From The February 2000 Issue of Nutrition Science News
by Monika Klein, C.N.
Mary came to my practice complaining of weight gain, fatigue and severe bowel problems. She felt "toxic" and said, "Nothing in my body works right." She had gained 80 pounds over a five-year period. Her addictive and destructive eating patterns included sugary and fatty foods as well as starchy breads and pasta she believed were weight-loss foods. Chronic diarrhea forced her to the rest room after every meal. She also had a penchant for diet soft drinks: On a good day she drank eight cans, but her real quota was closer to 14. Her normal afternoon lows were relieved by a fresh can of diet cola. On many occasions she went home from her busy job as an engineer so exhausted she fell asleep by 6 p.m. More often than not, she'd wake in a few hours for a late meal.
I recommend a detoxification and food elimination program to help people like Mary begin to lose weight, get their bodies working more efficiently and encourage healthier eating habits. This also tends to decrease cravings for the usual unhealthy dietary choices such as coffee, salt, sodas and sugar. Giving the digestive system a break decreases the physiological or psychological need for certain foods.
A monthly or yearly detoxification process is beneficial for anyone at any age. Toxins--both environmental pollutants and those generated internally by food intolerances and even normal body functions including digestion itself--inhabit all areas of our lives. [1,2] Mental and emotional stressors can create additional physiological toxins that need to be eliminated.
Detoxification also reduces inflammation in the body by eliminating toxic by-products that stem from digestive conditions such as intestinal permeability, parasites and candidiasis. 
Using omega-3 oils in the form of flaxseed oil (liquid or capsules) or eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) in the form of fish or fish oil is an excellent way to reduce pain and inflammation. These essential fatty acids tend to produce more of the fatty acid prostaglandins vs. the production of the pro-inflammatory arachidonic acids. Because most pain is due to some type of inflammation, reducing it naturally reduces the pain.
For Mary, during a 15-month period, she underwent two detoxification programs with dietary changes, initiated an enjoyable exercise program, and lost 60 pounds.
Three Steps to Detox
Detoxification regimens generally start with the liver, the body's major detoxification organ. When the liver is working efficiently and effectively, other organs often follow suit. The skin, lungs, bowels, kidneys and bladder eliminate toxins processed by the liver, and of course are eliminative in and of themselves. Once the detox process begins, digestion, brain function and other physiological processes also tend to work better. 
The actual detoxification process is typically broken into three stages: the elimination, the intensive and the experimental. The duration of each phase varies with the individual.
The elimination process is the first step, and can begin if a person is relatively healthy and free of a serious chronic health condition such as cancer, colitis, diabetes or heart disease. The elimination phase rids the diet of potential food allergens such as citrus, coffee and other caffeinated beverages, dairy, eggs, sugar and sugared foods, red meat, and gluten-rich grains such as wheat, oats, barley and rye. 
The intensive stage for my patients comprises at least three days of eating only vegetable broth and non-starchy steamed vegetables. These alkalizing foods reduce acidity and inflammation. If a person is hungry during this stage, nuts and seeds such as almonds, sunflower or pumpkin seeds are also alkalizing, effectively satisfy hunger and are usually nonallergenic. 
The experimental phase slowly reintroduces foods into the diet to see if they are tolerated. During a detoxification program, a person often becomes more sensitive to food allergens. If an introduced food triggers a reaction, it is once again eliminated from the diet and added one or two weeks later to verify a food sensitivity or allergy. People often are more aware of their food and behavior addictions during this period. This is the longest phase and often requires emotional support and education.
At the onset of the initial elimination phase, I'll put the patient on antioxidants. Sufficient amounts of antioxidants are an important part of any detoxification program. If not eliminated, toxins and free radical damage may lead to disease. All of the following antioxidants work together to protect and strengthen the body during a detox.
GLUTATHIONE is a sulfur-containing amino acid. High concentrations of glutathione exist in liver cells. Studies have shown that glutathione attaches to toxic compounds in the liver in a process called conjugation that neutralizes toxins or enables them to be excreted. 
Glutathione is too large a molecule to effectively pass through the intestine into cells, so supplementing is not helpful.  But glutathione is effectively recycled -- protected from oxidative damage -- by vitamin C. In one double-blind study, 500 mg/day vitamin C raised glutathione levels by 50 percent in the blood, which transports it to the cells that need it. Interestingly, the same study found 2,000 mg/day vitamin C raised glutathione levels by only another 5 percent, so more is not necessarily better. 
VITAMIN C, or ascorbic acid, aids the detoxification process in several ways, one being that it recycles other antioxidants such as glutathione and vitamin E.
VITAMIN E is the major fat-soluble antioxidant in the body and is the most studied free radical quencher. Vitamin E and water-soluble vitamin C recycle one another in the fight against free radicals. Vitamin C and E, as well as beta-carotene, protect the liver from damage and help support detoxification mechanisms.  Oral doses of vitamin E up to 3,200 IU/day show no evidence of toxicity. 
ZINC is a mineral antioxidant that works with the sulfur component of the antioxidant enzyme superoxide dismutase (SOD) to protect tissues. It does this by converting damaging superoxide free radicals into hydrogen peroxide, which is further catabolized into water and oxygen.  Zinc also improves liver function.
In a double-blind, randomized, placebo-controlled trial, 22 cirrhotic patients with chronically enlarged livers took 600 mg zinc acetate supplements daily for seven days. The supplemented group exhibited an improvement in their condition by the eighth day, and also had serum zinc levels restored to normal. In addition, there was a significant increase in blood urea nitrogen in the supplemented group. The researchers surmised that short-term oral zinc supplementation probably corrected a zinc deficiency that compromises conversion of ammonia to urea. Longer-term effects were not tested. 
SELENIUM makes zinc more effective and works closely with vitamin E to maintain a healthy liver and heart. An animal study showed vitamin E supplementation of either 20 or 200 mg/kg bodyweight increased alpha-tocopherol levels in the liver. Adding 0.03 mg selenium/kg body weight significantly stimulated glutathione peroxidase activity, which enhances the antioxidant protection against lipid peroxidation. 
MILK THISTLE (Silybum marianum) added before the intensive stage is recommended. The detoxification program is usually successful without having to add it after the program. Milk thistle is beneficial to the liver because silymarin, the active component of the herb, inhibits liver damage and stimulates the growth of new liver cells to replace damaged cells. The standard dose is 70-210 mg of the standardized extract, three times a day. Even prolonged use has not been associated with toxicity--though silymarin does increase bile flow, which may produce a looser stool. 
Every person's detoxification program is unique. Mary needed to heal her intestinal lining before she was ready to detoxify. I started her on glutamine to preserve gut integrity  and the probiotics acidophillus and bifido bacteria to balance gut flora, which relieves bloating, gas and other gastric disorders.  Although Mary did not break her caffeine addiction for some time, she did make gradual changes to her diet.
Food and supplementation are only one facet of a whole mind and body detoxification. Mary began her own walking exercise program and started with a body worker to eliminate toxins through lymphatic drainage.  This is a common addition to detoxification programs. Any kind of massage or other bodywork increases circulation and therefore stimulates the lymphatic system to move and eliminate toxins. Homeopathic remedies, saunas and steam baths can also stimulate lymphatic drainage.
Because the intensive stage is low in fiber, additional colon help is recommended to keep things moving through the intestine.  My preference is ground flax seeds either sprinkled over steamed vegetables or taken at bedtime in warm water. Effective short-term colon cleansers include cascara sagrada (Rhamnus purshiana) and senna leaf (Cassia senna).  These herbs contain natural laxative chemicals. According to the German Commission E Monographs (American Botanical Council, 1998), cramplike discomforts of the gastrointestinal tract may occur from taking either of these herbs, which means a person should take a smaller dose. The individually correct dose is the smallest amount necessary to maintain a soft stool. The herbs should not be used for more than a week or two.
Some people incorrectly believe that a detoxification program is a great way to lose weight. Most people do lose weight, but it is only temporary. Permanent weight loss requires a concerted lifestyle change. Detoxification can, however, reduce and eliminate food cravings, reduce overall food consumption, and make the body feel more functional, whole and balanced.
Many people benefit from some sort of regular detoxification program. But whether it lasts two or 30 days, it is not recommended when one's life is filled with stressful situations such as tight deadlines, a holiday season or emotional losses. Those suffering from diabetes, thyroid conditions, cancers and other wasting diseases must be carefully supervised by a qualified health care practitioner. Balancing the blood sugar and insulin levels in diabetics and ensuring that additional weight loss does not occur in cancer patients may require additional supervision and care.
Detoxification programs are not recommended for pregnant or lactating women because the fetus or newborn may absorb some of the toxins being eliminated by the mother.  Also, it is not healthy for a pregnant woman to lose weight or deprive her baby of nutrition during this intense growth period. A rigorous detoxification process is not recommended for children and infants. 
Taking care of the body through proper diet and supplementation, exercise, self reflection and education often guarantees healthy aging and longevity. It is never too late to begin cleaning up.
Monika Klein, C.N., runs a nutritional counseling practice in Malibu, Calif., and is the television host of Total Health Talk.
Detox for Different Goals
1.Denison NIS, Whilock JP. Xenobiotic inducible transcription of cytochrome P450 genes. J Biol Chem 1995;270:18175-8.
2.Environmental Working Group. In the drink. Washington, D.C. 1995.
3. Parkes AI, Hughes GRV. Cytokines, thromoxanes/inflammation, rheumatoid arthritis and food: a case study. BMJ--1981;282:2027-9.
4. Simopoulos AP. Omega-3 fatty acids in health and disease and in growth and development. Am J Clin Nutr 1991;54:438-63.
5. Guengerich PF. Effects of nutritive factors on metabolic processes involving bioactivation and detoxification of chemicals. Ann Rev Nutr 1984;4:207-31.
6. Bland JS, et al. A medical food supplemented detoxification program in the management of chronic health problems. Alt Ther 1995:1:62-71.
7. Percival M. Functional dietetics: the core to health integration. New Hamburg, Ontario: Health Coach Systems International; 1995.
8. Odelye O, et al. Alcohol ingestion and lipoperoxidation: role of glutathione in antioxidant defense and detoxification. J Optimal Nutr 1993: 2:173-189.
9. Jones DP Glutathione distribution in natural products: absorption and tissue distribution. In: Vol. 252 of Biothiols Methods in Enzymology. Editor L. Packer San Diego. Academic Press. 1995.
10. Johnston CJ, et al. Vitamin C elevates red blood cell glutathione in healthy adults. Am J Clin Nutr 1993;58:103-5.
11. Meydani M, et al. Protective effect of vitamin E on exercise-induced oxidative damage in young and older adults. Am J Physiol 1993 May;264(5):R992-8.
12. Shakman RA. Nutritional influences on the toxicity of environmental pollutants: a review. Arch Env Health 1974;28:105-33.
13. Kappus H, Diplock AT. Tolerance and safety of vitamin E: a toxicological position report. Free Radic Biol Med 1992;13(1):55-74.
14. DiSilvesto RT, et al. Effects of copper supplementation on ceruloplasmin and copper-zinc superoxide dismutase and other indexes of manganese and iron status in women. Am J Clin Nutr 1992;11;177-80.
15. Reding P, et al. Oral zinc supplementation improves hepatic encephalopathy: results of a randomized control trial. Lancet 1984 Sep;2(8401):493-5.
16. Surai P, et al. Effect of vitamin E and selenium supplementation of cockerel diets on glutathione peroxidase activity and lipid peroxidation susceptibility in sperm, testes, and liver. Biol Trace Elem Res 1998;64(1-3):119-32.
17. Salmi HA, Sarna S. Effect of silymarin on chemical, functional, and morphological alterations of the liver. A double-blind controlled study. Scand J Gastroenterol 1982 Jun;17(4):517-21.
18. Van der Hulst R, et al. Glutamine and the preservation of gut integrity. Lancet 1993;341:1363-65.
19. Siitonen, et al. Effect of lactobacillus GG yogurt in prevention of antibiotic associated diarrhea. Ann Med 1990;22:57-59.
20. Whitcomb DC, Block GD. Association of acetominophen hepatotoxicity with fasting and ethanol use. JAMA 1994;272:1845-50.
21. Vahouny G, Kritchevsky D. Dietary fiber in health disease: N.Y.: Plenum Press; 1982. 49-80.
22. Izzo AA, et al. The role of constitutive and inducible nitric oxide synthase in senna- and cascara-induced diarrhea in the rat. Eur J Pharmacol 1997 Mar 26;323(1):93-7.
23. Haas E. The detox diet: Berkeley (CA): Celestial Arts; 1996. 115.
24. Perical M, Percival S. Infant nutrition: New Hamburg, Ontario: Health Coach Systems International; 1995.
DETOX FOR DIFFERENT GOALS
1. Reichelt A, et al. Efficacy and safety of intramuscular glucosamine sulphate in osteoarthritis of the knee. Arnzneim-Forsch./Drug Res 1994:44(1):75-80.
2.Srivastava KC, Mustafa J. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypotheses 1992;39:342-8.
3.Brouns F, et al. The effect of rehydration drinks on post-exercise electolyte excretion in trained athletes. Int J Sports Med 1998 Jan;19(1):56-60.
4. Kayman S, et al. Maintenance and relapse after weight loss in women: behavioral aspects. Am J Clin Nutr 1990:52:800-7.
5.Egger J, et al. Is migraine food allergy? Lancet 1983;ii:865-9.
6. Heptinstall S, et al. Extract of feverfew inhibits granule secretion in blood platelets and polymorphonuclear leukocytes. Lancet 1985;i:1071-4.