. Food and Drug Administration. This means that there is absolutely no proof that these products even work. There is also no record of potential harm from detox products.
Even if there are promising words on the packaging: the contents can often be very dangerous for many people. Many herbs have liver-toxic effects if consumed for too long and can lead to fulminant liver failure — as described in a case report from Drexel University Hospital in Philadelphia. The American Association for the Study of Liver Diseases (AASLD) defines acute fulminant liver failure as an acute deterioration of liver function associated with altered consciousness and disruption of blood clotting, with no known preexisting disease.
The patient discussed in this case consumed at least 1 cup of a Yogi detox tea daily for weeks. This is an American-made tea consisting of eighteen herbs marketed as “liver supportive.” Studies on the ingredients have demonstrated antioxidant and anti-inflammatory properties for all of them. However, less than 10% of these studies were conducted on humans, only on animals. Thus, animal studies are unable to mimic the complex process of herb-induced liver injury in humans. Cinnamon bark, black pepper, juniper berry and rhubarb root have also been linked to liver dysfunction.
How you can protect yourself from liver disease
The two biggest risk factors for liver disease are excessive alcohol consumption and a family history of liver disease. While genetic factors cannot be influenced, lifestyle changes can. Those who maintain a balanced diet rich in fiber and nutrients, keep their weight stable through exercise, and consume alcohol in moderation are supporting the liver in the most effective way. A recent study shows that weight loss of just 3 to 6% of body weight can reduce liver fat levels by 35 to 40%, providing tremendous relief to the body’s most important detoxification organ.
Wholesome foods, preferably organic, including vegetables, fruits, whole grains, beans, nuts, seeds, sustainably raised meats, fish, eggs, and minimally processed oils such as olive or coconut oil are major roles in the diet. Giving the liver a break from foods with additives and pesticide residues is the best detox diet a liver could ask for.
Here are our favorite liver-friendly foods:
Almonds: Almonds, sunflower seeds, peanuts, wheat germ, salmon and avocado are all great sources of vitamin E, a powerful antioxidant that research shows can counteract the oxidative stress associated with fatty liver disease.
Artichoke: Bile helps transport toxins so they can be removed from the body. Therefore, impaired bile flow can lead to toxin accumulation and liver damage. Artichoke contains phenolic derivatives that have been used for centuries to stimulate bile flow to help eliminate toxins from the liver.
Berries: Dark berries such as blueberries, blackberries and raspberries not only contain lots of fiber, but also contain phytochemicals called anthocyanins, which have powerful antioxidant properties and have been shown to scavenge free radicals and promote normal inflammatory processes.
Red Beet: These ruby red roots contain pigments called betalains, which help support cell repair in the liver thanks to their powerful antioxidant properties. They also contain betaine, which helps liver cells eliminate toxins, and pectin, a type of dietary fiber that helps bind and eliminate toxins.
Broccoli Sprouts: Cruciferous vegetables such as broccoli sprouts, broccoli, cabbage, cauliflower, Brussels sprouts and watercress contain sulfur-containing phytochemicals called glucosinolates that protect against chronic diseases and help the body eliminate toxins. One study found that a drink made from broccoli sprouts activates enzymes that help absorb pollutants from the bloodstream and flush them out through the urine. Another study demonstrated that eating broccoli slows the progression of fatty liver disease in mice.
Citrus: Lemons, tangerines and oranges contain a compound called D-limonene, which has been shown to help reduce oxidative damage to the liver caused by a high-fat diet. So drinking lemon water throughout the day is not only a great way to stay hydrated, but it also promotes the removal of toxins from the body.
Dandelion Root and Greens: Dandelion is known for its cleansing properties, and one study found that both the root and leaf help rid the body of reactive oxygen species that cause oxidative stress. Dandelion greens (along with other bitter vegetables like mustard greens and arugula) are also great because they stimulate bile production and promote healthy digestion.
Fermented foods: sauerkraut, kimchi, kombucha, lactic fermented cucumbers, kefir, yogurt and other fermented foods are rich in beneficial probiotic bacteria that promote healthy digestion and intestinal mucosal integrity, thereby helping to keep toxins out of the bloodstream.
Glutathione-boosting foods: glutathione is an antioxidant concentrated in the liver that helps bind toxins and carry them out of the body through the urine or bile. Glutathione can be obtained directly from some foods such as raw spinach, avocado and asparagus, thus supporting the body’s own production of glutathione from the amino acids glutamine, glycine and cysteine.
On the subject of alcohol: alcohol is converted in the liver to a toxin (acetaldehyde) that is highly toxic, attacks cell membranes in the liver, and has an inhibitory effect on other enzyme systems. If consumed regularly in excessive amounts, it can cause severe organ damage. The liver is most severely affected because, as the organ of breakdown, it is the most exposed to the toxin. When alcohol is broken down in the liver, the liver cells become damaged, “fatty” and increasingly lose their function and regenerative capacity. Over time, this can lead to fatty liver and later to jaundice, cirrhosis and liver cancer. Fatty liver can already occur in children and adolescents.
The recommended intake is only one standard drink per day for women and two for men until age 65. After age 65, men should also reduce to one standard drink per day. Drinking alcohol in moderation is the most important factor in protecting against liver disease.
Is “repair” of pre-existing liver damage possible?
Damage to skin or other organs in the body results in scars. The liver, on the other hand, is a unique organ in that it can regenerate damaged tissue completely and without scarring. But this regeneration takes time and also only works if there is enough regenerative tissue left. If the liver is constantly stressed by medication, excessive alcohol consumption or poor nutrition, this can prevent regeneration, leading to fibrosis (connective tissue transformation) and ultimately irreversible scarring of the liver (cirrhosis). Unfortunately, there is no turning back from here.
Text Sources:
(1) Kesavarapu K, Kang M, Shin JJ, Rothstein K. Yogi Detox Tea: A Potential Cause of Acute Liver Failure. Case Rep Gastrointest Med. 2017;2017:3540756. doi: 10.1155/2017/3540756. Epub 2017 Oct 24. PMID: 29204300; PMCID: PMC5674495.
(2) M. Lee, A. M. Larson, and R. T. Stravitz, “AASLD position paper: the management of acute liver failure,” in Hepatology, vol. 55, pp. 965–967, 2012.
(3) Kalra A, Yetiskul E, Wehrle CJ, Tuma F. Physiology, Liver. 2020 May 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30571059.
(4) Kim SW, Ha K-C, Choi E-K, Jung S-Y, Kim, M-G, Kwon D-Y, Yang H-J, Kim M-J, Kang H-J, Back H-I, Kim S-Y, Park S-H, Baek H-Y, Kim Y-J, Lee J-Y, Chae S-W. The effectiveness of fermented turmeric powder in subjects with elevated alanine transaminase levels: a randomised controlled study. BMC Complement Altern Med 2013; 13: 58
Image Sources:
